#provide healthcare

[worldhumanitarianday]

Support people impacted by the violence in Haiti!

The allocation from the UN’s Central Emergency Response Fund (CERF) will go towards providing food, water, protection, healthcare, sanitation and hygiene support to displaced people and host communities in the capital and in the neighbouring Artibonite province. A $12 million contribution from a United Nations emergency humanitarian fund will support people impacted by the violence that broke out in Haiti’s capital, Port-au-Prince, in March. 

Learn more about the fund of $12 million for Haiti.

[pastadoughie]

[thebibliosphere]

Yesterday was my first time in the ER since my hEDS diagnosis was officially added to my file (instead of me having to tell them and hoping they’d believe me), and everyone in my emergency care team was on top of it. Like on the ball, fully engaged and interested in keeping the zebra in the hospital comfortable.

They also all knew what MCAS and POTS were and deferred to me when it came to medication and pain management. Which was also wild, because they were not shy at all about offering pain relief. They straight up offered me narcotics, when usually the most I get offered is Tylenol.

Even the CT tech knew what MCAS was and asked if we should pre-treat with Benadryl because he knew some patients could experience mast cell destabilization from the radiation even without the contrast dye.

He and the nurse even helped brace my neck when I was going into the CT machine because I mentioned having cranial instability, and the position I was in was making my neck click, so they stopped everything to find multiple pillows to brace my neck and shoulders while I was on the table.

Afterward, while being bussed through the corridors in my bed (because they had to dehydrate me to take the CT scan and my POTS was going haywire, and they made sure I had to be upright as little as possible), I commented to my nurse that I was startled that everyone I’d spoken to that day knew about EDS/MCAS/POTS and were so accommodating.

He paused before answering, then told me, “We probably don’t know as much about EDS as we should, but we’ve seen a lot of the other two over the last few years. Covid really messed people up. Did yours start with covid?” No, I told him. We think I was probably born with it and a dental infection turned it lethal. He expressed his sympathy and again reminded me I didn’t need to be a hero and I could press the pain med button whenever I needed to.

Back in my room, they started me on IV fluids to combat the dehydration from the POTS. And I was laying there, I became aware of the nurse bracing my elbow so it wouldn’t hyperextend while he futzed around with the IV and I remember thinking, “this is how it always should have been.”

The kindness and care shown to me were in such stark contrast to past experiences it made me quite tearful. There were no accusations of anxiety, no referrals to psyche, and no implications that I was over-exaggerating my pain. No denying of my experiences.

Just a quiet, vocal acceptance that I “knew my body best” and that they’d do whatever they could to help.

It was nice.

[melancholic-pigeon]

there is a special place in hell for cat owners who allow their cats to free-roam a residential neighborhood because it's ~natural~.

The amount of devastation and heartbreak I have seen from loved ones whose cats accidentally got out makes me like twice as mad too because I cannot. I cannot fathom the cruelty and selfishness required to ignore what we know to be best practice for cat husbandry because your feefees get uncomfies when people tell you it's animal abuse to wilfully, knowingly cut your cat's expected lifespan from 15-20 years to 2-3.

KEEP. YOUR. FUCKING. CATS. INSIDE.

[halorvic]

The danger is clear and present: COVID isn’t merely a respiratory illness; it’s a multi-dimensional threat impacting brain function, attacking almost all of the body’s organs, producing elevated risks of all kinds, and weakening our ability to fight off other diseases. Reinfections are thought to produce cumulative risks, and Long COVID is on the rise. Unfortunately, Long COVID is now being considered a long-term chronic illness — something many people will never fully recover from. Dr. Phillip Alvelda, a former program manager in DARPA’s Biological Technologies Office that pioneered the synthetic biology industry and the development of mRNA vaccine technology, is the founder of Medio Labs, a COVID diagnostic testing company. He has stepped forward as a strong critic of government COVID management, accusing health agencies of inadequacy and even deception. Alvelda is pushing for accountability and immediate action to tackle Long COVID and fend off future pandemics with stronger public health strategies. Contrary to public belief, he warns, COVID is not like the flu. New variants evolve much faster, making annual shots inadequate. He believes that if things continue as they are, with new COVID variants emerging and reinfections happening rapidly, the majority of Americans may eventually grapple with some form of Long COVID. Let’s repeat that: At the current rate of infection, most Americans may get Long COVID.

[...]

LP: A recent JAMA study found that US adults with Long COVID are more prone to depression and anxiety – and they’re struggling to afford treatment. Given the virus’s impact on the brain, I guess the link to mental health issues isn’t surprising. PA: There are all kinds of weird things going on that could be related to COVID’s cognitive effects. I’ll give you an example. We’ve noticed since the start of the pandemic that accidents are increasing. A report published by TRIP, a transportation research nonprofit, found that traffic fatalities in California increased by 22% from 2019 to 2022. They also found the likelihood of being killed in a traffic crash increased by 28% over that period. Other data, like studies from the National Highway Traffic Safety Administration, came to similar conclusions, reporting that traffic fatalities hit a 16-year high across the country in 2021. The TRIP report also looked at traffic fatalities on a national level and found that traffic fatalities increased by 19%. LP: What role might COVID play? PA: Research points to the various ways COVID attacks the brain. Some people who have been infected have suffered motor control damage, and that could be a factor in car crashes. News is beginning to emerge about other ways COVID impacts driving. For example, in Ireland, a driver’s COVID-related brain fog was linked to a crash that killed an elderly couple. Damage from COVID could be affecting people who are flying our planes, too. We’ve had pilots that had to quit because they couldn’t control the airplanes anymore. We know that medical events among U.S. military pilots were shown to have risen over 1,700% from 2019 to 2022, which the Pentagon attributes to the virus.

[...]

LP: You’ve criticized the track record of the CDC and the WHO – particularly their stubborn denial that COVID is airborne. PA: They knew the dangers of airborne transmission but refused to admit it for too long. They were warned repeatedly by scientists who studied aerosols. They instituted protections for themselves and for their kids against airborne transmission, but they didn’t tell the rest of us to do that.

[...]

LP: How would you grade Biden on how he’s handled the pandemic? PA: I’d give him an F. In some ways, he fails worse than Trump because more people have actually died from COVID on his watch than on Trump’s, though blame has to be shared with Republican governors and legislators who picked ideological fights opposing things like responsible masking, testing, vaccination, and ventilation improvements for partisan reasons. Biden’s administration has continued to promote the false idea that the vaccine is all that is needed, perpetuating the notion that the pandemic is over and you don’t need to do anything about it. Biden stopped the funding for surveillance and he stopped the funding for renewing vaccine advancement research. Trump allowed 400,000 people to die unnecessarily. The Biden administration policies have allowed more than 800,000 to 900,000 and counting.

[...]

LP: The situation with bird flu is certainly getting more concerning with the CDC confirming that a third person in the U.S. has tested positive after being exposed to infected cows. PA: Unfortunately, we’re repeating many of the same mistakes because we now know that the bird flu has made the jump to several species. The most important one now, of course, is the dairy cows. The dairy farmers have been refusing to let the government come in and inspect and test the cows. A team from Ohio State tested milk from a supermarket and found that 50% of the milk they tested was positive for bird flu viral particles.

[...]

PA: There’s a serious risk now in allowing the virus to freely evolve within the cow population. Each cow acts as a breeding ground for countless genetic mutations, potentially leading to strains capable of jumping to other species. If any of those countless genetic experiments within each cow prove successful in developing a strain transmissible to humans, we could face another pandemic – only this one could have a 58% death rate. Did you see the movie “Contagion?” It was remarkably accurate in its apocalyptic nature. And that virus only had a 20% death rate. If the bird flu makes the jump to human-to-human transition with even half of its current lethality, that would be disastrous.

[notmusa]

[welcome-to-green-hills]

To all of the lovelies that are concerned about having access to contraceptives in the USA, please know that Plan B has a shelf life of a few years when stored properly (Plan B Fact Sheet, 2024). The same can be said for Julie Plan B.

These are not abortion pills. These morning-after pills delay the ovulation process, which means the menstrual cycle starts quicker and prevents the fertilization of the egg. Take when needed and store safely. All of these can be bought online and/or Target and CVS.

[etakeh]

hate hate hate hate

[tainbocuailnge]

every service crucial to the functioning of society, namely government, healthcare, banking, etc, needs to at all times consider that people who are very stupid need to be able to navigate and use these services with minimal struggle, and people who don't have easy access to the internet or a smartphone also need to be able to navigate and use these services with minimal struggle. unfortunately many of the people who design these systems and services are in possession of a higher education a smartphone with consistent high speed internet connection and a critical lack of awareness about how universal these experiences are

[thescreamcorner]

Sometimes it's really really concerning how much anti-psychiatry and anti-recovery rhetoric exists-- and for once I'm not just talking about endos, but even within the OSDDID internetsphere, especially in actively pro self dx circles. It's not to say that you can't or shouldn't work on things away from a healthcare team, but with chronic and intensely debilitating disorders it is rare, if not impossible to fully be "fine" without help.

Like. If you're experiencing dissociative amnesia or memory/identity issues in general (even when caused by things as innocuously treated online like ADHD if it's at a debilitating level), you NEED someone who isn't affected by those things in order to have a sense of grounding and heal. And it's vital for that to be someone who has a baseline understanding of how dissociative disorders work.

My caseworker calls are sometimes the only thing giving me any sense of the passage of time, and she remembers things during calls that I completely forget or dissociate through. Not even my partner can consistently provide this because of her time blindness, vs the professional who reaches out, doesn't have a disorder affecting her memory, and takes notes during our calls.

My therapy visits, as infrequent as they've been lately, are some of the only reason why we've made progress toward one of our alters no longer making contact with our abusers when she fronts, and that fight isn't over yet. My partner can't stop her from doing it-- she'll wait until they're asleep. They also don't have the resources or bandwidth to address with her why doing this is bad, and if they intervene incorrectly it increases the chance that one day I wake up in another state.

I get from firsthand experience that healthcare, especially in the US, is notoriously inaccessible, and in some places the facilities available are full of inexperienced, incompassionate tools who don't care about their patients. But instead of using that as an excuse to stop trying, instead of pushing others into not seeking care and not trusting doctors, that needs to get channeled into finding and providing resources.

Many states have government funded healthcare available for those below the poverty line. Many facilities offer payment scaling plans even without insurance. A fair amount of insurance companies that "don't cover this" will make exceptions if you go through other channels and get professional referrals. It's not easy, it's not always free, and it's not fast. For those underage, it may be awhile before you can legally access it.

But for the love of all that is sacred on this burning planet, do NOT discourage trauma survivors from trying to get psychiatric help over the potential of a bad experience or a bad doctor. You are not helping people heal and learn to love themselves. You are creating paranoia and enforcing a regressive mentality that can prevent someone from reaching out before its too late.

[acepalindrome]

If you say that healthcare and shelter and food and clean water are human rights, that everyone deserves to be treated with a baseline of decency and respect, you have to accept that includes people you dislike, people you hate, even people you find morally reprehensible. And that’s good! Human rights are not conditional on how likable or good a person is! Everyone is entitled to them, no matter what! You don’t get to cherry pick who deserves to be treated like a human being!

[skyloftian-nutcase]

Provider Discretion (LU in Healthcare)

(Lots of technical jargon in this one, lovelies, hope you don’t mind)

Something wasn’t right.

The patient herself was… okay. Mostly. She had called 911 because she’d had back pain that had just been getting worse, and she’d said she couldn’t even get around anymore.

Mo and Hyrule often exchanged a somewhat exasperated look when someone called an emergency line for something that had been an ongoing problem, but today this… was different. She just didn’t look well.

“I’m really sorry,” the patient apologized for the fourth time as Hyrule and Mo loaded the stretcher into the ambulance.

“It’s okay,” Hyrule quickly reassured her. His heart ached a little at how much this woman wanted to seem to shrink into oblivion. Even Mo, who, despite his big heart, often came across a little standoffish, had tried to make her smile multiple times. “This is what we’re here for.”

With a chief complaint of back pain, there wasn’t much to do outside of check vital signs. Mo could easily take this call. But Hyrule just… this felt wrong.

“Let’s get a 12-lead,” he said, already grabbing the cables for it while Mo got vitals. His partner didn’t argue, helping him place the leads in the right positions.

Vitals looked mostly fine. The patient’s blood pressure was high. She said she had a history of hypertension, so perhaps between that and her pain that would explain it. Though 180/98 did not make Hyrule particularly happy. But he couldn’t treat that.

The 12-lead showed normal sinus rhythm. Nothing wrong there. But something just didn’t feel right.

Grabbing the blood pressure cuff, Hyrule checked it again, but on the opposite side.

There was a discrepancy.

Hyrule and Mo looked at each other, eyebrows pinching. Mo took a manual on the left. Hyrule took a manual on the right.

They still didn’t match.

Feeling dread fill him, Hyrule told Mo, “I’m taking this call. Let’s get going. We don’t need lights but… just drive expediently, ok?”

The transport was blessedly uneventful. But the discrepancy remained. Her blood pressure was high, but higher on one side than the other. Coupling that with back pain…

Her aorta. Hyrule was worried about her aorta. The biggest artery in this woman’s entire body could getting ready to tear apart.

When Hyrule texted Warriors later, he got his answer.

Dissection. They rushed her to the OR. You pointing out the BP difference really tipped off the doc. Good catch.

Mo whistled. “Good thing she didn’t rupture in our truck.”

Hyrule blew out a breath. He was just thankful he trusted his gut.

XXX

The dispatch information had been for diabetic emergency. Fire had gotten there first, which Aurora was thankful for since she and Dawn were coming from the hospital and therefore farther away than if they’d responded from the station.

When they arrived, the house was a nightmare. The street was so narrow that the ambulance and fire truck blocked the road entirely, the stairs were so narrow Aurora felt like she had to squeeze her arms in just to climb up them, and the turns were so sharp she wasn’t sure how any kind of equipment could get up there. The patient was lying on his bed, altered, and unable to move.

According to the patient’s friend, he’d heard him fall and came up to check on him. He knew he was a diabetic and figured his blood glucose had to be low. Fire had already checked it, saying it was over two hundred. As the firefighter paramedic gave information to Aurora, he said, “He could be acting like this because of his sugar. Could be a stroke. We’re not sure.”

Honestly, Aurora couldn’t see the patient all that well from her vantage point. Dawn had already walked in and started assessing, they’d handed a reeves stretcher to the firemen, and they were working on loading him on to it. The girl went downstairs to prep the stretcher for their arrival. Once they managed to get the patient into the ambulance, Aurora stared.

This man’s entire right side of his face was noticeably drooping. He was moving his head a little to the left, eyes somewhat moving, pupils equal. Aurora quickly asked him to look at her, to follow her finger. While he could stare at her, he couldn’t track at all, and his eyes wouldn’t move to the right. He blinked once while attempting, and was only able to blink his left eye.

Who the hell thought this could be his sugar??

Once Dawn got in the truck, they were quick to get vitals and a 12-lead. He was hypertensive, all other vitals fine.

“We need to stroke alert this,” Aurora immediately said.

“But he was last seen normal three hours ago,” Dawn said uncertainly. “Isn’t that outside the window? Or is the window four hours now?”

“I think it’s four,” Aurora answered. “And it doesn’t matter either way. This is absolutely a neuro issue. Drive us hot, okay?”

Dawn nodded, heading to the front. She drove to the hospital with the lights and sirens on, allowing them a faster transport time, while Aurora called it in to the hospital. As they progressed, she tried to get the patient to follow commands, but he couldn’t. He held up his right arm but couldn’t hold his left up at all, and he still didn’t really track any movement.

When they arrived at the hospital, they were placed in a major room, transferring him quickly to the hospital bed. Warriors was charge that night, working on coordinating all the help they’d need for this patient. The ED physician entered, looking the patient over, and then turned to Aurora, asking, “So what makes you think he’s having a stroke?”

Aurora stopped in mid motion, looking at him with the most enraged and bewildered expression. “I’m sorry, what?”

“Why do you think he’s having a stroke?” The doctor repeated.

“What makes you think he isn’t?!” Aurora snapped, completely mind blown that this was even a debate. “His face is drooping so low it’s hitting the earth’s fucking crust, he’s altered, not tracking movement, blinking with one eye, down on one side, is hypertensive, and you’re asking why I—do you even know what a stroke is??”

“Let’s just alert it,” Warriors said calmly as he walked into the room, clearly sensing that the paramedic was about to explode. “It’ll get us a CT to rule it out.”

Aurora was fuming, and she stormed out before she could hear a response. Dawn tried to gently check on her, only to be subjected to her ranting for the next hour.

Later, Warriors texted Hyrule, who relayed the message. “You were right.”

“OF FUCKING COURSE I WAS!”

XXX

Legend wasn’t particularly a fan of working triage.

There were aspects of it that were exciting - he was the one to make first contact with patients who didn’t come in via ambulance, and he determined their acuity. But there was also a public relations aspect to it, a patience dealing with impatient people, a kindness and sympathy for those who were genuinely hurting or needing help but had to wait anyway. It was understandable, but public relations… was not Legend’s forte.

There was a reason he was put in triage, though.

It wasn’t always obvious, what was wrong with someone. But there were times when a patient just didn’t look right. Legend saw the man limp over, listened to him as he explained that he had some leg pain that had been going on for the last few days, how he thought maybe he’d strained a muscle but the pain hadn’t improved.

There were always signs to look out for. Little things, cues that something was off. The man looked resigned, reluctant; he clearly had been talked in to coming to the hospital, and he commented that his wife insisted on it. Legend saw the clothes he wore, heard the accent he spoke with, saw his muscles, and pieced together that he was probably a farmer.

Farmers never came to the hospital.

“We’ll get you back as soon as we can,” he finally said after completing his assessment. Usually, this patient would be low on the acuity scale—a muscle spasm or strain was not nearly as important as a heart attack, pneumonia, sepsis, strokes, traumas—but Legend made him a yellow rather than a green. Just to be sure.

That higher acuity score got him a room far faster. That faster room made a doctor assess him and notice that his left leg was bigger than his right. That doctor made sure he got an ultrasound of his leg, found clots in his leg. She also learned the man was short of breath sometimes, which his wife insisted was new, and got a CT scan.

Legend glanced at his chart later to see him being admitted. Confused and curious, he did some digging.

The man had a pulmonary embolism.

Huffing with a small smile of satisfaction, Legend closed out of the chart as another patient approached.

XXX

Time had to admit, he did not spend as much time assessing his patients as he should. His hours were stolen away in the OR, unpredictable and chaotic as his line of work was. So sometimes he didn’t get to round, sometimes he didn’t have a chance to walk in and chat with the patients and the nurses and the licensed independent providers who took charge of their care.

Today he was glad he did.

The patient was actually calm and pleasant, had little complaint of anything except for some lower back pain. In the world of uncomfortable hospital beds, it wasn’t a huge surprise.

But Time saw something. Some staining, bruising, around the patient’s groin. He peeked around their gown, turned them a little, and saw it.

Their groin was purple. He asked the nurse, who said they were told this had been baseline for a day or two, and that the independent providers over them had acknowledged the finding and moved on.

Time walked into the doc box where the providers were. “I want a CT abdomen for room 3. She’s got some bruising that’s concerning. Her H&H has been down trending steadily.”

“Her JP drains haven’t put out much,” the physician assistant noted, looking over the patient’s chart.

“She might have a retroperitoneal bleed,” Time pointed out. “Let’s just be sure.”

Years of education and even more years of experience had taught the trauma surgeon well. The war was especially humbling and educational. So when he got a text from the PA that the patient did indeed have a retroperitoneal, he wasn’t surprised. But he was disappointed that he had to be the one to notice it.

Sometimes, he supposed, it took the leader to point out the problem.

XXX

Four… didn’t like this.

Report had been bad enough. The day shift nurse spoke of how the patient had been previously septic and was recuperating well before her pressor demand had gone up during the day. She looked… not great. She was so edematous they were constantly changing the sheets underneath her arms because her body was leaking fluid from every inch of itself - they had dumped fluids into her over the last few days just to maintain her blood pressure. She was on a lasix drip to get her lot o pee off the fluid as best as possible, and her kidney function was… decent, but not great.

As Four assessed her, the clenching his chest only worsened. She was alert, oriented, a little miserable but trying to be in good spirits, bless her. She was peeing a decent amount, her pulses were present despite the swelling, her lung sounds were a little coarse but overall mostly clear. Her abdomen was soft and non-tender, her pupils were equal and reactive, and she didn’t have much complaint of pain aside from being sick of laying in bed, which Four could understand.

But still. This just… didn’t look great.

As the night progressed, the woman’s pressor need climbed. Four continued to increase epinephrine, increase norepinephrine. He tried not to increase the vasopressin too much as it had such a profound effect on vasoconstriction that it could cause necrosis. Also, the woman had a history of heart failure and had a pretty weak heart.

Four eventually went to the resident in charge of the patient for the night. “Hey. Can we maybe give 11 some albumin? She has plenty of fluid to give, but clearly it isn’t in her vasculature - she’s peeing ok but her pressure isn’t tolerating it. I feel like it could help.”

The resident shuffled on his feet uncertainly. “The surgeon really wants to make sure we can get this fluid off. I’d rather keep her negative and not give her more fluid, you know?”

“Yeah, I get that,” Four greed before continuing, “But albumin is only 250mL, and if it helps suck in the fluid that’s third spacing, it’ll still help. We’re dumping fluid in her through the pressors anyway.”

The resident continued to waffle, before the night attending asked, “She’s on vaso, right?”

“Yes.”

“Just go up on that.”

Four stared a moment longer, starting to doubt himself. He hadn’t been a nurse for long, and if an attending physician was saying this, then… it had to be true, right?

Sighing, he went back to the room and did as he was told. The patient’s blood pressure improved well enough, and the night progressed fine.

The next night was not as fine. At rounds, Four suggested that perhaps she should be lined for CRRT, a continuous dialysis that would allow for Four to control how much fluid they were pulling and would likely be better for the patient to tolerate. The night doctors shrugged, saying they’d mention it to the day team.

Again, the woman’s blood pressure was tanking. Again, Four had to increase pressors. Vaso had been turned down and was told to be left alone because the woman’s systemic vascular resistance was so high the attending was worried about her heart. (Four couldn’t help but feel a little bitter about it, because he knew that was going to happen)

This time, though, she went into atrial fibrillation as well. As Four called the resident and attending into the room, they deliberated the matter, muttering, “Maybe we should line her for CRRT.”

Four blinked. Stared. Was he… losing his mind?? Was he invisible? He’d suggested this earlier!

Ultimately, Four had managed to keep the patient stable enough so that it wasn’t needed. Ultimately, the shift ended uneventfully.

But when Four came back for his third night, he could hear the woman’s breathing from the door, he could hear how she was drowning in fluid because she couldn’t tolerate losing fluid but had too much for her lungs and heart to handle. The day team had lined her for CRRT, but her pressors were almost maxed out at their dosage, and she was so hypotensive that the renal nurse who had set up the machine was hesitant to start it up, saying it would further bottom out her pressure.

Tonight was different, though. Tonight, the provider in charge of making decisions and orders was a nurse practitioner, someone who was used to this unit. She walked in, saw the issues Four had seen, and she walked right back out, making a call.

Four struggled to keep the patient alive long enough for the ECMO team to arrive as the patient fell apart. He felt frustration boil his blood as he had to hand off her care after fighting for her, had to watch as the CV ICU nurse came in to take over while surgeons put large cannulas into the patient’s body to redirect blood flow around her heart so she could still perfuse her organs. He watched as they wheeled her out of the trauma ICU to go to the cardiac ICU where she would remain while on such extreme support, and he threw his pen on the desk, burying his face in his hands, fuming.

They should have listened to him.

[vyeoh]

My new favorite thing is when a nurse congratulates me on losing weight on my yearly check up around finals season, responding with "oh yeah I forget to eat or exercise when I'm stressed :// trying to work on it" and feel the vibe in the room get so much worse

[bluebstopcat]

Every time a "chat with AI" button shows up in a piece of software that I am required to use and has no alternative I get a little bit more radicalized.

[uncanny-tranny]

Even if you don't agree with incarcerated people having access to education, monetary compensation for work, or whatever, I really hope you acknowledge that so long as you provide the state incentive to imprison people (free labour or whatever it may be), the state will continuously imprison people - especially for non-violent crime.

[wikipediapictures]

Midwife

“Midwife with child in Oslo, Norway.” - via Wikimedia Commons