#but now you are taking new meds and monitoring side effects AND managing those AND monitoring those

[dinosaurcharcuterie]

Both wife and me got a change to our medication regimen last week.

Both of us are experiencing unpleasant side effects.

They're fairly harmless and they're not the same ones, so we can still constitute one fully functioning adult if we work together, but they're still unpleasant.

[alanshee-keeper-of-realms]

Fire at Borg Industries

In honor of Ninjago Writers Day I decided to show the hardest thing I'm working on completing, this is the biggest sneak peak you'll get till I'm done! Happy Ninjago Writers Day Everyone

Trigger Warning For Medical Cpr wound and bone cracking mentions people get hurt and someone briefly is deceased also mentions of an explosion

Summary: A normal day erupts into chaos as an accident at Borg Industries Flips the Ninjas worlds upside down.

Words so far: 2,227

Chapter 1 (Work in Progress) Chaos What Else?

It had started as a normal day, there was no training since it was their off day. Zane had gone with Pixal to help with a project at Borg Industries while the others just relaxed.

That was until they got the call from the Ninjago Police there had been a massive explosion at Borg Industries, it appeared to them that the sprinkler system had been knocked offline.

They were immediate in their reaction racing to the scene not only were their friends in danger but the workers of Borg Industries needed their help as well. Now standing by the Bounties railing stunned as smoke billowed from the middle floors of Borg Industries. There was already a mass scene of barely organized chaos on the street below. 

To begin with, Kai tried to control the fires to put them out Nya right by his side dowsing the flames from above as they went to the other side of the Bounties deck they took a running start and leaped into one of the broken windows a sign told them they were on the correct floor for the Emergency control room.

Jay and Cole soon were behind them, they ran towards the room to get the sprinkler system rebooted, the team came to the doors which were blown off their hinges, debris blocked their way.

“Stand back!” Cole called out as his arms glowed orange, he struggled but managed to lift and get the beam out of the way.

“Steel beams are nasty “ he commented grimacing as they entered Jay raced over to the computer typing quickly his fingers flew over the keyboard, then suddenly, and to their relief they heard it, 

Welcome Ninja, Systems Online Fire on levels 56 through 70th detected activating sprinklers now

Now that the system was back up they could use the voice activation to locate who they needed to, 

"System locate Pixal Borg," Nya called out

Pixal Borg is located on floor 60 

"Status?" 

Offline

Immediately everyone ran out, pushing their training as they ran several floors, throwing their hoods on to try and give a barrier against the smoke.  Time seemed to slow each looking at each other as Cole broke through the door…

Mayhem greeted them, scientists, trying to help more injured comrades, one stumbled looking around

"WHERES MR BORG HAS ANY-" the scientist stopped clutching his side coughing heavily darting over Lloyd caught the man before he collapsed carefully easing him to the floor leaning against the wall which was wet from the sprinklers the Man looked at Lloyd pleading"Please Mr. Borg he needs to be located," 

"Of course sir, but we need to make sure you and everyone get help as well." Lloyd looked at the technology inclined members "Nya Jay ETA on the Crews?" 

"3 minutes, they're on the Stairs."

"Good can you stay here and help them transport down using the Bounty-"

"You guys locate Zane Pixal and Cyrus," Jay interrupted nodding as Nya went and tried to help stabilize the injured

With that they separated, Lloyd Kai and Cole ran through the seemingly maze-like hallways 

As they broke into the lab they spotted Zane lying over Pixal unconscious as if he'd thrown himself on top of her to protect his love from the blast. However, the first thing Lloyd realized was the fact Zanes injuries were bleeding

"Wait bleeding Nindroids don't bleed!?" Lloyd said out loud the thought that crossed everyone's minds

"That doesn't matter Zane and Pixal need our help!" Kai set them straight as Kai moved towards their injured comrades Cole warned

"Careful don't move them they could have neck injuries," 

Kai carefully touched the side of Zane's neck pressing to the usual pulse points a couple of moments passed then he felt it thump thump thump against his fingers,  his eyes widened

"GET THE MEDICAL CREW IN HERE" he shouted

Cole and Lloyds eyebrows rose looking confused 

"They're Nindroids-" 

Kai immediately whipped his head around glaring,

"I don't know what they were working on here, but Ninjago keeps on pulling Wild Cards... they're Human a Nindroid doesn't have a fucking pulse let alone bleed get those damn paramedics in here NOW"

Scrambling to do so as reality hit them, Lloyd was the first who touched his earpiece

"Nya, we need a med team to bring their equipment Zane and Pixal are injured"

"Roger that" it seemed to take a few moments "wait" 

Lloyd sighed this entire situation was confusing,

"Explain later get those crews here please!" Lloyd emphasized the last word slightly shaking the shock and concern setting in as the radio cut off 

Soon a group ran in Cole and Kai helping them as Lloyd went and located Cyrus. 

The Green Ninja of Energy spotted the inventor's wheelchair first, wheels bent and twisted, scanning the area he saw the man lying flat on his back a few feet away, his legs stuck out from the shelving that had fallen on him. Lloyd grabbed the shelves and hauled them off along with the ceiling plates he spotted Cyrus's glasses a few inches away he could only assume they had been knocked off his face in the violent explosion. The metal frames even looked like they had slightly melted.  Lloyd placed two fingers on the scientist's throat waiting for anything though the man's wide-open eyes staring a look of shock eerily etched into the CEOs features told him Cyrus Borg was currently dead Lloyd though wouldn't accept that he yelled over his radio set 

"I NEED MORE MEDICAL!"

He began doing chest compressions periodically stopping to check, to also breathe into his mouth do anything to help the blonde-haired man could feel ribs crack as he continued 

"Damn it Mr. Borg don't do this." He paused a split second to scream again"HURRY!" 

Lloyd continued hoping he wasn't breaking anything else inside Cyrus but if the Raven haired inventor recovered that's all that mattered,

"Come on," he pleaded as if Cyrus would immediately pop up and tell him this was all a joke, he pinched Cyrus's nose closed and breathed again before continuing compressions 

Soon though more paramedics ran in and he was shoved to the side, Lloyd could only watch begging whoever to let Cyrus come back… the man was still vital to so many if anyone deserved to come back it was the scientist, let alone Pixal couldn't lose her Father, not like this not in such a violent matter, time seemed to slow once again as the Paramedic team worked hard to try and save Cyrus Borg. 

"Still no cardiac rhythm or pulse, try again, everyone clear." The female looked around as everyone on her team made sure they were away from the body before yelling the final "CLEAR!" 

Cyrus's body arched as it settled the team converged back one doing compressions another vitals. The Female listening she sat back as they all paused as she looked at the machine. With a look of defeat and heartbreak, the head medic went to move to cover Cyrus's form, 

"Let's call it...Time of death?" She looked to her male partner who looked at his watch 

Cyrus suddenly let out a sudden gasp coughing, the monitor simultaneously springing to life with his heart rhythm strong the effect was immediate the paramedics immediately setting to work to stabilize him he looked around 

"I don't know how he came back to us, he has what sounds to be a punctured lung." The leader murmured looking shocked but ecstatic as she listened  

"Don't question the writers or First Spinjitzu Master both only know our stories." Another responded as she put a collar on the scientist's neck "Mr. Borg you're in good hands your daughter was just taken out okay?" 

This seemed to calm him as some comprehension filled his eyes before they slid shut Lloyd felt something wet run down his face he reached up to touch the streaks…. only to realize he was crying, he was crying in relief that Cyrus was alive, may not be out of the woods but he was fighting, Cyrus had given his grandfather the First Spinjitzu Master a kick in the ass and came back. He watched as they finally slid him onto the backboard and rushed him out. 

He went to check on the others he heard a commotion Pixal had sustained less severe injuries as she had regained consciousness and was putting up a fight 

"DAD!" She croaked trying to break free one arm wrapped she kept trying to get up Lloyd  ran to her he knelt beside her she met his"please Lloyd my dad " 

Her eyes now as human as his met the green ninja's own emerald green. Pixal's looked unfocused as she stared pleading the master of energy carefully took her uninjured hand trying to calm her, he did a motion he'd seen Cyrus use on her he ran his fingers carefully through her hair 

"It's alright Pixal, your father's alive okay? You need to relax please big sis before you strain your injuries."

The news of her Father seemingly finally broke through the dazed state the former Nindroid was in as she stilled; they immediately secured her. 

"There you go." He murmured trying to continue to keep her calm"We'll see you at the hospital promise." 

Soon they were lifting her and getting her to the point where the bounty and even the Ronin REX hovered. The REX took down the more serious cases so the Bounty could focus on loading as many as she could handle before going fully down to the street level to unload and pass the injured onto the hundreds of Firefighters, Police, Medics, and even off duty Nurses and Doctors who had joined into the Mayhem. It was not the most fluid of plans….but it was a lot better than trying to get over 3 thousand workers down to the ground floor using only the stairs.

Speaking of the Bounty Hunter Ronin stood on the ground eyeing the REX giving whistles as soon as he was told another was loaded when later questioned about it he'd respond with 

"I may be cruel and heartless at times, but Ninjagos my home, and I owe Mr. Borg for something unforgivable I did years ago. Not to mention ya have to be a sociopathic manic to not try and help in some capacity right now with this Disaster. I knew REX could be used to transport those injured quicker than the stairs and that's why I'm here. End of story."

When Lloyd got to the ground he looked around and helped people get from the bounty suddenly he heard the squeal of tires and looked just in time to see a car barrel towards a small girl Nya jumping and shoving her away the car striking her making the Water Ninja go flying several feet  Cole reacting a second later creating a wall in front of the Vehicle a man stumbling out yelling slurs at the Ninja of Earth not even caring that at current several Police Officers were holding Nyas Brother and Fiance from Killing him but Lighting did strike dangerously close making everyone near the man stand back

"GUYS GET A FUCKING GRIP NYA NEEDS US!"Cole boomed, Kai and Jay instantly stopped and then darted Lloyd right behind Nya already had a group of Medics around her 

"Compound fractures of the skull Pupil dilation she's still with us." One of the doctors said as the nurses did on-site emergency IVs and intubation 

"Guys please I need to go," Jay said as they loaded her 

"You and Kai go with her we will handle the Bounty and evacuation you guys just go"

The two nodded

"I'll ride behind Jay be with her ride in the Ambulance," Kai said, Jay quickly hugged Kai to show how grateful he was before turning and immediately hopping into the vehicle; they slammed the doors shut afterward, the sirens wailing, the Ninja of Fire chasing after.

The police officers had wrestled the man to the ground he kept saying slurs that made everyone wince 

"God can someone shut this racist fuckwad up?! We are having enough stress without a drunkard trying to kill and maim even more!" Another man cried out

There were jeers of agreement and finally the man was hauled off gagged and in handcuffs. Lloyd looked back towards his remaining team member. Cole had collapsed, for once looking on the edge of a breakdown. Lloyd had, to be honest, he was numb right now but knew he'd break later when it finally hit him.

3 of his team was in critical condition heading to the hospital, and they weren't alone as Lloyd looked out he saw the covered forms of those who had not made it some had people standing by them clinging to one another,

"COMING THROUGH PLEASE CRITICAL PATIENT," 

"THEY FOUND MR BORG!" One of the scientists recognized who they were rushing to an ambulance,

Lloyd watched as relief washed through all there 

"HIS DAUGHTERS OKAY TOO!"  another called out as the 2nd team ran behind 

Hugging ensued between members of scientific teams whom Lloyd had seen seemingly praying before, they were crying what he knew were tears of relief. He knew Cyrus and Pixal were much loved but never to this extent… it tugged at his heartstrings

[twice-the-twice-love]

Whumpy ideas (manga spoilers)

Not for the most recent manga but until the anime has it animated its manga spoilers to me.

So I have had an idea that could have been an out for Jin to be alive. The what if he did get handed over to the hero commission by Hawkes. Jin would not want to fail but using the fist to the back of the skull with a haymaker punch instead of a sharp feather blade would be a knock out instead of a killing blow.

But ignoring the Dabi fight for one second so it would be Dabi more pushing his limits to keep up with Hawkes as he is carrying Jin out of the mansion. If Dabi hit Hawkes at that height it would be a fatal drop for Jin too so he stays his hand and goes to find some of the other league members.

Hawkes gets Jin out of the danger zone and out to a hero safety line and instructs some of them to get this man tied down he is knocked out but this is an S class villain. Hawkes knows he might be breaking the rules slightly but to make sure the students and other heroes don't have a sad mans parade wave or a bunch of cloned nomus he breaks Jins right hand.

He can't make a duplicate of what he made on the right if he can't clone from there right? Thats correct.

As we don't know how things calm down let's say for now this little group of heroes do manage to get Jin to the hero commission. Jin wakes up strapped down like how we saw stain or All for One. Jin just sees the basics around him with a 1 way mirror and knows hes being watched. But its only him here so he holds hope the others are alive and got out of dodge.

Later on when there is time.he is wheeled in for investigations on where the league would run. They know he cant get out so they tell him who got hurt and who is alive. They can make a plea bargain for Jin as Hawkes is going to vouch for him for a decent trial despite all the damage the League has caused.

Jin laughs at them then speaks up, "I'll tell you everything."

Shit. The mask was gone, he had more peace with his splitting but that could give everyone away if he wasn't careful. The people surprised with how he was going to accept the plea bargain wait for him to speak up. Jin freezes and clamps his mouth shut, "No! Fuck this if you think I'll be the reason everyone gets hurt for a third fucking time."

They nod and remember the split mentioned and footage from the Yakuza raid makes a bit more sense.

"If you don't take the plea bargain someone else will."

They let Jin sit for a few hours seeing if he changes his mind. But Jin doesn't move his mouth a damn muscle that split could fuck over everything. The league trusted him with information. He can't screw them now. Not ever again.

A day passes and he is brought back in, "Well Bubiagawara someone took the plea bargain. Someone you know, Nemoto Shin."

To Jin the name should have been Nemoto oh Shit. That was the guy who made him and Toga blab everything and with the commission asking direct questions he can't side step things like last time. He tried to bounce his foot im the straight jacket but that didn't help he knew he needed to shut himself up no matter the cost.

He just needed to bite his tongue and not say- bite his tongue. He moved his tongue between the molars on the right side of his jaw. He squeezed his jaws shut a bit more and he could feel the nerves protesting it already. He breathed out a swear as he heard footsteps. Now or never.

He moved his tongue to the front part of his mouth and bit as hard as he could. He drew blood and felt the piece of tongue on his bottom lip. Spitting it out to the side as tears rolled down his face involuntarily he pushed his tongue out and to the right and bit down again. The molars not making as much progress as he hopped as the tongue piece was attached to him. He tasted coppery blood in his mouth.

He quickly thrashed and that got him off of where his back was held against the restraint. He had speed and force. Pushing his tongue out as far as it would go and pushing his legs back to give him room he closed his eyes and slammed his chin into the table. Another large chunk of his tongue came out.

He tried to swear but nearly puked at the tongues open nerves touching things in his mouth. He spat out more blood as it dribbled down his chin and onto his nice gifted hero commission straight jacket.

Shin and the other agents came in to see Jin spitting out more blood. He gave them a red stained smile and then opened his mouth to reveal the stump of a tongue effectively muting himself.

He thought it would be over but he heard them calmly state, "He can still write get him to the medbay."

Jin gave a wheezed laugh as he got pushed away then heard the lingering comments to Shin, “With Trigger can you make him tell the truth in any form?” 

“That I am unsure of, but to uphold my end of the bargain I am willing to try.” 

They were going to try and get him to write all the locations for the league. But to do that he had to be careful of his timing, he could bite off his fingers, see if he could impede them from getting anything out of him for a bit longer, he knew they could add limb replacements like what happened with Shigaraki, But if he could slow them down that is all that mattered. 

Jin was taking to the med bay and they patched up his tongue, he couldn’t do much else but pass out when it was plain cauterized by putting a hot piece of metal in his mouth. He thrashed slightly before unconsciousness took him. He woke up back in his jacket in his cell, they hadn’t changed the clothes and he felt gauze in his mouth that was stemming the bleeding as well. He tried to spit out the gauze and felt it remain on his face. 

Opening an eye he looked down to see he had a face guard now. Guess if he bit off his tongue they planned ahead for him. He gave a half hearted laugh to himself, his split voice yelling at him for fucking things up this badly. But he knew he was fucked well before the league, he was fucked for a long time. 

But he could still write, and while self mutilation was not something he wanted to do more of, he knew he was going to have to. He just needed to figure out how to make his hands useless without being able to bite off his fingers. Or see if he could just escape. He looked around and saw monitors behind the window if he squinted, dumbasses forgot bright lights can still almost be seen through cheap shit mirrors. 

Activity monitors, he wanted to see of what he could see rhythmic lights so he started quickening his breath to spike his heart for a second, those didn’t change much a different set of lights appeared before a body moved in front so someone was watching. 

“Jin don’t try to do anything, what you did to yourself will be a hindrance but we don’t want any more surprises, you can still lead a normal life if you hand over the league, we have all of your records.” The guard says over the microphone. 

Jin glares at the mirror and sneers as best as he can through his new mask. He hears a snicker on the microphone. He thrashes his head back and forth for a bit he feels an air bubble and hears the tubes beside him start to add a sedative to him. His chest sears in pain as he looks at the mirror and he laughs through the pain. He’ll figure something out, its their problem if they want him to cooperate. 

He can write but if he keeps any part of his hand he will make clones, he knows his measurements he can see the new tongue in the mirror even for a split second that is all he needs the image, a reflection on someone's glasses and he can get the fuck out of here. Hell he could get the rest of the vanguard squad, break out Stain. Maybe Toga and Spinner could forgive him if he brought Stain to them. 

[itsnotokbutwereallright]

Oh! Oh! If you’re taking prompts from the Drabble list, could you do a #38/39?? Or your choice!!

This rambling brought to you by writer's block, margaritas, and a sudden urge to write instead of working from home.

*****************

"I'm just tired"

"It just...hurts"

The capacity for want had been beaten out of Natalia and the other Red Room girls early. They were taught that wanting something meant it could be used against them. Money, fame, and the attention of a beautiful woman were the most common desires of their targets; the Red Room trained them to ensure the third became the only. Natalia quickly became adept at manipulating men (and sometimes women) to succeed. They were taught first not to express wanting. If a girl wanted a specific weapon, it was used against her. If they asked for an extra portion, they went hungry. And if they asked to rest, the girl never came back to her bed. Instructors repeatedly hammered into the girls that their only desire should be to serve the Soviet state; anything else was a weakness, and there was no weakness allowed in the Red Room. The girls learned not to ask for anything, and they learned to accept what they were given. 

One time, at the end of what had been a particularly bloody mission, she caught herself wishing she had more discretion about who died at her hands. She made the mistake of asking her handler why even those in their beds had to die. Her arm was broken and she was forced to sleep in a concrete cell for a week without medical care for questioning the orders she was given. It was a painful, but effective, lesson. Wishing led to wanting.

It wasn't until a man in black with a fucking bow and arrow was chasing her through Eastern Europe that anyone brought up wanting with Natalia again. When he finally cornered her in Budapest, panting against a wall with blood in her eyes and an arrow aimed at her heart, Hawkeye asked, "Do you want to hear an offer that doesn't end with an arrow in a vital organ?" She'd been planning to catch her breath so she could break his hands. The recruitment offer had sparked a pain in her chest that she'd grit her teeth against as she nodded. 

The next few days were a blur of questioning, testing, and more instances of that chest pain than she was willing to acknowledge. People kept asking her what she wanted, so Natalia did what she had been taught to do - manipulated them into giving her an indication of what they wanted and pushing that agenda forward. It was determined she was able to be released to the SHIELD base at large after only four days. When she walked into the cafeteria for her first meal outside of a cell, all eyes were on her until she slipped on a friendly mask and went through the line. The agents cautiously turned back to their meals, except for Hawkeye (Agent Barton, she reminded herself). He studied her with those cool blue eyes and a wry twist of the mouth as she sat, then stole the pudding cup off her tray. It was a game she'd been playing for as long as she could remember, and she knew better than to show a reaction. It turned that twist into a frown, but Natalia ignored it as she ate the vegetables off her plate and diverted him with asking about the various facilities. He'd want her to take an interest in her new home.

Clint would needle her into making choices between two things - pineapple on pizza or no? Milky Way or Three Musketeers? Cats or dogs? He normally did it at a time where she was focused on something else - once, memorably, as she was hanging out the passenger window trying to blow out the tires of an SUV that was chasing them through the streets of Puerto Vallarta. She'd been annoyed about that one and took it out on him on the mats - in the middle of the night, after she dragged him from his bed. Afterwards, as he lay panting on his back, he gasped out the logic. If she didn't have time to think, if he could get her brain to turn off, it became more of a gut instinct. She couldn't play off of what people wanted to hear, he'd said while side-eyeing her. The searing pain in her chest stopped her from acting on a want right then. She'd strolled to the locker room only to collapse with shuddering breaths as soon as the door closed. Natasha resolved that she would get rid of this trigger on her own. No matter how long it took. 

Six months later, she hadn't progressed much beyond smacking Clint's hand away from her pudding cups and stealing his fluffiest blanket when she came to his room. There would be plenty of times that Clint flashed that grin at her, the one so sure of itself, that she had to step back to keep the pain from showing. The smile dimmed a little, but it made Natasha work harder for the day when she could show how she felt.

A year after that, Natasha had started stealing the cookies off his tray, and was firmly team pineapple. She was able to go to him on particularly rough nights (the hospital fire, waking up to the smell of smoke in her nose and a ringing in her ears) and ask to stay - always on his couch. He didn't ask about the bed after her first vehement rejection of the idea. 

It was another six months before she could say the words to her mirror. The day that Natasha convinced herself to say them outside of her room, she walked into breakfast to find him sitting hip to hip with an agent named Bobbi - sharing a muffin. The heaving in her stomach had never been a sign of a trigger before, so she could only blame herself. Natasha dipped her head courteously as she nabbed an apple and headed back out to the gym. Stupid girl - wanting is weakness. The faintly Slavic accent couldn't be ignored, no matter how much Natasha had changed since the Red Room. They were right all along. It would just have to be packed away and ignored. She'd done it this long, she could keep doing it.

Except that she couldn't close Pandora's box once it had been opened. Every laugh, every secretive wink, every time Clint showed up to a briefing late and flushed, it was like a dagger to her heart. Natasha pushed herself as hard as the Red Room had taught her and tried desperately to forget. The risks that she took on missions became greater; Coulson and Clint side-eyeing her in briefings but unable to argue with results. And that pain in her chest became more and more frequent, until it was just a continuous pain that made her want to scream that Clint was HERS. Still she kept quiet, though the distraction of Clint and Bobbi started causing mistakes. Little ones at first that only she noticed, but they gradually became larger. When they were panting in a warehouse in Istanbul (not Constantinople, dammit Clint for singing that on the way here) it was clear she had Fucked Up. They had found temporary cover and Clint was cursing in several languages as he tried to staunch the bleeding from her abdomen. 

"What is going on with you?! You've been in black ops for as long as you've been alive! What the hell were you thinking?!"

She shook her head. She hadn't been thinking. At least, not of the mission. She'd been thinking about the slim gold band she'd seen Bobbi Morse wearing in the cafeteria this morning. One that matched the ring on the chain Clint stashed in his locker on the Quinjet before they disembarked. "I'm just tired."

He snorted at her. "Oh, spare me the bullshit. You could beat these assholes with only your pinky toe if you had your head in the game." They heard the roaring of ATVs at the same time. "Keep the pressure on that. I'll take care of this and then we're going home to figure this shit out." She shook her head again, but he ignored her and moved to high ground to take out the gang they had been assigned to monitor. Once that was done and the emergency evac was on its way, Natasha pretended to pass out to avoid the discussion. She did actually pass out from shock at some point, she assumed, as she woke up in a white room in a med bay with fresh stitches and an IV. Clint had his dirty boots on her bed as he played an invisible drum set to music only he could hear. It was just another thing she lo- 

Sharp pain, gasping as she came off the bed. Clint jerked up and tried to grab her so she didn't run. "Tasha, Tasha, I'm here! You're safe! It's okay!" Shallow, rapid breaths as she tried to focus on something other than the necklace that she could glimpse beneath his collar. "Come on, Nat, deep breaths," he tried to soothe as he reached to jab the nurse call button. 

"Back. Up," she managed to force out as she slapped his hand away from her remote. A panic attack. God, if Ivan could see her now. Yelena would kill her in a heartbeat. Clint jerked back, more from surprise than anything else. Hurt showed in his eyes, but he stayed with her. Natasha forced her breathing to regulate. If this is what her body was forcing her to, she would have to fess up. It took several minutes to get her breathing under control, but Clint stayed the whole time. "Sit down and stop staring at me," she grumbled at him.

"Excuse me for being concerned," he snapped, but he sat. "Does this mean you're ready to explain?"

Natasha closed her eyes and nodded. "You don't get to say anything until I'm done." It wasn't worth checking for a response. "I love you, Clint. It's not fair for me to say that to you, not with what you and Bobbi have, but I can't not tell you. It just...hurts. I've wanted to say something for two years, but I was trying to break the conditioning and I couldn't even out, and then when I could it was too late, and ever since then it's just been pain and I feel so weak and I hate it," her breathing started speeding up again and she had fistfuls of the sheets as she tried to anchor herself but couldn't and she ruined everything and…

Clint placed his hand over hers. "Two years?" Natasha slowly nodded, not loosening her grip on the sheets. "What a mess," he sighed. Natasha squeezed her eyes shut, refusing to cry in front of him. "Tasha, I've loved you since that day you let me steal the pudding off your tray without breaking all of my fingers. I waited for you to be ready. No one should go through what you've gone through. You survived, and you deserve to set your life on your terms. Bobbi and me? It was a bet that escalated really quickly. She's got her sights set on some British hot shot, and I've been busy pining after my partner." A tear leaked out of her eye and was brushed away, causing her to open them. "I want you, Natasha."

Finally, finally she could say the words. "I want you, too." He moved to capture her lips and she put a hand on his chest. "I also want a shower. And some food. Like pineapple pizza."

"Aw, Nat," was Clint's answering whine.

"And then? We'll see what else we find out I want."

He laughed, loud and long, and was allowed to push the button to call the nurse. "Let's get out of here."

[quirkykayleetam]

Empty Shell

Hello!  This is an entry in the Broken Pieces series.  The previous piece is Kind Restraints and can be found by that title or the tags of any of the main characters.

“We have a problem.”

Special Agent Daniel Wei looked up from his desk at Morgan Security to find his boss scowling down at him.  He took a sip of coffee.

“You remember that Jonathan kid?”

Daniel nodded.  How could he forget? 

 Despite the “Security” in the name Morgan Security, most of his assignments since joining the firm eight years ago were pretty tame.  Intimidation was the name of the game for the most part.  Sometimes he got to make people feel safe.  Those days he drank less coffee and whistled on the car ride home.  

What happened with the kid...?  Daniel hadn’t seen anyone hurt that badly since his time in the service.  He tried not to dwell on the fact that all that damage was done a 26-year-old civilian just protecting his job, but the image of Jay’s protruding ribs still woke him up at night.

“It’s his caretaker.  Apparently she ordered Jones around like a schoolboy.  Spit in Wilson’s face for good measure.  They’re off the case, effective immediately.”

“Who is she?”

“Some brood named Evelyn or Emily or something, though the boys are calling her something else.”

Daniel’s boss chucked.  Daniel didn’t.

“Look, Wei, I know it’s not your usual gig, but this whole thing is still on a need-to-know basis.  I got managers breathing down my neck that nobody else even hears a fart about what happened.”

Unceremoniously, he dropped a bundle of blue medical files on Daniel’s desk.

“As of now, you’re the kid’s case worker for the firm.  You screw this up and it's your neck on the line, not mine, you hear me?  The whole thing was fucked from the start if you ask me.”

Daniel didn’t hear him.  All he could see were the pictures closely documenting the welts, cuts, and bruises down Jay’s left side.  They must have been taken the night of his rescue sometime after Jay passed out in Daniel’s trunk.

The agent took another long drought of coffee.  Apparently he was going to have more nightmares tonight.

Daniel arrived early at the hospital the next morning.

Jay was already awake.  A nurse in pink patterned scrubs slowly spooned swallows of lukewarm eggs into the patient's mouth.

Daniel looked away.

He pretended it was for Jay’s sake.  Being spoon fed had to be a humiliating reminder of the computer scientist’s immobilized hands.

In reality, he couldn’t handle the look in Jay’s eyes.

Jay stared unseeing at the blank hospital wall in front of them.  It was as if they came back to themselves any further they’d have to feel the pain and trauma and heartbreak of everything they went through and, at least now, early in the morning, forced to rely on strangers and IVs and pain meds just to survive, Jay’s body couldn’t handle it.  It reverted into an empty shell.

Instead, Daniel found the figure slumped near the opposite wall.  Elizabeth “Beth” Martinez, 38-year-old Art Department secretary at Landring Community College, looked like she’d collapsed more than fallen asleep in the stiff metal chair by Jay’s bed.  Her mouth hung open a little and her hands stretched out on the armrest toward Jay.  A rumbled duffel bag huddled under her feet.  It couldn’t have held more than two sweaters and three pairs of socks, but Beth obviously wasn’t leaving that room unless she had to.

A flurry of movement brought Daniel’s eyes back to the nurse and her charge.

“We’ve just got a new protein shake in.  It’s chocolate!  I know it’s just breakfast, but you need to get some meat on your bones.”

She set the brown liquid and straw within reach of Jay’s mouth, but instead of taking a sip, Jay’s eyes went wide.

Jay lashed out, spooking the nurse and sending thick chocolate liquid puddling across the tile floor.  Before Daniel could blink, Beth was by Jay’s side, rubbing their back as they buried their face in her neck.

“Don’t drink it!  Don’t drink it, Beth!” Jay half yelled, half sobbed.

“I won’t.  I promise, Jay.”

“It...It’s poisoned.  You never know how it’s gonna hurt you, but it always does.  I know, I know I need it.  I have to stay alive, have to keep them away from you, but I’m tired, Beth.  I’m so weak and tired, I don’t know what to do…”

With gentle hands, Beth gripped both sides of Jay’s face.  She moved them upward until she could look Jay in the eyes.

“Jay, when you were at Princeton and your dad died and you drove miles and miles home in your roommate’s car just so you could be there for your mom as soon as possible, were you weak for wanting to sleep when you got back?”

“N...No.”

“It’s okay to be tired, Jay.  It’s like, I don’t know, warriors on watch.  You’ve done your job protecting us.  Now it’s your turn to rest so we can take care of you.”

Daniel Wei left the hospital without a word.  He had work to do.

***

Weeks later, the agent returned to find Jay sitting at a table on the other side of the room.  Their hands were still in splints.  They still had dark circles under their eyes.  They stared at the table like its solid plastic was grounding them.

Daniel bit back a sigh as the kid didn’t even look up as he entered the room.

Then there was a kerfuffle behind him.

“Aha!” Beth said, bursting through the door.  “I finally found a nurse who doesn’t do the Chronicle Sunday crossword at ass o’clock in the morning!  Jay-bird we are good to go.”

Jay’s eyes lit up as Beth smacked the paper down in front of him and grabbed another chair.  For the first time, Daniel realized they were blue.

“Bet you stole it,” they said quietly.

Beth hand flew out of her purse where she was rooting for a pencil and struck above her heart.

“I am deadly offended that you would even think that I would stoop to such things, especially on the day of our Lord!  I asked, thank you very much!  Besides, if you’re so against stealing, maybe I shouldn’t give you your other treat…”

“You’d withhold a treat from a poor invalid?” Jay deadpanned.  “Oh my poor arm.”

Beth chucked.  Jay smiled.

“I know you’re having trouble with straws, Jay-bird, but I thought, maybe…”

Beth pulled a purple aluminum can out of her purse.

Jay leaned forward eagerly, but then made himself pause.

“Am I allowed to…?”

“Hell, I don’t see why not!  They’re trying to get calories into you anyway that they can.  Junk food is only gonna help with that!”

Beth popped the tab on the Grape Crush and stuck a straw in it, moving it toward Jay as she nudged his foot companionably.

Tentatively, Jay took a sip.  Then a swig.  Then a gulp that took up half the bottle.

“Whoa, slow down there Jay-bird.  They will kick me out of here if you die from a sugar high.”

“It tastes like capitalism,” Jay sighed.

“And?”

“And not like hospital food!”

“Good!  Then this will be the first of our illegal smuggling adventures, deal?”

“Deal.”

There was a pause as Jay savored his soda.

Daniel cleared his throat.

“I’m sorry to interrupt, Jay,” he said.  “I’m Special Agent Daniel Wei from Morgan Security.  Would you mind if I borrowed Ms. Martinez for a few minutes?”

Jay looked at Beth who nodded wearily and got up to follow Daniel out the door.

***

As soon as Daniel and Beth got settled in an empty conference room, her whole demeanor changed.  Her smile slid into a tight thin line and she squared her shoulders even as they fell a few inches.

“So, Agent,” she said.  “When are we going to be able to get him out of here?”

“Jay’s casts home off in two weeks.  If he passes all his physical examinations, I don’t see any reason for him to stay longer than that.”

“Good.  And where we’re going?  I assume you’ve got all of that sorted.  There are a few things I’d like to bring with me, but everything else can go.”

Beth clenched her jaw as she said the words.

Daniel closed his eyes.

Here was a woman trying to hold the world together for a kid who’d completely lost his life.  In the process she was losing hers too.  If he made her, she would have to go back into that hospital room and tell Jay that everything was working out perfectly even if she didn’t know where they were going to be tomorrow or what Morgan Security would require of them.  And she’d do it.  He could see that weary determination in her deep brown eyes and he knew exactly how hard she’d come down on all of them if they pushed Jay too hard.

“We’ll continue to pay for your old apartments as long as we need to,” Daniel promised.  “You’ll be able to get your stuff whenever you need to, whether that means going back yourself or letting us hire folks to get it for you.  We won’t make you leave things behind.  Not when they’re as important as Grape Crush.”

Beth didn’t smile, but her shoulders relaxed a little.

“As for where you’re going…”

Daniel passed a manila folder across the table to Beth.

“The firm picked out a safe house with the latest security.  It’s off the grid with the best locks and monitors and motion detectors money can buy.  And, for lack of a better word, it’s a bunker.  I saw the place where they were keeping him Ms. Martinez.  I thought Jay might prefer something more homey.”

Holding his breath, he took out another file.

“This holding just came on the market.  It’s not far outside the city.  You’d have to drive longer for doctor’s visits, but you’d have access to a public pool and a park a few blocks away.  I made sure that it was only one story so you wouldn’t have any problems with dizziness and falling from Jay’s pain medications.”

“And it has windows,” Beth said softly.

“And it has windows,” Daniel said.  “It looks like a home.”

He cleared his throat.

“There is one more thing about this property that you should know about that’s not in the papers.”

Beth looked up.

“I understand Jay has been seeing a Morgan Security psychiatrist.”

Beth almost sprung out of her chair.

“Look, I get it!  You want to know what happened to him.  You want him to tell you the story of every mark to make sure he didn’t tattle when they beat him half to death.  Just don’t bring me into it.  I’m not spying for you.  I’m trying to make him better while you’re focused on your own damn pride!”

“I agree.”

“What?”

“Jay needs someone who understands what he’s going through and is focused on his recovery, not his worth to any company,” Daniel said calmly.  “Next door to this address is Dr. Stephens.  He’s an old army buddy who specialized in special service members and PTSD.  This would not be his first time working with the aftereffects of torture.  Jay might still have to meet with the Morgan Security doc for appearances sake, but Dr. Stephens has promised to see him off the books.  Doctor/patient confidentiality would apply.”

That made Beth deflate completely.

“Do you really think this Dr. Stephens could help?  Jay talks more in his sleep than he does in person.  I still don’t know what’s going to set him off and I just…I just want him to feel safe.”

Daniel placed his hand on her, cold on the tan plastic table.

“So do I.”

***

Daniel returned Beth to Jay’s hospital room with the hope of a smile on his face.  Before the could close the door, the pair started bickering about the answer to the crossword’s 27 Across.  Beth held her pencil like a dagger while Jay batted at it with ineffective, casted hands.  Through it all, their feet remained pressed together with comfortable pressure, reminding each other that they were there and they weren’t going away.

Like that night long ago when he rescued Jay, Daniel pulled out his cell phone and dialed Morgan Security.  His boss picked up.

“No sir, there’s no problem,” Daniel said.  “I just need to get a copy of the Chronicle delivered outside the city to Westover drive.  Yes, this is a matter of great importance.”

Filling the “Empty Shell” square with Original Characters for @badthingshappenbingo​!  I think I’m setting a record for filling the most squares without actually making any of them line up lol.

Tagging the Broken Pieces Crew: (If you want to be added or taken off this list, just let me know!):  @stoic-whumpee​​​​, @whatwasmyprevioususername​​​​, @whumpty-dumpty-fell-off-the-wall​​​​, @straight-to-the-pain​​​​, @castielamigos-whump-side-blog​​​​, @0idril0​​​​, @fallingstormphoenix​​​​, @whump-fantasies​​​​, @imagination1reality0​​​​, @whumpback-wail​​​, @whump-tr0pes​​​, @untilthepainstarts​​​, @captivity-whump​​, @burtlederp​​, @redwingedwhump​​, @whumpiary​​, @captivity-whump​​, @blue-flare10​

All credit to @stoic-whumpee​ for the idea of making Daniel a main character.

[macgyvermedical]

3-Quinuclidinyl Benzilate is My New Favorite Chemical Weapon, A “Mason+Cable+Choices” Medical Review

This episode. This freaking episode.

First of all, Charlie Robinson, who I really thought was going to stick around in this version of the series after he survived his first episode, had to go and become the instrument to someone else’s revenge scheme. We also got to see a relatively hard side of Mac in the interrogation room, and I’m not sure whether to applaud it as character development or feel like they’re going too dark.

From a medical and whump standpoint, this episode sure has a lot of things covered- the gunshot wound, the neck needle, the 3-quinuclidinyl benzilate poisoning (Yay!), the heart needle/antidote, and the toxic smoke. I'm warning you now, most of this review is about the 3-quinuclidinyl benzilate poisoning.

The Gunshot Wound

Honestly, there’s not a lot to be said about the gunshot wound- it was to the outside of Charlie’s thigh, so while it would have been painful and probably would have bled some (the duct tape wouldn’t have helped stop the bleeding) it probably wouldn’t have been enough to really threaten his life. If he hadn’t later plummeted to his death, he might have needed some antibiotics, professional medical attention, and physical therapy.

Neck Needles

Neck needles aren’t a thing, but I’ve talked about those in previous posts.

3-Quinuclidinyl Benzilate Poisoning

Oh hey look, we’re already at 3-quinuclidinyl benzilate poisoning! And fam? this is where I really did my research.

If you’ve been on this blog long enough you know I like my chemical weapons. Not in a “kill everyone” way but in more of a “strong academic interest I may one day write a thesis about” way. And man, do I love having access to an academic library again. Whoo buddy. This was fun.

In the episode, Mason uses a chemical weapon called 3-quinuclidinyl benzilate (also noted in the episode as “BZ”), smuggled in a false tooth, to subdue Mac before making his escape from the interrogation room. The tooth contains QNB  in an aerosol form, which when released forms a visible cloud in the room. Mac breathes the aerosol, which appears to instantly paralyze or possibly sedate him, while Mason takes advantage of the small amount of uncontaminated air in Mac’s water bottle before making his escape up the air vent. A security team makes their way to Mac, Desi calls for a med team, and Mac is revived with an antidote delivered by a needle straight to his heart.

When someone mentions chemical weapons, most people think of mustard gas or nerve agents. But poisons designed to torture and kill people aren’t the only things that fall into the category of chemical weapons. In fact, there’s a whole class of them, called “incapacitants” that are specifically designed to take people out of commission without a high risk of death or permanent disability. 

Let me just say, Jim Adler is a writer after my own heart. He wrote both this episode and “Mac+Fallout+Jack” and considering both were absolutely gut-wrenching and contained reasonable choices of incapacitating agents, I really, really appreciate what he’s done for the canon. He didn’t get everything right here (*cough cough* neck and heart needles *cough cough*), but he clearly understands enough about drugging people to buy some literary license. Not all of it, but some.

Now, as I’ve talked about in other posts, drugging people into unconsciousness isn’t a particularly safe thing to do. Unconscious people can’t protect their airway, and most drugs that render people unconscious significantly impact their respiratory rate, blood pressure, or both. Unless the party doing the drugging is prepared to devote at least one trained person to monitoring and management of the drugged individual, there’s a chance that person could suffocate and die. Paralytic agents have a lot of the same issues.

This becomes even more problematic if you’re trying to incapacitate multiple people. Case in point- in 2002 a small group of Chechan rebels held over a 1,000 Russian civilians hostage in a theater in Moscow. After several days, in order to end the stand-off, Russian military personnel used what was probably an aerosalized opioid* to render everyone in the building unconscious. They then stormed the building and rescued the hostages. Unfortunately, even though antidotes were available and used, about 1 out of every 10 hostages ended up dying due to the mass drugging, which didn’t win any PR points for the use of incapacitating agents.

But if you get just slightly more creative, sedation and paralysis are not the only two ways to drug enemy combatants into uselessness. Turns out, a variety of hallucinogens and deliriants can achieve the same goal without the same risk of death by suffocation. If you can get someone to a state where they can’t remember what they’re doing or perform basic skills like reading or decision making, they can’t easily attack and kill your own personnel.

This is where 3-quinuclidinyl benzilate, (NATO code BZ, US Army code EA-2277, Soviet code Substance 78, and usually referred to as “QNB” in medical circles) starts to stand out. QNB is a deliriant and hallucinogen. Now, there are lots of drugs that fall into these categories- think LSD, ketamine, PCP, and atropine to name a few. QNB works very similarly to atropine, by selectively blocking the action of the neurotransmitter acetylcholine (think the opposite of a nerve agent), but with significantly more of its action concentrated around the mind-altering side-effects. It’s also safer, hardier, more versatile, and has a more ideal onset and duration of action.

The typical course of incapacitation with QNB involves:

An initial period of progressively worsening anxiety, restlessness, and confusion

A period of extreme drowsiness

Finally, more confusion, an inability to perform simple tasks, difficulty with movement, hallucinations, and bizarre behaviors including picking at things, which all gradually wane over the course of 2-4 days.

Here are some reasons QNB stands out as a particularly effective incapacitant (and all the ways the episode ignored them):

The first is therapeutic index. A drug’s therapeutic index is the difference between its effective dose and it’s toxic dose. If we say a drug has a “narrow” therapeutic index, that means there’s a very small difference between an effective dose and a toxic one, while a “wide” therapeutic index means that the two doses are very different. When drugging someone without their knowledge, no matter how you’re delivering the drug, it’s really hard to estimate the actual ingested dose. Because of this, you want the widest possible range of effective-but-not-deadly doses you can have- the best drugs for mass druggings are those with the widest possible therapeutic indices.

QNB happens to have a very wide therapeutic index compared to other possibilities for incapacitants. The lowest effective dose is about 150 micrograms, while a toxic dose is more than 650 times that at about 100 miligrams. In small doses, the drug doesn’t last as long and causes more sedating vs delirious effect, but is still very useful in lowering the effectiveness of an enemy force.

The second is its options for route and availability in an environment. How any drug is given is referred to the route of administration. These can include:

PO (oral- taken as a pill or liquid)

IV (intravenous- injected into a vein)

IM (intramuscular- injected into a muscle)

SC (subcutaneous- injected into fat)

IO (intrasseous- injected into a bone in an emergency)

Inhaled (breathed and absorbed through blood vessels in the lungs)

PR (rectal- given rectally)

Transdermal (absorbed through the skin)

Most drugs work best when administered a certain way, and some may only be produced for use by a certain route. Some, like ketamine or LSD, can’t be absorbed in the stomach, so giving them orally doesn’t work (LSD “tabs” are actually absorbed through the mucous membrane in the mouth). QNB’s advantage is that it can be given by any route. You want to drug food or drink? It works. Aerosolize it and pump it into the air? Also works. Inject it IM, SC, or IV? Yes but you might have to answer some questions. Coat something like a doorknob? It goes through skin too!

QNB is particularly suited as an aerosol, not because it readily evaporates, but because it’s odorless. No one would even know they were breathing it until it started working, and even then, they might not know what happened. It also stays in the environment for a long time- up to several weeks depending on conditions- and can survive extreme heat without degrading, so it could be disbursed via explosive (LSD would not survive). Bottom line, everyone that came into that room to rescue Mac was contaminated, probably enough to cause them problems. Also, so was Mason, so take that as you will.

The third is the drug’s onset and duration of action. In the episode Mac is almost instantly incapacitated when the spray hits his face. This is not how any drug works (even via the IV route, the quickest-onset drugs still take at least 15-30 seconds to be felt), but particularly not QNB. QNB has an onset time of about an hour, no matter the route. This is actually beneficial to the drug’s original purpose- if no one shows symptoms from drugging with an odorless aerosol until an hour after exposure, there’s no way to take protective measures. Suddenly everyone’s hallucinating and can’t do basic math. Sucks for that attack plan you were working on.

The fourth and final benefit that QNB provides is both it’s lack of (specific) antidote and the fact that there are no lasting effects. Some people point to physostigmine as a possible antidote, but it’s not perfect and has some incapacitating side effects of its own. As incapacitation with QNB is generally not life threatening, it’s probably better for most people to be cared for in a safe place and ride out the effects. Since it’s also not a carcinogen or mutagen, once the effects subside, there shouldn’t be any additional problems.

Phew. Okay.

Heart Needles

I swear I’ve talked about heart needles before, but I’ll do it again since it hasn’t been recently. In the episode, Mac is injected with an antidote directly into his heart. Now, like we said before, using an antidote wouldn’t really help him much, and its not really necessary. He’s just gonna have to ride it out (I don’t make the rules...).

But they chose to do it, so we should talk about it- in the pre-CPR era, intracardiac injections represented the only way of getting emergency medications like epi to the heart in the case of cardiac arrest. As late as 1992, there were still some groups advocating for it if the patient was in asystole (flatline) and IV or IO access couldn’t be obtained. Mac has excellent veins if I do say so myself, and he also wasn’t coding, so there’s no reason for this to have been a thing in the episode. It’s also never used today.

Also, I’m going to be particularly disappointed if that was just a callback to the similarly inaccurate Pulp Fiction scene. Because this show has already used epi to counter an acetylcholine-based problem, and you already only get to do that once. EPINEPHRINE IS NOT AN ALL-PURPOSE ANTIDOTE.

Jim Adler based on your other work I have to assume you know better.

Also it’s late and I’m not talking about the toxic smoke. See my many posts on cyanide and some time in the future come read my post on carbon monoxide.

*According to the book Chemical Warfare: Secrets Almost Forgotten by James Ketchum, who did a lot of the initial research on chemical incapacitants. Other sources reference the drug used as anything from traditional nerve agents to QNB itself, but the onset times and symptoms initially reported seem to match up better with an opioid than QNB.

R E F E R E N C E S

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 -

[showmetruecolors]

Being a nurse during the COVID-19 Era.

I was a nursing student during the Ebola crisis where they taught us how to suit up and doff properly without being contaminated. It so happens that the hospital I was interning in at the time was planned to be the hospital in NY State that would take on the first Ebola case if it were ever to hit our state. They made it clear that if the case were to come to the hospital, the student nurses were to not even be on the same unit, and that they would move us. However, in cases of lack of assistance, they would need us to know how to properly enter and exit the room with the hazmat suit without providing contamination to ourselves and the environment. 

I have also been a nurse the past almost four years during crazy and erratic flu hits. I have seen flu kill the terminally ill and the elderly. I have also seen the flu hit my coworkers pretty bad as a result of working in health care. Working overnights in a section of the emergency room, we always have flu patients and we are always prepared to a certain extent, how it would affect our patient once getting report.

But not with COVID.

As of two Saturdays ago, I am currently a part of one of the designated groups of nurses for COVID-19 for my hospital. I am on the float pool and they started by emptying out one of our main units to reserve them for COVID-19 rule-outs and positive patients. (Obviously the expansion of designated COVID units grew over a week...) There are cameras watching us every time we enter and exit a room and put on and off our PPE gown. With that, staff must sign (pretty much their life away) each time they enter or exit the room, by providing contact info, DOB, who watched us and their info, etc. This includes staff that also enter to pick up the garbage. Everyone in the hospital had to learn the steps of putting on and taking off the protective equipment. Not just nurses and doctors. At this point, it felt all hospitals were ready to respond to this clientele and the caseload.

At first I was so thrilled to be one of the COVID nurses and to be assigned on one of the COVID units. And then, came the first time another nurse and I actually had to gown up. Each time we gown up in the protective equipment, we must have another nurse on the other side of the glass watch us and check off a checklist of things we are doing. The purpose of this is to also catch any contamination to ourselves or the environment quickly. The first situation of us gowning up, I was actually the observer. Gowning up takes some time so after a few minutes of checking off the checkboxes, watching her, and giving her a thumbs up after every step, then comes the part of the eyewear which then caused me to look up at this nurse’s eyes. She had tears filling up her eyes , something I didn't notice while checking her method of donning her equipment, and her hands were shaking as she was placing the eyewear onto her face. She has a young child at home and she used to tell me about how she is also a caretaker for her parents. I wonder if this is what she was thinking of before entering the room. I heard rustling behind me and I turned around. Two evening administrators were there intensely watching from the distance almost unsure about walking near the door where we must stand to observe.

Later that evening when it was around the 3rd time I had to gown up to go to my own patient’s room, I went in the with PCA so he can assist me with closing the back of my gown as well as him getting comfortable coming in and out of the room per protocol. I looked up halfway through our gowning process, to see staff and admin watching us as well. Everyone had a look of fear in their eyes. I turned to look at the PCA who would not make eye contact and always had a strong demeanor when it came to things like codes, rapids, etc. He looked startled and like he didn’t want to talk about anything. At that moment I realized, we actually don’t know anything about what is behind those isolation doors once we enter. All we know is that it is airborne, we have only SOME information about the viral processes and the human body reaction, and that the human race can only receive oxygen in only three different ways before complete intubation... (Breathing on their own, nasal cannula, and Non-rebreather. The other options would cause viral shedding, leading to worsening of the viral spread and even contamination.) We also knew that each time we gowned up and enter the room, we were able to see facts and theories in front of us and assist us in understanding the virus more and how to manage based on other EBP methods from past, and new methods. Which made the situation SO interesting.

On my second shift being one of the COVID nurses, we learned more about the virus. And one thing was confirmed about my previous shift, and it was that the beliefs even among staff/the hospital and community members about what it all is, varied...

We started learning that after a couple of days of confirmed testing, people were coding. There seemed to be a peak time that the virus was causing severe respiratory failure and a systemic failure response and our managers told us that this was an ongoing and similar experience with other hospitals that they have collaborated with when discussing support during emergency responses. Days later, a nationally recognized public health organization actually published a report online that showed the timeline graph of peak levels during viral process and that proved the theory to possibly be correct. After a certain amount of days, almost regardless of intervention, certain people were rapidly deteriorating.

I walked into shift that day briefly assisting my colleagues in a code. Although this person had several cofounding factors that would've made even the basic flu difficult for the person to overcome, it was scary to see. Next thing you know a staff member’s gown had ripped in the process of helping the patient. Some staff were actually nervous for her. She followed proper decontamination protocol but it was still the fear of the unknown that is controlling everyone that is causing complete mayhem and chaos.

It is also the lack of supplies causing unreal scenarios....I took complete pride in the fact that my team would be some of the first COVID nurses , until I realized we didn't even have enough n95 respirators...that we were reusing products...(Which almost puts us at risk for contamination of ourselves and our environment and loved ones) we also don’t have enough face shields or goggles. So we are reusing them every shift. We can blame politicians or our actual health care orgs or whomever you feel is responsible when it came to emergency prepardness and allocation of funds. But all I know is that I am, as well as other staff, are becoming more and more at risk every shift as well as at risk when community members can't follow basic instructions and educate themselves with resources that are actually not factual. Which brings me to my next thanggg - When I see families out in the super market using gloves and masks, I get angry.

1. The masks you see people wearing are not n95 respirators so you will catch corona and even TB regardless. Jokes on you, folks.

2. Gloves? Are you serious? You think that will protect you? Each time you pick up an item wearing gloves and touch your face/fix your hair (which is what I actually saw the other day) you’re not protecting yourself. That glove is now contaminated regardless, and unless you’re bleaching the shit out of the products you are buying before placing them in your vehicle or bag, they are holding onto whatever the environment has, as well. Contaminated or not.

3. I understand the fear of the city/stores closing down so you must stock up on essentials and food. However, you are now defeating the purpose of preventing viral spread and you’re causing large groups in one tight area to take place. (Shoutout and much love to grocery store / restaurant employees, etc.) It’s to the point where I am less of a threat if I walk into a patient’s room with symptoms of COVID and then run over and cough on and hug 100 people, than those who have been at Walmart or the grocery store everyday this week spending a long amount of time getting items. I understand the need to have essentials, and that online services may be more expensive, but at times like these, they may be worth it especially if you or someone you are at home with is compromised in some way. This also, by the way, helps with the job industry including forcing one to have more self-awareness with WIC covered products and can assist in monitoring that they are not taken off of shelves and into carts out of pure human PANIC as opposed to other replacement products.

4. This happening does not give you the excuse to blame a certain group of people. If you do not know what corona is (and by going to CVS the other day to pick up my acid reflux meds and hearing chatter about it at my second job by non-medical personnel , I realize this is the case) then you need to shut the fuck up and not be an inherently racist prick. The end. No excuses.

Do not panic. BUT. Stay home once all your essentials are brought together. I know that during these times, there may be job and financial hardships, loved ones you are concerned about, and some children’s/college students’ education is on the line and being effected as a result (as is mine...), and that there is fear due to the unknown contamination of the virus and due to the different directions in leadership and advices. But please try to stay calm. And stay home. Staying home is the only thing you have control of at this moment, that can eventually help restore everything going on. The more you stay home, the more you’re helping ease the situation/exposures which can eventually lead to the life we were living before where you can work, go to school, etc. And since you will all have time now, educate yourself on the spread of Corona and understand WHAT it even is. One of the leading issues seems to be that no one was properly educated on it, causing the reaction everyone is having which is putting more people in danger and hospitals in complete stress and OVER the capacity to diligently care for patients that have the virus, among with other serious illnesses.

Flatten the mother fucking curve.

Love,

Emily RN

[lucysweatslove]

There is something to be said about starting over.

Truthfully, though, I’m not sure what it is. My story is not new or unique; I’m just a woman in her mid-20s trying to figure out how to be herself again, or what that ever would look like. Few paths are linear, or even with one definitive trend. We start, we stop, we remodel and backtrack or go in an entirely different direction. I came back to tumblr for two reasons: 1, I really believe blogs are helpful in my planning, recording, and motivation for any part of my life, and 2, I tried a few other types of blogs and didn’t like them. Tumblr was where I got my life in order when I went to college. I made connections with people who helped me, in various ways, connect the dots in my own life as I became an adult. And then, for some reason, it stopped being that space. I could blame this change on politics, and honestly, deep in my mind, I do. Even prior to Trump taking office, or his campaign, tumblr’s focus shifted heavily to politics and the state of the world’s affairs. Understandable, and I harbor no ill will to those using their platforms to speak about what they believe to be right, but that shift took over my feed. Instead of positivity, I felt anger and desperation. Facebook, school, or work were places for politics- tumblr was my place without it. Tumblr was my place to work on my own health, inside and out, ignoring the health of our society. I could not- and still can’t- focus on my health while being bombarded with reminders of the degradation of the world. I don’t remember when exactly I stopped being on Tumblr for good, but it wasn’t recently. In the years since then, I didn’t have a place to hold on to my health, and I’ve deteriorated. I hate it. I don’t hate myself, nor do I hate the workings of my body, but I see myself and I am discouraged and disgusted. I try to do basic things, like body weight squats, that used to be easy activities, and I struggle. Some of this is related to age, some of it is related to health issues, and some of it is related simply to poorly managed stress. I have made numerous attempts now to get myself back to the health I was in 4-5 years ago. A previous post from 2018 on this very blog shows that off. In early 2019, I attempted a keto diet- which, even though I was very consistent with, did not “work” for me. I’ve started other blogs (which obviously failed), personal journaling, linking up with different food tracking apps, going to the gym more regularly, intuitive eating, even a well designed rewards program based off of the psychology and neuroscience of behavior modification and rewards- they all failed in the end (although the rewards program was wildly successful for the two months I did it, but after it ended and I went on a trip, it became too difficult to keep up). The problem with all of these attempts has been a lack of integration. Any attempt at in-person or even online but direct social support has been futile, and my attempts and feigning the idea of support or accountability (eg, a blog as I feel the “support” whether or not it is actually read) haven’t integrated what actually works best for me: numbers. I need all pieces to come together, and so far, I haven’t been able to do that. It’s like working on a large puzzle where the pieces continually go missing. You have one piece in your hand, but can’t find the piece it connects to, and when you finally do, the first piece mysteriously vanished. I think big parts of my difficulties the last two years especially have been medication and health. Right before I started this blog, I was started on a new antidepressant and anti anxiety med. This first made me REALLY sleepy, so as I was adjusting, I slept so much that I didn’t eat regularly. When that resolved, I thought I was doing fine on the medication, but without changing anything else, I experienced many side effects, including a 20 pound weight gain and a whole host of weird, systemic/somatic concerns (I was even lactating a small amount). I stayed on it because my anxiety seemed better, even though I felt all my emotions were dull. When this medication stopped working for my depression, I finally decided to switch it- and that was a process that lasted, no lie, over six months. I tried medication that gave me horrible heart palpitations, dizziness, tachycardia, and erratic blood pressure readings. I tried genetic testing. My psych moved practices. It was a mess. During this process, I tried multiple times to start going to the gym. There was ALWAYS something wrong. I would go consistently for two weeks, and then I would develop muscle spasms in my back. I couldn’t do yoga anymore because I developed a soft tissue injury in my left hand and could no longer put weight-bearing pressure on that hand. In early November, I developed an upper respiratory infection that lasted two months, required two courses of antibiotics, and still hasn’t fully resolved. But now I need to be determined. My honeymoon to Cancun is in 13 weeks, and every day now counts. While I can’t solve all my problems in a mere 91 days, nor will I have my “best body ever,” I am determined to be able to enjoy the beach vacation with my husband without letting my body, my insecurity, or my complete lack of fitness stop me. When is started paying attention to my diet, I was technically obese (just barely, but still). This number hit me hard. I remember crossing the line from normal weight to overweight and sobbing, so angry that I had let myself down. I remembered how awful I was treated by my peers the last time I had such a high weight. Now, I would love if I could reach that weight before my honeymoon. My “goal,” which I have entered into MyFitnessPal, is to lose 30 pounds starting from last week at 176.2; this would place me at 146.2 and a BMI just barely overweight. Would I love it to be lower? Yes. I would be overjoyed if I could lose even more weight. However, I don’t want to attempt anything unrealistic; if it happens, great! If not, I won’t be (too) disappointed. I have been too scared to measure my waist recently, or my hips or thighs, but I have a few linen dresses that I really want to fit in to, and while the scale is a great way to measure weight loss, I am really looking for more fat loss, improvement in how I look and feel, and to fit into clothing again- so as long as inches are going down, I’ll be happy with the weight loss too. As a disclaimer, for anybody reading this. Yes, 30 pounds in 14 weeks IS over 2 pounds a week, and it IS over 1% of my body weight per week as well (both of those values are typical suggested maximum rates). I’m not suggesting this particular weight loss goal to anybody, and my general/systemic health is constantly monitored. This last week included, I am being VERY conscious about keeping myself in good health throughout this process, and if I cannot reach a goal while maintaining my health, then the goal (in some part) will change so I CAN meet it healthfully.

[justheretobreakthings]

Reach Out, I’ll Be There - Chapter 7

(First Chapter)(Previous Chapter)

Word Count: 2,589 (Total Word Count: 18,868) Read on AO3 Chapter Content Warning: needles

Story Summary:

After so long trapped in the astral plane, Shiro is finally back in the world of the living, back with his team, his family. But there are downsides to fusing into the body of his clone. Downsides to having to share its memory.

When Haggar took over, Keith wasn’t the only one who came out of that fight with scars.

Chapter Preview:

Krolia finished her cursory once-over of the injuries quickly, then stood, scooping Keith up into her arms with a surprising gentleness considering the haste of the action and the intensity that seemed to be pouring off of her in waves.

“Coran’s been preparing what medical provisions we have,” she said tonelessly as she marched out of Green’s maw and headed across the hangar, Shiro and Pidge behind, the latter practically having to skip to keep up with Krolia’s long strides. “We radioed Allura’s team to see if she could return to the ship and see what she could manage with her… alchemist powers, I believe Coran called them. She said she’ll try to get back quickly, but it will still be a bit of a wait. For now we just have to get him as stable as possible and do what we can.”

Time was meaningless on the journey back to the ship. Shiro felt like he was in a fog, a daze, and it could have been seconds before they made it back, or it could have been hours. Pidge had radioed the moment they were within range and told Coran that Keith was injured and gave him an ETA, but the words to lost to Shiro, drowned out by the rush of blood in his ears.

And that was nothing compared to the blood on Keith, the blood that had stained the armor that Shiro had removed and the blood seeping through the tears in his undersuit, tears that revealed splotches of blackening bruising across his skin. He did the best he could to keep any bleeding under control, but there was only so much he could do with Green’s first aid kit. At least Keith was too out of it to move much, or to jerk away when Shiro applied the disinfectant to the visible wounds. He did tense, though, and let out a small keening, which left Shiro whispering apologies to him over and over until the words became meaningless.

The cockpit lurched a little when Pidge touched down in the hangar, Black following close behind. Shiro had expected Coran to be in the hangar waiting for them when they got back, as even without the med bay around he was the one to go to for first aid, but when Green lowered her jaw to allow them to exit, the pounding footsteps that came hurtling up to the cockpit belonged to Krolia.

Shiro stepped aside hastily when Krolia entered the cockpit hurried over to kneel down on one knee and examine Keith. “Have you been able to assess the full extent of his injuries?” she asked sharply.

“Just - just the exterior wounds,” Shiro said. “I don’t know how much internal damage there is, but I’m pretty sure a couple of ribs are at least fractured. And the head wound, um, I - I don’t know how bad it is. He was conscious earlier, but not exactly lucid.”

Krolia pursed her lips, brows drawn, as she brushed Keith’s bangs aside to get a look for herself. Shiro watched her face, watched the flame in her eyes that was so like Keith’s, although hers had a steeliness and control to them that Keith’s didn’t. At first glance her expression appeared angry, but Shiro knew better than that. Keith was the same way; he was constantly glaring, brow creased, gaze sharp, jaw set, but he was seldom angry. All other negative emotions - worry, grief, fear, stress, frustration - simply disguised themselves as anger to those who didn’t know him well.

And not many people knew him well. For the longest time, Shiro had been the only exception.

Krolia finished her cursory once-over of the injuries quickly, then stood, scooping Keith up into her arms with a surprising gentleness considering the haste of the action and the intensity that seemed to be pouring off of her in waves.

“Coran’s been preparing what medical provisions we have,” she said tonelessly as she marched out of Green’s maw and headed across the hangar, Shiro and Pidge behind, the latter practically having to skip to keep up with Krolia’s long strides. “We radioed Allura’s team to see if she could return to the ship and see what she could manage with her… alchemist powers, I believe Coran called them. She said she’ll try to get back quickly, but it will still be a bit of a wait. For now we just have to get him as stable as possible and do what we can.”

“Right,” Shiro said. “Sounds, um, sounds good.”

“Anything we can do?” Pidge asked.

“I don’t know,” Krolia said. “Coran’s going to be in charge of this whole matter.” Shiro wouldn’t have thought it possible for there to be any more tension in her face than there was already, but she pulled it off, her hands curling protectively around Keith as she pulled him tighter against her. Something told Shiro that Krolia was reluctant to hand off the medical care of her son to someone else.

An ‘infirmary’ of sorts had been set up on the ship in one of the spare cabins where they had been storing their first aid supplies, and they had thus far managed to avoid using it for anything beyond scrapes and bruises. The paladins were being more careful, whether consciously or unconsciously, now that they no longer had a fully-stocked med bay at the ready for them to heal up injuries in a matter of days or even hours. Even the one healing pod they had with them, the one in which Shiro had rested as his consciousness had merged with his new body, could do nothing more than monitor vitals without the Castle and its crystals to power its healing processes.

It was here where they met up with Coran, who had prepared the infirmary’s bed and gotten bowls of water and bandages on standby for wound-cleaning. He was all business when they walked in, hurrying forth to help Krolia lay Keith down on the bed and immediately getting to work removing Keith’s underarmor from his torso. Vaguely Shiro heard Pidge mutter something about it being crowded in here before ducking out, although he didn’t know if that was actually the reason she left the room or if it was more in regards to maintaining Keith’s modesty. It was rather cramped in the room, to be fair, but Shiro couldn’t bring himself to leave and give the others space. He had to be here to watch. He had to.

Coran got to work steadying Keith’s head and neck and dabbing at the wound that even this much later was still oozing a trickle of blood down Keith’s distressingly pale face. He motioned for Shiro to come take over, instructing him to hold the cloth in place but not apply pressure, before moving along to examine Keith’s shoulder. Shiro tried not to look anywhere but at the cloth, not letting his gaze drift to Keith’s closed eyes or the line of blood that had started to dribble out from between his lips at some point. Krolia, in the meantime, had taken up a towel and one of the water bowls and begun cleaning away the dried blood staining his chest, revealing the gashes that were the source of bleeding and providing them an unobstructed view of the many bruises across his abdomen.

Coran said something, and Shiro blinked wearily at him before shaking his head and asking, “What?”

“I said, has he been having any trouble breathing?” Coran repeated. He had now moved away from the shoulder to instead prod inquisitively at Keith’s battered ribcage.

“I - no, I, um, I don’t think so,” Shiro answered.

“That’s good,” said Coran. “A few of these ribs are likely broken, but it doesn’t seem a lung has been punctured. How long has he been unconscious?”

“Since just before we got on Green.”

“And he was conscious before that?”

“He was out for about two doboshes but he came back around for a while. He was delirious, though.”

“Hm.” Coran frowned deeply in thought. “Well, the fact that he was able to regain consciousness before is still good news. Krolia, pass me the white bag on the tray behind you, these are going to need stitches,” he added, fingers brushing against a gash at Keith’s side.

Krolia obliged, passing Coran a bag from which he pulled out a set of needles and a silvery thread. “Hold him steady for me, you two,” he said as he readied the needle. “It’s precision work.”

“Wait, aren’t you going to give him any sort of, like, anesthesia?” Shiro asked. “Something to numb him?”

Coran shook his head. “With the pods, I never needed to figure out what sort of dosages to give a half-human half-Galra to effectively put him under without overdosing him. It’d be too risky to try now without the guidelines in place. Besides, it shouldn’t matter much here. He’s unconscious anyway, and the needle doesn’t hurt near as much as these wounds will if we don’t close them up before we risk infection. Allura will hopefully be able to help with pain relief once she gets back, but for now... Sorry.”

Shiro sighed. “No, don’t - don’t be sorry, it’s all right.” He moved his hand from the cloth on Keith’s head to his shoulder, where he pressed down to hold him in place. Krolia had taken his other arm, at the forearm since the shoulder was swollen and out of place, and had one hand at Keith’s waist, and Coran moved in to start sewing up the gashes. Shiro winced as the needle pierced Keith’s skin, but kept watching as Coran laced it through.

At the third stitch, Keith finally seemed to react, squirming slightly under Shiro and Krolia’s grips, his brow furrowing. When Coran moved to another gash on his chest, he began letting out the tiniest hints of a whine with every few stabs of the needle. Shiro shushed him under his breath, trying his best to be soothing. He needed another arm, wanted another hand to comb his fingers consoling through Keith’s hair and wipe away the sweat on his pale face while his other arm was occupied holding him down for Coran.

“All right,” Coran said when he’d finished with the stitches and set the needle aside. “How’s his head wound holding up, Shiro?”

“It, uh, it looks - it doesn’t look any worse,” Shiro said slowly.

“How’s the bleeding?”

“Slowed.”

“Good, good.” He took a breath and moved back to Keith’s shoulder. “What exactly happened here? Pidge said it was an explosion that hurt him, I’ll assume the bone broke at the landing, but - ” He looked up at Shiro. “There’s some twisting of the joint here, like he was still trying to swing his arm around after it had broken.”

Shiro could physically sense the blood draining from his face as he swallowed down nausea, thinking back to the base. To the way he’d had to pull Keith’s arm around to the scanner after unevenly dragging him across the garage with his one arm. “Is - is that - what does that mean for him?”

“Just that it’s going to be that much more difficult to reset the bone,” Coran answered, moving around the bed to ready his hand between Keith’s shoulder and neck. “Krolia, if you’ll take the bicep there. Shiro - ”

“Wait, Coran, I don’t know if I - ”

“Allura’s on her way,” Pidge’s voice interrupted, and Shiro turned to see her standing in the doorway, looking out of breath. “She just radioed into the bridge. The Red Lion and Blue Lion will be landing soon.”

“I’ll go meet her,” Shiro said hastily, practically jumping back from Keith’s bed. “I’ll bring her over. Thanks, Pidge.”

“Um, you’re welcome,” Pidge said, although Shiro was already out the door.

He half-ran to the hangar, the halls rushing dizzily past him, and when he reached it the Blue Lion had already landed, and Red was following close behind. Allura wasted no time hurrying down from Blue’s mouth. “Shiro!” she called when she spotted him, her eyes widening as she approached him. “You’re hurt too?!”

“No, no,” Shiro said. “It’s not my blood, I’m fine.”

“Not the blood, the bruise. On your head.”

“On my - ” With a frown Shiro raised his hand, finding a tender spot near his temple. Well, he had been knocked out for a hot second, he remembered now. It must have knocked against his helmet when he’d been thrown by the explosion. Well, no matter, it was unimportant now. “It’s just a bruise,” he said. “Keith’s the one who’s hurt. Coran and Krolia have him in the infirmary, they need you there.”

“What happened?” asked Matt. Red had made her landing, and Matt was now making his way out of the cockpit, Lance following close behind him.

Shiro grit his teeth. He didn’t have time to answer any more questions now. He had to get Allura to Keith. So, without bothering to reply to Matt, he took the princess by the hand and began pulling her along as he raced back to the infirmary. Pidge jumped aside from her place watching through the partly opened door as Shiro practically shoved Allura through and Coran gestured her over to the bed. Shiro hesitated at the door before pulling it shut.

“You’re not going in?” Pidge asked.

“It’d be too crowded in there,” Shiro answered. “How is - how’s he doing?”

“I think they set the broken bone,” Pidge said. “He let out a hell of a yell a minute ago. You okay?”

Shiro nod mutely and leaned against the wall, sliding down it until he reached the floor and resting his arms across his knees, then dropping his forehead on top. He was glad, in a distressingly selfish sort of way, that he hadn’t been around to set that bone. Regardless of the fact that it was to help Keith, to heal him, he didn’t think he would have been able to stand watching his little brother be in any more pain at his hand. He’d had enough of that today already.

“Shiro?”

Shiro glanced up to see that Matt had joined them in the hallway. His face was creased with worry and he held his hand awkwardly at his side, as if he were debating whether to reach out to Shiro or keep the distance. “You all right?” he asked. Shiro nodded. “What, uh, what happened? Coran had radioed Allura, Pidge had said something about some sort of explosion?”

“It was the building,” Pidge answered him. “The electrical system was really badly maintained, and after this long it wasn’t ready to handle any energy uses besides keeping the lights and air the way it has for the last few thousand years. When we started using the computers and doors, we wound up with power surges, and the place was really structurally unsound. Whole thing was looking for an excuse to blow.”

“So that’s what took Keith out?” Matt asked, peering toward the door.

“Yeah, it was - ”

“It was my fault,” Shiro said softly.

There was a pause of silence, and without looking Shiro could tell that Pidge and Matt were staring at each other, having one of their telepathic sibling conversations.

“Shiro,” Pidge said slowly. “You had to move him around to get his hand on the scanner. It’s not your fault that - ”

“Not that,” Shiro said. “The explosion.”

“Keith was the one who overloaded the door security when I warned him not to.”

“He only did that because he was desperate. He was trying to find the quickest way out. Because he was scared. Because of me.”

“Shiro - ” Matt started.

Abruptly Shiro got to his feet. “I’m - I’m going to go to my room. I just have to - I have to rest my head. It’s - I can’t - ” He took a deep breath. “It was too soon. I shouldn’t have gone on a mission with him, not yet.”

“I know,” Matt said softly. “I know, and I’m sorry, Shiro. I shouldn’t have pushed it.”

“Me neither,” Pidge mumbled, eyes on her feet.

Shiro swallowed, opened his mouth to say, “that’s all right,” or “it’s okay,” or “you were only trying to help.” But instead all he could say was, “Let me know if there are any big changes,” before he turned and left down the hall and didn’t look back.

[fandom-blerd-life]

Black Lightning 1.05: How Do You Feel About Latex?

Previously on Black Lightning, we met Tori, the alliterative addition to the Tobias & Tori evil duo, Anissa explored her new powers, and the kids in Freeland got hooked on a brand new drug called Green Light.

Hellooooooo (Mrs. Doubtfire Voice™) and welcome to another recap of Black Lightning! We’re 5 episodes into this season and there are no signs this show is slowing down. In fact, they’re still introducing new and exciting world-building elements that I 100% did not expect! But as usual, I’m getting ahead of myself.

Last week, Black Lightning got to test out some new electric vision and this week, Gambi hooked him up with some flying action! (Well, it’s closer to a hover than a fly, but the guy’s been gone for 9 years, he’s got to ease in.) During a test flight, Black Lightning notices a kid trying to evade police capture. It turns out, he was high on Green Light. I think the more important note about this scene though, is the fact that the officers were prepared to shoot the kid, even though he was unarmed. And Black Lightning--and in turn, the show--calls them on it. Sure, this kid was tweaking worse than me before my morning coffee, but if the officers felt as threatened as they claimed, they could have tased him first. Once again, small moment, HUGE statement being made by this show. Black Lightning subdues the kid with a lightning blast and uh oh, it looks like he’s having some head pain. Surely it’s just a fluke and won’t come up again.

I don’t know what kind of operation Gambi is running here, but while he’s down in the Lightning Lair, his shop is empty AF upstairs. Not an employee in sight! That can’t be good for business. However, that doesn’t deter Tobias and Henchlady (yay! She’s back!) from making their presence known. Tobias and Gambi trade insults and threats about Black Lightning’s identity, but before our villains leave, we find out that Tobias has some kind of anti-aging serum running through his veins. ::record scratch:: Say what, now?? Tobias doesn’t age? How old is he? Where did this serum come from? What kind of side effects does it have? Is it magic? We all know magic ALWAYS comes with a price! I have questions, show! One person who is not giving up any answers though, is Gambi. We’ve seen hints of his shadiness in previous episodes, but it’s clear that Gambi’s hair is filled secrets upon secrets, including some kind of deal between him and Tobias.

Meanwhile, at Pierce Palace, Anissa is deep into research about enhanced abilities. Like many superheroes before her, she turns to Generic Search Engine dot com. She’s basically one step away from an unstoppable WebMD spiral, when Jennifer barges in to borrow one of her sister’s jackets. I love the Pierce Sister banter in this scene soooo much. They give each other shirt like only sisters can. “Are you watching porn?” I mean, come on! The Pierce sisters are very important to me dot tumblr dot com. Anissa gets back to work, and discovers that 30 years ago in Freeland, 9 kids with enhanced abilities just disappeared.

There are a few things in this episode that are just so quintessentially Black and 2 of them happen at the roller rink. I don’t know about you, but the rink was a staple of my childhood. I had and went to countless birthday parties there. Not only that, roller skating has been a staple in the Black community for decades. It has roots in the Civil Rights era when rinks would have nights specifically for Black folks to come and skate to rhythm and soul music. It gave them a place of their own to have a good time and skate to their own music. We got to see a glimpse of that time in this episode, with the addition of smartphones and a good old-fashioned girl fight. While Jennifer is finding her perfect selfie light, two girls come at her after consuming a large amount of Haterade™. They throw several insults Jennifer’s way (including a low blow about Khalil), but Jennifer claps back with the Blackest of insults by calling out Lana’s crusty ash knees. Only on this show will the thing that sets a girl off be someone else saying they’re ashy. Amazing. Just so perfect. Anyway, Lana lunges toward Jennifer who fights BOTH Lana AND her friend without breaking a sweat! Could it be? Could there be three Pierces with abilities??

Back at the drugstore where Anissa threw a grown ash man across 3 aisles, Jefferson overhears a man pleading with the cashier over medicine he purchased for his sick daughter. Jefferson steps in to help and loses his temper when the cashier takes no responsibility for the situation. That pesky headache is back but this time, it comes with glowing eyes. Huh. Maybe this will be a big deal.

Anissa is still in her research rabbit hole, but learns that when those kids disappeared, there were a series of canceled articles that would have revealed a vaccine to be the source of those enhanced abilities. The editor of the Freeland Gazette who nixed the stories was David Poe, and the reporter who broke the stories? None other than Alvin Pierce, Anissa’s grandfather. DUN DUN DUN. Alvin was murdered and his murder was never solved. Anissa is 100% a Murderino and wants to get to the bottom of this.

Jeff hits the streets again as Black Lightning, but this time it’s to check out an address that could lead them to the Green Light supplier. One of my favorite things about this show is how gorgeous the camera work is. There is a shot of Black Lightning in this scene that damn near took my breath away. Clearly, not everyone in Freeland is excited that Black Lightning is back, because he is greeted by a racist white guy wielding a shotgun. This douchenugget threatens to shoot Black Lightning’s “Black ass” because he know he’ll be seen as a hero. Black Lightning doesn’t let that get to him and blasts douchenugget until he finally admits the chemicals at that address are to make Green Light, and the guy in charge of it? Joey Toledo: Tobias’ right-hand man.

Back in the Lightning Lair, Jeff is pissed at Gambi for hiding the fact that Joey Toledo was still around. In the middle of screaming at Gambi, Jefferson just...falls over. Down for the count. I guess maybe he should have paid a liiiiiittle bit closer attention to those headaches! The writers even had him taking headache meds the last two weeks! But Lynn comes to the rescue and after doing a workup on Jeff, determines that there doesn’t seem to be a medical cause for these headaches, but she wonders aloud of it could be Black Lightning. As if on cue, lightning surges through Jefferson’s body, the monitors go crazy, and he wakes up.

It’s been a bit since we’ve checked in with our villains. What are they up to? Well, Tobias is being arrogant AF and Tori is trying to talk some sense into him. Something tells me he shouldn’t be so cavalier about Lady Eve’s power, because later in the episode, we see Tobias open an envelope filled with dust in a wonderful callback to last week. But Tori isn’t all negativity; she’s also got good news. She found Eldridge and it’s flashblack (I meant to type flashback, but this typo is too hilarious to fix so I’m keeping it!) time! We see a young Tori and an exactly the same age Tobias being berated by their father Eldridge. Specifically, Eldridge can barely stand to look at Tobias’ “pale ass.” Now, I’m not saying Tobias’ #DaddyIssues justify his villainous journey, but Eldridge’s behavior toward his children was atrocious. Hey Tobias, might I suggest some therapy? Perhaps in lieu of, I don’t know, straight up murder?? Think about it.

Meanwhile, it’s time for a little Daddy/Daughter, Superhero-to-Superhero quality time! Anissa wants to talk to Jefferson about her grandpa, his father. At first, he’s hesitant to have this conversation and even snaps at her. But he softens, apologizes, and comments that Anissa has a lot of her grandfather in her. That no matter what, Alvin always did the right thing. That must have been exactly what Anissa needed to hear, because she marches right into the Freeland Gazette to meet with Mr. Poe. They have a cordial conversation and Poe speaks fondly of Alvin, until Anissa mentioned those missing kids. Mr. Poe promptly kicks her out of the office and Anissa is left frustrated and confused.

I wasn’t even going to mention this next seen with Black Lightning and Henderson, but Black Lightning referring to the burner phone he gives Henderson as the “Black signal” had me cracking up too hard for me not to call it out.

Back at the Pierces, Lynn is checking on Jeff when DING DONG, they have visitors and OMG IT’S LANA AND OMG DOES LANA HAVE TWO MOMS? These ladies are not pleased about their (?) daughter’s broken wrist, but Lynn and Jeff manage to talk them down and even end up chatting and laughing with them! At least, until Jennifer comes home. Lynn is ready to serve her daughter some punishment and even drops a “You really wanna play with me right now, little girl?” And y’all. When I tell you I got chills. I could HEAR my mom saying that exact same thing to me when I was younger. You can go ahead and add this to yet another thing that makes this show so damn Black. Jeff, on the other hand, can barely contain his pride when he finds out the Jennifer managed to hold off TWO girls without getting hurt herself. That move costs him though, because somehow both he and Jennifer are on the receiving end of a Lynn Verbal Takedown.

Anissa, our Persistent Polly over here, decides to go back to the paper to get some information out of Poe. He knew she would be back because he had pulled a box of files for her. That box came with a warning though. Alvin had tapped into something huge that Poe wanted nothing to do with. Whoever these people are, they’re still watching, and Poe warns that Anissa will get killed if they find out she’s looking into this. 

Tobias and Tori roll up to Eldridge’s place, and Tobias greets him with swift punch to the face. If you were hoping the years had softened Eldridge, well, you would be incorrect. He throws more insults at his children and even expects praise because he stayed when their mother left them. This is such an interesting story choice. There are so many stories where we hear about Black fathers just up and leaving their children, and rarer is the case where the mother leaves. It’s because of that, Eldridge wants credit for sticking around. He’s not like the other fathers. He stayed. What he fails to realize though, is that even though he stayed, the life he gave his children was no life at all. Tobias goes in for a hug, Eldridge takes the bait, and ends up with a broken back. He’s going to die and he’s going to die slowly.

Back at the house, Jefferson joins Jennifer as she watches track. Jenn is frustrated to be on punishment when all she did is defend herself. Jefferson responds with a quote, “The one thing you can’t take away from me, is the way I choose to respond to what you do to me.” He wants his daughter to realize that defending herself is about regulating her emotions and fighting only when necessary. And then, because they’re the cutest things ever, they throw around Star Wars references and they hug and I LOVE THEM OKAY.

While Anissa goes through her research, she comes across a bunch of articles about Tobias, and a key to a storage facility. Obviously this is a chance for her to suit up and test out those new skills of hers but OH NO, she has too much ass for her cosplay suit! LOL listen. I appreciate this so much. Too Much ass is a real thing and should be treated as such. Time for a new suit! Anissa heads to the store armed with a fake name (Monica) and almost as much sass as her stylist. Cut to a fashion show/montage that I watched...an unimportant number of times. (It was a lot. It was many times.)

She goes to the storage facility rocking her new suit, new hair, and a painted on gold mask. I love that the show is taking their time with an “official” reveal of Thunder. We get to see Anissa exploring her powers on her own and she’s even calling herself a superhero! Once she smashes into the storage unit, she finds a mysterious vial in a safe.

Henderson was able to contact one of Joey Toledo’s old girlfriend’s and even though Gambi tries to talk him out of it, Black Lightning goes to find him anyway. It turns out, Joey Toledo is the Tobias’ henchman from last week who used brass knuckles to kill the Medical Examiner! The two fight, but Black Lightning’s headache comes back just in time to give Toledo the upper hand. We end with Black Lightning on the ground struggling to get up. You might even say, that he could use a spark. (Credit to @CloneNic for that one because LOL)

So, what did you think of And Then the Devil Brought the Plague: The Book of Green Light? I know personally, I wish we got to see our girl Grace, BUT we did get our first taste of Jennifer kicking ass! As always, I’d love to hear from you! You can find me @njnic23 on Twitter. And huge thanks to @punkystarshine for all her advice and editing!

[messymotherfcker]

It’s bell let’s talk day. A day for sharing stories and breaking down stigma around mental illness. I’m more than a little nervous to share this but I think it’s worth sharing. This is my story:

12 years old: I feel sad all the time but can’t cry. Something’s wrong but I don’t have a name for it.

13 years old: The first time I consider suicide. I tell a friend who accuses me of attention seeking. Maybe they’re right. I don’t really know. 

14 years old: Things aren’t getting better. Maybe it’s my fault. Everything feels dark and exhausting. 

15 years old: I am someone special. The world is my oyster. I can do anything I set my mind to. Until I’m too tired to do my homework and my entire body hurts. I’m an athlete though so no one thinks twice. 

16 years old: Things have been ok for a while now. I think I might actually be ok. Until I’m spiralling and everything is clearly not ok. I try to ask for help again, this time from an adult, only to be met with a warning “if you tell me what I think you’re about to tell me I have to tell your parents”. So much for that. I get so sick I lose 15lbs in two weeks. The doctors chalk it up to overtraining and send me on my way. No one notices the cuts on my hips. Or maybe they just don’t care?

17 years old: I graduate this year. My life is falling into place nicely. Somehow I’m still empty. Empty and angry. When I ask for help this time though, someone listens. 

18 years old: Determination, positivity. I’m healthy now so I decide I should be a psychologist. I can totally get a PhD. Oh wait. Not again. I’m empty. I go to the doctor finally. He sends me away with a prescription for antidepressants and advises me to “get more exercise”… did he listen? This started when I was a swimmer. I know my problem isn’t exercise. But no one believes you when you’re a “moody teenager”. 

19 years old: Shit. Hits. The. Fan. One moment I’m choking back tears at work despite loving my job the next I’m convinced I’ve found the key to happiness, there’s a bounce in my step. I am a strong, independent woman. I’m making reckless decisions but I am HAPPY. Aaaaand here we go again. Down I go at record speed. The summer ends in my first stay on a psychiatric ward. 

20 years old: I’m in awe that I’ve survived this long. Wishing that I hadn’t. Another stay on a psych ward and a diagnosis of borderline personality disorder. A suicide attempt means I spend my sisters birthday hooked up to multiple IV’s and monitors, drifting in and out of consciousness. I meet my new psychiatrist and start treatment for bipolar disorder. Things start to look up. 

21 years old: I am stable. Ish. I make it through two whole semesters of university without dropping classes and a gpa of 3.0. Things are going steady at my job. Sure there’s some blips but therapy is helping me manage those. Summer brings a surge in energy and confidence that leads to the completion of a massive project. 

22 years old: I’m almost happy to celebrate my birthday. Perhaps a little tired and slightly empty but I’ve come so far from where I was. Until the meds seem to stop working and I’m spiralling once again. Well shit. 

I know this isn’t a story totally unique to me. In fact it’s more common than you might think. Bipolar disorder is a chronic condition that effects approximately 1-2% of the population. It can often be managed by medication and therapy, however, it takes an average of 10 years to come to the correct diagnosis. All the while patients are unmedicated or incorrectly medicated often leading to the worsening of symptoms, higher likelihood of relapse and increased suicide rates. We can help change this - by starting a conversation about mental health with those we love, by changing the language we use surrounding mental illness, by taking the time to really listen to each other and by educating ourselves.

Finally, I want to thank anyone who has ever taken the time to listen and the friends who have stayed by my side despite everything I’ve put them through.

[pommunism]

so your pet has had a seizure - now what?

watching your pet have a seizure - whether it’s “fly biting” or a total grand mal - can be a deeply traumatic experience. maybe they were sleeping when it happened. maybe they were romping around with their favorite toy and suddenly fell over. regardless, now they’re flailing, their neck is rigid, they’ve lost control of their bowels and bladder, and if you’re like me when my dog first had a grand mal, you’re probably crying. so, what do you do?

first of all, what do seizures look like? in animals, they can manifest in many different ways. a generalized/grand mal, or the most extreme seizure, is when they lose total consciousness, fall over, become rigid, and spasm or paddle their legs like they’re swimming. many tend to urinate or defecate during this time. some stop breathing and turn blue. some drool excessively. some seizures are more minor and the animal may briefly lose consciousness, go limp, stare off into space unresponsively, or have facial twitches. some seizures are psychomotor, meaning they manifest as weird repetitive behaviors such as frantic tail chasing, lip smacking, snapping at the air (”fly biting”), excessive vocalizing, or aggression that are unusual for that specific animal. one animal can have different types of seizures. my dog usually has full-body generalized seizures, but when she was first started on phenobarbital, those eased up into facial twitches.

make sure your pet is away from harmful objects. this includes cords, sharp objects, furniture legs, etc - anything that can cause injury. they are completely unconscious at worst and disoriented at best and don’t understand where they are in relation to their surroundings. do not put your hands anywhere near their mouths. their jaws are also affected by muscle contractions and can reflexively snap down. it has absolutely no reflection on your relationship because they don’t know they’re doing this. the best thing you can do is gently move them to an open area and wait it out. i try to slip a puppy pad or towel under mine because she’s inclined to urinate.

time the seizure. this is SO critical, not just for you but for your vet. before i started using the stopwatch on my phone, i was trying to estimate it just by observation and i was surprised to realize i was overestimating it by a full minute and in reality, her seizures were roughly 10-20 seconds in duration. a seizure that approaches five minutes is an immediate medical emergency.

monitor their recovery. the recovery phase, also called the post-ictal phase, varies wildly between dogs. they may be unconscious for awhile. if possible, it’s a good idea to check the color of their gums and tongues by using something like a nail filer or wooden tongue depressor so you’re not sticking your fingers in their mouth. pink is good, purple means they are very low on oxygen, but if they’re breathing normally they should pink up. wrap ice packs and place them on their bellies and footpads or squirt alcohol on their footpads. overheating is the biggest complication of seizures, especially for overweight animals. they may have lost control of their bowels and bladder, so you can clean them up as best you can. it doesn’t hurt to pet them and speak softly to them. some may pop up and act almost normal. others may wake up but be temporarily blind, disoriented, clumsy, clingy, aloof, aggressive, hungry, thirsty, or have other behavioral changes for an hour or so afterwards.

write down everything that happened. this includes the date, the time the seizure started, the duration of the seizure, description of the seizure, any changes you might have noticed shortly before onset, and what their recovery was like. i keep a seizure journal in the form of index cards. this not only helps you keep track of seizures  - especially if there are more than one - but helps you and your vet look at patterns and frequency. some don’t seem to have any triggers, but others do. stress is a common one. our groomer has had to bring a dog to treatment more than once because it started seizing as soon as he put it in the tub.

are seizures an emergency? when in doubt, my answer is always yes, please take it to the vet as soon as possible. however, i understand that sometimes these things happen after hours and emergency services can be expensive. in this case, i’ll tell you to look at context. one seizure by itself isn’t necessarily an emergency, as long as it’s not secondary to another event - trauma, liver complications (is your animal yellow?), poison, etc are all events that demand immediate attention by a vet, seizures or no. if your animal has more than one seizure in a 24 hours period, that’s called clustering, and is a medical emergency. having one seizure lowers the threshold, making them more susceptible to having them. the more they have, the less time they have to recover from the previous one, meaning their brains aren’t completely able to stop misfiring and can potentially lead to the worst case scenario: status epilepticus. this happens when the brain can’t stop misfiring, period, and the pet can’t stop seizing. status epilepticus refers to a seizure that lasts five minutes or longer. this is an absolute emergency. your pet’s brain will essentially fry itself and lead to permanent brain damage and death. personally, i would have my emergency vet on the phone once my dog hit the 3 minute mark.

what happens at the vet? your vet will want background, not just about the seizure itself but the context of it and history of the pet. they may want to do blood work and x-rays. ct scans and mris are great, but out of most people’s means. animals from pet stores or backyard breeders are more prone to epilepsy because of poor breeding practices, such as inbreeding. certain dog breeds are more prone to epilepsy, such as herding dogs, boxers, and cocker spaniels. the age of the pet matters - very young animals may have a liver defect called a portosystemic shunt, while much older animals are more likely to have a brain tumor. it can be an emotionally draining appointment.

epilepsy can be managed. if your pet is diagnosed with epilepsy, the good news is that most pets respond to medication and can have normal lifespans. the first drug of choice is phenobarbital. it’s inexpensive and very effective. chronic use may eventually impact the liver, so your pet will have to have routine testing to ensure it’s in the proper range and its liver is still functioning well. some pets can stay on nothing but phenobarb their whole lives. sometimes you may be given diazepam - aka valium - that you can administer rectally to stop seizures. potassium bromide and zonisamide are most commonly used as a secondary anticonvulsant when phenobarb alone isn’t enough. keppra is also good, but less common and more expensive. instead of rectal diazepam, my dog is on intranasal midazolam, which is better to manage her problem with clustering. there are side effects, but they generally improve after a few weeks on the meds. it’s not unusual for pets to have breakthrough seizures even when they’re otherwise well-managed. some may have one seizure every 6 months. my dog clustered for no discernible reason not that long ago, but my vet and i agreed it didn’t warrant a change in meds.

the important thing to remember is that epilepsy is not a death sentence, and it doesn’t have to affect your pet’s quality of life. dogs and cats don’t have our level of awareness; believe it or not, they don’t suffer half as much having the seizure as you do watching it. my dog is as happy and stupid as ever - happier, in fact, because she actually had anxiety until she went on phenobarb. i genuinely believe she’s never been happier, not even compared to the seven years she lived without a single seizure. it’s not a burden to give her medicine twice a day (ALL my dogs’ favorite time of day, because “pill time!” means peanut butter) or always have one ear listening for the sound of her paddling on the floor, it truly isn’t. it’s just another routine, and one that keeps her healthy, happy, and by my side.

so your pet has had a seizure - now what? well, now you know you’re not alone, and whether it’s epilepsy or not, i hope this helped you in some small way. 

[ulrichfoester]

My Teen Just Started Antidepressants, What Should I Look Out For?

Many parents are concerned about how a new long term medication will affect their teenager, especially in the first few weeks. It’s reassuring to think about how antidepressants will improve the life of a depressed or anxious teenager, but those effects don’t appear right away. Here’s a guide on how to monitor your teen during those first few weeks of transitioning before the antidepressants kick in.

Watch Out for Worsening Symptoms

First and foremost, parents should be aware that one of the side effects of a new antidepressant is worse anxiety or depression, including suicidal thoughts. It seems unusual that the medication would have the opposite effect of what it’s prescribed for, but research indicates that it happens in children and teens more often than in adults. To make sure your teen isn’t one of the few who are negatively affected by their new medicine, it would be a good idea to keep an eye out for any unusual changes in behavior. Increased anxiety or suicidal ideation can manifest itself in anger, isolation, or insomnia. If your teen is suddenly throwing fits, hiding from the world, or having trouble with their sleep, there might be serious implications. If you notice these changes in the first few weeks, you should report them to your teen’s psychiatrist right away.

Physical Side Effects

Most antidepressants come with a long list of potential physical side effects that you should look out for as a parent. Some of the common side effects are digestive problems, nausea, dizziness, weight gain, dry mouth, headaches, sedation, and sexual problems like lower sex drive and the inability to achieve orgasm. You should know that if your teen is experiencing any of these side effects, they usually go away after the first few weeks. However, if they persist, we recommend you talk with your teen about whether or not the benefits outweigh the cons. If it’s not worth it, you might want to talk to your teen’s psychiatrist about tapering off the medication and starting a trial on a new antidepressant. Everyone’s body is different and it might take a few tries to find a medication that is a good fit, but don’t get discouraged if you don’t find a perfect match on the first try.

Keep Them on Schedule

One of the best ways to watch out for your teen who is starting antidepressants is to make sure they are taking their medication regularly. A lot of antidepressants require a gradual increase in dose to reduce the chance of side effects until your teen arrives at the ideal therapeutic level. It’s important to check in with your teen to make sure they are increasing their dosage at the right pace and not missing doses so the medicine doesn’t cause any undesired effects. Plus, forgetting to take the medication for a few days might mean that your teen has to restart the dose back at a low level again, meaning it will take even longer for their depression or anxiety symptoms to start improving.

Some reminders you can use include posting notes in a visible place like the bathroom mirror. You might want to write down an inspirational quote along with a friendly reminder for your teen to take their meds. Another is using apps on your teen’s smart phone to set alarms for their medication schedule. You could also check in at the end of the week for a progress report on how often your teen is taking their medication to remind them to be more responsible.

Don’t Let Your Teen Rely on Meds Alone

We think it’s very important to teach your teen that antidepressants won’t magically cure everything, so watch out if your teen is depending on the medicine instead of actively making other lifestyle changes. Medication is more like training wheels that make solving psychological problems a little easier. If your teen decides to rely solely on medication, they could be missing out on developing lifestyle changes such as getting more exercise, socializing more, or improving time management that can also boost their mood. To best help your teen get over their depression and anxiety symptoms, we recommend that they start taking to a therapist in addition to starting the medication. A therapist can help your teen talk through complex problems and come up with helpful solutions so your teen can use medication as one of many self-improvement tools instead of a single crutch.

Signs of Improvement

As a parent concerned about your teen’s mental health, you are probably looking out for signs of improvement. Many of the positive effects of the medication don’t appear in the first few weeks, it could honestly take a month or two for the desired effects to kick in. This is an important perspective because you and your teen shouldn’t feel like the medication is useless if it’s taking a while to make a noticeable difference. Although, slight effects might start to appear within two weeks’ time. We think you should pay attention to small changes like laughing more often or having a little bit more optimism because sharing those changes with your teen can help them to keep up with their regimen.

Thanks for Looking Out

The transition that comes with starting a new medication presents a few challenges to your teenager like potential side effects or a feeling that it’s taking too long to start working. As a responsible parent, you now know what exactly to look for to make sure that your teen is on the right path to improvement. Even if it’s tough at the beginning, remember to encourage your teen that it will get better.

The post My Teen Just Started Antidepressants, What Should I Look Out For? appeared first on The Treatment Specialist.

My Teen Just Started Antidepressants, What Should I Look Out For? published first on https://familycookwareshop.tumblr.com/

[ntrending]

FDA approves a digital pill to track whether patients are keeping up with their meds

New Post has been published on https://nexcraft.co/fda-approves-a-digital-pill-to-track-whether-patients-are-keeping-up-with-their-meds/

FDA approves a digital pill to track whether patients are keeping up with their meds

Not all will need regulatory clearance, and some are already being used or tested in patients with heart problems, stroke, H.I.V., diabetes and other conditions.

Because digital tools require effort, like using an app or wearing a patch, some experts said they might be most welcomed by older people who want help remembering to take pills and by people taking finite courses of medication, especially for illnesses like tuberculosis, in which nurses often observe patients taking medicine.

The technology could potentially be used to monitor whether post-surgical patients took too much opioid medication or clinical trial participants correctly took drugs being tested.

Insurers might eventually give patients incentives to use them, like discounts on copayments, said Dr. Eric Topol, director of Scripps Translational Science Institute, adding that ethical issues could arise if the technology was “so much incentivized that it’s almost is like coercion.”

Another controversial use might be requiring digital medicine as a condition for parole or releasing patients committed to psychiatric facilities.

Abilify is an arguably unusual choice for the first sensor-embedded medicine. It is prescribed to people with schizophrenia, bipolar disorder and, in conjunction with an antidepressant, major depressive disorder.

Many patients with these conditions do not take medication regularly, often with severe consequences. But symptoms of schizophrenia and related disorders can include paranoia and delusions, so some doctors and patients wonder how widely digital Abilify will be accepted.

“Many of those patients don’t take meds because they don’t like side effects, or don’t think they have an illness, or because they become paranoid about the doctor or the doctor’s intentions,” said Dr. Paul Appelbaum, director of law, ethics and psychiatry at Columbia University’s psychiatry department.

“A system that will monitor their behavior and send signals out of their body and notify their doctor?” he added. “You would think that, whether in psychiatry or general medicine, drugs for almost any other condition would be a better place to start than a drug for schizophrenia.”

The newly approved pill, called Abilify MyCite, is a collaboration between Abilify’s manufacturer, Otsuka, and Proteus Digital Health, a California company that created the sensor.

The sensor, containing copper, magnesium and silicon (safe ingredients found in foods), generates an electrical signal when splashed by stomach fluid, like a potato battery, said Andrew Thompson, Proteus’s president and chief executive.

After several minutes, the signal is detected by a Band-Aid-like patch that must be worn on the left rib cage and replaced after seven days, said Andrew Wright, Otsuka America’s vice president for digital medicine.

The patch sends the date and time of pill ingestion and the patient’s activity level via Bluetooth to a cellphone app. The app allows patients to add their mood and the hours they have rested, then transmits the information to a database that physicians and others who have patients’ permission can access.

Otsuka has not determined a price for Abilify MyCite, which will be rolled out next year, first to a limited number of health plans, Mr. Wright said. The price, and whether digital pills improve adherence, will greatly affect how widely they are used.

Questions about the technology’s ability to increasecompliance remain.

Dr. Jeffrey Lieberman, chairman of psychiatry at Columbia University and NewYork-Presbyterian Hospital, said many psychiatrists would likely want to try digital Abilify, especially for patients who just experienced their first psychotic episode and are at risk of stopping medication after feeling better.

But he noted it has only been approved to track doses, and has not yet been shown to improve adherence.

“Is it going to lead to people having fewer relapses, not having unnecessary hospital readmissions, being able to improve their vocational and social life?” he asked.

He added, “There’s an irony in it being given to people with mental disorders than can include delusions. It’s like a biomedical Big Brother.”

Abilify, a widely used drug, went off patent recently, and while other companies can sell the generic form, aripiprazole, Otsuka, has exclusive rights to embed it with Proteus’s sensor, said Robert McQuade, Otsuka’s executive vice president and chief strategic officer.

“It’s not intended for all patients with schizophrenia, major depressive disorder and bipolar,” he added. “The physician has to be confident the patient can actually manage the system.”

Dr. McQuade said, “We don’t have any data currently to say it will improve adherence,” but will likely study that after sales begin.

Proteus has spent years bringing its sensor to commercial use, raising about $400 million from investors, including Novartis and Medtronic, Mr. Thompson said.

Until now, the sensor could not be embedded in pills, but pharmacies could be commissioned to place it in a capsule along with another medication.

In 2016, the encapsulated sensor started being used outside of clinical trials, but commercial use is still limited, Mr. Thompson said.

Nine health systems in six states have begun prescribing it with medications for conditions including hypertension and hepatitis C, the company said, adding that it has been found to improve adherence in patients with uncontrolled hypertension and others.

AiCure, a smartphone-based visual recognition system in which patients document taking medicine, has had success with tuberculosis patientstreated by the Los Angeles County Health Department and is working with similar patients in Illinois, said Adam Hanina, AiCure’s chief executive.

He said AiCure has shown promising results with other conditions, including in schizophrenia patients whose pill-taking would otherwise require direct observation.

A Florida company, etectRx, makes another ingestible sensor, the ID-Cap, which has been or is being tested with opioids, H.I.V. medication and other drugs.

Made of magnesium and silver chloride, it is encapsulated with pills and avoids using a patch because it generates “a low-power radio signal that can be picked up by a little antenna that’s somewhere near you,” said Harry Travis, etectRx’s president, who said the company plans to seek F.D.A. clearance next year.

The signal is detected by a reader worn around the neck, but etectRx aims to fit readers into watchbands or cellphone cases.

“I get questions all the time, ‘Hey is the government going to use this, and can you track me?'” said Eric Buffkin, an etectRx senior vice president. “Frankly, there is a creepiness factor of this whole idea of medicine tracking.

“The thing I tell them first and foremost is there’s nothing to reach out of this technology to pry your mouth open and make you take a pill. If you are fundamentally opposed to this idea of sharing the information, then say, ‘No thank you.'”

Seeking to address concerns about privacy and coercion, Otsuka officials contracted with several bioethicists. Among them, I. Glenn Cohen, a Harvard law professor, said safeguards adopted include allowing patients to instantly stop physicians and others from seeing some or all of their data.

Asked whether it might be used in circumstances like probation or involuntary hospitalization, Otsuka officials said that was not their intention or expectation, partly because Abilify MyCite only works if patients want to use the patch and app.

How patients will view Abilify MyCite is unclear. Tommy, 50, of Queens, N.Y., who takes Abilify for schizoaffective disorder, participated in a clinical trial for digital Abilify.

Tommy, who withheld his last name to protect his privacy, encountered minor issues, saying the patch was “a little bit uncomfortable” and once gave him a rash.

A compliant patient, Tommy said he does not need monitoring. “I haven’t had paranoid thoughts for a long time — it’s not like I believe they’re beaming space aliens,” he said. If offered digital Abilify, he said, “I wouldn’t do it again.”

But the method might appeal to patients who want to prove their compliance, build trust with their psychiatrist, or who feel “paranoid about getting accused of not taking their medicine.”

Steve Colori, 31, of Danvers, Mass., who wrote a memoir about his illness, “Experiencing and Overcoming Schizoaffective Disorder,” said he took Abilify years ago for symptoms including believing,”I was a messiah.”

Although he sometimes stopped taking medication, he would consider digital pills “overbearing and I think it stymies someone and halts progress in therapy.”

William Jiang, 44, a writer in Manhattan with schizophrenia, took Abilify for 16 years. He said he steadfastly takes medication to prevent recurrence of episodes of paranoia when “I was convinced everybody was trying to murder me.”

He said some noncompliant patients might take digital Abilify, especially to avoid Abilify injections recommended to patients who skip pills.

“I would not want an electrical signal coming out of my body strong enough so my doctor can read it,” Mr. Jiang said.

“But right now, it’s either you take your pills when you’re unsupervised, or you get a shot in the butt. Who wants to get shot in the butt?”

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[andywg]

A New Direction

Well, I have been fairly cool with this blog for some time, but now I wonder if it is time to try and put some effort back into it. However, as if to make up for lost time, this is a long one (as the actress said to the bishop). The subject is tantalisingly held out for you above the jump. 

Those who have followed for a while will know that I used to run quite swift, but then fell out of love with it and life just kept getting in the way. Recently my wife gave birth to our first child and we have been engrossed in the first time parents thing, which has been made more complex by his frequent hospital admissions. Firstly he was in for airway issues and severe reflux, and this spring he developed a sever epilepsy that required three admissions in two months, the last one was so sever (Status eplipticus) that the only way to control the seizures was to sedate him, put him on a ventilator to breather for him and send him to Paediatric Intensive Care Unit to monitor and extubate when he was settled sufficiently. This took some time as he failed the first attempt as the ventilator tubes inflamed his laryngomalacia, Effectively he was in a coma from the Sunday to the Friday and then needed some proper management for opiate withdrawals as he was a rhino to sedate. Whilst my son was in the hospital we got the results of some tests run after his first admission two months before. We finally had a diagnosis to explain the epilepsy, the ataxia (shaking movements) and the delayed development - my son has Angelman Syndrome – a chromosomal disorder which appears not to have been inherited, he just happened to win a really shit lottery with odds of 1 in 15,000 to 20,000 at the time of his conception. This will leave him with mild to moderate physical disabilities and severe mental and learning difficulties.

This was hard to take in. I have always queried whether I might really be up to the job of raising a child and my one certainty was that I did not believe I could cope with looking after a child with serious mental disabilities; I just could not even begin to empathise with what one must go through. Now, in a heartbeat, I am told I will have to find out and master it. The first step was a kind of grieving for the life I had thought I would have with my son. Any hopes of running and cycling with him, or watching him play rugby were scuppered. We will be quite lucky if he walks unaided and the general expectation is that he will speak between 5 to 10 words (though comprehension should be better such that non-oral communication with PODD books and the like allows better expressions of their feelings). It also means he will never live an independent life, we will always be parents to a toddler of some age.

And after feeling grief and upset (and constantly asking why this had to happen to us) I then feel guilty as I still love him and nothing will change that and I feel I should be happy for what we do have, mostly being a permanently happy child, rather than sad for what we have not.  Then there is the fear of just how will I cope with this?

The exact details of how our home will have to be modified are yet to be discovered as depending on how he develops depends on what the house needs. Whilst it will certainly need some level of wheelchair access and him to have a downstairs bedroom and bathroom, if the wheelchair is only required for when he is ill rather than all the time then it changes our approach.

I try to remain positive in the outlook, but suddenly it seems like everyone I know has a healthy child that is developing normally, any social gathering just rams home the condition. This was hard in the period after our first baby was miscarried, but at least then there is a finality to it. Again, I do not wish death or anything ill on my son, but this is something I have to face and deal with every day of my life. I know that is a little dark, but I can say it is not the darkest thing to cross my mind for a fleeting moment since we received the diagnosis. And having so many people now say they know we are strong and will make great parents for a child with Angelman Syndrome does not help as much as they might think it does. The sour part of me thinks how that is exactly what I would say and then wake up the next day relieved that it was not me going through that.

Thankfully, for now, the epilepsy appears to be under control, and that is what will cause the immediate risk to my son's health and development. That period of 9 days in in intensive care knocked our son back a few weeks as well as restricting our ability to to give him physio to help him develop as much as we can. As he has presented with his epilepsy earlier and more severe than many, we have a diagnosis much earlier than many others, so we have a chance to try and assist with the alternative communication and applying the physio to help develop the weaker muscles.

For me, I am waiting for a good recommendation so I can get counselling to deal with all sorts of issues I have (and no doubt some I don't notice I have) and come to terms with this. There are so many points, from the medication timetable meaning we cannot simply wake him and feed him, but have to plan things around meds that need half an hour either side without consumption, to needing to put in the physio work such that when after time for feeding, on the bottle, napping and bathing there is so little time for just playing and enjoying having a baby. Further, there are so many hospital and doctor appointments it is tough to get into any routine.

However, I should be thankful we are no longer in PICU and are home and seemingly improving.  For reference, here he is whilst in PICU but shortly after coming off the ventilator:

And, more recently, seemingly telling some secrets to the cat from CATS (Children Acute Transport Service - the charity that transported him from our local hospital up to London where he was monitored whilst on the ventilator):

When I am away from other children, and just spending time with my son, his easy broad smile and infectious chuckle make me not care for anything else.  And for now that is the most important lesson, to enjoy my son for being the small baby that he is. Today has plenty enough concerns that there is no need to borrow worries from tomorrow.

Finally, as a concluding homage to my original purpose for this blog, a new member of my team at work is a beastly good runner and seems to have taken me under his wing as a project. Despite my frequent protestations (particularly when I am busting a gut on a short effort and he leans in to quip that this is his marathon pace) he has worked wonders. Before I started 8 weeks off work to become the primary carer for my son I was in close to, if not the, form of my life. I finally broke the 20 minute barrier for 5k, but did so at the halfway point in a 10k race. I managed a 29 second 5k PB on my way to an 89 second 10k pb (40:38) of a time I had set only a month before and way faster than my last best effort of 44:17 in 2011. The next step is a marathon or two and then I will ponder some longer things. Providing I can find the time to train.

[alexatwood86]

Rehab for amphetamines

Got a problem with an Amphetamine?

If you find yourself asking:

Why can’t I stop taking speed over and over again?

Why do I need more to get the same effect?

How can I get out of this horrible cycle of using drugs to feel OK?

Do not despair.  You are not alone!

We’re here to help.

If you can’t quit using on your own, it might be time to ask for help. And we are coming to understand that a drug problem is a medical condition. In fact, amphetamines can “hijack” the brain, changing the way that it functions. When you understand addiction as a medical condition that responds to medical treatment, you can take hope. And we’re here to tell you:

Treatment works!

In this article, we’ll introduce you how drug rehabs can address the issue of chemical drug dependency.  We’ll also briefly explain the amphetamine treatment protocols to prepare you what to expect. Finally, we gladly welcome your question(s) in the comment section at the end. Or, feel free to share your personal experiences with us.

Your recovery matters.

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Treatment can help you find new meaning in life. Regain your freedom. Call 1-877-217-8574 TODAY.

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Why do people use amphetamines?

1. As medical treatment. 2. To get high.

Amphetamines – also known colloquially as “uppers” – are a class of drugs known as stimulants, which decrease feelings of fatigue while they increase energy and wakefulness. Some individuals take amphetamines prescribed by their doctors for legitimate reasons such as ADHD or narcolepsy. However, these types of drugs may also be taken illegally for recreational reasons.

Chronic use or abuse of amphetamines will often lead to physical dependency and addiction. This is because stimulants make us feel extremely good. As we repeat drug use, the brain becomes “wired” for this cycle of pleasure. Over time, our decision making centers at the front of the brain weaken, and our personalities change.

Use drugs.

Feel good.

Repeat.

Signs of a drug problem

So how can you know if you or a loved one is using amphetamines in a dangerous way? Signs of drug misuse can include:

Taking other people’s prescription.

Using amphetamines in a way other than prescribed.

Using an amphetamine prescription to get high.

Mixing amphetamine with alcohol and/or other drugs.

People who are addicted to amphetamines will usually find that they are unable to function without their drug of choice. They will also usually experience a number of uncomfortable (and possibly dangerous) withdrawal symptoms when they do not take the drug for an extended period of time. Of special concern include withdrawal symptoms that can provoke suicidal ideation, such as:

depression

dysphoria (deep disatisfaction)

extreme fatigue

Readiness for rehab

Rehab for amphetamine addiction is often an effective way to break the cycle of addiction. However, it can be hard to determine if you need rehab or if you’re even ready take the first steps toward recovery. So, who can benefit most from amphetamine rehab and treatment?

You might be ready for rehab if:

You’ve tried quitting on your own, but can’t.

You can benefit from a daily routine.

You are no longer in denial of a drug problem.

Leaving your home environment will help reduce stress.

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Why Waste Another Second in Pain? We Can Help You Get Back on Your Feet. Call Us at 1-877-217-8574. Recovery Starts Now.

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Amphetamine Addiction Treatment

Q: What does rehab for amphetamine addiction look like? What can you expect?

A: Generally, there are two types of rehab for amphetamine addiction: inpatient or outpatient treatment.

Inpatient programs, also known as residential treatment, require you to live into a controlled environment where you’ll undergo a structured program. Meals are planned. So is regular sleep. These daily routines help re-set your biological, chemical system. Inpatient amphetamine rehabs also provide 24-hour medical and emotional support during detox and treatment. Residential treatment programs allow you to decide between programs with different lengths. You can either choose to undergo a 30-60-90 or longer treatment program.

Outpatient programs are usually part-time programs that operate in the AM or PM. They allow you to keep going to work or school during the day, while visiting recovery lessons at night. These treatment programs are flexible and recommended for those who cannot leave home or work to seek treatment.Most programs last for 10-16 weeks, although some people benefit from attending treatment for a year or longer. While outpatient programs are less expensive, they do require high levels of commitment. In fact, experts recommend that those who’ve tried quitting on their own (but have failed) consider an inpatient facility first.

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Amphetamines will drain your life of meaning. Call 1-877-217-8574 and start recovering TODAY. Live the life that you dream of!

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Customized rehab

Addiction is best treated from person-to-person. In other words, a treatment plan is a very individualized process. Not all treatment methods will work the same way for everyone. In fact, reputable rehab plans are generally created based on a case by case basis. Some or all of the following elements may be used during a stay in an amphetamine rehab.

1. Assessment

Initial medical assessment includes a physical exam, standard interview questions, a medical history, and drug testing. Doctors and addiction specialists use assessment and screening tools to determine the extent of a person’s addiction as well as identify any other mental health issues that may be contributing to the addiction. Co-occurring disorders such as depression, anxiety, or trauma issues can also be treated during amphetamine rehab. Once the initial assessment is complete, a rehabilitation plan can be created. Oftentimes, periodic assessments are also used to determine how effective a rehabilitation program is and if changes need to be made.

2. Medical detoxification from amphetamines

Occasionally, an individual addicted to amphetamines may need to undergo a supervised medical detox from the drug. While this isn’t always necessary, a medical detox has a number of benefits over detoxing from the drug alone. First of all, detoxing from amphetamines can result in numerous side effects, including strong cravings for the drug, tremors, dehydration, extreme fatigue, and possibly even heart problems or seizures. During medical detox, doctors and nurses can monitor a patient and possibly ease some of these symptoms. Additionally, the likelihood that an addicted person will relapse in medical detox is much lower than if he or she tries to detox alone.

3. Psychological treatments

Mental health treatment is often at the core of all reputable programs. Individuals struggling from addiction typically participate in individual and group therapy sessions, which can help them better understand addiction and how to overcome it. Many amphetamine addicts will also be treated for underlying mental health problems, such as depression or anxiety, which can either contribute to or be caused by their addictions. Addressing these issues is crucial to maintaining long term abstinence from amphetamines. Family counseling can also be helpful for some amphetamine addicts and their loved ones.

4. Addiction education sessions

During the course of amphetamine addiction rehabilitation, individuals typically attend numerous addiction education sessions. These sessions help addicts better understand that, while environmental factors do contribute to substance abuse, addictions are also influenced by biological and genetic factors. This gives many people the hope, determination, and skills needed to beat an addiction.

5. Support and social services

Since it’s nearly impossible to beat an amphetamine addiction without help, a strong network of support is imperative during rehab for amphetamine addiction. This can include social support, such as group therapy sessions, as well as typical social worker case management in areas of financial, medical, and vocational support. Addicts may qualify for financial support to help cover the cost of their treatment. Some rehabilitation programs may even offer education and vocational programs on site to help recovering addicts become self-supportive once they finish their treatment.

Medication During Amphetamine Treatment

Q: Can medications be used during amphetamine addiction treatment? A: There are no officially approved medications used to treat amphetamine addictions.

However, over-the-counter or prescription medications may sometimes be used to ease some of the amphetamine withdrawal symptoms that many people experience. Furthermore, when you undergo a medically supervised detox, doctors may administer the following meds to ease the intensity of your withdrawal symptoms:

Analgesics, for the relief of headaches and other minor pains.

Antidepressants for significant clinical depression.

Benadryl is prescribed to help you with agitation during detox.

Trazodone is sometimes prescribed as a sleep aid. This medication can help with cases of severe insomnia.

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Decide NOT to stay where you are. Reach out for help for your addiction. We can help you reach sobriety. Call 1-877-217-8574.

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Rehab for amphetamine Questions

As you can see, rehab for amphetamine addiction consists of a wide range of services and treatment options that can be tailored to your individual needs. What’s next?

Take a step towards recovery and reach out for help.

If you or a loved one is suffering from an amphetamine addiction, there’s no time like the present to seek help. If you have any additional questions about amphetamine rehab or would just like to share your experience, don’t hesitate to leave a comment below. We love to hear from our readers, and we look forward to helping you move forward.

Reference Sources: DEA: Drug Fact Sheets

NIDA: Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

NIDA: DrugFacts: Treatment Approaches for Drug Addiction

NIDA: Prescription Stimulant Medications

State of New Jersey: Division of Addiction Services

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