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#maxillofacial surgery#tmj specialist#temporomandibular joint dysfunction specialists#maxillofacial surgeon in mumbai#tmj specialist near me#tmj specialist in india#best maxillofacial surgeon in mumbai#bimax surgery#tmj specialist in mumbai#tmj doctor near me#tmj doctor#best oral and maxillofacial surgeon in india tmj disorder treatment#best maxillofacial surgeon in india#tmj surgery#jaw doctor near me#best oral and maxillofacial surgeon in india#facial fracture treatment#free paralysis treatment in mumbai#tmj face shape#jaw surgery cost in india#jaw specialist near me#receding mandible#tmj cure#tmj arthroscopy#best cleft palate surgeon in india#msi full form in medical#doctor for jaw pain#mandible surgery#lefort fracture lines#facial bone fracture
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Facial Degloving: Causes, Important Symptoms, Treatment, and Recovery
Facial Degloving: Causes, Important Symptoms, Treatment, and RecoveryIntroductionWhat is Facial Degloving?Causes and Risk FactorsSigns and SymptomsDiagnosis and AssessmentTreatment ApproachesMultidisciplinary ApproachRecovery and RehabilitationPotential ComplicationsLong-Term OutcomesPrevention StrategiesPatient StoriesAdvancements in TreatmentSupport SystemsExpert InsightsConclusionFacial…
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#Aesthetic concerns#Bone realignment#degloved face picture#Disfiguring injuries#Emotional support#Facial bone fractures#Facial deformities#facial degloving#Facial injuries#Facial reconstruction#Facial rehabilitation#Facial trauma#High-impact accidents#Maxillofacial injuries#Medical innovations#Multidisciplinary treatment#Nerve damage#Plastic and reconstructive surgery#Prevention strategies#Protective gear#Recovery process#Skin detachment#Soft tissue damage#Soft tissue repair#Surgical reconstruction#Swelling and bruising
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Multiverse part 3
You sat in a small room on a padded chair, with equipment set up around your arm, chest, and fingertips. A polygraph test. That's what you were being forced to take. And to your chagrin, Ghost is in the room with you and Captain Price.
"Try to relax, yeah?" Price commented. He must've noticed your restless leg.
"I'll do that, shall I? I've done nothing wrong, other than exist and I'm being interrogated. Because that's what this is— an interrogation." You finally turn your attention from Ghost to look at Price, who's sitting at the desk by your side. "Tell me, Captain. Did you get this same treatment when you came back after spending all that time locked up in the gulag?"
His dark eyebrows furrow in confusion. A sigh escapes your bitten lips. That's only in your...world, for lack of a better term. Dimension? Universe?
"I haven't been to the gulag here." Yeah, obviously.
With an impatient wave of the hand that doesn't have cables strapped to it, you mutter, "Let's get on with this circus act, then. Ask your questions."
Ghost steps forward, his arms unfolding as if he's about to speak to you, but Price swiftly intervenes, halting him with a raised hand.
"Alright then. Baseline questions first. Name." Ghost gives away nothing when you say your last name is Riley.
It goes like this for a few, then he switches to the control questions, until finally moving on to the relevant ones.
"How did you get here?" I don't know.
"Do you know why you're here?" No.
He pulls up a photograph. "Recognize him?" Captain MacTavish.
Another photo. "Him?" I don't know.
"What do you mean by that?" If that's Roach, I've never seen his face unmasked.
"You're sure you don't know him?" Unless that man's name is Gary Sanderson, no. I do not know him.
Price acknowledges your response with a nod, then shifts his gaze towards Ghost, whose head slightly tilts forward. Returning his attention to you, he retrieves a final photograph. "What about him?"
As you look at the picture, your eyes begin to well with tears, lip trembling violently. A new fracture reverberated through your tender heart, intensifying the ache in your chest. Yes.
"Who is he?" Price softly asks.
"That's my Simon," your voice broke on the last syllable. It was hard to not use a possessive adjective when the face of your husband was in that picture.
Blinking the tears away, you clear your throat. "Anything else, Captain?"
Price purses his lips under his hefty facial hair and responds, "Just a few more questions."
Once finished, you sat unabashedly staring at Ghost in the tiny room. "I wear Roach's tags alongside yours, in honor. He was with you until the very end, and for that, I couldn't be more grateful."
Ghost is completely silent, but you continue talking anyway. "I've been married to you since a bit after you came home on leave that one time. You know the one."
His eyes are emotionless, blank, as he stares at you. But you know him like the back of your hand. You've got his full attention.
"I accompanied you to your brother's wedding. He married a woman, Beth. She was good for him. They had a baby, your nephew, named Joseph. The love you had for him was one of a kind. I had told you later that evening that I dreamed of the day you'd look at our children like that."
With a shuddery breath, you tell him how none of those matters. Because your husband is dead, and you're stuck here. With his counterpart that hates you.
With a hushed click, the door closes shut behind him as he leaves, yet its resounding noise fills the compact room you're in.
You begin to fidget with the sizeable ring that hangs on a thin necklace beneath your shirt— the metal is warm under your touch as if it had never gone cold in the first place.
As if Simon had never taken it off his finger to go find Makarov.
ah theyre short but hurt. much pain.
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#call of duty#simon ghost riley#simon riley x reader#multiverse cod#09 ghost#22 ghost#cod mw2#cod mwii#cod#simon ghost riley x reader#simon riley x you#simon riley#simon ghost riley x you
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Hi! Just made a new account here. I'm running a TTRPG where I have an NPC who recently got un-petrified with an experimental treatment. The dice and players decided that they would keep sequels from that, and I think that's a good idea anyway. The disabilities that makes the most sense to me is some flavor of chronic pain, and/or needing aids to walk, since all her joints were turned to stone. Maybe her bones are heavier or rougher or something. BUT. I myself have chronic pain and use aid to walk. While I have no problems with representing this in fiction, I have enough self insert NPCs in this campaign already. I'm looking for alternatives if you have ideas. Thanks!
Thank you for your ask! My first through was muscle atrophy, since she wasn’t moving for a while her muscles might have started weakening. Symptoms for whole body disuse atrophy can include difficulty moving (including facial muscles), numbness/tingling sensations, difficulty swallowing and breathing and even memory loss. Atrophy not caused by an underlying medical issue can be reversed with physical & occupational therapy, though it’s going to take some time and your character might need to use aids until then, and what aids used depends on how long she was frozen & the severity of her condition.
Muscle atrophy can happen alongside muscle and joint stiffness, which would limit her range of motion as well as causing pain. Other symptoms can include joint swelling, cracking or popping noises when moving, and cramping. Things such as massages, heat/cold therapy and plain relief medication can help, along with the treatments listed for atrophy.
Also taking a page from Dungeon Meshi’s book, someone turned to stone is at risk of cracking. This could range from hairline fractures (like getting a long paper cut) to chucks falling off (would need immediate medical attention once unfrozen). Body parts with less mass that protrude from the body are at higher risk of chipping, and while everyone’s body is different these can include fingers/toes, ears and nose. Things like hair and eyelashes are also a break risk, though that’s more of an aesthetic concern.
These are all I can think of, but definitely look into paralysis recovery and rehabilitation after being unable to move (there are probably more google-friendly ways to phrase that though lol)
Have a lovely day!
Mod Rot
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† The Believer †
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General information | Prime Asset backstory | Trials | Dialogues
「 Prime Asset backstory」
Although she has a complete history of somewhat questionable crimes committed at an early age, it is not denied that a part of the subject's biography is missing. Especially the Walrider.
Originally born in Jujuy, Argentina, her family moved to California, USA, along with the girl's uncles with the decision of a better life and continuing with field work. Maria has been a fanatic of God since she can remember, a believer in religion. Her family and she have always been believers, praying for good progress and better crops in the field or better cattle.
It is said that she has ended up with a disability due to an accident while riding a horse, leaving fissures and poor physical development that affects the mobility of her left leg in the femur. Despite treatment with antibiotics, an alternative for the family in terms of economics, she has experienced moments of emotional decline due to her situation and living day to day in this condition. Despite being humble and with a clearly poor economy, she made the greatest effort to study. Because of her disability, she was not fit to work in the fields and was forced to study with her uncles at home, thanks to their professions as teachers and professors.
At eight years old, the girl's life took an unexpected turn after an incident that harmed her and her family. During a short walk with her uncles, running a couple of errands, they lost sight of Maria and could not find her anywhere in the village, the only thing they found was the cane that she used to help her move.
According to the latest reports of the Carmichael case, being a kidnapping, she has suffered years of psychological and emotional torture. The girl returned after six years, without the help of the cane and walking normally. Something that scared the family is that she still looked just as young, but the only difference was her height, her facial features didn't change completely and walking like a normal human was a miracle. According to the medical reports, she showed that the bones in her leg and femur were still the same, but somehow she walked well. However, her development has been affected by poor nutrition, clearly malnutrition and dehydration. Although it will take María some time to adjust to her old lifestyle after living day after day, it can be seen that she is not at all affected by the trauma she experienced during her childhood, which is quite scary and worrying.
She had confessed what her life was like being with her kidnappers, listening to screams of pain from other victims being tortured physically, psychologically and sexually. She has never been hurt or raped, luckily, according to what she remembers it is because she was too small to be used as a weapon. Weapon, that is what worried the officers who interviewed her after her reappearance.
The girl gave the address where she was kept in the shadows, out of her freedom and the other people who could not escape. The authorities immediately went to raid the place, what they found was an abandoned textile factory. In the basement of the place, they found bodies of men and women. In addition to artifacts, machines were used to experiment on people to try to make a weapon. The kidnappers identified themselves as foreigners, Russians and Germans. At least five doctors, fifteen armed men and seven men in charge of kidnapping many test subjects. After forensic studies, the victims are not correctly determined how they were massacred. They found fractures and parts of lower limbs separated from their bodies, which leaves many theories about the massacre. One person couldn't have killed thirty-five people, but what hasn't been determined is the gunpowder and ashes, which puts the theory on an attempt to erase evidence by burning the place.
The case had been put to one side, María being the only survivor of the kidnapping and the inhuman torture she had been through. However, Carmichael's case was taken up again after a year, after a serious accident at home left the village traumatised.
María's parents and uncles died in a fire, the house burned down and they lost most of their home and left the girl and her one-year-old sister, Annabelle, orphans. The origin of the fire has not been determined, but what is suspected was the girl's attitude. Since the accident she had been playing with the baby, ignoring the screams and cries of her family dying in the flames. But she wasn't identified as a suspect, as her way of acting was possibly fear and trying to block it so that it would not remember the trauma of her kidnapping, distracting Annabelle from the accident. It was a miracle that she and the baby survived that fire with ease, but after an interview with the girl, it left many questions for investigators. About the angel who called himself “Manny,” who saw him from the first months of his kidnapping. However, they brushed the questions aside, being nothing more than beliefs or possibly the girl’s imagination.
The girls were sent to an orphanage, unable to contact other relatives. But after a few months, Annabelle was adopted by a family, separating Maria from her. She was discouraged since then but never lost faith. But everything changes when the caregivers, nuns and priests end up slowly committing suicide, leaving the children. Some of those victims had confessed to having committed sins that do not deserve to be forgiven, such as physically and sexually abusing minors. But the most suspicious thing was the confession of one of the deceased nuns, who had seen the devil handling a puppet of flesh and bones, with that innocent smile and those eyes that look into the window of the darkest soul, feeding on our sins, fears and weaknesses.
María had been sent from orphanage to orphanage. With the same results, people who have taken their own lives or died under the flames of a fire. But the case comes to a conclusion, leaving the girl as the main suspect of all these events, since the incident with the Carmichael family. She was caught, trying to effortlessly hang a priest, with her feet on the roof of the church, however, she ends up killing the man by just breaking his neck. And as a response to trying to be stopped, she ended up killing the officers. However, it hasn't been determined how she killed them, but the forensic experts determined that they had found gunpowder and ashes, the same material that was found in the massacre of Maria's kidnappers.
Many neighbors said that they had seen the devil, disguised as the girl from the day she returned to the village. From time to time, detaching itself from Maria's body, being a kind of humanoid without facial features and composed only of dark shadows. Being one of the strangest and most sinister cases of the town, something supernatural. Although Maria had slipped away from the authorities, she didn't stop moving forward until she was nineteen years old, rebuilding her life in another country. In Cuba she had inherited fields from her grandparents, having the opportunity to do agriculture, but at the same time working in a fish market and keeping both businesses in balance for her own economy.
Clyde Perry went to investigate more about María Carmichael, being one of the people who has attracted a lot of attention. At first it was very difficult to communicate with her, since she was very distant and lonely. Finally, after buying fish and asking some casual questions, she invited him to talk in a more private place like her ranch, which Perry accepted with some trepidation but willing to take advantage of the opportunity.
From the moment they met, casually drinking tea and mate, María confesses that she knows that he has been following her and investigating her, being an interesting and peculiar person. But not only that, but she also flatters the investigator a lot about his appearance, especially his eyes, which makes him a little nervous. But after her questions and mockery, María shows the darkest side that a human being could have seen. Confessing how she hurt adults when she was a child, doctors, her kidnappers, nuns and priests, enjoying every scream of pain and asking for mercy as if God were judging each of them for their actions, the sins they committed. Feeling pleasure and satisfaction in doing justice with her own hands alongside her angel.
She had taken off her glasses and revealed one of her eyes completely dark as the devil, hungry for blood and afraid of its next victim. Then, the man could see how a kind of humanoid detached itself from its body and showed itself before him. Its dark form, without facial features and with swarms of ashes scattered on its body and the woman's, seeing the fear and before the eyes of the investigator. And the moment the humanoid tries to do something to Perry, Maria stops it with just one order and calling it "Manny."
The Walrider follows her order, returning to the woman's body and making her move normally again. She apologizes to the man, leaving him with a warning not to bother her again and to let him go unharmed, but wishing he would visit her again for being the only man to have caught her attention. Terrified, Clyde Perry leaves the shack with one hand in his pocket hiding his gun, unsure if that thing was going to come for him.
As Perry writes, he confesses that he has been having nightmares and bizarre dreams. After going to treatment for a while, they discovered that he had some kind of nanomachines and ashes in his ears, which explains his bad dreams and possibly a way for Manny to manipulate the minds of the victims to ground them, and corner each of them with the thoughts of taking their own lives. Which leaves the man traumatized, having seen the devil with his own eyes. After the researcher's treatment, Maria was later captured and sent to the Sinyala facility. However, she allowed herself to be captured while controlling Manny inside so as not to harm another person. Since then, she meets Dr. Easterman at some point, placing an ounce of her trust and loyalty in him.
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#my oc#my original character#prime asset oc#the walrider#outlast walrider#the outlast trials#lore#oc lore
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Yuliia "Athena" Khomiak
Behind the scenes of the battle for Bakhmut
It was especially difficult, physically and psychologically, at the stabilisation point* in Konstiantynivka, during the battle for Bakhmut. I went to the stabilisation point for the 92nd Brigade and the International Legion, one might say, of my own free will. There were relatively few injuries among our unit's soldiers in those days, so I went to the stabilisation point to ask if anybody else needed any help. "I really need it," I was told. There was a stream of wounded 24/7. Sometimes 15 a day, sometimes 50 [wounded]. There were injuries that I had never seen before, for example, facial skull fractures and eye injuries... I lived in this flow for about three months. Hundreds of fighters have passed through my hands. My basic specialties are midwifery and gynaecology, which are surgical specialties. That's why I worked at the stabilisation point as a surgeon and anesthesiologist. Now, 90% of my work is as a therapist. Soldiers get sick just like civilians. Because of the big load, chronic diseases worsen. We need to develop treatment algorithms for different diagnoses. All this is my responsibility. I have enough work to do. *a place where combat medics evacuate the wounded from the line of contact and provide first aid - Ukrainska Pravda
—Yuliia "Athena" Khomiak, junior lieutenant and combat medic
Source: War tears off masks. Сombat medic Athena talks about the fear of death, the fragility of life, and her sense of time at the frontline
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Skull Fractures: Le Fort I-III
Le Fort fractures are a specific type of midfacial fracture which can be split into three types: Type I, Type II, and Type III. These three types vary in severity and presentation. They are most commonly caused by high-speed or high-impact forces.
Facial and Cranial Anatomy
Le Fort fractures of all types involve different bones which make up the facial structure. You can look up a picture of the skull if you don't know what I'm talking about, but you should have an idea of what's going on from. Anyways, the skull is 22 bones and that's too much to get into right now. Onto important stuff.
The mandible is not part of the skull and isn't part of what makes a Le Fort fracture, though facial trauma may also cause the fracture of this bone. It is also an important part of the facial anatomy and its misalignment with the other bones can help diagnose Le Fort fractures.
Le Fort Type I
Le Fort type I injuries are the least damaging type of Le Fort fracture, though they still cause significant damage to the facial structures. This type of fracture involves the maxilla and pterygoid plates (four structures that are up inside the skull/back of the mouth) primarily. Due to the involvement of the maxilla, it can also be referred to as a trans-maxillary fracture.
There are several mechanisms of injury for this type of fracture. Most commonly, it is caused by a downward blow to the face. This can be the result of a fall, assault (like stomping on someone's head), or motor vehicle accident, which causes the maxilla of the patient to impact a hard surface and detach from the rest of the facial structure.
The downward force on the face causes the fracture of the internal structures of the maxillary sinus as well as the pterygoid plates. The fracture extends to the maxillary antrum, or the antrum of Highmore, which is a large sinus cavity that sits superior to the upper teeth and posteriorly to the nose. All three walls of the sinus are fractured, and the maxillary structures break away in a palate-facial separation.
Type I fractures oftentimes present with swelling in the upper lip and ecchymosis (bruising) to the maxilla and cheeks. The most telling sign of maxillary dissociation is malocclusion of the teeth. This means that the upper teeth are not in alignment with the lower teeth, which can be seen in dissociations and fracture of the maxilla and mandible. The triangular area of the face that comes away from the cranium is made of the maxilla, palate, and pterygoid plates.
The soft tissue damage of this fracture is mostly within the oral cavity, sinuses, and nasal cavities. This can cause the respiratory ability of the patient to become compromised. Because of the damage to the nasal passages and the possibility of fracture of the inner bones of the skull, a nasopharyngeal airway (NPA) device is not recommended. NPAs are devices made of a pliable foam or rubber, which are inserted through the nares, and allow for the linkage of the nasal openings to the pharynx (throat). When heavy facial trauma, especially to the nasal area, is present, NPAs are not indicated. Instead, airway management should be done with an endotracheal tube, which goes into the trachea (windpipe). This bypasses the damage done to the oral or nasal cavities and allows for the establishment of respiratory function.
Other symptoms of the patient should be managed until they can reach a trauma center for further treatment, with the patient's airway, breathing, and cardiovascular function taking precedence.
Le Fort Type II
Type II fractures are more severe than Type I. They involve more facial structures and cause a greater portion of the face to separate from the skull. This type of fracture involves the nasion, which is commonly referred to as the bridge of the nose. It also involves the medial wall of the orbit and the inferior orbital rims. Importantly, this type of fracture does not involve the zygomatic bones (cheek bones).
This fracture is best traced beginning at the nasion. The fracture extends laterally to the medial wall of the orbit and downward into the inferior orbital rim. It then crosses downward into the maxilla. Inside of the structure, the fracture extends superiorly to the hard palate, and ends with the separation of the pterygoid buttress. The section of bone that breaks away from the cranium is pyramidal in structure.
The involvement of the orbit in this fracture increases the severity of this fracture because of the complexity of orbital bones as well as the involvement of the soft tissue of the eyes. The forces which are of a great enough magnitude to fracture this portion of the face can create severe damage to the delicate tissues inside the orbit, including blood vessels and the eyes themselves.
Type II fractures present distinctly from Type I fractures. In Le Fort Type II fractures, there will be mobility in the maxilla, but the nasal region will move with the maxilla away from the other facial structures. The increased severity also opens a possibility of cerebrospinal fluid (CSF) leakage from the nasal passages. CSF leakage can be confirmed using a piece of gauze to absorb some of the fluid. As the CSF dries, it will create a distinct two-ringed figure, which mucous does not. CSF is also very clear and watery compared to mucous, which is yellowish and sticky.
Due to the damage to the nasion and surrounding area, the intercanthal space (the distance between the corners of the eyes) has a high possibility of widening. This will lead to severe deformity of the normal facial structure. Bruising will be significant, with presentation of bruising on both orbital areas, or bilateral periorbital ecchymosis, sometimes called “racoon eyes.”
As with Type I fractures, an NPA is not indicated, particularly when CSF leakage is present. This indicates a fracture deep enough to compromise the integrity of the intracranial space. If an NPA is used in this case, even the soft tip of the device could worsen the intrusion into the cavity or cause severe damage to the sensitive nervous system structures. The airway should be established using an endotracheal tube instead. The patient should be transported with haste to the nearest trauma center.
Le Fort Type III
Type III fractures are the most severe type of Le Fort fracture. This type is also called a full facial-cranial separation. It involves the nasion, two walls of the orbit, the orbital rim, the zygomas, and the pterygoid plates.
The path of this fracture can be traced starting at the nasion. From there it extends laterally through the medial orbital rim and orbit. The fracture extends horizontally across the entire orbit and to the lateral rim. Finally, it extends downwards across the zygomatic arch and through the superior pterygoid plates. This fracture extends bilaterally through both sides of the facial structure5.
Due to the fracture extending horizontally through the orbit, there is a great risk of damage to the soft tissues of the eye. The fracture also extends parallel to the base of the cranium, and will cause a complete separation of the midfacial skeleton from the cranium. Because of this extreme dissociation, there is an increased risk of cerebrospinal fluid leakage. This leakage can result in infection or serious brain injury.
This type of fracture is most typically caused by large amounts of force to the nasion and superior maxilla. This force is of a great enough magnitude to cause a fracture to extend through the entirety of the facial structure in a posterior and downwards direction.
Many signs from Type I and II carry over, including bilateral periorbital ecchymosis, orbital edema, and buccal ecchymosis. However, Type III presents uniquely with a sign commonly called “dish-face deformity.” This condition results from the breakdown of the structure of the face, and results in a lengthened and shallowed face. There may also be a condition known as “orbital hooding” present, which is the drooping of the upper eyelid commonly seen when zygomatic structure is compromised. Battle’s sign may also be seen, which is the bruising of the mastoid region, or the region behind the ear. Enophthalmos, the sinking of the eyes posteriorly into the sockets, may also be seen. This is due to the severe damage to the orbital area. CSF may also leak out of the ears and nasal passages, called CSF otorrhea and CSF rhinorrhea, respectively. Blood may also be within the inner ear in a condition called hemotympanum.
The severe damage to the facial bones, along with intracranial hemorrhaging and CSF leakage will most likely cause a patient with a Type III fracture to be treated as critical. Airway integrity should be maintained with an endotracheal tube, but if the oral airway is compromised, stabilization can be difficult without a tracheostomy. A tracheostomy is a procedure where an opening is made in the neck into the trachea, where a breathing tube can be inserted. This bypasses any oral damage and allows for the respiratory function of the patient to be secured. The patient should be rushed to a trauma center, as the signs presenting give an impression of a condition that can be lethal.
Treatment
As with any trauma patient, those with Le Fort fractures should be stabilized to ensure the continuation of life before any effort is made to repair the damage to the face. This gives the patient’s airway, breathing, and circulatory systems precedence in their care. Once the patient reaches the emergency room of what is hopefully a trauma center, more specialized care can begin. This includes testing, scans, and stabilization.
Computerized tomography (CT) scans are very useful to determine the extent of the fracture and the type. These scans use several x-rays and an interpreting computer system to create several two-dimensional slices of the structures captured. This is important in severe facial injuries, as simple film x-rays do not typically provide enough data to accurately diagnose and see all of the damage done to the face. In Le Fort fractures, the most appropriate type of CT scan ordered is a non-contrast, fine cut scan with axial cuts. Contrast is a substance injected intravenously that allows for a better view of body structures on the scan, but it is not used in this case. Typically, contrast used in trauma cases is for abdominal injuries. The CT scan should be fine cut, which means that the slices of data gathered from the patient are 2 mm in width. This means more can be seen from the scan.
The two main areas of treatment in facial fractures are reduction and fixation. Reduction is the process of putting the structures back where they are meant to sit. Reduction can either be open or closed. Open reduction requires the “opening” of the face through surgical means. Typically, this means that the fracture was too complex to be reset through external manipulation. A closed reduction is done without exposing the bone. This is done externally through manipulation of the structures. Fixation is the process of keeping the bones in the correct place, typically through the use of metal plates, wires, and screws.
Intermaxillary fixation can be used to repair or stabilize the fracture. This should be done after all CT scans are completed. Intermaxillary fixation uses metal pieces screwed to the maxilla to demobilize it. Typically, metal plates are also screwed to the mandible and wire is connected between the mandible and the maxilla. This will reestablish proper occlusion of the teeth. Intermaxillary fixation can be used to stabilize the face while other surgeries are done, or as the treatment itself.
Facial reconstruction is most likely with Type III fractures. In a broad sense, facial reconstruction includes the reduction and fixation detailed previously. However, it also includes more fine and cosmetic reconstruction. After a more severe fracture and the resulting fixation, the skin and formation of the face can be altered from the patient’s original appearance. Due to this, there may be more extensive work required by a plastic surgeon after the initial treatment to repair the bone structure.
The goals of the fracture repair are to reestablish proper structure and restore the integrity of the face. The correct facial projection should be reclaimed, as to correct any deformity or dish-face condition. The sinus cavities should also be repaired so that they have proper function and location within the facial structure. The realignment of the orbital and nasal structures is also important to the overall soundness of the facial structure and function. Finally, malocclusion should be remedied, as proper occlusion of the teeth is necessary for not only facial structure, but the function of the teeth and mouth in chewing food.
Outcomes
The recovery of this type of fracture can be long and difficult, but the ultimate outcome is generally good. Mortality rates of patients with complex facial fractures, which includes Le Fort fractures, are estimated around 11.6%. Mortality of patients with simple facial fractures is estimated around 5.1%. For Le Fort fractures specifically, there are different mortality rates for each type. For Type I, there is a 0% mortality rate. For a Type II fracture, there is a 4.5% mortality rate. For Type III fractures, there is an 8.7% mortality rate.
Besides death, disability can also be the result of Le Fort fractures. The following conditions have been reported as a result of Le Fort fractures: difficulty breathing (31% of patients), difficulty chewing (40% of patients), vision issues (47% of patients), double vision (21% of patients), and excessive tearing and poor eye drainage (37% of patients). These disabilities can greatly affect the ability of the patient to return to normal activities. For Type I and II fractures, 70% of patients were able to return to work. For Type III fractures, only 58% reported being able to return to work. The facial deformities resulting from these fractures and their repair have an impact on the patient’s mental wellbeing. Of patients who had facial surgery, 89.1% reported satisfaction with the outcome of their appearance.
End Notes
Wow this was fucking long, wasn't it? I guess I just got going and couldn't stop. Now you know everything you need to know about Le Fort fractures, which was probably nothing. But anyways, I wanted to include the outcome of severe injuries like these because I feel like in fiction I don't see it enough. Like if you get that fucked up you're gonna need some help for a while. I also think I see too many NPAs in patients that don't need them or shouldn't have them, so I think that might be some valuable information. I'm gonna write on the structure of the nose eventually, but for the love of god don't stick anything up there, especially if someone has head trauma.
Thanks for reading :))
#medicine#med studyblr#medblr#head injury#whump writing#medical writing#fractures#skull fractures#whump#trauma#medical school#med student
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Georgia: Brutal Police Violence Against Protesters
Effective Investigations, Accountability Urgently Needed
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(Berlin, December 24, 2024) – Police and other security forces have used brutal violence against largely peaceful protesters in Georgia’s capital, Tbilisi, Human Rights Watch said today. In widespread and apparently punitive acts, security forces have chased down, violently detained, and beat protesters. Police also tortured and otherwise ill-treated them in police vans and police stations.
Human Rights Watch spoke with a dozen survivors of police violence who said they had sustained head traumas: concussions and multiple fractures to their noses, facial bones, ribs and limbs, and scratches and bruises all over their bodies. Police were wearing riot gear or full-face black masks, with no identifiable insignia. The authorities charged hundreds of protesters with the misdemeanor offense of police disobedience, and prosecuted them in perfunctory trials, while failing to take effective steps to address serious allegations of ill-treatment.
“The level of the authorities’ violence against largely peaceful protesters is shocking, blatantly retaliatory, and violates Georgia’s domestic laws and international norms,” said Hugh Williamson, Europe and Central Asia director at Human Rights Watch. “The scale of the police ill-treatment of protesters and the failure of Georgian authorities to hold them accountable for it indicates they either authorized or condoned the violence.”
Massive, nationwide protests erupted in Georgia following the ruling party’s November 28 decision to abandon Georgia’s EU accession process. The decision came one month after disputed October 26 parliamentary elections that kept the country’s ruling party in power, but local and international observers and Georgia’s president said it was marred by massive vote-rigging and other irregularities. The elections also follows the adoption of repressive legislation targeting civil society and independent media.
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https://www.scribd.com/document/751731436/Common-Procedures-in-Oral-and-Maxillofacial-Surgery
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Main Story S2 Chapter 3-17: Noble Illness (崇高的疾病) | Light and Night 光與夜之戀
S2 Chapter 3-15
♡———♡
At 2:42 p.m., I hurried alone towards the emergency surgery department.
Charlie's declaration earlier still hadn't satisfied Director Wang. But instead of storming off again, when the director tried to argue further, Charlie simply raised his hand to silence him.
Then, he gave me these instructions: Tell Old He to have Fu Ming operate on the captain first. The patient has severe facial injuries, and he has experience in the ENT department, so he can do the initial treatment.
I repeated those instructions in my mind, along with his last whispered words, "Don't worry, I'll be there soon."
On one hand, there was the power struggle, and on the other, critically injured patients in need of urgent care. Those in power chose the former, Dr. Zha chose the latter, but Charlie refused to give up on either.
Don't worry, he had said. Right, what was there to worry about? He was someone who could bend the rules of the world to his will.
The bitterness of the past and the anxieties about the future were all temporarily stored away in that hazy, drunken night. Now, whenever I thought of the name "Charlie," my heart swelled with pride.
In the chaotic emergency room, I found Dr. He and relayed Charlie's instructions. He immediately called for Dr. Fu.
Dr. He: Dr. Fu, Dr. Zha won't be free for a while. You start the surgery on the captain.
Dr. He: The patient has severe facial trauma. The surgery is quite complex, so you go ahead, and I'll have Dr. Zha join you later.
At 2:52 p.m., Charlie arrived alone at the surgery preparation room.
Dr. He: So what's the plan?
Charlie: We do it my way, of course. No matter how much they complain, they can't perform the surgery themselves.
Dr. He chuckled and shook his head.
Dr. He: You're always like this.
Dr. He: I've already had Dr. Fu start on the captain's surgery. It's a very complex case.
Charlie: I'll go take a look.
The moment Dr. He finished speaking, Charlie turned and headed towards the operating room without hesitation.
-
By the time Charlie entered the operating room, Dr. Fu had already begun the surgery. Charlie nodded to the nurses and quickly entered the observation room next door.
Charlie: What's the overall condition of the two patients?
Dr. He: The more severely injured one is the ship's captain, male, 50 years old.
Dr. He: Approximately 85% deep second- to third-degree burns across his body, combined with inhalation injury and abdominal trauma. The burns cover his face, neck, torso, and limbs.
Dr. He: Most of the skin on his upper limbs has a leathery appearance, and some areas show large, thrombosed capillaries with loss of sensation.
Dr. He: The most severe area is his face. There's displacement and detachment of the nasal bone and alveolar bone on the left side.
Dr. He: Oblique fracture of the mandible, partial tooth loss on the left side, and nerve damage.
Dr. Fu looked up at Charlie through the observation window, a flicker of complex emotions in his eyes before he quickly masked them, leaving only a professional, serious gaze.
Fu Ming: He needs facial debridement surgery as soon as possible.
Fu Ming: But considering his overall condition, we'll probably have to wait until he stabilizes before performing tissue repair.
Charlie: How's his breathing?
Dr. He: Not good. Significant oropharyngeal congestion. We need to secure his airway urgently.
Charlie: What about his abdomen?
Dr. He: He was hit in the abdomen by shrapnel from the explosion. We don't know if it penetrated the abdominal cavity.
Charlie frowned at this.
Charlie: Immediately inform the blood bank to prepare for a massive transfusion. And get a CT scan done right away.
Charlie: Have an ENT specialist come and perform a tracheotomy and intubation as soon as possible.
Charlie: What about the other patient?
Dr. He: A pregnant woman, 29 years old, 14-18 weeks pregnant. Her injuries are less severe than the captain's.
Dr. He: Approximately 40% deep second- to third-degree burns across her body, mainly on her upper limbs, but also with smaller areas on her face, neck, and chest.
Dr. He: The third-degree burns are concentrated on her hands and forearms, with a leathery appearance.
Dr. He: Some areas show thrombosed capillaries and loss of sensation.
Charlie: Any other injuries?
Dr. He: None that we've found so far.
Charlie nodded, and the other two fell silent, awaiting further instructions.
No one mentioned that Dr. He was the head of the burn department, nor did anyone mention the animosity between Dr. Fu and Charlie.
In the operating room, it wasn't just the patients who were laid bare, exposed in their vulnerability, but also the medical staff.
Charlie: Establish IV access for both patients for fluid resuscitation.
Charlie: Fu Ming, you go to the captain first and assist the ENT specialist with the tracheotomy.
Charlie: If they can't find an ENT specialist, you'll have to do it yourself.
Charlie: Check for internal organ damage, bleeding, and embedded shrapnel.
Charlie: I'll start with the captain. If there are any internal injuries, I'll help with hemostasis and removing the shrapnel.
Charlie: We'll perform the escharotomy and facial debridement later.
Charlie: As for the pregnant woman, Old He, you go ahead and perform the escharotomy on her upper limbs first.
Charlie: Make sure to stabilize her vital organ functions and try to avoid hypovolemic shock.
Charlie: While ensuring effective blood volume, also limit the total amount of fluid you administer.
Charlie: I'll come over as soon as I'm finished with the captain.
Dr. He: Okay, hurry up.
Charlie: No problem.
When Charlie, now wearing scrubs, entered the operating room where the captain was, Dr. Fu was already there.
Charlie: How is the patient's abdominal cavity?
Nurse: The CT scan showed no shrapnel or organ damage in the abdominal cavity.
Charlie nodded and glanced around the operating room, but didn't see the ENT specialist.
Charlie: Didn't they send anyone from the ENT department?
Nurse: No, all the available doctors are in surgeries. Dr. Fu decided to do it himself.
Fu Ming: Prepare for the tracheotomy. Scalpel.
Charlie watched Dr. Fu's hands intently. Just as the scalpel was about to touch the lower edge of the cricoid cartilage, Charlie spoke up.
Charlie: Perform a median tracheotomy. Locate the cervical white line to minimize bleeding.
Fu Ming: ...Okay.
The scalpel swiftly made an incision, and the nurse used a suction device to remove black and grey phlegm from the tracheotomy site before connecting the patient to a ventilator.
Dr. Fu exhaled slowly.
Fu Ming: That's taken care of. Now, let's proceed with the escharotomy on the upper limbs.
He looked at Charlie and nodded hesitantly.
Fu Ming: I can handle this part myself. Time is of the essence. You go assist Dr. He. I'll call you for the facial debridement when I'm almost done here.
Charlie hesitated for a moment, then nodded in agreement. Dr. Fu lowered his head, took the scalpel from the nurse, and began working.
But just as Charlie was about to leave the operating room, the monitor emitted a sharp alarm.
The blood pressure reading plummeted, and blood seeped through the sterile drapes covering the patient's lower body.
Dr. Fu froze for a second, then grabbed a hemostat, lifting the drapes and applying pressure as he searched for the source of the bleeding.
Charlie immediately returned to the operating table.
Charlie: Start a rapid infusion of crystalloids. Request 4 units of packed red blood cells.
Charlie: Where's the bleeding coming from?
Dr. Fu continued applying pressure, his voice laced with panic as he spoke.
Fu Ming: It seems to be deep in the left thigh, but I haven't been able to pinpoint the exact source yet.
Charlie: Don't worry, take it one step at a time. Check the femoral artery first.
Charlie held Dr. Fu's stiff wrist, guiding his hand to the correct position. He understood; he had seen this countless times. In moments of panic, even experienced doctors could forget the most basic things.
Dr. Fu gave him a grateful look and used the hemostat to clamp the femoral artery, but the bleeding continued.
Charlie: It seems the source is closer to the proximal end. I'll take over. Hemostat.
The nurse handed the hemostat to Charlie, who began probing further up the leg.
Blood gushed from beneath the charred, fragmented flesh. But Charlie's expression remained unchanged as he carefully searched.
His breathing slowed, his eyes bright like flames, his hands steady. No matter how many times he stood at the operating table, the feeling was the same.
Was it nervousness, excitement, or perhaps the tension and exhilaration of battling death were simply two sides of the same coin?
Charlie: Found it.
He clamped the proximal end of the bleeding vessel, and the blood flow finally stopped. When Charlie put down the hemostat, Dr. Fu and the nurses visibly relaxed.
Charlie: Okay, re-sterilize. We'll proceed with the escharotomy on the upper limbs.
Charlie: Stay focused. An injury this severe requires intense concentration and patience.
Dr. Fu's expression turned slightly ashamed, as if realizing something.
But he quickly composed himself. When he looked at Charlie again, his eyes held gratitude, determination, and trust.
Fu Ming: I'll assist you.
Time flew by as they worked tirelessly to save the patient. Finally, the escharotomy and the debridement of the other areas were complete.
Charlie straightened up and gave Dr. Fu an approving nod.
Charlie: The rest can be handled with routine treatment—
Before he could finish, a nurse rushed over.
Nurse: Dr. Zha, the pregnant woman in the next room has gone into shock. Could you please take a look?
Charlie's expression remained unchanged. He nodded, signaling the nurse to operate the central control panel.
Charlie: Turn on the camera.
The screen on the panel soon displayed the scene in the adjacent operating room.
The pregnant woman was pale, drenched in cold sweat, and breathing rapidly.
Charlie: What are her vitals?
Nurse: Temperature 36.4°C, heart rate 138 bpm, respiratory rate 48 breaths per minute, blood pressure 90/60 mmHg.
Charlie: It appears to be hypovolemic shock. Start an IV drip, request plasma from the blood bank, and quickly replenish her blood volume.
Charlie: If her blood pressure still doesn't rise, administer 0.5 mg of epinephrine.
Charlie's brow furrowed slightly as he spoke.
Dr. He was right beside him, seemingly engrossed in examining something. Logically, he should be able to make this kind of assessment himself.
It was unusual for Dr. He, a seasoned surgeon with countless operations under his belt, to forget basic knowledge in such a situation.
The pregnant woman's condition gradually stabilized. Just as Charlie was about to continue with the final steps of the procedure, Dr. He on the screen looked up, his face pale.
Dr. He: Charlie, the amount of fluid we've administered has already exceeded the normal limit, but her blood pressure hasn't risen significantly.
Dr. He: I didn't order a CT scan earlier because she's pregnant, but now it seems there might be an issue with her abdomen.
Charlie: Did you check with an ultrasound?
Dr. He: Yes, there's fluid in her abdomen. I've already contacted the obstetrician.
Dr. He: But her blood pressure is still dropping. It's best to perform an exploratory laparotomy to stop the bleeding, but...
Dr. He's hand, holding the scalpel, trembled uncontrollably.
Charlie noticed and didn't ask any further questions.
Charlie: Don't panic. I'm coming over.
He had finished treating the captain's leg injury, and all that remained was suturing. He looked at Dr. Fu, who nodded.
Fu Ming: Leave it to me. Dr. He needs your help.
Charlie briefly confirmed the next steps with Dr. Fu, then headed straight to the adjacent operating room.
Dr. He's eyes crinkled as Charlie entered, his smile etched with exhaustion.
Dr. He: Charlie, you're here.
Charlie took the scalpel from Dr. He. Old He couldn't make a decision right now, couldn't continue. As much as he hated to admit it, he had to trust his instincts.
Dr. He's hand, initially gripping the scalpel tightly, loosened its hold.
Charlie spent the entire afternoon shuttling between two high-risk surgeries.
After both surgeries were completed, he immediately performed the debridement procedure on Director Wang's son.
Before entering the operating room, the patient, lying in bed, expressed his gratitude, just like countless other patients.
Stepping out of the operating room, the tension that had been gripping him finally eased, and a long-forgotten sensation washed over him. Charlie realized it was exhaustion.
Seeing Dr. He waiting at the door, he gave a lazy wave of acknowledgment.
Charlie: Old He, are you getting enough rest lately?
Seeing Charlie's relaxed demeanor, Dr. He seemed to relax as well, a smile appearing on his face.
Dr. He: It's nothing. Probably just a bit tired from all the recent surgeries.
Dr. He handed Charlie a bottle of water.
Just like Charlie had done for him countless times after a long surgery.
Dr. He: I'm really glad you were here today. Otherwise, those two patients might have been in grave danger.
Dr. He: Not only was I unable to help you, but I even tried to dissuade you, even though I knew your intentions.
Dr. He: I've disappointed you as a teacher.
Dissuade, Charlie pondered the word. Perhaps there had been some dissuasion. When he first arrived in Guangqi, Dr. He had tried to mediate between him and Sun Taizhong, advising him not to go against the family's wishes.
And when he had refused to prescribe DEA, Dr. He hadn't tried to persuade him, but there had been a hint of disapproval. As the head of the department, Dr. He had certain things he had to say and do. He wasn't as free as Dr. Zha.
Under the harsh white lights, the streaks of grey in Old He's hair were particularly noticeable. Charlie was suddenly reminded of the first time he had met him, accompanying his mother to the hospital.
Back then, Old He had been young, and Charlie hadn't known he would become a doctor.
After all these years, they had become a pair of master and apprentice, their paths similar, yet different.
He had simply wanted to save people, that was all. He had tirelessly chased his ideals for years, only to discover that everyone in this vast world was trapped in their own shackles.
Charlie thought of her voice that night, carried by the wind, filled with both frustration and drunken sincerity, bringing clarity to his own confusion.
Charlie: Old He, someone once told me that even the most unpleasant, the most despicable patients, deserve to be saved.
Charlie: I'm a doctor. I don't get to choose which surgeries I perform.
Charlie was silent for a moment, then looked up at Dr. He and shook his head with a smile.
Charlie: I think... that's right.
Dr. He was taken aback at first, then laughed. His earlier self-deprecating bitterness transformed into a relieved smile.
Dr. He: Charlie, you've really grown up.
Dr. He leaned against the wall, closing his eyes, his voice soft.
Dr. He: There have been more and more patients lately. The hospital is short on both staff and funding.
Dr. He: Xiao Lu from orthopedics, she's pregnant and still performing surgery after surgery.
Dr. He: Xiao Ji from their department didn't think it was right, so he pulled some strings and got transferred to the health checkup center.
Dr. He: And Xiao Chen from our department is about to resign. And Xiao Gu, who joined the same year...
Dr. He: They were both so busy recently that they ended up getting sick and hospitalized. It's ironic, a doctor treating patients until they end up in the hospital themselves.
Dr. He: No matter how idealistic a doctor is, how dedicated they are to healing and saving lives, once they take off that white coat, they're just an ordinary person.
He rambled as if speaking to himself, then, remembering something, urged Charlie to go and rest, to reassure his fiancée.
After his student left, Dr. He clutched his chest. His heart had started hurting again.
He shakily pulled out a blister pack of pills and swallowed the amount that was about to exceed the prescribed dosage.
Just then, a young nurse rushed towards him, her face pale.
Nurse: Dr. He, it's bad! That patient, he... he's crashing!
.
.
.
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S2 Chapter 3-20
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#light and night#light and night translations#evan#sariel#osborn#jesse#charlie#light and night season 2 translation#light and night rebirth movement#xiao yi#qi si li#xia ming xing#zha li su#lu chen#light and night main story translation
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hiiiii, gurl! it s me (again). I'm diving into a new obsession and I think you're the only person on the internet who knows about the existence of this man. may i request ANOTHER set of random headcanons about Carl Stargher from The Cell? and maybe the SO is also a psychologist like Catherine that gets close to him, in his mind, by approaching the mad side of Carl, rather than the innocent one, potentially avoiding his death? thank youuuuu!!!!😭😭😭
Hey Friend! I’m so grateful that I’m not the only one who loves this guy 😭❤️ so thank you for the ask!
Also sorry it took me awhile, I wrote these headcanons a little differently, kinda going through the plot of the movie (at least what I could remember of it) hopefully they’re worth the wait 😅
Carl definitely piqued your interest before entering his mind, both from a psychological aspect and a personal level
At one point, while still in college, you had considered joining the FBI and using your education to help better understand the behavior of serial killers
But you were concerned over how much you empathized with each killer you studied. So many of them had such terrible, abusive childhoods that you couldn’t help but feel for them
So instead you focused on helping children, in hopes to prevent future serial killers
After graduating and working as a child psychologist, you were presented with an opportunity that definitely was too interesting to pass up, a project involving an experimental virtual reality treatment
When the FBI contacted you and the other doctors working on this project with a proposal of using it to acquire information about a serial killer, you felt a mix of excitement and anxiousness
As you prepared to enter his mind, you stood beside Carl, your fingers gently touching the side of his face, committing his facial features to memory
You had no idea what to expect once you entered his mind but you wanted to be able recognize him
Waking in Carl’s mind was different, it was jarring, fractured, and cold… so many different areas and facets to explore
You feel like you could spend weeks analyzing it all, digging deep into what each scene and piece of imagery meant
It was clear that he was a complicated being, proud of his ‘accomplishments’, by how each of his victims were displayed, but there was also this darkness like he knew that it was wrong/twisted
When the strong woman dropped you unceremoniously on the ground, it took you a moment to regain your bearings… the man who had been seated upon a throne, stood up
“Where did you come from?” He demanded, his voice sounded distorted and monstrous.
You froze, thumb hovering over the button on your hand, part of you wanted to scream, but the other part wanted to see where this would go
His stare was unnerving, dark eyes watching your every move, you could hear shrieking in the background, you recognized the being as Carl, or at least a part of him, a terrifying part of him
You’re not sure what compelled you, but instead of escaping, you reached out towards him, fingers brushing against his hand
There was a moment where the two of you simply watched the other, your fingers still touching his skin when suddenly without warning he moved, faster than you expected
He tried to grab your wrist
Falling back, panic finally set in, and you scrambled backwards, your hands coming together and then you woke up
Afterward, you couldn’t stop thinking about the whole experience. Sitting on your bed, in the safety of your home, staring at your television while hands rubbed the very real fabric of your comforter, you were hoping to anchor yourself in reality but every time you closed your eyes, you felt like you were back there with him
The whole experience was… fascinating… terrifying… erotic, leaving you eager to return
It was strange how after that first encounter he could sense your presence/arrival, instead of waking alone on the ground, you’d wake on a bed of dead flowers or in shallow waters or in an empty tub and Carl/king Stargher was always close by, waiting for you
With each visit the length in which you stayed became longer, you’d greet him with the same feathery light touch that soon lingered longer and longer
It left you questioning your sanity, wondering why you weren’t more afraid, wondering why you attracted to this sort of darkness
When you encountered the part of Carl that most resembled the actual man, it was the first time the two of had an actual conversation
You told him your name, which he quietly repeated to himself several times
The conversation was brief, he was curious about you, you learned about his the abuse he endured but when you started to press him for information about his latest victim he became volatile
When he changed, becoming the evil/darker version of himself, you simply gave in
You didn’t fight him as he grabbed you from behind then pushed you to the ground
When he produced the collar, you simply allowed him to put the collar on your neck, even going as far as stretching your head up and moving your hair out of the way
The hungry look he gave you, filled with desire, spurred you on
You pressed your hands against his pale chest, leaning towards him for a kiss
He immediately reciprocated
His touch was rough, desperate
You hands grazed over the rings on his back and arms, causing him to buck his hips against you
You lost yourself to the dream, your mind drowsy, you had no clue how long you had been here this time around, but you didn’t care
All you wanted was to stay with him
During your stay, your surroundings would change, but you were constantly by Carl/King Stargher’s side
Sometimes you found yourself sitting on his lap in the gold colored throne room, his hand on your lower back, your head resting on his chest, while he sat perfectly straight and still
Other times you were on the floor with him crawling over you and his hands roaming all over your body
Or you’d find yourself sitting on a lavish bed, wearing an ornate dress and mask, while he admired you
His changing appearance would make you question if they were all different separate pieces of Carl or the same evil side
Either way you cared for him all the same
His own feelings for your were a combination of ownership and worship, similar to being a prized possession
At some point the other doctors and FBI would have to intervene, because you had gone too deep, giving into your feelings and allowing yourself to believe that Carl’s world was real
All parts of Carl were here in your mind, each aware that you accepted all of him, the innocent and the evil
This was enough to keep himself from fighting you and from hurting himself
It was unfamiliar, being welcomed in by someone, in way he wanted to stay here in this beautiful and peaceful world that was your mind
His whole world/mind was warped, his father had twisted his perception of strength, right and wrong, and of women
He idolized the the perverse part of himself and stifled the innocent part
Carl never quite understood how he had both this disdain for women but also this wish to understand them, to have one care for him
Perhaps you were the answer to that wish
Having shown him the sort of empathy and compassion and protection he had wished for as a child
Unfortunately whether Carl stays in the coma or wakes up, there isn’t a possibility for a traditional happy ending
If he remains in the coma, you visit him regularly, when you enter his mind for a visit he’s always pleased to see you, but when you can’t you sit by his bed, holding his hand and talk to him
If he wakes from his coma, you do your best to support him but he’ll have to face the consequences for his actions… depending on the sentencing you visit him whenever possible… but for both of you it’s never enough. He’ll write to you, long letters, and always looks forward to your replies
He’ll miss getting to hold and touch you, but absolutely appreciates how you’ve stuck by him
Similar to the actual ending, you adopt Carl’s dog, giving him updates on how the dog is doing, showing him pictures
#the cell#the cell 2000#carl stargher#Carl Stargher x reader#reader insert#the cell headcanons#Carl Stargher headcanons#vincent d’onofrio
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Understanding the Role of a Maxillofacial Surgeon: Insights from Dr. Anurag Bhargava, a Leading Maxillofacial Surgeon in Indore
Maxillofacial surgery is a specialized field that addresses complex conditions of the face, mouth, and jaw. It requires a unique blend of dental, medical, and surgical expertise. Dr. Anurag Bhargava, a renowned maxillofacial surgeon in Indore, provides invaluable insights into this fascinating field, highlighting its importance and the transformative impact it can have on patients' lives.
What is Maxillofacial Surgery?
Maxillofacial surgery, also known as oral and maxillofacial surgery (OMS), involves surgical interventions to treat diseases, injuries, and defects of the face, mouth, teeth, and jaws. This specialty bridges the gap between medicine and dentistry, requiring a deep understanding of both fields. Procedures can range from corrective jaw surgery and facial trauma reconstruction to dental implants and cosmetic enhancements.
Common Conditions Treated by Maxillofacial Surgeons
1. Facial Trauma:
Fractures: Maxillofacial surgeons treat fractures of the jaw, cheekbones, and eye sockets, ensuring proper alignment and healing.
Soft Tissue Injuries: These include lacerations and injuries to the facial skin and muscles, often requiring precise suturing to minimize scarring.
2. Corrective Jaw Surgery (Orthognathic Surgery):
Malocclusion: This involves correcting misaligned jaws to improve chewing, speaking, and facial aesthetics.
Sleep Apnea: Surgical intervention can help reposition the jaw and airway structures to alleviate obstructive sleep apnea.
3. Congenital Disorders:
Cleft Lip and Palate: Maxillofacial surgeons perform surgeries to repair these congenital deformities, improving function and appearance.
Craniofacial Anomalies: These are complex conditions affecting the skull and face, often requiring multi-disciplinary surgical approaches.
4. Dental and Oral Health:
Impacted Teeth: Removal of impacted wisdom teeth and other problematic teeth.
Dental Implants: Placement of dental implants to replace missing teeth and restore oral function.
5. Temporomandibular Joint (TMJ) Disorders:
TMJ Dysfunction: Treatment includes surgical and non-surgical options to alleviate pain and improve jaw function.
The Importance of Maxillofacial Surgery
Maxillofacial surgery is vital for restoring both function and aesthetics. Conditions affecting the face and jaw can have profound impacts on a person's ability to eat, speak, and breathe, as well as their self-esteem and social interactions. A skilled maxillofacial surgeon can significantly enhance a patient's quality of life through meticulous surgical interventions.
Dr. Anurag Bhargava: Expertise and Approach
As a leading maxillofacial surgeon in Indore, Dr. Anurag Bhargava combines extensive training and experience with a patient-centered approach. His expertise spans a wide range of maxillofacial procedures, ensuring comprehensive care for his patients.
1. Personalized Treatment Plans:
Comprehensive Evaluation: Dr. Bhargava conducts thorough evaluations to understand each patient's unique needs and conditions.
Customized Care: He develops personalized treatment plans, considering both functional and aesthetic goals.
2. Advanced Surgical Techniques:
Minimally Invasive Procedures: Whenever possible, Dr. Bhargava employs minimally invasive techniques to reduce recovery time and enhance outcomes.
State-of-the-Art Technology: He utilizes the latest technology and surgical advancements to ensure precision and safety.
3. Holistic Patient Care:
Pre- and Post-Operative Support: Dr. Bhargava provides detailed guidance and support throughout the surgical process, from pre-operative preparation to post-operative recovery.
Interdisciplinary Collaboration: He works closely with other specialists, including orthodontists, plastic surgeons, and ENT specialists, to provide comprehensive care for complex cases.
Success Stories and Patient Testimonials
Dr. Anurag Bhargava’s expertise and compassionate approach have transformed the lives of many patients. Here are a few success stories:
1. Corrective Jaw Surgery: A young woman with severe malocclusion and facial asymmetry underwent orthognathic surgery. Post-surgery, she experienced improved chewing function, enhanced speech, and boosted self-confidence.
2. Facial Trauma Reconstruction: A patient with multiple facial fractures from a car accident received reconstructive surgery. Dr. Bhargava’s skillful intervention restored the patient’s facial structure and function, facilitating a remarkable recovery.
3. Cleft Lip and Palate Repair: A child born with a cleft lip and palate underwent surgical repair. The surgery not only improved the child’s appearance but also enhanced their ability to eat, speak, and breathe properly.
Why Choose Dr. Anurag Bhargava?
Choosing the right maxillofacial surgeon is crucial for achieving optimal outcomes. Here’s why Dr. Anurag Bhargava stands out:
Extensive Experience: With years of experience and numerous successful surgeries, Dr. Bhargava is a trusted expert in the field.
Comprehensive Care: From consultation to recovery, he provides thorough and compassionate care.
Patient-Centered Approach: Dr. Bhargava prioritizes patient comfort, safety, and satisfaction, ensuring a positive surgical experience.
Conclusion
Maxillofacial surgery is a transformative specialty that addresses complex facial and jaw conditions, enhancing both functionality and aesthetics. Dr. Anurag Bhargava, a leading maxillofacial surgeon in Indore, offers expert care and personalized treatment plans, ensuring the best possible outcomes for his patients. If you’re seeking skilled and compassionate care for maxillofacial issues, Dr. Bhargava is the go-to expert in Indore.
For more information or to schedule a consultation, visit Dr. Anurag Bhargava’s website.
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Unmasking Degloved Faces
Facial trauma is a term that refers to any physical injury to the face, particularly the structures of the head and neck region. This type of trauma can result in severe facial disfigurement, including degloving injuries. Understanding the causes, management, and rehabilitation of degloved faces is crucial in providing appropriate care and support for affected individuals.
Facial trauma can occur due to various reasons, including:
Motor vehicle accidents
Workplace accidents
Sports injuries
Physical assaults
Accidental falls
These incidents can lead to the separation of the skin, soft tissues, and underlying structures from the facial bones. This degloving injury is often associated with significant damage to blood vessels, nerves, and facial function. The severity of the trauma can range from minor lacerations to extensive facial fractures.
Facial reconstruction surgeries
Facial reconstruction surgeries play a vital role in the management of degloved faces. The primary goals of these surgical procedures are to restore facial form and function, improve aesthetics, and enhance the patient's quality of life. The specific surgical techniques employed depend on the extent and nature of the facial trauma.
Some common facial reconstruction surgeries include:
Skin grafting: In cases where there is a loss of skin due to degloving, a skin graft may be performed. This involves taking healthy skin from another part of the body (donor site) and transplanting it onto the affected area.
Soft tissue reconstruction: Degloved faces often require reconstruction of soft tissues, including muscles, tendons, and blood vessels. Techniques such as tissue flaps, microvascular surgery, and facial reanimation procedures may be utilized.
Orthognathic surgery: Severe facial trauma can result in misalignment of the jaws. Orthognathic surgery aims to correct these skeletal deformities, improving function and facial aesthetics.
Maxillofacial implants: In cases where there is significant bone loss, maxillofacial implants may be used to restore facial symmetry and provide support for other facial structures.
Reconstructive rhinoplasty: Injury to the nose can cause functional and aesthetic problems. Reconstructive rhinoplasty can address these issues, improving breathing and restoring the natural appearance of the nose.
It is important to note that facial reconstruction surgeries are highly complex and require the expertise of a multidisciplinary team of healthcare professionals. Surgeons, plastic surgeons, oral and maxillofacial surgeons, and other specialists collaborate closely to develop comprehensive treatment plans tailored to each patient's unique needs.
Post-surgical rehabilitation
Rehabilitation plays a critical role in the overall management of degloved faces. It is aimed at maximizing functional recovery, promoting psychological well-being, and facilitating the reintegration of patients into their daily lives.
The rehabilitation process may involve:
Physical therapy: Physical therapists work with patients to restore muscle strength, flexibility, and range of motion. They utilize exercises, manual therapy techniques, and other modalities to optimize functional outcomes.
Speech and swallowing therapy: Facial trauma can affect speech and swallowing functions. Speech-language pathologists assess and treat communication and swallowing disorders, developing strategies to improve these functions.
Psychological support: Dealing with facial trauma and its consequences can have a significant psychological impact on patients. Mental health professionals provide counseling and support to help individuals cope with emotional challenges, promote self-esteem, and enhance body image.
Prosthetic rehabilitation: In cases where facial reconstruction is not feasible or desired, prosthetic rehabilitation may be considered. Specially designed facial prostheses can help restore appearance and function.
Throughout the rehabilitation process, close collaboration between healthcare professionals, patients, and their families is crucial. The treatment plan should be individualized, taking into account the specific needs and goals of each patient.
In conclusion, understanding the causes, management, and rehabilitation of degloved faces is essential in providing comprehensive care for individuals with facial trauma. Facilitating the recovery of form and function through facial reconstruction surgeries and post-surgical rehabilitation can significantly improve the quality of life for affected individuals. It is imperative for healthcare professionals to stay updated on the latest advancements in this field and adopt a multidisciplinary approach to deliver optimal care
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