#catheterization at home | Explore Tumblr Posts and Blogs

twinfools · 2 years

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I’m 3 years post phalloplasty and I realized I’ve never really made a post about how things are going. Phalloplasty is a hard surgery to talk about because, bottom line, it’s not part of common conversation to talk about yo dick. That being said I think it’s really important for me to talk about this procedure to help break stigma and misinformation— both inside and outside of trans and non-binary communities.

I had ALT phalloplasty, glansplasty, scrotoplasty, no urethral lengthening (UL) with vaginectomy. This means that tissue from my thigh was used to create my penis, my urethra was not extended or moved (so I don’t stand to pee) and my vagina was closed. I feel like this detail is important because this is one of many variations for this procedure and what I opted for/out of were decisions made according to trade-offs between personal benefit and risk.

I opted out of UL because I do not tolerate catheters well and, due to my very active lifestyle, was not willing to risk longer term catheterization or bladder spasms which would impede my quality of life. This risk, for me, outweighed the benefit of standing to pee.

I opted for ALT knowing that I would likely need debulking (which I didn’t end up needing but opted for anyway out of preference). Debulking is a procedure to make the penis less girthy as ALT phalloplasty is more girthy because of the nature of tissue on the thigh. I chose ALT because, first and foremost, I did not want scarring on my forearm. My ALT scar is covered by clothing most of the time which I appreciate. I also chose ALT because I have skinny forearms, which wasn’t ideal for forearm phalloplasty (RFF).

Vaginectomy, for me, was a no brainer. I have never used or connected with that part of my body so I wanted it gone.

Glansplasty is a procedure to make the glans (head) of the penis and was a short procedure done after my initial stage of surgery. I may get it redone but I’m still undecided on that. Scrotoplasty creates a scrotum, I was ambivalent about this procedure but have grown to more appreciate it over time.

I am considering further surgeries: erectile implant (which creates the ability for the penis to “get hard”) and testicular implants (fills to scrotum with testicle implants). But I’m undecided and want a break from surgery while I finish my degree and focus on work. I’m also considering phalloplasty tattooing to help enhance the contour and coloring to make it appear more like a cis penis.

Whew! Lots of info, right? These are big procedures completed over multiple stages and are very unlike chest surgery, hysterectomy and other surgeries I had completed prior. When I was first considering this surgery I didn’t know there was flexibility in terms of tissue donor site and UL. I waited to have this surgery and am so happy I did because the information I gained from research and consulting with professionals and folks with lived experience was so valuable.

Was surgery hard? Yes. This surgery was the hardest thing I’ve ever been through. I’ve never been so uncomfortable for the first 2 weeks after recovering. I had to re-learn how to walk. I couldn’t sleep. Peeing hurt… but would I do it again? Yes. It was worth it for me but I can’t underscore enough that that doesn’t mean I didn’t have moments where I felt regret while recovering because post op depression is a thing and I was in pain while adjusting to a new body part that was also a healing surgical site… LOTS going on there!

3 years on I feel really at home in my body. Just having a penis is such a comfort to me in ways I didn’t anticipate. I’ve had a feeling my entire life that I was missing a body part and this was it. The quiet gender euphoria of just sitting and feeling my body and for once feeling complete in that is something that’s hard to articulate.

I’m thankfully back to full mobility and got back to full mobility about 3 months post op. I was grateful for this since a long term recovery wasn’t what I wanted. There are still weird twitches, pains and feelings, especially around my donor site (thigh) from time to time but nothing that inhibits me. Just interesting when it happens (usually when weather gets colder?).

What is one thing I would want to go back and tell myself before surgery? Well:

Your penis will feel HEAVY. Like it will fall off. It won’t fall off and your body will adjust to the weight in an area you didn’t have it before. Until then it will feel like you need to hold it at all times.

Hopefully this helps someone as an overview of what an experience with this procedure may look like. Again, my goal is to put information out there and have frank conversations— because it’s these same things that greatly benefitted me in my surgery journey.

Finally— my inbox is open for anyone that has questions. I am in a privileged position to feel safe talking about these things and I feel comfortable doing so. Not everyone does, so please don’t assume that this invitation applies to other folks who have accessed surgery unless they say so.

Thank you for reading :)

#ftm #phalloplasty #surgery #trans #transition #transgender #trans man #trans guy #gender affirming surgery #phallo

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specialmedicalcentre · 9 months

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Irina recently arrived at SMC's Emergency Department with a paramedic crew. She is now stirring in her ER bed in some discomfort. She is confused and frightened. The head emergency nurse tells her brief story.

"The patient is a 22-year-old female who arrived in an ambulance, unconscious, with symptoms of possible heart attack or stroke. She had been complaining of dizziness and light-headedness, and her breathing was labored. She lost consciousness while the paramedics were attending to her. When she arrived at SMC-ED she was breathing on her own."

Once safely at SMC, Irina was placed in an ER bed and hooked up to blood pressure and pulse monitors and had EKG leads attached. Her street clothes were removed and she was catheterized and fitted with a hospital diaper for sanitation and comfort. A blue patient ID tag was placed on her.

(The nursing staff has temporarily placed Irina's bra back on for her privacy and discretion.)

Irina awoke very recently and did not know why she was here or why she was attached to all the machines. She is stable for now, and the SMC ED team will be evaluating her condition and recommending further tests.

=====

SMC's home is on deviantart: https://www.deviantart.com/specialmedicalcentre

Visit us on pixiv for anime-style visual storytelling: https://www.pixiv.net/en/users/100327986

Connect to SMC on Twitter/X: twitter/special_medical

#hospital #medicalfetish #nasal cannula #cardiofetish #cardiophilia #ekg #medical diaper

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magellanicclouds · 4 months

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Halo - An Essay: regarding waste management systems and devices for MJOLNIR armoured Spartans It has been a hectic sort of few weeks. Between work and getting sick again (for the fourth time already this year thanks to my crewmates who can't remember it's their duty to stay home when they're ill) I've been on the outs. I haven't had the energy for much, but I'm usually a pretty active person, so this has kind of made me loopy? Which feels like as good a time as any to talk at length about the concept of catheterizing Spartans for waste management in MJOLNIR.

Let me explain.

This Silly Post crossed my dash recently and I fully understand it is meant as lighthearted fun - we have fun here. But it also dragged out some strong thoughts I've had haunting in the back of my mind about this for years because I'm super normal about Halo, and have time on my hands and the right amount of sleep deprivation and medication on board. So I wrote 3500 words about it. And about Karen Traviss, who is pretty knotted up in this conversation, since she's the one who decided to start it back in 2011.

To preface, I'm not an expert, but I have worked in emergency medicine for 25 years, and been a fan of Halo for almost as long. I've had more of a lukewarm relationship with it the last decade or so if I'm being honest, but it will always have a home in my heart; I just think letting it under my skin like that in the first place may have made me feral and prone to biting. Thankfully, I can always happily rotate Fred in my mind until the heat-death of the universe, so that's nice. Anyway, full disclosure: the essay below contains discussion about medical devices, physical trauma, and I am sharing quite a lot of personal negativity about the Kilo-5 trilogy and Karen Traviss. That said, if you'd like to sit in on the length of what I'm about to yell into the sky about all this, you can find it under the cut. I love you.

Welcome to my dissertation.

Section 1 - The Relevant Background:

Equipping Spartans with urinary catheters weeded itself into the Halo universe in the 2011 book Halo: Glasslands, during a conversation between Spartan II Naomi-010 and ODST Mal Geffen. Glasslands was the first in Karen Traviss's Kilo-5 trilogy, and she is both the originator of this, and the only official Halo author or source to have used catheters specifically since. Some context: I don't personally like these books, or their author, or even her reasoning for why she chose to add this. My personal preference doesn't make something 'bad', and I'm not out to hurt any feelings. Kilo-5 isn't a total wash for me, there are some characters and ideas that I'd of otherwise loved to have seen explored through the lens of a different author, but these books felt smothered under Traviss's habit of always injecting her very loud personal voice into the narrative fabric. I think this is something that's fine to do in an original series, but doesn't really belong in an established third party IP. She bangs on about so much of her own narrow worldview and self-assured prejudices across the trilogy that still discussing them today creates division in the fandom, and sadly did a lot of lasting damage to a couple characters. But for the topic here, the dialogue that started all this cath chat came from Naomi-010, having idle conversation with Mal who asks her about bathroom breaks. “I’m catheterized. Another reason why that machine has to be so precisely calibrated. This suit plugs into me in a lot of places.” 'The Machine' she's referring to is a Brokkr assembly, which was introduced to the lore as a large mechanical armature used to get Spartans in and out of MJOLNIR. You can see them in action in cinematics from Halo 4 (+Spartan Ops) and 5.

One single mention, and it was big news. Traviss was naturally interviewed about it because of course she was - people can't help themselves but forget an entire novel and tunnel vision on 'but how pee pee?', and her answer has always irritated me. It's not in what she says, so much as what 'what she says' means in her voice. Traviss didn't answer it directly, but instead talked about how she likes to get into character's heads by addressing the mundane necessity of things that often go overlooked to expand a sense of familiarity with the character and their world. Sounds super reasonable, I know, but don't give her too much credit - that's not a quote. It's just me paraphrasing and honestly I was pretty generous in my wording. Probably because I agree! What bugs me about it, is if you've ever read literally any interview with her, or her personal musings about her writing process, you know there's a bit of an 'honesty' issue there. She's somebody who feels perfectly comfortable ignoring established character voices, traits, or histories to satisfy whatever roles she's reinvented for them, and too many others wind up as mouthpieces. How much are you really challenging yourself in finding characters' voices when most of them are just yours? And the part about familiarity with their world? I giggled a little. She doesn't care about their world, or their aesthetics, or their technology, or their medicine. Because she didn't care about Halo while writing these, and she's not vague about admitting that. It's a matter of pride for her to purposefully refuse to research those things, in the same way she disregarded Star Wars and Gears of War - she doesn't consider the effort to be a valuable part of her process. So instead she'll skim the foundation, gather some recognizable names, pick her targets, and trusts that her personal experiences combined with an outsider perspective will generate better content to seamlessly overwrite what existed. Cool, Karen. Annoying, but why bring all that up? We're here to talk about catheters, right? Well, the fandom for the most part begin and end their assessment of the dialogue at urinary catheters, but the whole quote implies so much more than that - "This suit plugs into me in a lot of places." We're not just dealing with a cath, but apparently with multiple additional external-to-invasive connections. Reader, this dialogue is a plinth to Traviss's bizarre refusal to research not only the franchises she's contracted to write in, but also just into the basic function and hazards of existing concepts that she wants to introduce, and all because she's convinced herself she's done learning about the world. Choosing to ignore the creative freedom of limitless potential in a future of technology that would be basically magic to us today, and instead degrade 529 years of advancement is certainly a take, but it's even more ridiculous to do it with a subject (The Spartan Programme) that is considered to be the peak of advancement in that future's setting. That's clownery, just like her alleged commitment to adjusting her perspective to suit a universe's world.

I want to close out this section with a question: Why is it that writers in the Halo space - both fan and official - cling so tightly to current-day modern concepts as if they'd still be perfectly relevant in 500+ years? Music, for example, apparently suffered a multi-century stagnation in lots of published and fanmade Halo media. Though my partner made a strong counterpoint about this to be fair: we still listen to music composed by Mozart. So there's an argument to be made there. Medicine though. There is way less latitude to embrace the classics there. It's been shown across several games, novels, and films to be sufficiently advanced well beyond anything we're currently capable of or even understand, so why undermine that and choose to drag it centuries backward? For clarity, I am not talking about what might be standard in the public or private sectors, nor the enduring things that'd be used by the public and military alike, like sterile dressings, syringes, supplemental oxygen equipment. Those are the Basics and they will be relevant to us indefinitely. But I'm talking about the UNSC. I'm talking about ONI R&D. I'm talking about Section Three. Retrograding tech and failing to address a necessity that applies to every living person in the Super Soldier Wizardry department makes my mouth flatten into a tight little line.

Section Two - Caths, and why this whole thing got written:

Indwelling urinary catheters, both urethral and suprapubic. There's a laundry list of problems here, but I've distilled it down to the three biggest when suggesting they'd have any safe practical application in Spartans: Care. Activity. Damage. There is unreasonable expectations of care and maintenance for caths with regards to people who can be on operations isolated for months at a time with no support of any kind and are often limited to carrying only what can be kept on their person. The level of extreme physical activity Spartans engage in on any perfectly normal day whether deployed or not is unfit for the stability and safety of a cath. And damage; obvious enough, but with this one I'll be taking a huge emphasis on concussive forces - explosions. Something Spartans are subjected to a lot. I'll be using the height of modern-day catheter quality as a baseline for this, since that's what Traviss felt was sufficient. Regarding Urethral vs Suprapubic, Traviss doesn't specify by name, but Naomi's comment in full reads to me that she's only catheterized temporarily while armoured, hence the assembly needing to be so finely calibrated. Foley caths are temporary urethral caths that would only supplement the urinary process while a person was armoured. Suprapubic caths however are surgically placed devices. They do need routine tube replacement to keep them clean, but unlike the Foley that just serves as an aide measure for an otherwise fully functioning bladder, suprapubic caths are usually placed in people with congenital bladder disfunction, or who've suffered injury or disease that left the bladder in poor health or failure. This type of access will always require a tube in place and this would be the exclusive method of urination - in or out of armour. My Big Three Concerns fit both types similarly, though there is some additional risks associated with urethral caths that I'll cover.

Care: Caring for an invasive cath is a not insignificant effort. They're prone to blockage, kinking, and bacterial growth. They're so frequently responsible for UTIs and kidney stones that these complications are just considered the Standard Fair for having a cath. Their need to be frequently replaced because of their penchant for bacterial growth is the kicker here - whole floral colonies sprout up in caths and can eek their way out into the body through compromised tissue and wreck havoc. They have no self-cleaning mechanism, and steadily deteriorate. Changing and replacing an indwelling cath is a procedure that requires additional supplies that'd have to be carried, and needs to be done in a practiced and clean setting; preferably medical. Granted, there are people who manage the removal and insertion of their own caths at home, but they still need to ensure a clean and safe environment while they do this. A Spartan could never be guaranteed that, nor would it even be wise to consider the vulnerability of removing so much armour to handle it. Modern day caths are recommended to be replaced every 30 days or so, with some models able to be in place for a few months at a time, but that's with constant daily care and cleaning; something that'd be unreasonable for a Spartan to maintain while entrenched who knows where for who knows how long, and without access to replacement medical supplies. Those endurance times between replacements are geared for the average public person who leads an average public life and care for their cath as directed and don't get into fist fights with Sangheili. Needless to say, the endurance time for the same device in a Spartan who leads a wildly different lifestyle probably cuts those times down to a third.

Activity: Modern day caths are designed to offer people the most utility and versatility possible. Both models are available for people who are bed-bound or have extremely limited mobility, as well as for those who are mobile, independent, and live out average lives. With regards to the latter, suprapubics are somewhat more common, if for no other reason than to reduce the Foley's higher risks of induction injury, but modern urethral caths also allow for regular movement and activity with a more reduced chance of becoming dislodged or damaged than they would have had a couple decades ago. But when I say regular activity, I mean going on a walk. Shopping for groceries. Doing basic house chores. Even light exercise and sexual activity can be managed with physician advisement and the appropriate precautions taken. Anytime a Spartan was fielded they'd have to be all the more overly-cautious about Movements Outside of Their Control during confrontations, maneuvers, ambush, environmental or vehicular incidents. Even when things go well there'd be too much risk involved. That said, traumatic decatheterizations happen more frequently than anyone would like, and I'm talking about regular old Joe Everybody. I respond to no less than a dozen of these incidents a year. Both types of catheter are held in place by a bulb balloon that's inflated from a port with around 10-30ccs of saline after the tube enters the bladder (30ccs would be more appropriate for better security of the line). Before removing a cath, the saline is removed to deflate the balloon and the tube is guided out - with a Foley cath, that means being guided out of the urethra. When a Foley cath is traumatically removed, the saline filled balloon - which is like five times wider in diameter than the average 6mm urethra - does a pretty devastating amount of damage on it's way out, penis or vagina; though a penile urethra has significantly more length to damage, and the penile meatus very typically is torn. These incidents run high risk of bladder hematoma as well, which requires urgent surgical intervention. The very worst traumatic decatheterizations I've responded to were all penile and had trauma to external tissue. Ever microwaved a hotdog a little too long?

Damage: How often are Spartans subjected to explosive and other concussive forces? Silly question - answer: a lot and often and unavoidable. And we know they still feel the powerful feedback. Despite shields and dampeners and a self-moderating gel layer, strong inertial forces are still felt through the suits. Across multiple novels we're given details about near misses and blasts, accelerated or uncontrolled falls, rattling their teeth, hampering their vision, hearing, or balance; they've been rendered unconscious and suffered internal injuries. The fact that most of these events don't flat out kill them is a credit to their armour and augmentations. For reference - when a person experiences explosive or concussive force from a distance enough to avoid separation of limbs, bisection, etc, the totality of their injuries can't and won't be seen externally. How they present on the outside is just the tippy tip of the iceburg - it's what's happened to them internally that you need to be concerned about. Cracked or fractured bones, torn musculature, arterial shearing, hollow organ rupture, cardiac and brain tissue bleed, to name some common ones, and this kind of trauma extends to all implanted devices as well. For example, rods and nails and other structural aids or replacements are much more resilient than your organic tissues, and can dislodge when tissues tear or rupture, damaging anything in their way like shrapnel. The fragile little balloon of a catheter will shatter when subjected to even relatively minor explosive force, so to even consider for a moment that this would be a viable piece of equipment for people intended to routinely be involved in explosive environments is beyond willful negligence. That there wouldn't be a better solution to the question of waste management - a necessity for literally all human people who make up the entirety of the Spartan branch, with the infinite funding of ONI R&D seems so stupid to me that I… well, that I wrote this. Because, friends - participating in active warfare is not cath-safe. The kinds of physical demands and forces on Spartan bodies are not cath-safe. The risks will never outweigh the benefits to this. Even while sealed in powered armour and a skinsuit tech layer, the very thought of Section Three engineers or Halsey or anyone involved in the development of MJOLNIR dismissing the glaring obvious failure of Spartans having any kind of externalized invasive devices is so unreasonably negligent that it could only be the brainchild of an author who's convinced that these characters are all actually just psuedo-intelligent government boogiemen who aren't as capable as they claim to be. But No. They are that capable, and they are that intelligent and the fact that they have a bottomless budget and deeply flexible ethics is literally what makes them so dangerous.

So if we have to address this, how do we do it? Apparently there was always an official answer for this. Former Franchise Development Director, creator of the Master Chief**, and extremely racist asshole Frank O'Connor weighed in on this in the same interview, where he almost immediate rejected and denied Traviss's catheterization claim and says that 'this sort of stuff' was the kind of thing he and the other creative heads at Bungie/343i talked and planned about all the time. So how does this work then, because we're invested now. According to 'ol Frankie's elegant input: they just pee freely into the suit. That's it. For clarity, he's talking about the skinsuit and not the MJOLNIR interior proper. He goes on to say that connectivity between body and MJOLNIR at all levels is fully noninvasive, but precise, and that it doesn't matter what kind of body output a Spartan introduces into the suit interior, because a hygienic valve system (??) will scrub it continually and collect all matter for recycling and reintroduction via capillary action powered by movement. It's not clear in what layers or intermediaries these mechanisms occupy, he doesn't break it down more than that. But that's the answer, and it did exist back when Traviss was penning Kilo-5.

Is this answer better than haphazardly plugging extension cords from actual organ systems into MJOLNIR interior? Yes. Like, leagues better by comparison, but also I still think it sucks. To me anyway. It's flat out gross as hell, which definitely fits the personal brand of a man who proudly overfed his cat and called himself "Stinkles", but also it just doesn't strike me as the kind of design strategy ONI would pursue for any of their assets. Beside it just being 100% torn from Dune's stillsuits, it's also missing that special brand of proprietary Section Three je ne sais quoi. There's layers upon layers of too-specialized equipment installed into these people for everything else, why skip this? A body function that should have been Point 3 on a 50 point list of 'stuff to manage'. Also though? It's a lot of freedom. This is just another easy opportunity to add yet another layer of dependence. Spartans are expensive equipment. It doesn't do to give them any fewer reasons to think they can ever walk away.

So anyway, I figured I'd take a crack at it. I came up with this while editing the last two paragraphs: [Waste management] - a fully internalized collection and processing device - lets say a cybernetic implantation - that entirely replaces the bladder. It has bio-organic lumens that interconnect it to the GI and Hepatic organs. The implant assists in accelerating the processing of gathering and refining waste materials with the help of nanobots that identify and redirect waste along the lumens of each system, plus they keep the implant clean and free of bad flora. All twice-processed waste gets refined a lot quicker and any water by-product of the process is refined and redistributed back to the organs along the lumens. None of the refined water is removed from the body for drinking, because that's an unnecessary step; it's already inside. (Drinking water would be the responsibility of a suit system more likely - like, sweat leeching in the skinsuit; refine, filtrate, purify, collect into a reservoir, and jettison the excess sodium. ) There is no 'extraction of other viable nutrient' from the remainder, it's been twice identified as waste. It gets catabolized and consumed by the nanobots as a fuel source, and no externalized waste is created at all while the Spartan is geared up. The implant doesn't always run like this - it only engages this way when the Spartan is wearing MJOLNIR, and when they're not, it just works like an out-of-the-box bladder. The intermittence of usage lets the organic organs truck along as usual, preventing risk of atrophy, and the Spartan can just use a bathroom like everyone else. I'm not a bioengineer, but I do like sci fi and I think all that sounds like something that'd be possible in this sandbox. And that's the real fun of it, isn't it? There's no way anyone today can anticipate what sort of gadgetry might be available 500+ years from now, especially in a fictional universe that includes military tech hybridized with reverse engineered alien tech.

I think it's fascinating when writers and artists shake loose and really grab the reins, and I love seeing the fruit of that labour in this particular tumblr community so often. We're not a huge Halo circle, but we're a passionate one, and if this essay leaves you with nothing else, I hope it will at least remind you to Go For It when you're writing your next fic or drawing your next piece, or composing, or sewing, or printing, or anything!

In Conclusion: Rest easy, friends.

Despite Traviss's word and even books that went to print, the official canon is that Spartans are not catheterized. If that's a bummer for anyone, canon can't stop you from writing whatever you want, but I do hope maybe you'll remember my reasoning for why it might not be the best idea? At least not for armoured Spartans. A Spartan, but they're laid up in hospital? Any non-Spartan personnel? Maybe you're writing in the public sector, a colony world or vessel? Sure - I'll bet caths are still plenty widely used. Why not? They're a blissfully simple and useful effective piece of equipment. It's just all about adjusting and adapting for practicality. Medical science, like any technology, adapts and evolves infinitely as we learn and discover new things. Treatments or drug algorithms I'd of used just last year have already undergone changes, and protocols are amended constantly. It's why a person 'practices' medicine; why a scientist is always a student. If questions like this or similar really need answering in your next work, remember: Give yourself the credit you deserve, and embrace the spirit of invention. Let my Cyber Bladder, by Sparklets be the candle in the window for you!

You may all retrieve your keys from the bowl and unsilence your phones. Stay safe and please text me when you get home. Thank you. ' u ' **Addendum: Former Bungie Creative Art Director Marcus Lehto is in fact the person who is most associated with the creation of the Master Chief.**

#halo #long form #my writing

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arwasis · 4 months

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I am Mohammed Habeeb, a 35-year-old father from Gaza, Palestine, blessed with three beautiful children: Lana (10), Abdullah (8), and Lim (4).

Abdullah's spirit embodies courage and determination, his laughter a beacon of hope amidst adversity. His dreams of becoming a programmer, alongside Lana's aspirations of becoming an interior designer and Lim's dream of becoming a doctor, remind us of the resilience of the human spirit.

In the first week of Abdullah's life, our world was shaken when he was diagnosed with Hypoplastic Left Heart Syndrome (HLHS). His tiny heart faced an immense challenge – only one chamber developed correctly, leaving the left side underdeveloped. We were presented with two daunting choices: embark on a complex medical journey, fraught with uncertainty, or face the unimaginable loss of our precious son. Choosing to fight alongside him was our only option.

Abdullah has since undergone three open-heart surgeries and numerous cardiac catheterizations at Sheba Medical Center in Israel, a beacon of hope amidst our darkest hours. Each surgery was a harrowing battle, marked by moments of uncertainty and fear. From his first surgery at a tender 12 days old to the latest, Abdullah's resilience has been awe-inspiring. However, his journey is far from over.

Now, at 8 years old, Abdullah requires urgent surgery to close a Fenestration Fontan. Every day, we hold onto hope as we navigate the complexities of his condition. Yet, our path is fraught with obstacles beyond medical challenges.

The recent war in Gaza shattered our once peaceful existence. Our cherished home, a symbol of stability and love, now stands in ruins, a casualty of conflict. Our children's dreams, once filled with promise, now face uncertainty amidst the chaos of displacement and destruction.

For 170 days, we have sought refuge in a makeshift camp in Rafah, where each day presents new trials – from scarce resources to uncertain futures. Our resilience is tested at every turn, yet we refuse to surrender to despair.

Today, we stand at a crossroads, embracing hope as we seek a path to safety and healing. Our journey leads us beyond borders, to Egypt, and onwards to the USA or Europe, where Abdullah can receive the care he urgently needs.

Your support is a lifeline in our journey, offering hope where there was once despair. Every donation, no matter the size, brings us one step closer to a future where Abdullah can thrive, where dreams are not bound by circumstance.

Note: This fundraising campaign is managed by a trusted friend on our behalf, ensuring the legitimacy of our cause amidst banking complexities.

#palestine #gaza genocide #palestine will be free #gaza #free palestine #save gaza #save the children #save palestine #free gaza #فلسطين #رفح #رفح تباد #معبر رفح #رفح تحت القصف #غزة

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some-melon · 13 days

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Hello my friend I am Abedalrahman Alhabil from G4za🍉

im stuck with my family in G4za, and my father is sick with a heart and needs urgent surgery in Egypt😔

I hope you can help me by donating or reblogging

Check the pinned post to be sure ❗

The intended target was 120,000 and what was collected was 80,550 The donation link is in my profile

Thanks 🙏🏻

Please share and/or donate to help Abedalrahman Salem Alhabil and his family. He is a graphic designer, but due to Israeli forces destroying his home and all of his belongings, which included his laptop, he is not able to work anymore. He currently resides with 60 of his family members, which includes his parents and 5 siblings, in a tent. His father suffers from chronic heart disease and high blood pressure, there is no medication or medical care for him in Gaza, so they are seeking to evacuate to Egypt to get him urgent catheterization surgery. ♥ 🍉

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anti-workshop · 1 year

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"Last month, I spent days sobbing quietly in the bathroom. I was low on medical supplies for my daily catheterizations—and worse—low on income, desperate to figure out how I was going to swing it. Despite having a near constant flow of work (for which, I’m both lucky and grateful), I’m always barely making it, financially.

While life with a disability isn’t necessarily as removed from the normative experience as I think many able-bodied people tend to think it is, the barriers that plague our access to any semblance of economic stability are nearly impossible to overcome. I have not one dollar to put toward retirement, and no realistic path toward home ownership or meaningful savings or investment. I carry over inflated debts acquired from birth onward that are impossible to pay in a lifetime, regardless of any income I manage to bring in.

I am not alone in this. Contrarily my situation is entirely common. For most disabled people, both those able to work full-time and those living on partial or full federal support funding, economic stability or freedom is often impossible to achieve. We live day to day, crisis to crisis, with little more than the hope that it will work out until tomorrow. I often catch myself wondering: what would it take to feel financially secure in my own disabled future?

I asked a few others what that meant to them." - A. Andrews

#please read this #great art #well done #disability

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smalife1234 · 25 days

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This is our 4th weekly smiles!! 👍 Please enjoy the read!

What made me smile this week?

Monday, 8/19/24 - today, we chilled for most of the day, and I was standing using our catheter box. During that moment, I fell over and smacked my face on the side of Luz's wheelchair! It made me start dying in laughter! And we just chilled on our tablets and we had a pretty good day in Catheterization wise! Sadly a butter knife almost fell on my foot! Poor my feet! but today's chill day made me smile!

Tuesday, 8/20/24 - we're on our third vitamin gummy! I tried a new flavor it was good! We washed a squish mellow that hadn't been washed for six months lol! It made us start dying in laughter! Then we chilled for the rest of the day. Sadly, our mom had a rough night and was hitting the headboard of her bed. It scared us, but thankfully, she's doing ok! And it didn't make us smile; however, Luz, our friend, had many Catheterizations, like 7 of them, which sucks! But we smiled, heading to bed at 1:00 a.m. Goodnight!.

Wednesday, 8/21/24 - today is my wife's six-month anniversary of living with an SCI! It made me smile! As she has made this far into her journey I am beyond proud of her ❤️! Lots of love to my awesome baba, then we headed to an open house since school is starting on August 26th! Scared yet excited! We went to the Open house, got some of our supplies and lots of papers, and I found out I have a class with my friends!! Hooray 🎉 made me smile! I got to say hi to Mrs Lawson!! Which is good! We got home and tried on my green button-up shirt for senior pictures!! September 3rd anxious yet excited! Made me smile! At the beginning of the day, I had my 38th round of chemotherapy! Thankfully, no symptoms. It made me smile!

Thursday, 8/22/24 - we chilled most of the day and played Subway Surfers for most of the day. We had a fun time hanging out with friends. It was a fun but chill day! Sadly, our friend Luz had a meltdown, and the other Luz kept having tic attacks and seizures! That didn't make me smile but the nice day certainly made me smile!

Friday, 8/23/24 - today I woke up around 7:48 Am! Which is early, and I woke up around 4:00 Am, but considering the time, I did not want to start my day just yet, lol! We chilled on Subway Surfers until Big Donny got a jackpot!! On his tablet! Which is amazing! It was amazing to see on the screen! And it made me smile! We soon chilled and laughed for a few to a funny choking audio from Instagram! (Obviously, the audio was made for laughs)! We were laughing and now we're just enjoying the rest of our summer! It made me smile! For dinner, we had yummy chicken, Alfredo!

Saturday, 8/24/24 - today, I woke up around 7:15 Am but then fell back asleep, lol, and then woke up again around 7:39 Am, which is good since I've been waking up later recently! We watched reels in the morning and discovered another paraplegic! T9! It was cool how she transferred in and out of the pool! Now we're chilling just hanging out and talking about paraplegic struggles and how if I went up a steep ramp my head would tip backward and I wouldn't be able to get it back up recently we've been talking about my strength since my third month of ALS is approaching don't worry I already have a long lengthy post for y'all to read :) And we saw a lizard in our window. It brought us immense joy! As we laughed and filmed the lizard, sadly, I have my 39th round of chemotherapy tomorrow! Which sucks but I'll push through it! And big Donny got another jackpot. It was amazing indeed! And it made us all smile! Then we chilled for the rest of the night. Sadly, our friend Luz, who is in the red wheelchair (since we have two friends named Luz), felt sick and was probably having Autonomic dysreflexia that night since she had a runny nose. She was coughing a lot and had a headache! Which sucks and that did not make us smile :( our other friend named Luz had a rough day in Catheterizations. It was not as bad as before, but she managed to get to 5, which is not normal, and kept needing to transfer out of her chair, which did not make us smile! But chilling the rest of the night and having a good night's sleep made me smile!

Sunday, 8/25/24 - today I have my 39th round of chemotherapy! I don't have much of a weekly vlog put together lol! So it will be very short! But I am happy to almost be 40 rounds in! And I am excited/nervous to be hitting my third month with ALS! And school starts Tomorrow!!! So I'll be nervous then but we are prepared! And cannot wait to see our friends! That made us smile. And I got a little greedy, lol, and ordered a chicken with egg biscuit with starry, hash browns, and a peach cobbler, but I am very grateful for our parents buying us a yummy breakfast! Thank you in advance! We chilled for a long time and had yummy potato soup! It was very good! Well, I won't keep y'all waiting! So, I will end this entry early. Thanks for reading, and I hope this week made you smile! Feel free to share your thoughts!!

What made you smile this week?

Img desc #1: shows a picture of a lizard on their window.

Img desc #2: doc is seen smiling with a pink long-sleeved shirt brown colored pants and dark brown shoes she is in her electric wheelchair

Img desc #3: shows Donny yelling into the camera/making a silly face. He is lying in bed. There is a blue hue in the camera because of a blue LED light.

Img desc #4: doc is seen driving down a ramp, turned away from the camera. The ramp seems to be having some work done. Doc is in her electric wheelchair while wearing a green short-sleeved shirt and beige-colored shorts.

Img desc #5: Emmie is seen smiling with a drink in her hand she is wearing a white Hawaiian-themed shirt and beige-colored shorts she is in her electric wheelchair

Img desc #6: Emmie is seen smiling into the camera while wearing a red shirt. There is a grey filter over the image. Emmie has a pair of sunglasses on her face.

Img desc #7: doc and Emmie are seen smiling while at an event. Emmie, seen right of the image, is wearing a black short-sleeved shirt and grey jeans. Her arm is resting on Doc's electric wheelchair. Doc, seen left of the image, is seen smiling in her electric wheelchair while wearing a pink long-sleeved shirt and beige-colored jeans paired with dark brown shoes.

Img desc #8: doc is seen smiling with someone as she wears a complete purple tuxedo. There is an orange background behind Doc, and her electric wheelchair is titled to the left of the image. She is staring into the camera and smiling.

Video description #1: shows Doc and Matthew showing off a lizard they thought was cool/ funny to see! In the video, you hear the commentary of laughter and the word lizard being repeated. The lizard is shown on the window as the Pokemon curtain is draped back.

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unexpectedyarns · 11 months

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I have an update.

I am home, and that is a BIG thankful.

During the catheterization they found no blockages, and didn't have to put any stents in. That cardiologist, Dr Reed, said that as far as he could tell externally, my heart looks healthy and is doing fine.

They did not fix the aortic aneurysm. The vascular cardiologist showed me the reports, and it has grown only half a cm (from 4.4cm [not 3] to 4.9cm) in the 6 months, and he said they usually don't fix them until 6cm, not 5. And that for some people they aneurysm never really progresses. Since mine is doing so, we will revisit that issue.

But there is a more serious issue - my aortic valve is leaking. He said it isn't BAD right now but it isn't something we can let go, so I will see him again mid-January for a new echocardiogram and new CTA scan, with a view to discussing then the possibility or probability or actual need for surgery. He said when he goes in to fix the aortic valve, he will fix the aneurysm.

It's telling to me that he didn't say "IF he needs to go in and fix the aortic valve…" but rather "WHEN he goes in to fix the aortic valve."

He said in the meantime, Reduce Stress. I told my boss that and she said, Haha does he know what your job is? I told her that I had told him I was Emergency Medical Dispatch and he laughed nervously.

That's all the news. I have today (taking it easy) and tomorrow (simple chores) off before I have to start back to work on Friday.

I just qualified for the insurance 2 weeks ago, since it was a 1-month delay. My question is, how soon can I legally quit this hellscape job and not have the insurance charge me for fraud over the hosptial bill?

#nikki talks about stuff #heart issues #I freeking hate my new job #how soon can I leave it now that insurance has a bill to foot:

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skippyv20 · 2 years

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Our Prayer List 🙏🏻❤️❤️❤️❤️❤️

Prayers and good thoughts for our friend. She is awaiting results for pre-cancer test and we pray it is benign. We pray for good results.

Prayers and good thoughts for our friend’s husband who has not been well.

Prayers and good thoughts for @truthseeker-blogger who is preparing to move and has yet to find a new place. Prayers for her legal issues to be quickly resolved.

Prayers and good thoughts for friend’s mom. She had a stress test that showed some issues, as well as some indication of a possible old heart attack. She has an appointment on March 16th with her cardiologist & we assume she'll need a cardiac catheterization & stents.

Prayers and good thoughts for formerlyroyal who has passed away unexpectedly. Prayers for her family and her loving pets.

Prayers and good thoughts for our friend who has severe iron deficiency and the treatment is very harsh and makes her sick. Her husband has been unfaithful during her illness and her family is ignoring me. She feels very alone.

Prayers and good thoughts for our friend and her mother who both have Covid.

Prayers and good thoughts for our friend’s church friend’s husband who has passed away peacefully! Prayers for the family.

Prayers and good thoughts for our friend’s family whose lineage is greatly affected by cancer in the family.

Prayers and good thoughts for our friend’s brother in Spain. Unfortunately, over the past two days he has been having terrible pain in his toe and is needing high levels of pain relief. The doctors have decide to keep him on antibiotics. Prayers they work, and prayers for his partner.

Prayers and good thoughts for Baby Roy who has passed away. Praying for comfort for his parents, and family as they mourn his loss. Praying for Baby Roy as he makes his journey home to God. Prayers and good thoughts for our friend who suffered from sciatica. The sciatica has resolved itself now, but she has 4 ruptured disks, 2 of which are torn. They have done a laser ablation of the nerves in her upper lumbar region which helped some. Also, she has had several epidurals in her lower lumbar & sacroilliac joints but that hasn't helped. She has an appointment with a neurosurgeon on the 14th.

Prayer and good thoughts for our friend’s newborn grandson who was admitted to the NICU yesterday with a Group B Strep infection. Baby Elliott was intubated last night and placed on a ventilator. Please pray for him, his parents, and his grandmother.

Prayers and good thoughts for our friend’s beloved nephew, Norbert. He is heartbroken after a breakup and is depressed.

Prayers and good thoughts for Rob who may have a re =tear in knee and need further surgery.

Prayers and good thoughts for our friend who is going through a very difficult time. Her husband is divorcing her after 33 years. After the first hearing, the judge is having him give her so little that she will have no place she can afford to live, while he has already gotten himself a new house. She fears her attorney is firing her due to how emotional she is. The day after the first hearing she had to go to the hospital for kidney failure, she has stage 4 heart failure, a tumor in her lung and leg. Please pray for judge to rule in her favour.

Prayers and good thoughts our friend’s brother in law. He has severe heart failure and he had colon cancer removed last nov. He must get chemo to be put on heart life saving machine but heart is too weak for chemo. This is his 3rd week in the hospital and the prognosis is he might live a couple months. Prayers and good thoughts for our friend who has been battling depression long-term due to trauma and the resulting difficult circumstances.

Prayers and good thoughts for Karen. She has been through much medically, and her sister is worried about her mentally handling changes.

Prayers and good thoughts for our friend’s little boy who will be going through treatment for speech impediment. We pray for his quick success.

Prayers and good thoughts for our dear friend whose disability renewal was denied. She has another battle ahead.

Prayers and good thoughts for our friend’s father who has been diagnosed with early stage dementia.

Prayers and good thoughts for our friend’s son-in-law’s mother. She has cancer in her spine, leg and lung. She will be having surgery on her spine. This woman raised 4 boys by herself, her now 23 year old son is severely autistic and needs 24/7 care, which his mom has provided him his entire life. She is only 64 years old, a wonderful person, warm, loving and very independent. My heart breaks for her. Please also pray for my son in law - he is in the Navy, fortunately stationed only a few hours from his mom. He has power of attorney for his mom and his brother’s care - he has some very difficult and no doubt heart wrenching decisions to make.

Prayers and good thoughts for our friend’s friend whom was diagnosed with a rare form of cancer called Myelodysplastic Syndrome, or MDS is now in remission. She is still doing chemo and is still waiting for the bone marrow transplant.

Prayers and good thoughts for our friend’s daughter who is struggling. She is in much pain mentally. We prayer for her family as well as they try desperately to help her.

Prayers and good thoughts for our friend who is battling an undiagnosed mental illness which led to decisions with consequences. Praying for her to stay strong in faith, for her family issues to be resolved. Also, for her to be free of financial hardship.

Prayers and good thoughts for Baby James and his heart brother Matthew. Also their heart brother Conrad

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mcatmemoranda · 1 year

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Patient is a [ ] yo male/female presenting to the clinic for a preoperative evaluation.

Procedure [ ]

Scheduled date of procedure [ ]

Surgeon performing procedure requesting consultation for preop is [ ] and can be contacted at [ ]

This patient is/is not medically optimized for the planned surgery, see below for details.

EKG collected in office, interpreted personally and under the direct supervision of attending physician as follows- sinus rate and rhythm, no evidence of ischemia or ST abnormalities, no blocks, normal QTc interval.

The following labs are to be completed prior to surgery, and will be evaluated upon completion. Procedure is to be performed as scheduled barring any extraordinary laboratory derangements of concern.

Current medication list has been thoroughly reviewed and should not interfere with surgery as written.

Patient has no prior history of adverse reactions to anesthesia, problems with airway management, difficult IV access, prolonged emergence, or postoperative nausea/vomiting.

Airway Mallampati score: This patient is a Grade based on the criteria listed below

-Grade I Tonsillar pillars, soft palate, entire uvula

-Grade II Tonsillar pillars, soft palate, part of uvula

-Grade III Soft palate, base of uvula

-Grade IV Hard palate only, no uvula visualized

Patient is a low/medium/high risk for this low/medium/high risk surgical procedure.

Will send documentation of this preoperative visit to surgeon [ ].

**** ADDITIONAL INFORMATION****

Patient Risk for Elective Surgical Procedure as Determined with the Criteria Below:

1- Very Low Risk

No known medical problems

2- Low Risk

Hypertension

Hyperlipidemia

Asthma

Other chronic, stable medical condition without significant functional impairment

3- Intermediate Risk

Age 70 or older

Non-insulin dependent diabetes

History of treated, stable CAD

Morbid obesity (BMI > 30)

Anemia (hemoglobin < 10)

Mild renal insufficiency

4- High Risk

-Chronic CHF

-Insulin-dependent diabetes mellitus

-Renal insufficiency: creatinine > 2

-Moderate COPD: FEV1 50% to 70%

-Obstructive sleep apnea

-History of stroke or TIA

-Known diagnosis of dementia

-Chronic pain syndrome

5- Very High Risk

-Unstable or severe cardiac disease

-Severe COPD: FEV1 < 50% predicted

-Use of home oxygen

-Pulmonary hypertension

-Severe liver disease

-Severe frailty; physical incapacitation

Surgical Risk Score Determined as Below:

1- Very Low Risk

Procedures that usually require only minimal or moderate sedation and have few physiologic effects

-Eye surgery

-GI endoscopy (without stents)

-Dental procedures

2- Low Risk

Procedures associated with minimal physiologic effect

-Hernia repair

-ENT procedures without planned flap or neck dissection

-Diagnostic cardiac catheterization

-Interventional radiology

-GI endoscopy with stent placement

-Cystoscopy

3- Intermediate Risk

Procedures associated with moderate changes in hemodynamics, risk of blood loss

-Intracranial and spine surgery

-Gynecologic and urologic surgery

-Intra-abdominal surgery without bowel resection

-Intra-thoracic surgery without lung resection

-Cardiac catheterization procedures including electrophysiology studies, ablations, AICD, pacemaker

4- High Risk

Procedures with possible significant effect on hemodynamics, blood loss

-Colorectal surgery with bowel resection

-Kidney transplant

-Major joint replacement (shoulder, knee, and hip)

-Open radical prostatectomy, cystectomy

-Major oncologic general surgery or gynecologic surgery

-Major oncologic head and neck surgery

5- Very High Risk

Procedures with major impact on hemodynamics, fluid shifts, possible major blood loss:

-Aortic surgery

-Cardiac surgery

-Intra-thoracic procedures with lung resection

-Major transplant surgery (heart, lung, liver)

High risk surgery: yes/no

Hx of ischemic heart disease: y/n

Hx of CHF: y/n

Hx of CVA/TIA: y/n

Pre-op tx with insulin: y/n

DM/how are blood sugars?

Pre-op Cr >2mg: y/n

OTHER EVALUATIONS BASED OFF PATIENT HISTORY SEE BELOW:

1. CARDIAC EVALUATION

A. Ischemic Cardiac Risk- Describe any history of cardiovascular disease and list the cardiologist/electrophysiologist. For CAD, report the results of the most recent stress test or cardiac cath, type of procedures or type of stents, date of MI, and recommendations for perioperative management. Include antiplatelet management. Continue baby aspirin for patients with cardiac stents - unless having neurosurgery, then coordinate with surgeon.

B. Ventricular function - include most recent echocardiogram evaluation ideally performed within the past 2 years

C. Valvular heart disease- include most recent echocardiogram, type of prosthetic valve

D. Arrhythmias - include any implanted devices and recent interrogation report, contact electrophysiology about device management during the surgery and include recommendations provided. For A-Fib, include CHA2DS2-VASc score

E. Beta blockade - All patients on chronic beta blockers should have these medications continue throughout the perioperative period unless there is a specifically documented contraindication.

F. Hypertension - Other than for cataract surgery, ACEI inhibitors and ARBs should be held for 24hours prior to surgery and diuretics should be held the morning of surgery

G. Vascular disease - include antiplatelet management and dates of strokes

2. PULMONARY EVALUATION

A. COPD/Asthma - include any recent exacerbations, intubations, chronic O2 use, amount of rescue inhaler use

B. OSA risk - STOPBANG score - address severity of sleep apnea and CPAP use

3. HEMATOLOGIC EVALUATION

A. Bleeding Risk - assess the bleeding risk and history for every patient

B. VTE Prophylaxis/Thrombotic risk - estimate risk and provide recommendations

C. Anticoagulation management - include pre-op and post-op medication instructions

D. Anemia - pre-op treatment plan

D. Oncology - history and treatments

4. ENDOCRINE EVALUATION

A. Diabetes mellitus - include type, medication use, recent A1c, pre-op and post-op management instructions

B. Adrenal insufficiency risk - assess for prolonged steroid use in the last year

5. RENAL EVALUATION

A. CKD - include stage, baseline labs

B. ESRD - include dialysis schedule, type, access, dry weight, location of dialysis. Generally, surgery should not be scheduled on a dialysis day.

C. Electrolyte abnormalities

6. GI EVALUATION

A. Liver disease - including MELD score and Child-Pugh classification

7. OTHER relevant comorbidities or anesthesia considerations

[substance abuse, chronic pain, delirium risk, PONV (post-operative nausea and vomiting) risk, psych disorders, neurologic disorders, infectious disease, etc.]

#Preop eval #Preop clearance #preoperative eval #Preop

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