#chronic wound symptoms

[inseparabiles]

This isn't an urgen concern or something that's coming out of a present situation of feeling the worst ever,

but like, with chronic illness, how are you supposed to know when something's an actual emergency? There's a new "this is the worst I've ever felt" with frightening symptoms of impending doom at least three times a year, and it's never anything. It's never anything and going to the urgent care for it just wastes everyone's time.

How the fuck are you supposed to know which "feeling the worst you've ever felt" is the one?

[kbkhospitals]

treatment for chronic wounds in hyderabad

Effective Care for Chronic Wounds at KBK Multi Speciality Hospitals offers top-notch treatment for chronic wounds. Heal faster with our expert care.

[baby-yongbok]

Remedies

OT8 x Reader

Genre - Comfort WC - 746

Summary - These are ways that I think the boys would help you to get over your mental and/or physical struggles Content Warning - Themes of mental and physical illness/struggles, mention of hospitals, mentions of medications/needles, mentions of food

A/N - I wrote this on my living room floor just now because I’m sick of being sick. I’m sick of being chronically ill, and I needed some comfort, so I thought I’d share it for anyone else who could use some comfort, too. I based these off of my experiences with my illnesses/disabilities. If you can relate then I just wanna say that i see you and you're strong. Keep fighting 💕+ I tried to write this to be gender neutral, I think I nailed it

✧ Masterlist ✧

Hugs from Jisung when your panic attacks have subsided. He whispers sweet praises of “You're okay” and “You're so strong” while he rocks you in his lap. You're still on the floor where he found you. His shirt soaks up every tear and his soft kisses on your forehead bandage every wound. You tell him that he can go, you apologize for causing a commotion, but he just holds you closer.

Laughing with Changbin while he tries to distract you from your symptoms flaring up. He's loud and silly on the couch with you. He's careful not to go overboard, he watches you to make sure that you're still comfortable while he makes silly voices and dances around for you. He's not ready to watch you cry yourself to sleep from the pain but he'll be ready to make you laugh again when you need it most.

Kisses from Chan while you're at your doctor's appointment. Your leg is shaking and he's soothing gentle circles into your back while he kisses your knuckles. He knows that you're scared, he is too. You have no idea what the doctor will say but he knows one thing for sure, no matter what the results are he'll be right by your side. He'll fight with you every single day and he'll kiss the pain away.

Adventures with Hyunjin when he realizes that you're avoiding going outside again. He knows that you get paranoid. He knows that every corner that you turn feels unsafe so he holds your hand. He skips across streets with you and dances on the white lines of the cross walks. He pulls you into shops that you've been too scared to visit yourself and buys you everything that you touch. He molds new memories with you with his bare hands. He'll do it everyday if he has to.

Cooking with Minho when he sees that you've been watching your diet too closely. He's gentle with you. You taste test everything together, he feeds you with silver spoons and kisses your nose with every hesitant swallow. He stands behind you while you stir the contents in the pots and plucks flour at you to see that pretty smile that he loves so much. He feeds you from his fork and he wipes away the mess. He makes it feel like it all goes down easy.

Reading with Seungmin when he comes to visit you in the hospital. He knows that you feel like you're going mad in here. He knows that you want to get up out of bed and walk out of here with him, that's what he wants too. Instead he holds your hand while you rest your head on his shoulder. He reads you each word with a softness that somehow drowns out the beeping of your monitors and the commotion on the other side of the curtain. He transports you to a place where you aren't sick. To a place where it's just you and him.

Cuddling with Jeongin when you feel that dark cloud consuming you again. He knew what was wrong when you let your alarms ring on for the third day in a row. You're huddled under blankets together, unmoving and quiet. His arms circle your waist and he pulls you closer. He weighs you down to reality. He makes you feel something besides the bubbling emptiness in your chest. He hums to you when the tears start to fall. He hums and holds you tighter. He won't let you drift away.

Singing with Felix while he helps you with your medication. There's so many to take that you've been overwhelmed with it all so he puts on a playlist and grabs all your pills. He lays them out and organizes them just how you need them. He uses the TV remote as a microphone, passing it to you when he sees you staring at the medicine littering the tabletop. He has you sing for him when he gives you your injections. He makes them as quick and painless as he can, always joining you for a high note as he sticks the band-aid on for you. He spins and hugs you once you're done for the day. He doesn't have to give you any praise, you can feel the love in his touch. You can hear it in his voice and see it in his actions. He's always going to be there to make it all feel easier.

If you liked this and wanna see more of this content let me know!

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[macgyvermedical]

Reference Guide to Writing Drug Withdrawal

So your character has a substance use disorder (or physical dependence to a substance for another reason). This post will tell you how to write a scene (or story) in which they go through withdrawal.

NOTE: THIS POST DOES NOT INTEND TO COVER ANYTHING EXCEPT WITHDRAWAL, WHICH IS A VERY SMALL PART OF SUBSTANCE USE DISORDER AND PHYSICAL DEPENDENCE.

Substance Use Disorders and Physical Dependence:

Substance use disorders are chronic illnesses in which a person continues to use a substance (commonly nicotine, alcohol, cocaine, opioids like heroin or fentanyl, benzodiazepines, etc...) even when acquiring or using the substance can be dangerous or cause significant problems in their life (such as problems with money, safety, law enforcement, job security, child services involvement, or physical problems like wounds, infections, side effects, hangovers, and withdrawal). Substance use disorders are a common cause of physical dependence.

Physical dependence is also it's own problem and can occur for other reasons too. For example, many people take prescription medications that they would go through withdrawal from if stopped abruptly (say, because the pharmacy couldn't fill it in time and they ran out). Assuming that the medication is being taken as prescribed, physical dependence in itself does not mean someone has a substance use disorder.

So what is withdrawal? Withdrawal (sometimes called "detox") is the process by which a body stops being physically dependent on a substance. Generally speaking, it is unpleasant. This is because when a body is exposed to a substance repeatedly, it changes how it functions to accommodate that substance. When the substance is removed, there is a period of time where the body has to re-adjust to not having the substance.

For example, alcohol is very similar to the neurotransmitter (brain chemical) GABA. If you drink a lot of alcohol (more than about 4 drinks per day) for longer than about a month, the body decreases the amount of GABA it makes naturally to accommodate the "fake" GABA from the alcohol. If the alcohol is suddenly removed, the body doesn't have enough GABA, and the effects of not having enough GABA result in withdrawal symptoms.

The difference being, someone taking a medication they no longer want to take can slowly reduce the dose to minimize withdrawal symptoms. Someone with a substance use disorder usually finds cutting back nearly impossible. Because of this, managing physical dependence in someone with substance use disorder generally means giving them a similar substance which they get from a pharmacy and take continuously (methadone, buprenorphine), or a similar substance they can then taper off of in a controlled way (benzodiazepines, gabapentin).

Specific Withdrawal Syndromes:

Alcohol/Benzodiazepines:

These are the only two substances that result in a potentially life-threatening withdrawal syndrome, and it's essentially the same syndrome. As stated above, when taken for either 2 weeks for benzodiazepines or 4 weeks for alcohol, the body decreases the amount of GABA it produces naturally. GABA is the "brake pedal" in the brain, slowing things down and decreasing the amount of activity. If you don't have enough GABA, you get too much activity, which can result in severe anxiety, insomnia, seizures, hallucinations, high blood pressure, temperature, and pulse rate, heart arrhythmias, and confusion.

6-12 hours after a person's last drink, they will experience insomnia, anxiety, tremors, and headache.

12-24 hours after a person's last drink, if untreated with benzodiazepines or gabapentin, they may start to experience hallucinations (they typically know they are hallucinating at this point).

24-48 hours after a person's last drink, if untreated, they may start to experience seizures.

48-72 hours after a person's last drink, if untreated, they may start to experience a severe symptom known as delerium tremens. This is a state where they are hallucinating severely and they don't know they are hallucinating anymore. This is also a state where the person has heart rhythm problems that could result in death. This is the most dangerous period during withdrawal.

If a person makes it through 72 hours, they are usually in the clear as far as life threatening symptoms go, though they may experience mild symptoms like headaches and insomnia for long periods afterwards.

Note that medication for alcohol or benzodiazepine withdrawal like other benzodiazepines, phenobarbital, and gabapentin are given only for the first 5 days of withdrawal, tapering to lower doses each day. This gets the person through the dangerous part hopefully with no life threatening symptoms. It does not mean all symptoms are controlled, but they are hopefully kept on the milder end while the brain learns to make it's own GABA again.

Opioids:

Opioids include a range of drugs including prescription medications like oxycodone, hydromorphone, and morphine, as well as street drugs like heroin. Today, the street drug supply in many places is heavily adulterated. Many samples of heroin (and even "pressed pills" made to look like prescription opioids) contain the much stronger opioid fentanyl (which increases risk of overdose) and the sedative xylazine (which causes wounds) in addition to the expected heroin or oxycodone.

Opioids work by pretending to be endorphins- another neurotransmitter usually used by the body to reduce pain and stress. Similarly to GABA in alcohol use, the body reacts to having sustained high amounts of fake endorphins by decreasing the amount of endorphins it makes itself. This means, when the opioids are no longer present, the body can't make itself feel good or recover from pain.

There are many parts of the body that endorphins work in, including the brain, gut, nerves, and spine. When they are removed, symptoms include:

Nausea and vomiting.

Diarrhea.

Insomnia.

Anxiety.

Increased body temperature.

Racing heart.

Muscle and bone pain.

Sweating.

Chills.

High blood pressure.

There is not really a universal timeline for these symptoms like there is with alcohol. For someone who primarily uses short-acting opioids, withdrawal begins 8-24 hours after the last use (though anxiety and cravings can start much sooner). For people who primarily use long-acting opioids, withdrawal can take up to 36 hours to begin following the last use. Generally, symptoms peak within 1-3 days after they start, and acute symptoms last 10-14 days.

Unfortunately, someone who has an opioid use disorder will frequently experience cravings for very long periods of time (potentially the rest of their life) after they stop use. For this reason, people do significantly better at reducing or stopping use over the long haul if they are taking an opioid replacement drug like methadone or buprenorphine.

Methadone and buprenorphine are prescription medications that a person goes somewhere each day to get (methadone) or picks up each day from the pharmacy (buprenorphine). The drugs essentially make it so the person won't go into withdrawal and will have significantly fewer cravings for as long as they take the drug.

The management of opioid withdrawal is usually done by switching the person from a street drug to one of these opioid replacement drugs. However, it is important to note that methadone doesn't work immediately (usually it takes about 2-5 days of titrating it up to get it to a high enough dose to work, longer if the person has a very high tolerance). Buprenorphine requires a certain amount of time in withdrawal (usually a day or two) before it can be given, or it can make withdrawal worse instead of better (something called precipitated withdrawal).

Once someone is on one of these medications, they can choose to stay on them (recommended) or taper off (nice to be off meds in theory, but high rates of return-to-use).

Cocaine/Amphetamines:

Instead of pretending to be a neurotransmitter, stimulants like cocaine and amphetamines prevent the body from re-absorbing the neurotransmitter dopamine, leading to a whole bunch of it hanging out in the brain. This increases concentration and energy and boosts mood. However, taken over long periods of time, the brain kind of burns out and fails to respond to the high levels of dopamine.

You may have heard that amphetamines and cocaine don't have withdrawal states. That would be a myth. People who use stimulants repeatedly for long periods frequently have a withdrawal that is essentially the opposite of the effects of stimulants- they feel very tired, have trouble focusing, and feel depressed because their brains can't use dopamine the same way they did before the drug use. This may last for weeks after cessation of stimulants.

Unfortunately, unlike with alcohol and opioids, there's not a ton that can be done for this withdrawal. There have been several studies, including testing medications like the antidepressant mertazapine, the migraine medicine topiramate, as well as naltrexone and buproprion (also an antidepressant).

In Conclusion:

There is so much more to drug use, substance use disorder, and physical dependence than I am covering in this post. I am just covering a small part of physical dependence, however the cause, by discussing the effects and common treatments for withdrawal.

Thank you all for reading this far! I hope you learned something and will use it in your writing!

[darkficsyouneveraskedfor]

The Pain of Living 1

Warnings: non/dubcon, chronic pain, blood/violence, perversion, and other dark elements. Not all kinks or triggers are tagged. My username actually says you never asked for any of this.

My warnings are not exhaustive but be aware this is a dark fic and may include potentially triggering topics. Please use your common sense when consuming content. I am not responsible for your decisions.

Summary: You deal with pain every day, but a new source of pain lands on your front step.

Note: I know I shouldn't.

As usual, I would appreciate any and all feedback. I’m happy to once more go on this adventure with all of you! Thank you in advance for your comments and for reblogging.

You can’t sleep. That’s nothing new. Your fatigue is more than just a symptom of your condition. It’s a purgatory. Much like the pain that often adds to your restlessness. Funny how you know moving hurts, yet you hate to be still. 

You sit up and groan at the stiffness in your neck and shoulders. It isn’t just in the mornings. It follows you through the day. You fall asleep with the same tension wound into your muscles. 

You stand, dragging your feet as you try to shake out the tingling in your arms. Your thumb twitches. You yawn, long and loud, and wade through the early dim. You made it almost to three in the morning. That shouldn’t be a great feat. 

You grab a sweatshirt from your closet and leave the small bedroom. The place is tiny. One-floor; a kitchen, a bedroom, a front room, and bathroom. Detached and lonely but affordable. You don’t go out anyway, not where there are people. And you don’t have friends. 

You slip into your shoes and open the front door. There’s a bench at the edge of the property. Ten steps. That’s it. Sometimes they’re easy to count. Other times, it feels like Everest. You get there and you’re out of breath and the way back feels tenfold. 

You can’t stay inside. You feel claustrophobic in your own body, holing up in the house, only makes it worse. The air is cool and damp as dew settles on the grass. Your slips clap on the narrow pavement path.  

...Two, three, four, five... 

You slow and squint at the bench. There’s something on it. At first, you think someone left a bag of rubbish there again, but then you notice the way something dangles over the edge. It’s a man. 

You stop and turn back, looking at the front door, but then you think better of it. He could be hurt. Likely, only drunk. 

Six, seven, eight, nine, ten. 

You stop beside the bench and look down at the figure. He’s breathing. You can hear each painful wheeze as he sucks it in. He’s face down, one arm and one leg hanging over the side. His head droops down as well, he’s too tall for the slats. 

More startlingly, there’s a slick patch of red across his left shoulder. His shirt is torn around the gaping wound and blood smears across the fabric and his neck. There are even stains in his hair that seep past the buzzed strands into his scalp. 

You’re weak at the sight of him. You reach to the back of the bench to keep from collapsing. He’s in rough shape. What do you do? 

You stare at him then at the house. Ten steps. What do you? Do you go back and grab your phone, call for help? You try to get him up? Then what? You’re certainly in no state to help him. 

You lean back on your heel. Something wraps around your ankle and you yelp. You look down as the man clings to you. You try to shake him off and he grumbles. 

“Don’t leave,” he rasps, another breath rattling from his chest. 

“I... sorry,” you try to twist your ankle free. “I can’t--�� 

“Dammit,” his breath whistles from him. “Don’t.” 

He squeezes even tighter and you whine. 

“Sir? I can call someone.” 

“Fuck... no,” he sneers. 

He releases your angle, raising his hand up your leg, dragging along the loose fabric of your pajamas. He reaches up, waggling his fingers. All three of them. You’re sickened at the sight of his bloodied and stubbed ring and pinkie fingers. 

You take his wrist and latch on as firmly as you can. He grunts as he pulls himself up and angles to sit against the back of the bench. His feet hit the ground heavily and he puffs out a tortured huff. 

“Fuckkkkkkk me,” he groans as he hugs his ribs. More blood across the front. 

You stare, dumbfounded. 

“I’ll get my phone.” 

“Don’t you fucking list--” He coughs and bends forward, keeping his arm around his middle as he hacks. He spits a reddened wad onto the ground and growls. “No. No calls. Get me inside.” 

“Inside?” 

“You keep making me repeat myself and I’m going to drown in my own fucking blood,” he reaches for you again, “come on, honey bun, I just need a boost.” 

You wave and once more peek at the house. He snarls and drops his arm. You glance back as he folds over again and reaches under his pant leg. He sits up with a pain roar and extends his arm in your direction. Your eyes nearly cross at the sight of the short barrel. 

“Get me off this fucking bench before you’re in worse shape than me. Got it, tater tot?” 

Your blood runs cold. You’ve never had a gun aimed at you. You’ve never even seen one up close. Only water pistols. 

You don’t think of arguing. You don’t even try to explain that you’re not very strong and that you hurt all over and you really don’t think you can get him that far. You don’t because you don’t feel any of it. Adrenaline overflows and drowns out all your doubts. 

You put your hands up and sway, “I’ll help. Please put it way.” 

He sighs and drops his arm. He leans forward and raises his other, waving you closer as he dips his chin. You move in front of him and grab his elbow. He rocks slightly, “on three.” He pushes back and forward, “one, two, three.” 

He uses his momentum to stand and whittles out a brittle breath as he hunches over. He stretches his arm over your shoulders and you fight not to wilt under his weight or the scent of blood radiating from him. You move cautiously, measuring each step as you work to keep from tipping over. 

You turn him back down the path. Should you really bring in a man with a gun? You don’t have much of a choice. Even as your bones ache and your muscles burn. 

He sounds awful. Like he’s dying. He could be. If he is, you’d hate to leave outside to do so but you’re not sure him doing so inside is much better. 

“Fucking Christ, move a little slower,” he drones. 

You don’t say anything. You can’t. You’re scared and in agony. You get him over the single step onto the porch and manage to push him through the door. The effort of your last surge has his arm sliding from your shoulders and he keels over onto the floor with a terrible thump and groan. You stand over him as he rolls onto his back. 

“Balls,” he croaks as he sprawls on the rug. “For the love of my dick, get some fucking towels before I bleed out.” 

You blink as you register his command. You don’t hesitate. You can’t. You hope he knows what to do because you sure don’t. 

You turn and go as fast as you can to get the towels, too distracted by his blood to worry about him staining your them or the floor. 

[thevenerated]

04. Bass Fugato

Coda

Synopsis: Eventually, the bile rises back from his throat, smears his teeth, and burns him whole. (tw suicidal ideation, unethical medical practices, curly’s misogynistic + trad awakening, manhandling, likely ooc curly. MINORS DNI.)

Word count: 2.5k

Chapter Navigation: [1] [2] [3] [4]

Notes: hehe. this is what i was building up to write... i love you misogynistic curly my beloved.

Call it an impulse, call it a consequence, or the price of free will.

Curly didn’t know what exactly called him to scale the abandoned parking lot; nor did he understand why he was so compelled to stand on the rooftop, feet planted on the very edge of it. It’s not like he wanted to die. He hadn’t a single suicidal bone in his body.

But he was curious, what stood between where he was, and the plummeting depths below. A conclusion to his lifetime of cowardice, probably. Likely something more, beyond the bleak loneliness of space. 

You were at home, sleeping. He was rougher with you, in all the places he hadn’t before. You seemed to take it well, enjoy what was never in his nature. 

Fuck. Just what did any of this mean? And why was he so compelled to find the answer to this stupid question? It was only a step and a short fall away. Maybe everything he’d wanted in his life would be there. His past would be meaningless. 

But was it cowardly to abandon what he had now, or cowardly to forego a future possibility?

He closed his eyes, feeling the wind tug at him, daring him to let go. A part of him wanted to. But a deeper, quieter part whispered something else—stay. Not for you, not for love, not even for the hollow comfort of familiarity. Stay, because nothing else had worked, and maybe, just maybe, there was something left to try.

With a sharp exhale, Curly stepped back from the edge. All this will be a reliable end if that ache gets worse. It’s all it should ever be. 

It’s as good a day as any could be.

He’d finished with what little he had to do early: went on a run, did some pumps that bit his muscles in all the right places, and made breakfast. He even cleaned up after himself. It was only 9 AM. Not much else to do.

Curly rolled his shoulders, feeling the pleasant ache settle in his muscles. For a fleeting moment, there was a quiet satisfaction in the routine, in the control of it. But the moment passed quickly, leaving him restless, an itch under his skin that had nowhere to go.

His feet carried him without thought, wandering through the apartment, past the things that were once his, now softened by your touch, your choices. He found himself outside your study, the door ajar just enough to peek inside.

He hesitated.

It wasn’t like he was snooping. Just looking.

The desk was cluttered, as it always was. Your laptop sat open, but it was the papers strewn across the surface that caught his eye. 

His name. Over and over. Scattered across the desk like the pieces of a shattered mirror, each page imaged detailed pieces of himself to form a dirty, wounded reflection. Curly stepped in, his stomach twisting with a visceral unease. He reached for one of the papers, fingers brushing it like touching something dangerous, and scanned the words before his brain could keep up.

‘Unresolved attachment issues. Aversion to emotional vulnerability.’

His jaw tightened. He shuffled through the stack. Psychological assessments; evaluations of him.

‘Need for control rooted in a lack of foundational self-worth.’

‘Reluctance to assert needs or boundaries due to chronic validation-seeking behaviour.’

It was accurate. Too accurate. But as he read, that accuracy only made it worse. Every carefully worded observation, every neat, clinical summation of his entire fucking life reduced him to a collection of symptoms, carving away anything human until all that remained was a hollowed-out list of defects. His life—his essence—is compressed into bullet points and diagnoses. 

A project. A broken thing to be analyzed, studied, fixed.

It didn’t say anything about the nights he stayed up with you, laughing at dumb movies. It didn’t mention how he still carried the lessons he learned from falling on his ass a thousand times, or the times he made people feel safe just by being around. None of that was here. Just deficits. Weaknesses.

‘Subject exhibits passive tendencies that indicate a deep-seated need for external guidance.’

Subject. Subject.

His grip tightened on the paper, fingers curling so tight the edges crumpled. Is that all he was to you? A case study? A puzzle you were piecing together in your spare time?

His eyes landed on another section; this one made his stomach twist.

‘Potential paths for improvement: Encourage assertive behaviour within a structured environment to counteract learned helplessness.’

Learned helplessness. Fuck.

His breathing grew uneven, heat rising to his face. Is this what you thought of him? That he was just some helpless thing trailing in your shadow, waiting for you to guide him to salvation? His fists clenched at his sides, muscles twitching with restrained anger.

And then, there it was: the final blow.

A note, scrawled in the margins, like an afterthought.

‘Sometimes I think he doesn't even know what he wants. Maybe he never has.’

Curly’s heart slammed against his ribs. He swallowed the lump in his throat, but it did nothing to smother the sick, simmering feeling inside him.

This wasn’t just disregard. This was everything. Every ounce of himself, every scrap of pride and autonomy he had left, compressed down into a neat little file for your convenience.

He let the papers fall from his hand, his pulse a steady, pounding drum in his ears.

You thought he didn’t know what he wanted?

Curly’s lips curled into a humorless smile, something dark and bitter rising inside him.

He stood there for a long moment, the papers scattered at his feet like the remnants of something he should have seen coming. His hands flexed and curled at his sides, itching for something—anything—to ground himself. But there was nothing. Just the quiet hum of your study, the soft scent of your perfume lingering in the air, and the sharp, suffocating realization that you’d been dissecting him like some kind of fucking specimen.

He exhaled sharply through his nose, running a hand down his face.

Alright. Fine.

He turned and left the room without a sound, but each step felt heavier than the last. He could feel the tension coiling inside him, wrapping tight around his chest like a wire about to snap. Every second, every breath, the weight of it pressed harder.

By the time he found you in the living room, curled up on the couch with a book in your hands, he wasn’t even sure what he was going to say. But it didn’t matter, because the second you looked up at him, eyes soft and warm like you hadn’t just shattered something inside him, it all came rushing out.

“Is that what I am to you?” His voice was low, rough, edged with something. “A fucking case study?”

Your brows knit together in confusion. “What?”

Curly’s jaw tightened, and he took a slow, measured step forward. “Don’t do that.” His voice was sharper now. “Don’t act like you don’t know what I’m talking about.”

You blinked at him, setting the book down. “Curly, what—”

“I saw them.” His words cut through your sentence, and the shift in his tone made your lips part slightly in surprise. He scoffed, running a hand through his hair. “The psych evaluations. My life—my mind—spread out like some kind of fucking school project.” He took another step forward, and this time you leaned back slightly. “Is that what I am to you?”

You opened your mouth, but nothing came out at first. When you finally spoke, it was quiet, careful. “Curly, it’s not like that.”

He let out a breathless, bitter laugh. “Then what the hell is it like?”

You hesitated, and that hesitation was enough. It was all he needed. His patience, his restraint—whatever fragile thing had been holding him together—shattered in an instant.

Before you could react, he was on you, hands gripping the arms of the couch on either side of you, caging you in. His face was inches from yours, his breathing heavy, controlled, but his eyes—his eyes were something else entirely.

“You think you get to decide what I need? What’s best for me?” His voice was a low, dangerous rasp, the weight of it pressing down on you like a physical force. “You think I don’t know myself well enough, so you had to do it for me?”

Your lips parted in protest, but he cut you off again, his voice rising just enough to make your breath hitch.

“No. Not this time.” His grip on the couch tightened, knuckles white. “I’m done letting you make the calls. I’m done being your goddamn… pet project.” He leaned in closer, his lips almost brushing yours, but there was no tenderness in it—just the sharp, electric tension that had been building for too long. “If you want to stay in my life, you do it my way. Do you hear me?”

Your breath trembled against his skin, and for the first time in a long time, he saw something other than certainty in your eyes. Doubt.

Good.

After a moment, your fingers hesitantly found his shirt, grasping it tightly as your face pressed itself into his neck. He doesn’t waver, and he doesn’t breathe a word, even when your hands tremble, and dampness smears the skin of his neck.

He lets you breathe for a moment, a small mercy he allows, before sitting on the couch and dragging you right onto his lap. His instincts war against the rational part of his mind, leading to a palpable stiffness in his limbs as he struggles to not hold you too tight. For all your indifference and unwavering nature, you always have bruised so easily.

But was it wrong that everything felt so fucking right, seeing you tremble on his lap with the uncertainty that plagued him, weighing on your shoulders? 

Thumbing your cheek with a calloused thumb, coaxing you to shamefully meet his gaze, he spoke quietly.

“You don’t respect me.”

“I—I do—”

“You don’t do this to a man you respect.”

“I just wanted to help you.”

“You didn’t. You made everything worse,” he muttered, pinching your cheek gently while the other hand settled on your hip, squeezing the flesh. You don’t push at him, instead shifting your hips to sit more comfortably on his lap, straddling his thighs. 

Curly’s hand on your hip, though tense, wasn’t threatening anymore. It felt like an anchor, like he was trying to keep both of you from spiraling into something neither of you could come back from. His fingers dug into your skin, but the pressure was different now, not out of anger, but as if he was grounding himself—and you.

He leaned closer, his breath warm against your cheek, his voice a quiet command. “Just stop talking.” His words weren’t laced with venom, but with something harder—something like control. He’d taken the papers, the clinical assessments, the theories, and thrown them out the window. His being isn’t a collection of issues. 

“You think you’re the one who’s been hurt in this, don’t you?” Curly’s voice was low, steady

You opened your mouth, but he cut you off, palm pressing to your lips.

“You’ve been so busy trying to make everything right that you’ve lost track of what really matters,” he continued, his voice rough but calm, measured. “What matters is us. And you don’t get to decide what that looks like.

“I want kids. I want a small home near the woods. Away from the noise of this stupid fucking city. We’ll get married, we’ll pack our shit, and we’ll leave. On my dime.”

Your head bows, nose brushing against the stubble of his jaw. A pause, and then you spoke. 

“You’re serious?” The words barely made it out, caught somewhere between disbelief and something darker you didn’t want to name. You were so close now, so tangled in the warmth of his presence that it was hard to tell where you ended and he began.

“When have you ever known me to joke about something like this?” His voice was calm. Calmer than the turmoil in your mind.

You leaned back just enough to look at him, your eyes searching his face for cracks—some sign that he wasn’t as steady as he seemed. But his expression was unyielding.

“Curly,” you began, your voice softer than you intended, “this isn’t something you just decide on a whim. People don’t—”

He cut you off, his head tilting as if he were observing something small and fragile. “People don’t what? Make decisions for themselves? Take control of their own lives?” His lips quirked, not quite a smile. “Sounds exhausting, being the one holding the reins all the time. Maybe you should try letting go.”

“That’s not what I meant.” The words rushed out, defensive, but they felt hollow even as you said them.

He let out a quiet laugh, low and bitter, his gaze locking onto yours. “Of course not. You never mean anything, do you? You just... guide. Shape. Mold. All for my own good though, right?”

“Don’t twist this,” you snapped, though your voice trembled. “I’ve always been trying to help you.”

“Help?” He scoffs softly, his hand slithering to cup the back of your neck, then gently tugging your hair, goading you to look at him. It was hard to. “You mean help me become the version of me that fits your description? That’s not help.”

You opened your mouth, but no words came. There was something about the way he was looking at you now that froze the thoughts in your mind before you could grab hold of them.

“I let you steer for years,” he said, voice steady but cutting. “Told myself it was safer that way, easier. But letting someone else lead? It’s never where you need to go. It’s always where they think you should be."

“I didn’t—”

“Didn’t what?” He leaned in, close enough that his breath ghosted over your skin, close enough that his presence felt overwhelming. “Didn’t mean to strip me down piece by piece? Didn’t mean to leave me feeling like nothing I do is ever enough?”

“That’s not fair,” you whispered, but the words carried no weight.

“No,” he said, his voice dropping to a dangerous softness. “It’s not. But fair doesn’t matter, does it?”

The air between you felt too heavy, oppressive, and you realized too late that he wasn’t waiting for a response. He wasn’t asking.

“Curly—”

“No. Enough. I’m sick of your voice. I made myself clear. Once I get some things put together, we’ll start preparing for a baby and move into the countryside.”

Again, you opened your mouth to speak, but he tugged your hair again, a little rougher.

“Enough.”

You fall quiet.

“...Good. Good girl,” he sighs, softening the slightest bit, cupping your jaw, fingers digging to the soft of your cheek. “I get that in your field, drugging your patients is the key to happiness. I wouldn’t be surprised if you eventually would’ve tried to prescribe me something.

“...”

“Hundreds of years, societies found happiness in their homestead. The answer doesn’t need to be some bullshit established just a couple of decades ago. So be quiet, and I’ll bring us somewhere peaceful. Spiritually and physically, because God help me, I’m done with this shit.”

A pause. You contemplate.

Then, with uncertainty, you nod quietly. With a huff of a laugh, he kisses your forehead.

“I knew you’d understand. You’ve always been smart.”

[covid-safer-hotties]

Also preserved in our archive

By Betsy Ladyzhets

Since early in the pandemic, people with Long COVID have faced challenges in applying for disability benefits, including from their employers, insurance providers, and the U.S. Social Security Administration. Applications often take a long time and are denied even for people who clearly have debilitating symptoms, leading to years-long, arduous appeals processes. The same has been true decades prior to 2020 for people with other infection-associated chronic diseases.

To learn more about the disability insurance system, Betsy Ladyzhets spoke to Barbara Comerford, a long-time disability lawyer based in New Jersey who specializes in these cases. Comerford has represented people with myalgic encephalomyelitis (ME, also known as chronic fatigue syndrome or CFS), for more than 30 years, including high-profile cases like that of journalist Brian Vastag.

Comerford discussed how the process works, her advice for putting together applications and appeals, how Long COVID has impacted her practice, and more. This interview has been lightly edited and condensed for clarity.

Comerford’s tips for disability benefit applications:

Comerford recommends that people applying for benefits extensively document their symptoms. Medical tests such as neuropsychiatric testing and cardiopulmonary exercise testing are her recommended method for documentation, though she acknowledges that these tests can be expensive. Comerford suggests that applicants should be careful to find lawyers and medical providers who have experience with these cases and won’t dismiss their symptoms. During the appeals process, Comerford recommends requesting a company’s administrative record and combing through it for any evidence that they abused judgement, cherry-picked evidence, or made other errors in assessing the case. Make sure to follow deadlines for filing appeals, as cases are closed if documents are not submitted on time.

Barbara Comerford: Should we focus on disability insurance, or do you want to focus on social security disability, or both?

Betsy Ladyzhets: Both, because people [with Long COVID] are applying for both.

BC: Right. And often, people think they should only apply for one, [but they should apply for both.]

Most of the disability plans that people have are often through their employer. Those plans are known as ERISA plans, that refers to Employee Retirement Income Security Act. It was created in the 1970s… Congress created this regulatory scheme, and then immediately created a zillion loopholes that corporations can drive a truck through. Later, ERISA covered all employee benefits in general.

Insurance companies wound up selling policies to corporations saying, “You can get the best people if you offer incentives.” And what’s a better incentive than, if someone gets sick, they can collect a substantial percentage of their salary until full retirement age? These are the sorts of perks that… People think, “If something happens to me, I’ll be protected.” The promise of these policies is that they will give people, usually, between 50% and 80% of their pre-disability income if they satisfy the requirements. Well, that’s a big if.

I’ve been doing this for 38 years. And I can tell you that 38 years ago, these [disability claims] were not problem cases. I used to do them for free for my litigation clients… But over the years, and really starting after 2001 with September 11, all hell broke loose. They [insurance companies] began to get very aggressive. Every time there is an economic downfall, whatever it is, they get extremely aggressive. So you can imagine, with the onset of the pandemic, they knew what was coming.

I did, for many years, advocacy for ME/CFS cases. I represented thousands of people… A lot of my colleagues say, “Long COVID social security cases are almost impossible,” because they don’t know what to do with them. My office hasn’t found that to be the case. I think the difference is, you have to document these cases with as much objective documentation of symptoms that people have… Get neuropsych testing, cardiopulmonary exercise testing, and other tests.

I started doing webinars and seminars [about disability benefit applications] in 2020, because I knew this was coming. At that point, they weren’t calling it Long COVID, they were just saying, some people with COVID weren’t getting better. But I knew it was going to turn into another ME/CFS disaster.

BL: How have you found the rise of Long COVID has impacted your practice? Do you find you’re more in demand now?

BC: We’ve always had a high volume of cases. Quite a few of them were ME/CFS cases. We did a case, Vastag v. Prudential, in 2018. Brian Vastag, who was a science writer for The Washington Post, was my client, and I could not get over how aggressively Prudential was just dismissing him because it was an ME/CFS case.

And the same is happening with Long COVID. We do cases all over the country on Long COVID and ME/CFS. It’s my livelihood, so it’s important for me, but it also makes me a little crazy that people get treated the way they do and that they have to hire people like me.

One of the things that people get upset about is that they have to spend money to medically document their symptoms. And worse than that… I see these Long COVID clinics, with doctors who are completely ignorant on Long COVID, who surreptitiously write notes in the chart that they think it’s a psychiatric case. I don’t know how familiar you are with this.

BL: Unfortunately, I’m very familiar.

BC: It’s awful. Not only is it really hard on my clients… It triggers them to read things that might not be what they said or might not be pleasant. And the number of times that I have seen that and it has sabotaged cases! I have to reconstruct the cases and have the clients contact the clinic [and get them to make corrections].

Mental/nervous limitations exist in all of these [insurance] policies… They can limit someone’s payments to two years if the case is a psychiatric case or mental/nervous limitation with a DSM diagnosis.

BL: I wanted to ask also — there’s been a lot of research on Long COVID at this point, and there was a report this summer from the National Academies specifically in response to a request from the Social Security Administration about Long COVID as a disability, in which they found that this disease can result in inability to work, poor quality of life, all that stuff. Have you seen that report, or other research, like the growing body of research on these diseases, have an impact?

BC: I was asked to comment on that [report]. Part of the problem with Social Security’s initiatives in this regard is that every social security case goes through what they call “sequential evaluation process.” You have to go through five steps to determine whether or not someone’s disabled. And among those steps is [matching people to a “medical listing of impairments,” but the list doesn’t include major symptoms for ME/CFS and similar diseases].

Years ago, there was a ME/CFS ruling called 99-2p. It offered guidelines [for ME/CFS cases that don’t fit the typical Social Security process]. After that, I was asked to present to the national association of Social Security judges, there were 500 judges in the audience. And I asked, “By show of hands, how many of you are familiar with 99-2p?” Two hands went up.

Despite the guidelines, in practice, [the judges aren’t familiar with these diseases]. Until there is a time when we can come up with a firm diagnostic criteria for Long COVID, and we can say, “This is what you have to document for this illness.” … And it can’t just be a positive COVID test, because many people got sick before testing was prevalent or they got sick after people stopped documenting that they were positive.

The other problem for Long COVID cases is it’s not like cancer or a broken leg or herniated disc or something that people are accustomed to. Those people are not told they’re crazy. Those people are not told they’re imagining it. Those people are not told, “Well, we just don’t buy it.” This is what happens with [Long COVID] and ME/CFS. The psych component that they try to pigeonhole these cases into is really a master stroke by the insurance industry that spends billions of dollars trying to persuade people that anyone who files for these benefits is a crook or fraud.

BL: It’s infuriating, especially when you see how deeply people’s quality of life is impacted by these diseases.

BC: Yes, every part of their life is impacted.

BL: I see what you’re saying about needing diagnostic criteria. In this time where we don’t have that yet, what would you want to see the Social Security Administration or other government agencies do to make it easier for all these people who are applying for benefits with Long COVID and ME/CFS?

BC: They should [reevaluate] the sequential evaluation process, which has been there forever, and look at medically determinable impairment in the context of Long COVID and ME/CFS. These diseases can be documented by things like neuropsych testing.

I’ll quickly go through the five-step sequential evaluation process. The first step is, “Is the person engaged in substantial gainful activity?” That is something you can do predictably, something that will last at least 12 months, and something that leads to gainful work, where you get paid and you can report for a job either part-time or full-time. In Long COVID cases… you have to document that this person is not engaged in substantial gainful activity because they don’t know tomorrow if they’re going to be able to get up and get out of bed and take shower, never mind report for work.

If you satisfy step one, they go to step two. There, they ask, “Do you have the ability, in light of your disability, to perform basic work-related activity?” Sitting, standing, reaching, pushing, pulling, reading, concentrating, things of that nature. And, “Does the disability negatively impact your ability to do these things?” [You need medical evidence, which can come from] a physician’s evaluation from a Long COVID clinic, for example.

If you have that, you go to step three, which is where that horrible “medically determinable impairment” crap comes in. There isn’t {a specific listing} yet for Long COVID, although they’re talking about it. Frankly, we’re still waiting for them to do one for ME/CFS, so I’m not holding my breath. That’s the only step in the process where, if they don’t satisfy it, you can still move on to the next step.

The fourth step is, “Is this person capable of performing the work that they performed for the last five years?” Until June of this year, it was the last 15 years… So we go through each job they had, all their symptoms and limitations and why they can’t do [the job anymore]. If we document successfully that they can’t perform their past relevant work for the last five years as a result of their disability, we can then go to step five.

Step five, the burden shifts to the Social Security Administration. Social Security has to document that, in light of a person’s age, education, and work experience, that there is no work in the national economy that they could perform. [To do this], Social Security has a big graph called the “medical vocational guidelines.” And essentially, the younger you are, the more skills you have, the more education you have, and the more skills that are transferable, generally you are found not disabled. But the graph is not supposed to be used for cases that involve what we call non-exertional and exertional complaints together. Pain, fatigue, things of that nature are all part of the non-exertional limitation.

That is how we lift ME/CFS and Long COVID cases out of that graph. Despite the fact that many of our clients are very young, many of them are highly educated, many of them have developed skills that are not only transferable, but are also in high demand in the national economy — [we say that] because they can’t predictably perform sustained work of any kind, the grid should not be used to find them not disabled. But with all of this, every one of these cases, medical documentation of limitations is crucial. I can’t emphasize that enough.

BL: I know a lot of people in Long COVID community, they’ve already sent in their applications, and then it gets denied, and then they have to appeal. What is that process like, and how would you suggest people go about finding someone like you?

BC: It’s really important to do some research. You want to know if the doctor or attorney you’re dealing with has experience in these cases… I do [webinars and one-on-one education] for lawyers all the time, because I’d rather them hear what has to be done, and understand what happens if they don’t do it.

If I’m giving people advice on appeals… If it’s coming from a United States employer, you’re going to be governed by ERISA. That’s important because people might file a claim without knowing the exact company policy. Despite the fact that federal regulations require employers to give that information to employees, when someone gets sick and files a [short-term] disability claim, they are immediately cut off from the employee benefits portal [that has all the exact policy information]. So then I’ve got to write a letter to the employers, and fight to get that information.

You can’t even get discovery in these cases… Sometimes they will award benefits, and then six months in they’ll say, “We no longer believe you’re disabled.” Under ERISA, [employers and insurance companies] get all the advantages.

BL: It seems like people should know, if you’re filing against an employer, to save that policy information before you lose access to it.

BC: When you get the notice of a denial, you can request a complete copy of the administrative record. You are entitled to see everything that the insurance company had on the case, and under federal regulations, they have 30 days to produce it.

And then you have 180 days to appeal that [denial]. People say that’s a long time. It’s really not. Because you’ve got to go through thousands of pages of documents. You’ve got to document where they abuse their discretion. It’s not enough to have medical evidence… [The standard you have to push back on is that] the insurance company or the employer has a “reason�� to deny the claim.

The lawyer’s job or the claimant’s job is to show all the examples they found in the administrative record that show [mistakes or poor judgement on the part of the insurance company or employer]… Sometimes, you will see reports of experts that they’ve retained to review the case, and the expert will say, “I think it’s a payable claim.” And then the next thing you find is them looking for another doctor who’s a little more receptive to their suggestions. If we see they’ve ignored the opinion of one of their experts, that’s an example of abuse of discretion and arbitrary, capricious conduct. Cherry picking the evidence is another thing you often see in these cases.

BL: So it’s not just sending your own medical records, you have to show that the company has messed up.

BC: The insurance company or the employer, whoever is paying, you have to show that they abused their discretion.

BL: Is there anything else, any other advice or resources you would give people?

BC: This is really important. If it’s an ERISA case and they do not get that appeal in within 180 days, they’re foreclosed from pursuing it any further… [It’s a big mistake] if you blow those time deadlines.

All articles by The Sick Times are available for other outlets to republish free of charge. We request that you credit us and link back to our website.

[opal-kitty333]

So, I like Horror Sans, and being a nerd, I've been thinking about him a lot during my recovery with brain damage. A lot of people treat his wounds like brain damage, giving him memory problems, chronic headaches/migraines, speaking difficulties, fugue states, just issues collecting his thoughts. All understandable and reasonable symptoms, but there's something about just what truly horrific, completely life altering, brain damage to such an extent can do to a person that hasn't been explored very much. Yes, he doesn’t technically have a brain, but considering someone with head trauma like him would be in a comatose like start for weeks to a month, we can choke up him taking that hit like he did and being able to walk and talk to that. Plus, we can take inspiration from real injury and science and have wiggle room for it to not be 100% accurate. Anyway-

This is Phineas Gage.

It is one of the earliest extreme cases of brain damage where the patient survived while psychology as a scientific practice was getting on it's feet. If you've taken a psychology class, you've heard of him. He was a railroad worker foreman who had a rod blown through his skull in an accident, destroy most of his frontal lobe.

If you don’t know what the frontal lobe is it's where your ability to reason and make decisions, the ability to control your muscles voluntarily, and your ability to process knew information and recall old information. It's well known for being the part of your brain that inputs logic, the part gives you the ability to remember what happened last time you picked a fight with someone, so instead you choose to walk away despite how much your want to punch them for being a prick.

As I stated before, this man was a foreman, well known for keeping a level head, being responsible, and hard working. After the injury, that completely changed. Everyone agreed he was barely recognizable as himself. He was impulsive, prone to extreme mood swings, impatient, making massive plans only to almost immediately abandon them, and generally seemed to have no control over his desires or ability to distinguish between a want or a need.

Now, let's look at Horror.

I'd say it's safe to say his frontal lobe but also part of his parietal lobe would be utterly fucked. Your parietal lobe controls your ability to process sensory information (mostly touch) and to understand not only where you and your body is, but to process the world around you. You see a massive enough tent, some clowns running around, the right music, and your parietal lobe is what does the work to label that as a circus.

To have these two structures damaged, or the closest equivalent in a monster, would radically alter Sans' personality, his ability to move, his understanding of the context around him, and connect with others.

He'd become rather self centered on his own desires and beliefs, struggling to even have the patients let alone the want to give other people the time of day. His actions would be impulsive, made on his emotions in the present moment and with little concerns other than the immediate consequences. He'd be prone to loud outbursts, not just rage, but any other emotions like sadness or glee with little ability to realize how he's acting may be overblown or inappropriate. Not only could his ability to put his thoughts into words be a struggle, but his ability to say those words could be affected as well. He'd be very present focused, with pass relations or responsibility mattering little as he keeps marching to the beat of his own drum.

That is, if he could march. He'd not only struggle to know where his limbs are or what he's touching, but his sense of balance would be awful. He'd likely have a constant wobble, having to go slowly and potentially hold onto or lean on things if he wanted to move quickly. God forbid how much he'd bump into furniture or trip and struggle actually grab onto something to catch himself. It's entirely possible he'd have difficulty reading and writing or confusing his left and right regularly. He'd need more time to process a situation and could very easily misidentify what's actually going on could likely lead to him acting even more unpredictable as the world around him is so much more dangerous and he's struggling to fully understand what everyone is doing and trying to keep two steps ahead of everyone around him.

But here's the thing. The brain is also incredibly adaptable in ways your wouldn't believe. Phineas Gage slowly recovered over time. He died twelve years after the incident from epilepsy but over time he slowly regaining his social skills and general functionality. He picked up a job as a stage coach four years after the indecent even. He was never quite the same person he was before, but he wasn't doomed to be what he first was after the indecent.

Imagine what this kind of thing could mean for Sans. Not only would the betrayal cut deep enough and the world falling apart put him through trauma that would shred the soul, but people he trust literally damaged his ability to think logically and control his impulses. Of course he's going to lash out, focus on doing anything he can to survive with little respect for what anyone else thinks. Even forcing his brother to do things and refusing to listen to him unless given no other option. All while he thinks the biggest problems after the indecent is how much his head hurts, how his memory is shot, that it's harder or even down right painful to think, and how he's struggling to cling to his independence while never having the patience or resources to give himself the ability to heal. He doesn't even realize how much he's changed. If you point it out Sans would likely get defensive and aggressive, or brush it off as everyone underground being awful people out to eat each other alive.

But then he gets out to the surface. He gets stable food, a safe place to live. His brother is recovering and as the years pass his mind can finally start pulling itself together and healing, finally. Sans begins to regain his ability to think critically on his own actions and others, his emotional outburst and vindictive behavior start to wind down and fade. He's able to think and start sifting through all the shit he remembers.

The guilt of what he did, the people he hurt for no reason other than pettiness. The stupid decisions he made that hurt himself and/or Papyrus in the long run. All the hindsight he has now. Imagine how much he would bury those memories and thoughts. Justifying everything he could and insisting he had reasons, or that it's just how it was and that everyone was as awful and cruel he was. Or just accepting that what Undyne had done to him and the famine after had ruined him, broken and rotted all the good he had and left him vile and malicious. That he'll never have a chance to truly be who he was before.

[scientia-rex]

I got home from work today sneezing my head off with a right eye that won’t stop watering, took a hot shower, climbed into bed, and I haven’t climbed out since. I’m grumpy and I have a headache and if I’m not testing positive for COVID or debilitated by symptoms tomorrow I’ll still need to go to work because that’s twenty patient visits that would need to be rescheduled, usually with someone else, and that’s twenty people I’m letting down. Today I did one of my patented 45-second Pap smears (if it takes longer than that, your doctor needs to get better!) for someone with vaginal atrophy from menopause (it is both very common and very treatable) and she was in disbelief. (This time it was more like 30 seconds.) I saw a suicidally depressed patient who’s clinging to life with both hands and I changed their meds last week and I am not making them wait to see me. I cleaned a wound no one else gave a shit about and I saw a bitter pissy Republican Party bigwig who has terrible anxiety and depression she doesn’t tell anyone about, who’s alienated everyone but who I can still convince to try treatment.

I do my job on hard mode on purpose. I like being important—who doesn’t? I like being legendary, I like that when people move to town and ask for doctor recommendations on Facebook so many people mention me that other patients feel compelled to tell me about it. I got nominated for best doctor in our local region last year. (I didn’t win, out of 5 nominees.) But when I’m sick, when I’m the kind of sick that can be hidden easily, the kind of sick I was always expected to go to school and rotations and residency with, it’s so hard. I hate exposing patients, even to a cold, but the benefits of receiving care are probably enough to outweigh the chance of transmission. I wrestle with myself: if I call in, it starts a ripple effect. Can they get a per diem from their “pool” (of three) to come in? Can they reschedule my patients with me? I don’t have any open spots for five weeks. Can they open same days? None available for three weeks. Can they open blocked spots? That’s going to make my life hell when I come back from being sick. That’s clinic staff calling twenty patients, trying to reach them. That’s twenty patients who feel abandoned. They can know intellectually that doctors get sick too, but they don’t believe it. They take it personally. I have seen this over and over again, until I had to believe it.

It is so EASY for people who don’t do this job to tell me how I’m doing it wrong. “Just stay home!” Oh, okay, you want to tell the person whose chronic opioids I’m supposed to write for that I can’t? You want to put the nurses through getting the on-call to write a bridge prescription? I write more ADHD meds than most of my peers—usually a lot more. You want to tell my colleagues to write meds they’re uncomfortable with? How about tell my suicidal patients (which is a lot of them!) that the provider they know and trust after months or years will be replaced today by a 70-year-old white man who still thinks they should pull themselves up by their bootstraps? Tell my queer patients that they have to wait until I’m better and back to get their hormones and their STI screenings, reschedule a Pap someone was dreading. Every day is a kaleidoscope of opportunities to make a real connection with “difficult” patients. I’m good at it. I may be the best at it at my clinic.

I don’t hate calling in sick just because the clinic manager is a judgy bitch, though that doesn’t help. I hate it because of what it does to my patients. And it’s not simple. Pretending it is does all of us a disservice. I am not a widget. I am not easily replaceable. You can’t plug any of our per diems (all men, 2/3 white, 2/3 old, 1/3 a Bitcoin bro) into my place and call it an equivalent, and my schedule is already so packed that if I call in sick, patients will be guilt-tripping me about it for months. I’m not kidding. That happens every single time.

Christ alive, I wish it was true that doctors never got sick.

[elicathebunny]

learning to let go of lingering negative emotions + Entering a calm state and regulating emotions.

(@anitalenia for the divider ౨ৎ)

Holding Grudges and struggling to let go.

Holding a grudge can affect you in many different ways ...

✦ Mentally:

Increased Stress: Constantly thinking about past experiences can keep your body at high-stress levels, leading to high cortisol and other stress hormones. Over time, this can contribute to anxiety.

Heightened Anxiety: Holding onto a grudge can lead to feelings of anxiety, as you may constantly worry about encountering the person you're resentful towards or replaying the situation in your mind. This can create a cycle of rumination and distress.

Negative Mood: Resentment and anger are negative emotions that can change your perception of the world and affect your mood. Holding a grudge can lead to feelings of bitterness, hostility, and general negativity, making it difficult to experience joy or contentment.

Impaired Relationships: Grudges can strain relationships, both with the person you're holding a grudge against and with others in your life. It can lead to communication breakdowns, conflict, and social withdrawal, which can further bring up feelings of isolation and loneliness.

Impact on Self-Esteem: Holding a grudge can also impact your self-esteem and self-worth. It may lead you to question your own value, especially if the grudge is related to mistreatment.

✦ Physically:

Increased Risk of Cardiovascular Problems: Chronic stress and negative emotions can contribute to high blood pressure, heart disease, and other cardiovascular issues. Holding onto a grudge can keep the body in a constant state of stress, leading to high levels of stress hormones like cortisol, which can negatively impact the heart and blood vessels.

Weakened Immune System: Prolonged stress and negative emotions can weaken the immune system, making you more prone to infections and illness. Holding a grudge can activate the body's stress response, leading to chronic inflammation and a weakened immune response.

Digestive Problems: Stress and negative emotions can also affect the digestive system, leading to issues like stomach pain, indigestion, and irritable bowel syndrome (IBS). Holding a grudge can increase these symptoms by keeping the body in a heightened state of stress, which can mess with normal digestive processes.

Sleep Disturbances: Negative emotions and stress can interfere with sleep quality and quantity, leading to problems like insomnia or disrupted sleep patterns. Holding onto a grudge can keep the mind racing with negative thoughts, making it difficult to relax and fall asleep.

Pain and Tension: Emotional stress and tension can manifest physically as muscle tension, headaches, and other bodily aches and pains. Holding a grudge can increase these symptoms by keeping the body in heightened tension.

Why might we struggle to let these feelings go?

Emotional Attachment: Negative emotions, like anger and hurt, can be intense and create a strong emotional attachment to the incident.

Need for Justice: We often feel the need for fairness or justice, and holding onto a grudge can feel like a way of ensuring the other person is held accountable.

Fear of Vulnerability: Letting go of a grudge might require forgiving someone, which makes us feel vulnerable and exposed.

Identity and Ego: Sometimes, grudges become part of our identity. Letting go can feel like losing a part of ourselves or admitting we were wrong.

Lack of Closure: Not having a clear resolution or apology can make it harder to move on, as the issue feels unresolved.

Recurrent Triggers: Frequent reminders of the event or person can continuously reopen the emotional wound, making it harder to let go.

Negative Reinforcement: Replaying the event in our minds can reinforce negative feelings and make them harder to release.

Low Self-Esteem: When we feel bad about ourselves, we might cling to grudges to deflect attention from our insecurities.

How can we try to overcome grudges?

Acknowledge Your Feelings: Recognise that you're holding a grudge and understand why. Reflect on what happened and how it made you feel.

Express Yourself: If possible, talk to the person you're holding a grudge against. Express your feelings calmly and honestly without being confrontational.

Empathy: Try to see things from the other person's perspective. Understanding their point of view can help you feel more compassionate and less resentful.

Forgiveness: Remember that forgiving someone is more for your peace of mind than theirs. It doesn't mean you condone their behaviour; it just means you're ready to move on.

Focus on the Present: Let go of the past and focus on the present moment. Holding onto grudges keeps you stuck in the past.

Self-Care: Take care of your mental and physical health. Exercise, meditate, or engage in activities that make you happy and relaxed.

Set Boundaries: If someone continually hurts you, it’s okay to set boundaries. Protecting yourself can help you let go of grudges while maintaining your well-being.

Seek Help: If you’re struggling to let go, consider talking to a therapist or counsellor. They can provide professional guidance and support.

How to enter a calm state.

Mediation: When we pay attention to our breath, we are learning how to return to, and remain in, the present moment—to anchor ourselves in the here and now on purpose, without judgment. This increased awareness allows you to recognise and understand your emotions as they arise, rather than reacting impulsively. Regular meditation trains your mind to stay calm and composed. This practice helps in regulating emotions and reducing the intensity of negative feelings like anger, anxiety, and sadness. As you become more skilled at meditation, you'll find it easier to maintain emotional balance and respond to situations in a more thoughtful and measured way.

Here are five reasons to meditate: 1. Understanding your pain 2. Lower your stress 3. Connect better 4. Improve focus 5. Reduce brain chatter

Journalling:

Emotional Expression: Journaling provides a safe space to express and process emotions. Writing about feelings, experiences, and challenges can help individuals acknowledge and make sense of their emotions, leading to increased emotional awareness and regulation.

Stress Reduction: Writing about stressful events or worries can act as a form of stress relief. By putting thoughts onto paper, individuals can release pent-up emotions and gain a sense of control over their circumstances, thereby reducing stress levels.

Problem Solving: Journaling encourages reflection and introspection, allowing individuals to gain insights into their thoughts and behaviors. This process can help identify patterns, triggers, and potential solutions to problems, fostering personal growth and resilience.

Self-Discovery: Regular journaling promotes self-discovery and self-awareness. Through writing, individuals can explore their values, beliefs, strengths, and weaknesses, leading to a deeper understanding of themselves and their identity.

Physical Exercise: Regular exercise can help reduce stress and improve your mood. Activities like yoga, walking, or swimming can be particularly calming. Stretching is often associated with physical benefits like improved flexibility and reduced muscle tension, but it also offers numerous mental benefits. It helps to release physical tension in the muscles, which is closely linked to reducing mental stress. As your body relaxes, so does your mind, leading to a calmer state of being. Stretching enhances your awareness of your body and its movements. This increased body awareness can help you become more in tune with how stress and emotions affect your physical state, allowing you to manage your mental health more effectively.

Watch what you consume: Put down the phone and silence any distractions. Purposefully make your environment peaceful enough for you to have a clear mind. Don't disrupt your session, stay in this calm moment for as long as you need to to properly reflect on yourself and make a difference to your emotions.

Allow yourself to dig deeper into your emotions without rejecting any ideas:

Really ask questions to make the most of the state you are in. Don't reject or suppress any feelings that come up, accept them and use those thoughts to understand yourself better. This will help you let go or work out anything that is bothering you. Understand your triggers and why you feel this way by prodding yourself with more and more specific questions. This may be an uncomfortable process but by understanding what is blocking you from being completely at peace within yourself then it must be done.

example: I feel like this -> why do I feel like this? Well, because this happened -> Why does this make me upset? Because it reminds me of this -> Why can't I let it go? and so on.

[cripplecharacters]

Hi, 

So, I have written expression disorder and dysgraphia, which means this might be a bit rambly or unclear but I’ll try my best to stay on as clear and as brief as I can. 

I’m currently writing a fanfiction for Wynonna Earp as a way to improve my writing skills without needing to stress about it. Background on the show: It’s a supernatural show based around a descendant of Wyatt Earp who was a legal officer in the wild west and got involved in a massive feud. It also has his friend Doc Holliday becoming immortal and being a love interest for the main character. The primary reason I’m doing this is because I dislike how they portrayed Doc Holliday in the series (often outright the opposite of the reality) and also because they just left out the fact he was disabled completely. Due to a gunshot wound when he was fairly young, probably along with weakness due to having tuberculosis for most of his adult life, which did eventually kill him, he used a cane part time. He also had a cleft lip and palate that was surgically corrected and he got surgery for it as an infant and had speech therapy, which doesn’t really seem to have impacted his adult life much in what I’m writing.

 I do have chronic pain due to an injury which was pretty bad when I was younger, so having a character who’s portrayed as dealing with that and continuing to be brave and selfless would have meant the whole world to me at that point in my life and still will. But as I was doing research I ran into a few things I knew very little about. 

My own disabilities are invisible, which means that I don’t have much experience with how people respond to seeing mobility aids. It would be interesting to show people’s responses, especially since he pretty famously took offense easily and didn’t leave things alone. There’s a fun scene there but I’m not sure what a common response to set it off would be. The biggest problem I have, that I haven’t been able to find a lot about: according to a medical article I read even when it’s cured people who had tuberculosis typically have some lung damage. I haven’t been able to find a lot on how that would impact someone day to day. He was cured of it magically but the idea of there still being damage makes sense based on the in universe rules and also someone being magically cured is generally considered not good. So how would it impact someone on a daily basis?

There’s some things in the research I did that make me think he was autistic (namely literal thinking to the point where he almost killed someone due to not understanding that a duel was meant to be a joke as a teen). Or maybe I’m just projecting because I am. Any ideas for how somebody who grew up in a time where nuerodivergence just wasn’t known would accommodate himself and be helped by friends? How would they understand it at that time?

How in general do friends respond to disabilities and try to help now?

There’s a few other things but they’re mainly just me being a beginner writer who doesn’t honestly. Thank you so much for reading through this even if you don’t end up responding!

[part 2] clarification: I meant the cleft palate wouldn't come up in what I'm writing because he's an adult and it didn't seem to have huge bearing on his adult life. I'm so sorry I left out part of that sentence in my ask bc I have a learning disability! didn't mean to! I'm so sorry and thank you again!

Hello!

People respond in many ways. In the modern west a lot of it involves random strangers being intrusive as shit ("what happened to you??") but in historical times I think it would be more of avoidance, especially if he has visible symptoms of tuberculosis. People still think that "visibly disabled person coughing = plague". If you're going for historical accuracy, it wouldn't really surprise me if strangers didn't want to sit next to him.

Long tuberculosis (affecting 25% of those who had TB) seems to be very similar to COPD, so the main day-to-day effect would probably be fatigue, being out of breath after physical exertion, etc. COPD is an incredibly common disability so you should be able to find a lot of info about it and how it can be managed.

Friends will also respond in many ways, and it also depends a lot on the disabled person. This guy sounds like the "hyper-independent physically disabled man" type and in my experience most of them don't talk about their needs much, especially not with the boys. In this case the accommodation is often just silently agreed on after spending some time together (e.g., after a few times going out they can see how annoyed he gets when they suddenly change plans so they learn to tell him as soon as they know, if he drops something they pick it up for him without saying anything since they know it's tiring for him to get up, etc.). If they know him well enough to know he takes offense easily they probably wouldn't bring up his inability to do something to not upset him and try to work around it instead.

I don't have enough historical knowledge to answer the second question, so I'll leave it to other mods. But I think it'd make sense if they just thought he was eccentric or weird rather than having a medical condition.

Hope this helps,

mod Sasza

Hello, thank you for your ask! In regards to the second question, it would depend on his symptoms, how well/if he could mask, and how other people view(ed) him.

I'm assuming he's level 1 / low support needs, as you don't mention him having a caretaker or difficulty doing tasks. Some of the examples include specific autistic traits that he may or may not have/used to have, they're mostly there to be examples. These are also assuming you're writing him as an adult only, if you want some info on how it would be like growing up during this time let us know!

Without good knowledge of autism, most people would think he's very strange if he cannot [fully] mask. Flat affect, lack of social understanding and other symptoms would make most allistic people uncomfortable, with responses ranging from thinking he's just weird [and would want to avoid him] to believing he's angry at them specifically [and would either want to avoid him or get aggressive themselves]. Most people will probably just see it as character quirks rather than symptoms of anything, or even think he's choosing to act the way he does. His friends would most likely be other neurodivergent people who either experience the same symptoms or don't have enough of a social understanding to realize he's not acting 'correctly' if he doesn't mask.

Unless his friends/family experience similar symptoms to him, they probably wouldn't understand why he does/reacts the way he does. This isn't to say they wouldn't try to accommodate him still, that moreso depends on the individual, but those who don't understand might try to push him to 'get over it' more than someone who gets it. Like Sasza said, over time his friends would be able to accommodate him by noticing what makes him upset/happy and how to help. 'Doc likes to keep his hands busy so I gave him my butterfly knife to spin' or ' the yelling in the hall was bothering him so I asked if he wanted to go to outside with me' could be ways of accommodating him without realizing, basically seeing his symptoms and trying to find an easy solution to help, wether or not they understand them. They could also give him unhelpful solutions while trying to accommodate, which would probably just further stress Doc if given in a stressful situation. Essentially unless he knows what helps and tells them it would be a guessing game for them [if he does that or his friend[s] respect it depends on them]. Try to think of his symptoms and what might be available at the time to help [like stim toys didn't exist back then but butterfly knives did, and ear defenders weren't a thing but he could walk away if needed].

As to how he'd accommodate himself, he wouldn't know words like 'stim' or 'overstimulated,' but if he doesn't care about/understand social norms he would be more likley to 'move in odd ways' or exit an upsetting area. A more socially conscious person might try to hide it, like using small tactile stims [i.e. rubbing a cloth or tapping his foot] or making excuses to leave an upsetting area. He might also be able to mask and try to just bear it, only unmasking around friends or in private.

Also the wiki said he was born in 1851 but died in 2020, and although autism would be named during his lifetime I'm not sure he would identify with it. The first medical documentation of autism was in 1877, and at the time it was called developmental [r-slur]. I doubt he'd want to identify with that, and even later on autism was only ever studied in children, and of course was not thought of well. It was thought to be caused by cold parenting or a form of psychosis/schizophrenia exclusive to children in the early to mid 1900's. For many, many years the only idea of autism he'd have would essentially be that. Because most studies at the time thought autism could be 'grown out of' [with exception to higher support needs people] he'd have lived most of his life at that point believing it was a child only disease. Even if he hadn't heard about autism until the late 1900's-early 2000's, it was still thought of as a stigmatized childhood disease by the public until recently [even by people today, hence the blog's existence]. If he's the type of character to be less set in his opinions at an old age then maybe later he could read on modern autism and identify with it, but I find older people tend to prefer dismissing disability for the sake of avoiding any change.

I hope this was at all helpful!

Mod Rot

[kbkhospitals]

Understanding Chronic Wounds: Symptoms, Causes, Treatment, and Recovery Tips

Chronic wounds are injuries that do not heal within the usual timeframe, often lasting weeks or months. These wounds can severely impact a person's quality of life, making early detection and treatment essential

Symptoms of Chronic Wounds:

Persistent pain, redness, or swelling.

Slow healing or wounds that remain open for over four weeks.

Signs of infection like pus, foul odor, or warmth.

Discoloration of the surrounding skin.

Causes of Chronic Wounds:

Poor Circulation: Conditions like diabetes or venous insufficiency hinder blood flow.

Infections: Bacterial or fungal infections can delay healing.

Pressure: Long-term pressure, especially in bedridden patients, can cause ulcers.

Underlying Health Conditions: Diabetes, obesity, and weakened immunity contribute to chronic wounds.

Treatment for Chronic Wounds:

Debridement: Removing dead tissue to promote healing.

Advanced Dressings: Special dressings to maintain moisture and prevent infection.

Medications: Topical antibiotics or antiseptics.

Hyperbaric Oxygen Therapy: Increases oxygen delivery for faster healing.

Recovery Tips for chronic wounds

Keep wounds clean and follow medical advice.

Eat a balanced diet rich in vitamins and proteins.

Manage underlying conditions like diabetes.

Regularly change dressings as directed.

Watch for signs of infection and seek medical help if needed.

Proper care and early treatment are vital for managing chronic wounds and ensuring a successful recovery.

KBK Multi Speciality Hospital provides advanced, non-invasive treatments for chronic wounds, using cutting-edge technology like hyperbaric oxygen therapy and specialized dressings. We focus on early intervention and personalized care, addressing underlying conditions to promote faster healing and improve patients' quality of life.

[chocodile]

Query; how much would Hyden taking proper medication and treatment for his real physical + mental ailments ACTUALLY do for his overall well-being?

That's a good question! There certainly are things that hypothetically could help him, but it would depend on whether we're talking modern medicine or not. He's already getting the "best" treatment his time period can offer (a few magical charms, dozens of folk remedy tonics, some of which contain mercury, opium, and unicorn blood). I imagine he has a whole shelf of tonics, tinctures, and other oddball cures he's tried and discarded over the years.

Unfortunately, his most significant problems can't be treated with the medical knowledge of his time period. (Even magic doesn't help that much: Healing magic is somewhat primitive and falls more under "speed up rate at which a wound closes" rather than "cure chronic conditions, fix nerve damage, and stop a magic crystal from burrowing its roots into your frontal lobe".) So all Hyden can really do is (poorly) manage symptoms.

In a more modern setting: He would have many more options. Depending on how "modern" we're talking, he might be able to get his gigantism treated in childhood. His abnormal height meant a lifetime of joint and muscle issues, among other things, and early-onset osteoarthritis in his early 40s. Stopping him from growing so tall would prevent a lot of pain and inconvenience in his future. Other than that, physical therapy and a marginally less sedentary lifestyle could also help, if he stuck with it. However, even with modern medicine, his two primary non-magic-brain-crystal-related physical ailments (osteoarthritis and nerve damage) cannot be cured, only managed.

In terms of mental health, he'd be a very difficult person to treat. If he lived in a modern-ish time period, I do think he might get (mis)diagnosed as bipolar, and mood stabilizers probably would help with taming some of his most extreme and impulsive behavior. The problem is that he'd be really bad about taking medication as prescribed. For example: stopping a med cold turkey when he "feels fine" and suddenly starting it again during a "I'm so fucked up, there's something wrong with me" spiral after a wild manic bender lands him in trouble.

As he got older and his reckless behavior slowed down, he'd probably wind up with a regular prescription including an antipsychotic, antidepressant [of dubious effectiveness], painkiller, and a bunch of common middle aged person medications for blood pressure and the like. They might not fix him, but they'd certainly leave him feeling better than the sketchy medieval folk remedies he canonically takes, at least.

[thegreatwicked]

Medical Writing Resources

I've been away for a while, and I've missed you all! I hope your holidays were fun and peaceful! While perusing my stuff to see where I left off, I browsed through my liked posts, and wow, I liked a lot of resources, so it's time to organize those for you all! And because we enjoy hurting our fictional darlings, I think it's time to make a new list!

If you've been tagged more than once, I apologize, I just want to make sure that credit is given where it is due. With that, enjoy these resources. Go show the original posters some love, and go write your story because no one else will.

Stages of Decomposition by @literaryvein-reblogs We write about death a lot and this is a great breakdown of life after life. Including descriptions of each stage and the proper names.

10 Non-Lethal Injuries to Add to Your Writing by @hayatheauthor I've hever had a broken finger but now that I think about it I have no idea how that works but I can't think of a more inconvenient injury, may as well get it right.

Writing Notes & References by @literaryvein-references This is a complication of a lot of resources but rahter than cut it up I'll probably just list it in a few resources. It includes things like color blindness, autopsy, bruises, drowning, pain, poison ivy. Go check it out.

How to Draw (Some) Burn Scars by @saszor and reblogged by @cripplecharacters. It is a drawing resource but sometimes visualizing it can help with descriptions.

Hospital Lengths of Stay by @macgyvermedical good references for simple things you might use in your writing if one of your character has to stay in the hospital. This is also an amazing blog.

Writing Tips - Fevers by @pygmi-says-hi Fevers are simple thing sbut if you're looking to make it more complex then you have this to help you know where to start.

Stop Doing This in Injury Fits by @pygmi-says-hi another good mention! Bleeding,s tab wounds, concussion, and symptoms!

The Anatomy of Passing Out by @hayatheauthor I've never written a character passing out and always wondered about it but here we are, maybe I'll have my characters pssing out more now that I know how to write it!

Addiction by @novlr Addiction is a disease and deserves better representation.

Disability Writing Guides by @whumpinggrounds Disability etiquette, wheelchairs, writing chronic pain, low vision. Great stuff here!

A Glossary of Medical Terms by @mylonelybraincell Invaluable! Absolutely invaluable!

Resources for Writing Injuries by @wordsnstuff Very comprehensive list of general information

The Writers Guide Authentic Wounds and Fatalities by @hayatheauthor check out this MVP here giving us these amazing resources.

Basic Sutures for Writers and Artists by @squidlife-crisis Never known how to describe these but seeing them is super helpful!

A Little Revolution's Dwarfism FAQs by @a-little-revolution Oh, now this is a gem!

Well, that's a good start for this new list! Go show some of these creators some love, and go write amazing things!

[astrobiscuits]

Chiron: where is our physical (and mental) wound?

I'm currently reading a book about Chiron (did you know it's actually half asteroid, half comet? me neither), which inspired me to make this post. I'm in no way an expert in medical astrology, just a curious owl that wants to learn more about every branch of astrology out there (my Sag Venus loves it!!🤭)

DISCLAIMER!!! I'm not a doctor. If you've been feeling any symptoms described here, TALK WITH YOUR DOCTOR, NOT WITH ME

Observation: Before we dive in, i'd like to mention that the position of Chiron in the houses is important. Not every house placement suggests having a poor physical condition. The most prominent Chiron placements when it comes to having a medical condition are: Chiron in 1st house (house of self, visible illnesses), Chiron in 5th house (illnesses since birth/early childhood), Chiron in 6th house (house of health, if Saturn is also sitting there it points to chronic illnesses), Chiron in 8th house (house of death, may point to severe diseases or poor reproductive health) and Chiron in 12th house (house of the unconscious, deals with mental illnesses)

Honorable mention to Chiron in 3rd house and Chiron in 9th house as they represent accidents while travelling. If Chiron is heavily afflicted in these houses (unless it's also conjuncting Jupiter), it may point to...let's just say you're gonna be in a hospital bed in a vegetative state, but remember, nothing has a 100% possibility of happening, you're just more susceptible to it happening. I suggest checking the position of Chiron in Solar Return charts for the possible timing of it happening (look for Chiron in 3rd house/Chiron in 9th house as it activates your natal Chiron)

Without further do, let's dive in⚕️

Chiron in Aries: frequent headaches, frequent nose bleeds, teeth problems (sensitive teeth, tooth decay), deafness, skull fractures, cerebral anemia, brain tumours, hemophilia, epilepsy, BPD

Chiron in Taurus: frequent colds, frequent voice loss, thyroid problems (goiter, hyperthyroidism, hypothyroidis, etc.), tonsilitis, OCD

Chiron in Gemini: lung problems (asthma, tuberculosis, pneumonia, etc.), speech problems (stuttering, cluttering, mutism), alzheimer's disease, ADHD, OCD

Chiron in Cancer: frequent stomach pain, prone to lactose intolerance, (for girls) breast lumps, breast cysts, breast infections, nipple discharge, depression, anxiety

Chiron in Leo: prone to insolation, frequent heart palpitations, chest pain, hypertension, hypotension, arteriosclerosis, scoliosis, kyphosis

Chiron in Virgo: frequent bloating, prone to gluten intolerance, chronic allergies, diabetes, rabies, autism, ADHD, OCD

Chiron in Libra: prone to acne, frequent lower back pain, disc herniation, spondylolisthesis, chronic kidney disease, kidney stones

Chiron in Scorpio: frequent pain down there, chlamydia, gonorrhea, syphilis, HIV/AIDS, depression

Chiron in Sagittarius: frequent pain in the hips, prone to hips dislocation, cirrhosis, sciatica

Chiron in Capricorn: prone to knees dislocation, osteoarthritis, bone problems (osteopenia, osteoporosis), gout, depression

Chiron in Aquarius: electrical injuries, shin splints, osteofibrous dysplasia, ankle sprain, ankle fractures, poor blood circulation, schizophrenia

Chiron in Pisces: prone to break toes, athlete's foot, bunions, addison's disease, hormonal deregulation, aphantasia, psychosis, schizophrenia, anxiety

Yes, i'm aware of the fact that it's a generational planet and it moves very slowly through signs

BONUS: It's important to take into consideration all planets that conjunct, square or opposite Chiron (regardless if they're personal or generational) + the Ascendant for additional info about our illnesses

Ex. Let's take me as an example. My Chiron is in my 10th house in Capricorn squaring Saturn in 4th house (so double Capricorn energy) and Aries Ascendant. Guess what? I've got TMJ (basically a jaw disorder affecting the joints) and i've got it from my fam -_- (Saturn rules tradition i love my fam)

I also believe that having a heavy afflicted Chiron in general makes someone prone to having a medical condition, even if it's not in the houses mentioned previously (like in my case). However, these people are more focused on the main meaning of the house, not their health problems. They tend to ignore their health problems or they just don't care

I hope you enjoyed my post and found it insightful :)

What's your wound? Lmk in the comments your placements and your illnesses

Kisses xoxo

[insipid-drivel]

Endometriosis, Fat Doctors, And Bellybuttons: What They Don't Teach You In Health Class

Woo another rambling TED talk, but I just got home from a meeting with a doctor specializing in wound care that I really feel a lot of you should hear:

Firstly, I've been having mysterious pains in my bellybutton area since... probably last Autumn? But I've had menorrhagia (extremely heavy, painful, and even dangerous periods that can cause spontaneous hemorrhaging) since I was 13 years old. Since my menorrhagia became active, I've been begging for a hysterectomy. I'm moving into my 20 year anniversary of Living With A Uterus That Hates Me As Much As I Hate It.

Being trans (agender) also really incentivizes the whole "yeet the uterus" thing, too, but that doesn't really have anything to do with why I wanna talk to y'all about endometriosis and bellybuttons.

Anyway, as of this year, I've had a lot of issues with my bellybutton region. Random infections, inflammation, pain, trips in and out of the ER; the works. My doctor has been so confused by my bizarre constellation of symptoms that he hasn't been sure of what's going on or what the best course of action is, aside from referring me for more tests and prescribing comfort measures in the meantime.

Until today. My desperate track for a diagnosis began over a week ago when my symptoms became alarmingly sepsis-like, but my test results came back with nothing but signs of an elevated white blood cell count. My doctor has been rushing me from specialist to specialist, and today was a wound care doctor that specializes in treating bariatric, hospice, and disabled patients that can't necessarily follow conventional wound-care advice meant for young, abled, and thin people.

I didn't expect much. Maybe some magnifiers, swabs, and a biopsy at worst, followed by antibiotics and whatever else, but definitely nothing that would help me solve this latest scary health mystery. While the worst of the pain I had that landed me in the ER went away on its own enough that I can get by with mobility aids, I still haven't had a diagnosis.

Until Awesome Fat Doctor.

Awesome Fat Doctor I celebrate. I live for this man. He literally gave me a reason to keep on trying and not give up. I was so scared of the appointment I'd gone nonverbal (not weird for me these days), but I got my voice back after I spent a while with him and his nurse (who was also fantastic). Even though I only met him for a few minutes and he forgot to introduce himself so I can't remember his name right now, Awesome Fat Doctor was a rock star. He was in his later middle age, scruffy, unshaven, and fat - enough that I could imagine the reason he specializes as a wound care doctor is because he may have gotten fed up of other doctors blaming his own health problems on his weight and life choices.

AFD gave no fucks. Along with being a big guy, he carried himself with the gruff no-nonsense of a man that's probably beaten up his ableist colleagues overdiagnosing fibromyalgia in the back of a Wendy's parking lot. He had been informed of my autism and my own needs for a wheelchair due to my own long-term chronic pain and other health issues, as well as my troubles speaking, and treated me like a little cousin that was having a rough go of things like he'd had.

He was compassionate and a straight-shooter with me. He was respectful of my boundaries, talked to me as casually as if I could respond like anybody else with working vocal cords (which I was eventually able to), and generally had all the bedside manner of someone that has worked with patients with special needs of all kinds. He looked at the trouble area and my records and history, told me that he was gonna do his best to get things straightened out, and then went quiet as he studied the timeline of my issues.

"Do you have endometriosis?" he asked, while studying a photo my mom had taken of a... skin infection over my lower abdomen, which had spread from my bellybutton.

I was confused.

"Not that I know of," I answered. I'd found my voice already when he and his nurse both helped put me at ease and showed me I was respected, safe, and seen. I've been tested a few times in my life for endometriosis and had my fair share of ultrasounds (the most common way to diagnose endo), and nobody had found anything unusual. But I have menorrhagia, am always in pain from my reproductive organs, and am desperate to get them removed. I'm on a 24/7 regimen of 2x normal birth control pills just to keep me from menstruating for my own safety. It sucks.

"My wife once had to get emergency surgery for what we thought was appendicitis. Do you know what it turned out she had?" he asked me, very suddenly, and like he had an idea.

"Ectopic pregnancy?" was my first guess, because women have died in the past to ectopic pregnancies that were mistaken for appendicitis.

AFD shook his head. "It was her menstrual cycle, and she had endometrial tissue bleeding into the space beside her appendix. I think you may have endometrial tissue in your bellybutton, and every time your hormones try to cycle in spite of your birth control pills, it bleeds and infects."

I was gobsmacked. Endometriosis and PCOS run in my family as reliably as eye and hair color, but I'd never really thought of how pernicious endometrial tissue could actually be. When I picture endometrial tissue, I picture overgrowths inside of reproductive tissue, or clinging to the outside; not growing randomly within the abdominal cavity or emerging out of my fucking skin like a turkey pop-up timer of doom.

AFD slowly nodded. "And the only way we'd be able to see the endometrial tissue is if you had it tested while you were menstruating and the tissue itself was inflamed and bleeding. Otherwise, it won't show up as anything different to the normal, healthy tissues surrounding it. A biopsy isn't reliable, either, because we have to know exactly where the tissue is before we test it. You have to have your hormones triggering the tissue to inflame and behave differently so it can be diagnosed if there are no big deposits of tissue to see."

After a long time of my ears ringing, I asked him, "Do you think it's possible that the ultrasounds were showing false negatives? Like, I have endometriosis and had it all along, but the tissue is too small to see or were being looked at at the wrong time?"

As it turns out, that's exactly what may be going on.

I see my doctor tomorrow, and meet with my surgeon at the beginning of next month.

Listen to your bodies, y'all. I am so thankful to that doctor, who wound up diverting into a very colorfully-worded rant about how much he hates the American medical system immediately after that. He gave me hope that I was just having new issues with old problems and was right all along about what my body really needed, and that my symptoms now are just showing what happens when doctors neglect their patients' needs.

I did wind up asking if he specialized with wound care because of how other doctors responded to his weight, and he said that it was a mix of reasons beginning with Yes: Both so he could have a safe space from fatphobia and ableism for himself and his patients, but also so his wife - who, while I hadn't seen her, he explained was about as big as he was - would have her own pain taken more seriously, being both fat and female. As he'd already explained, she hadn't been successfully diagnosed with endometriosis until she was symptomatic of full-blown appendicitis-levels of pain as an adult and her doctors were forced to stop blaming her pain on her weight.

Now, as I sit here reflecting... It's hard to believe that, thanks to this doctor's theory, I may finally be free from pain and dysphoria sooner than I imagined. It just took a doctor who could empathize with me to see me, and choose to take the scarier hill to fight on with me.