#and the only way to get cools is with sutures. also the opening incision and the closing bandage but that's only 2 so i needed cool sutures

[dravidious]

So far, Under the Knife 2 feels like a massive improvement over UtK1, mainly by how good it feels to chase high ranks. Not only does it make it easy to jump right back into the level you just finished to get a better score, it also tells you what special bonuses are in each level instead of it just being a seemingly-random mystery score (it only tells you when you actually get them, but still better that UtK1).

But also, I was getting such high ranks so easily that I decided to go back to UtK1 to see if it was harder or if I just got more skilled, and it turns out that UtK1's rank thresholds are just kind of awful. The reason I was getting C-ranks on everything is because there's a pretty small gap between C-rank and S-rank. Missing just one special bonus can turn an S-rank run into a C-rank, so you'll pretty much always get a C-rank unless you're really good.

UtK2 is far more reasonable with handing out B- and A-ranks, so rather than C-rank meaning "you did less than excellent" it means "you did bad". So when I'm going through the game getting As and Bs, and then on one level I get a C? I'm so much more motivated to say "screw that" and try again.

[okay-sky]

whoa how cool that you’ve had phallo!!! is that something you’d be more open to talking about on here, for other curious transmascs? no pressure!

hello hello! yes i had phallo last may (may 2023) and my husband had phallo in november (november 2023), and i would be plenty happy to talk about it here! feel free to send me asks (or a dm if you want to get more personal questions answered) and i will answer them to the best of my ability and comfort level :3 i will share the broad strokes of my husband's experience too, but not the more personal details, just for comparison's sake.

details about the general overture of my phallo operation and experience below the cut. there is some semi-graphic discussion of surgery and genitalia just as a warning.

we both had delayed ALT (anterolateral thigh) phalloplasty with dr crane in austin TX, so we used a skin graft from our thigh instead of forearm for it. delayed ALT allowed us to get ALT despite having a good deal of fat on our thighs, and it was a relatively new technique our surgeon was offering when we first had our consultations but now it's his preferred way to do ALT.

with delayed ALT, they basically did one operation before starting any of the actual bottom surgery stuff where they cut out 3 of the 4 sides of the graft, and completely separated the full thickness of the graft from the muscle underneath. the flap was only tethered to our body still by the side at the top (up by our groin), the 2 vertical sides and lowest side (right above the knee) were fully severed. then they laid that baby back down and stitched the edges back on. they also performed liposuction to remove a lot of the excess fat from the flap, so until it was relocated to my groin, i had a large dip in my thigh where there was just less fat than before. after that operation was done, i had to wait 6 months before i could have Actual phallo, which gave the flap time to slowly grow its own blood supply without being disconnected entirely from my body. when it finally did get moved to my groin in my 2nd surgery, the blood supply was so well-developed that it pulsed visibly with my heartbeat! the chance of tissue death due to poor blood flow is vastly reduced this way, so it's a win-win: allows heavier guys to get ALT, and improves the odds that your new dick will heal without tissue death.

another thing that was pretty unique about our surgery (not like, "we were the only ones that did this" but more like "a lot of surgeons won't do this bc they aren't comfortable with it, and a lot of guys that are eligible don't do it anyways for personal reasons") is that we had urethral lengthening (which connects our original, natal urethra to the new neo-urethra inside the penis so that we can pee standing up) without a vaginectomy (which is the removal of the vagina). so i basically have a full dick and balls, plus my original hole hiding in the back. this is partly why i had such shit healing issues. unbeknownst to me at the time, i have ehlers-danlos syndrome, which is a connective tissue disorder that means i don't heal very well from injuries and especially from tears in my skin. by the time my sutures had dissolved, my body still hadn't even partly closed up my incisions, so i had a lot of just open wounds that should have already been healed if my body wasn't healing so slowly due to EDS. my husband, meanwhile, had the exact same operations as i did, but does not have healing issues and had no complications at all. lucky bastard. the chance of the connection between new urethra and natal urethra not healing right on the first go-around is higher if you do not have a vaginectomy, since the natal urethra is so close to the edge of the vaginal opening. they also like to use the tissue of the labia minora to help strengthen the urethral connection, which is obviously not an option if you still have your labia minora and vag.

i still haven't had glansplasty, but i'm planning to have that sometime next year when any lingering swelling has gone down and my dick has settled into the shape and flaccidity that i can expect to have forever. neither of us currently has any intentions to get an internal erectile device either, just because they do add future maintenance like replacements and the possibility of pump failure (not to mention my body would probably freak the fuck out if i tried to have another major surgery lol)

i have talked a bit more extensively about my phallo journey on reddit, the phallo community at r/phallo is an ENORMOUSLY helpful resource and are all-around just a bunch of great guys. you can find photos of post-op guys, some of which are many years post-op, and some guys even post videos of the pump inflating and deflating, urination, the movement of their dick, etc. if this is something you are interested in pursuing and want to get a better idea of what a phallo dick ACTUALLY looks like (without the terf-y fear mongering that you usually see around phallo), i would highly recommend checking out r/phallo and sorting by top of all time. usually pics and vids of fully healed dicks get the most upvotes so they float to the top.

again feel free to ask me any specific questions you might have, or dm me!

[resusheart]

After surgery (part two)

I raced to cubicle number three once again, her lips and fingernails had a bluish color, I watched her move her chest desperately, using all accessory muscles to breath, but she just couldn’t, the team had already lowered her bed to be totally flat, had taken the pillow from under her head and after tilting her head back, placed the ambu bag over her mouth and nose. She was still awake and I could not sedate her enough because of her weakened state. We had to aspirate her first. After pressing the ambu bag five times, I asked for the suction tube and slid it deep into her lungs, she was shaking as I did this, slowly losing consciousness. Her heartrate was shooting straight up, something I definitely didn’t want to happen to her recently sutured heart. Her blood pressure tanked while I was suctioning. Shit!  I gave the order to start chest compressions. This was going to be a mess. Every time her chest sunk from the pressure, her belly popped out. One could even hear the sound of both sides of the sternum rubbing against each other, and I am sure I heard a rib pop during the maneuvers.

The resident was trying to intubate her and failed, once, then twice, blood was coming out of her mouth so the nurse suctioned her again. Her eyes, open, staring into nothing, pupils sluggish, but I had to do something, this was not over yet. I asked for a pause to feel pulses, but even with chest compressions they were mostly absent. I had to crack her chest and at the same time, get her airway taken care of. So we started doing both things at the same time. While team B was performing an emergency cricothyrotomy to get a breathing tube in, we (team A) were spraying her chest with betadine to open her up. I knew something was wrong inside the cavity because her blood pressure couldn’t hold. The clock was ticking and I had to find out what it was and do it fast.

Her chest was sterile, I couldn’t open her up through her sternum because I had wired it shut just a few days earlier and it would take too long to go in that way, so I placed the scalpel on the fifth intercostal space and made a long incision. I quickly placed the rib spreader and was immediately splattered with blood that had accumulated inside the chest. Blood products were already being warmed and placed in the rapid infuser. I used suction and surgical gauze to try to clear the space so I would be able to see the bleeding site.

It was crazy and things happened quickly. The patient now had a breathing tube sticking out of her neck, two new lines had already been placed and we had asked the OR to be ready for us. The team started the pumps with blood units and I put my whole hand inside her chest. With my fingers, I reached to feel her barely beating heart to position my hand correctly and began compressing it firmly. While doing so, I felt the leak that was causing all these problems. Every time I pumped the heart, blood poured out of one of the veins that fed it directly. I asked for a clamp and immediately closed the hole. I kept massaging the heart internally, sterile drapes wrapped around my arm as the team tried to cover the wound (with my arm still in it) getting ready for transport to the OR. They released the brakes of the bed and we started rolling. I was walking, but my only focus was compressing the heart and getting enough blood flow to avoid any brain damage, if possible, while we got to surgery and I could fix her heart once more. When we got to the operating room, a junior surgeon took over the internal massage while I went to wash all over again and change my clothes. I was practically drenched in blood, so I was looking forward to getting on some clean, warm surgical scrubs. In the meantime, the junior surgeons were placing the patient in a proper position to continue the surgery and placed the lines to bypass the heart and divert the blood flow to the heart-lung machine. I quickly positioned myself in a comfortable position to start the surgery, with the machine now humming. I injected the extremely cold paralyzing agent straight into the heart muscle and began the surgery. Her poor mangled heart has gone through a lot. I was very careful, fixed the tear in the vein and checked that the heart valves had not been dislodged in all the resus efforts.

So now, all patched up, it was time to get that heart beating again. Because blood flow to the brain had been reduced for a long time we were going to do things differently this time. We were going to keep her body colder than average. We didn’t start the process of heating up her body, the fluids that we were introducing were not warmed up. If she was to have a chance at a normal life, I would have to keep her in induced hypothermia for at least 48 hours.

But first, I had to get her heart beating again. With sutures placed in the artery and vein and the removal of the clamps, blood began flowing back into her heart. It didn’t move at all. It had sustained injuries during CPR and was not looking great. It was not swollen yet and that is what I would try to avoid by cooling her down. I massaged it once more, as I had done hours before, but this time, it was colder and not surrounded by a pool of blood. I was hoping to get a small hear beat. I was begging in my head: “Come on, give me something to work with!” But the heart muscle stood still. I injected epi followed by amiodarone and massaged it once more for a while. It began moving a bit. I injected more epinephrine and hoped her heart would pick up the beat. Finally, it began quivering, I waited for it to find a rhythm on its own, but it didn’t, so I asked for the internal paddles, I placed them carefully around the heart and asked for 20 joules. The shock made the heart jump and the rest of her body contract gently but after a pause, her heart kept beating erratically, I asked for 30 joules and another dose of epi. The shock was more visible this time, her whole body shook in a single movement and then stood still. I couldn’t get a regular rhythm though. I decided to max out the epi and another dose of amiodarone before giving it another shock with the maximum dose acceptable for internal paddles, 40 joules. I held my breath and shocked her again. This time her body visibly jumped a bit with the shock. I sighed with relief when her heart began beating softly at a regular rhythm. She was OK…. for now. The junior surgeon proceeded to close the chest and I watched the EKG closely, her heart was beating at a steady pace but the blood output was small. If she didn’t improve we would have to consider using ECMO, but right now my main concern was keeping her at 30° Celsius (86°F) to prevent as much inflammation as possible in her heart and brain. I was trying to give her the best chance to live, but I knew, that right now, her chances of survival without serious brain injury were around 1%. We just had to wait and hope. I thanked everyone and left the room. After I had finished my notes I went into her ICU cubicle. She had a cold air blanket covering her whole naked, mangled body. New electrodes had been attached to her chest, running a permanent EKG, her brain function was also monitored through electrodes placed in her forehead under the cold water helmet the ICU team had placed on her head. Her core temperature was being monitored intravenously. She was heavily sedated. I was just hoping she would make it through the next 12 hours. Then I glanced at the window and realized it was dawn already. I thanked the teams that had worked the code hours before and left the hospital to get some sleep back home. While in the car, I kept remembering her pale skin, cold to the touch, her bluish lips and all the equipment surrounding her that always reminded me of old sci-fi movies. She was now my sleeping beauty, resting in her chilly sleep. And we had to wait and find out, first if she would survive, then, if she would have neurological deficits and what they would be. But, for now, we both needed to rest. I took the coastal highway to my apartment taking in the beautiful views, got home, changed into my most comfortable sweatpants and rested for a few hours, then went to the gym and took a dip in the pool. I had not heard anything from the hospital. No news is good news. I would go back in the evening to check on her again. I trusted the ICU team completely, so I ate a snack, relaxed and enjoyed the rest of the afternoon

[hark-an-x-wing]

FOR EVERY ACTION

This is my first time posting fic on tumblr(or really anywhere since I was like 13) and I am TERRIFIED. This is just the intro, but chapter one will follow shortly. Care to wager a guess at who goes with which boy? 😂 Warnings: Not reeeaaally wholllyyy TLJ compliant? Also bullshit medical discourse ahoy! Summary: In the resistance, nothing ever goes as planned, and often you’ve got to learn to fly by the seat of your pants. At least that’s how its gone in Cora and Red’s experience anyways. So when the two are sent to aid the locals on a nearby planet and the First Order shows up, it’s not a life changing moment, it’s just par for the course... right? Pairings: Poe Dameron x OC, Kylo Ren x OC Words: 2.1k+, part 1/15 INTRO The thick heels of Corrin’s knee high brown boots clanked against the metal grates of the Resistance’s main hangar as she paced the entrance way. Admiral Ackbar had paged her to be there when Green squadron returned from Ryloth- her best friend’s squadron- and that could only mean one thing. Someone was hurt. Badly hurt. The door to the hangar slid open and Corrin’s pacing came to an abrupt halt as other medical personnel filed in, along with some cots, and mobile supplies. Seemed it was someones, not someone. A nasty feeling settled in Corrin’s chest. Zara had best be alright or she’d have a storm coming to her. No sooner than Corrin had managed that thought did she hear the giant pod bay doors unlocked with a deafening ‘clunk’. Her head whipped to attention at the sound and she watched as the hydraulic shocks heaved and the hinges squealed as the doors began to open. The crew was home. She reached up and tied her long blonde locks up and out of her face; it was showtime.

The transport didn’t even come close to touching the ground before the doors were flung wide open. A sigh of relief escaped Corrin when Zara’s face was the first sight she could see inside the vehicle, but it was quickly washed away when she saw the other woman rear back and hurl something through the air. The next thing she knew was the cold metal that hit her face. Hard. As more of a subconscious reaction than anything, Corrin’s hand extended out to catch the metal thing as it fell. Looking down in her hand Corrin saw a set of identification bracelets, the ones used by the Green Squadron, with a holodata port embedded in them. That snapped her back into action; she whistled, held her arm in the air, and flicked her wrist towards the ship, wordlessly ordering the beds closer to the craft as it landed. Blood pumped through her, seeming to accelerate her thoughts and movements almost at once, as her adrenaline started really flowing. Without fumbling too much with the rush, she accessed the information on the bracelet. Scanning the information, she found the injured were people she had performed an enlistment physical for. Good news, that meant their files would be quickly accessible in her droid’s memory banks. She remembered the names ‘Sketch’ and ‘Cody’ from stories Zara told her, but faces weren’t coming to mind. Corrin had never been all that great with faces. The transport finally landed and the two injured were lifted off the floor of the transport and onto the cots, leaving dirt and blood shaped pools behind them. That wasn’t a great sign. It was a good thing Zara thought to toss over their bracelets, even if they would give Corrin a black eye later, they’d definitely be needing transfusions-and fast. Corrin quickly started barking orders to the nearest medics, keep them breathing, check for all cites of hemorrhaging, calling for orders for each of their blood types. Crimson had completely soaked through the already dirtied cloth that covered their wounds, both seemed to have passed out from the pain of what appeared to be burns and cuts, all over their bodies. Wheezing and an abnormal bluish skin tone from one, the one called Sketch, Corrin thought, based on the ‘S’ stitched into the back of his uniform, seemed to indicate a collapsed lung. She snatched up the nearest medscanner and confirmed her suspicions. She’d have to focus on him first- she couldn’t do this and walk either- she’d need to do surgery in the hangar. “I need a scalpel, and get a droid so I can look in his chest!” She yelled out to another medic, Corrin briefly thought of the name Jain, who immediately put a scalpel in her hand and then hauled ass to look for a suitable droid. Without looking away from the patient in front of her she called to the rest of the medic team, “hook him up to fluids! If he’s stable enough to be moved take him back into med 5! His name is Cody Friedalessian- his records are with my droid- clean the wounds as best you can, his blood should meet you there!” Corrin then thought to address the rest of the squadron hovering around their teammates trying to catch a glimpse of what was going on with the two criticals, “Green squadron please report to med 5 to get cleared!” The scramble of feet and the sound of the cot rolling away were the only things that let Corrin know her orders were followed. At least now she didn’t have as much of an audience. As she made the incision, Corrin noted the patient wince. Corrin’s jaw involuntary clenched. Shit, he was awake. Of course he was awake. Letting out a ‘tsk’ Corrin knew she had to continue with her task, even with her patient aware, “I’m sorry, Sketch, this is going to sting.” She kind of hoped that the incision would be enough to alleviate the pressure in the man’s chest, but she knew she wouldn’t be so lucky. Not in her line of work. As Corrin worked she could over hear the officers behind her deliberating. “It was an ambush. Stormtroopers had been stationed in the village.” Zara’s voice was terse and echoed around the hangar, “even if we had known we wouldn’t have stood a chance, it was a simple recruiting and supply job we didn’t have their numbers. They flanked us and set fire to the huts with blasters.” Zara spit in anger as she reported to the Admiral, her temper getting the best of her. Her bright blue eyes narrowed their focus to a target that was probably a whole galaxy away by now, “the villagers lost more than we did- if we had only-“ Ackbar seemed to silence her with a look, “it is war, Commander. I share your feelings, but often we will never have all the pieces to a puzzle. For now we must regroup, and learn what can be learned from this tragedy.” Zara balled her hands into fists at her side and curled her toes in her boots. “Hundreds died! Some of my men included! This wasn’t supposed to happen- it wasn’t one of those missions!” She hadn’t meant to explode like that, not to her commanding officer, but the words were rattling around in her brain and needed to get out. “No, it wasn’t. And you did what you could, Commander, and brought home the rest of your men. Which is more than some can say. They live thanks to your decision to fall back. Report to med 5, as the doctor ordered to get your own wounds looked at. After that see the General for official debriefing. Dismissed.” At that the Admiral left the hangar with an upset Commander left behind. Her head hung low as she crouched to hide the tears that were stinging her eyes as they fought to get out. She let out a pained groan as she punched the hull of the transport, “FUCK!” The hit sent shocks of pain shot up her arm immediately and she snapped her arm back into her chest, cursing herself for losing her cool, or even thinking to punch something in the first place. Corrin heard the sound of fist on metal and called over her shoulder, “I’ve got a lot of injuries to look after, please try not to add to them, Zara.” “Not the time Cor.” Zara growled. “It never is.” Corrin muttered under her breath, she really wished she could help her friend but considering she was wrist deep into Sketch’s chest that would have to wait. The droid Jain brought back was thankfully a medical one, with anesthesia.Hooking the pilot up with the right dosage of knock ‘em out drugs had been a blessing, as it eased Corrin’s mind and let her focus fully on her work. The droid was easily able to point out the gashes in the man’s lungs for Corrin to suture. But she was still in the hangar and not her medical ward so the procedure wasn’t a smooth as she knew it could be. For one, and probably the worst bit, the chest tubes she’d normally use for stabilizing the pressure in the chest cavity were replaced by a droid providing suction through some cleaned unused gas tubes found sitting in the hangar. ‘That probably won’t have any repercussions later.’ She thought bitterly to herself and continued to work. Jain made haste as an excellent assistant and took care of hooking up Sketch’s fluids, including blood when it arrived. With the help of the droid and Jain, after a long stint of working to close the gashes in the mans lungs, Corrin finally had him stable enough to close him up and move him to med 5. Which meant time to look over the other patients. After walking her patient down with her two helpers, Corrin plunged her hands directly into the nearest sink. Washing off Sketch’s blood thoroughly, she accepted a report of Cody. The wounds had been cleaned to the best of the medics’ abilities. He was stable for now, but his wounds would need far more grafting and sutures. Possibly even mech replacements. She sighed sadly at the thought. She found out that another of the pilots had collapsed in the hall- but probably due to stress and over exhaustion rather than any internal injuries. She’d check on that one after her extreme patients. Briefly wondering where the other doctors on the base were for a moment, Corrin ordered the medics to clean Sketch as best they could, and had Jain get proper chest tubes to replace the horrible “make-do in a hangar” situation he was still hooked up to. Corrin figured the droid was probably of better use doing its actual job than acting like a vacuum. Making her way over to Cody, Corrin found Zara hovering over him, with a medic fussing over her arm. Zara didn’t seem to notice him, her focus completely on Cody, fists clenched so tightly the were just about as pale as her face had turned. Corrin held in her breath for a moment, what words would comfort her friend? She crouched over the now sleeping Cody to inspect his wounds, and noted his vitals. Grabbing a marker she traced the biggest wounds- plotting the course for the synthetic material she’d have to overlay before applying the growth cells to stimulate the skin’s reproduction. She pushed the tendrils of hair that had fallen from her ponytail out of her eyes with her wrist when she finished. Physical wounds she could handle. With a glance over her shoulder, she saw Red, eyeing her with a watery gaze. Emotional wounds were a different story. With a creak in her knees, Corrin stood up and placed her hand on her friends shoulder, meeting her eyes with a look of a compassion, “I’m glad you’ve made it. I heard what you said to the Admiral. I’m so sorry for your losses.” The statements went unacknowledged for awhile, and when it was clear there would be no response, weakly she tagged on, “you did what you could, Zara.” “It wasn’t enough. I should have known, I could have done better.” Her voice cracked as she looked away, towards the back of the room. Zara couldn’t face her injured private or her friend as guilt washed over her. They were her men, her responsibility. And she had let them down. Let their families down. Tears threatened to spill, and that couldn’t happen in here. Not now. “You should have known what the General or admirals didn’t know?” Keeping her voice to a low whisper, Corrin swatted away the medic that had still been trying to inspect Zara’s arm, and wrapped her arm around her friend, shuffling her to the office Corrin sometimes used as a makeshift bedroom on rough duties. “We won’t always have all the answers. A lot of our battles will be in the dark.” She walked Zara to the couch and sat her down, the woman before her buckled into the cushions. Zara placed her hand over her mouth taking in a deep breath. Instinctively Corrin lunged for the waste bin, hastily throwing it in front of Zara, anticipating a violent reaction. But the russet headed woman kept her hand in place, waving the other in dismissal before placing it on the edge of the can, letting the cold metal ground her to something besides her whirlwind of thoughts, “I’m fine.” Corrin wouldnt have believed her friend even if her statement hadn’t come out as a whine. She leaned over her desk and hit open one of the drawers which contained a canteen of water. She popped open the cap and kneeled down to face Zara, “here, drink something. I’ll be back after I check on your squad. Are you good for a few ticks?” She asked softly. “I don’t know.” Zara answered honestly.

[jarienn972]

The Right Place - Chapter 10

Since I finally got my other WIP all caught up here on Tumblr, I figured I’d better take a look at this one too which fell two chapters behind those I had up on AO3 and FF.net.  I apologize to anyone who’s been following my stories here for the Tumblr delays and I’m going to try my best not to get so far behind again.

From the beginning on Tumblr:  Prologue/One  Two  Three  Four  Five  Six  Seven  Eight  Nine

This next chapter is definitely a little fluffier than the previous ones but not without it's surprises...

Wednesday Morning, Portland Medical Center

When Killian's regular day nurse, Jackie, came on shift at 7AM, she was pleased to find that his appetite was returning although she was still mildly concerned about his lingering low-grade fever. She'd read the evening nurse's notes that he'd been given permission to try a cup of broth and if he managed to keep that down, they'd try something a little more solid in a few hours. He'd pleaded his case for a shower but the request had to be put on hold until Jackie could speak to Dr. Wallace - needing to be certain that it was safe to disconnect him from all of the machines and monitors - but she promised to bring him the broth while he awaited the doctor's response. He'd hoped to be free of the tubes and wires before Henry returned from the parking garage, but that wouldn't be happening.

His wait did end up being shorter than the nurse had expected though and only minutes after she'd brought him the cup of steaming chicken broth, she returned with a basket of supplies and a stack of towels. In the time she was gone, he'd managed to drink about a third of the liquid – determining quickly that it was much easier to sip it directly from the rim of the bowl rather than to attempt using the spoon. He really wanted to drink it all, but his stomach wasn't on the same page as his head so the rest would have to wait. The nurse didn't appear at all surprised that he hadn't finished it, not even commenting as she set the bowl off to the side so it wouldn't get spilled while she got him ready to bathe.

Figuring the fifteen year-old really didn't want to witness whatever weirdness and hilarity would likely result from his mother's attempt to help his stepfather shower for the first time in days, Emma had sent Henry to the cafeteria for breakfast with instructions not to return for at least half an hour. He eagerly snagged a ten dollar bill from her wallet, promising to bring her back coffee and a cinnamon roll, then hurried out the door. Once the teen was on his way, Jackie drew the privacy curtain and began talking them through everything she was doing as she untethered her patient from the equipment.

"It'll take me just a few minutes to disconnect all of these leads and then I'll remove the old dressings from each of the incisions. The IV has to stay in place, but it's portable. You'll just need to be very careful not to dislodge it," she stated as she went to work peeling away adhesives that held various wires in place – most of which Emma didn't even have the foggiest idea what they'd been for. A few alarms and buzzers sounded as the connections were severed, but the nurse was unfazed, switching off each machine that was no longer in use.

"Now," she continued, "I need you to take a deep breath and hold it for a moment, Mr. Jones. You may experience a little discomfort…" Killian knew precisely what she meant, instinctively holding his breath as the nurse pulled the catheter free. "Okay – you're all set there…"

"That's it?" he exhaled heavily as he asked for confirmation that she was done, not having felt much of anything despite the sensitive nature of the area in question.

"You're free of the catheter," Jackie laughed. "Wasn't so bad now, was it?" Even Emma had to chuckle at the relief evident on Killian's face, quite thankful that this step had actually been quick and painless or he'd likely still be complaining. "Okay – now let's get those bandages off…" Lowering the pale green gown to his waist to access the gauze patch on his chest, she swiftly pulled the tape loose from the edges and removed the entire covering, taking a visual inspection of his sutures to ensure that nothing looked out of the ordinary. "Sutures look great – no seepage or discoloration. Why don't you lean forward a bit so I can get to the dressing on your back now?" He shifted his center of gravity forward so Jackie could reach the entry wound and as he lowered his head, he was able to get his own first look at the surgical incision that stretched across the lower portion of his chest and a portion of his upper abdomen. Considering the narrow blade that had pierced his body, he was surprised at the length of the opening the surgeons had cut into him to reach and repair the internal damage but what had him scrunching his nose in disgust wasn't the wound itself but rather the fact that the medical team had shaved a broad patch of his dark chest hair in order to make that incision. His eyes darted from his shaven chest to his wife's face, glaring at her as she mouthed the words: It will grow back.

"It's not going to be a problem for him to get the stitches wet?" Emma wondered, ignoring his pining over missing chest hairs.

"Not at all. As long as you don't try to scrub over them, it should be perfectly fine. Best advice is just be gentle for the first day or two," Jackie replied as she disposed of the used gauze in the hazardous waste receptacle before going over the rest of her instructions. "Alright, Mr. Jones – now comes my question for you – do you want to attempt to walk to the bathroom or would you prefer if I brought in a transport chair?" His gaze immediately met his wife's, seeking her approval as she'd likely be the one tasked with catching him should he fall on his face.

"I can help get you there if you want to try walking…," Emma answered, already knowing what his intent would be.

"I'd like to attempt using my own two feet then," he insisted.

"Okay then, I'm going to have you get out on this side so you're less likely to get the IV tubing tangled," Jackie responded as she moved around to his right side, reaching over his head to remove the two transparent bags of fluid that hung above him, placing them onto a hook atop a tall metal pole with wheels attached to the bottom. This was apparently what she meant by the IV being portable. "Swing your legs toward me now," she instructed as she tugged away the bedcovers. Eager to be out of the bed for sure this time, he shifted around to let his bare feet drop to the cool tile floor. He grasped the bedside rail tightly, intending to use it for support while Emma positioned herself at his left, her fingers wrapping around his bicep ready to help him take that first tentative step.

"Easy now…," Jackie said as she stood in front of him. "Let's see if you can stand up and hold your balance…"

He quickly realized that standing and remaining that way was a bit more difficult than he'd thought, but damn, it felt good to be standing on his own accord – well, mostly on his own accord. He felt a bit like a fool but after spending three full days in that bed, but he was thoroughly enjoying this freedom – finding himself somewhat amused that this petite little ginger-haired woman was so confidently standing before him as though she'd be fully capable of breaking his fall. He wasn't even certain if his lovely wife – strong as she was – could accomplish that task if he were to lose his balance right now. It also wasn't lost on him that the flimsy gown the hospital provided was covering very little of his person right now, leaving his derriere in full view of anyone who should walk into the room.

"Think you can handle him from here, Mrs. Jones?" Jackie asked.

"I think so. It's not the first time I've had to shoulder his weight," Emma responded with a side-eyed glance toward her husband.

"Just remember to take it slow," the amber-headed nurse reminded them. "Once you get in there, you'll find that there's a flip down shower seat and a handheld showerhead. Make use of them – trust me. Your lungs aren't fully recovered from nearly drowning and you've been inactive for several days so this is going to feel like a lot of exertion. I'll bring a chair when I come back because you'll probably want to use it. Last note – keep the water temperature on the lukewarm side if you can stand it. Don't want the water to be too warm or too cold when fighting off a fever. Now, any questions for me or is there anything you need?"

"I think we're good. I've got soap and shampoo with me and you're already brought us the towels. I brought some of his clothes with me – would it be okay for him to put those on instead of the gowns?"

"Whatever you're comfortable with – just nothing with any metal on it. Dr. Wallace wants to get some new images of his lungs so it'll be off to Radiology when I return so, try not to get too carried away."

What he'd thought would be a simple process – just a simple shower – quickly proved to be anything but. He'd initially foolishly thought that he'd be able to stand but any hope of that happening vanished the moment Emma turned on the water and a sudden panic washed over him – the all-too-recent memories of waves pummeling him flooding back the moment the spray struck his head. Emma had to turn off the faucet and coax him to sit down, eventually climbing into the shower stall with him – clothes and all. With the handheld shower head, she gradually helped him wash off, working her way from his feet back up to his head while he pushed away that momentary fear. By the time she reached his hair, it took three rounds of shampooing and rinsing to remove all of the grime and restore the normal luster and texture of his dark locks.

He apologized to her repeatedly as she helped him to dry off and get dressed first while she stood there dripping wet. She took it in stride, shaking her head and snickering at how ridiculous they looked. As if on cue, they heard a rap on the door and then the voice of nurse Jackie asking if they needed any help – which of course caused both of them to break out in rolling laughter.

"I think we could definitely use a hand," Emma managed to say in between giggles. "Did you bring that chair you mentioned?"

"Have it right here," Jackie replied as the bathroom door opened toward her and the very first thing the nurse saw was a very drenched Emma standing inside the doorway, tee shirt and jeans plastered to her body – well, mostly the front of her body.

"I'd really appreciate it if you could help us get him into that chair so I can dry off and change," Emma said with a chuckle. "This ended up being a lot more complicated than we'd thought and we both ended up getting a shower…"

"Of course. Hang on…," the nurse smiled as Emma stepped out of the way and Jackie brought the wheelchair into the close confines of the bathroom finding her patient much drier than his wife and partially clothed in a pair of navy blue pajama pants. All of his effort to take his simple shower had left him exhausted, his lungs burning as much as if he'd just run the entire length of Main Street and he was struggling to catch his breath. "Let's get you standing for a moment and I'll bring the chair to you…" It took her no time at all to get him situated and once seated, she wheeled him back into the main room while Emma made her way over to the chair by the bed where she'd left her duffel bag, leaving a trail of water droplets in her wake. She pulled out some clean clothes and ducked back into the bathroom to change while Jackie turned her attention to her patient. "How about we get those sutures covered back up while your wife is changing?" the nurse suggested, a notion that Killian was smart enough to realize wasn't actually a choice.

By the time Emma stepped out of the bathroom now clad in black twill pants and an oversized burgundy long sleeved tee shirt, Jackie had replaced the bandages on both of Killian's incisions and was helping him don the heathered dove grey tee shirt that he'd chosen earlier. Were he in Storybrooke, he likely would have selected the long-sleeved button up shirt instead as it fully covered his stumped arm but since everyone here, including Deputy McCallen, had already viewed his deformity and weren't horrified by it, he decided on simplicity.

Emma glanced over at the clock on the wall as she towel-dried her damp hair. It was just after 8:00AM so Regina would be on her way to pick up Henry soon, having promised to be there by 10AM. She hadn't yet heard anything from McCallen although that wasn't entirely surprising considering the number of people he needed to get in contact with this morning regarding the latest revelation in the case. She was certain that he'd let her know as soon as he could, but now that they had a suspect to pursue, Emma found herself growing impatient. She knew who had nearly killed her husband and now all she could think about was how they could catch him.

Killian had decided to stay seated in the wheelchair, not wanting to make the extra effort required to get back into bed before the nurse took him to this Radiology place. He wasn't really certain what that meant and he wasn't about to ask until the nurse stepped out of the room to see if they were ready for him. Once they were alone again, Emma tossed the damp towel onto the foot of the bed and strolled up behind her husband, wrapping her arms loosely around his neck and nuzzling her face into his nearly dry hair before he tilted his head back to gaze up at her.

"I missed this," she smiled as she kissed the center of his forehead.

"Aye, Love," he replied. "I promise, once I am healed, we shall make up for lost time…"

"Let's just focus on that healing part first, okay?" she laughed. "Hopefully, the images will come back clear enough that they'll let you go home."

"About that – what are these Radiology images everyone keeps talking about?"

"Radiology is the name of the science and the department. Basically, they use special machines that are capable of taking pictures of your insides so they can see things like broken bones and in your case, the amount of fluid still affecting your lungs. Don't you remember the X-rays they took of your broken ribs when you were hit by Greg's car during your stand-off with Gold?"

"Swan, there's much I remember about that evening, but alas, I don't recall anyone taking strange X-rated photographs of my innards…"

"X-rays, not X-rated. Very different things and I suppose you probably wouldn't remember. Pretty sure they had you pumped full of pain killers – assuming you were even conscious…"

"So, just how do they manage to take these images?" he wondered, uncertain as to whether he should be expecting invasive poking and prodding or should prepare himself for additional pain.

"It depends. Usually, you lie on a table and they position a special camera above you. I don't exactly know how it works, but it just takes a few minutes and its pretty much painless." She heard his audible sigh of relief at the painless part of her explanation. "If they end up doing an MRI, that's slightly different. It takes a lot longer because they take hundreds of pictures from different angles to get a more detailed image. Maybe Jackie can explain it to you on the way?"

"I'll be certain to ask…," he replied snidely as he heard the door creak open behind them.

"Everybody decent?" Henry called out, unwilling to even take a peek around the curtain until he was sure it was okay to do so.

"Yes – it's okay to come in," Emma responded with a snicker. "I guess we can put this curtain back now too." She gave the fabric a tug and walked it back to its place by the head of the bed but in retracting the curtain, her son threw her a quizzical glance as he noticed her long blonde hair hanging in damp, scraggly strands against her shoulders.

"Guess you decided to shower too?" the teen asked as he extended his hand toward her with an offering of a steaming hot cup of black coffee that Emma immediately snatched up.

"It wasn't exactly planned…," she replied with a mock scowl before breaking into a wide smile, "…but we managed anyway."

"I don't even want to know…," Henry said with an I've already heard too much expression on his face. "Forget I asked."

"We'll spare you all the gory details," she laughed. "But thank you for the coffee."

"No problem," Henry said. "I was going to bring you a cinnamon roll but they were all out and I wasn't sure what else to bring. I knew I wouldn't go wrong with coffee though."

"Absolutely! I'll find something later after I've heard back from Deputy McCallen."

"I wish you'd let me stay and help you out," the teen pleaded.

"I know, but honestly, I want you safely back in Storybrooke," Emma replied firmly. "Now that we have a suspect, the investigation could get a lot more intense and I do not want you to get caught in the middle. As soon as Killian is released from here, he'll be heading back to Storybrooke too."

"But how are you going to get the Jolly Roger back home?" Henry wondered. "She still needs the sail repaired and I don't think Killian will be able to climb the rigging himself right now…"

"The lad has a point…," Killian interrupted. "He does know how to replace the line. I made sure to teach him properly…"

"Let's just deal with catching the man who tried to kill you first. We'll worry about how to get the Jolly Roger back home later. I'm sure we can find some help with that once the rest of this crisis is over."

"Okay, Mom," Henry sighed, still dejected but understanding her point as well.

"Why don't you gather up your stuff?" Emma suggested. "Regina should be here soon and hopefully she won't be in a huge hurry to head back. I've got a favor to ask of her…" Emma started to say something else but was interrupted by a chime from her cell phone on the nightstand. "Hang on a sec…" She scooped up her phone and tapped on the screen to see her notifications, spotting an important message. "That's from McCallen," she read off. "He said Sgt. Haviland from Portland PD is going to meet us here around 9:30AM." That was only a little over an hour from now and roughly the same time that Regina was due to arrive. "You might have to stall your other mom, Kid."

"I can probably manage that," the teen assured her. "As long as Killian is up for a visitor?"

Just before 9AM, the nurse returned to let them know that the Radiology team was ready for Killian and before whisking him away, she advised Emma that they'd be gone for about an hour. Her pirate was still rather bewildered as to what he was about to experience and just a bit displeased that he wouldn't be present when his wife and the young deputy met with Sgt. Haviland so that he could learn more about this Donleavy person. Emma repeatedly assured him that she would fill him in on all details later but he still wasn't satisfied. He wanted to be privy to the investigation – after all, he was the one most afflicted.

Not long after the nurse departed with her griping husband, she received yet another text from McCallen with a request to meet him downstairs in the hospital lobby. She wasn't really sure why the deputy wouldn't just come up to the room so her inclination was to believe that he must have learned something that couldn't be shared in front of Killian - or possibly Henry – so she replied with an agreement to meet him in five minutes. Hopefully it meant he'd found something that would corroborate Killian's account, not further upset him.

She couldn't immediately locate McCallen in the busy lobby but she finally managed to spot him seated on a bench by the floor to ceiling windows to the right of the hospital entrance. He'd changed into jeans and a red plaid flannel shirt that looked as though it could have been proffered from her father's closet but she noted that his demeanor certainly didn't appear as casual as his attire. She zig-zagged her way toward him, dodging people as she drew her still soggy blonde locks back into a ponytail and wrapped a hair tie around them hoping McCallen wouldn't decide to question why she looked as though someone had tried to drown her.

"Sheriff," he greeted her as she rounded the reception desk. "Glad you got my message and were able to come down here a little early."

"No problem. Killian's down in Radiology having X-rays done and my son is getting his things together before going home so I had a few minutes free. Are we still meeting with Sgt. Haviland this morning?"

"Yes, he'll be here in a couple of minutes but I really wanted to go over a few things with you before our colleague gets here."

"Okay… is there something going on that you didn't want my husband to hear?" she wondered.

"No, no – nothing like that. I just have a feeling that Portland PD might insist on taking over this case and since Sheriff Lassiter said to let Haviland take the lead if they want it, I can't promise that they'll include you any longer. I explained how valuable you've been to my investigation, but it'll be up to him. He also might not want my help anymore so I felt I should take a moment to thank you. This case turned out to be a lot more complex than I'd expected and I was really in over my head. I appreciate everything you've done to help me boost my confidence…"

"Aaron…," she started to say that it wasn't necessary, finding herself slightly unnerved by his rambling and even a little bit worried.

"Please, let me finish… I might not get enough nerve to say this again…," McCallen looked more nervous in this moment than he had been since Emma had met the young deputy yesterday. She was concerned that she might have made him a little self-conscious by suddenly using his first name, but he drew in a deep breath and continued. "There was a reason that Sheriff Lassiter originally assigned this case to me – I was originally just tasked with finding out the identity of the John Doe amputee and how he'd ended up on the beach, but that was only because he thought I'd be a kindred spirit or something… I don't know…"

Emma had no idea where McCallen was going with his rambling, but clearly, whatever he was trying to say was important to him so she withheld judgement and allowed him to continue his tale.

"Anyway, the Sheriff thought I'd have more empathy toward your husband because I could relate to his disability…"

"Why would that matter?" Emma asked him, still not certain of the meaning behind his story so far.

"Because even though I spend most of my time sitting behind a desk, Sheriff Lassiter thought I should get a little experience in the field. He thought this would be an easy case for me – identify John Doe, find his family and hopefully learn who wounded him…"

"Okay, McCallen," she sighed. "You've completely lost me here." Her confusion had finally overwhelmed her and she had to know… "What the hell are you talking about?"

"I'm sorry… I know I'm rambling, aren't I? I'm so bad at this…"

"Bad at what?"

"Talking about myself," he sighed.

"Yourself? I'm definitely missing something here…"

"Yes, I'm afraid… There's something I've been trying to hide from you," he lamented. "I didn't want you to think of me as any less of an investigator if you learned they'd assigned a disabled deputy to your husband's case…"

"Disabled?"

McCallen slowly bent over and tugged at the denim of his right pant leg, raising it to reveal a silicone cuff fitted around his ankle and most of his calf. She could see that the bottom of that cuff was fitted to a metal joint which extended into the black leather high-topped combat-style boot he wore.

"I've gotten pretty good at disguising it so I look almost normal walking but just don't ask me to run," he gave her a shy, slightly embarrassed laugh after revealing his secret prosthetic foot and managing to make a joke about it.

"I honestly had no idea…," she replied, surprised by his revelation, but certainly not that he'd still be capable of doing his job. "Actually, I take that back… Yesterday when we drove over to meet with Jean Scott, I thought there was something different but I was honestly so distracted by everything that was going on with Killian that I figured it was just me that was off. Now that I think about it, it's because you were driving with your left foot!"

"Sheriff had that old Taurus modified especially for me – gas pedal on the left instead of the right. He's made sure to find ways to keep me on the job since I lost my foot. Maybe part of it is guilt because it happened while I was on the job, but I'm still grateful he kept me on as a deputy. He was just so certain that this would be a simple case to get me out of the office for a while but look how that turned out…"

"You lost your foot on the job? What happened – if you don't mind me asking?"

"No crocodiles involved here," he chuckled nervously, again wary of making light of his own situation. "I was out on a call one night and it was the beginning of winter and snowing like crazy. I don't remember much but I had my lights and siren on heading through an intersection when I was struck head on by a car driving on the wrong side of the road. The impact pushed the engine block and dashboard forward and while the airbag protected my upper body, my right foot got pinned under there somehow. By the time rescuers were able to cut me out of what was left of the car, I'd lost all feeling and circulation in that foot. Doctors at this same hospital tried to get blood flow back, but ended up having to amputate. It's been about two and a half years now, so in some ways, I'm still adapting, but I was determined that it wasn't going to beat me. I know it plays a huge part in my insecurities, but I try not to let it define me…"

"You know what's funny – for a long time, Killian did define himself by his disability. He used it to his advantage by showing people that he wasn't going to let it stop him and even turned his prosthetic into a weapon of sorts." She had to stop herself there before she accidentally divulged that her husband's preferred prosthetic actually was a weapon. "Now he's trying to just be Killian Jones – husband and deputy Sheriff. His prosthetic hand just an extension of him – nothing more, nothing less." It truly was the way she felt about his hook when he was wearing it and how she looked at his stump when he didn't have it on. It was always still just Killian.

"So, you don't feel like I'm not capable of continuing the investigation? That's part of what Sheriff Lassiter was worried about. He was concerned that I wouldn't be able to handle the case if things got too physical."

"Why would I be worried that you were incapable of seeing this case through to the end? I wouldn't think my husband would be incapable of doing his job with one hand, so why would I think that about your prosthetic foot? If we get into a chase situation, you let me do the running."

"You don't want me off the case then?"

"Of course not. Unless we absolutely have to turn everything over to Sgt. Haviland, I'd prefer we keep working together. You deserve to see this out too."

"Then I won't offer to give up the case – not without a fight. Thank you for trusting me with this, Sheriff."

"You don't need to thank me. Just help me put Donleavy and his cohorts behind bars and that'll be thanks enough."

"Alright then. Let's go see if Haviland is here. He's going to meet us in the parking garage across the street."

"Lead the way." She was more than ready to get this case moving forward.

[sokuly]

Things about top surgery (will be a long post; hang on and read whatever topic you need)

I had a double incision mastectomy with free nipple grafts with Dr. Daniel Medalie on May 18, 2017. Here’s just some things I personally have experienced that may help others pursuing top surgery, wether or not it’s with Dr. Medalie. Before scheduling: I got into contact with Valerie, his receptionist. She’s very helpful and will try to answer any questions you might have. I live about 2 hours away from Cleveland, so it was up to me if I wanted an in person consult or just over email. I got my therapist letter and photos of my chest ready and sent out. Photos via email. The consult was $60. When I heard back, he signed off on my therapist note, and told me I was borderline for either surgery; peri vs double incision. He said he would need to see me in person to make that call, but it could wait until the day of surgery. I wanted to know what to prepare for so I went to Cleveland about 2 weeks after. I was not charged for this in person meeting. He told me he could do peri if I was concerned about the scars that DI would give, but he would prefer DI as he was worried about the extra skin. Ultimately it was my choice. I was hoping for so long I could get peri and not have scars. However, I wanted the most aesthetically appealing option. I didn’t want extra skin. I didn’t want “unknown” nipple landing, especially with the extra skin. I made my decision of DI, based on Dr. Medalie having more control of nipple placement, contour, and removal of the extra skin. I got home and pondered when to schedule. Before surgery: I scheduled about 2 months prior, and was hoping for a Friday date, but was told he doesn’t operate on Fridays so I took the Thursday, which was fine with me. I think it was about a $250 deposit to schedule. In those 2 months, it was more of me focusing on work and not really thinking of surgery, except applying for CareCredit. About a month out, my fiancé and I started putting some things together for the trip to Cleveland: food, post op care (light food like crackers, blankets, clothing, etc.), money, who’s taking care of the cats while we’re gone, and so on. We stayed at a Super 8 in Beachwood, OH (it’s like 10 minutes away from the surgery center and his office). We went to Cleveland the day before my surgery. On our way, the surgery center called to confirm my appointment, 9:15am and to arrive an hour early. We got to the hotel around 2:30-3:00pm. My grandparents and dad also came with us, different hotel room. They bought dinner. I couldn’t stop pacing. It was hard to get to sleep. Day of: I naturally woke up way before my alarm, but continued to force myself back to sleep; it was the last time I could curl up and cuddle with my fiancé for a while. I needed that time. But I also couldn’t hold still for anything. We got up, I got comfy clothes on (red athletic shorts and a purple button down flannel. I looked fantastic, trust me), and continued to pace. We headed for the surgery center at about 7:45. The things we took to the center: a comfort blanket (literally any blanket you really like), a pillow, and my post op vest (this is important!). We got there, I got all checked in and paid my fees. I sat down for like… 2 minutes and was called back. Usual questions, urine sample (which was collected in a styrofoam cup??), got told to strip down except for underwear. Which I wasn’t wearing. So that was awkward but whatever. Put on the gown and surgery socks. Nurse took me to my bed and kept asking if I was cold. Honestly I was burning up. She said that’s pretty usual, we come in burning up and leave freezing. She got everything ready to start my IV. She numbed the area, commented on how nice my veins are, stuck me and blew the vein. I warned her that my veins don’t take nicely to IV needles. She profusely apologized and felt so bad about it. I kept telling her it was fine and I was expecting it to happen the first time. Second numbing, second stick, worked. More apologizing. She went and got my grandparents first. Saw the anesthesiologist. Grandparents left and my dad and fiancé came back to see me. Dr. Medalie came back, drew on me, talked a bit, was on his way. Anesthesiologist came back, he was an odd but funny guy. Maybe I just get his sense of humor. We talked a bit, his nurse came with him and started doing her thing. Anti-nausea via IV, another anti-nausea medicine via patch behind the ear (I usually get really sick from anesthesia). And then some relaxing medicine. I was so out of it when it hit, I don’t remember much. Wheeled back to the OR and remember them having some issue with my left arm board. Then I was in recovery. Dad told me to wake up and I flipped him off. I asked the nurse for water. And then to pee. And then for a warm blanket. I was surprisingly mobile and awake for just coming out of anesthesia. The nurse helped me get dressed and sat me in a chair while my discharge was being approved and they showed my fiancé how to empty my drains. My fiancé went to get her car and the nurse loaded me up, pillow behind my back and seat leaned back a bit and even put my blanket over me after getting my seatbelt on. Got back to the hotel, dad watched over me while my fiancé went to get my prescriptions. She got back, I took a pill, I slept most of that day. My waking moments were spent snacking on crackers, my drains being emptied, peeing, and watching The Weather Channel. It was the only thing on TV I could focus on. Until I passed back out. The following days in Cleveland: Drains being emptied, peeing, Weather Channel, Percocet, crackers, Powerade. I got up sometime Friday evening and went for a short walk with my fiancé. Sleeping post op in the hotel I was in a chair that had a footrest. YOU WILL NEED YOUR OWN SPACE TO SLEEP. My body pillow was perfect under my feet since the footrest was JUST too low for me. Had a pillow under my back, decently sized light blanket over me. I sleep hot, so we just brought a light blanket from home so I wouldn’t overheat, plus a comfort thing. We left Cleveland Saturday morning. Back home: I was still sleeping in a recliner. Body pillow next to me for one arm and a pile of blankets for the other. Again light blanket. We brought the recliner to the bedroom before we left home so my fiancé could have the bed while also being there if I needed anything in the middle of the night. Still emptying drains. May 23, 2017 Goodbye drains: My post op appointment. Take your narcotic about an hour before your appointment or before you go! Being on the road isn’t exactly comfortable. Plus it helps with whatever pain you have during the drain removal. I had to pee by time we got there so I went and then was in the room with his nurse Mary and my fiancé. Mary is really cool and pretty funny. Mary opened my vest and the feeling of being able to breathe was shocking. I didn’t realize it was that tight. Off came the foam (and probably all of my chest hair) and I could see my chest for the first time post op! Seeing my chest: After the foam was off, I looked down and the first thing out of my mouth was “oh. Woah. They’re gone”. Nothing can really prepare you for your reaction. I thought I was going to be over the moon and happy crying like the other guys who posted their reveal videos. But I wasn’t. There was this relief. Realization that I closed a chapter on a part of my life and this new one just started. I was happy, but not how it was going to happen in my head for so long. It was just pure relief. It was flatter than I thought (later to realize it was just from all the compression). A lot less “I got hit by a train” than I thought too. Dr. Medalie came in after my drains were pulled (will be discussed soon) and basically said I looked perfect and was good to go. My next 10 days: I’m a day away from day 10 post post-op (a day shy of 2 weeks post op) at the time of writing this. I was still sleeping in my recliner for a while and just got back into bed a few nights ago, surrounded by pillows and blankets to keep me from rolling. My mobility has greatly improved over the past few days. I take ibuprofen for any pain. I use ice packs when I’m really sore. I take dressing changes seriously since it’s a short time I can breathe and move. After tomorrow the steri-strips come off and I’m done with this compression vest. I can soak in a bath as long has my chest is above water. I use a cup to wet and rinse my upper body and hair. I use baby soap. I’ve been able to finally lay on my side with great care in the past like 2-3 days. Take it slow! Let’s talk drains: They absolutely suck. I’m pretty sure it was the worst thing about this whole process. They’re annoying. They’re weird. They hurt sometimes. I was so happy to finally get them out. Which is also a very odd feeling. It kinda pinches, kinda burns, kinda hurts. I don’t know how to really explain it. My left one actually hurt coming out, but I had armpit hair caught up in the suture and all that. Take the narcotic before you get them out. I was told to do that, and I’m glad I did. How about those nips: They’ll look really weird at first. Like ghost nips. Do the dressings EXACTLY as Mary tells you. You don’t wanna lose them. My nips are starting to scab, blister, and peel. THIS IS NORMAL. Just keep them dressed as explained by Mary and the paperwork she gives you. I have limited feeling in mine; I can feel the outer edges but not much on the inside. It’s really weird, but also normal. Not about nips but: as your chest hair grows back (they shaved my chest) it’s going to itch like no other. Things I’m glad to have/have had: Pillow(s), comfortable blankets, laxatives!!! (MILK OF MAGNESIA. Do yourself a favor and get it), ibuprofen, Gatorade/Powerade, slightly heavier blanket for my chest (in case the fur kids wanted to love on me), body pillow, open front shirts (get a few cheap shirts/tank tops and cut them open in the front)

To keep from stupid long posts in the future I’ll update more regularly. Thanks for reading and I hope it helps! Any questions, please ask!

[seecourtneytravel]

October 1, 2018 Monday

Hot October

I can’t believe it is October already. I already feel like I will be missing my favorite season in New York. I miss the coolness and the changing colors in the leaves. It’s weird to be in a blazing heat of sun on the same month of my birthday where it’s normally chilly and breezy.

Today I go to LPH after having a fantastic weekend. I never thought I would expounds new families, friendships, and cultures all in one weekend. Seeing Sambawan island is one of my favorite places now.

The day is a normal day at the hospital. I help where and when I can, asking the nurses where they need me. They typically didn’t need my help because in all honestly I couldn’t. Everything was so different and I literally didn’t know how to control my resource usage or make due with such limited resources. Medications here are pretty much the same just prepared differently. I’m not sure if I mentioned, but they do a “skin test” to make sure a patient is not allergic to an antibiotic and wait 30 minutes before administering. I was surprised they did that just as they were shocked we didn’t do that.

Anyways.. it’s around 10am and this kid who is maybe 8 or 9 is hunched over approaching the triage desk. He is tachycardic in the 150��s, high fever of 38.5 axillary, and is complaining of severe right lower quadrant pain. It was an obvious appendicitis. Or worse, a ruptured one.

I asked immediately if I could be present for the surgery. I asked if it was going to be emergent. They said yes. Emergent but scheduled at 4pm.

I am not used to the sitting and waiting. In my head I have the unlimited resources. Here I have to be patient. I’ve learned a great amount of patience but I will never lose that urgency bug that every ER nurse has. When you lose that, it might cost the patient's life. At the same time I don’t express panic. Sometimes here I’ve had a lot of “wow” factors in the differences with western medicine.

My fave Doctor

Dr. Villarente. He a general surgeon that is seen a lot roaming around the ER assessing surgical cases and seeing follow ups that come into the ER. He is very sociable and has American humor and wit. After getting to know him he invited me to assist with the appendectomy of the young boy that afternoon. I said yes eagerly. I left at 1pm to return at 3pm that day to prepare. An opportunity I didn’t want to miss.

When I arrived at three I hung around the ER and waited for the dr’s go ahead. The OB doctor came to the ER at 3:45 saying she had an emergency C-section that took priority. They only had one OR with one anesthesiologists. I asked if I could join in on that as well. Volunteering here I’ve learned you really had to ask for the opportunities.

I feel like I’ve lost my opportunity to shadow or jump in assist in an American OR. There are too many rules to do that. Maybe there’s not too many rules but this was an opportunity I took advantage of now. I guess I wanted to see if maybe being an OR nurse was still in the deck for me.

They were already prepping the patient for the c-section, or the “CS.” The doctor started making her incision, cauterizing small blood vessels on her way in. It seemed very movie like and straight forward. Before I knew it she reached in and grabbed the baby and the baby was crying. The baby was handed off and the umbilical cord was cut with the placenta removed. I stood back and appreciate the entire birthing process and then excused myself while they finished suturing her up again.

It felt like another hour went by and it was 630pm and the boy didn’t even get in the room yet. I never went home and all I could think about was how worried my Nanay was. She probably had food spread on the table waiting and wondering like usual. But she had no phone and there was no service at the hospital.

Finally, it was time. The room was prepared and the boy was wheeled in my wheelchair. He could barely stand to get onto the OR table. The anesthesiologist gave him a spinal injection for his pain. I forgot his name but he was fantastic. He had gentle eyes and was really easy to talk too. Everyone in OR seems like such a close group with constant smiles. That seems to be most of the staff here, always on a no worry spectrum.

As they prepped the patient, Dr. V asked me to scrub up. I never thought in my life I’d be asked to do that. Last time I did was in nursing school. I did, followed his directions and walked in with my hands in the air terrified to touch even...the air!

They had cloth sterile gowns and drapes, the assistant had assisted me and prepped me with my 7.5 sterile gloves. I was the tallest in the room and felt like I was in a dream. I stood across from the surgeon as the nurses made her counts of all gauze and surgical tools. He began his first cut.

It’s nothing out of the ordinary to me, I guess I was mostly impressed that the bleeding was at a minimal even without cautery. People get skin tears and bleed out in the ER it seems like. Here the Dr cuts through the subcutaneous, muscle, and even through the peritoneal cavity that encases the intestines and still not a ton of blood. I could be saying some things anatomically wrong but you get it.

The doctor had made a midline incision with only his assessment knowledge pointing towards his appendix has already bursted. Without CT, he was correct. This procedure has made my presence feel very useful. It was very difficult to find the end of the patients appendix because the intestes would fall in his way. The other nurses hands were busy handing the surgeon his tools and holding one side. I had the job of holding the opposite side open for the doctors visual aid. It felt like more hands were definitely needed.

The patients peritoneal cavity was cleaned with sterile water and betadine. This just proved to me how crazy the human body is. Afterwards, layer by layer the patient was sutured. I was given the job of cutting the sutures. I stuck around until the patient was fully sutured. I excused myself because it was nearing 8pm.

I finally arrived left. When I was on the jeepney I received message from Ronja saying my Nanay was looking for me. I also informed staff members that I would be home late. Nancy was double informed and when I arrived she looked very eager to see me come through the doorway.

[momscookingthebooks]

Living Out Loud, an all-new emotional standalone from Staci Hart is available NOW!

Bestselling author Staci Hart brings you another installment of the Austen Series, inspired by the works of Jane Austen, with a heartfelt contemporary retelling of Sense and Sensibility.

When Annie Daschle arrives in New York City, the only thing she can control is her list.

Not her father’s death or the loss of her home. Not the hole in her heart or the defective valve that’s dictated so much of her life. But she can put pen to paper to make a list of all the ways she can live out loud, just like her dad would have wanted.

See the city from the top of the Empire State Building: Check.

Eat hot dogs on the steps of The Met: Check.

Get a job at Wasted Words: Check.

What wasn’t on her list: Greg Brandon. And just when she thinks she’s figured out where to put him, everything changes. In the span of a few staggering heartbeats, she finds herself her caught in the middle of something she can’t find her way out of, with no clear answers and no rules.

List or no list, she realizes she can’t control anything at all, not even her heart.

Not the decisions it makes, and not the moment it stops.

Excerpt:

GREG

We chatted as we walked down Fifth to the bike rental station and unlocked one of the blue bicycles. And a little while and one park bench later, we were walking through the park in search of a grassy stretch off the beaten path.

We found what we had been looking for—a space lined with trees, somewhat shielded from the rolling, open knoll by boulders jutting up out of the grass.

“This looks good,” I said, lowering the kickstand before taking off my backpack.

She pulled off her bag, looking nervously at the bike as she took a seat in the grass. A thin sheen of sweat glistened on her cheeks and forehead, her face a little pale.

“You sure you’re okay?” I asked, eyeing her.

She smiled—her favorite way to answer. “It looks worse than it is. Promise.”

I frowned. “Really, maybe the bike is too much. Maybe we can do this after your surgery.”

“Greg, I’m fine. Come sit by me for a minute.”

I kept my arguments to myself and sat next to her.

“The cool air feels so nice,” she said, gathering up her hair and pulling it over one shoulder, exposing her neck.

“When they fix your heart, will you still feel like this?”

“No. I should be able to do anything physical I want within a few weeks of the surgery.”

My brows drew together. “Really? After open-heart surgery?”

“Really. It’s not like a heart transplant or anything. The hardest part of my recovery will be the incision and the fusing of my sternum back together.”

A shudder tickled its way down my spine at the thought of a bone saw opening her rib cage. “What all will they do to your heart?”

“Close the hole, repair my valve. I’ve had open-heart surgery before, but I was too little to remember anything about it. The scar is the only proof that it happened. Well, that and my mother’s stories. But this shouldn’t be too hard on the muscle itself, just some sutures when it’s all said and done. My body will work a lot more efficiently once the surgery is complete—like, immediately. I just have to get through the whole split-ribs thing,” she said with a little smirk. “All right, I feel better. Are you ready?”

She looked better. Her cheeks and lips were tinged with color, and the waxy quality her skin had taken on was gone.

“Ready when you are.”

We got to our feet, and I stepped to the bike to lower the seat. Once it was down, I waved her over.

“Come here and see if this works.”

She climbed on cautiously, her feet on the ground and her hands gripping the handlebars. The seat was probably too low, but I figured it’d be better for her center of gravity—plus she could stop herself easier if she tipped.

“Okay,” I started, one hand on the back seat and my other on the handlebar next to her hand, “I’m gonna hang on and hold you steady while you pedal.”

She shot me a worried glance. “And if I fall?”

“You get up and try again.”

She laughed, not looking convinced.

“Don’t worry; you’re not going to hurt yourself on the grass, but I’m not going to let you fall. I’ve got you, okay?”

With a deep breath, she nodded once. “Okay.”

“All right. Put your feet on the pedals.” My grip tightened when the balance was all on me. “Ready?”

“Ready,” she echoed with determination.

“Now, pedal.”

She did, moving us both forward, the bike only wobbling a little bit under her.

“Good, let’s go to that tree. Just keep it slow like this.”

Her tongue poked out of her lips, her hands white-knuckled on the handlebars until she got to the tree. And when she smiled, it was with more confidence.

“I did it!”

I laughed. “You did. Come on, let’s go back. Ready?”

She nodded, and we took off again. This time, she wobbled a little less, speeding up until I had to trot next to her to keep up.

When we stopped at our backpacks, she cheered. “Again!”

“All right,” I said on a chuckle. “I’m just gonna hang on to the back this time. And…go.”

I did just that, my hands on the back of the seat, the handlebars swerving a little but nothing she couldn’t correct. And then I let go.

She didn’t notice, wholly focused on staying upright, and I kept jogging, pulling up beside her. When she glanced over, I held my hands up in the air and wiggled my fingers.

Her face opened up with joy, and a whoop passed her lips—just before she swerved into me.

A string of expletives hissed out of me as I tried to grab her, but it was too late. She tumbled into me, bike and all, taking us down to the cold grass.

Annie was lying on top of me, her hair tossed across her face. The ground was cold and damp under me, and the handlebar of the bike was jammed into my ribs, but I barely even noticed. Not with Annie sprawled out across my body, her green eyes sparkling and her laughter ringing in my ears.

My own laughter met hers like an old friend.

“Are you okay?” I asked, sweeping her hair out of her face to tuck it behind her ear.

She flushed but made no move to pull away from me. “I’m fine. Are you okay?”

“I’ll live.”

We watched each other for a moment through the rise and fall of my chest, the movement carrying her like a rocking ship. And then she giggled again, climbing off me before reaching for the bike.

It was then that I began to fully comprehend the depth of the trouble I’d found myself in.

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Wasted Words

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About the Author

Staci has been a lot of things up to this point in her life -- a graphic designer, an entrepreneur, a seamstress, a clothing and handbag designer, a waitress. Can't forget that. She's also been a mom, with three little girls who are sure to grow up to break a number of hearts. She's been a wife, though she's certainly not the cleanest, or the best cook. She's also super, duper fun at a party, especially if she's been drinking whiskey.

From roots in Houston to a seven year stint in Southern California, Staci and her family ended up settling somewhere in between and equally north, in Denver. They are new enough that snow is still magical. When she's not writing, she's reading, sleeping, gaming, or designing graphics.

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