#can a biopsy tell if you have cancer

[ceyhanmedya]

What is a biopsy? 2023

New Post has been published on https://bankakredin.com/what-is-a-biopsy-2023/

What is a biopsy? 2023

BiopsyBiopsy, which is a diagnostic method, is the process of removing cells, fluid or tissue from the area of ​​​​the body where the disease is suspected, by surgical methods. Biopsy, which is the process of examining a small tissue, cell or fluid sample taken from the patient in the pathology laboratory for the definitive diagnosis of many diseases, especially cancer, can also be performed during surgery in some cases. As a result of the pathological examination, the changes and abnormalities in the patient’s tissue or organ are examined and reported by the pathologists. Thus, the diagnosis required for appropriate treatment becomes clear. Suspicious tissues are examined thanks to the biopsy, which has been applied for centuries, with advanced technology and knowledge, which can get very fast and precise results. With the applied biopsy method, the entire tissue can be removed when necessary. 

What is a biopsy?

Biopsy, which is the process of taking tissue from the area thought to be a disease or mass in the body, can be performed using different needles without the need for open surgery. In the presence of a mass in the suspected organ, the relevant area can be clearly identified by imaging the biopsy method. The procedure, which is mostly done to determine whether the tissue or tumor is benign or malignant, is also done to determine the stage and course of the disease in some infections or inflammatory diseases called inflammatory. With biopsy methods performed using local anesthesia, a small piece is taken by entering the lesion in the suspicious area with a needle and sent to the pathology laboratory to determine the result.

How is a biopsy done?

Biopsy, which has no health hazard when performed by a specialist physician under appropriate conditions, is performed using different equipment and techniques depending on the region where it is performed. Some biopsies are performed with imaging, some are performed during and after surgery, and some are performed under local anesthesia.

How is a lung biopsy done?

In the presence of lung diseases or lung cancer detected after a chest X-ray or tomography, lung biopsy is performed for a quick and definitive diagnosis. Local anesthesia is applied to the area where the mass is detected in the lung, tissue pieces are taken from the relevant area by fine needle aspiration biopsy or thick needle biopsy. The procedure is performed with imaging accompanied by ultrasound or computed tomography. Samples are taken with the help of a thinner needle that is passed through a wide needle that pierces the lung membrane. In this way, air leakage to the pleura is prevented or even if air escapes, it can be evacuated.

How is a liver biopsy done?

It is performed to examine the damage caused by many diseases such as hepatitis, fatty liver, and cirrhosis. It can also be applied to clarify the diagnosis of the existing mass in the liver. Since sedative medication will be administered via the intravenous line before the procedure, the patient should be fasted 5-6 hours before the procedure. A small incision is made in the relevant area of ​​the patient lying on his back and a piece of tissue is taken with the needle biopsy method. The patient remains under observation in the hospital that day and is discharged the next day.

How is a kidney biopsy done?

In the diagnosis of undetected kidney disease, when it is necessary to obtain information about the status of the existing disease, when it is necessary to learn the status of the transplanted kidney, kidney biopsy is a procedure of about half an hour. It is performed under local anesthesia with ultrasound-guided needle biopsy method. Since there is a risk of bleeding after the procedure, the patient is kept under observation for 24 hours. In the meantime, the patient’s condition is checked by making urine and blood counts.

How is a breast biopsy done?

With a breast biopsy performed in as little as 15 minutes, cell, tissue or mass removal can be performed. It is performed using ultrasound MRI or tomography, needle biopsy under local anesthesia, vacuum biopsy or surgical biopsy under general anesthesia. The factor in determining the method is the size of the audience.

How is a thyroid biopsy done?

The procedure, in which there is no possibility of bleeding, is performed under local anesthesia with ultrasound guidance. Before the biopsy procedure is started, the entry and passage route is determined by the radiologist with detailed ultrasound. Cells are taken from the thyroid nodule with the fine needle aspiration technique. If there is more than one nodule, the procedure is done one by one for each nodule. Thus, it is clarified whether the nodule is benign or malignant. After the procedure, the patient can return to his normal life after being kept under observation for about half an hour.

What are the types of biopsy?

Needle Biopsy:  It is applied with two different methods. Fine-needle aspiration biopsy, also known as percutaneous biopsy, is performed with the help of a black needle injector. This method, which is the process of taking cells from the targeted tissue, is mostly applied in thyroid nodules and prostate diagnosis. Thick needle biopsy, which is another needle biopsy, is a method in which cylindrical tissue pieces are taken from the targeted mass.

Open Surgical Biopsy:  A part of the mass in the suspected area or all of it, as in lumpectomy, is removed through the incision made under general anesthesia.

Brush Biopsy : It is performed endoscopically and is a method of examining the swab taken by applying a small brush to the tissue.

Chorionic Villus Biopsy:  Chorionic villus biopsy, abbreviated as CVS, is a method applied to pregnant women between 10 and 12 weeks. It is made from the cervix or abdomen to detect genetic and chromosomal abnormalities of the baby in the mother’s womb.

Cone biopsy:  It is the process of removing cone-shaped tissue from the uterine cervix.

Endoscopic Biopsy:  Small pieces of tissue are taken with instruments passed through the endoscope channel. With a lasso-like equipment, the tissue is cut by strangling or cauterizing, that is by burning, and is removed by holding it with another instrument.

Senitel Lymph Node Biopsy:  Blue dye is applied to the patient in order to mark the lymph node where the cancer cells in the tumor are most likely to spread. Lymphatic vessels first carry this dye to the area where the cancer is located, namely the lymph node. With another device, the area with color change is detected and the relevant area is removed.

Biopsy with Shaving Method:  It is the process of removing the area under the lesion on the skin together with the upper part of the skin. With this method, the shaved area is removed parallel to the skin.

Stereotactic Biopsy:  With this method used in the brain and breast, the biopsy area is determined. With the help of tomography, the biopsy area is clearly determined. A biopsy is done with the help of a needle or wire.

Punch Biopsy:  With this method, which is mostly applied to the skin, a piece of tissue is removed with a small cutting tool.

Vacuum Biopsy:  Vacuum-assisted biopsy begins with the insertion of a needle with a sharp edge and a hole into the lesion. While the needle, which is moved back and forth, shaves the tissues, the tissues are pulled by the vacuum inside the needle.

All parts removed from the body by this and other biopsy methods are placed in transparent glass and plastic containers and sent to the pathology laboratory without disturbing the tissue integrity. Biopsies performed during the surgery are examined and reported macroscopically and microscopically by the specialist physician, provided that they are prioritized in the laboratory.

For a long and healthy life, do not forget to have your check-ups at regular intervals.

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[dontmeanyoudontmissit]

.

[a-sleepy-ginger]

21/6/24

❊✺❂✺❊

Had alot of fun drawing

Yuru camp

[scientia-rex]

I had one of those days where I just had too many feelings to fit inside my skin, and I’ll have to recover from it.

Telling a patient she has breast cancer. Telling a patient she has dementia. Calling a patient at 6:30pm, still sitting at my desk, because even though I finished seeing patients at 5pm, I have work to do. Doing an endometrial biopsy on a patient who may have cancer. Calling a company so I can get the password to a website so I can recredential every three months so my clinic can charge for my work. Working with an assistant on whom I’ve also done an endometrial biopsy. My regular MA is out with COVID. I’m getting a year-end bonus for the first time in my life. Some idiot kid thinks I don’t know how ears work. I saw back to back ADHD patients; one is a trans woman who paused her transition because she can’t afford it. One is a kid who did loops around the exam room chairs the whole time I talked to his mother. His mother was frosty towards me at first because I was running late because I was telling a patient she had breast cancer, and she was crying, and her daughter was crying, and when her partner died of a different cancer last year the hospice workers were homophobic and she’s afraid of hospice. A different idiot kid thinks I don’t know how soap works. The ADHD kid’s mom warmed up to me when she realized I cared and knew what I was talking about. The kid said, “AHEM. What’s up, chicken butt?” I laughed and high fived him. I gave his mom the Vanderbilt forms to assess ADD symptoms across multiple environments. I saw a patient who had a certain air about her that I recognized intimately, and at the end I asked what she did, and she was a doctor, too. I knew it had to be something like that. When I explain medical concepts I aim for lay language, but I can see when people get faintly impatient with me for it, and I’ll add in more and more technical language and see when they start looking confused; she didn’t. I could watch every new patient take in my brightly-colored hair, combined with the utterly forgettable rest of me, all browns and grays and dress slacks and comfortable shoes, because the hair is my one concession to my deep need for attention; in the exam room, I need to recede into the background so the patient can be the focus. Studies have shown that patients don’t like it when doctors disclose that they have the same medical issues. It might seem like bonding, but it shifts the focus away from where it belongs: the patient. That island of time is theirs. The breast cancer patient’s daughter said to me, “Thank you for spending the time with us. I know you didn’t have the time.” And I said, “From each according to their something or other, to each according to their needs. It’s lukewarm Marxism.” I don’t think she heard it all, or took it all in, which was good. I had a migraine that made my head feel three sizes too big with a steady drumbeat of pain despite taking two Ubrelvy, two Aleve, and two Tylenol, plus 100mg of caffeine and a propranolol and a Zofran. You have to disconnect each patient from the next. I can’t bring the breast cancer patient’s grief and heaviness into a room where a little boy is doing hand-stands and telling me silly puns. One of the nurses brought me a sublingual Toradol from a stash—someone’s purse, somewhere—because she wanted me to feel better, and I felt tears stinging my eyes because she cared about me. I couldn’t afford to cry. I just told a woman she has dementia and she doesn’t believe me. I told her to bring her husband to our next visit. I ended my clinic day doing an endometrial biopsy, trying to pass a uterine sound through a stenotic cervix, but I’ve done this before enough times to know to have the set of dilators ready. I dilated her cervix gently but firmly, with the back pressure of the tenaculum, until I could get the sound in, and then I left the sound there while my assistant handed me the sampling pipelle, because if you remove it there’s a good chance the cervix will tighten down again and you’ll have to repeat the dilation. The patient was holding her husband’s hand and chanting to him under her breath, in pain despite the Xanax I gave her.

I’m a doctor. It’s everything to me.

[reality-detective]

The Shocking Truth About Skin Cancer: What You’re Not Being Told About the Sun

Is everything we’ve been told one big fat lie? The answer seems to be a resounding yes.

While the public is constantly told to avoid the sun to prevent skin cancer, what they’re not telling you is that sunlight is arguably the most important nutrient for the human body.

And get this: avoiding sunlight can double one’s risk of dying prematurely, and it also increases the risk of all other cancers.

Sunlight also:

• is critical for mental health

• reduces the risk of breast cancer

• is vital for cardiovascular health

• increases one’s longevity

So, why all the fearmongering? The answer seems to be “follow the money.”

A Midwestern Doctor writes:

“A remarkably sophisticated public relations campaign was launched to transform society for the benefit of [the dermatology] industry.”

The demonization of the sun has “allowed the dermatologists to cast themselves as heroes and to stir up as much anxiety as possible about the sun—especially as a psychological investment they had to make constantly putting sunscreen on would make them more likely to go to their dermatologist.”

Moreover, the skin cancer fear campaign has created “a massive sales funnel by being allowed to do a massive number of routine full body skin exams (on otherwise healthy individuals) and hence have a huge pool of potential cancers to biopsy or excise (remove).”

Lastly, the war against sunlight has allowed them “to piggyback onto the fear the medical industry has marketed around cancer to justify charging a lot of money to do something questionable to prevent cancer and having every patient go along with it the second they hear the dreaded ‘c’ word.”

Read the entirety of this masterful article by A Midwestern Doctor here: 👇

So, there you have it. Now, you understand why they want you to fear the sun. 🤔

ZeeeMedia

[am-i-the-asshole-official]

WIBTA for not telling my husband that I have cancer?

I (32F) have been married to my husband (38M) for five years, we got married after two years of dating and living together. I love him dearly and he's completely devoted to me, we have a great relationship and are good a communicating about most things.

I recently got good health insurance for the first time in nearly 10 years (US American ofc) and haven't been to the doctor regularly in the past decade for a lot of other additional reasons as well. The last time I had a pap was when I was 21 - shortly before my husband and I started dating. At that time I tested negative for HPV and had no abnormal findings. This time though there was some "unusual growth" that they took a scraping of, and a lab that came back positive for HPV.

It was one of those "we won't call you if there's nothing to worry about" things. And my doctor did call me, and informed me that I have cervical cancer. She said that it's very early and could be addressed pretty easily with an office surgery, I might not even need more than local anesthesia.

After getting the news I'll admit to being stunned and not really sure how to feel about it - I tend to keep my struggles to myself until I can sort through my feelings on my own. Trying to deal with other people's reactions to my difficult experiences just makes it harder for me to handle tough stuff.

Here's where I might be the asshole. I don't want to tell my husband. He would be incredibly distraught, and probably assume that it was his fault. I'm not blaming him, and HPV is incredibly common. Either one of us could have already had it prior to our relationship. To me, it feels easier to just do the surgery and play it off like something less serious (because he's obviously going to notice during the recovery that my downstairs is out of order - maybe say they were doing a biopsy on a potential problem and then later say it came back negative) than to have to shoulder his emotional upset on top of my own stress.

I handle our finances so there's very little chance he would ever find out, even when the bill comes due. Nobody but me and my doctor knows about this. Am I a huge asshole for wanting to do this on my own and not telling my husband?

What are these acronyms?

[kinardsevan]

spare parts

(this is only part of a concept. who knows when i'll find time to actually write it.)

He falls asleep at some point. He’s not entirely sure when; he wasn’t really keeping track of time. But the sound of the front door opening rouses him, and when he sits up, Tommy is coming through the door. 

“Hi baby,” he greets. His voice is weary, but cheerful. He drops his duffel beside his shoes and leans down over the couch, pecks Evan on the lips. “How was your day off?” 

He doesn’t answer at first; lets the idea that he’s still waking up fill the moment instead as Tommy comes around the couch and sits down next to him. The sun is setting, but there’s still enough light left in the room that they can still see each other. 

Still, they’ve been together long enough now that they’ve memorized all the nuances about each other. Which means when Evan doesn’t start offering up an answer about anything, Tommy can tell something is up. 

“Evan, what’s wrong?” 

He inhales a deep breath. 

“I had a doctors appointment today,” he admits after a tick. He’s staring at his hands, wringing them tightly together. Tommy reaches out and slides his fingers between Evan’s, forcing him to stop. It makes him look up at his husband. 

“Tell me,” Tommy replies, his own tone gruff, but patient. Cut the bullshit and just tell me.

“M-my leg has been acting up,” Evan continues. “Thought maybe I pulled something, but it didn’t feel like it was getting better even after I took extra time off last week. So I called.” 

Tommy nods, watching him intently. 

“And?” 

He inhales another deep breath. 

“And it’s not good,” he replies, his voice trembling. When he manages to look up at Tommy, the tears in his own eyes are welled so high that half of his husband’s face is blurred, and his chin is quivering. Tommy just keeps watching him, waiting.

“Th-they did some x-rays, a-and then an MRI, and-and a CT,” he explains. 

“And they found,” Tommy prompts him. His tone is tight and gravelly. It’s like he knows what’s coming, but still needs Evan to say it. 

“Cancer,” Evan rasps when finally finds the strength to say the word. “Osteosarcoma, they think.” 

His tears fall then, and Tommy nods as he wraps his hand around Evan’s head, pulling him and pressing his lips to his husband’s temple. Evan cracks at that, unable to stop the silent sobs that fall out of him then. 

“Dr. Benton transferred me over to one of the orthopedic oncologists,” he continues, even as the tears keep coming. “Sh-she wants to do a biopsy in a few days.” 

“Okay,” Tommy replies, like it’s the easiest decision in the world. “Then we do that.” 

Evan lifts his head up, a pained expression in his eyes. “Tommy-..” 

Tommy shakes his head, his fingers still in his husband’s hair. 

“No. You are not somebody’s spare parts anymore, Evan,” Tommy tells him. “You do not need to operate on someone else’s schedule, especially if we’re facing a fight like this.” 

Evan doesn’t have the words to respond then. He’s not entirely sure how he feels about the whole process yet. It’s been almost three decades since Daniel passed away, but he still remembers enough of his childhood in hospitals to recall the pain of being the access point for anything his older brother needed while he was still alive. 

[religion-is-a-mental-illness]

We have a serious problem

Michael Laidlaw, MD: I'm a board-certified endocrinologist, practicing in private practice for the last 16 years. I've been studying and publishing in this area for the last 5 years, including peer reviewed journals such as Journal of of Clinical Endocrinology and Metabolism, and others. I also have a patient who is a detransitioner.

I think it's important to note that studies are shown that desistance, or growing out of this condition, of children by adulthood is very high. It's some 50-98%.

I want to be sure before I give someone a very powerful hormone like Insulin that they in fact have diabetes.

What about cancer? Before we give any powerful agents such as chemotherapeutics or surgeries, we certainly want to have physical evidence of this problem, such as biopsies or imaging.

Now, the gender affirmative therapy treatment proposed by WPATH gives very powerful hormones and surgeries on what basis? Where can we find the gender identity to be certain that these children will not desist by adulthood? Can we use imaging of the brain or blood tests, genetic testing, are there other biomarkers to ensure that we are correct? There is no such thing.

Julia Mason, MD: The Endocrine Society put out guidelines in 2017, and they were very careful in the guidelines. One, to point out that the evidence was of low and very low quality. And they also said in the guidelines that they have no idea how you identify which kids are trans and require this treatment.

And then the American Academy of Pediatrics the next year just leapt into that void and said, oh, oh, we'll tell you how you know which kids. You ask them.

Prior to 2018 I had maybe one trans patient. But then there was another one. And another one. And another one.

It wasn't until later that I started asking questions like, wait, every single kid I send to the gender clinic gets put on puberty blockers or cross-sex hormones. Just, it was happening immediately.

Patrick Hunter, MD: This affirmative model of care has spread wildly in the last 8 years. Now we have objective, unbiased systematic reviews. These systematic reviews tell us the evidence for youth transition is poor quality, and with very low certainty for benefit.

In JAMA Pediatrics, there was a study reported from Northwestern University in Chicago. Patients ranged in age from 13 to 24 years. The authors concluded that mastectomy was beneficial and should not be delayed in youth. What lead them to that conclusion? The finding that 3 months after surgery, the 36 patients were happy with their flat chests. They lost 9% of their surgical cases to follow-up. Nine percent. In 3 months.

It is absurd, meaningless to draw any conclusions after 3 months.

This paper is indicative of the quality of research we have in this field, published in our most prestigious journals.

We have a serious problem.

[adventuresasmrsfindley]

TGIF! What a week it's been. This may be a TMI post but we're all friends here right? 😅

I went in for the colposcopy (reminder, this is for the cervix, not a colonoscopy) on Wednesday. My PCP said this was precautionary but I was still pretty nervous for the procedure. Imagine my shock when the OBGYN was talking to me before and said the cells they found were more on the side of concerning and this was an "absolutely need to do further testing" scenario. Not just "let's be extra cautious". I completely broke down in that poor woman's exam room. After coming off the breast scare, her throwing around the word cancer again was too much for me. I cried for a good 10 mins while she talked me through everything. I explained what had been going on recently and apologized for being such a mess. She totally understood and was great considering this was the first time we met lol. Anyways, she said that she definitely wanted to do biopsies which I was hoping wouldn't be needed but I trusted her judgement and let her proceed with the procedure. She took 3 total, and it was definitely not a pleasant experience. The last one sucked the worst. I took ibuprofen before the appointment just in case and I'm glad I did. Luckily it was over pretty quick but I had quite a bit of bleeding (duh - she basically hole punched my cervix 3 times) so she had to use extra of the solution that is supposed to stop the bleeding and lemme tell you. It's gross. It looks like coffee grounds coming out and I'm still dealing with it 2 days later. I was pretty sore the night of but haven't had much pain after that. It's more just annoying. It's also annoying because she said the results take about a week. If they come back a level 1 or lower we will just continue to monitor with yearly paps, but if they are higher than that she is going to recommend a LEEP. You can Google that if you want to know what I'm in for 🙃 all the research I did before said most places do it in the office but she said they are not equipped for that and it would be done in an outpatient surgery room and I would be put under general anesthesia. I am hoping soooo hard that my results come back good but a week is a long time to wait!!! I am so over this year.

On top of that, I found out I'm going to be traveling to CA multiple times this summer for work. I knew one trip was very likely but was not prepared for probably having to go once a month. It's going to be a great career opportunity so I'm not going to pass it up but I am not stoked about being away from my guys so much. I'm not in a great place with my MIL either right now and she's the best equipped to help us out while I'm gone because she's retired. So we will see how that plays out...

It's a lot going on right now. I just really need some good news back from the doctor and then I feel like I can fully focus on getting our summer planned and setting us up for success since things are going to get pretty crazy I'm sure.

[kickthecan-revolution]

So a little curveball. My oncologist told me that there’s a tiny spot under my nipple that hasn’t grown but hasn’t shrunk, so they want to do a biopsy on it just in case it’s something. I asked if it was cancer, why it wouldn’t have shrunk and she said the only reason is that it would be a different kind of cancer, though that would be rare. I had a flash of panic and despair and was so thankful Michela was there who asked several questions when I couldn’t. I bounced back and was able to ask a few more of my own- basically, if it is cancer, they want to know so they can remove it during the surgery. “We just want you to go in once so you know, we don’t look dumb.” and we all we laughed. It’s small.

As I was getting hooked up, I was emotional at the thought of another biopsy but M helped me reframe it. “This way we’ll know, it’s not going to require more chemotherapy, it’s likely nothing and if it’s something, they’ll just remove it in surgery. “ remembering what the doctor said, helping me tell others in a way that’s not frightening.

I’m so used to not having people in my really personal spaces, that having them here feels miraculous. Weird, but miraculous.

Round 5 +1d. I’m back on my routine and I will stay on it. I needed that rebellion to reset - so here we go and then one more after this. I’ll deal with this biopsy. I’m still on track to be cancer-free, I am not allowing this development to swirl in my mind, it can be there in the front yard but it’s not going through the gate. I’m not allowing it.

[lestappenforever]

hey mona how are you feeling? how did the surgery go? <3

Hello, anon! You're so sweet for asking, and my apologies for the slightly delayed response here! Yesterday became a bit more stressful than I had hoped for. 😅

Putting this under a 'Read more' just so people who don't want to read about stuff like this can avoid it. TW: Mentions of blood.

I'm feeling pretty well! No pain or discomfort yet, so that's good. A little bit tired due to the blood loss and the overall stress of last night, but overall I'm feeling good.

The surgery itself went really well! It took a bit longer than anticipated as the surgery was performed by a surgeon in training, so there was a lot of consulting with the attending surgeon and double checking everything that was being done. But, the surgeon in training, the attending surgeon and the nurse who was there to look after me were all so incredibly sweet! They talked me through everything they were doing, explained every step and what to expect, and they were so generous with the anesthesia that I didn't feel any pain or discomfort during the procedure itself. And the nurse did an amazing job at keeping me distracted while the surgeon was burning away the affected parts of my cervix.

Due to how I started bleeding immensely a few days after my biopsy in June, they gave me prescription for pills with tranexamic acid to stop bleeding from organs and advised me to start taking them after the surgery, which I did. They also put like 3 meters of gauze up there that I had to leave in for four hours.

But, when I removed the gauze as instructed four hours later, I started bleeding a lot. Much, much more than I did after my biopsy, and I was honestly pretty terrified. So I called the hospital, they told me to come back and I did, which was good because it turns out a blood vessel had ruptured that was causing the bleeding, and it wouldn't have stopped on its own. (And the pills can't stop bleeding from a ruptured blood vessel.)

The sweetest gynecologist checked me out and discovered the ruptured blood vessel, and put in two stitches to close it. That bleeding stopped right away when he did, and that was that. I'm not gonna lie, that was quite painful at times, but it was also necessary. So I'm very happy that I called the hospital and was asked to come in, and now I feel completely fine!

And as stressful and scary as yesterday ended up being, it's a million times better than not doing any of it at all. I'd get a thousand stitches and go through a hundred procedures to remove parts of my cervix as long as that results in a seriously reduced risk of at some point developing ovarian cancer.

So moral of the story: Don't skip your Pap smears, take your health seriously, and listen to your body when it's telling you something is wrong because, most likely, you'll be right. Don't fuck around and find out with your health, please. ❤️

[queerheadcanoncentral]

Request from @gfuudb

"House and Wilson: so its like an episode of house execpt its Wilson treating a patient but he suddenly pukes blood and then collapses and then its a lil time skip of like 10 minutes and its House storming in to his office and raises his voice as he tells everyone what happened to Wilson and that their taking the case so he’s frantically having the team (of your choice whether its the original three or the second ones or a mix) give him ideas ect. And it ends in fluff pls"

(It's my first time writing anything like that so I'm sorry if it's a bit rough. Also all the medical information is from only one article to it's probably not medically accurate)

—⁠☆—⁠☆—⁠☆—⁠☆—⁠☆—⁠☆—⁠☆—⁠☆—⁠☆—⁠☆—⁠☆—⁠☆—

It was a slow morning for everyone. Especially for Wilson. No face to face meetings with patients, just some prescription renewals and an email consult or two.

Everything was going great, except a slight cough that didn't seem to want to leave him, even House hasn’t bothered him today yet.

As he was looking over an email a strong coughing fit hit him, when it subsided his stomach was turning, he got up to get another mug of water and the room started to spin, he felt the acidic saliva build up in his mouth and the contents of his stomach emptied out of him. Just for a brief second he managed to notice that the liquid on the floor was a copperish red color, before it all went dark.

“You’ll never guess what cuddy is wearing toda- Wilson?” Whether House walked in at the right moment or not is up for debate, because he did probably save his life but oh boy is he not going to let go of the position that he found Wilson in, with his ass up and his face flat on the carpet.

He promptly walked out of Wilson's office and into his own. “Cutner, Taub. Go help Wilson in his office.” If you didn’t know House you’d probably think that he is an asshole for not immediately running to help his beloved friend. But letting someone else, someone more physically able, take care of Wilson while he figures out what’s wrong with him is the best thing he could do right now. “What’s the differential for vomiting blood and loss of consciousness? Go.” “Wait, is this about Wilson? Shouldn’t we help him?” “Yes, that’s why I sent Taub and Cutner there, and we can help him even more if we figure out what’s wrong with him. Symptoms! Go!” “Could be stomach cancer,” said Thirteen. “Or pancreatic.” added Foreman. "Or esophageal.” “Good test him for cancer markers.”

“Hi Thirteen." “Oh, you’re awake. That’s good. Just need to draw some blood.” “What are you testing me for?” There was a moment of silence. The air was thick and Wilson already knew the answer. “You’re looking for cancer. That would be ironic. Spent my entire life fighting it just to end up dying from it.” “It might not be it. We’re just exploring all the possibilities.” “Yeah, yeah, I know how it goes. I’ve done this a million times.” “Has House visited you?” “No he hasn’t. And he probably won't, at least I hope that he doesn’t, because that would mean that he gave up on me.”

There isn’t much that you can do in a situation like this except sit around and pray that it isn’t the worst.

“It’s negative for all cancer markers.” The atmosphere in House’s office is gloom. The lights are off with the exception of his desk lamp. House caught his ball that he was playing with and looked up at Thirteen. “We need to biopsy. Tell Chase to get the OR ready.”

During the operation the whole team was anxiously waiting in their office. Altho they didn’t talk to or interact with Wilson all that much they still cared about him. Whether it’s because of the proximity of having their offices share a wall or because he was their bosses best friend, it doesn’t seem to matter. So when Case finally walked into their office they shot out of the seats and House came in from his, where he was locked for basically the whole day.

“Did any of you check his stomach before you ordered the biopsy?” “No, we just checked his blood for cancer markers.” answered Thirteen. “It wasn’t cancer. It’s just some peptic ulcers.” with that he left.

There was a stunned silence that was broken by- “YOU IDIOTS! You didn’t check his stomach!?” “You just told us to run a blood panel” “I’m not talking about you! I’m talking about those two idiots who don’t know that when you check in a patient with GI issues the first thing you do is look into their stomach!” “We’re so sorr-” Taub didn’t manage to finish his sentence because House was already out the door on his way to Wilson.

When Wilson woke up after his surgery, the first thing he saw was a pair of extremely blue eyes staring right into his soul… but lovingly? “How are you feeling?” “Good. Like I was hit by a bus... so is it cancer?” “No. It’s just an ulcer. They got it fixed right away.” He breathed a sigh of relief. But he had one more question on his mind. “Then why did I pass out?” “Your body was too weak to handle the strain of vomiting. You weren’t eating enough lately because it felt like something was chewing through your stomach, which it was.” “So I just take some pills and I’ll be fine.” “A while of IV nutrition first but after that,” Wilson felt House's hand on his and he intertwined their fingers with a relaxed smile. “,yeah. You’ll be fine.”

Bonus:

After Wilson gets off the IV and can eat regular food, House always makes sure that he eats a few times a day and asks if he has any symptoms to make check that the ulcer isn't coming back.

If they are hanging out at House’s place, he cooks food for him that won’t upset his stomach.

[stupittmoran]

The Shocking Truth About Skin Cancer: What You’re Not Being Told About the Sun

Is everything we’ve been told one big fat lie? The answer seems to be a resounding yes.

While the public is constantly told to avoid the sun to prevent skin cancer, what they’re not telling you is that sunlight is arguably the most important nutrient for the human body.

And get this: avoiding sunlight can double one’s risk of dying prematurely, and it also increases the risk of all other cancers.

Sunlight also:

is critical for mental health

reduces the risk of breast cancer

is vital for cardiovascular health

increases one’s longevity

triggers the production of Vitamin D

is vital for proper immune system function

So, why all the fearmongering? The answer seems to be “follow the money.”

A Midwestern Doctor writes:

“A remarkably sophisticated public relations campaign was launched to transform society for the benefit of [the dermatology] industry.”

The demonization of the sun has “allowed the dermatologists to cast themselves as heroes and to stir up as much anxiety as possible about the sun—especially as a psychological investment they had to make constantly putting sunscreen on would make them more likely to go to their dermatologist.”

Moreover, the skin cancer fear campaign has created “a massive sales funnel by being allowed to do a massive number of routine full body skin exams (on otherwise healthy individuals) and hence have a huge pool of potential cancers to biopsy or excise (remove).”

Lastly, the war against sunlight has allowed them “to piggyback onto the fear the medical industry has marketed around cancer to justify charging a lot of money to do something questionable to prevent cancer and having every patient go along with it the second they hear the dreaded ‘c’ word.”

So, there you have it. Now, you understand why they want you to fear the sun.

Read the entirety of this masterful article by

@MidwesternDoc

Shared from @VigilantFox on Twitter/X

[scientia-rex]

Saw a patient today who had been through a series of medical visits that epitomizes what I hate about multiple different kinds of care providers. Their VA dermatologist took a scoop out of them to remove a basal cell cancer. Fine. I’m not a dermatologist, maybe it needed those wide margins. (If it didn’t, going that deep should mean it was an excisional biopsy and they put in sutures to close it.) They gave the patient and his wife confusing instructions about wound care. They didn’t provide guidance around keeping it covered or moist. It got infected. His wife took him to Urgent Care. The UC doc took a swab of the wound and started antibiotics. They came to see me for a visit we scheduled ages ago for something else.

Here’s the thing. Wounds need to be kept at what I call the Goldilocks moisture level: not too dry and not too wet. If it’s pruny/white/mushy like it’s been in a bathtub, it’s too wet. If it’s cracking, it’s too dry. This is why you can’t say “cover it for X days and then leave it out.” That would be like telling someone with heart failure and lower extremity edema “take the diuretic for a week and then stop” without any instructions around dry weight, dizziness, etc. It’s more complicated than that.

This wound was too dry. No one had talked to them about keeping it moist. No one had even mentioned Vaseline.

No, they got a wound swab. Want to guess how good a wound swab is for an open wound exposed to the world? Pretty terrible. You can improve it a little bit by making sure you’ve removed some kind of layer and then expressing fluid directly from the wound with the swab, but it’s still bad. The only time I give a shit about what grows from a wound swab is when it was a) collected in the OR (as when the podiatrist gets a sample of osteomyelitic bone in a sterile environment) or b) when it grows pseudomonas. Everything else? I can figure out by looking at it. If it’s skin it’s probably either staph or strep. If it’s staph, it’s either MRSA or MSSA. If it’s MRSA, it’s making a lot of pus, it’s red, it’s hot, it’s painful. This wasn’t. So it was either MSSA or strep. So what are we going to do for systemic antibiotics? Probably the same thing we would have done anyway—Keflex.

And what’s the utility of systemic antibiotics in a skin wound? Not a lot, most of the time. This wasn’t cellulitis proper. It wasn’t red or hot or angry enough. A red border around the wound does not a systemic infection make. And if you don’t care properly for the wound itself, there’s no point in antibiotics, because it still can’t heal. Antibiotics can get where blood goes. Blood does not go into the slough that is the bacterial biofilm covering a wound.

So I sat there with gauze and saline and gently debrided the 100% slough off the wound. It’s yucky and it takes time and attention. It doesn’t get compensated. That’s why no one else had done it yet. The derm had blown it off as “it’s healing, it’s fine.” It wasn’t healing. It was developing rolled edges, where the wound edges couldn’t heal across the slough and so they started to curl back under themselves. If taking off the slough (and keeping it gone by MAINTAINING PROPER CONDITIONS) doesn’t let it heal, I’ll need to get him back in and rough up the edges with a Buck’s curette until it can heal.

Multiple professionals who should have known better tried to make my patient just go away, rather than heal him.

I’m pissed. I’m tired. I think I have a cold. I shouldn’t be doing the work the dermatologist or the UC provider should have done. And because of everything they’d told her, his wife was pissed at me for doing what was correct. “We’ve heard a lot of different things!” Yes, and I’m right. You’ll find out when the wound actually starts healing when we care for it properly.

The value of a model is in what it can predict. Wounds are great about making it clear when your model sucks.

[f1-disaster-bi]

Once again apologising that I haven't posted much when I said I was going to.

I wasn't going to post this, but it's important to talk about and I want to encourage people to listen to their bodies, especially those of us who have a uterus and female reproductive system.

I went to my doctor back in June after a almost 2 years of changes to my menstrual cycle that were impacting my life. I got extremely lucky because I have a doctor who actually listens to me and immediately he scheduled tests and appointments and got me on a Borth control that works for me (I've had several bad reactions to different ones).

Unfortunately, some of my tests came back with traces of abnormal changes, which was scary because that could mean nothing or it could mean pre-cancerous cells or it could be cancerous cells. I got the news pretty quickly and got an appointment that I went to today.

I went in nervous and expecting the worst. The gynaecology staff were so nice and sweet and funny. They made the experience so easy and lovely despite the bit of discomfort I was going through.

Luckily, it seems as if I am in the clear. I had a minor procedure to remove some small, what is most likely benign, growths, and a biopsy, and was home after about thirty minutes. They were happy with what they saw, no immediate worries, and they don't think my lab results will show anything to be frightened about.

This was scary.

The possibility of cancer is always terrifying, especially when your family has a history of it, but I'm glad we can possibly rule it out. It makes it easier for my doctor to look at other causes for what I'm going through, and it'll make my other appointments easier if we can rule it out now.

The point of this is: listen to your body.

I put off talking to doctors about this for two years because like a lot of people with a uterus, I've had doctors who told me what I was experiencing was normal and that I just needed to suck it up and take some pain killers, but no one knows your body better than you.

All in all, I'm doing good. I'm tired and exhausted from overthinking and worrying. I'm a little sore and crampy after everything but also relieved.

Just look after yourselves and your body and listen when it tells you something is wrong and go for your recommended checkups 💖

[secretlythepits]

Legos, Teeth, Nightmares

I’m not taking care of myself. I’m not taking care of business. I have no time to waste but that’s all I’m doing. I’ve noticed my unhealthy coping behaviors creep up and now I’m worried. I’m using this post to help me— I don’t know— I need help.

I’ve been watching a lot of tv. This is what I do when I numb down. I’m rewatching This Is Us. So, themes. But also, catharsis.

I’m not eating consistent meals. I skip, forget, and I feel starving. Sometimes I stay starving and sometimes I make a poor choice. Or, i’ll make a good choice but then the rest of the meals are thrown off.

I’m not exercising or even walking. Part of this is due to my sprained ankle, though I think walking would be good at this point. Part of it is a heat wave making most of the day too hot so have a narrow window to make it happen. But the biggest thing is that I feel utterly paralyzed so I’m sitting on the sofa thinking about all that I need to do that I’m not doing and feeling ashamed and overwhelmed. It feels like I just CAN’T.

I need to complete important paperwork. I made good progress and just stopped. It still needs to be done.

I haven’t worked on my business since I came back. I need to get it up and running, but my mind is not in that head space. This is a needed income source.

I need to make a bunch of appointments for myself and the kids, but I haven’t because I don’t know what my husband’s doctors schedule will be. That’s stupid. I should just set them and adjust if necessary, but I CAN’T.

All I want to eat are carbs and sweets.

My body composition is changing rapidly due to perimenopause and these behaviors are making it worse. This greatly affects how I feel about myself.

I’ve been having so many sleep issues. Last night I had a dream where I was getting married in a couture LEGO dress, but as I was getting ready, all of my teeth fell out. I was naturally distressed and then I realized that I must have bone cancer. The dream lasted forever and I kept running around, looking for help, but nobody seemed to care enough to even try to help me. My husband was like, ok, you have to just deal with it. It’s still time to get married. I was freaking out and nobody could recognize the emergency. I felt so lost, panicked and alone.

The PET scan results will come in any day or maybe in a week. I am on edge. They will be the most telling. Biopsy is tomorrow.

I need support, but I don’t even know what to ask for. What can my friends do? I can’t talk to my husband about it because he is overwrought.

What I wish:

I want to remember to stay in my lane. Eyes on my life. Keep moving forward with my goals.

I really want to prioritize my own health and wellness. I want to lose weight and build strength. I want to feel inside of my body again. I like that feeling.

I want to renew my spiritual practices because they ground me, renew my energy, and bring me peace. (I’ve been avoiding them too.)

I want to make progress on my to do list so I have less to worry about.

I want unlimited amounts of good chocolate.

I want to sink into a good book, literary fiction that captivates me wholly.

I want to sleep through the night.

I want to know how to feel more supported while not having any of this touch my husband.

I want to be able to approach my day with a spark of go get em.

I don’t know how.