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publiccollectors · 5 years ago

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QUARANZINE #14

QUARANZINE #14: Rachel Herman. Rachel was diagnosed as a presumptive positive for COVID-19 after a test for Influenza A and B turned up negative. She's been fighting the virus for just over two weeks. Yesterday she posted this long message on Facebook about her experience so far and I asked her about publishing it in QUARANZINE. She had been thinking about reaching out to me, so we were both on the same page. The text is very long for the format I adhere to so the type is quite small, unfortunately. Here it is in its entirety: Dear friends,

This is the week many of us will get sick. Social distancing is working, but most cities waited too long to declare shelter-in-place orders and many others have yet to. So, we will see spikes in confirmed cases within the next week or so. I want you all to be armed with pragmatic and useful information if this happens to you or someone you care about.

I am on Day 14 of what was diagnosed as a presumptive positive for COVID-19 after a test for Influenza A and B turned up negative. (I am still waiting for my COVID-19 results.) I’ve had a relatively mild case, and I’m on the mend. My congestion is clearing up, I can breathe deeply again, and going up and down the stairs doesn’t make me winded. My energy and appetite are coming back though I still have had a fever of 100+ for 14 straight days. Most of us will get a mild case. 40-70% of us will get it, but so much of the media frenzy right now is focused on things that were important last week and yesterday (every day feels a year these days, though, to be fair). I have seen shockingly few articles or helpful testimonials advising how best to treat ourselves at home, and, trust me, I’ve been looking. So much of the information we’re focused on now is preventing transmission, but there is woefully little on what to do IF and WHEN we get sick.

Being waylaid during the time that so many folks have been still frantically trying to avoid getting sick has offered me a strange bubble of calm and insight. I’m grateful for that because the fear out there is palpable. I would like for this to be an offering to assuage at least some panic. That is my hope anyway.

The CDC and the WHO have labored and lengthy instructions on how to prevent transmission to someone else in the household or orders to quarantine. This creates a new problem for us as caregivers. A potentially critically ill person separated from everyone else drastically reduces a caregiver’s ability to monitor, replenish fluids, and generally take care of the person who is sick. On top of that, these two trusted sources offer only the most basic (honestly, negligible) recommendations for treating symptoms: sleep, keep hydrated, and take Tylenol (or the generic acetaminophen). This kind of bare bones advice is, well, skeletal. We all want to know how best to take care of ourselves and each other so that we can avoid having to go to the hospital. We want to be able to recuperate at home because we want to prevent putting a strain on the system and, face it, the idea of going to the hospital in this scenario is downright daunting. The better we know how to nurse ourselves back to health, the better our odds are healing well in our own beds.

So, I wanted to share what I’ve learned.

Caveat emptors/disclaimers because I’m making this public and shareable: This is based on my own personal, lived experience. I am not a doctor, so this does not replace or supplant solid medical advice from a professional you trust. I have had relatively mild symptoms but still a longish case. I am one of the freakish 5% who has had never-ending nasal congestion that went into my upper respiratory tract, but I somehow avoided the dreaded cough. YMMV (your mileage may vary). I have no underlying health concerns, I’m 52, a non-smoker, and fortunate. I have a comfortable apartment to myself, and I was able to spend $500 to stock up on essentials before the lockdown and before I got sick. (For the love of all that is holy, I swear I did not stockpile anything, especially TP. Stocking up is simply incredibly expensive. I dwindled my account down to almost my last dollar, since I’m adjunct faculty at two local universities and don’t make a whole lot.) Still, that is more than so many of us are able to do, and I am grateful for all that I have. What follows goes a bit beyond common sense, because this virus is unlike anything I’ve experienced before, even though to be clear, this is certainly a far cry from the sickest I’ve ever been. I hope it can be a boon to friends and strangers alike.

Here are the things I did that helped:

WHILE YOU ARE WELL

1) Start taking your temperature in the morning and at night so that you have a baseline.

One of the first signs of the virus can be a low-grade fever, though this virus does present in different ways. Full disclosure: I was one of those people who had to go to 3 different drugstores on Wed Mar 11 looking for a thermometer amid decimated shelves.

2) Before you get sick, change your diet.

Stop eating and drinking things that will make it harder to fight off the virus. Mellow out on the processed foods, dairy, and sugar (alcohol and gluten are in this category too, sorry).

Increase your intake of immune-boosting foods like green vegetables, fish and other omega-threes, garlic, ginger, and citrus. You don’t have to give in to the whole elderberry craze (though it does taste pretty good). Replace coffee with chaga, a fungal immune booster that you can brew into a strong, soothing tea, for a few weeks.

If you think these dietary recommendations are extreme, consider that you are in a temporary but dire situation where everything else around us is collapsing. Change your eating habits this month, even if it’s just a little for a little while.

3) SLEEP at least 8 hours a night. (I know, I wake up at 4am in a blind panic too. But, still, try.)

4) Make a pot of soup NOW while you are healthy or at the first sign of any symptoms.

This is especially important if you are sheltering in place alone. When/if you get sick, trust me, you won’t have energy to cook. You will barely want to eat anything anyway. But you will force yourself to have two bowls of it every day, and it will help. The pot should be big enough so that you can eat from it for a week. Make your favorite broth-based recipe: chicken, vegetable, or bone. Bone is most healing, obviously. Avoid dairy and noodles because these ingredients increase congestion and inflammation. Freeze it if you don’t have any symptoms at this point, so you will be able to thaw it when you start to feel oogy.

WHEN YOU GET SICK

1) At the first sign of fatigue, a tickle in your throat, aches, or a fever, go to bed and stay there. SLEEP. Don’t try to keep working. Your body needs to heal, and it can do that most effectively when you are sleeping.

Early symptoms reportedly vary. Some have aches and fever, scratchy throat, and chest tightness with a dry cough. Headaches, sneezing + nasal congestion, shortness of breath, nausea, and diarrhea have all been reported. I woke up on Mar 14 with a headache, body aches, congestion, and a fever of 101. My fever spiked to 102.5 on Day 2, and I’ve had a fever of 100+ every day since along with body aches, nasal congestion (my nose opened up like an actual running faucet on day 5), chest tightness and upper respiratory congestion, exhaustion, lack of appetite, and some lower GI distress (though not full-on diarrhea, everything just felt labored and different and, sincere apologies for the vivid image I’m about to put in your head, my poop seemed to be covered in a gauzy cloud). The two aberrations from most commonly reported symptoms: I have only had a negligible cough, and I never had a sore throat. My baseline temp leading up to getting sick was 99, but I am usually a straight-up 98.6 kind of person.

I had a dinner party the Monday before I got sick, and a friend who helped me in the kitchen came down with the same thing at the same time. My friend has asthma and has had a much harder time of things. But we are both on the road to recovery, in large part because we have been sharing what we’ve learned, checking in with each other, and doing some intense jobs taking care of ourselves while in isolation. (No one else from the dinner party has gotten sick to date.)

2) DRINK WATER, every 15 minutes when you are awake. Every time you wake up or roll over, drink. It should be room temperature, not cold. Cold liquids exacerbate the illness.

3) Drink WARM liquids like herbal tea and broth. Hot liquids keep everything in your system moving. Make soothing, healing, and warming remedies out of whatever inexpensive supplies you already have available.

4) In the giant void of an antiviral treatment that works on COVID-19, I have turned/returned to plant medicine, and it has helped me a lot.

My cousin, who is taking a Chinese medicine course in Singapore right now, sent me directions on how to make a ginger and licorice root decoction that was used throughout China during the Hubei lockdown. It’s easy to make. You bake the licorice in molasses, and then you boil the licorice root and the ginger for an hour. The ginger licorice decoction has really helped my friend who also got sick at the same time I did.

Making tea from Chaga – an Alaskan mushroom – has been so incredibly helpful. I’ve made a large pot of it every day, reserving the chaga and re-steeping over and over again for the past two weeks. Was it the chaga or the fact that I was drinking a gallon of warm soothing liquid daily, ladling out a mugful every couple of hours, that helped me get better? I’ll go with a little of both.

Other natural antiviral immune boosters that might help include vitamin C, C60, and olive leaf extract, oregano oil, and Manuka honey. Since stores are closed and Amazon has stopped shipping, we have to make do with what we already have. Make a tea with citrus peels and cloves and sliced ginger, if that’s is in your fridge.

5) The word on the street is to manage fever with Tylenol or acetaminophen or paracetamol, which are supposed to be more suited to treating respiratory illness than other alternatives. Frankly, I have been taking acetaminophen as sparingly as possible to avoid putting strain on my other organs. Cool compresses work too.

Some people are saying NOT to take Advil and its generic ibuprofen, as they have anecdotally said to propel otherwise healthy people to hospitals for oxygen. There is a lot of noise and confusion in this debate, and I’m going to sidestep this thorny conversation for our purposes.

6) Zinc lozenges and elderberry syrup help with a scratchy throat and cough. A friend of mine prone to bronchitis recommended Myrtol, a German cough syrup made from natural ingredients, including elderberry. If you have a pharma protocol in place for managing a persistent, chronic cough, you are probably already on it.

7) The fatigue is real. It also becomes really hard to think clearly. That’s why it’s so important to have soup and tea and other supportive supplies ready ahead of time.8) When you think you are getting better the first three or four times, STAY IN BED.

The arc of this virus is really rollercoaster-y: up and down and up and down. After the initial alarm passes, (and it is alarming at first because you don’t know which way it’s going to go and that seizing up can make everything feel worse), I was able to focus on getting better, calmly. I made it through the first scary fever spikes, but right when I thought I was feeling better, I would get knocked down again. There were critical junctures around days 3, 5, and 7 where I was certain I’d turned a corner, and, well, yesterday.

I’d get up and do dishes, take out the trash, take my dog for a walk around the neighborhood (face covered), and try to get some work done (end of quarter grades were due at both my schools and my departments have been preparing like mad to take our classes online in the spring). Then I would feel hot and light-headed again, taking my temp only to see it had sprung back up to 101.5. You will feel better and want to get back up and do things only to get knocked right back down. The moment I ease up on drinking water and tea constantly, I start to feel horrible again.

Remember: YOU ARE ESSENTIALLY PREVENTING YOURSELF FROM DEVELOPING FULL-BLOWN VIRAL PNEUMONIA. I would say the new mantra needs to be SLEEP + DRINK WATER. Start now, to the extent that you can. Please resist the urge to get up and do things. Rest. Do your Zoom meetings from bed with a virtual office background, if you absolutely have to be on a call. But, truly, you shouldn’t because this is the time to sleep sleep sleep and binge watch The Good Place (my choice for existential dystopian laughs/insert whatever makes your socks go up and down). For the past few days, my temp has been normal in the morning only to spring back up to 100+ if I try to do too much (e.g. read: ANYTHING). When I let myself sleep, my temp goes back down.

9) A humidifier has helped. Some recommend running a hot shower and sitting in your own makeshift bathroom sauna. Steam eucalyptus or rosemary, if you have any, and inhale deeply. I just made a homemade vaporub with a base of coconut oil and a few drops each of clove, thyme, rosemary, and peppermint oil. It is wonderful.

10) My breathing never got dangerously shallow. But this virus can potentially fill your upper and lower respiratory tracts with mucous until you feel like you are drowning. A physical therapist wrote with life-saving advice about the importance of Postural Draining, a method of draining mucous from the lungs using gravity and percussion. It involves physically moving your body so that you tilt your lungs and bronchial tubes upside down and then firmly clap the back or chest. This allows the mucous to flow up out of the lungs along with deep, prolonged exhales. Then you can cough it the rest of the way out. You can do postural draining alone or have someone perform it on you. Google postural draining diagrams – there are different for positions for each of the five lobes of your lungs. Do these exercises for 3-5 minutes a day before you get too sick. You can get into position in a chair or laying over a yoga ball, bean bag, or pillows for support.

Failing steps 1-10, if you have difficulty breathing or your temperature spikes beyond what you and your doctor are comfortable with (I’ve heard different numbers), please go to the ER immediately. Some of you will develop dramatic and dangerous symptoms quickly. Please do not wait to seek care if your lungs are struggling beyond what you can manage at home. My advice is geared to keeping as many of us comfortable for as long as it takes to heal, but that obviously is only going to go so far for those who suffer from chronic conditions, are older, or are immunosuppressed. If you have a finger oximeter, and are able to monitor your oxygen levels numerically, then you will know when you have to go to the hospital. But very few of us have those, and they are way sold out.

THE OTHER SIDE

Healing from even a mild case (and mine IS mild) takes about two weeks to a month.

As my dad would day, take it easy. It is unclear how immunity works with COVID-19. Some have said that there was a patient in Japan who tested positive a second time. There is speculation that this, in fact, was a relapse and not re-infection. We need more time to learn about the virus. In the meantime, please give yourselves time to heal.

We don’t know how long immunity lasts, and we don’t know about immunity to slightly different mutated strains even if we have recovered from one of them. I do hope that we get to develop a fair amount of herd immunity in the next year, but, again, there is a lot to learn. We will obviously still need to protect our vulnerable populations, and our society will continue to bend and contort itself around the virus.

But I hope to be in a position to assist when others get sick. I will happily help you to the best of my abilities. Looking to a future I can hardly conceive at the moment, I anticipate learning more about plant medicine. Scientists will develop new antivirals, retrovirals, and vaccines. I look forward to donating plasma as part of a treatment for those who get sick in the future, whenever that near-distant moment may be.

And thank you, friends. I am good. I have everything I need. My inner circle is incredible (I love you, mom!). I have been quarantined since developing symptoms and went out for a half hour only to get tested (thank you, Howard Brown for your invaluable service). No one else I spent time with beforehand has gotten sick (except my one friend whose illness coincided with mine, and they are also struggling a bit today with the ups and downs. Please hold them in your thoughts).

May you and your loved ones stay healthy. Or, more to the point, may we all get well and stay well. Sending love to all corners.– Rachel Herman

#QUARANZINE #Rachel Herman #Public Collectors #Marc Fischer #Zines #RISO #Publications #covid-19 #coronavirus

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damienthepious · 5 years ago

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hey, Lizard Kissin’ Tuesday Crew. we’re finally back on real, actual Second Citadel content, huh? But. here’s the thing. not even that can put me off my bullshit. How do y’all feel about a chapter two?

Scattered On My Shore (Chapter 2)

[Ch 1] [ao3] [Ch 3] [Ch 4] [Ch 5] [Ch 6] [Ch 7] [Ch 8] [Ch 9] [Ch 10] [Ch 11] [Ch 12] [Ch 13] [Ch 14] [Ch 15] [Ch 16] [Ch 17] [Ch 18] [Ch 19]

Fandom: The Penumbra Podcast

Relationship: Lord Arum/Sir Damien/Rilla, Sir Damien/Rilla

Characters: Rilla, Lord Arum, Sir Damien

Additional Tags: Second Citadel, Lizard Kissin’ Tuesday, Pre-Relationship, (for the three of them. it’s established r/d), Alternate Universe - Canon Divergence, Injury, Injury Recovery, Hurt/Comfort, (this will also be), Enemies to Lovers, (for damien and arum eventually lol)

Fic Summary: Strange things wash up out of the lake near Rilla’s hut, on occasion. But this monster… this monster is certainly the strangest.

Chapter Summary: The monster should be on the mend. There are, however, one or two complications.

Chapter Notes: This chapter deals with a lot of medical talk, there's some mention of blood and more specific descriptions of injury, and description of something close to surgery. There is also some talk in this that hints at some mild suicidal ideation, so if you’re sensitive to that tread with caution. Also if anyone with any knowledge of actual real life medical stuff reads this i am desperately sorry, i know virtually nothing. Forgive me for my nonsense.

It’s difficult to really stabilize the monster. And of course it is- Rilla is essentially paddling with her hands over here, she’s reduced to guesswork (she hates guesswork) and trial and error (which is slightly less irritating, but it’s certainly too goddamn risky when it comes to trying to save a life) and his body is already so strange that it’s hard to figure out what’s actually damage and what’s just inherent to him.

One of his four (four) wrists is broken, but she notices that late because his wrists turn so strangely in the first place (there must be a purpose to that; maybe he’s partially arboreal? That sort of range of motion would be useful for- no, focus, focus, Rilla-) and she doesn’t catch the jagged slackness of one among the four until he winces through trying to move it during one of his rare moments of consciousness.

That, too, is hit and miss, how aware he is at any given moment. It’s difficult to find a sedative that works- she doesn’t know much about lizard sedation, let alone pseudo-lizard-snake-bug-dragon (potentially ashdragon, specifically) sedation, and he wakes at unexpected moments. Unexpected, and he is often still near-delirious when he rouses, still snapping ineffectually with his eyes rolling in instinctive panic and/or pain. Very, very occasionally he comes around to lucid, or close to lucid, and then he always fixes her with that frightened, suspicious violet gaze.

She tries to use those opportunities when they arise. If he can answer questions about his pain, she can at least get a better idea of what still needs mending. Or- she would get a better idea, if the stubborn ass would answer any of her questions without complaining or deflecting or, yet again, complaining.

“Your attention is both unwanted and unneeded, little human, and the very instant that I- ha,” he bursts into a whine, his throat whirring sharply as he pants, lifting a clawed hand to press weakly at his midsection.

“That one still hurts, then?”

“All of it h-hurts, you idiot.”

“But the pain there is sharper? More acute?”

He hisses, then snaps his teeth ineffectually in her direction. “I- I will not be patronized,” he says in a snarl, and Rilla rolls her eyes and gently finishes re-wrapping his wrist.

“Okay, okay,” she agrees gently. “Now, don’t move that any more than you have to, understood?”

Terrible patient. Just- abysmally bad.

Though, oddly, he hasn’t made any move to actually hurt her.

She had been expecting things to get fairly bad on that front, if she’s being honest. Right at the start, when he was barely, barely conscious, like absolutely tongue-lolling out of it, she obviously wasn’t worried about attack beyond just accidentally catching herself on his limp claws.

But even as he comes more aware, even as he complains bitterly and tries, with unpredictable frequency and an utter lack of success or self-preservation, to slip from his bed and towards either the door or the window, he hasn’t tried to hurt her. He hasn’t tried to bite, though he snaps his teeth at her pretty much every time he’s awake. He hasn’t tried to claw her, though he pushes her hands away with a scowl when he’s lucid enough to do so.

It’s just odd, honestly. Not that she’s complaining. She’d rather not have to don falconer’s gloves just to redress his broken wrist or to check his pulse.

“I do not need to be mmf-”

He cuts off as she presses the cup against his mouth, burying her smile in a stubborn frown.

“You can barely lift your arms, let alone a glass. Drink. I don’t care if you’re embarrassed, you need to hydrate. Losing blood is no joke.”

“And certainly you care about my hydration,” he says with a sneer, his teeth clinking against the clay. “You expect me to believe-”

“I expect you to believe that I’ve barely gotten any sleep in the last two days trying to keep you from dying, and I believe that you’re going to drink from this damned cup right now, yeah, actually.” She blows her frown out like a candle and smiles bright and dangerous instead. “Drink. Now. And shut up.”

He sneers, but she presses the cup against his mouth again and his tongue flicks out and he blinks, and she sees the moment the big stubborn idiot realizes how thirsty he is, and then with very, very bad grace he lets her tip the cup until he can take a few long, slow swallows, his entire frame sagging in relief. He sighs when the cup is drained, and she can tell that he’s drained, too. More tired than she expects, at this point, but honestly it’s hard to tell with a monster. He’s half-dozing again before she’s lowered the cup.

He doesn’t tell her that he’s cold. That one is infuriating, actually. Might have something to do with the excessive fatigue, which she has to fold into her theories and speculations. She should have guessed, too, from the way he always unconsciously seems to lean into her touch. He gets furious when he notices himself doing so, and she’d been distracted from the actual possible causes of that by the way his snout wrinkles when he’s embarrassed. It’s- almost cute, in a weird sort of way.

Or it would be, if his frill didn’t try to flare when he’s embarrassed, too. It’s still torn, and it’s a very difficult part of the lizard to bandage, so every time he moves it without meaning to (partially conscious motion, or at least partially conscious control- he can move it at will, she thinks, but it also moves reactively, maybe in a similar way to blinking when startled), he exacerbates the edges of the tears, delays the progress of his recovery at least in that one small way for that much longer.

The cold, though: she notes his subconscious leaning towards her own skin, at first thinks that’s just some natural, biological response, and of course she’s warmer than him and she assumes that warmth would be soothing for a lizard-type creature. She notes the way he tenses when the sheets of the cot are pulled away from him for the purpose of checking his injuries and redressing, and she assumes mostly that it’s just more of the embarrassment that he seems so prone to, more than anything. She puts the pieces together when he sighs in a rather dramatically satisfied way as she’s pulling the sheets back over him, though, and she blinks down as he eyes her suspiciously.

“Wait- hang on. Have you been cold this whole time?”

He frowns, ducking his head and burying his chin in the thin cloth. “Does it matter?”

Her mouth hangs open, too shocked by the stupidity of the question to even answer for a long moment. A really, really long moment, actually. She stands up, and she leaves the room before the words find her again, because obviously, obviously-

She comes back with an armful of covers and quilts and he eyes her in alarm as she clomps back to the bedside and dumps the entire pile onto the cot, onto his legs, where her point will be made without the added gentle weight potentially pressing on his injuries.

“There,” she says, frowning. “Saints, I could have warmed you up ages ago if you only told me, you idiot.” She reaches into the pile and starts rearranging, layering the covers over him with systematic attention, the softer sheets lower and closer to him, the warmer heat-trapping layers on top.

“You- little doctor do you really believe this necessary?”

“If you’re cold it could be exacerbating your lethargy, which could interfere with your recovery,” she says with sharp look. “Or, for all I know, it could be masking other symptoms. Next time, if something hurts or if there’s a way I can make you more comfortable, tell me.”

She pokes him in the tip of his snout lightly to emphasize her words, and he snarls automatically though his expression is more sheer surprise than anything, and he looks like he’s already settling into the heat, drifting sleepily down.

“I- I-”

“Don’t get embarrassed, don’t get all haughty, just ask. That’s what I’m here for. I can’t help you if you don’t let me.”

“Could have fooled me,” he mutters, and she flicks him in the snout again. He- laughs, then, a breathy and stunned sort of nose, before he lifts a clumsy hand to rub the offended point. “You are absurd,” he says, and he sounds a little impressed.

“And you,” she says smugly, “aren’t cold anymore.”

Eventually, after every injury she’s certain of is at least somewhat accounted for, wrapped, disinfected, dealt with, she starts to feel like it’s just a game of waiting for his body to start to fix itself-

But days later, he doesn’t seem to be improving. Even when he comes out of the sedation, his fatigue and his pain are still severe, and it almost seems like he’s more confused than before just after waking. His breathing continues to grow more shallow, more labored, and his arms have taken to wracking spasms. It was just rare, at first, but the frequency is increasing. Muscle spasms, difficulty breathing, lethargy and confusion-

Most troubling: his scales are developing patches of sickly purplish red. Subtle, at first, and difficult to notice among the rest of his dark green and black mottling, but once she notices the first one slowly discoloring his upper left pectoral, she notices the rest fairly soon.

Symptoms suggest a likely cause of infection. Possibly septicemia. Potentially lethal, when he should, by rights, be on the mend.

Complication regarding that potential diagnosis: Rilla has already started the monster on antibiotics specifically to combat a burgeoning infection in one of the scrapes on his arm, one that was pretty wretched before she got her hands on it. So, if any of his other injuries managed to get infected before she had the chance to clean and wrap them, her treatments should already be mitigating it. This, however, is progressing instead of healing.

Which means that Rilla must have missed something.

Obviously that prospect is infuriating, but Rilla’s not going to deny facts just because they’re inconvenient. Somewhere, somehow, she made a mistake. She’ll have to fix that mistake if she’s going to make any of this better.

She is systematic. She redresses his wounds, carefully noting the progression of his recovery with each (to a one: slow), looking for evidence of discoloration, of odd smells or discharge, looking for anything at all more amiss than just the injuries themselves, anything that might prove to be the cause of the lizard’s lack of progress.

(He hasn’t given up. She knows that, at least. Knows that isn’t a possible cause. For all his complaints and sarcastic pleas for her to just end his humiliation, he is struggling towards life with a fervor, she can see it. There’s something in his eyes- some fire, maybe, and Rilla knows that he hasn’t given up. He hasn’t- and she won’t either.)

One of the injuries on his midsection, a sloppy claw wound or possibly a bite from a strange angle, catches her attention. His progress is slow all around, but this one- it almost looks worse that it did when she dressed it. The edges haven’t even begun to knit back together, and it hasn’t quite stopped bleeding in a slow, sullen sort of way.

While he’s out cold, she examines the area more closely, pressing incredibly careful fingers around the wound, taking samples of the blood to compare to others she’s taken in the last few days, trying to decide if she can actually distinguish necrotic scales from just damaged ones with her current base of knowledge, but when she’s probing with her fingers she feels-

Something. She doesn’t want to press any harder than it takes just to feel the shape, but there is definitely something very wrong in this particular injury. Something hard, and out of place. A piece of broken rib, maybe? No- no she doesn’t think it’s that. Maybe something more malicious- her brain leaps to arrowhead but it’s not that kind of wound, of course. Speculation is rarely helpful, though, and she knows that if she wants this injury (and hopefully the rest) to actually begin to improve, she’s going to have to-

Well. It’s essentially going to be surgery.

The next time he wakes, he’s even weaker. She can tell by the way the nictitating membranes stay flipped over his eyes defensively, fogging his bright violet back to a soft, concerning lavender. By the way the hand he lifts to bat at her misses her wrist entirely. By the way he doesn’t even manage to pretend not to lean his cheek into her palm when she cups his face to make him look at her.

“Wh… human, what are you…”

“I know you don’t want to talk about what happened to you,” she says, voice firm but gentle, and after a moment he tenses. “I’m not going to ask, don’t worry, but I do need to ask-”

“Not going to- to tell you anything-”

“Is there any chance that whatever attacked you could have left something behind in one of your wounds? The tip of a claw, or a tooth, or horn? Anything like that?”

His brow furrows, and he finally seems to focus on her fully, his foggy eyes flicking between her own. “It… it is possible, human, why-”

“Is there any chance that there might be a poison or toxin involved as well?”

The membranes slide away from his eyes, finally, and he stares at her with narrowed violet diamonds as he pulls his face away from her hand. “Yes,” he says. “Yes, that is possible.” He inhales deeply, and the breath shakes out of him. “This protracted weakness. You believe-”

“It appears that there’s some foreign object stuck in one of your wounds, and you’re showing signs of infection or something worse,” she says, matter-of-fact. “I suspect it’s the cause of why you’ve been improving so slowly, and why it’s seemed like you’re about to start a backslide.”

“A foreign… object,” he repeats in a hiss. “Excellent. My injuries were… obviously not extensive enough already.”

“The point is,” Rilla says, sighing, “that I think you’re going to continue to deteriorate, unless the object is removed.”

He stares at her, blinks slowly, then raises one ridged eyebrow.

“Then it seems… your path is clear, does it not?” He pauses. “Unless, perhaps, this is precisely the excuse you were searching for, to allow the monster to die with as little effort-”

“Don’t be an ass,” she says, quiet but sharp. “I’ve been treating you, and that started when you were barely alive, let alone conscious. Obviously I didn’t ask permission for any of that. I couldn’t. But this- this is gonna be surgery. I’ll have to sedate you, and anything like that- there’s always a risk of something going wrong. And it- it’s different, now. You’re awake. You know what’s going on. You know that I’m not trying to hurt you.”

He scoffs, but he doesn’t interrupt.

“I can ask, this time. If I don’t try to remove it, you’ll probably get worse, but there’s also a chance that trying to remove it could… could go wrong. So,” she straightens her spine, curls her lip into a wry half-smile, and meets the monster’s eye. “Do you want me to try? If you decide not to, I can- I can try more aggressive pharmaceutical methods, but to be entirely honest I’m not optimistic that there’s anything I can change on that front that will make a difference, and-”

“Wh-what are you doing?”

Rilla blinks, watching the suspicious twisting of his face. “What do you mean?”

“Asking, human, what are you asking for? Why pretend as if you care about the input of a monster?”

“Be… because I do?”

He scoffs again. “Ridiculous. Don’t be absurd, if you think you can manipulate me into-”

“Hey, hey-” she reaches out, her fingers just barely, barely brushing the scales of his shoulder and startling him into a wordless hiss. “Don’t work yourself up. You’re already exhausted, you don’t want to make yourself even more tired.”

“I am tired, human, of you pretending as if-”

“I have a name, you know.”

He flinches, lips pressing together as he glares at her sulkily. “I do not care. And I do not care what you do with me, either. I will likely die either way, so I may as well leave it in the hands of the universe, even if the universe is acting through such absurd means.”

Rilla frowns, her heart pulling a little. “I’m not going to let you die. Not if I can do anything about it. Please, just- tell me what you want me to do.”

He clenches his jaw tight, still frowning and not quite looking at her. “I told you. Do as you like.”

“No. No, that's not how this is going to work.” She frowns, brow furrowing stubbornly, and she meets his sharp eyes until he quails, glancing away. “What do you want?”

He swallows, ducks his head, and she can see the turning of the gears in his head for a long moment.

“I… I would rather die quick than slow, little human. If you believe there is some poison in me, and the attempt to remove it may destroy me, I would rather be destroyed in the attempt than in some painful, protracted helplessness.” He pauses, then aims his sharp, tired eyes up at her again. “There. You have your answer. Act as you will.”

“Okay,” Rilla says, and then she sighs. “Okay. That- honestly I’m glad you feel that way. And- and it’ll be better if we do this sooner rather than later. I’ll have to prepare a little bit, but- is that okay?”

“I would rather not waste time putting it off, yes,” he agrees in a drawl, looking away again.

“I’ve-” Rilla pauses. “I’ve been meaning to ask. It- I’ve been feeling pretty damn rude, actually, just- what’s your name?”

He blinks, eyes wide with something like panic. “What?”

“Your name. I’m not just going to call you monster if there’s something else I should be calling you. And-”

And this might be the last chance she has, to ask. If things go wrong.

She can see the moment he realizes her thoughts, the morbidity of them, and something like resignation slips into his expression. Not exactly the desired effect. She wishes he didn’t seem so agreeable to the concept of dying, but-

“Fine. Fine, if you care so very much. I am Lord Arum, he who rules the Swamp of Titan’s Blooms. If you must call me anything, you may call me that.”

“Lord, huh?”

“Indeed,” he hisses, narrowing his eyes.

“Seems pretty formal, considering.”

“Indeed,” he repeats, more snarl in his tone, and she laughs.

“Okay, okay, formal, then. You may call me Amaryllis of Exile, oh Lord of the Swamp. Pleasure to formally meet you.”

His frown deepens. “Pleasure,” he hisses under his breath with a scoff. “Now. May we get this done? If you are so very concerned with my well-being as you claim, certainly you should not delay.”

“Yeah,” she says with a sigh, and then she stands. “Yeah, I know. If you’re ready, I can put you under.”

“As ready as I expect I will be,” he mutters as he watches her cross the room to fetch the sedative.

It’s a little unsettling, actually, how close he watches her as she draws the proper dose into the syringe, as she returns to the side of his cot.

“Okay,” she says, quiet with his eyes on her. “Ready, Arum?”

He scowls at his name in her voice, at the distinct lack of his title, maybe. He still nods, though, after a moment. “Do as you will, human.”

“I’ll do everything I can,” Rilla says, and he closes his eyes even before she injects him with the sedative. “Hang in there for me, okay?”

“As if I have a choice,” Arum says, and he must have already been only hanging on to the waking world with the tips of his claws, because he barely makes it through the sentence before his head slumps to the side, his breaths evening out.

Rilla takes a deep breath, stares down at the monster in her care, and then she turns to prepare what she’ll need to get this job done.

Rilla is so utterly focused on the monster beneath her hands that she does not register the noise in her front room. She hears it: the familiar creak of her door, the noises of footsteps approaching, but her eyes are fixed on the injury that is her current dilemma, fixed on the instrument she is using so very, very delicately to try to pull what her revised estimate assumes must be a broken piece of talon from between this monster’s ribs.

She does not register the noise. She doesn’t even register the much closer noises, the familiar voice, until there is a light knocking at the door to her exam room.

Even then she barely understands, through the buzz of her exhausted focus. She’s so close, she can feel the edges of the curved piece of sharpness that’s pierced him, and if she can only get the angle of her tool just right, if she can only get a little bit of grip, she’ll be able to pull it out. This is the source of the infection; Rilla is sure of that. Poisoned talons or envenomed fang, a tip left behind, bleeding more and more tired pain through his body. If she can just get it out, her other treatments will finally have the chance to make an impact, will finally be afforded the foothold they need to really help him.

The knock comes again, and Rilla mutters something wordless under her breath and she absolutely can’t pull her eyes away. She almost has it. Almost. The blood is making everything slippery but she can see a darker shade among it too and she needs to get this out of him, she just needs to, and she’s almost there-

The door opens. It was not locked.

“Rilla, my heart, you failed to answer and I-”

Rilla feels a very distant twinge of worry, but she’s still so damned close and she can swear she feels her tool catch a grip, just barely. She can’t afford to lose her focus, not now-

“A monster.” Damien’s voice is… utterly devoid of inflection. “Rilla- my Amaryllis- remove yourself from that creature and I shall resolve the situation in an instant-”

“’n the middle of something, Damien,” she mutters, and there is sweat on her forehead and she can’t pull her eyes away, not for him and not for anything. “Outta my exam room now.”

“That is a monster,” Damien repeats, and now there is a tone in his words. Dark, terrified, furious. With her? She can’t tell. Doesn’t really care at the moment, if she’s being honest. “Move away from it and I shall slay it for you.”

“Don’t you dare,” Rilla growls, and her hair must have come loose from her braid because wisps are falling in front of her face and she really, really doesn’t have time for this right now. The tool in her hand catches against an edge, pulls, and she feels the curve of the foreign object between Arum's ribs move, just slightly. “Almost- almost got it, c’mon c’mon c’mon-”

“Rilla before it wakes, before it sets upon you-”

“Don’t be stupid,” she manages. “Knocked him out for this. Obviously. Otherwise the pain’d be- too much. He’s not gonna wake up. Probably not for hours. Shut up and let me focus.”

“Rilla that is a monster-”

“Damien,” Rilla snaps, sharp and harsh and unquestionable, and when her eyes finally jerk towards him Damien’s spine stiffens, his eyes going wide. “I heard you the first time. You think I don’t know this is a monster?” She scoffs, and her throat hurts with the effort of not absolutely screaming at him. “What I am doing, Damien, right at this moment, is incredibly delicate. You are going to leave this room- no, don’t you dare interrupt me, I am talking right now. You are going to leave this room and wait outside. When I am done, and not a moment sooner, I am going to come and join you, and then we are going to have a conversation about him. About this.”

“Rilla-”

“I said that all as nicely as I am physically able, right now. If you make me repeat myself, Damien, I’m not going to get any nicer. Get out. Now.”

He opens his mouth, but she turns away, refocusing back on the task at hand. The task literally, literally in her hands right now. Her grip on the talon is miraculously maintained. Somehow it hasn’t slipped away entirely, or slipped deeper. She delicately, delicately starts to maneuver the object, and if she angles it just right she should be able to slip it right out without scraping the business end of the thing against anything else inside him- without doing any further damage. Removal of something like this is dangerous and delicate and-

And Rilla barely hears it, when the door clicks shut behind Damien again.

She almost has it. Almost.

She twists her wrist. She bites her lip hard enough that it might bleed. She holds her breath and twists and pulls so, so gently-

The small black curve of a broken talon (or, possibly, fang) slips out from between his ribs with not an ounce of fanfare. It barely looks big enough to worry if stuck in the sole of a decent boot. It doesn’t even have the courtesy to dramatically drip black poison. But-

It’s the source of so much of Arum’s pain, and now Rilla has pulled it from him.

Now she can really, really start to help him.

… if she can convince Damien not to kill him, first.

[->]

#elle's fanfic #the penumbra podcast #second citadel #rad bouquet #lizard kissin' tuesday #amaryllis of exile #lord arum #sir damien #>:3c #WE ALL BE LOVE LIZARDS <3<3 #MY HEART IS FULL OF LOVE DANGIT #scattered on my shore

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gordonwilliamsweb · 3 years ago

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Not All Experts Are Ready to Vaccinate Kids Against Covid

Lucien Wiggins, 12, arrived at Tufts Children’s Hospital by ambulance June 7 with chest pains, dizziness and high levels of a protein in his blood that indicated inflammation of his heart. The symptoms had begun a day earlier, the morning after his second vaccination with the Pfizer-BioNTech mRNA shot.

For Dr. Sara Ross, chief of pediatric critical care at the Boston hospital, the event confirmed a doubt she’d been nursing: Was the country pushing its luck by vaccinating children against covid at a time when the disease was relatively mild in the young — and skepticism of vaccines was frighteningly high?

“I have practiced pediatric ICU for almost 15 years and I have never taken care of a single patient with a vaccine-related complication until now,” Ross told KHN. “Our standard for safety seems to be different for all the other vaccines we expose children to.”

To be sure, cases of myocarditis like Lucien’s have been rare, and the reported side effects, though sometimes serious, generally resolve with pain relievers and, sometimes, infusions of antibodies. And a covid infection itself is far more likely than a vaccine to cause myocarditis, including in younger people.

Lucien went home, on the mend, after two days on intravenous ibuprofen in intensive care. Most of the 800 or so cases of heart problems among all ages reported to a federal vaccine safety database through May 31 followed a similar course. Yet the pattern of these cases — most occurred in young males after the second Pfizer or Moderna shot — suggested that the ailment was caused by the vaccine, rather than being coincidental.

At a time when the vaccination campaign is slowing, leading conservatives are openly spreading disinformation about vaccines, and scientists fear a possible upsurge in cases this fall or winter, side effects in young people pose a conundrum for public health officials.

On Friday, the Centers for Disease Control and Prevention’s vaccine advisory committee is set to meet to discuss the possible link and whether it merits changing its recommendations for vaccinating teenagers with the Pfizer vaccine, which the Food and Drug Administration last month authorized for children 12 and older. A similar authorization for the Moderna vaccine is pending, and both companies are conducting clinical trials that will test their vaccines on children as young as 6 months old.

At a meeting last week of an FDA advisory committee, vaccine experts suggested that the agency require the pharmaceutical companies to hold larger and longer clinical trials for the younger age groups. A few said FDA should hold off on authorizing vaccination of younger children for up to a year or two.

Interestingly, Lucien and his mother, Beth Clarke, of Rochester, New Hampshire, disagreed. Her son’s reaction was “odd,” she said, but “I’d rather him get a side effect [that doctors] can help with than get covid and possibly die. And he feels that way, which is more important. He thinks all his friends should get it.”

Data regarding covid’s impact on the young is somewhat messy, but at least 300 covid-related deaths and thousands of hospitalizations have been reported in children under 18, which makes covid’s toll as large or larger than any childhood disease for which a vaccine is currently available. The American Academy of Pediatrics wants children to receive the vaccine, assuming tests show it is safe.

But healthy people under 18 have generally not suffered major covid effects, and the number of serious cases among the young has tumbled as more adults become vaccinated. Unlike other pathogens, such as influenza, children are generally not infecting older, vulnerable adults. Under these circumstances, said Dr. Cody Meissner — who as chief of pediatric infectious diseases at Tufts consulted on Lucien’s case — the benefits of covid vaccination at this point may not outweigh the risks for children.

“We all want a pediatric vaccine, but I’m concerned about the safety issue,” Meissner told fellow advisory commission members last week. An Israeli study found a five- to 25-fold increase in the heart ailment among males ages 16-24 who were vaccinated with the Pfizer shot. Most recovered within a few weeks. Two deaths occurred in vaccinated men that don’t appear to have been linked to the vaccine.

Young people could experience long-term effects from the suspected vaccine side effect such as scarring, irregular heartbeat or even early heart failure, Meissner said, so it makes sense to wait until the gravity of the problem becomes clearer.

“Could the disease come back this fall? Sure. But the likelihood I think is pretty low. And our first mandate is do no harm,” he said.

Ross said the biggest pandemic threats to children that her ICU has witnessed are drug overdoses and mental illness brought on by the shutdown of normal life.

“Young children are not the vectors of disease, nor are they driving the spread of the epidemic,” Ross said. While eventually everyone should be vaccinated against covid, use of the vaccines should not be expanded to children without extensive safety data, she said.

The government could authorize childhood vaccination against covid without recommending it immediately, noted Dr. Eric Rubin, an advisory committee member who is editor-in-chief of the New England Journal of Medicine. “In September, when kids are back in school, people are indoors, and the vaccination rates are very low in certain parts of the country, who knows what things are going to look like? We may want this vaccine.”

Moderna and Pfizer this summer began testing their vaccines in younger kids. A Pfizer spokesperson said the company expects to give about 2,250 children ages 6 months-11 years vaccine as part of its trial; Moderna said it would vaccinate about 3,500 children in the 2-11 age range.

Some members of the FDA advisory committee proposed that up to 10,000 kids be included in each trial. But Marion Gruber, leader of the FDA’s vaccine regulatory office, pointed out that even trials that large wouldn’t necessarily detect a side effect as rare as myocarditis seems to be.

At some point, federal regulators and the public must decide how much risk they are willing to accept from vaccines versus the risk of a covid virus that continues to spread and mutate around the world, said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“We’re going to need a highly vaccinated population for years or perhaps decades,” Offit said at the meeting. “It seems hard to imagine that we won’t have to vaccinate children going forward.”

Ross argued that it makes more sense to selectively vaccinate children who are most at-risk for serious covid disease, such as those who are obese or have diabetes. Yet even to raise questions about the vaccination program can be a freighted decision, she said. While authorities have a duty to speak frankly about the safety of vaccines, there is also a responsibility not to frighten the public in a way that discourages them from seeking protection.

A 10-day pause in the Johnson & Johnson vaccination campaign in April, while authorities investigated a link to an occasionally fatal blood-clotting disorder, led to a major decline in public confidence in that vaccine, although as of late May authorities had detected only 28 cases among 8.7 million U.S. recipients of the vaccine. Because of the declining appetite for the Johnson & Johnson vaccine, millions of doses are in danger of passing their use-by date in refrigerators around the country.

Focusing too much attention on potential harms from the Pfizer and Moderna vaccines for children could have a tragic result, said Dr. Saad Omer, director of the Yale Institute for Global Health and an expert on vaccine hesitancy. “Very soon we could be in a situation where we really need to vaccinate this population, but it will be too late because you’ve already given the message that we should not be doing it,” he said.

Eventually, perhaps next year, K-12 mandates might be called for, said Dr. Sean O’Leary, a professor of pediatric infectious diseases at the University of Colorado. “There’s so much misinformation and propaganda spreading that people are reticent to go there, to further poke the hornet’s nest,” he said. But once there is robust safety data for children, “when you think about it, there’s no logical or ethical reason why you wouldn’t.”

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Not All Experts Are Ready to Vaccinate Kids Against Covid published first on https://nootropicspowdersupplier.tumblr.com/

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stephenmccull · 3 years ago

Text

Not All Experts Are Ready to Vaccinate Kids Against Covid

“Could the disease come back this fall? Sure. But the likelihood I think is pretty low. And our first mandate is do no harm,” he said.

Ross said the biggest pandemic threats to children that her ICU has witnessed are drug overdoses and mental illness brought on by the shutdown of normal life.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

USE OUR CONTENT

This story can be republished for free (details).

Not All Experts Are Ready to Vaccinate Kids Against Covid published first on https://smartdrinkingweb.weebly.com/

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gordonwilliamsweb · 3 years ago

Text

Not All Experts Are Ready to Vaccinate Kids Against Covid

“Could the disease come back this fall? Sure. But the likelihood I think is pretty low. And our first mandate is do no harm,” he said.

Ross said the biggest pandemic threats to children that her ICU has witnessed are drug overdoses and mental illness brought on by the shutdown of normal life.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

USE OUR CONTENT

This story can be republished for free (details).

Not All Experts Are Ready to Vaccinate Kids Against Covid published first on https://nootropicspowdersupplier.tumblr.com/

0 notes