#elevated platelets

[mcatmemoranda]

Screening evaluation includes CBC/differential, blood smear, history and physical examination, and ferritin, as described in UpToDate content on evaluation of thrombocytosis. Clinical emergencies and complications (eg, thrombosis, bleeding) should be managed without delay by evaluation of thrombocytosis.

CBC: complete blood count; MPN: myeloproliferative neoplasm.* Definitions:

Worrisome findings on smear: Leukemic blasts, leukoerythroblastosis

Persistent thrombocytosis: Platelets >450,000/microL confirmed on repeat CBC

Vasomotor symptoms: Erythromelalgia, flushing, pruritus

Constitutional symptoms: Fever, sweats, weight loss

Unusual thrombotic presentations (eg, unusual or multiple sites; <45 years old; unexplained, unprovoked, or recurrent thrombosis)

¶ Refer to UpToDate content on evaluation of thrombocytosis for details.Δ Refer to UpToDate content on diagnostic testing for MPNs for details.

Thrombocytosis – Thrombocytosis is defined as a platelet count >450,000/microL (>450 x 109/L) in adults and children.

●Causes – Thrombocytosis can be caused by:

•Reactive processes – Platelet counts increase with iron deficiency, splenectomy, and in response to infectious, inflammatory, or malignant conditions.

•Autonomous processes – Essential thrombocythemia, polycythemia vera, and other myeloproliferative neoplasms cause unregulated, clonal proliferation of hematopoietic stem and progenitor cells.

●Evaluation – Initial evaluation (algorithm 1) should seek to distinguish reactive thrombocytosis from an autonomous process, based upon:

•Clinical – History of bleeding, thrombosis, vasomotor symptoms (eg, erythromelalgia [painful feet with redness due to clots], flushing, pruritus), constitutional symptoms (e.g., unexplained fever, sweats, or weight loss), iron deficiency anemia, and examination for splenomegaly

•Laboratory

-Complete blood count (CBC)

-Blood smear

-Serum ferritin

●Further evaluation and management – Further studies and management are guided by findings from the initial evaluation.

Scenarios include:

•Evidence of iron deficiency – Thrombocytosis may be due to iron deficiency in patients with a history of blood loss (eg, gastrointestinal bleeding, menorrhagia, multiple pregnancies), hypochromic/microcytic anemia, or low serum ferritin (eg, <15 ng/mL).

The source of blood loss should be investigated, and the platelet count should be re-evaluated after iron repletion.

•Inflammatory causes – The patient with an apparent infectious or other inflammatory cause of thrombocytosis should be evaluated as clinically indicated and the underlying disorder addressed.

•Post-splenectomy – No further investigation is warranted for thrombocytosis after splenectomy.

•Suspected hematologic malignancy – Essential thrombocythemia, polycythemia vera, or another myeloproliferative neoplasm or hematologic malignancy should be suspected in a patient with erythromelalgia, pruritus, constitutional symptoms, splenomegaly, or an abnormal blood smear (e.g., nucleated red blood cells, teardrop cells, blasts).

Further evaluation for a myeloproliferative neoplasm or other hematologic malignancy should include testing for mutated JAK2, CALR, MPL, and BCR::ABL1, as described separately.

•Family history of thrombocytosis – An inherited disorder may be suspected in an individual with primary relatives who have unexplained thrombocytosis, leukemias, or characteristic skeletal, skin, or other somatic anomalies. Evaluation and diagnosis of familial causes of thrombocytosis are described separately.

[two-calicos-in-a-trenchcoat]

Ahhhhhhh

Ok so I didnt get the xray cuz my copay wouldve been $300 and the ultrasound looked fine so it seemed not worth it

But apparently ive had elevated platelets in my blood for awhile now and it was better yesterday but since it keeps showing up they want me to get it checked out

So ive been referred to hematology and theyre supposed to call me in the next week to set up an appointment

I hate going to the doctor

Thats almost more stressful than anything being potentially wrong

[fanaticsnail]

Love you, Doc

Hey Doc Masterlist

Word Count: 4,400

Synopsis: Eustass Kid has come down with the non-life threatening ailment known as "the common cold." It is your job to care for him, no matter who orders you to do so.

Themes: Kid Pirates x gn!reader, platonic fic, you are the doctor of the Kid Pirates, you have been injured in the leg a few chapters ago by a person from your past, platonic love confessions, swearing, cuddling, Kid is sick, teasing, aged wound care, remedial massage, medicine taking, platonic kisses, swearing.

Notes: Shout out to @thenotsofantasticlifestory for being an absolute darling, listening to my rambles, and steering me into the right direction. Love you lots, Sto.

“Hey Doc,” a flash of a high, blonde ponytail flicks through the threshold from the doorframe, “You busy?” Placing down your medical journal you ordered, authored by a traveling doctor stationed on Drum Island, you turn towards Hop and offer her a two finger salute.

“Not if something’s broken, bleeding, or on fire,” you shrug nonchalantly while giving her a once over with your pointed gaze, “Didn’t go too hard sparring with Hip again, did you? Nothing sprained?” 

“No, no, nothin’ like that! I, uh-...” she trailed off, clutching the back of her neck while avoiding your gaze. Furrowing your brows, you turn your body fully towards her while remaining seated on your rotating swivel chair. 

“Spit it out, Hop. What do you need?” While your question was more tonally a statement punctuating your order, you still assumed your position of duty of care for your crew. She slouched her shoulders, hanging her head and gesturing a single pointed finger out to the side. 

“Cap’n needs you,” she whispered, barely audible. Feeling a little proud for a moment, you lean forward and raise your hand up to cup the shell of your left ear. 

“What was that, sweetheart? Come again?” you offer with a cocky smirk. The tall, blonde pouts while sucking in a large breath through her nose. Arching her back to full stature, she points more firmly in the direction of Kid’s quarters with her lips curled back in a soft snarl.

“The captain needs you, or,” she removes her hand from its outstretched position and crosses her arms over her chest, “Technically speaking: Heat told me to tell you that, Wire told him that he overheard Killer having an argument with the Captain about needing medical attention. Satisfied?” She offered the last part with a huffy taunt, prompting you to grin back at her. 

“Not for years,” you tease her, gesturing for her to come a little closer to your position sitting at your desk, “Come on, help me up. Leg’s still not the same since the spear incident.” You place down the book and 

Rolling her eyes, she casually strolled over towards you and wove herself beneath your arm. With one hand around your waist, the other clutching your wrist, she raised you to your feet and prompted you to let out a soft hiss at the impact of the elevation. The injury to your leg had only begun to crust over, the ooze from the coarse platelets itching at the skin. Bandages only did so much to ease the pressure from the wounds to the muscles, but you tried your best to push it aside to tend to the needs of your captain and your crew.

“Ah, shit,” you laughed through the pain, feeling the prickle of pins and needles pooling to your foot after having your leg elevated for so long beneath the desk. Hop chuckled along with you, giving your hip a gentle pinch while aiding you to stand properly. Without even finding the need to open your mouth, she wordlessly handed you the cane Kid fashioned for you to balance on. 

“Thanks, Hop,” you offered her a half-smile, removing yourself from her grip and looking to your desk. Scrunching up your nose briefly, you arch your brow up at her. 

“Did Wire tell Heat to tell you what type of medical attention he overheard the captain arguing with Killer about?” you offer her a sly smile, reaching for your satchel below your drawers, “Or am I going into this blind like the Reck incident a couple months ago?” 

“Honestly, I have no idea. Heat told me nothing,” she overemphasized her words by swiping her right hand in front of her chest. You shook your head, snorting out a soft laugh while throwing the loop of your satchel over your shoulder. 

Taking a moment to pause, you took a quick glance back at the medical journal and rolled over in your mind the last chapter of wound care and advanced treatment. Internally arguing with yourself for under a second, you decided to take a vial of oil extract from a medicinal plant to promote healing treatment for aged wounds and scars. If your captain was down with something, he might be more pliant in allowing you to experiment with your newfound knowledge. If not, there was always Killer who would always allow you a go at him with medicinal practicing.

“Alright,” you give her a soft nod, “Thanks again, Hop. I’ll go see to him now. Go back to whatever you were doing, or hide here to avoid duties. I don’t mind, just don’t touch the instruments.”

“Aye, Doc,” she offered you a soft salute, plopping herself down on your elevated bay bed and flicking through one of your medical magazines. You chuckle at her, shaking your head at the ease she made herself at home in your office, before hobbling your way down the hallway towards the steps up to Kid’s quarters. 

Slowly bracing yourself on the wooden wall, you took your time walking up the steps to not overdo your injury. While the Kid Pirates were more inclined to ignore the roaring ache you felt lingering beneath your skin, you wanted this to heal properly: taking your own advice, no matter how much you fought the urge not to. The Captain and the three commanders worked hard to save your leg, especially Heat, and you didn’t want to do wrong by them by having to lose it if you didn’t care enough for yourself. 

As soon as you made it up the last step, you heard a large rukkus and commotion from behind the door. Elevated voices, spluttered coughs, and mucusy sniffles ricocheted through the wooden walls and down the lengthy corridor. 

“I don't-,” the voice of your captain crackled, his usual tone more nasally than his usual cadence, “-And then I-!”

“-Get them, I swear, Captain. Doc needs to come and see you,” Killer’s soothing tone was more harsh than it usually was. It was unlike Kid and Killer to be fighting like this, especially for so long given the time it took to communicate it back to you. 

Exhaling more than what you had prepared for yourself, you hang your head while mentally preparing to deliver him his treatment of choice. Considering it was not that long ago that you, yourself, had suffered with this sort of affliction, you knew you would be able to endure being in the same room as your captain without much risk to yourself. Killer wore a mask, likely shielding him from catching the most of the illness, much to your joy. 

This could only mean one thing, and one thing only. Eustass “Captain” Kid had the non-life-threatening ailment known as: the common cold. 

With a lengthy inhale, you straightened your spine and rolled your neck around on your shoulders. With several pops of bone and muscle, you shrugged off the last of your inhibitions and readied yourself for an afternoon of treating your captain of his illness. Thanking your prior preparation of including several bottles of various tonics and honeyed anti-inflammatories, you brought your knuckles to the door and rapped on the wooden surface. 

You couldn't fight back the smile that rose upon hearing a repetition of “Please be Doc, please be Doc, please be Doc,” from the blonde first-mate. The door creaked open in a harsh tug, halting at three inches as the blue and white mask of Killer peeked through the small crack. 

“Oh, thank fuck,” Killer exhaled, his shoulders falling in a large slouch, “Please, in. In, in, in,” he ushered you inside Kid’s quarters with a hand floundering on your shoulders. You grimaced as you balanced out your weight on your injured leg, hobbling to adjust to a comfortable stature. Killer took a minute to insure you were safely tucked inside Kid's quarters before using a spurt of energy to flee from the room with a sheepish air to his actions. 

“He's all yours, Doc,” the jovial, teasing tone of the first mate cut through the air and prompted you to almost growl as Killer closed the door behind himself. Staring at the chipped paint of the wooden door, you heard a spluttering cough from the corner of your captain's quarters. Far away from the coziness of his bed, you turned to view the hulking figure of your captain hunched over his desk, his shoulders donning his large duvet as he scratched etchings onto a blank sheet of pressed paper. 

“Captain?” you slowly asked, turning away from the door and stepping towards his desk, “Captain, are you alright?” 

“Go away,” the nasally voice growled from beneath the shroud. His right arm continued to roll the utensils within his digits and scratch inked blots into the pages. “M’working. Go do doctor things, Doc. Find someone else to torment.” 

Rolling your eyes, you saunter over to the desk and peer over his shoulder. The page was littered with sharp lines of various sizes, neat notations within the marines depicting metallic elements on the periodic table, and heat temperatures for soldering purposes. You shake your head and slowly reach over your captain's shoulders, perching your hands over the duvet and giving the taut muscles a gentle squeeze. 

“I am not here to torment you, Cap,” you confess to him, tugging at his shoulders until his broad torso slunk against your chest. He pressed his head back against your chest, slowly leaning to the side and peering from the corner of his eye up at you. “I'm here to look after you.” You smile sweetly down at him, reaching up and smoothing your digits over his fluffy red hair. 

Eustass Kid’s bottom lip protruded, his eyelids swollen and puffy, and nostrils peeling skin from the swollen corners of his nose. His eyes began to water as he sniffed back another blocked rumble of air through what could manage to pass through his nose. 

“Do you want me to look after you, Captain?” you ask, truthfully knowing the answer he was desperately pleading with his eyes, but wanting him to speak it anyway. Taking a deep inhale through his raspy, crackling throat, Eustass Kid brayed out his answer in a forlorn whine. 

“Ye-es,” he wailed, leaning fully into your arms and closing his eyes. “I can't breathe, my mind is foggy, I can't lay down without my fuckin’ nose dripping all over the place, and I can't fuckin’ sleep while that's the only thing I really want to do. I haven't slept in three fuckin’ days.” The floodgates of Eustass Kid’s needs were broken like a dam, each word rolling over the other as you ushered him over to his large bed. Gently prying his duvet from his shoulders, you guided him to his bed while he continued to whine hoarsely. 

“My throat feels like I've swallowed glass, my eyes won't stop leaking, my ears keep popping and crackling, and there's this infernal ringing going on like a mosquito is trapped in my eardrum.” You ushered him to sit on his bed, propping him into a reclined position with his right arm propped over his stomach with a pillow beneath it, and his left stump elevated. Finding more pillows in his personal linen cupboard, you stuffed a few more up to hold him comfortably upright before tucking the duvet over his waist. 

“Sounds like you've got it bad, Cap,” you nodded sympathetically, locating your bag and popping the seal, “Tinnitus in which ear, hm? Left or right?” 

“Left, I think. It's like a buzz at this stage, don't pay it any mind,” he nodded, feeling the weight of his eyes falling like anchors over his glassy orbs. “What's really fuckin’ bad is my arm. It feels like it's still there, and it's like fire in my skin,” he looked down at his missing left arm with pain written on his features, “I can feel my hand gripping hard, like I can't let go of something important. S’always shit when I get sick, and this time it's just tauntin’ me.” 

You sigh empathetically, looking briefly down at your still healing leg before you continued to ready a cocktail of medication for your captain. Antibiotics, probiotics, pain relief, blood thinners, muscle relaxants, and sleep aid was calculated and lumped in according to his height to weight distribution, and adjusted for more comfort to his high pain tolerance. Usually, you would make fun of him for acting like this, but this vulnerability had you feeling closer to your captain than ever. You hastily clutched the vial you packed into your satchel within your palm before walking with your knees towards the reclined posture of the large red-head. 

“Take these with some water. I know it's shit, and it'll hurt your throat, but I'll get Killer to make you some lemon and honey tea to aid with the sting,” you nodded, reaching up your hand to his lips and popping the assortment of pills within his painted lips. Watching as he held them in his mouth briefly, you reached the top of his drawers for the glass of water you knew Killer put there a few hours ago and drew it up to Kid’s lips. He eagerly gulped down the contents, wincing at the hard pills lodging in his raw throat, before swallowing them down obediently. 

“You'll start to feel better in about ten minutes,” you nod to him, placing the water glass on the bench top beside the bed, “And while we wait, I'm going to see what I can do about your arm.” Reaching into your pocket, you uncorked the vial and poured a generous amount of oiled liquid into the center of your palm. Rolling your hands together, you warmed the liquid with the heat of your skin before drawing it towards the scarred left arm of your captain. 

“Keen for me to experiment a bit with your skin?” you quirked at him, hovering above and awaiting consent from the hulking figure of your captain. 

“You said you're gonna take care o’ me,” he grumbled, huffing and pouting like a petulant child, “So hurry up and do it already. I fuckin’ hate feeling like this, and I just-... I just-...” His eyes welled up, prompting him to turn to the side and hide his face from you, “...I just don't want to be in charge anymore. I can't be in charge anymore. I feel like absolute dog shit, and I just-... I need help sometimes.” He turned his orange eyes up at you, begging within his rounded orbs, “Please, Doc? Just make it stop? Please?”

Immediately pressing your hands to his arm, you give his muscles a constricting grip and roll the flesh beneath your digits. 

“Tense up with me,” you order him, squeezing his bicep with the intentional strength in a few key areas, “And then release.” You relaxed your grip on his arm, holding the grip over his flesh and thumbing along the veins. As he tensed his muscle, you tighten your grip, “Now hold it,” you nod, your hands shuddering beneath your strength, “And release.” 

You coached him through this method a few more times, rolling his skin between your hands and feeling the ripped and repaired muscles beneath his skin. Moving up your eyes, you focus on Eustass Kid’s face as it contorted in agony. The way he sucked in his lips and grit his teeth matched the telltale signs of him trying not to cry. 

Only ever seeing this expression on him once before, you decided to use a different method of care. 

“Doing so well, sweetheart,” you bore your fingers into his solid flesh, coating each morsel with the oil and sculpting his pain away with circular motions, “You are so brave, Kid. You bare the weight of our large crew, you have done so much for everyone. Captain I-.” Your words caught in your throat, feeling the tension in his muscles pull taught as you held firmly against his arm. 

“Say it. Whatever it is. Please, Doc,” Kid nodded, fighting back through the pain and urging you along. While the two of you were distracted by focussing attention on Eustass Kid’s pain, you remained ignorant of the door opening and closing behind the blonde-haired first mate reentering the room. 

You inhaled a deep breath, humbling yourself and giving him something truthful to focus on rather than gritting his teeth through the praise he often craved. 

“Captain, I'm proud to serve under you,” you utter to him, gently rolling your digits over the base of his healed scarring. Thumbing over the stump, you focus your eyes on his flesh, “We are all proud of you. I-...” You halted your motion, closing your eyes and lighting up your soft smile on your lips, “...I have loved every minute of serving you as your doctor, regardless of what I say most of the time. I love you, Captain.” 

Looking at the mess of oozing oils over his skin, you feel his right hand gently reach up to clasp your forearm. 

As Kid made to open his lips, using his words to mirror your admiration back at you, his mind did not match what curled on his tongue. 

“Hah! You love me? Pfft, what a fuckin’ softie, Doc,” he slunk back against the pillows once more, his eyelids growing heavy and weighted beneath the growing intensity of the medication. “You're a little shit most of the time. A real pain in my ass, and you ruin a lot of my projects and fun by banning them. Shoulda kicked you off the crew years ago.” 

Your jaw slackened, eyes widening as your brows furrowed beneath the weight of his words. Just as you were about to bark back a witty retort of your own, he silenced you by lazily rolling your name over his palate. 

“But I fuckin’ love you,” he confessed in a breathy tone, a dopey smile tugging up his face, “Take’n such good care o’ us. Keepin’ me in line when I start with the bullshit. Always bein’ nice, in your own sadistic way.” He gave your hand two warm taps before the medication pulled him down in a warm recline. 

“I love you so damn much, Doc. I need you to know that,” his tone grew slower, his yawn tugging his lips up and his voice muffled beneath the wide inhale, “I love you.” His head lulled to the side, his lips parting as sleep finally caught up with him. His breaths came out in rattled breaths, saliva mixing with mucussy underlay of his firey illness. 

“And just like that, you're out like a light,” you chuckle to yourself, cradling his left bicep and laying it down beside him. Gently tucking in his duvet over his broad torso, alongside removing the pillow from his stomach, you smooth over the plush material and secure the captain beneath the shroud. Giving a brief pause, your eyes raked over his face and noticed his breathing was relaxing with each inhale. 

“Rest well, sir,” you nodded, slowly inching yourself off the bed and wincing through the shooting pain up your leg. Just as you rose to stand at your feet, a slow drawl crooned from the corner of the room. 

“What? No kiss for your captain, Doc?” Killer teased you, finally making his presence known as you hobbled away from the captain’s bedside. “No little stroke on the forehead after the professions of love? Not even a gentle cup of his clammy, sick cheek?” 

If your scowl had the ability to sear through metal and bone, the look that bloomed in your eyes would've sent Killer to his grave. 

“Caressing and kissing my unconscious crewmates is not my forte,” you spat in return, upturning your lip and snarling at the blonde. He was taken aback by your menacing altitude, raising his hands at his sides while he shook his head softly side to side. 

“I meant no disrespect, Doc,” he lowered his head and stooped to your height, “I was just playing, as we always do. Are-... Are you alright-?”

“-No, I'm not,” you growl in return, reaching for the cane and propping yourself up with it. “I had to hear from Hop that Heat told her, that Wire told him, that he overheard you telling the captain to ask for medical attention from me.” You leaned on your cane, feeling your hand shake under the weight of your body. “Do you know how fucking ridiculous that is, Kil? How fucking stupid that is? How worthless that makes me f-feel?” You choked on the last few syllables, feeling the well of emotions finally simmer in your chest and rise in your throat. 

“Hearing Kid, joking or not, say he wanted to kick me off this crew while I'm treating him?” you fought back your tears, finally succumbing to the emotion and having the liquid sear down your cheeks and drop onto the floor. “I can take a lot of shit, Kil. But this? This? This fucking took the cake.” 

The noise from your deep confession managed to stir Kid from his medicated slumber, his body fighting the sleep in a bid to remain awake for your words. He heard every lick falling from your snarling lips, every passionate exclaim causing him to slink back down and listen intently. 

“And when I tell someone I love them? Platonic or not, I don't enjoy being laughed at, or made fun of when I say somethin’ fuckin’ stupid like that,” your eyes drew to Killer's mask as you bore your soul to him, unaware of Kid attempting to sit up in his bed further. “When I-!”

“-Get over here, both o’ you,” Kid interjected, causing both Killer and you to snap your attention over to the captain reclining on his bed. 

“Captain, I-,” you began, prompting Kid’s raspy growl to drown out your repose. 

“-I don't wanna fuckin’ hear it,” his left arm wobbled, patting the pillow in a bid to call you over further, “I'm not tellin’ ya’ both again. Get the fuck over here, now. You too, you big asshole.” 

Killer rolled his shoulders back, his muscles and bones clicking as he kicks off his boots and saunters over to you. Without giving you a moment to reject his order, Killer hoisted you up and slammed your back gently on the large bed beside your captain. Nestling you within the crook of his left arm, he tugged you closer into his embrace, cradling you against his chest, while Killer moved to Kid’s righthand side. 

“Now, you little shit,” Kid growled playfully into your ear, “You're gonna fuckin’ sleep, I'm gonna fuckin’ sleep, and Kil? You're gonna fuckin’ sleep. We're all sleepin’, ya hear?”

“Cap’n, I need to tell Wire that he's in charge-,” Killer attempted to convey, hushed by Kid harshly tugging him into his chest and locking him against his body. 

“-And I don't fuckin’ care. You're cranky as all hell, and Doc is too, ain't ya?” he chuckled down into the crown of your head, stroking it with his cheek, “Now you're both gonna sleep. I don't care how long you sleep for, but you're gonna sleep.” 

“Cap, I-,” you try him, prompting Kid to bark down at you in response. 

“-I don't fuckin' care. Go to sleep, so-...” he took a moment to yawn, his voice groaning at the back of his raw throat, “...-so I can sleep. You're both loud, and I need the people I love close to me. So shut up, and be close to me.”

He turned his face towards Killer, puckering his lips and pressing them against the top of his mask. Emphasising his kiss, he moans an overenthusiastic hum against the cool metal. 

“Mmm-ah,” he releases Killer’s mask from his lips, laughing as he watches the first mate gently punch his arm. “Night, Kil. Enjoy your snooze.” Kid then turns to you, using the stump of his arm to coax you towards his lips. 

Gently fighting yourself away from the captain's affection, he wins by pressing his lips to your forehead and offering the same exaggerated moan. 

“Mmm-ah,” his grin splits up his cheeks as he watches you becoming visually flustered by his actions. “Night, Doc. Sleep tight.” Kid rolls into his back, holding both you and Killer tucked tight into his armpits and sighs a raspy breath of glee. 

“Love you, Kil. Love you, Doc,” he smiled, closing his eyes and truly basking in his two crewmates offering him comfort. He felt Killer adjust himself to make his mask comfortable above his cheek, nestling against the redhead's side. You do the same, giving up on the notion of fleeing from the captain's embrace and drawing your own comfort within his bicep. 

“Love you too, Cap,” both you and Killer whisper in unison, feeling the call of slumber sing it's sweet song under the comfort of Kid’s warm embrace. 

It wasn't an unheard of thing, sleeping beside your crewmates and offering them comfort. Bubblegum often came to either you or Killer when he needed that extra care, and you would always give in when he needed that softness from you. 

But this felt different. 

The soft, likely cold medication-induced love professions after a hard cry with one another made you, yourself, vulnerable to this embrace. Your care for Kid and your crew, the love you all share unlike anything you had ever encountered before. Feeling raw, you draw your hand over Kid’s waist and tuck your face against his chest. As you felt yourself well up once more, a hand came up and cloaked your own beneath its warmrh. Slowly peaking from the corner of your eye up, you notice Killer's hand covering your own and thumbing over your knuckles. 

“Love you, Doc,” he whispered over Kid’s heavy breathing, giving your digits a gentle squeeze, “I mean it, and so does he. We all love you. You're perfect for our crew, and Kid has never wanted to ever kick you off. He was just sayin’ it to-.”

“-I love you too, Kil,” you whisper in return, gently rolling your hand up and squeezing his palm, “And I know. I was just being silly, and a little bit vulnerable after the injury. I know, okay?” You shifted closer to Kid, adjusting so you were comfortable and offering Killer one final quip before your eyes weighed beneath the call of sleep took you. 

“Now do as your told, and fuckin’ sleep would you.”

“You too, Doc.”

Tag list: @mfreedomstuff @daydreamer-in-training @since-im-already-here @gingernut1314 @writingmysanity @sordidmusings @i-am-vita @indydonuts @feral-artistry @the-light-of-star @empirenowmp3 @racfoam @sunflowersatori @carrotsunshine @skullfacedlady @jintaka-hane @thenotsofantasticlifestory @nerium-lil @sinning-23

[grison-in-space]

Poor Matilda's abscess came back and grew somewhat dramatically between Monday (when I called the vet) and Wednesday (earliest they could squeeze her in). It started leaking bloody pus less than an hour before the actual visit. So, uh, that rocked for everyone. I've never seen a dog abscess as fast and violently as she has two or three times now*, for whatever reason always under her left eye. I'm not giving y'all a picture today because she looks like Quasimodo, if Quasimodo was also covered in hair that had recently been shaved under one eye and was also wearing a fetching rainbow e-collar. But I have some thinking out loud under the cut, because apparently this one is not as simple as I was hoping...

*Benton accidentally lanced this one, to everyone's mutual horror, two weeks ago. She did see the actual vet for it shortly afterwards but it looked fine at that point.

See, I had figured this was going to be like the e-vet visit when she had an abscess in the same place a year ago: lance it, flush it with saline, course of antibiotics. Easy.

Except a) it turns out the swelling was not a squishy sac of gross, and b) as best my vet could tell from carefully observing where the pus was coming from, it seems to be an infection of the nasolacrimal glands, which, what the fuck.

And then c) vet finds really elevated platelets in the pus smear, confusing us all even more: white blood cells make sense, but platelets doesn't. So I am waiting on a bunch of labs and uneasily cramming my dog full of antibiotics. We are checking, among other things, tick borne diseases, which is always a great time.

Did I mention I'm leaving town on Saturday? Because I'm leaving town on Saturday. Ahahaha god.

I just—what even, Tilly?! What even? Wish us luck getting to the bottom of this one...

[appalachiananarchist]

Work-related rant here…

I have noticed that a lot of the colleagues in my area let so many "minor" abnormalities slide despite being signals of a larger problem. I have had patients walk in with really obvious abnormalities ongoing for years without any further investigation done. Example: I had a guy come in with a complaint of weight loss and joint pain. His skin looked weird. Did some basic labs - AST was 40, platelets were ~130. Obviously alarm bells started going off, so I checked his ferritin. It was 3500. Did genetic testing to confirm- hereditary hemochromatosis. It took me quite literally one visit to diagnose this man. Here's the annoying part: afterwards, he got me copies of labs from his previous providers. He had mild LFT elevations and mildly low platelets for years. He has been dealing with this, having damage done to his liver, for years because no one thought an AST 40 + PLT 130 was a combination worth investigating, despite his "unexplained" family history of death by liver cancer.

I would love for this to be a one-off event, but it isn't. I inherit "diet controlled" diabetics with double-digit A1Cs, patients with positive HCV ab testing and no follow up, people with a GFR <60 and no mention of kidney disease in their chart or renal dosing performed, HFrEF patients with no ACE-I/SGLT-2/BB etc, and just… ugh! I am so upset about this HH patient that now I all of my frustrations about shoddy local care are coming out. I just want people to pay attention. I feel like I am always cleaning up messes and I am tired of it.

[pinkpossibly]

Well back on my bullshit low ferritin iron issues. Im just nervous because is my body just stupid and doesnt like to hold onto iron? I know i dont eat a lot of meat which doesnt help. Or is this something more serious? My platelets and eosinophils are elevated and i dont know why. My doctor didnt seem too concerned but said she would refer me to a hematologist. I just dont want anything to be really wrong. Maybe itll just be like last time and i just need iron infusions every 5 years or so.

[teachingrounds]

Q. What's on the differential for quantitative platelet disorders, separated by disease mechanism?

A. DDx: Decreased production: • Aplastic anemia • Infectious diseases: HIV, hepatitis C, varicella, rubella • Liquid malignancies: leukemia and lymphoma • Myelodysplastic syndromes • Marrow infiltration from solid tumors in bone • Nutritional deficiencies: copper, folate, B12 • Radiotherapy or chemotherapy treatments

Increased destruction: • DIC = Disseminated intravascular coagulation • DTIP = Drug-induced Immune ThrombocytoPenia • HELLP syndrome = Hemolysis, Elevated Liver enzymes, Low Platelets • HIT = Heparin-Induced Thrombycytopenia • HUS = Hemolytic Uremic Syndrome • ITP = Immune ThrombocytoPenia aka Idiopathic Thrombocytopenic Purpura • TTP = Thrombotic Thrombocytopenic Purpura

Image: Platelet-Chan by Maxibillity, Deviant Art

[cierraonline]

Medical Textbooks & Confessions

Masterlist | Next Chapter

Medical Textbooks & Confessions

Fuller Chapter 

The United States Medical Licensing Examination Step 2 Clinical Knowledge was in two days. Two childhood best friends were holed up in their shared Boston loft apartment, poring over textbooks as they prepared for the final hurdle standing between them and their medical degrees. This test would determine if they’d graduate and don their white coats at the ceremony.  

One of them was laser-focused, the other clearly uninterested. Intelligence Stark, a twenty-year-old certified genius, leaned lazily against the arm of the couch, her legs sprawled over Jackson Avery's lap. Her piercing hazel eyes skimmed the page with feigned disinterest, her glossy dark curls framing a face that could command attention in any room. She was the daughter of Stacy Webber-Stark, a renowned biomedical engineer for the US military, and Tony Stark, a billionaire entrepreneur and CEO of Stark Industries. Yet her tone was as detached as if she were reading a grocery list. 

“A 52-year-old bastard presents with chest pain for two hours,” Intelligence began, her voice tinged with sarcasm as she half-heartedly read from the textbook. “The pain is crushing, radiates to his left arm, and is associated with sweating and nausea. His ECG shows ST-segment elevation in leads II, III, and aVF. What is the likely diagnosis, and what immediate management steps should be taken?” 

Jackson Avery, the ever-dedicated grandson of Harper Avery, didn’t even glance up. His deep, velvety voice carried confidence as he answered, “The diagnosis is an acute ST-elevation myocardial infarction, abbreviated as STEMI, involving the inferior wall. Immediate management includes morphine, oxygen, nitroglycerin, aspirin, and percutaneous coronary intervention within 90 minutes, or thrombolysis if PCI is unavailable.” 

“And you are…correct, once again,” Intelligence cheered sarcastically, tossing the textbook onto the beige shaggy rug she begged Jackson to put in the loft. She stretched out further, reaching for a People magazine. 

“A 45-year-old man presents with jaundice, dark urine, pale stools, and pruritus,” Jackson read from his book, unfazed by her lack of focus. “He also has a history of ulcerative colitis. On examination, he has hepatomegaly. What’s the likely diagnosis, and how is it diagnosed?” 

Intelligence flipped through the glossy pages without looking up. “A man who doesn’t know how to use a condom, diagnosed by his girlfriend screaming, ‘Why does it burn when I pee?’” 

Jackson sighed heavily before giving her thigh a playful smack. Her warm skin was smooth under his hand, the contact sending a jolt through both of them, though Intelligence masked hers with a sly grin. “Nope. Now give me the right answer.” 

“Or,” she teased, holding up the magazine, “I could keep judging celebrity outfits. Scary Spice or ‘It’s Britney, Bitch’?” 

Jackson smirked, shaking his head. “Neither—they both look a mess. Now focus. You’re taking that test.” 

“But I don’t wanna be a surgeon, Daddy,” she whined, laughing as she got up from the couch and sauntered into the kitchen. Her oversized t-shirt swayed over her shorts, revealing glimpses of her toned legs as she reached for a cold beer from the fridge. “There can’t be two surgeons in this friendship. I’ll be a bar owner, and you’ll go into plastics. Then you can give me a free breast reduction for my birthday.” 

Jackson followed her, leaning against the doorframe with his arms crossed. “You’re becoming a surgeon, Amara. It’s in your blood.” 

She twisted off the bottle cap and took a swig, her lips painted a bold matte red. “The only thing in my blood is plasma, red and white cells, and platelets—and they don’t care if I’m a surgeon or not.” 

“Okay, well…what if we’re not friends anymore?” Jackson suggested, shrugging his shoulders as his hands slid into the pockets of his worn jeans. His tone was casual, but his eyes held a hint of something deeper, something unspoken. 

Intelligence Stark froze mid-sip of her beer, her brows shooting up. “Oh no,” she said, shaking her head as she placed the bottle down with an exaggerated motion. “I did not waste twenty years of my life being your best friend just for you to ‘nice guy’ dump me like I’m some nerdy girl you made popular, only for her to fall back into obscurity because popularity wasn’t meant for her.” 

Her voice grew louder with each word, her gestures more animated. “You know how many bars my underage ass got into because of my last name, and you had to drag me out? Or how many times I had to jump out of some guy’s bathroom window because he had a hidden girlfriend—and you caught me every single time?” She threw her arms up dramatically. “Who else is going to do that for me? No one! You are not allowed to best-friend dump me. Quite frankly, you can’t afford it.” 

“I’m not saying we stop being friends,” Jackson interjected, his voice steady despite her whirlwind of energy. “I’m saying…what if we were more than friends?” 

Her eyes widened in shock, and she spat out her beer, barely managing to swallow the rest. “Hmm?” she croaked, wiping her lips with the back of her hand. 

For a fleeting moment, she was grateful she’d accidentally broken her Saint Laurent ruby red lipstick earlier, forcing her to opt for the NYX matte liquid lip—the transfer-proof formula was earning its keep. 

“No, no, no,” she said quickly, shaking her head as if trying to dispel the idea. “You don’t want to do that. You’d live in regret��worse regret than I felt the day after I got lip filler.” 

Jackson smirked, stepping closer. “Or I’d feel content…more content than you the day after you got them dissolved.” 

“Trust me, you don’t,” she said, taking a step back, her voice tinged with desperation. “I don’t have daddy or mommy issues.” 

“That’s okay,” he countered smoothly, closing the distance between them. “I have enough daddy issues for the both of us—and an overbearing mother to boot.” 

“I’m a spoiled rich brat,” she tried again, her voice growing higher. 

“We’ll make a budget,” he quipped. “And when I’m head of neurology—or, you know, Harper finally kicks the bucket and I get my trust fund—you can have whatever you want.” 

“My boobs are too big, and they hurt my back,” she blurted, retreating further. 

“I think they’re perfect,” he said with a soft smile, stepping closer still. “And I vow to give you a back massage every night.” 

“My grandfather doesn’t like you,” she said, grasping at her final excuse. 

“And mine can’t stand you,” Jackson replied, his grin widening as he cornered her against the counter. “What are you afraid of, Bunny?” he asked, his voice gentle now. “You’ve known me your whole life.” 

“And that’s exactly the problem,” she whispered, her voice trembling. “You’ve known me my whole life. I’m a mess who will only make you regret this. I’m a spoiled brat with a hardcore mother and a father whose only real problem in life is me. For the past seven years, I’ve told my mom I wasn’t going to become a surgeon and that I wanted to open a bar. Don’t do this to yourself. Don’t ruin everything by revealing some lifelong hidden feelings that’ll make me gag—and then punch you.” 

Jackson chuckled softly. “The only regret I have when it comes to you is pretending I was okay being just your friend when I’ve been in love with you for years.” 

Her breath hitched as he leaned in closer, their height difference forcing her to tilt her head back to meet his gaze. Slowly, Jackson reached out, gently tilting her chin with his hand. His touch was warm and steady, grounding her in the moment. 

“What other excuse do you have that I need to dismantle?” he asked, his tone teasing but tender.  

“Ew,” she replied, sticking out her tongue in mock disgust before weakly punching his shoulder. The playful gesture only made his smile grow. “Just remember you wanted this,” she warned, her tone shifting into something more serious. “So you can’t leave me for some redheaded white woman who forgets to check airways and causes patients to die. Because then, not only did you leave me for a white woman—you left me for a dumbass.” 

“Deal,” Jackson said with a soft laugh, sliding his hands to her hips and lifting her effortlessly onto the counter. “But you can’t leave me for the nearest plastic surgeon who offers you a free breast reduction,” Jackson added which caused the woman in front him to pout, her lower lip jutting out. 

“Boo,” she murmured, her playful expression melting as his lips met hers. 

When he finally pulled away, a mischievous glint danced in his eyes. “Is this a bad time to tell you I matched with Mercy West?” 

Her jaw dropped. “Wh—” 

Before she could erupt into the sarcastic tirade he knew was brewing, Jackson silenced her with another kiss, stealing her words and her breath.  

[jinxedshapeshifter]

Tbh I think anyone with autism should have the serotonin levels in their blood tested before they’re put on meds that can mess with their serotonin levels.

Serotonin toxicity is a very real thing, and from what I’ve researched, around 30% of autistic people have an excessive amount of serotonin in their blood platelets (which is one reason gastrointestinal problems are so common in autistic people). This tidbit actually has me wanting to get my blood tested for excessive serotonin levels because I’ve had stomach issues for over a month now, they’re so bad I hate getting out of bed.

Anyway. In autistic individuals serotonin levels can be unbalanced between the brain and the blood and as a result elevated in the blood of autistic people and make certain antidepressant classes dangerous, get your blood tested if you can so you know what is and isn’t safe for you :D

[itsreviveaesthetics]

Scar Reduction Treatments: Options and Effectiveness

Scarring is the expected natural outcome of healing, but sometimes it can be very embarrassing to look at. With so much advancement in skincare in the recent past, you are now able to reduce this appearance of scars significantly, hence bringing about your confidence in your skin. Let's delve deeper into these most effective available treatments and what can be expected from them.

Types of Scars

Before looking into treatments, let's learn about the types of scars:

Atrophic Scars: Indented scars, like those from acne or chickenpox, caused by loss of tissue.

Hypertrophic Scars: Thickened scars that remain confined to the limits of the primary wound.

Keloid Scars: Elevated, raised scars that project beyond the injury area.

Contracture Scars: Frequently found following burns, they pull the skin into contracting and can impair movement.

Treatment Options for Scar Reduction

1. Topical Treatments

Over-the-counter creams, silicone gels, and patches can improve the appearance of newer scars. Silicone sheets are particularly useful in flattening raised scars and reducing redness. These topical treatments prove more effective when continuously applied to fresh scars.

2. Microneedling

This treatment is all about the tiny needles creating micro-injuries in the skin to stimulate collagen production. It is especially effective for depressed scars, such as acne scars, and can improve texture over time. You might need multiple sessions, but the results are worth it!

3. Laser Therapy

Lasers can be miracles in resurfacing the skin and promoting growth. For raised scars, they can reduce height and redness, while for depressed scars, they promote collagen. It may take several treatments, but the results can be dramatic.

4. Chemical Peels

If you’re dealing with discoloration or superficial scars, chemical peels can help. By exfoliating the outer layer of skin, they encourage fresh, healthy skin to come through. This is a great option for mild acne scars or pigmentation issues.

5. Steroid Injections

Raised scars, such as keloids or hypertrophic scars, can be flattened over time by steroid injections. The treatment is fast and effective but often needs to be repeated for a permanent effect.

6. Dermal Fillers

Depressed scars can be temporarily lifted with fillers, giving your skin a smoother look. The effects are immediate, although they last only 6 to 12 months.

7. Surgical Options

In most cases, for the bigger and deeper scars, surgery to remove or revise would be an excellent choice. Usually, a last resort but can work well enough in many burn or injury cases.

How Effective Are These Treatments?

No treatment can completely erase a scar, but many can make it much less noticeable. This is all dependent on the type and age of the scar, the type of skin you have, and how well you follow through with aftercare. Sometimes, using a combination of treatments—such as microneedling and PRP (Platelet-Rich Plasma)—can create an even better outcome.

Next Steps: Find Your Treatment

If you’re ready to explore scar reduction treatments, consulting with a skin specialist is the best first step. At Revive Skin Clinic, we specialize in advanced scar treatments tailored to your needs. Let us help you achieve smoother, healthier-looking skin.

Don’t let scars hold you back—book your consultation today!

[jcsmicasereports]

Coinfections and pulmonary embolism in a patient with onset of Leukemia concomitantly with COVID19- Case report by Evgenia Papakonstantinou in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

The pandemic of COVID19 is ongoing, with the treatment of neoplastic diseases to be challenging. Patients with acute leukemia are vulnerable to many pathogens due to impaired immunity coming from their disease and simultaneous chemotherapy. Although the COVID19 disease evolves milder in children, concomitant treatment for leukemia may be fatal. We present a girl with COVID19 and Escherichia Hermannii infection at diagnosis for Acute Lymphoblastic Leukemia (ALL). This child suffered bilateral pulmonary embolism after initiation of treatment. We discuss the therapeutic challenges about the initiation of chemotherapy in the context of coinfections as well as the role of COVID19 and other predisposing factors to pulmonary embolism. We found that the slight delay in the antineoplastic treatment contributed to the remission of the acute infection and did not negatively impact the initial response to the leukemia treatment. Nevertheless, the resumption of the oncological treatment should remain among our priorities.

Keywords

Acute leukemia, COVID19, Escherichia Hermannii, pulmonary embolism

Introduction

Given the immunodeficiency due to their disease and chemotherapy, patients with cancer are vulnerable to infections and COVID19 infection is really threatening. We describe a successful management of a girl diagnosed with acute lymphoblastic leukemia (ALL) and COVID19 infection concomitantly with Escherichia Hermannii sepsis. The initiation of chemotherapy was slightly postponed, due to the danger of these severe infections until blood cultures were negative for E. Hermanii. Pulmonary thrombosis was added, as COVID-19 infection predisposes for developing cardiovascular complications, while our patient was under existing predisposing factors for thrombophilia, but with appropriate management had successful outcome.

Case History

A three-year-old girl who presented with a four-day fever, rhinitis, and cough, found positive for COVID19 infection without mutation, as all her family members. She had anemia (Hb: 2.9 g/dL), neutropenia (N: 371/μL), thrombopenia (PLT: 24 K/μL) while tachypnea (RR=31/min), tachycardia (HR=146/min), fever 38.6°C, air oxygen saturation 97%, were found on examination. Empirical antimicrobial treatment with Tazobactam-Piperacillin, Amikacin, Teicoplanin, and Micafungin were given for febrile neutropenia, transfusions (blood, platelets) for myelosuppression, Remdesivir (5 mg/kg) for COVID19. Blood culture yielded Escherichia Hermannii sensitive to receiving antibiotics, but therapy was upscaled to Meropenem due to elevated CRP (109mg/l) and persistent fever 40.6°C. The antibiotic treatment lasting 14-days ceased after two negative cultures. Baseline chest computed tomography (CT) scan showed small cloudy glass spots, areas of pulmonary thickening, atelectasis. Bone marrow aspiration, with 61% blasts, set the diagnosis of pre-B acute lymphoblastic leukemia (ALL) hyperdiploid, Central Nervous System (CNS) negative. Abdominal ultrasound showed hepatomegaly and splenomegaly. Examinations for thrombophilia revealed heterozygosity for factor V Leiden. Chemotherapy started while positive for COVID according to ALLIC 2009 protocol, standard risk arm, 15 days post diagnosis. Remained in COVID clinic until two negative PCR tests. The ALL re-examination showed good prednisolone response on Day 8, complete remission on Days 15, 33. On Day 40 from the initiation of chemotherapy, she had tachypnea with a value of D-dimer elevated at 2.145 ng/mL. Chest CT revealed subsegmental pulmonary embolism on both lower lobes of the lungs. She had not high oxygen requirements, hemodynamic instability requiring intubation, and was treated with low molecular weight heparin for 3 months. She continued chemotherapy without delays, with regular weekly tests for COVID19 and without reactivations, despite the use of corticosteroids and immunosuppressive therapy.

Discussion

The management of children with haematological malignancies and Sars-Cov 2 infection remains challenging since limited data about the impact of COVID 19 in these children are available. Main goal is to optimize the oncological treatment and avoid severe Sars-Cov2 infection due to immunosuppressive therapy. The Escherichia Hermanni bacteremia1 at diagnosis increased the risk of severe complications and led to slight delay of the chemotherapy initiation. The risk of virus transmission to the immunocompromised children in our department required a structured protocol regarding nursing care and isolation techniques. According to American Society of Hematology guidelines2, (January 2021), treatment for ALL patients is individualized, especially during the induction period. Reducing chemotherapy doses is not recommended since it may alter the expected therapeutic effect on ALL, while the severity of COVID19 does not seem to be affected. According to SFCE3 (French Society Committee for fight children and adolescents' Cancers), the main threat to children with ALL remains the ALL itself, even if life-threatening infections are emerging. We slightly delayed the chemotherapy initiation and prioritized treating the viral and bacterial infection since the type of leukemia of our patient was neither potentially life-threatening nor high risk (WBC<20.000, no HR cytogenetic findings, no CNS involvement). Our concern was that the co infections could be deteriorated if we had started induction chemotherapy and corticosteroids. The limited data available suggest a significant heterogeneity regarding the time till the first negative COVID19 PCR test in oncology patients (from four to 94 days). Bisogno et al. reported 19 patients with a mean time to negative PCR of 22 days and eight patients with 19 days4. Our patient demonstrated negative PCR testing for Sars-Cov2 on the 40th day of chemotherapy. As there is no standard therapy established for paediatric oncology patients with COVID19 yet, many centers follow the treatment strategy as in adults. Bisogno et al. treated nine out of 29 oncological patients suffering from COVID19 with Ritonavir, Hydroxychloroquine, and immune plasma. The Children's Hospital of Philadelphia (CHOP) reported their experience with the plasma administration to critically ill children5. Remdesivir is RNA polymerase inhibitor recommended in children with severe Sars-Cov2 infection and underlying medical conditions, especially in the early course of illness. According to a recent meta-analysis remdesivir has the most promising evidence that improves the time to recovery6. In our patient the seven-day lasting antiviral therapy was well tolerated, without any pathological findings. The reported cases of venous thromboembolism may be related to the systemic inflammatory response or a state of hypercoagulability8. Our patient had multiple coexisting risk factors predisposing for thrombophilia, such as administration of Asparaginase, use of a central venous catheter (Hickman), and heterozygous status for the factor V Leiden. In patients with ALL and COVID19, prophylactic administration of anticoagulants may have an impact, but there are not yet standardize recommendations. We need to maintain a high index of suspicion for pulmonary embolism in patients with COVID19 and leukemia and to measure D-dimers regularly. There is need for guidelines for prophylaxis with low molecular weight heparin for pulmonary embolism in patients with COVID-19 and existing risk factors for thromboembolism. The patient was treated successfully with three- month administration of low molecular weight heparin. She continued chemotherapy without delays, with regular weekly tests for COVID19 as some authors have reported reactivations, without reactivations, despite the use of corticosteroids and immunosuppressive therapy.

Acknowledgements

Dr Pappa A., Medical Biopathologist-Microbiologist, Professor of Microbiology, Aristotle University Thessaloniki, Dr. Polychronopoulou Sofia, Coordinating Director Department of Pediatric Hematology-Oncology Agia Sofia Children’s Hospital Athens.

[juuraju19768]

The Hidden Benefits of Eating CHILLI You Never Knew Existed 🌶️

Chillies, often seen as just a way to spice up your food, are actually packed with amazing health benefits that many people overlook. These fiery little peppers are more than just heat; they’re a powerhouse of nutrients that can positively impact your body and mind. Let's dive into the hidden benefits of eating chilli that you might not know about!

Boosts Metabolism 🔥 Chillies contain a compound called capsaicin, which is responsible for their heat. Capsaicin helps boost your metabolism by increasing the rate at which your body burns fat. Regular consumption can assist in weight management and fat loss.

Reduces Inflammation 🌿 Capsaicin also has anti-inflammatory properties, which can help reduce inflammation in your body. This makes chilli a potential natural remedy for conditions like arthritis and muscle pain.

Promotes Heart Health ❤️ Studies have shown that eating chillies can help reduce blood cholesterol, triglycerides, and platelet aggregation. This means that consuming chillies may lower the risk of heart disease and promote overall cardiovascular health.

Improves Digestion 🌱 Contrary to popular belief, chilli peppers can actually improve digestion by stimulating gastric juices, which help in breaking down food. It also helps in preventing acid reflux by regulating the flow of digestive acids.

Rich in Vitamins and Antioxidants 💥 Chillies are loaded with vitamins, especially Vitamin C, which is essential for maintaining a healthy immune system. Additionally, they are packed with antioxidants, which help fight free radicals in the body and reduce the risk of diseases like cancer.

Natural Pain Relief 🌟 Capsaicin in chillies is known to act as a natural pain reliever. It’s used in many topical creams to relieve pain from conditions like arthritis, muscle strains, and joint pain. It works by desensitizing pain receptors in the area.

Elevates Mood 😊 Eating chillies triggers the release of endorphins, the "feel-good" hormones, which can help reduce stress and boost your mood. This makes chilli a great food for keeping anxiety and depression at bay.

Next time you add some chilli to your meal, remember that it’s not just about the flavour—it’s also about giving your body a boost in health! 🌶️💪

[two-calicos-in-a-trenchcoat]

The blood has been stolen

The blood stealer was cute

I have to go to the hospital to get my blood stolen later

Help

[toadsrbutch]

me to the person I’m training: SO if you look at the MCHC of this sample, it’s way too high since it’s elevated even though the same is not lipemic & it has this weirdly high platelet count and values just look off. also, the sample just doesn’t pass the vibe check just looking at it. SO you spin a hematocrit and TADA it is grossly hemolyzed. looking at the sample, it’s super short so that with the gross hemolysis, suggests that this was probably a really difficult draw for the clinic so hopefully we can get them some results at least but this sample is nasty so it seems unlikely :(

him, internally: wtf is their problem

[killed-by-choice]

“Henna Roe,” 30 (India ~2008)

“Henna” went to see a doctor because of severe abdominal pain. The doctor noticed she had a mild fever and that her abdomen was tender. Henna had not suffered any recent illnesses or physical trauma— with the sole exception of a recent abortion at 16 weeks pregnant.

The lab tests showed a low platelet count and elevated liver enzyme levels. An emergency ultrasound revealed a large lesion, prompting doctors to run a CT scan of her abdomen to get a better understanding of what was wrong.

Henna’s CT scan indicated rupture of the right hepatic lobe with large hyperattenuating subcapsular haematoma and ascites. Aspiration of the lesion was attempted, drawing blood. Henna was aggressively treated, but died a week after being admitted to the hospital.

The diagnosis was a very rare complication almost never seen outside of the third trimester: HELLP Syndrome. Henna had no noted pregnancy complications or other health problems before her abortion (especially significant since HELLP syndrome typically occurs with preeclampsia and not with a healthy pregnancy), but the abortion itself triggered a rare form of the disorder that can occur up to a week postpartum. Although the pathophysiology of HELLP syndrome is still not fully understood, post-abortion inflammation may have triggered it in Henna’s case.

With treatment, about 99% of mothers with HELLP syndrome survive. However, the effective treatment is delivery (frequently in combination with supportive care and medications to manage various aspects of the disease until it subsides). In this rare case where the disease was a complication of an abortion, this approach couldn’t be used (for obvious reasons). Henna fought for her life, but even the best attempts of her doctors couldn’t save her from this unusual form of an already-rare disorder.

(Please note: There is some debate in the medical field about the relationship between preeclampsia, HELLP syndrome and other diagnostic labels. I used the terminology as it was written in Henna’s case report.)

[appalachiananarchist]

I saw a patient with palpable purpura on bilateral lower extremities, hematuria + proteinuria, and elevated platelets + white cells who was following up after she went to the ER and they sent her away saying it was "due to venous insufficiency." Why, God? Why?