#pre pa

[populationpensive]

Abdominal Pain PSA

I've had a run of people admitted to the ICU after have 1-2 weeks of abdominal pain who were struggling to eat or drink that ended up having conditions leading to necrotic bowel. Dead bowel makes people incredibly sick. Like, death's door sick. Anecdotally, I'd say maybe 60% of our patients make it through such an ordeal. Every time I talk with their families, their loved ones say that they looked bad and they tried to get the patient to go get some help. Often, these people wait too long.

So.

PSA: if you're having abdominal pain and can't keep anything down for more than 48 hours (especially in the context of N/V WITHOUT bowel movements), you NEED to go to the ER. Not urgent care. Not your PCP. The ER. Please get checked out. Do not let things sit. If you have known GI disease like diverticulosis, a hernia, etc, even more of a reason to get checked out.

[real-reulbbr-band]

I headcanon Victoria to be a cat without claws, a trait that shaped her personality and interactions with others from a young age. Instead of feeling disadvantaged, compared to her peers, She felt an innate sense of apprehension whenever confronted with situations that hinted at potential physical conflict. 

Unlike other kittens who engaged in play fights, Victoria couldn't bring herself to participate. Instead, such scenarios only heightened her sense of caution, making her interactions more hesitant and reserved. Which led her more into hobbies like dance, and maintaining a peaceful demeanor, especially around kittens her age she encountered. Dancing didn’t require touch, at least when Victoria started, it was her escape, her expression, and she could Share it with others without touch. It wasn’t easy without the common stability of claws, but when she found her balance she achieved a grace like no one else. 

Her grace gave her an approachable aura, drawing others to her like a magnet, they were captivated by her sense of wonder and inherent softness. This same magnetic presence was evident when she crossed paths with the young Plato, who bore a harsh appearance, a stark contrast to her own gentleness. Despite his exterior, he often cast glances her way, though he remained silent, his curiosity was still palpable.

She had never seen anyone quite like him before. Jenny had brought him in, claiming she had discovered him lurking in a paper bag. Malnourished, wet, and frightened.

He had only been at the junkyard for a week, keeping mostly to himself, and finding solace in the company of the older cats rather than interacting much with those of his own age. When Victoria first noticed him, she couldn't help but feel a sense of compassion. Despite his withdrawn exterior, he appeared only slightly older than her, and his demeanor hinted at a past devoid of love, perhaps even lacking a home altogether. This was evident in his reluctance to forge connections with others, a hesitance Victoria couldn’t help but feel pitiful for. 

One afternoon, when Plato was waiting for Jennyanydots to return from patrol outside the car boot she approached him. For a moment, they just stared at one another, not exchanging a word, he didn’t seem all that bothered so Victoria moved closer. 

Despite her initial hesitation, Victoria extended her paw to Plato in a gesture of trust and understanding. It was a small act, but one that carried profound significance for both of them. Plato, unused to such displays of kindness, was initially confused but ultimately accepted Victoria's offer, gently holding her paw in his own, wrapping his claws around the area where her claws should be.

Though they came from different backgrounds, Victoria and Plato found solace in each other's company, as they grew up together, their paw-holding was like a secret touch between the two, Plato felt like the piece Victoria had been missing, her dance partner hiding in plain sight and she in turn brought a softness back to his soul that he believed was long gone. 

Thank you @seeking-chrysalism for beta reading <3

[airenyah]

you know how pat and wai can't stand each other at first but ultimately end up friends through pat's relationship with pran? and like, esp in ep12 and the our skyy special we can see that they do genuinely like each other

well, i'd like to think that while they are genuinely friends... i'd like to think that they have a little joking hostility going on once wai and pa start dating. not in the way they couldn't stand each other pre pat getting shot, but in a protecitve older brother vs boyfriend kind of way. where pat will be all "don't you DARE hurt my little sister", you know?

[samdeancrimespree]

thinking about sam and dean trying to pass the time on their endless road trip of a childhood. because half the time, there weren’t even enough cars to play license plate games, and there’s only so much i-spy you can play when the only thing around is trees or fields. so they would sit in the backseat together and look at the maps dad doesn’t need for navigating and giggle at weird place names. sam’s favourite was boring, oregon and dean’s favourite was hazard, connecticut.

[abrahamvanhelsings]

the people at the archives nationales want to see me dead but i also found out they built a stand at the notre dame just so people can watch the cranes move and the builders walk around the scaffolding and that did brighten up my day

[fyodior]

blegh

[kitkatcadillac]

pause. stop. hold the phone. arrête.

droit(e). right. opposite of left, right. the right thing, the right side. the direction to the right.

tourne droite. turn right. go in the righthand direction. that way. yes. turn

tout droit -> straight ahead. excuse me. how dare you

[mutantenfisch]

Pölle is missing Mama but looking cute while doing it

[fern-pajamabrain]

me 💅slayqueenearon💅 horriblemente al Sol de Mayo, no sé quien hizo esto pero pagará por sus crímenes

[rubbish78]

Live in Chicago 2008 (x)

[populationpensive]

Trauma Season

Well with nice weather comes all the traumas. It has begun.

It's fine - entering my 6th summer as a PA, I have a good barometer for the crazy shit that comes our way. At this point, it is fair to say that I've seen just about every weird fucking thing you can see.

I'll be picking up more HBOT than ICU over the next several months. Usually, I do 18 shifts in 6 weeks and 7 of those are HBOT. I'll be shooting for 9-12 for the time being.

Truth is, I am a little burnt out. And, if I am honest with myself, I have not really organized or processed some of the things I have seen and dealt with. Compartmentalize, yes. 110% great at that. But it's like my foggy ass brain is full of boxes that I need to unpack. I feel like a sponge that has soaked up too much.

We do an AWFUL fucking job at this in my specialty. Like, a horrible job. It didn't occur to me that this was a problem until recently when I had a difficult family. The patient came in brain dead and no matter how I tried or the approach I used, this family didn't believe their loved on was gone. I found myself rather angry and ultimately took a day off of work because I didn't want to interact with them or be around the situation. I had completely lost sight of the pain and grief these people were going through and was just...completely pissed at their ignorance. And while it is ok for me to feel frustration with the ignorance (truly, it took almost 2 weeks for them to get it), the intensity of that anger was...not normal.

I've been doing some version of critical care for 5 years. I love my job. I love the clinical complexity. I love the stories. But it has cost me mentally and emotionally.

I am so tired. All the time. I can't sleep enough if I tried.

I am bloated. Puffy. I feel alien in my own skin.

I am foggy. Exhausted. Apathetic. Blank. It's just...not ideal.

Honestly, if my work would let me be 0.8 FTE or something that would be great. At least temporarily. They won't do that (we are short staffed all the fucking time) but less time there would probably be good. Hence why my option to do less ICU is to do more HBOT.

My department would LOVE a straight HBOT person. Like, they are hankering for that. But lord that would be SO boring. I could not go from the continual excitement of ICU to...that.

I'll see how the next few months go. I have a lot of figure out moving forward but ultimately I have worked so hard to get where I am that I am unclear how ready I am to give up the privileges or autonomy I have earned for a different specialty. Only time will tell, I suppose.

[moonrecalled]

as much as i love the idea that ryoji doesn't even have a home for the sheer ironic potential of it, i feel like he probably has like a small apartment that he lives in when he's not in school. the universe literally rewrote itself to allow him into said school, after all, so it makes sense that the same thing would happen to give him a place to stay.

but i think it'd be interesting if it was like... really bare-bones and empty, save a couple of mementos he's picked up along the way over time that he keeps in his room?? the main reason being that he basically spends no time in there at all. he's always out and about with someone or another, and on the occasions where he is by himself, he's always outside admiring the scenery or doing something in the city instead.

he hates how it feels when he's alone, after all. and why would he, when there's so many people to meet and things to do in the world?

[topguncortez]

i'm gonna drop out and marry glen powell

[utterdrip]

goodnight friends!!!!!!

[strawberry-pretzels]

RUGHRGHAGHR TANGINA kailangan ko pa gumawa ng assignment para lang makareview sa quiz bukas......... tas un pa ung assignment na iniiwasan ko 🥰🥰hehe.. 😃 (😭😭😭 PUTA GUSTO KO NA MATULOG)

[prodkeiji]

be risky or be risky