#but it’s like the only birth control option I have given my symptoms

[bass-alien]

.

[allsadnshit]

please disregard this if it's invasive or unwelcome in any way, but do you have crohn's disease? i ask because i'm newly diagnosed and very scared, both for my future and of the treatments that are common for it. are you afraid it's going to progress, without western treatment? or have the treatments you've used helped more than any of those? my doctors have told me that it will get worse without treatment but treatment also seems to leave me very open to even worse things down the road :/

I don't have a crohn's disease diagnosis nor has any medical professional suggested I be evaluated for it but I have definitely looked into it given the symptoms I have that align with it.

I personally am a believer of "third options" or the idea that if you're between a rock and a hard place that instead of feeling forced to choose we can be open to something we haven't thought of or seen yet. I know when you're scared stuff like that feels impractical or even insensitive to the severity of your situation, but for myself I think I end up there no matter if I struggle against it or not.

When I got my endometriosis diagnosis they told me my genuine only options for getting better were hormone therapy or continuous surgeries even though I had already just had one and wasn't sure if it was going to make a difference to my daily pain yet (it didn't).

I don't think any medical professional should be telling you you're out of options if you don't feel good about anything being suggested and I'd advise seeking help elsewhere if you don't feel supported and your doctors are not committing to the process with you and finding a solution that works for you.

I knew I wasn't interested in having my uterus taken out, birth control, hormones, or surgery even though I was told those were my options and although I am not 100% better now going the "holistic" approach, neither are the people I know who have followed their doctors orders so I think it's an uphill battle no matter what and what's important is you fighting that fight in the way that makes sense to you.

Many cultures outside of the American medical system have found all sorts of remedies in the natural world for illness that have since been dismissed or not even given the funding or attention to be seen through and I think that's a direct result of racism and the idea that "modern medicine" is based in science while anything that came before it or exists outside of it is NOT science, when it ultimately still is even if it doesn't follow the exact same procedures. I think it's important to look into alternative medicines even if you decide to go with what is prescribed by your current healthcare providers and keep an open mind that our society destroys and dismisses a lot of valuable history and knowledge based on a hatred for cultures and societies outside of our own which was so largely founded on the idea that not all people and bodies deserve the same autonomy or rights.

I suggest looking into how the research is conducted for the options being given to you if you feel uncomfortable with your current knowledge of them: is it on a wide array of people from different sexes, racial backgrounds, ages? Or just one type (usually white cisgendered middle aged men) and consider that in your decisions making! The world has more to offer than what is on Webmd and at hospitals that wouldn't treat you without health insurance and if you're getting a chronic illness diagnosis it's especially important for you to be in that conversation.

[espressodepressogirl]

It's been 3 years since I posted here but heeere we fucking go.

First off, holy shit the app has changed and after ten long fucking years they finally added a read more option into the app. About fucking time.

Anyway, existential crisis hours on deck.

Like all my blood tests are coming back as fucked as ever. Somehow my imaging said my liver is fine. Yay, I guess, but the whole area hurts like a mother fucker. I don't get how they excuse that shit, but I have to assume they're using statistics and it's likely I have a thinner rib cage than average, so even though my liver is on the larger end of acceptable it's just too large for what my body can accommodate. The tech that did it said she can see it's enlarged enough to impact my heart and breathing, but whoever officially signed off said it's okay. Who the fuck knows.

My bloodwork is as fucked as ever. Since the hepatitis came back negative that's one issue that's knocked off the list, but my levels they're monitoring are so fucked. So far I'm coming up negative for illnesses that can be tested for, but that leaves no answers for how I got here. My strongest guess is that it's based on my medication, but aside from my mounjaro shot everything else was out of my system by the time I took my blood tests.

Also I don't even know if this is necessarily based on my medication. The meds I was given are standards for my situation. Mounjaro to help the pre diabetic symptoms and weight loss, metformin for blood sugar, birth control pills to prevent cramping, and spironolactone to act as an androgen blocker. All super standard to take together for PCOS. I don't necessarily understand how they could have lead to these issues. At most maybe the metformin since I had a back reaction to another version, but who fucking knows.

The doctors are just releasing all my test results to me without talking to me first. I just keep seeing all the bad shit and I'm wondering why they aren't calling me or giving me a heads up. Right now I'm captain of the Google team trying to see what's possibly going on. All I can really gain is that I either have fatty liver issues, an infection of some sort that's not been available through a blood test, super lactic acidosis from the metformin, or non drinking based cirrhosis. All of which I have no idea how to address. The metformin one should have been resolved already since the body metabolizes it out in a few days, so my tests on 7/14 shouldn't have been worse than 7/5 when I stopped taking metformin on 7/7.

Aside from the cause, which is basically a null point, I don't know what to do. I feel as shitty as ever all the time. It feels like my organs are trying to burst out of my rib cage on the right side and I can't fucking breathe. On top of that I'm an emotional mess. Anything and everything sets me off and I don't know if it's the stress or what.

I'm so mad. I'm mad at my parents for never giving a shit about my health since I was a kid. I'm mad at my mom for prioritizing her desire to avoid doctors over my wellbeing. I'm mad that when she got over that bs it was only for herself so I could play nurse maid for her. I'm mad that I couldn't afford to go to the doctor on my own for years. I'm mad that my body has failed me despite my best efforts. I'm mad I wasn't just born normal. I'm mad I was so neglected that no one cared. I'm mad that I've watched my life pass by. I'm mad that I've come last in every close irl relationship I've ever had. I'm mad that I haven't experienced true happiness in years. I'm mad about my lack of love life. I'm mad that my genetic issues made me so ugly and fucked up. I'm just mad that I can't fucking win no matter how hard I try.

I just wanted a basic, normal life for a woman. So a bit of college, work, get married, live with my husband and have a happy, modest life. I didn't want much, I never asked for anything if I couldn't do it myself. I don't know what I did wrong to not deserve that. I don't understand what else God or the fates want out of me. To die? Alone and unloved? Surrounded by my parents that couldn't have cared about me in the first place? Worst of all is that aside from my parents I only have two friends. Neither can see me. I'm stuck rotting in their house just slaving at schoolwork on the off chance I make it through and I don't want GPA to be bad. I wish I wasn't such a try hard and could just relax, but I can't even chill out if I tried. My professors will not excuse my work and give me an incomplete to finish later. I can't sit still if someone does something for me because my mother raised me to be her caretaker rather than my mother taking care of me. Wild concept that me, with fucking liver failure to the point my doctor doesn't know how I'm alive, is having to rush around my mother to cook and clean when I'm here to be on bed rest in the first place.

I wish I wasn't stuck here, but I'm sort of trapped. My parents won't leave me alone and I know it's because they care. It's just very much too little too late. Where were these fucks they had to give when allllll this shit began in spring of 2013? Why did they not care when I told them I was throwing up at least once a day just a week ago? Suddenly they care. I have to assume it's because I'm their meal ticket. I have a feeling they only agreed to help put me through college again for the sake of cashing out when I finish and get to working since that's about the time dad retires. Can't have their meal ticket dying on them, I guess.

Makes me so frustrated. I lived my whole life for them. I did everything for them, to make them happy and proud. I drove myself crazy and to misery for them. Every social expectation they had I live up to. Every task they asked I completed. And for what? To live my life as their little puppet? I hate it. I've been disciplined so hard by those fuckers that I lived in Stockholm syndrome for my whole life. Even all these years later I won't be free, I don't think I would have ever been free unless they or I die. Whichever comes first.

Also I'm so fucking tired of my forever existial crisis of dying alone. And before now it's been a hint of sarcasm, like I had at least another 40 years to find someone, so like I would have hated living my life solo but it was an option. I don't even know if I'll have that option. It's such low hanging fruit of a goal as well. Just wanting a partner that genuinely loves me seems to be asking for too much. Really, really burns my tits when I try to talk to anyone. It's always "one day you'll meet someone" or "it'll happen when you least expect it" but it's always coming from people who are either in relationships or don't want one. Like of course that's easy to say, you don't know where I'm coming from. You don't know what it's like to live your whole adult life watching yourself get uglier and uglier. You don't know what it's like to insulted mid sex or find out how much your ex can't stand you. I can't even sleep around for fun to fix the void. I'm fucking demi as hell, I literally can't get turned on unless I feel something and I'm not so delusional to fall for a one night stand. On top of that it's no longer an option, I'm just stuck in pain from sitting, I highly doubt being jostled around during sex would be comfortable, much less pleasurable.

I'm disappointed looking back at my life. I have nothing to show for my whole existence. As an artist I've created nothing. I've never worked anything but dead end jobs. I couldn't even finish a real degree before my 30s. I have no family of my own, not even a boyfriend that lasts more than a few months. I can't even make more than two friends. I'm not even good at my hobbies. There's no goals and no dreams, I didn't even plan to live this long in the first place. I don't even have a purpose.

Is this all my life is? Mediocrity? What even was all this for? Why did I have to suffer all this time? Why was I even born? Is my life even worth the resources to continue it? Do I even want to get better? Would the world be better off without me?

[scriptlgbt]

What would pregnancy symptoms be in an trans guy who is on T? How can my character find out he's pregnant because the main sign of missed periods doesn't exist? Might other signs differ? I can only find info on trans guy pregnancies when they want to get pregnant and they stop T and go for fertility treatments.

I've had to do some research myself on this. We've been asked a number of questions about this before, so I'm going to give general information as well as do my best to answer your questions.

I've found this quote from this survey-based study, in reference to the experiences of their sample size (which was relatively small tbh). Please note their survey only interviewed trans men who came into their identity prior to pregnancy. And in general, I highly recommend reading the full report (it's all free at the link) because it provides a lot of really useful information on this. Including terminology, which we're asked about all the time. For example, some trans men referred to pregnancy as "heavy time" or referred to themselves as "gestational parents" or "carriers" along with "dad" and others. There were also some questions about the general experience of pregnancy for trans men.

Nearly half of the transgender men who had not used testosterone had an unplanned pregnancy, a proportion comparable to that of the U.S. population. Comparatively, one fourth of those previously on testosterone had unplanned pregnancies. By design this study cannot speak to incidence or prevalence of unplanned pregnancies among transgender men. However, given the financial burden and risk of increased morbidity from unintended pregnancy as well as the contraindication of testosterone use during pregnancy, these findings suggest a potential unmet need for contraceptive services for transgender men.

I also want to mention that as a general thing, people on hormones long-term are recommended to get bloodwork done around once a year to check a variety of things. I have other issues so I usually test more broadly, but my iron and B12 levels get checked, cholesterol, my kidney function. Often, a part of this experience, for me anyway, is pee tests. I believe the last few times I did it they were testing for something else besides pregnancy, but there were a few times when getting it re-prescribed (switching from patches to injections) where it was for pregnancy. I think it's possible someone could just tack it on to their requisition.

Here's also a thing from Planned Parenthood's Tumblr about pee stick tests:

Pregnancy tests only test for the presence of a specific hormone in the body: Human chorionic gonadotropin (HCG). HCG is a hormone that’s produced after a fertilized egg has implanted into the wall of the uterus. So taking “T” will not interfere with pregnancy tests.

If a trans man gets a positive pregnancy test, he should talk to his health care provider about his options, as testosterone could have an effect on the pregnancy.

As for your question, here is an article written by a trans man who became pregnant while on testosterone, (BIG TW: framing abortion as "killing" a baby, by the author) and here's an excerpt that's relevant to your question specifically.

Line breaks added for accessibility.

Despite being on testosterone, and taking a testosterone safe form of birth control, I was/am in fact, pregnant. It was a complete shock to me. And not only am I pregnant, but I am also already (now) 5 months along, and hadn't even realized it.

The morning sickness was very brief and masked by food poisoning and the fact that it wasn't unusual even before this for me to get nauseous now and then for different reasons. I never had the strongest stomach.

And as far as other common symptoms, I did have some of them but they were spread out and random, and most were things I also dealt with normally just because my body is the way it is, and having never really looked up symptoms of pregnancy, I had no idea that the symptoms were in any way connected either.

Being on testosterone meant that I had no monthly cycle to keep track of, at least not that I had physical signs of, so I had no way of knowing I had "missed" anything. It was only when I started getting later symptoms of pregnancy as I got further along, that made me wonder enough to take a test. And lo and behold, positive.

I want to mention that later on in the article he mentioned the pregnancy was totally healthy and fine despite having taken testosterone up until then.

That isn't the case for everyone though, and it's not always due to testosterone. I'm not going to quote it, because the specifics and descriptions could be triggering for some. But this is an article which describes an instance where a stillbirth occurred after a trans man's labour symptoms were not taken as urgently as a woman's would have been. (It was evident from the article that the lack of urgent enough care is what caused it.)

I also know, in one of the articles I read (I can't remember which, maybe the first one?) that trans people who carry a pregnancy are much more likely to opt for non-traditional birthing situations (ie outside of a hospital, like with a doula or something) in order to avoid discrimination.

- mod nat

[royallyprincesslilly]

Title: F*@k The Chef {One Shot}***

Ransom Drysdale x Family Chef Reader

Warning: NSFW, SMUUUUUT, Cursing, Hard Dub-Con, DARK Creepy Ransom, ALL STARS ON NSFW METER

***DO NOT READ AT WORK!!! TAKE THE WARNINGS SERIOUSLY***

Words: 4k

Summary: HA! Nope.

Note: So, my first attempt at Ransom and more importantly Dub-Con. I don’t know about you, but Ransom does not scream anything but dubiousness. That means consent is given but by dubious means. I hope this is even a fraction of good. Was this dark? Thank you guys for reading!! 

Also, this was not written to offend anyone.

**Loosely Edited/Proofread**

***Gif Not My Own***

~~~~~~~~~~~~~

When you got the call that you’d been chosen for an in-home chef position, you were happy. You’d hit bottom when you’d tapped out all of your savings trying to help your mother when she got her diagnosis. Cancer—stage three Cancer. It was a death sentence, your mother said. She was hell-bent on not fighting it, but you wouldn’t hear a thing about it. She’d birthed you a fighter, and you’d go down as a fighter. The cancer didn’t waste any time progressing. Before long, she went from no symptoms to every symptom in the book. She said she’d made her peace with death, but you weren’t ready to face a world without her.

 You drained your bank account with her meds, her care, and funding the portion of treatment her insurance refused to. After six months, you were broke. The call that you’d be chosen for a live-in position automatically garnered a refusal. You couldn’t leave your mother. Then the offer got even better, not only were you requested but the salary was better than any personal chef had ever seen. There was no way you wouldn’t take the job.

 When you rolled up to the address, your jaw dropped when you realized where you were—the Thrombey estate. You weren’t an idiot, you’d heard about the Thrombey Dynasty, everyone had heard the rumors. They’re the wealthiest family, they controlled serious portions of the business world and even that the family was seriously weird. You’d even heard the torrid tale of the black sheep of the family, Ransom Drysdale. You’d heard about his arrest. The release of information was interesting. The whispers said he’d killed his grandfather and the family housekeeper, but the official story said the family was a victim of insufficient evidence that pinned the murders on Ransom. It was safe to say the family had secrets, and though you’d never met Ransom, he looked dangerous.

You couldn’t believe your luck. Upon speaking with Linda Drysdale about the position, you knew this would be an interesting position. Linda told you what you needed to know to do your job accordingly, and you took detailed notes. It was clear that everyone in the household and the family had particular tastes that had to be paid attention to.

 Six months into the position, you’d learned a lot and developed on the job skills it took to survive working for the Thrombeys as well as living with them. You considered yourself an expert now. That was until you walked into your kitchen one day and saw a set of shoulders that looked ripe for the touching. He was bent inside the fridge, and it gave you a good view of his backside. It looked nice—toned. You got lost looking over the muscles you knew were underneath the brown sweater they wore that you didn’t even realize when they looked over their shoulder right to you.

 “Holy Shit,” you gasped.

 Ransom Drysdale stood a few feet away. His body straightened and came to full height. He was huge, or bigger than you. You were clearly the omega, and he looked every bit the vicious alpha.

 “You kiss your mother with that mouth?” His mouth remained relaxed, but there was a playful but dangerous glint in his eyes. “Or maybe you do entirely different things with a mouth as pretty as that.”

 Unexpectedly, butterflies filled your belly. You usually were immune to pick up lines like that, but that was a blatant pickup line, one that was dark but for some reason, affected you. As he sauntered toward you, you caught dangerous vibes coming off of him. You backed up with every advance he made. When your heel hit the threshold of the kitchen entrance, panic set in. You were alone with a man who’d quite possibly killed two people, one of whom was his own grandfather. He stopped mere inches from touching you and smirked. Goosebumps flooded your skin.

 “Yeah, you do entirely different things with that mouth. Care to share?”

 You were stunned silent; his eyes were an intense shade of blue you couldn’t help but admire. That, coupled with his perfectly coiffed dark hair and chiseled jawline, it would have been an honest assessment to call him beautiful. When you didn’t answer, his smirk widened and sent chills down your spine. Leaning forward to your ear Ransom took a deep inhale then groaned.

 “One day.” With that, he walked off, leaving you dazed and slightly shaking. You didn’t know what it was you were shaking from fear or excitement.

 You thought to render your resignation after that encounter, but you couldn’t convince yourself to pass up on the clearly over-generous salary, not when your mother was still in treatment. After an all-night debate with your door securely locked and bolted with a chair underneath the knob, you decided to keep the job but tread carefully, especially when it came to a one Ransom Drysdale.

 For the next four months, you put up with a lot more than an average family chef would have had to. You stomached the catcalls, the whistles, and the demeaning sounds Ransom made every time he saw you or was close to you. You just steeled your spine and pretended you’d heard nothing at all. Every time you were left alone in a room, you made an excuse to leave. When you had to bring his dinner to his room because he hated his family so much that he refused to eat with them at the dinner table, you kept it simple. Rather than go into the lion’s den, you left it on the floor in front of the door, knocked, and made a mad dash to get away before he opened the door. You skated by for four months.

 As time went on, his advances became more and more blatant. What started as catcalls or whistling turned into sly comments about your uniform and how it should be shorter and how the fit did wonders for your waist and breasts. That escalated to outward attempts at getting to you. On the off chance your eyes met, he’d bite his lips, lick them obnoxiously and wink at you. When that had no effect, he found ways to touch you slyly. He’d squeeze past you sliding his body against yours, take plates or other items from you while ensuring his hand grazed yours. A few times, he’d even grabbed your waist. Each time it produced a loud yelp that could be heard throughout the house.

 After months of you not reciprocating or opening up to his advances, his delivery became even crasser. It was a little strange to you. You knew from the sounds that came from his bedroom that he had no shortage of women that would do whatever, whenever he wanted. You didn’t know why he had this fixation with you. Part of you said it was the draw of breaking someone—something. He possibly wanted to break those around him that were put together, and you were just the closest target. Whatever it was, you didn’t want to provoke him.

 One night, Ransom must have been lying in wait for you. When you approached his door with the tray of food, he swung open his door, startling you half to death. He smiled like the Cheshire cat if the Cheshire cat was a convicted murderer.

 “Funny meeting you here,” Ransom said, leaning one brawny shoulder on the threshold.

 “I—I have your dinner.”

 “You have my dinner who?” Clenching your jaw, you swallowed the smart comeback that nearly slipped from you. As if sensing it, Ransom smiled as his eyes darkened. He tilted his head to the side, quietly reminding you he was waiting.

 “Sir,” you filled in.

 He nodded and breathed out. You saw his eyes lazily travel over your body. He wasn’t even being coy about it; he was doing it outright like he wanted you to know what he was doing. Doing your best to ignore it and not say something reckless you’d regret in the trunk of his car as he took you to some abandoned part of the estate to kill you.

 “Bring it inside,” Ransom ordered. You hesitated. Going inside was a stupid idea, anyone with half a brain knew that. You also thought what other option did you have? He didn’t even bother repeating it. It was as if his privilege told him you’d obey.

 Cursing to yourself, you slowly stepped into his room and looked for a place to put the dinner tray. As you walked across to the small table up a few steps on the other side of the room, you did your best to slow your breathing and calm your nerves. Once you placed it down, you began walking back to the door. Before you got near it, Ransom shut it and leaned against it. Your stomach fell.

 “Uh—what’re you—what’re you doing?”

 “Whatever the hell I want,” he gruffly said. His eyes didn’t look clear tonight. He’d taken something. In your time working there, you’d learned a few things about Ransom. He liked women, alcohol, good food—rich food, and drugs. You suspected he did them all, but you knew for a fact he liked weed and molly, otherwise known as ecstasy. He must have taken one tonight, you though.

 Ransom rubbed his nose and sniffled as he did it and zeroed in on you. “Come here.”

 Instead of listening, you backed away, trying to create distance between you. “Come—here!”  It was said more loudly. He meant business. Panic set in and a feeling of dread. Before he moved, he growled then pounced. You yelped and got ready to scream, but Ransom’s hand clasped over your mouth before he pushed you against the wall on the other side of his room.

 “Let’s not go doing something stupid, sweetheart,” he drawled his voice dripping with wickedness and sin.

 “Tell me—sweetheart,” Ransom began with his face just inches from yours. “What would you do to keep your job?” You felt his finger trail your throat. It inched lower and lower until it was at the rise of your breast. “One word from me, and you’ll be out on your ass faster than you can say Cancer treatment.”

 With those words, your eyes widened. He knew about your mother. When he saw you realized it, he smiled sinisterly.

 “That’s right, sweetheart. I know you need this job. The question is, what will you do to keep it?”

 Moments passed where he kept his hand clamped over your mouth. Only when he was sure you weren’t going to scream did he remove it.

 “The next words out of your mouth better be anything, sweetheart,” Ransom warned. Glaring at him, you hoped to convey all the hatred you had for him at this moment. Ransom didn’t look like he cared, his smile said it didn’t faze him one bit.

“Haven’t you heard the rumors? Hate turns me on. I’d be careful how you look at me, Y/N. I just might bend you over that table and have my real dinner.” Your eyes bugged with his threat, but your belly did cartwheels. What the hell was wrong with you, you wondered.

 “So—again, what will you do—to keep your job?” He said it in a sing-song voice this time. He was enjoying this. The sick fuck was enjoying this.

 “What do you want?”

 As if he’d been waiting for you to ask him that. He smiled and got so close his nose touched yours. You tried to press your back even further onto the wall hoping it would suck you in. That didn’t happen though; instead, ransom’s hand tightened on your hip and pulled you to him. Your body was now crushed flush against his. Even dressed in the teal-colored wool sweater, you could still feel every muscle underneath. He was athletically built.

 “You.”

 As if for emphasis as soon as the word left his mouth, you felt his erection poking against you. Again, your belly did backflips as you were filled with strange feelings; fear was the least of them.

 “I’m tired of waiting for you to throw yourself at me so I can take what I offer. You are the only one who has resisted this long. Why resist? Just give in. Give me what I want,” Ransom spoke through clenched jaws as he ground his crotch into you. A small moan escaped your lips, one you instantly regretted. His lips touched your ear before he spoke.

 “You want me. Give it, or I will take it.” Ransom then bit your earlobe, but it wasn’t gentle. It was forceful. His teeth relinquished their hold before he bit your neck. He wanted to mark you.

 Suddenly a loud knock broke the heady aura in the room.

 “What!”

 “Where is Y/N! She’s needed now. Have you seen her?” It was Linda. You’d never been happier to hear her voice.

 Ransom’s anger was evident, and it grew when he saw relief in your eyes. He looked like he was thinking of all the things he wanted to do to you, and none of them ended with you clothed and unmarked. Ransom then begrudgingly scoffed and went back to your ear. “Soon.”

 After he spoke, he released you. Quickly you scurried to the door and out. You didn’t even bother to shut it behind you. You just ran.

 For days you looked over your shoulder. For days you lived on edge. You kept your door locked with the chair underneath and even pushed one of the nightstands against it in case he was strong enough to barge in. Night after night, nothing happened. Day after day, Ransom was on his best broody behavior. The catcalls stopped, the whistles were a thing of the past, the touches nonexistent. He’d gone one hundred to zero overnight, and it confused you.

 You were relieved the first few weeks, but that relief turned to doubt. You were convinced he was working some twisted angle. You were sure he would sneak out from every corner and push you over whatever furniture was nearby and have at it. It was a constant worry. After four weeks and nothing, you began to relax, especially when you found little things lying around at your door either early in the morning when you rose to get breakfast ready or late at night when your day was done. The items weren’t huge things; they were things such as your favorite flower, or your favorite dessert. There was one time you found a diamond necklace in your favorite color. You knew who it was from. You didn’t acknowledge them, though. That must have been encouragement, every so often you’d find pieces of jewelry, earrings, bracelets, rings, all items that looked like they cost more than an average weekly paycheck. You didn’t wear them, you kept them in a drawer and tried not to think about them.

 His behavior was erratic and confusing. You couldn’t figure him out. One morning ransom was waiting in the kitchen for you. You nearly tripped over your own two feet. You couldn’t walk away because he’d already seen you. Cautiously you walked into the room, taking the path that left enough breadth between you and him. You wanted to get to the fridge, but the action meant your back was turned to him. You didn’t want to turn your back on him.

 “Don’t bother. There is no one here today—no need to make breakfast,” Ransom informed.

 “Uh—what—

 “I have breakfast already.” He nodded to the pink box sitting on the island. Your eyed dropped to it and caught the aroma of pastries. You recognized the box.

 “I made coffee,” Ransom informed. Shock filled you.

 “You?” He scoffed, got up, and walked to the fancy espresso machine. He then poured the dark liquid into a mug and approached you. The scent of the exotic coffee beans teased your nostrils. He stopped a few feet from you and held out the mug. It was the mug that read “my house, my rules, my coffee.” You couldn’t help but think of the stories you’d heard of Marta. Marta who was now strangely gone without a trace.

 “Take it. I promise I didn’t do anything to it.” You slowly reached out and took the mug and sniffed it hoping to be able to smell if he poisoned or drugged it.

 “I didn’t poison or drug it. You have entirely the wrong idea about me, Y/N.” He chuckled and walked back to the espresso machine to get his own mug. He then came back to you and leaned on the island while facing you.

 “I want to apologize,” Ransom began. You almost dropped your mug.

 “Apolo—huh?”

 “I know, it is not a concept I’m familiar with, but neither is forcing myself on the help. I don’t have to force anyone to fuck me,” Ransom crassly explained.

 “Nice. Lucky you.”

 “Meh. I didn’t mean to—I was high. I didn’t have full control.”

 You studied him trying to assess if he were being sincere or if this was yet another ploy.

 “Come, I got your favorites.” Ransom walked away to the stool and sat then opened the pink pastry box.

 It was filled with your favorites, madeleines. It was a box of an assortment of them, and they smelled delicious. Ransom waited for you to approach. When you did, it was a slow stride, and you took the stool that was farthest from him. The two of you ate and drank in silence. You could feel his eyes on you the entire time, though. You tried to keep your nervous ticks to a minimum, but it was difficult. The longer you sat across from him, smelling his cologne, the more you felt temptation. It was confusing. Though you hated him, you were strangely intrigued by him, inexplicably attracted to him. It was one of those things that you felt ashamed of. When the last madeleine was eaten, Ransom stood and walked out of the kitchen without a word. Your head was spinning from this three-sixty.

 That wasn’t the end of Ransom’s peculiar behavior. It all continued as did the wayward glances. At times they were soft, and other times they were hard and intense. You were convinced the man had bipolar disorder or even multiple personalities. Several more weeks passed with him giving you the hot and cold treatment, the psychopath and sane citizen act. Though you tried to talk yourself out of it, you found yourself with mixed feelings for him.

 You were minding your own business preparing the lunch for the household. You’d just finished putting a freshly kneaded loaf of bread in the oven and checked on your pot of stew on the stove slow-simmering when heard the clink of metal. Your curiosity won out, making you look behind you to the nook in the kitchen, and there stood Ransom. He was dressed in his favorite white cable knit sweater and dark pants. Your eyes immediately dropped to those pants to see his belt undone, and him slowly zipping down his pants. You were frozen in place. The slowness of his moves was like torture. You knew you should have looked away, but you were interested in knowing just what had countless women compromising their morals. When his cock flopped out of his pants, you gasped and placed your hand at your throat. He was long and thick and completely ready.

 You heard a growl from him, and in seconds, he was across the kitchen and in front of you, pressing you against the fridge.

 “Looks like soon is today. When we first met, you showed me a glimmer of how dirty your mouth was. That was just a fraction though Y/N. Get on your knees and show me more,” Ransom demanded. His eyes were again dark similar to the way they’d looked the night in his room.

 “Ransom pl—” Ransom grabbed your throat, but he didn’t squeeze.

 “What did you call me?”

 “S—sir,” you replaced. His top lip rose in a devious smirk.

 “On your knees. Or we can call this your last day working here.”

 You knew he was serious. Linda was wrapped around his finger, and she didn’t even know it. All he had to do was say he hated your food, and you’d be out on your ass, and your mother would suffer for it. After quick calculation of your options and the fall out from them, you slowly dropped to your knees. Ransom’s thick cock was right in front of your face. The violent veins were protruding to give you an idea of just how engorged he was.

 “I’ve dreamed of this for months. Open your pretty mouth, sweetheart.”

 You opened your mouth, and without warning, Ransom thrusted forward, sending his cock down your throat. You gagged, but Ransom kept it nestled in the tight confines of your throat. You groaned, hoping to relay your panic from your lack of oxygen intake, but either Ransom didn’t understand, or he didn’t care. You were sure it was the lather. He pulled his hips back, allowing you to chough and gasp for it. The reprieve was only momentary. In seconds, he shoved his cock back into your mouth and held the back of your head where he wanted it as he fucked your face.

 You did your best to remain conscious. With every thrust, Ransom shoved his cock further and further down your throat, suffocating you in the process. Soon slobber and thick globs of mucus dribbled from your chin and down to your flour-covered uniform. Ransom didn’t slow his actions or take heed to not break your throat with his cock. He fucked your face viciously. His only concern was his pleasure. When his thrusts became so fast you couldn’t keep up; you gagged with every forward thrust. Your struggle must have been a turn on for him because the sounds coming from him were animalistic but also vulnerable.

 “That’s it; sweetheart suck my cock. You take me so fucking well. swallow me!” His hands loosened their grip from behind your head, and he caressed your cheek with the back of his hand. It was out of character.

 “Use your hands!” you wrapped both your hands around his shaft and worked his length as he continued to fuck your mouth. Ransom dropped his head back and groaned loudly.

 “Yes, that’s it, sweetheart, swallow this cock! show me how bad you fucking want it!”

 When you moaned on his length, you were shocked. You couldn’t believe this; you were turned on. Ransom must have known it too because it was then he plowed into your mouth with reckless abandonment. The moment before he came, you saw his intention. When you felt the hot splash of his cum shoot against your tonsils and down your throat, Ransom clasped his hands behind your head again and held you in place so not one drop escaped your mouth. His grunts were loud and forceful. From the look of him he was in ecstasy.

 “Swallow every drop!” It wasn’t a suggestion. You struggled swallowing and attempting to breathe. It felt like his cum was coming through your nose. You began to feel lightheaded and woozy as Ransom swished his cock around your throat, nudging it against the walls. The sensation fiercely triggered your gag but thanks to his cock in your mouth, there was nowhere for anything to go. Gulping, you swallowed what he deposited, and that action had your eyes rolling to the back of your head. It was then Ransom pulled himself from your mouth, finally allowing you to chough and gasp for air.

 After a few moments, Ransom stooped down before you, his cock still out and slowly coming back to life. Your eyes met, and he had a smile on his face.

“There, there sweetheart. You did good.” Ransom used a dish towel to dab at the corners of your mouth before he wiped your messy chin. “Could be better, but don’t worry, I’ll train you proper tonight.” He leaned to your ear and whispered. “Let the big bad wolf in Y/N. I promise I’ll fuck you right.”

When he said it, he stood and walked out of the kitchen, leaving you on the floor in complete shock at what just happened and the fact that you liked it—a lot. 

~~~~~~~~~~~~~~~~~~~~~~~~~

[pornoes]

This fucking asshole doctor…. I’m going off now don’t mind me

So I have very limited birth control options. I’m allergic to latex so I can’t use condoms. I get migraines with aura so all hormonal birth control is out. So that leaves me with the IUD and the implant. The only issue with that is I have major repulsion to the idea of things being installed/implanted in me. Makes me feel physically ill to think about. I’d called it a phobia but I never bothered getting it diagnosed. Anyway after I’d exhausted all my options and after doctors kept pressuring me for somewhere around 3 years, I gave in agreed to get the damn IUD to avoid the guilt trips. So I got the damn IUD. And it sucked getting inserted, and didn’t stop sucking.

You can expect to cramp mildly here and there for the first 1-2 weeks. I was cramping all the time at period-level pain nonstop for 3 months. So I went back to the gyno and was seen by a male doctor who I had never had an appointment with before because my symptoms were scary and they wanted me to come in asap. This guy….. in the middle of the exam he asks what my other most recent birth control method was, aside from the IUD. That’s a fair question. I explain why my options are limited (see above) and tell him I use the pullout method. His reaction is to crack up– very clearly laughing at me, not with– because the correct term is “withdrawal method” and because I didn’t know that. This man is currently inside my vagina while laughing at me and shaking his head. I was 27 but felt like an idiot child.

We learned at this visit that IUD had given me a nasty infection and that was what the pain was attributed to. I was given antibiotics, was told by the doctor not to eat after taking them unless i really needed to, and I left. Thus begins the antibiotics journey. I’ll just summarize: they made me repeatedly vomit and made me so sick that I ended up just laying on the floor unable to move for several hours. I tried to push through it, but after day 4 my husband was scared for my condition and made me eat saltines with them since yeah, I really needed to. Those saltines helped so much; it was like magic.

At last I went back for my follow up visit (same doctor). I was still in pain and was not having a good time. The exam started with the doctor asking how the antibiotics were. I explain how it was, which was terrible, but I’m grateful that eating helped. This guy….. he said “you ate? I told you not to. Well, hopefully you didn’t ruin anything and the antibiotics still did something”. Fuck. Off. He did another exam and now that the swelling had gone down, he found that the IUD was in the wrong place and was digging into my uterus in 2 places. Well, that explains the pain! The IUD was removed which was also painful, but it was a different kind of pain and I did feel some immediate relief. But this guy…….. the doctor didn’t give me time to chill before he said, “okay let’s get this reseated in you!” UHHHHHH no. I had gone through so much, had been in so much pain for coming up on 4 months now, had been so sick from antibiotics, and didn’t even want this thing in the first place. So I said no. He tried to convince me to get the implant. I said no. So he laughed at me, threw his hands up and said, “well don’t come to me when you’re another statistic”. Bruh.

As if I’m some irresponsible teen having unprotected one-night stands and willfully neglecting birth control. Even if I was, that should never have been said by a healthcare professional. But I’m not even irresponsible! I have one partner in a very committed relationship, we’ve both been tested, and I have tried every other birth control I could. I tried a fucking patch that’s not even readily available and gets gunked up like an old bandaid. I tried hormonal birth control because my last gyno didn’t care if I got a stroke. I tried nuvaring and got pregnant on it. I tried the IUD and got stabbed and infected. I don’t need to be threatened about being a statistic on top of all that. (Also, which fucking statistic? He said it like it would be a teen pregnancy. I’m married and in my late 20s, asshole.)

My exam wasn’t even over after that but he hurried through it and didn’t speak another word to me. The quality of care decreased astronomically right before my eyes. The whole experience was embarrassing, shaming, horrifying. I felt small. I felt unsafe. I was shown that I would receive second-rate care because of my physical limitations to be on birth control and my choice to stop torturing my body. Dr. Noffsinger can eat a bag of dicks.

[booitislife]

Let’s Talk About Periods

My period is horrible. I have heard people who don’t get periods say: “It can’t be that bad.” Yes, yes it can. Some studies suggest that cramps can be a worse pain for women than a heart attack. My period technically starts a few days before bleeding. I get a period flu. A period flu is a few days of unexplained illness and flu-like symptoms (low grade fever, chills, etc) a few days before your period starts. I didn’t used to get this, but my body decided I needed this. The first time I got it, my doctor put me on antibiotics thinking I had a sinus infection. (She is proactive about fevers because I am a transplant patient).

My minor symptoms are bloating, diarrhea, lethargy, sometimes headaches, I get irritable, my breasts hurt for a few days, and some other lesser inconveniences. However - my biggest two issues? Pain and bleeding.

Bleeding - I bleed for eight to ten days every month. Usually the first one and last two of the cycle are light. I tend to have one or two very heavy days, depending on the month, and when I say heavy - I mean clots. Lots of them. I will soak through a ten hour pad in less than two hours. I have lost so many pairs of underwear. I now have “period underwear” that is darker or just old so I don’t care if it gets stained. The rest of the days are moderate.

Pain - This is the worst part of my period. I start cramping on day one and I usually don’t stop until the second to last day of my period. When I say it’s bad - I mean excruciating. I was once taken to the hospital by my mom because I couldn’t breathe right during cramps. The doctors rushed me in, thinking I was having a miscarriage, a burst cyst, or maybe appendicitis. They did lab work and ultrasounds. While I was waiting they gave me fentanyl, which is 80-100x stronger than morphine. I could still feel the pain. It dulled it, but didn’t negate it. The doctor came back in shock - there was nothing wrong. No miscarriage, no cysts, and my appendix looked great. These were just the cramps I was going to have to live with. I was given pain meds for every month - 20 - to deal with that I’m going through.

I have a few period journal entries that I would like to post. If you don’t want to read, please scroll down past the blue writing. Sadly, these are only four of dozens of examples.

September 17, 2020 - Day 5 of my period.

Woke up with horrible cramps that were so bad I was shaking. Slept on the couch again because I was tossing and turning so much from the pain. Didn’t fall asleep until nearly 4. Passed a clot which, usually by day 5, will alleviate some of the pain, but it didn’t. The exhaustion took over and I fell asleep until about 11:30, but when I woke up I was so tired I could barely move.

November 16, 2020 - Day 4 of my period.

I could not sleep last night. The pain is intense and comes in waves. The bleeding started to get heavy a little after 7AM. It’s a little after 8:30 when I’m writing this and I have passed 2 large clots and probably 5-6 smaller ones. I soaked through 1 pad already. I’m going back to bed and hopefully sleep for a few hours. Woke up with horrible cramps. Haven’t been able to get out of bed. Managed to get some food down to take my antibiotic, but that’s it. I am exhausted and the pain is radiating to my knees.

February 9, 2021 - Day 3 of my period.

I finally fell asleep around three, but I woke up a little after five with searing cramps. They went down my legs and around my back. I could barely think straight. I took meds, tried meditation, used a heating pad. Nothing helped, I finally passed a big clot and the pain subsided. I moved to the couch and was almost asleep when the pain started again around 9. I did everything the same - meds, meditation, heat. I’m going to try to get some more sleep.

April 14, 2021 - Day 2 of my period.

Having trouble getting to sleep. After taking pain meds and using pain cream on my back, the pain is just getting worse. I almost fell asleep, but woke up in pain. It’s 1:30 AM, and I am heading downstairs to lay on the couch with my heating pad. I can’t get comfortable and the pain is getting worse. It’s 5AM. I still can’t sleep. The pain is very bad. I just want to sleep through it and I can’t. Couldn’t sleep. The pain has somehow gotten worse over the afternoon. As of right now, I have pain meds in my system, pain cream on my back and abdomen, I took a very hot bath, and I am now laying with a heating pad. I am still in searing pain. I can’t do this much longer. I burst into tears a few minutes ago. Why won’t someone help me?

I have asked doctors, so many times, to have a hysterectomy. At first I was told I was too young. Then? I was told my husband would need to sign off on such a procedure. My husband was more than ready. If anything, he was just overtly appalled that he would have to do that, or that any doctor worth there degree would ask that. He asked what it would take for him to get a vasectomy. They said just call a urologist. “Would she have to sign off?” He asked indicating me, and when he was told no he said: “This is a ridiculous double standard. booitislife can make her own choices.”

I have seen 6 OBGYN’s in the last 8 years. The first told me I was too young. She offered a procedure called an Endometrial ablation. It does greatly reduce the bleeding issues. However, I wasn’t really worried about the bleeding - I was worried about the pain. She told me it wouldn’t really do anything for the pain, so I said no. I have to be careful with my transplanted kidney and any kind of anesthesia can be dangerous.

The second OBGYN was a man in the same office who was also conducting a cervical biopsy on me. I’ll never forgot the intense flash of pain and how I nearly yelled, but I did start to cry. According to my husband there was blood spray on the floor as the doctor looked up at me and said in a condescending voice - “That doesn’t hurt! Come on!” And then he laughed. He wouldn’t even discuss a hysterectomy. From that biopsy I learned I have pre-cancer on my cervix and underwent a LEEP procedure. They use a hoop wire heated by electric current to scrape off the parts that could become dangerous.

The third was about a half an hour away at a bigger hospital. He was the guy who did an endometrial biopsy on me. Different than the cervical biopsy, this was just a precaution after something looked off. He wasn’t as condescending as the others, and that biopsy came back normal. However, he wouldn’t do the hysterectomy either. He said I should go to a doctor in a hospital that has a transplant team - seemed reasonable.

Between the 3rd and 4th doctores I had been doing my research. I went to my nephrologist that was keeping track of my transplanted kidney, and told him about my struggles. He said he saw no issue with me getting a hysterectomy and, in fact, I should. He even confirmed with the current head of transplant from the hospital I had my transplant surgery in. So, I was off - feeling more confident. This new OBGYN was a doctor at my transplant hospital.

The fourth OBGYN - or as I call him “The Biggest Mother Fucker I had the displeasure to meet”. He dismissed a lot of my concerns quickly, and talked to me as if I didn’t know anything. Then, he asked if I wanted to try an IUD. Now, I have nothing against anyone who gets an IUD. If that is for you, and it’s working - awesome. I know my brain. I know my brain would focus on everything bad an IUD could do. I politely explained this to my doctor. This wasn’t an option for me. My panic would go crazy. He wrote some things down and told me he wanted to to a procedure just to check for any cancer cells that could be hiding, but (and oh yes, there was a big but) he would only do the procedure if I signed yes to getting a Mirana IUD. I had to sign a consent form before he would even schedule the procedure. So, I did. Then I canceled my procedure and never went to see him again. Oh, also, this asshole handed me pro-life pamphlets on my way out.

The fifth OBGYN - more trusting, no results. At this point I was exhausted. I was tired of trying and being let down, fighting to get an appointment. This OBGYN was a woman and she worked in the same office as the second guy I went to. I laid it all out for her. I told her what the previous doctor did. I told her about the pain, about not being able to barely move. I poured out my heart and soul to her. She empathized, then told me she did not feel comfortable doing my hysterectomy. Because the uterus is close to the transplanted kidney, she thought I needed a specialist. A type of doctor called an OBGYN oncologist. As luck would have it, there was one on staff at my transplant hospital. I waited and waited for an appointment. I waited for over a year. Finally they called and said they were just too booked. They had one doctor who did it, and it was most dire cases first. I understand that. So, I wasn’t angry or frustrated this time. The office at the hospital asked me if I would like to see another OBGYN on staff. I said as long as it wasn’t OBGYN Biggest Mother Fucker I had the Displeasure to Meet. I asked if it could be a woman and we set it up.

Okay, the last one for now. The OBGYN they set me up with was a resident. She seemed nice at first. We sat and talked about my pain, the exhaustion. She wanted to talk birth control options. Great. Her advice to me was to stay away from the shot and the implant. She agreed about the IUD not being right for me. So, she said she wanted me to start talking the pill. I stopped her. I had been on the pill twice. Once when I was 16, another time when I was 24. Two different kinds. Both times I had side effects. The most prominent was this intense stomach cramp. I would get headaches, nausea, extreme weight gain. I couldn’t live my life. I told this doctor that and she didn’t even look at me in the eye when she said...... “Well, I won’t even consider a hysterectomy until you’re on six full months of birth control.” It didn’t matter what other symptoms I had. It didn’t matter what I was and wasn’t comfortable with, not really. So, here I am, looking for lucky number 7 when it comes to OBGYN’s.

As I sit here tonight, losing a lot of blood through clots, being so tired I can’t think, but in too much pain to sleep. I found myself so angry. About an hour before I started writing this I had a pretty big panic attack. I haven’t had one of those in a long time. But - Tuesday night I slept for three hours. Last night I slept about five. Tonight it is almost 3 AM and I’m still awake. The pain is exhausting, but also keeps me awake. It also makes me tense. So, parts of my body started tingling. Instead of my logical side taking over and saying, “Yeah, you have been clenching for four days. You’re gonna feel odd things.” I convinced myself I was dying and had to take medicine. I am so tired on a deep level. I don’t want to have to go through this anymore, and I don’t know if that makes me sound selfish... I just.., I DON’T WANT TO GO THROUGH THIS ANYMORE.

So, here we are. If you experience cramps like I do, I am so truly sorry. You don’t deserve them, and if I could do something to help you - I would in a heartbeat. People should not have to live like this. Doctors should listen to us and hear when we say that something like this is, genuinely, detrimental to our lives. If we want permanent birth control whether it be our tubes tied, an ablation, or a hysterectomy - it’s our body. We should decide what we can do with it. Please don’t stop fighting. Please don’t stop advocating for yourself. If you ever need to talk, I’m here. Have a good night, anyone who reads this. Thank you for reading this long-winded rant. Take care of yourself.

[jenroses]

So 30 years ago today I almost died of a massive saddle pulmonary embolism caused by birth control pills and medical ignorance.

I went undiagnosed for 3 weeks despite telling every medical provider I saw from the moment I asked if it would be safe for me to take the pill, "my mother had a pulmonary embolism while pregnant, and then 2 more after she lost the baby."

I was told "It's not genetic" even though they just didn't know yet... Most coagulopathy that is genetic had not been figured out yet.

When I first told a care provider I got short of breath walking to the store, and that my mother had had an embolism while pregnant, and that I was on birth control pills, she said, "you're obviously depressed."

When I told the student health clinic that I was horribly short of breath just sitting up in bed and that I was concerned because my mother had nearly died of an embolism while pregnant and I was on birth control pills, they diagnosed me with asthma and bronchitis, gave me antibiotics and an inhaler, and said, "sleep here so we can keep an eye on you overnight."

I took the meds as directed and lay there desperate for oxygen and waited for the nurse to come back so I could tell her that the meds were not helping. She never came back.

The next morning I dragged myself to the nurse's office and she wasn't there, so I used her phone to call my mother who said, basically, "why are you messing around with the student health clinic, go to the ER and tell them they need to rule out a blood clot."

The ER did not, in fact, rule it out.

A vq scan and angiogram later, they have me a then-experimental clot buster and told me not to move for 12 hours. I recovered most of my lung oxygenating capacity, eventually. I did not recover my ability to manage college effectively long term.

17 years later I had another embolism, and asked about the drug I've been given, and they said, "we don't use that for this. People are never quite the same, after."

If my first instinct had been to go to the ER and ask them to rule out a clot, i probably would not have needed that drug at all. Because the clot would have been so much smaller.

The entire time it was happening, I tried to minimize it, because I'd always been told that I made too much of things, that I just wanted attention.

What has been demonstrated time and time again in my life is that if anything, I routinely downplay how bad things are.

So a moment to be frank about my current health: it's not good. The ra is bad enough that we're far down the list of treatment options. The current drug is requiring me to take other meds to quell my reaction to it and this week it started wearing off on day 5, I did everything I do to prevent migraines, and I still developed an immediate headache.

RA is not usually considered "terminal" but it does shorten lives and my case... The numbers are very bad and my response to treatment has been mediocre to terrible. I have not been fully off steroids for more than a few months in 4 years.

This is not a request for money or fundraising. I'm blessed to have a secure home and double insurance. I'm not alone. I have a supportive spouse, caregivers who knows how to quarantine properly who take my health seriously, and most of the adaptive equipment that could possibly do any good and a source for the stuff I don't have yet.

What this is a request for is to take yourself and your health seriously.

If a doctor doesn't know why you are having symptoms or the treatment doesn't help, it's okay to say, "if you don't have an answer, please send me to a specialist."

If you think you know what might be the problem, challenge them to rule it out.

If they ask why you want the diagnosis, say, "obviously I don't want to be right, but I'd rather know what I'm dealing with so we don't try to treat the wrong problem." (The albuterol was probably dangerous given what it does to heart rate and blood pressure, with the massive clots.)

It may help to act a little bored by it. "I know this might be nothing but given my risk factors we don't get to guess."

They only get to decide it's anxiety or depression when they rule out more life threatening causes. I have both, partly because of, you know, The Medical Trauma. But sometimes something being seriously wrong will have anxiety or depression as a side effect. Most of the people I know with RA had new anxiety months before diagnosis.

The thing I heard the most?

"Oh, you're too young for an embolism!"

What they didn't know is that at the time I had two genetic risk factors on top of the pills. I now have several additional acquired risk factors. But the science wasn't there yet, and I had not been diagnosed yet.

I'd had four embolisms before we learned about the second genetic issue that makes me particularly likely to have multiple embolisms.

There's no tidy ending. One of my many health issues will probably get me sooner or later. I had to break it to my kid the other day that yes, I've been such his whole life and it's not looking like it's getting better but it's only getting worse slowly. He has no memory of me well. Sometimes I think I have no memory of that, either.

[pro-birth]

Fertility awareness is often used as a tool by trained health care providers to pinpoint the cause of reproductive issues and resolve them without use of synthetic estrogen/progesterone (aka, what many birth control methods contain). I know far too many women who were given BC and no other option, despite having health complications that contraindicated it’s use, or wanting the issue fixed instead of covered up by a pill or other birth control device. Because that’s what BC does for health problems: it might relieve symptoms, sure, but it never truly heals what is going on. It never sets the foundation to require health care systems to value our bodies as they are.

Some women prefer birth control and that isn’t the issue, but fertility awareness definitely has a place in women’s medicine, especially since many are frustrated with BC being their only option given. These fertility awareness based models of care offer medical, surgical, and sometimes herbal/natural options for healing, but the best you can get at a majority of OB offices is BC. That’s it. (And then there’s the issue of some bc methods preventing implantation, but I’ve already discussed that so moving on—)

It’s not just about being able to become pregnant — it’s about the fact that ovulation and menstruation, when healthy, have a huge impact on the wellness and health of women, and it’s not something to treat flippantly. To reduce rates of cancer, mental illness, chronic pain, sexual dysfunction, etc, we HAVE to look at our biology and realize that it needs certain types of medical care to function in a way that benefits our short term and long term health. Our biology isn’t useless if we don’t have babies, our biology deserves a range of options for health care because our ovaries and uteri and other organs!!! Are a part of us!!! And have benefits to offer outside of pregnancy if we keep them healthy!!!

Seriously, I have yet to see people fighting for men to prevent ejaculation through suppressive artificial hormones because they “only need sperm if they want to be dads anyway.” Uh, no, in fact, one of the things a doctor will ask a man is if whether he has trouble getting erect or if he has nocturnal emissions. Because his functioning gonads is considered a sign of health worth protecting for reasons other than reproduction. And if they aren’t functioning, he isn’t offered potent hormones to “regulate”/suppress the sperm-making process: he’s given actual medical or holistic help! Why is it that for women, we can’t be given the same treatment? Why is it that our fertility health isn’t considered good enough to support regardless of whether we want kids? Why can a man be proud of his erections and semen yet women are expected to either renounce their biology as a problem to deal with or only respect it if they want kids?And even then infertility treatments in mainstream medicine are subpar?

And the worst part is that fertility awareness and it’s branch of medical care has been around for decades...yet it isn’t mainstream or well understood because of the monopolized hold that birth control and it’s ideology have over women’s health. Seriously, the maker of the Mirenda IUD has tried to argue that it’s healthier for women to not menstruate through forced hormonal suppression!!! Uh no!! Wtf!!!! Women’s bodies are not broken just because they ovulate and gestate and menstruate and lactate! Fuck the narrative that we are imprisoned by our own bodies and our only hope is to further break down our organs instead of obtaining actual medical care!!!

This shit is so normalized, even people who fight against sexism believe this crap. I see self-loathing for our bodies c o n s t a n t l y in feminist and health circles. And it’s caused and continues to cause all sorts of medical and social harms to improvement for our health. Obviously if people only know of one option (BC) and it prevents you from crippling pain every month, then yeah, I can see why it would be easily acceptable to feel untouched by or to hate our own biology.

But why not question this? Why not question when the world says “Your organs are only useful if you’re breeding to our liking, otherwise here’s some chemicals to make your organs stop working and we won’t tell you the health consequences of it lol″??? We question and critique everything else from how men sit on the subway to air conditioning at work to taking down fucking Hollywood with the #MeToo campaign...but saying that our bodies should have access to respectable healthcare because our gonads and fertility have a reason to exist outside of babymaking is weird, or unpalatable??

I’m so sick of being nice about this, I’m sick of the expectation that I’m supposed to like or be grateful for birth control when all it’s done is make the female body less than, and done social harm for women, childbearing or not, in our culture. Seriously, birth control didn’t “allow” women to work, it made women into convenient sterile workers even after they became sexually active/married, for the explicit use of overworked industries who did not wish to accommodate for female biology like motherhood; maternity and paternity rights were delayed by decades! The year I was born was the year they finally passed the Family and Medical Leave Act!!! And even then it was still subpar protection!!! FFS!!

So yeah, why be “grateful” for birth control when all it’s done is prevent a majority of women from having options outside of potent hormones that may hurt or kill them, or taking out their whole organs with invasive surgeries, whether it’s for birth control or for healthcare? When those are the only options we are given for other people’s convenience? When it’s history and current day use is riddled with sexist and racist ideologies that perpetrate systemic problems that harm me and other women? Fuck that.

And if saying that makes me a deluded sexist, then at least my sexism doesn’t involve devaluing female biology at the expense of women’s health and welfare.

[lairofsentinel]

What can we say about the relationship between the tadpole and the person who appears in dreams?

[Baldur’s Gate 3, Early Access, Spoilers]

At a first glance, in a careless attempt, we immediately connect the tadpole with the image of the person in our main char’s dreams. One is inclined to think it is the tadpole itself asking for the host to let them in. However, after carefully watching the scene, and checking all its options... I started to doubt it.

During Early Access we only can see four dreams [video compilation of the dreams]:

The first one, in which only the voice is heard for a couple of seconds, shows a weird... tentacle-like creature? It’s not made of the gray skin of a Mind Flayer, it’s red, and unless it’s a terrible bug... it may say that we are in the presence of something different than the usual Mind-Flayer. In fact, I think it looks like a tiefling or a Cambion tail/wings (they have thorns). Could it be Raphael’s since he is red? How do we explain those boots in the top of the screenshot?. Maybe it’s a mere bug.

The second one, in which the main char awakes in that intense green garden, has a peaceful sense to it.

The third one is when that desired person in the dreams shows you an enemy you stab in self defence, and then you observe an entire city under siege.

The forth one is when you have the ability to kill that person in the dreams.

After having the second dream, we can talk about this with our companions. All of them, except by Astarion, explain that their dreams were about desire and power. About a promise. 

It's clear for us that Gale dreamt about Mystra and Wyll about Mizora. Both women are the embodiment of power and desire. We don't have a clue who Shadowheart dreamt about, but we know is a he that represents the same values. Astarion is the one who disrupts the pattern. 

He dreamt about Cazador, which is for sure the representation of power, but of his desire? At first I thought it was a twisted taste forced onto him over two hundred years of slavery. As a slave, maybe he had to learn how to enjoy the worst things just to endure it, so the incredibly wicked and twisted insinuation of Astarion being attracted to his tormentor... was surprising at first. Especially when you explore his dialogue and he shows a strong bad reaction to such insinuation. 

Thinking about it a bit more, I realised that maybe Astarion “desiring” Cazador is another thing he is forced to do against his own will. Or maybe it's the typical consequence of the vampire relationship with the sire: the childe is always attracted to their sire, no matter how much they hate them. Astarion is not even free of having his own desire due to Cazador's power, so... his dream about Cazador was another display of the control that such figure has over him. Therefore, we can say that, in the end, he is also following the pattern, but his desire is commanded by being a vampire spawn. 

When it comes to the main char, we also know that such figure in their dreams is someone they are attracted to [that's exactly what we were asked to do in the character creation part].

The tadpole in the main character's head reacts negatively to this desired person, and it’s strange. It can mean that the projection of that figure and the tadpole are not the same (Gale, are you wrong?). The figure acknowledges the presence of the tadpole and the transformation in process, and they seem to be in power of stopping it if only you let them “in”. But the presence of the tadpole is always there while interacting with this figure, uncomfortable and wanting to get away from that desired person. The tadpole feels threatened by this figure. 

At times, this beautiful figure feels like an entity proper of a demon, asking you to let it in and possess you. We know by Shadowheart’s comment that this voice appeared in her head when she was in the ship, so that we can assume it started to affect the hosts by the same time the tadpole process started.

The hag provided us the most valuable information I found out in the game. She confirmed that the tadpole has been altered, as everyone had suspected. But not only that... they had netherese magic, shadow magic (*) in it. This, however, feels wrong in terms of lore: mind flayers detest arcane magic, they believe its a corrupt version of the psionic power they have. Mixing it with their traditional birth procedure looks odd. Odd if this new experiment is only their idea. Maybe the big mind behind these new tadpoles is not a Mind flayer.

With this bit of information given by the hag, I was inclined to think that this magical compound may explain the presence of the person in the main char's dreams. What surprises me is that the tadpole wants the figure away, so how is it possible that both, the figure and the tadpole, work one against the other? If we assume that the tadpoles were altered to perform a transformation of some sort, shadow magic embodied by that figure and the tadpole should work together. However, the tadpole triggers hunger and animal instincts to rip that figure out. It feels endangered. Maybe it’s because the whole procedure is an experiment yet.

The desired figure keeps claiming they want you to help, but in the process, they also tell you that you can be more powerful and conquer Baldur's Gate [yes, despite the blurriness, it is enough to distinguish the characteristic entrance of the city].

[image from the trailer]

The last dream is one of the most disturbing ones. You awake with symptoms of your skull starting to change its bones, and apparently, the presence of the figure is the only thing which is preventing the transformation. The figure is irritated. You can ask them for help you because the parasite is going too far. The figure says that they need to go deeper into you to calm down the “animal” inside. And once more the tadpole activates a defence mechanism. 

You can indulge yourself in the desire of destroying the figure apart, and you ride the figure strangling them and killing them. The figure calls you “monster” and tells you that you deserve what's coming for you [which I assume, it's the standard Mind Flayer transformation]. The experiment may have failed in this way since you destroy the stasis.

If you resist the impulse of killing them and at the same time resist the intrusion of the figure, the figure is disgusted with you. The figure only is understandable with you when you tell them the truth about your impulse of killing them. They will state that they knew about it, and they trust you to control it while they go deeper into you. 

It’s disconcerting if the sudden hunger for death comes from the tadpole (I put my coins here) or from the figure going deeper into you. I assume it’s the tadpole because the figure will call you monster and wont be happy if you indulge yourself in that hunger. 

By the end, the figure calls you ungrateful if you resisted them once more and tells you that the next time you meet them, you will ask forgiveness. Early access allows that last dream and no more.

Hypothesis

Now, all these strange urges for murdering the figure makes me wonder if the magical compound that now these tadpole have is related to some evil divine entity, playing a role similar to Bhaal in Baldur’s Gate 1 and 2. In those previous games, you and a bunch of people were direct spawn of the God of Murder, and in a couple of occasions, you had strong urges to kill losing control of your character [and killing NPCs you were fond of]. What if... this new tadpole is an experiment combining the Mind-Flayer procedure of birth (needed in order to have a completely different body for new demi-god powers) with a divine-infused-magical compound from the shadows. What for?. I don’t know... maybe to create an army of demi-gods? [following the usual flavour of Baldur’s Gate series]. 

This procedure, if it’s as such, could allow to have god-spawn creatures without the God sleeping with mortals and waiting mortal-gestation times. xD If we follow this train of thoughts, and we believe a God is behind all this, it must be some tyrant God, like Bhaal or Bane, since the dreams are all about power and control, showing Baldur’s Gate under siege. Maybe the procedure is not perfect, since there are two different effects working one against the other: The shadow magic that infuses a degree of divinity is about desire and power, but the tadpole’s only interest is to go on with the standard Mind-Flayer procedure. 

I thought about this divinity-compound because we saw that there are third parties interested in this new particular tadpole: Raphael. What Gale says to you after his visit is a fact: if a cambion become interested in these tadpoles, it’s because there is more than souls at stakes. But all of these are specualtions. The only certanties are:

Tadpoles are not only Mind-Flayer-made.

They have been altered with Shadow Magic (weird for Mind Flayers).

The Tadpole and the figure which offers you power are different entities.

The more you use powers of command, the more these dreams come and the more it triggers the Mind-Flayer transformation.

The figure in your dreams is the only one preventing the Mind-Flayer transformation.

Conventional tadpoles only cause Mind-Flayer transformation in a week.

Extra information I found later [here]

More content of bg3 in general [here]

-------------

(*) Shadow magic is a Weave-base magic in the Forgotten Realms. It comes from the Shadow Planes connecting to them via the Weave. It's not related to Shadow Weave (an alternate Wave crafted by Shar), something I talked about when explaining some bits of Mystra [here]. You use the standard Mystra-Weave to use shadow magic, but it's not rare that users of shadow magic find some affinity with Shadow Weave. Apparently it's a type of magic strongly related to a human [Tethyrian] ethnic. Churchs of Lolth, Mask, Set, Shar, and Shargaas  show interest in this type of magic. 

[macgyvermedical]

Soup: a “Tesla + Bell + Edison + Mac” Medical Review

“You have a perfectly functional syringe pump with the PCA in the background, and you’re going to give him an injection with a metal needle? Also, if you’re gonna sedate him you might as well use the IV pump too??? Like, you have a whole ‘nother channel?? Most floor nurses would kill for that setup?” <--- From my notes on this ep.*

Awl - X-Ray + Penny - Duct Tape + Jack - CD + Hoagie Foil - Guts + Fuel + Hope - Wilderness + Training + Survival - Father + Bride + Betrayal - Lidar + Rogues + Duty - Nightmares - Seeds + Permafrost + Feather - Friends + Enemies + Border - Mason + Cable + Choices - Bitter Harvest - Kid + Plane + Cable + Truck -

In case you didn’t see it, the story went like this: After being knocked unconscious trying to prevent Codex from stealing an encoded map to a Tesla-era WMD, Mac wakes to find he’s lost certain memories of the event that are crucial to interpreting the weapon’s location. In order to recover the memories and stop Codex from getting there first, Matty calls on a friend at DARPA who studies experimental memory-recovery drugs. Drugged, Mac enters a dream state to track down the memories, where he encounters his mother, a man he recently chose to kill to save everyone in LA, his high-school bully, and a darker version of himself who thinks Codex’s directive to kill an eighth of the population to save the world might not be too far off the mark.

So there’s a lot to talk about here medically. For this post, I’ll go into the concussion and its aftermath, the drug and it’s administration, and the medical technology that the Phoenix infirmary seems to have at its disposal.

The Concussion/Amnesia:

Mac is knocked out by a blow to the head. He wakes up “a few hours” later in the Phoenix infirmary. I’ve talked about concussions before (see here, here, and here), so I’m not going to go into too much detail about them in this post, but essentially if someone’s out for that long, they’re in trouble.

It’s reasonably common to lose consciousness in a concussion, but it’s usually only for seconds to minutes, and if it occurs at all, that person needs prompt medical evaluation in an emergency room. Even if there ends up being no major complications, like bleeding in the brain or an increase in pressure in the skull, the recovery time for concussions with a loss of consciousness can be in the weeks or months range. Someone who’s out for “hours” is looking at a stay in a neuro ICU and probably severe and possibly permanent brain damage. Like, it’s a season-long arc at least.

Since we’re not seeing that level of medical need, I think it would probably be safe to assume that Mac wasn’t actually out for “hours” as stated. He could have been briefly unconscious, as shown in the house attack scene, but then had trouble forming memories after that, which caused him to not remember the ride back to Phoenix very well, if at all. These are still concerning enough symptoms that I would have taken him to an emergency department instead of to the infirmary, but at least with that scenario there’s a possibility what happened to him isn’t actively life threatening outside of a neuro ICU.

Unlike the extended period of unconsciousness, the portrayal of amnesia isn’t far off the mark for once. The amnesia that Mac suffers is actually pretty reasonable- trouble remembering the incident and the events just before it is common in head injuries, as is having trouble forming new memories after. Not only is accurate amnesia something that I didn’t expect out of Rob Pearlstein (writer of the infamous Guts + Fuel + Hope), but it’s something that fiction as a whole (including, I’ll admit, 1985 MacGyver**) tends to struggle with. So kudos for that specific part of this episode, Pearlstein.

The Drug:

Even if we assume Mac wasn’t unconscious that whole time, the brief unconsciousness and memory problems indicate that he still had a pretty significant concussion that needed medical care and monitoring. I’m guessing that as advanced as the Phoenix Infirmary is, it doesn’t have the capacity to do neurosurgery or intracranial pressure monitoring. That means the Phoenix medical team’s priority in this situation would essentially be to catch any major, life-threatening complication as early as possible, and if one happened, get Mac to a hospital quickly enough to save him.

The best and lowest-tech tool they have to this end is repeated mental status exams. Mental status exams have the patient answer a series of questions like “what’s your name?” “what day is it?” “where are you right now?” “what happened to you/why am I asking you these questions?”  followed up with a series of mental tasks like counting backwards from 100 by 7s or making a logical decision based on a given scenario. If Mac’s answers significantly change, from one assessment to the next, that could mean he’s in trouble. 

Because these assessments rely so heavily on Mac’s ability to answer questions and perform tasks accurately, and they’re really the only thing that’s going to catch a serious problem early enough to save Mac’s life, the last thing you’d want to do is give him a drug cocktail that would alter his perception of where he is and what’s going on around him. I’ll just… leave that there.

But let’s assume that for some reason they have a non-CT way of assessing whether Mac’s about to die from a brain bleed while in a drug-induced dream state (they do appear to have limited EEG capability- can anyone tell me if this would still be helpful in the context of the drugs?). I’m not going to talk too much about the drug cocktail itself, since it was stated as fictional (so, essentially, anything they say it does it can probably do), but since they do reference it as containing DMT, I invite you to check out the erowid experience vault for DMT for stories of other people’s experiences with it.  

I will, however, talk a little about the administration of the drug. In the episode, a syringe with a needle is used to deliver the medication. Though not explicitly shown, I assume Dr. Cheryl inserted the metal needle into one of Mac’s arm veins and injected the drug.

Something that fiction generally doesn’t understand is that inserting a metal needle into a vein in order to administer medication doesn’t happen in a medical setting. Ever. The ONLY way to administer a medication IV in a medical setting is through an IV cannula- a short, flexible plastic tube inserted into a vein, often just colloquially called an “IV”:

If Mac had one of these ^^^, the syringe could attach to one of the blue and white pieces and the medication could be injected without worrying that the needle could slip out of the vein (many IV medications must be injected slowly over several minutes, and that’s a long time to hold a needle still).

Before Dr. Cheryl gives him the drug, she takes his vitals and asks him some questions, namely whether he has ever had “a psychotic break”, then, without explaining further, asks if he thinks he will become violent.

Now, it does make sense to ask someone about their psych history when administering a drug known to have psych side effects, because those can be a lot worse or more likely for people with certain psych histories. Think about SSRIs and SNRIs- they’re good antidepressants, but when given to someone with bipolar disorder, they can greatly increase the risk of a manic episode, and that possibility has to be evaluated before the drug is prescribed.

The conversation should have started with Dr. Cheryl asking everyone else to leave the room. Asking if someone has ever experienced psychosis in front of their coworkers, is not only a serious breach of patient privacy, but could also be incredibly dangerous. If Mac had experienced psychosis, but didn’t want his coworkers to know, he’d either have to lie and risk side effects without being able to prepare, or feel pressured to release that medical information and possibly risk his job or reputation***.

Then she’d ask something to the effect of “have you ever been diagnosed with a mental illness, been hospitalized for a mental health reason, or do you take any medications for a mental health problem?” And if the answer to that question was anything that would make the drug particularly dangerous to him, she’d probably tell him the risks and her assessment that it was a bad idea to proceed.

If there was no other option for some reason (I’d argue not the case in this situation), she’d tell him what the risks were, and only then would she possibly have to ask if he knew he might become aggressive, at which point they’d come up with how he’d like her to handle that possibility.

I know it’s not quite as snappy, but I would have really liked to see it.

Plus, unless it’s been asked off screen, Dr. Cheryl hasn’t asked him if he has any other health problems, if he takes any medications, or if he has any allergies, all of which could significantly impact how safe this drug could be for Mac.

Phoenix Infirmary Medical Tech

Now let’s look at some of the bits and pieces in the background of the episode. Particularly, I wanna talk about that chair, the IV pump, and the monitor.

So, chair first- it’s a dentist’s chair. It’s good for dental things and maybe some minor procedures (we have a slightly different chair in a doctor’s office I work at- we use it for things like implanting birth control, removing warts and moles, and providing wound care), but it’s not great for anything else. It’s especially not great if you have to sit there longer than a half hour. Considering we know from previous episodes that they have a full-on hospital bed somewhere at their disposal and possibly a couple of carts (narrower beds you see in the emergency department), I gotta say it makes literally no sense to put the guy who’s unconscious from a head injury in the procedure chair.

Next, the IV pump

We talked above about administering medications “IV push”- a medication “pushed” through an IV by a syringe, one dose at a time. Another way to give IV medication or fluids is via an IV drip or “piggyback”- the medication is diluted in a bag of saline or other IV fluid, and set to continuously run into a person’s IV. These are nice for doses of IV medication that have a lot of volume (like IV antibiotics) medication that wears off quickly and may need constant adjustment (like some kinds of sedation or some types of pain medication or medications that counteract shock), or just straight up IV fluids.

IV pumps control how fast the medication or fluid goes from the bag into the person. You can vaguely control this without a pump using gravity, a drip chamber, and a roller clamp, but if you need to know precisely how many milliliters of medication/fluid per hour is getting into a person, and you didn’t start your nursing career in the 1970s, you need a pump.

The one pictured above specifically consists of a central computer box (colloquially called a “brain”) where the pump rate can be programmed, flanked by interchangeable modules that each do a slightly different thing. The modules on the pump in the episode include an infusion pump, which essentially just pumps fluid from a bag hanging above it into a person, and a PCA pump. A PCA pump holds a syringe of medication (usually pain medication) and delivers a dose of it when the patient presses a button.

Honestly I think the whole things is just chillin’ in the background making the room look medical-y, but they really could have used it to continuously administer the drug or the sedation if they’d really wanted to incorporate it.

Side note, the modules are actually kind of heavy, so you have to balance them a little or the whole thing kinda tilts (see the screenshot from the episode). Also, for some reason if you stick an infusion module on the same side as a PCA module, the brain won’t recognize it half the time. Not sure if it’s a feature or a bug. Below is how someone who has ever once used one of these things would have set it up:

The other thing they have in the episode, and the last thing I’ll talk about before I let you get back to your life (I’m sure your cat misses you by now, mine sure does), is the monitor. 

I read several user manuals for this (real) monitor system in preparation for this post. I’ve concluded that it’s way, way above my med-surg pay grade, and usually used in operating rooms by anesthesiologists to monitor sedation level (so at least in theory they could be using it correctly? I’m as shocked as you are, really). I don’t even know what half those numbers mean (beyond the SpO2, heart rate, and respiratory rate), more than just being able to say they (surprisingly) do actually reflect real monitoring options on this thing. This leads me to believe this may be some kind of weird product placement thing? As if the gratuitous use of the Toyota backup cameras weren’t oddly forced enough.

Now, beyond the fact that this is a wildly high-tech, completely overkill machine for what is happening in the episode, the thing I would like to impress upon you is that regardless of the high tech-ness, every line on a monitor requires at least some attachment to the patient. Something measuring an EKG requires at least 3 leads on the patient. Something measuring oxygen saturation and pulse requires a clip on an ear or finger. Something measuring blood pressure requires a blood pressure cuff. Something measuring temperature usually means a probe somewhere the sun don’t shine. Mac has two little leads on his forehead. That is actually hilarious. He’d be covered in wires. He would have so much adhesive stuck to him.

In case you’re wondering, the heart/lungs/brain/person outline picture on the monitor just tells you how each part of the body is doing- like, the brain will turn yellow and then red if something starts going weird with the brain-related monitoring, same with the heart and lungs. It took an insane amount of searching to figure that out. I’ve been writing this post for 4 days now.

 *I had a much longer and rant-ier intro to this but I feel like I’ve complained enough on main about how the reboot dumbed down and politically neutralized an extremely opinionated and hardline character. I do really like this show, and the storylines are really interesting, but I need you all to understand how science-based and politically charged the original one was, especially in later seasons. You had such a platform for good here, CBS, and I’m hoping against hope the generic-action-show it’s become was some kind of weird, collective misunderstanding and not a censor problem. My main problem, having finished writing this post, is that he looks really weirdly good for someone who was unconscious with a head injury and then subjected to what was another few hours unconscious and hallucinating. Like, his shirt is still tucked in. Great update to the theme song, though.

**Twice. They played the bourne-style-amnesia storyline twice.

***At this point I can only recommend you watch the 1985 MacGyver Season 7 episode “Obsessed”- it’s a ridiculous-criminal-plot episode but the undertones are all anti-ableist (both criticizing the Phoenix Foundation board of directors’ ableism in assuming Pete is no longer fit to do his (desk) job after he loses his sight, and the pressure Pete himself is under to let MacGyver go because of mental health symptoms).

[dxmedstudent]

I’ve been on nights for the past few days, so my few waking moments have been inundated with angry messages from friends and family about the furore surrounding Dominic Cummings right now. UK politics is in a weird state. For those not in the know: Mr Cummings is an unelected advisor to the UK prime minister. He’s widely thought to hold unsavoury views. When his wife came down with coronaviral symptoms, he drove their family hundreds of miles to his parents’ estate - this much has been confirmed by him. His official excuse was that this was to ensure childcare in case he and his wife couldn’t care for his child. However the rules are clear - no unnecessary trips. People are to stay at home. People with symptoms are especially to self-isolate and aren’t even allowed out for shopping let alone travel. The elderly must be shielded: so children are not allowed to be foisted on their grandparents. People are furious. Many have died at hospital without their loved ones present - because of rules surrounding self-isolating. So many healthcare workers are mad because we’ve been there having those difficult conversations with patients and relatives. So many people have not been able to be with their loved ones, or mourn properly. People are worried about all the people he and his wife may have infected along the way, and the risk they exposed their parents and the local community to. And the example that this sets. Many have struggled with childcare when they were sick - because the rules were clear that you had to stay home.  It’s been pointed out that he and his wife have family and friends in London and that if they felt they were sick enough to need help there must have been a closer option than driving hundreds of miles and endagnering the elderly. It’s been pointed out that Mr Cummings was spotted out and about in local tourist spots during this time - so he was very likely making multiple trips there, and flauinting lockdown unnecessarily. This isn’t the first time a politician has jetted off to their holiday home - in fact, our prime minister and his partner made unnecessary trips to Chequers (his country estate) under lockdown - there’s no way that’s technically necessary travel for business, and he can work and recover well enough at Downing Street. We’ve had senior advisors resign for visting their second homes, or allowing their lover to visit. It wouldn’t surprise me if a lot of politicians were breaking the rules because. But it shouldn’t be publicly accepted - when prevous people broke the rules, they were condemned. What’s infuriated people is that Cummings has been defended by multiple cabinet ministers, including the Prime Minister, who point out that anyone would look after their family.  People who should never have waded in have fallen over themselves to justify his actions. Why? They aren’t even your actions to justify!  It’s widely thought that Cummings must have a lot of dirt on people if this many politicians are falling over themselves to lick his boots. Except the rules specifically asked us to do what was best for everyone - no exceptions.  And not make exceptions for ourselves based on what was convenient for us. The rules are clear: by no reasonable interpretation could it have been considered OK to take infectious people hundreds of miles to vulnerable family members. It was not allowed to visit second homes or homes that aren’t yours, particularly from areas of high disease prevalence to those with less. Non essential trips and tourism were also not allowed. And the police are involved: senior police officials in the area where he wa alleged to have gone have demanded an investigation into his rulebreaking. People are spitting feathers because we’ve all sacrificed under this lockdown. Some people have sacrificed a lot  - many haven’t been able to attend their loved ones’ passing. Funerals have gone ahead without loved ones. Special events have been cancelled or celebrated alone - including most recently, Eid. People have gone without seeing their loved ones, including babies born under lockdown. People have been kept apart from their support networks, rendering most lives harder. I can think of all the patients who have struggled with being alone in hospital - we don’t allow visitors unless patients are critical or dying - regardless of someone’s coronavirus status in my hospital. Even when technically allowed, lots of relatives can’t come in to be with their dying loved ones because they need to be shielding. So many people have limited their lives a lot during lockdown, and so many people are going through a hard time. So I can see why people are really, really mad. My friend has just had a baby and some pretty severe complications - imagine how she felt struggling alone under lockdown without family to help with her firstborn after a complex birth. I know people with kids who would have loved support when they got sick. A lot of people now feel that it’s one rule for the rich and wealthy, and another for everyone else. I can see why it’s left people feel incredibly frustrated - because they’ve followed the rules and voluntarily given up lots of freedoms to help the vulnerable. Only to find that not only are politicians breaking the rules, but they are falling over each other to justify why it was responsible and absolutely the right thing to do as a loving family member - thereby painting all the people who followed the rules as callous, uncaring, and ignorant of the rules. We can’t pick and choose the rules - that’s not how things work in a pandemic. If all of us take risks, the chances of us actually controlling this disease get a lot smaller. For example, the rules don’t allow me to see my boyfriend. Well, now they allow me to walk past him at 2m in the park like some Austen-esque charade at propriety - but we can’t actually be together in any meaningful way. He lives alone, so being with him would affect few people - and if we lived together he’d have to take that risk - so the rules keeping us apart feel silly. But we respect them nonetheless because the lines had to be drawn somewhere, and meeting people outside your household does technically increase risk of spread. The rules also don’t let me see my family or friends - the risks in these cases are greater so I feel much more justified in following the rules in this case.  But you don’t just follow rules when it feels risky - you have to think of others and follow them even when the risks are lower - because they aren’t zero. Ultimately I fear that exploits like this have critically weakened the message of the lockdown - that we have put rules in place that are there to protect everyone, especially the most vulnerable, and that all of us need to follow them. No, we can’t make special exceptions for ourselves or what we feel might be most convenient for our own families. Because that would put others at risk.

[twodogsoneguy]

I went to bed around one am today. Athena woke me up again around two, vomiting. I called the vet hospital to ask them about it, and about when she’d had her last antiemetic. They said that her last shot had been Saturday (lol) after admission and that it was very normal for her to have vomited bc of how long it had been. She should’ve had another pill at three yesterday afternoon so twelve hours later it makes sense that she’d puke. Puking is a part of renal failure; I don’t know exactly why but it’s one of the things taken into consideration about when euthanasia will be the correct course of action. If the dog is vomiting frequently and cannot keep down fluids and food, quality of life has decreased enough that euthanasia is probably the correct choice, however if controlled with medications you can kinda wait.

I’m trying to wait until this weekend for her euthanasia, though I don’t know if I’ll be that lucky. My mother is having surgery tomorrow, and will be in the hospital until Friday. Athena has been such a blessing to her as well, and I would love for her to be able to share in her euthanasia, however both of us have agreed that Athena’s comfort and quality of life comes first and if she declines majorly before my mom can come home we will go ahead with the euth at the best possible time.

I guess I wanna take the time on this post and talk about at home euthanasia. There’s not always a service for this, though sometimes vets will travel to your home regardless of whether they participate in a service or not. At home euthanasia is more difficult during the pandemic, though my local service is still providing this option.

There are several benefits to at home euths. First, your pet will be in a place that they are already comfortable with, and you can usually pick a spot where they will be the most at peace while they pass. It saves you the trouble and heartache of traveling to a clinic and the logistics of getting your pet transported because there are no ambulances for animals. Performing it in your own home is often easier on you as well. Another benefit not often talked about is that if you have other pets in your home, they can either witness the passing or be allowed after your pet has passed to investigate the body and understand what happened. There is also often more dignity and compassion in home euthanasia, your pet will pass without having to go through an intake at a clinic or veterinary hospital and you can have them when it’s best for you, rather than on a clinics schedule or as a last minute emergency. The service that will be taking care of Athena also provides resources for grief and mourning your pet, as well as suggestions of local resources should you need them. In addition to all of these things, like with any euthanasia there are many options for your pets aftercare, from home burial to cremation and urns and mementos that memorializes your pet.

I have personal experience with at home euthanasia already; it was how we helped my parents dog over the rainbow bridge last year. She was very old, around seventeen if the estimate of the shelter was correct, and her mobility had decreased to the point where she had very low quality of life. She had a very peaceful passing in our living room, surrounded by her family and after having lots of yummy treats. Afterwards, we were able to allow both Athena and Harley time to see her and understand what had happened to the matriarch of their little pack. It was so beneficial to both of them, while we did see grief symptoms in them, they seemed to fair better in terms of anxiety and confusion and moved on in a more relaxed way. We opted for her to be cremated alone so that only her ashes would be in the container we received. We also had them do clay imprints of her paws, which are a sweet keepsake to remember her by. We opted to not get a fancy urn for her, given that at some point I hope to bury her on my own land. There’s is something to be said for being able to watch your loved one die in the comfort of your home; I’ve also done euthanasia at a hospital and while they did everything they could to make the dog comfortable and the process as easy as possible, it hurt a lot more because it was a strange environment and you could tell she was stressed because of that in addition to her condition.

With Athena I plan to do similar things as we did with my parents dog, I will have her cremated alone and get paw prints done. I also am going to try and get an ink imprint of her paw so that I can have a memorial tattoo done when time and conditions permit. Her euth will be slightly different due to covid, we will have to practice social distancing and rather than being in our living room we will have the procedure done in the backyard per health standards in our state. I think it’s fitting though, to have her pass in her favorite portion of the “house”. She has spent countless hours in the backyard, watching the birds and the squirrels and bunnies, soaking up the sun in the summer and rolling in the snow in the winter time. I’m going to try and plan for an evening time, because the light is perfect around that time this time of the year and I want it to be as nice as possible. It’s hard to talk about these things, but I think it’s important that we start to destigmatize the conversations we have around death, dying, and euthanasia in our pets because so many people don’t know about their options and how they can help their companion pass with dignity and grace.

I will try to post more updates as we go along, though I don’t know if I’ll be able to keep up or if I’ll be in a place where I can put my emotions into words. I’ve come to terms with the fact that Athena is dying and that there really is nothing we can do except keep her comfortable until it’s her time. Renal dysplasia is a killing disease because the kidneys are malformed from birth, though you can’t always tell. These dogs never have good values in their lives, though they often tolerate the condition for a year or two before becoming very symptomatic. The fact that Athena is 2yr 7mo is a miracle, most renal dysplasia dogs have onset of symptoms much earlier and pass at around 18mo. I am so grateful for the time we have had together, and that I will be able to keep her comfortable up until the time becomes right to help her pass on. I going to miss her so much though.

[nirhauma]

Medicine shortages have been a massive problem in Europe during the past year due to manufacturing issues that started in Asia. Hormonal contraceptives and hormone replacement therapy drugs have been in particularly short supply with dangerous consequences for people like me.

I don’t need contraceptives for birth control (my partner has taken care of that) but because I have von Willebrand disease which means that my blood doesn’t clot properly. This brand is literally the only one that I can use. I’ve tried different types of progestogen-only pills and have always ended up with ovarian cysts which have ruptured twice and let me tell you, that shit hurts and is also dangerous if they start bleeding. A hormonal IUD is also out of the question because of this. I don’t normally have migraines but I’ve had an episode of migraine with aura symptoms while taking ethinylestradiol so therefore they’re not recommended for me either. That leaves only three different brands with ’natural’ (a wrong and disgusting word when it comes to science but I don’t know what else to call it but it’s structurally identical to the endogenous hormone) estrogen, one of which can’t be use continuously (Qlaira), one that works for only a few cycles and then you most likely start bleeding (Femilar) – and Zoely.

Pharmacies in Finland ran out of Zoely in June and because the supply chain disruption wasn’t going away Foxy prescribed me Femilar that you’re normally supposed to take one tablet per day. Because it’s a biphasic contraceptive I’ve had to take a double dose (with only some of the pills, the ones that are pink and not red, don’t ask me to explain it) and because I can’t have pill-free intervals it means that one month’s worth only lasts 16 days. I’m very happy that I have money because for me it’s also double the price.

There was an incident a couple months ago and I had to visit a gynaecologist and I told her about my current contraceptive method. She was shocked. She didn’t know that you could use Femilar like that and thought it was ’genius’. I broke out in a cold sweat because I understood what a big fucking bullet I had dodged by having an OB/GYN husband who specialises in birth control and off-label use. If I had seen this doctor in June – or anyone else in Finland, apparently – they would have given me ethinylestradiol or an IUD because of the lack of options and I could have been in huge trouble. But I’m not. And I’m so lucky.

Today Foxy brought me a gift. 😂

672 tablets. Or actually 576 tablets the way I have to take them. I’m not going to die any time soon, at least not of uncontrollable bleeding through my vagina.

[ihaveneverbeengivenflowers]

(Not so) Random considerations on birth control methods and menstrual cycle

Although absolutely nobody fucking asked, I wanted to talk about my personal experience with birth control pills and menstrual cycle. First of all, let's catch up on how did I get here.

I started taking oral contraceptives (OC) since my mother took me to a gynecologist for the first time. The doctor made me a prescrition because I told her I suffered with cramps during my period. I was about 13 years old.

I kept taking OC every single day for the following 11 years, until I reached 24. Several doctors I passed by along these years changed the dosage and combinations of hormones I took, because each of them gave me a different bunch of adverse effects. Headache, nausea, menstrual cramps, recurrent urinary tract infections, candidiasis, vaginal bleedings... the list goes on.

During my teenage years I found out some women from my mother's family have circulatory problems, from varicose veins to venous thrombosis. There are also cases of cancer possibly induced by sexual hormones. That is: conditions that make OC, especially the combined ones, contraindicated for me. I got worried and decided to come back to the doctor and talk about another options available. The only one that was presented to me was the so called minipills, which are OC made with a single hormone instead of a combination of two. I took it for the following 5 years straight, and it seemed a good idea at the time because I've spent all my life struggling with underweight and anemia. Since the OC completelly suspended my period, I was supposed to be fine.

However, last January I had a major vaginal bleeding, even though I didn't stop taking my OC. I had terrible abdominal pains, and the bleeding continued for almost 10 days straight. Like I said, being underweight didn't improve the situation and my immune system shut down very quickly. Besides, I was having a hard time to keep up with my bills and wasn't covered by any health insurance at that time (I live in Brazil, and for those who are not familiar, things are a little bit different here. Theoretically we do have a public health system, but in real life we can't barely count on it and the access to the private system is kinda surreal for those living with minimum wage).

Well, as soon as I could, I saved enough money to go see a private doctor. I paid for the appointment and a several exams to find out that my bleeding was possibly caused by multiple ovarian cysts. Both of my ovaries were 3 times bigger than the normal size, and the doctor hypothesized that a big one of them (or a few) must have simply ruptured, and that the whole shit was probably induced by the fucking OC.

In summary, the doctor said I had polycistic ovary syndrome (PCOS). Plus, I should stop taking my actual OC and go back to the combined ones. Yeah, those same I was not supposed to take both because of my family history and the previously described adverse effects. He emphasized that was the only treatment available, and that my condition actually had no cure, so I should just take it for the next 30-40 years until I’d reach menopause, while praying for not having cancer or thrombosis or embolia and... well, to die of something else not related with OC.

So, well... I quit. I smiled and waved to the doctor and left the office. I was about to turn 25 and I decided I wasn’t going to take it that way. Now that you’re up to date in the story, let’s move on to where I was really trying to get with this post.

Please note: I ain't no gynecologist nor physician, but nowadays I’m a post-graduate health professional with a couple years of clinical practice. And I think I’m allowed to apply the little knowledge I acquired during 7 years (so far, still counting) of higher education to see through this situation with a tad of criticism. Not only regarding my own case, but regarding the doctors’ position when it comes to women’s reprodutive health - at least in my country. Therefore, let’s consider some key points:

Is there a real need to prescribe OC to young girls aged 13 years or less just because they come to the office complaining about menstrual cramps? During the period the lining of the unfertilized womb is being shed through the vagina. It involves muscular contractions, so of course it might get painful. There’s nothing abnormal about it, so why purging it like a plague instead of teaching them that’s a physiological process and how to relieve the pain in case it happens? Nutritional counseling, physical exercises, simply using a hot-water bottle or even taking an occasional painkiller can totally solve the problem.

The primary aim when taking OC is expected to be, should be, birth control. Yet, they’re frequently prescribed to girls that don’t even have an active sex life because of light acne, oily skin, menstrual cramps and/or intense menstrual flow without any further clinical complications... or just because. You might take it as some conspiracy theory, but you know what it looks like to me? Creating a very profitable market for pharmaceuticals. And nothing more. If women get sick and end up developing cancer or whatever, even better, so more drugs (way more expensive ones) will be sold.

In fact, there are another treatments available for PCOS. But it seems doctors are too lazy, or too comfortable in their position of filling a single standard prescription, that they completely ignore any alternatives. Can you wonder why? Maybe because it requires a minimum of health and sex education, and that takes time. How are they going to be able to attend people in less than 5 minutes if they’ll have to talk to their patients, right? Simply doesn’t worth it. Anyways, again, alternatives include acupunture, homeopathy, phitoteraphy, dietotherapy throught nutritional counseling and regular physical activity. Each case is different, but keep in mind: OC aren’t the only way, indeed, literally speaking they’re not even a treatment because they don’t treat it.

Opening a parenthesis: of course there probably are exceptions and good doctors no matter where. But doctors at public health system are in general unsatisfied with their working conditions and environment, while doctors at the private system usually are anything but well paid by insurance companies. In overall terms, the more academically qualified the doctors get, the less prepared for attending real life demandings in developing countries they are. Also, the less willing to work in such places they are. (If you’d wish to read more about it, I highly recommend seeing Chapter 5 - An example of a paradigm and its social conditions: scientific medicine of La construction de sciences, by Gérard Fourez.)

Still on PCOS topic: first of all, having multiple cyst on one or both ovaries doesn’t necessarily mean PCOS. PCOS, as a syndrome, means there are multiple criteria that need to be fulfilled for closing the diagnostic. In this case, criteria involve imaging exams, symptomatology, clinical and biochemical evaluation. In my case, for instance, PCOS is a diagnosis that simply doesn’t suit my medical history, but no doctor has ever bothered making an anamnesis. I’m not trying to say anybody should go to Dr. Google’s opinion (seriously, don’t), but look out for more information than it’s given to you at the office, even because often none is given.

I know suspending the menstrual cycle can make life much more easier. No worries about pads, unexpected leaks, cramps, PMS etc. But take it from a different perspective for a second. There seems to be a lot of content over the internet nowadays about body positivity, empowerment and tons of so called movements of deconstruction of established paradigms in our society about feminility and feminism. I’ve seen a lot of girls online sharing their experiences on stopping taking OC etc. I don’t know how far it’s good or not, but there’s a point that can be taken from all of it: the menstrual cycle is a natural part of every woman’s reprodutory phase in life. It’s not disgusting, embarrasing or whatever nonsense we’ve been told. And it can be a good way for us to conect with ourselves, to listen to our bodies. Observing symptoms such as pain, fatigue, cravings, emotions, sex drive; checking on cervical mucus, body temperature, hours of sleep... all of this can be part of a daily self-care routine and, moreover, be useful to birth control.

Talking about birth control: I’m genuinely surprised on how much the doctors whom I interacted during my life underrate condoms as a method against unwanted pregnancy. They say out loud that it’s not safe and, unless the conspiracy theory about selling drugs is real, I simply don’t get the reason why they do that. In first place, this is bullshit because condoms are a very effective fisical barrier that prevent even a single spermatozoid from swimming along the vaginal canal and straight up to the womb. Second, there’s no 100% safe method except for sexual abstinence; not even OC + condoms (theoretically not even tubal ligation) are 100% safe, since the human body isn’t a static machine and everything is prone to error. So, yes, opting for non-pharmacological methods of birth control instead of synthetic hormones can be valid.

Obs: condoms work as long as they’re properly stored, used and discarded. But the same can be said about OC and any other contraceptive methods. And, important: choosing a contraceptive method involves not only statistical data on the margin of error of condoms and pills, but also individual phychossocial aspects. In other words: a determined method might not be the doctors’ first option and they might not personally like it, but they can suck it up and use their fucking knowledges to find the best alternative for you.

Again, I’m not trying to encourage you anybody else to contradict their doctors. However, I think that questioning is part of a healthy and constructive process. First because doctors are human beings, therefore they’re as prone to error as anybody else (or even more due to long working hours). Second, because they’re supposed to be the primary source of information for any questions you might have about your own health. Third, because I believe with all my heart that the relationship between health professionals and their patients must include, if not be based in, trust.

[mingethemerciless-blog]

The trials and tribulations of minge.

I’m a very scruffy person, when I was 13 I went through the usual teenage trial of having my teeth straightened, they had to take 4 molars out because they were pushing the others into such bizarre states of wonk that the orthodontist barely knew where to start.

I wore those badges of adolescent awkwardness for near enough two years. My friends all came out with american style smiles. Mine, although slightly straighter, remained resolutely, stereotypically british and scruffy.

Twenty years later I was walking at a smart pace down the track to the bus stop. I had washed and styled my hair, picked out an outfit which I hope said “responsible” and “in full control of her mental faculties” By necessity it included a slightly impractical maxi skirt, but I had learned over the years, that this was the best uniform for my current endeavour.

On the bus my reflection in the window told me that my luxuriant shiney bob had inexplicably flattened in places where I needed volume and frizzed up at the points where I had taken hours to smooth it out, the former gelam now looked distinctly greasy.

I fiddled nervously with my hair and the collar of my shirt until I arrived at the hospital.

This hospital is where I was born. Sitting at the top of a hill, it has one of the best views over the city that I have ever seen. I stared out of the window and almost calmed myself down, this might be the last chance I got to convince these people to help me...

My name was called, I shook the doctors hand.

“I hear you’ve been having some trouble with your periods” he understated.

Since the age of 23 I have been winning awards, if only in my own mind, for “worlds longest period” and “most blood lost without fatality.”

I launched into my unflinching and well practised description of the ping pong ball sized blood clots. The time one fell out of me in the shower and was so huge and heavy I was convinced I’d just given birth to an alien, I picked it up to check if it had a face, bits of it fell off and clogged the drain. I calmly recounted the years and years of seeping dread, the fact that I hadn’t gone swimming, worn white or finished a meal without a sickly slug of feroglobin in years.

I wasn’t scared any more, Cancer had suggested itself in my mind on and off for several years, but, as a nurse once blandly put it: “If it was cancer you’d be dead by now.”

My mind was throwing out tendrils of thought about my other dread. Pregnancy. When I was 18 I calmly accepted what I was told when I said I didn’t want children: 

“You’ll change your mind” they would say in a funny sing-song way.

 I’d probably want them when I was a proper adult, say, 25 years old.

25 came around, I was in no way a proper adult nor did I yet want children. No problem, there was plenty of time for me to want them, I’d just think about it a whole lot and then I’d want them.

30 came around, and I could no longer deny, the thought of pregnancy repulsed me. To be a host body to a parasitic bundle of flesh, to have my blood drawn away from me and into this other being. The idea of my cunt tearing open, a living thing coming out of me. A living thing with my weak jawline? With my scruffy hair? What if I didn’t love it? What if it turned out to be as intolerable a little shit as most of the children I’d ever met were? What if it grew up and went on being an intolerable little shit...come to think of it like most of the adults I’d ever met were?  What if, instead of doing something which changed the world for the better, it just became another consumer. Oh god what if it voted for Rees-Mogg? What if that apocalypse we’ve been promised actually happened and I had to raise an intolerable little shit in a cave whilst fighting off mutant tories and puerperal fever?

A more realistic and terrifying thought was never far from my conscious mind: What if I was raped? What if an abortion was too traumatic or, in the sadly likely event of an NHS sell off, too expensive? What if the current trends continue even further and an abortion was simply unavailable? Would I find someone clean and steady handed enough to do it on the kitchen table? Could I find the right hedgerow ingredients? Would I survive that?

“Do you want children?”

I was very glad that this came up.

“Definitely not, in fact I’d like to ask for a tubal ligation.”

“That won’t help with the bleeding”

“I know, it’s a separate issue, but I think it’s relevant…”

On the young man's face I saw faint hint of the bemused horror I’d seen on my GPs face when I had first asked, almost the beginning of a nervous laugh, although none had gone so far as to laugh at me yet…

My GP had looked at me the way teachers would look at me when I told them I’d lost my library card or forgotten my essay. Faux shock, the kindly-meant disappointment of a grandparent seeing you make a youthful blunder. His voice had come out with just the merest subtle hint of a condescending laugh in it when he told me he could refer me to a specialist but it was unlikely they’d give “someone like you” such a “drastic” operation.

Someone like me? Scruffy? Irresponsible? Disorganised? 

And how was maintaining my personal status quo drastic? Surely having to fire a fully dependant, sapient life out of my pelvis was far more drastic than just...carrying on as I was?

In any event, none of the appointments that GP had made had referenced my desire to get the snip, almost as if he didn’t even write it on the request he sent...

The current gynaecologist shook off the uncanny look he had given me for asking the forbidden question and asked if he could “scan me” Oh great, another date with the dildo-cam…

I’ve had this scan done so many times, my cervix is directly connected to the pain centers of the brain, one mere prod and all hell breaks loose in my nerves, it’s no good telling doctors this, they adhere rigidly to the “some women experience discomfort” school of thought.

The young nurse was wonderful, allowing me to squeeze her hand when the probe swept over my diva of a cervix and white stars of agony danced on the ceiling above me.

“You have a very large ectropion on your cervix, it’s probably causing a lot of the bleeding”

“Yes, I’ve been told that many times…”

“Hmm, we could get rid of this ectropion with silver nitrate, it might help stop the bleeding?”

Holy shit, you mean there was a way to get rid of that thing all along?!

I consented as calmly as I could.

The next thing I knew he was jabbing my insides with chemical soaked lollipop sticks, but I was more than willing for this to happen after 10 years of inaction and casual shrugs at my wayward cervix.

I was told to brace myself for “gritty discharge” as bits of burnt cervix dropped out of me along with all the other nonsense going on down there.

Later, pants back on, veins blossoming with green bruising from the “hormone level” blood tests, my innards were laid out in bland yet descriptive medical descriptions.

My womb had a “septum” which immediately made me think that it had a face, a scornful, angry face I would dearly love to punch for the years of ruined underwear, bedsheets and dates.

My right ovary was polycystic,

“This can lead to diabetes and heart disease later in life so you’ll have to be wary of gaining weight…”

My body type is made up of circles, I have rounded hips, boobs, thighs and face, when I was younger I worried briefly that I was chubby, but I was active and I ate well, I could still see my ribs and I could power walk up the hill to my house without so much as a sweat. I gave the doctor a blank look, he still hadn’t discussed my tubal options yet...

The doctor now took on a slightly lower, more cautious tone, evidently more scared of upsetting me with this next information than he had been by talking about my weight.

“You may find it slightly harder to get pregnant...but it’s by no means impossible”

I did a double take. 

“...That’s really not a problem for me...what with the tubal ligation request and all…” I hinted cheerfully.

He made a neutral sound and moved on with a list of my uterine shortcomings.

My left ovary was “very mobile” (my mind gave it a beard and a bindle stick) and showed some evidence of endometriosis.

“I’ve never had any symptoms of that…”

“Again this can lead to some minor complications in conception and pregnancy…”

Was I speaking klingon? Was I mispronouncing “tubal ligation”? Was IVF so much cheaper than the lady snip that they’d rather I reproduced despite my clear desire not to do so and regret an actual living human?

“You have some signs that there may be polyps in your uterus, that’s not harmful but they may be contributing to the bleeding, in which case, we can remove them.”

I was booked in for a hysteroscopy, which sounded painful in spite of the “some women experience discomfort” platitude, and a review in 3 months time.

“Do you have any questions?”

I took a deep breath, I knew this was a separate issue but I had to bring this up whenever I could because there was no obvious way to request it otherwise.

“How do I go about getting the tubal ligation?”

The look of horror came back, much stronger this time, the poor sod had run out of things to distract me with, his face turned to a look of utter defeat.

“I wouldn’t even consider doing that until you had exhausted all other contraceptive options and had fertility counselling, have you considered the mirena coil? It’s progesterone only and most women find it very good…”

My mind flashed back to the last “progesterone only” treatment I’d had: Migraines had hidden the worst of the symptoms for the best part of 6 months, by the time they were under control again the real problem became tragically apparent. My sex drive was so low that I could barely tolerate a hug, in desperation I had the little plastic rod dug out of my arm with a scalpel, but my libido never fully recovered, don’t try telling me the effects aren’t permanent…

A further flashback to the copper coil. The way it dug itself into the side of my womb, the way it hurt, exactly how much and how long it hurt for, How there had been no one in my local GP surgery willing to remove it for me (grab the string and pull, I refuse to believe that this requires a specialist qualification on top of medical training.) The serious thought I gave to yanking it out myself, only stopping when the prospect of a torn cervix put me off. 

A rich history of contraceptive pills danced through my brain, mood swings, swollen boobs and most memorably a migraine so bad that I called NHS Direct and was told to monitor myself for signs of a potentially fatal brain haemorrhage...

The time they’d tried to stop the bleeding with anti-inflammatories and discovered my allergy to this group of medications when I broke out in a measles style rash.

Those memories don’t blur with time, at least they haven’t yet.

“Statistics show that you would regret being sterilized, you don’t have a family”

For a brief second my imagination took me to an episode of The Twilight Zone. I don’t have a family? Shit! What happened to them? My siblings? My partner? My parents? My friends?

The anger when I realised what he really meant seeped through my mind like a blood clot through a pad.

“You don’t share DNA with anyone who came out of you therefore you have no family”

“You haven’t had to push your family with your pelvic floor therefore they don’t count”

“If you eventually decide to adopt that won’t count either”

“Everyone you currently live with, love and rely on will reject and abandon you because you didn’t give birth to them.”

Blood clots, along with anger of that magnitude tend to flood the sanitary pad or mind.

Luckily, I have had years of practise at crossing my legs and trying to discreetly aim my crotch at the driest part of the pad. This, in effect, was how I ordered my mind at that moment.

“Don’t yell at NHS people, they have enough problems. The poor man was just working off a script, of course they have to be careful, one litigious malcontent could set these heroes back years…”

I left, with no clearer an idea of how to get my tubes tied and no idea why this was the first time, cysts, polyps and septums had been discovered after so many tests over so many years.

Back home I attempted to find out how much private hospitals charged for tubal ligation. “Anywhere between $700 and $10,000 depending on your insurance provider”  ecosia informed me in very american and somewhat unhelpful terms.

An inquiry to Spire healthcare yielded an unapologetic result of £3000, that’s a lot of minimum wage hours and late rent payments, besides £200 of that was for a consultation in which they might refuse me anyway. 

I wondered if those places in Turkey where they do cheap facelifts might consider my case...Would having scalpels jabbed into me in a country where I couldn’t speak the language followed by a cramped and cheap flight be more or less unbearable than a kitchen table abortion? Either way the word “botched” was never far from my mind.

When the day came for my hysteroscopy I steeled myself for another try. The gynaecologist was a lovely, calm young woman with curly hair. She spent a long time reassuring me that I was in control and could stop the procedure at any time. She told me that she would take a biopsy from my womb lining in addition to shoving a camera up where no camera had gone before. She showed me the camera. I wish she hadn’t.

“See, it’s very small.”

It was slightly smaller than a pencil. Small compared to a baby maybe. But I knew exactly how big that thing was going to feel in my stupid nervy cervix. Turns out I was wrong.

It was far bigger and far sharper and far more white hot than I thought possible. 

The nurses squeezed my hand and told me it would be over soon.

I never stopped her, I wanted this done, I wanted to know what the hell was wrong with me. I wanted to show what a good patient I was, how in control of my mind and body I was, how I would take the responsibility of dealing with sterilization without regret...

I learned just how exponential pain can be.

When someone said “This will take another five seconds” I discovered how long five seconds can feel.

I found out, to my displeasure, that passing out does not necessarily stop you feeling pain, it simply stops you moving. I learned just how wonderful the overworked and underpaid folks of the NHS really are when they brought me water and later tea and let me sit in a comfy chair and shake without telling me that they needed me to get a grip and move on because they had a full waiting room…

The results were discussed with me. There were no polyps, there was no septum, what's more, my womb was perfectly shaped to receive a mirena coil…

Sterilization wouldn’t stop the bleeding, it was a separate issue. The mirena would stop the bleeding and stop any pregnancy. Sure I’d have to have it ripped out of the most sensitive, nerve rich part of me and then stuffed back in broadside first every three years, assuming I hadn’t emigrated and the NHS was still there that is. And the progesterone might...exacerbate certain things, but that would probably settle down...

 I sighed, drained my tea and smoothed down my faithful maxi skirt. 

Alright uterus, you don’t like me and I don’t like you, but it looks like we’re in this together. Here’s another burning hoop for us to jump through, lets give these folks the show they’ve been waiting for...