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cripplecharacters · 5 months ago

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Hi! I was actually wondering if you all could do a really in-depth post specifically on canes versus forearm crutches. I’ve noticed a couple of the recent asks pertain to it, and I think I myself still have one in the queue related to it, but in all of the posts y’all link us too in your answers to those asks, I have found the information is still very sparse and doesn’t directly compare the two in a lot of detail. I would really really love to see a specific dedicated post that breaks down the differences Between them directly, and goes into a lot more detail about what kind of person might prefer a cane and what kind of person might prefer forearm crutches. Differences in conditions, pain levels, fatigue levels, location of issue on their body, other symptoms, examples of disabilities that might more commonly default to one over the other, all that stuff. I’ve looked through basically all your posts on the subject I can find, and still feel like it’s really only scratching the surface, so if there’s a way y’all would be willing to do one big post on this topic specifically, I know at least I would really love it and I think others would as well! Most of the existing posts are a little too broad and surface level, and while I have found them super helpful as a starting point, I would love to see one that zooms in just on these two mobility aids rather than a broad overview of all types of mobility aids being compared like most of the existing resources y’all have. Seriously love what you all do and I would be extremely grateful for this!

Hi anon, just for you:

On Writing Characters Using Canes vs Crutches

[large text: On Writing Characters Using Canes vs Crutches]

This is a writing advice post that doesn't cover every single possibility because that's too impossible to try and do. It's simplified (!!!) to be coherent for writers who have little to no experience with these sorts of mobility aids, and I encourage anyone who wants to write a character using either of these to treat this post as a small part of a larger research process. This post will contain generalizations for the purpose of me wanting to actually finish it. This is writing advice, not medical information, nor something you should be applying to real life.

Please keep in mind that a lot of the disability examples will only be shown in a single category because otherwise this would be a comical block of text. So yeah, I know that a ton of conditions outside the "chronic pain" category also come with chronic pain, but I want this list to be actually easy to look through.

This will compare the cane (singular stick) to crutches (two sticks). Differences between a singular crutch and two canes will be at the end.

Canes

[large text: Canes]

The most primitive mobility aid that's out there. A wrist-height stick with a handle. You hold it in your hand (at a rather natural angle) and that's mostly it - it's meant to follow a standard (left leg forward, right arm forward) gait and be a support meant for generally milder mobility issues. A cane can take up to 25% of body weight, so like half of what a leg does.

As a TLDR, here's what they could be:

One leg unable to bear the entire weight (but not completely unable) - this could be a result of a problem anywhere from the bottom of the foot all the way to the hip.

Milder balance problems - largely neurological, so either a condition that affects the brain, the spinal cord, or the nerves in the leg. There are also some autoimmune, respiratory, and cardiovascular causes as well, plus a few more.

Back/trunk problems, most commonly pain.

To use a cane you need two legs, most people who use canes for leg reasons will have a “good leg” and a “bad leg”. If this is the case, you'd typically hold the cane on the good leg side, as that redistributes the weight - and pain - between the bad leg and the cane.

The good leg needs to be able to bear the whole weight comfortably, the bad leg needs to be able to bear, at the very least, half of the weight. If the disability affects legs to the point where either:

both have problems weight-bearing;

one can't bear weight at all (e.g., amputation, flaccid paralysis, pain too severe);

then two crutches (or other mobility aid, like a wheelchair) would be the move. The cane doesn't replace an entire leg and is meant to be a minor support.

Examples of what would cause someone to use a cane:

Monoplegia or hemiplegia that is spastic (rigid) in the leg. This could be a result of stroke, traumatic brain injury, cerebral palsy, multiple sclerosis, nerve damage, Brown-Séquard syndrome, polio, encephalitis, transverse myelitis, progressive multifocal leukoencephalopathy, alternating hemiplegia of childhood, hemiplegic migraines, or being a hemispherectomy survivor. And many more things.

Chronic pain; arthritis, hypermobility spectrum disorders, chronic patellar instability, h-EDS, neuropathy, peripheral artery disease, past injuries (e.g., broken foot that healed incorrectly), systemic lupus erythematosus, joint replacement, chronic bursitis, and a lot more.

Relatively minor fatigue - most fatigue disorders will be on a wide spectrum, and people's symptoms often vary a lot. But a cane could help with fibromyalgia, Charcot Marie Tooth disease, POTS, scoliosis, severe kyphosis/lordosis, COPD (and other respiratory conditions), or milder forms of CFS/ME. Someone undergoing chemotherapy (or taking some other fatigue-causing medication) could also use one.

Muscle conditions, which are an even bigger spectrum. Spinal muscular atrophy type 3 and 4, early Limb-Girdle muscular dystrophy, tibial MD, Becker MD, or early myotonic dystrophy type 2 can all be reasons to use a cane. Keep in mind that these have drastically different presentations from person to person, and it's not entirely unusual for two people with the same kind of muscular dystrophy to use very different mobility aids (e.g., a tilt-in-space powerchair vs ...no aid at all). These are just the ones where I'm aware of a person who 1) has it, 2) uses a cane, even if it's not the most common aid.

Prosthetic leg on one side; usually below knee (high level amputees will more often go for crutches, even if they use a prosthetic).

The second biggest reason why people use a cane is balance. For this the cane can be held in either hand; some people have a preference, generally for the non-dominant hand for convenience - although many people with balance problems will also have a coordination disorder that might make using their non-dominant hand too difficult. Some people will switch the side they hold it on.

For a lot of people with balance problems, a cane might be the aid they use at home, and use a rollator or a wheelchair outside.

A good cane for balance purposes is a quad cane - it has four legs at the bottom and offer more stability than the single point equivalent. However, the larger base might also mean that for some people it can be easier to hit it with their foot, which ranges from annoying to dangerous.

Examples of disabilities that affect balance;

Many of the things included in the first section - primarily those that directly affect the brain or nerves.

Conditions that cause vertigo - again, many of the same things as before because a lot of them tend to originate in the brain. So other than aforementioned meningitis or stroke and the like: Ramsay Hunt syndrome, migraines, basically any sort of brain damage, POTS, Meniere's disease, labyrinthitis.

Respiratory problems, like chronic obstructive pulmonary disease, severe asthma, or lupus.

Coordination disorders - again, a lot of overlap with aforementioned disabilities, so I'll skip to things I haven't mentioned yet. Ataxia could be caused by a lot of things; some include the Chiari malformation, ataxia-telangiectasia, Friedrich's ataxia, Parkinson's, brain tumors, or Niemann-Pick disease. Dystonia is usually a primary condition rather than being caused by other things (although it can be!). Dyspraxia is also a coordination disorder generally milder than ataxia, and canes can be potentially helpful for it as well.

As mentioned before, some coordination disorders will affect the upper limbs as well, and it might be too difficult to use a cane. For disabilities like Huntington’s disease, or ataxia that significantly affects the hands, rollators and wheelchairs tend to be more helpful.

Anything that causes the person to fall. Fall risk is the primary reason people use canes.

A cane can also be used for back/trunk issues. One can lift off some weight of the body from above the Problem by putting the weight on the arm instead. I have really severe kyphosis as well as (partial) trunk muscle atrophy/coordination problems and quite literally can't straighten my back for more than a few minutes at most - my cane allows me to do that more easily and without needing to think about it as much.

Examples of some conditions that cause that include;

sciatica;

degenerative disk disease;

past spine injury;

scoliosis or severe kyphosis/lordosis.

In my experience, you need fairly good arm strength to use a cane comfortably. For people with more significant weakness in upper limbs, rollators tend to work better.

Grip strength is also important; there are canes designed to mitigate this (the platform cane/crutch comes to mind) but they're not the most common because often (not always!) when someone has this issue they already require a larger mobility aid.

Canes are often a "starting" mobility aid, i.e., a person starts using it at first but later transitions to using something else as their disability progresses (or they realize that it wasn't adequate in the first place, it mostly happens with slowly progressive conditions - when they decide to get a cane, it's often just too late). A cane can be useful at the very start of an onset of amyotrophic lateral sclerosis, but it's basically worthless beyond that.

Similarly (kind of), a cane can be the "smaller" mobility aid for someone who uses multiple of them at the same time. Someone dealing with fatigue could use a cane at home, but need a rollator for going out, or a wheelchair for longer trips. Another person could use a cane when going out with a prosthetic leg on, but use a wheelchair or crutches at home when not wearing the prosthetic.

Crutches

[large text: Crutches]

These are more complex and provide more help. Crutches directly affect your gait depending on the exact disability, and take away both hands. They can potentially take up to 100% of body weight for parts of the walking cycle if you have good upper body strength and balance, and 50% otherwise (so, one good or two half-good legs still required).

Crutches are used for a lot of things (realistically too many to cover here) so I'll just go with the main categories that encompass most of them.

A) Both legs can't fully bear weight;

The same things as in the cane section, but present on both sides rather than one.

Hypotonia; can be caused by thousands of things. Some include Down syndrome, Tay-Sachs syndrome, achondroplasia, being born prematurely, brain damage, and congenital hypothyroidism.

Paraplegia that's low-level and/or incomplete, or quadriplegia that's incomplete. Quadriplegia is a huge spectrum as well, and it will depend on the amount of strength and flexibility that the individual person has in their arms and hands.

Bilateral amputation with prosthetics. (Someone who can bear weight no problem but has a milder balance problem could use a cane instead.)

B) One leg can't bear any or a lot of weight;

The same things as in the cane section, they're basically all on a spectrum, so some people choose a cane and others choose crutches.

Unilateral amputation, or congenital limb difference.

Limb length discrepancy where it doesn't touch the ground or barely does so.

C) Significant balance issues;

Same things as for canes, but either more severe or just someone's personal preference.

D) Back/trunk pain;

Same as C).

Additional note based on things I have seen: you can't use crutches if you have no legs and no prosthetics. You can't walk literally just on crutches. You need at least a single leg or prosthetic.

(Yeah I'm aware that there's probably a guy somewhere who does tricks where he does exactly that for a short video. That's Crutches Georg and he should not be counted because 99.9% of crutches users won't be doing that ever.)

Crutches will provide much more stability and relieve more pressure than a cane, but there is a wide range of the amount of support depending on how they are utilized.

What the disability is can actually present itself in the person's gait - there are a few main ones that are associated with crutches;

Four-point. The two legs and two crutches work as four different points of support, and three of them are in contact with the ground at any time. A lot (not all!) of people who use it will use crutches full-time and/or not be able to stand without them. The most stable and the slowest out of all of these.

Three-point. Probably the one most people have in mind when thinking crutches? The crutches both move at the same time, along with the bad leg, then the good leg follows. This is the "broken leg in a cast" way of walking.

Two-point. The closest to how non-crutch users generally walk. It's like having a cane on each side; left crutch forward, right leg forward. Fairly fast.

Step-to. The crutches work as one point of contact, and the legs as the other - both of each will move forward at the same time. In the step-to, a person puts their feet at the crutches' height. Fairly fast as well.

and step-through. I'd say the most difficult, least stable, providing the least amount of support. The same as in step-to, both crutches go forward before both legs, however here the legs get swung through them while the person is only holding up on crutches. This is the fastest that it gets, and can definitely be faster than an abled person walking. You can run quickly like this.

If you have issues visualizing them, there are a lot of great demonstrations on YouTube that you can look up for clarification.

There are a lot of subtle differences in which one people end up using, but as a rule of thumb, the more balance they lack, the more points of support they need. To provide some examples;

a person with quadriplegic cerebral palsy might lack balance and coordination, so they might use a four-point gait.

A person with one-sided tarsal tunnel syndrome can walk with a three-point gait, as it can be used to mitigate weight-bearing fully or partially - if the pain gets worse, they can just... not touch the ground with that leg.

A person with incomplete thoracic spinal cord injury could also work with a three point gait, though they would put both legs on the ground. If someone has good strength in the arms and trunk, they can get both crutches in the front along with one leg, then try to get the second one to go forward as well. This is how a lot of crutch users with a disability affecting two legs, but with decent balance and upper body strength, walk.

A person who had a traumatic brain injury and now experiences balance problems but not as much leg issues could opt for a two-point gait. It does help with weight redistribution, but primarily provides a lot of balance.

Both step-to and step-through are primarily used by single-leg problem havers (like unilateral amputees) in my experience, but I've seen people with diplegia or incomplete low-level spastic paraplegia use it too. You need very good balance and good upper body strength. I've seen dudes do backflips and ride skateboards on crutches like this. You can run as well and be way faster than you think.

The same as canes, crutches require arm strength. The more you're looking to take away from the legs, the more will go to the shoulders. If someone doesn't have the needed arm strength, a rollator will be more helpful. Walkers not so much as they still require some strength to turn.

More Direct Comparisons

[large text: More Direct Comparisons]

The differences between pain and fatigue levels might be somewhat evident from comparing the sections above - to generalize the subject as much as possible: the bigger the pain or the fatigue, the higher possibility of using crutches over a cane is. They provide more relief for both, as well as providing more balance.

Now, there's always exceptions. Someone might not be able to use two sticks, because of a disability affecting one of the arms - hemiplegia is a common example. In this case, the person could prefer to use a single crutch rather than two. They could opt for platform crutches, which don't require as secure of a grip. They might need a rollator instead. They might have a powerchair that they operate with their good arm.

Another thing is that some people will use crutches even if a cane would work just as well. Some people like the grip more, or find them easier to use. They could also like that crutches are seen as more medical than a cane, which could be seen as a fashion accessory. Maybe they can be faster on crutches than with a cane (e.g., if their disability is limited to a single leg, getting it out of the walk cycle might be more convenient) and that matters to them.

And to go with this, some people just don't like crutches! I personally don't like the forearm cuff because I tend to swing my wrist around with my cane rather than hold it perfectly straight, so the cuff seems annoying. For someone else that could be more than a preference, e.g. if they have a limb difference that affects the length of their forearms to be much shorter - a person like this could prefer two canes.

As to what mobility aids are better for which disabilities, it's highly individualized, but to heavily generalize again: canes tend to be more helpful for relatively milder disabilities, and crutches for relatively more significant ones based on the amount of support they provide. But that's an oversimplification so simple that it's not really useful.

Someone with neuropathy in parts of their foot might find a cane completely sufficient, but it wouldn't be as useful for someone with nerve damage that caused flaccid paralysis from the hip down; they would probably prefer crutches. But then again, someone with mild vertigo could use crutches because they prefer them (even if a cane would work just fine) while someone else might have incomplete C6 quadriplegia and use a cane with leg braces over crutches because they enjoy having a free hand.

For more similarities between the two; overuse injuries can happen to both cane and crutch users, generally in the shoulder(s). They're not very common unless you're putting more weight on them than you're supposed to. They're very annoying because it drastically tanks your mobility until they get better (unless you can walk without them just as much that is), but they're treatable with physical therapy.

Now for the two canes and a singular crutch. Let's start with the fact that the latter is infinitely more popular than the former. It's basically the same as a single cane but more supportive; it's good for people who need more balance than a cane provides but can't use both hands. Two canes is very rare and I can't tell you what the actual pattern of choosing them over other options is outside personal preference because I have no idea.

The general conclusion of the post is that crutches and canes really aren't that different, and are more of a spectrum of usable sticks by the amount of support they provide to the user. That's why often you'll see canes and crutches listed as the same thing when it comes to "management of XYZ disability" type resources - for a lot of them they're rather similar in practice, especially when compared to rollators, walkers, scooters, or wheelchairs.

I hope this was more in depth and therefore more helpful, if this still leaves you with some unanswered question feel free to reach out again.

mod Sasza

#mod sasza #anonymous #crutches #canes #long post #disabled character ideas

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covid-safer-hotties · 3 months ago

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Also preserved on our archive

By Jamie Ducharme

When you reach for a COVID-19 test, it’s probably because you’ve got a scratchy throat, runny nose, or cough. But those are far from the only symptoms that make Dr. Rohit Jain, an internal medicine doctor at PennState Health, suspect the virus.

These days, when someone complains of nausea, diarrhea, or vomiting, “I always get a COVID test on that patient,” Jain says.

Why? Despite its reputation as a respiratory virus, SARS-CoV-2 can also have a profound impact on the gut. Although most people don’t realize it, “COVID-19 really is a GI-tract disease” as well as a respiratory illness, says Dr. Mark Rupp, chief of infectious diseases at the University of Nebraska Medical Center.

Here’s what to know about the gastrointestinal symptoms of COVID-19.

What are the GI symptoms of COVID-19? While some people experience no gastrointestinal symptoms or mild ones, a subset of COVID-19 patients have experienced significant digestive symptoms since the early days of the pandemic.

Loss of appetite, nausea, vomiting, diarrhea, and stomach pain are common GI symptoms of COVID-19, according to Jain’s research. Some people experience these issues as their first signs of infection, he says, while others initially experience cold-like symptoms and develop gastrointestinal issues as their illness progresses.

It’s not entirely clear why the same virus can affect people so differently, but it’s good to be aware that SARS-CoV-2 can result in a wide range of symptoms, Rupp says.

How long do GI symptoms of COVID-19 last? Some patients recover in a matter of days, Jain says, while others may suffer from diarrhea and other symptoms for weeks.

Still others may be sick for even longer. Gastrointestinal problems are a common manifestation of Long COVID, the name for chronic symptoms that follow a case of COVID-19 and can last indefinitely.

One recent study in Clinical Gastroenterology and Hepatology found that, among a small group of adults who were hospitalized when they had acute COVID-19, more than 40% who originally experienced GI problems such as stomach pain, nausea, vomiting, or diarrhea still had at least one a year or more later. Overall, whether they were hospitalized or not, adults who have had COVID-19 are about 36% more likely than uninfected people to develop gastrointestinal disorders including ulcers, pancreatitis, IBS, and acid reflux, according to a 2023 study published in Nature Communications.

GI problems are also common among kids with Long COVID. Stomach pain, nausea, and vomiting are telltale signs of the condition among children younger than 12, according to 2024 research published in JAMA.

Why a respiratory virus affects the gut How can the same virus cause both a runny nose and the runs?

Once SARS-CoV-2 gets into your body, it infects cells by binding to a protein called ACE2, which is found throughout the body. ACE2 is prevalent in the lungs, which helps explain COVID-19’s respiratory symptoms—but it’s also found in high concentrations in the gastrointestinal tract, “so it makes sense that the GI tract would be a target for the virus,” Rupp says. It’s in part because SARS-CoV-2 collects in the gut that wastewater surveillance is a useful tool for tracking the virus’ spread, Rupp adds.

Studies have shown that the virus can hide out in the “nooks and crannies” of the digestive system for months or even years, says Ziyad Al-Aly, a clinical epidemiologist at the Washington University School of Medicine in St. Louis who co-authored the Nature Communications study on chronic post-COVID GI symptoms. This may explain why gut-related symptoms can long outlast an acute infection, Al-Aly says—but there are many potential hypotheses in play, and researchers don’t know for sure which one or ones are correct.

For example, many researchers also think the virus is capable of causing widespread and sometimes long-lasting inflammation, potentially affecting organs throughout the body. This inflammatory response may have trickle-down effects on the gut microbiome, the colony of bacteria and other microbes that live in the GI tract, Rupp says. “We’re just scratching the surface as to what happens there,” Rupp says, but studies have already shown that SARS-CoV-2 can change the composition of the gut microbiome both during an acute infection and chronically.

There’s also a complex relationship between the gut and the brain, adds Dr. Badih Joseph Elmunzer, a gastroenterologist at the Medical University of South Carolina and co-author of the Clinical Gastroenterology and Hepatology study on prolonged post-COVID GI symptoms. His research suggests people are particularly likely to suffer long-term GI problems if they also have signs of PTSD from their acute illness or hospitalization.

That’s not to say GI symptoms are all in patients’ heads; on the contrary, Elmunzer says, they are very real. But, he says, there’s a lot left to learn about the microbiome, the gut, and the myriad ways they interact with other bodily systems.

#mask up #covid #pandemic #covid 19 #wear a mask #public health #coronavirus #sars cov 2 #still coviding #wear a respirator #long covid #covid conscious #covid is airborne

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moonchild033 · 5 months ago

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D6 chart: Dissection of 6H 😌❤

How to draw a D6 chart manually by yourself? 💅😽

Since many websites are not too accurate in divisional charts, I thought I'll tell you an easy way of calculation to draw by yourself. Even if it is accurate, I think it is worthy or knowledgeable to know and not depend on anything. Trust your own brain more than the computers, it goes a long way, that's what I believe in. 🤗💛

OKAYYY SO---LITTLE MATH TIME---😉

One zodiac sign has 30 degrees. The stars and padas are assigned between these 30 degrees. D6 is dividing a single zodiac sign house into 6 parts (Baby math-> Divide 30 by 6 = 5). So, 5 degrees for each part. 👍

Now, how many zodiac houses are there? 12.

The male zodiac signs are- Aries, Gemini, Leo, Libra, Sagittarius and Aquarius.

The female zodiac signs are- Taurus, Cancer, Virgo, Scorpio, Capricorn and Pisces.

I think ya'll know that before, it's just the alternative signs but I added it for your reference as it is the most important part in drawing D6.

If any planet is in the assigned male zodiac signs in the D1 chart, they get assigned between Aries to Virgo in the D6 chart. If any planet is in the female zodiac signs in the D1 chart, they get assigned between Libra to Pisces in the D6 chart. 😃💜

Now how to assign the houses for planets in D6 chart? 🤫🤔

In your D1 chart, if a planet is present in a male zodiac sign and between 1-5°, assign the planet in Aries in D6. If the planet degree is between 5.1-10°, it gets Taurus house, 10.1-15° (Gemini), 15.1-20° (Cancer), 20.1-25° (Leo) and 25.1-30° (Virgo). Ex.: If mars is in Leo at 6° in your D1 chart, you assign it in Taurus in D6. If Venus is in Aquarius at 22°, you assign it in Leo in D6. 😌💙

In your D1 chart, if a planet is present in a female zodiac sign and between 1-5° (Libra house in D6), 5.1-10° (Scorpio), 10.1-15° (Sagittarius), 15.1-20° (Capricorn), 20.1-25° (Aquarius) and 25.1°-30° (Pisces). Ex.: If Jupiter is in Taurus at 29°, you assign it to Pisces in D6.

Just remember not to mess up with the male and female zodiac signs. Assign all the planets and ascendant like this, now you have made your very own D6 chart! 😍🤩

Few notes on D6 chart 💅🤫:

If the 6H lord of your D1 chart is assigned in a male zodiac sign in the D6 chart, you will get problems from the male gender in your life. If you are a male, you can end up having bad friendships, a boss who doesn't like you or targets you often, ur brothers can turn up against you or just not be supportive enough. If you are a female, be cautious with male friendships, they might exploit you or spoil your name. Some of the females could've faced harassment too. 🧡

If the 6H lord of your D1 chart is assigned in a female zodiac sign in the D6 chart, your problems or enmity will be from the female gender. If you are a male, your spouse can be less supportive, you could've had issues with your female colleagues. If you are a female, your female friends could be fake, toxic or extremely jealous of you and try to bring you down.💚

6H lord of D1 in the following signs in D6 and the kind of medical condition they are more prone to have-

Aries- Constant or consistent headache like migraines, Eyesight problems, Head injuries.

Taurus- Tonsillitis or other throat related problems, straining in the voice box, Neck injuries.

Gemini- Asthma, Bronchitis or other respiratory tract inflammation.

Cancer- Problems related to breast area, tightness in chest.

Leo- Heart and circulatory system malfunctions, high cholesterol.

Virgo- Digestive tract ailments, Frequent stomach aches, Sensitive digestive system

Libra- Pain in the vertebral column, especially while sitting, skin infections

Scorpio- Reproductive issues like fibroids, endometriosis , Hormonal imbalances

Sagittarius - Hip or thigh pain, prone to dislocation or injuries in that area.

Capricorn - Joint pain, knee pain and related issues like rheumatoid arthritis.

Aquarius- Ankle or calves pain or injury, can get scars in those areas.

Pisces - Swelling in feet, difficulty in moving toes, varicose veins (even Aquarius can get this).

If 6H lord of D1 sits in own house or exaltation sign in D6 chart, the native may get an authoritative position in government sectors. 💥🖤

Note: These ailments are what you can be prone to, so that you can keep yourself healthy and focus on those areas. This is not to make you feel afraid or sad. Always stay happy and healthy. 🤗

Feel free to comment down your thoughts/questions! 🤗

Let's Learn and Grow Together 💅💋

With Love- Yashi ❤⚡

Here's my Masterlist! 💖

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fortheloveofwonderland · 5 months ago

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Rusty | Chapter 23 | S.R

Previous Chapter | Next Chapter

A/N - penultimate chapter.

Summary - Spencer’s navigates being in alone in the ICU with his ghosts. Luke tries and fails to get through to him.

Pairing - Spencer Reid / Fem! Reader

Category - strangers to friends to lovers | angst | smut minors DNI

Warnings - hints at sexual activity (m/m), swearing, DID, talk of antipsychotic medication, a lot of internal monologging, mentions of urine, UTI, respiratory problems, suicidal ideation, mention of past sexual assault, past near relapse, heavy talk of hospital related things.

WC - 6.6k

Chapter 23 - Only the Lonely

It was unlikely you would have been able to sleep given everything that was running through your exhausted brain. With Spencer back on the ventilator in the ICU, succumbing to multiple personalities when he was awake, the fear was consuming.

You still hadn’t seen him, not even stepped in the room while he was sedated. Your time left together was getting shorter by the day and you knew it would soon be over. You shouldn’t be wasting a second away from him, but you couldn’t bring yourself to face him yet.

Even if your mind hadn’t been awash with thoughts of him in the hospital, you wouldn’t have gotten much rest anyway, given the activities taking place in your guest room next door. Luke and Grant had been going at it all night long, their moans and the banging of the headboard enough to wake the dead.

Copper had been perturbed by it too, deciding to sleep in bed curled up with you and occasionally barking if the noise got too loud. The men next door didn’t seem to notice.

You stifled a yawn as you leant against the kitchen counter, sipping coffee from a mug cradled between your hands. Copper was eating his kibble you’d put down for him and would no doubt need letting out for a good run considering he’d mostly been cooped up in the house for the last few days.

You needed to sort the horses too, Willow and Rusty had been extremely neglected recently and you were sure they both needed out of their stable for an hour or so to meander in the field.

You heard footsteps on the stairs and you braced yourself to face one of the men staying in your guest room. You sipped more coffee as Grant strolled into the room, a small, slightly sleepy smile on his lips.

“Morning,” he nodded his head at you.

“Morning, coffee?” You motioned to the freshly brewed pot and empty mugs on the counter.

“Please, I’m plum tuckered.” He headed past you towards the coffee and poured himself a mug.

“Hmm I can imagine.” You barely hid the bitterness from your tone.

Grant slid into one of the stools at the counter with his coffee and looked a little guiltily down into it.

“Ah, I guess we weren’t all that quiet, huh?”

“Oh you were the very opposite of quiet.” You clucked. “I mean don’t get me wrong it sounded incredibly hot the first time but after the third it was a little grating.”

Grant’s cheeks flushed red and he still wouldn’t meet your eyes. He continued staring down into his mug.

“I’m sorry. This is your home and with Spencer the way he is…it was inconsiderate.” He mumbled.

“Don’t sweat it, it’s okay. Can’t say I blame either of you, a couple of handsome studs.” You teased and when Grant looked up at you winked at him.

“You know he doesn’t know about our kiss, right?” Grant whispered.

And I assume you don’t know about my kiss with Luke. Jeez this is like a fucking soap opera.

“I figured as much. Don’t plan on telling him, don’t worry.”

“Thanks.” Grant smiled softly, raising his mug to his lips. “I, uh…can I be honest with you ‘bout summin’?”

“Uh, okay?” Your brow creased.

“I know your name isn’t Elizabeth Parker. You’re that girl that Luke’s old partner has been hunting. The fugitive.” His words almost caused you to choke on your coffee.

You coughed a little, staring at him in wide eyed horror.

“I…I’m sorry?” You choked.

“I saw a file in his office. How does this work? Why hasn’t he arrested you?” Grant leant his elbows on the counter.

“We have a deal.” You huffed out a breath. “He can take me in once he helps Spencer. Once I know he’ll be okay, Luke can slap the cuffs on me.”

“Holy cow,” Grant pulled a face. “You must really love him.”

“I do.” You nodded, trying not to look at the ring adorned on your finger. “I want him to be okay, I want to know that he’s going to get better. I don’t care what happens to me after that.”

You sniffed back tears as you heard another set of feet on the stairs and you focused back on your coffee and not on the pain in your chest at the thought of leaving Spencer.

Luke traipsed into the kitchen and offered you a small smile before sidling up to Grant and wrapping his arm around the other man. You turned away to give them a moment's privacy, not able to look at them like this without hearing the sounds they’d made last night.

You heard some whispering transpire between the two of them before Luke cleared his throat.

“Uh, sorry about last night.” He spoke, his words heavy with guilt.

“Just, uh, try to keep it down next time?” You turned back to him with a shrug.

“Duly noted.” Luke blushed slightly. “So, uh, the hospital called and said Spencer is exhausted. He was up half of the night vomiting. They gave him medication through his IV for the UTI but he’s still struggling to empty his bladder and it's causing him a lot of pain.

“On top of that his lungs are extremely sore and even with the ventilator it’s likely still putting pressure on his chest. They’re worried about the state of his lungs. He’s developed some scarring and it could lead to any number of respiratory illnesses. But Doctor Ryan was able to carry out some more neurological tests this morning and he was pleased that he doesn’t appear to have any brain damage or deficits. He’s still a little hazy in places but they think that could be a symptom of the DID.”

“So it is DID?” You asked, clutching your mug tightly.

“Doctor Vikram believes so. But she can’t say for sure if it’s permanent or just a causation of his sudden lack of medication combined with the alcohol. She has some new meds she wants to try him on - olanzapine - it's an antipsychotic used to manage symptoms of DID. It blocks some dopamine receptors in the brain, correcting the overactivity of dopamine. But they want to get his respiratory distress controlled and have him breathing on his own first. So he may have a few more days where he’s unsure of who he is and even who we are.” Luke took the mug Grant was offering him and sipped from it.

“So we could do him more harm than good?” Grant asked, looking up at his boyfriend.

“Possibly,” Luke nodded sadly. “I didn’t tell either of you this but when he first woke up, he thought I was…he thought I was one of the men who abused him in prison.”

Grant clutched Luke’s arm, looking at him with a sorrowful expression. You pouted, putting your mug down before you smashed it and wrapping your arms around your waist.

“Jesus,” you hissed. “Luke I…that must have been horrible for you.”

“It, uh, was not great.” Luke down played it. “But he’s sick, I understand that. I have to understand that.”

The three of you fell into a stilted silence after that, letting it all wash over you. You had to take the good with the bad, try and focus on the fact there could be a light at the end of a very long tunnel for Spencer.

***

The haze of sedation hung around him, clawing to every corner of his fractured mind. He wasn’t entirely pacified, but not yet completely in tune with his surroundings.

The first thing he became aware of was the tube in his throat, threaded down his airway. His initial reaction had been to remove it but he’d reminded himself he was in the hospital, it was supposed to be there. Thankfully the sedative medication he’d been prescribed stopped him from panicking at the strange intrusion.

He could feel the air being pushed into his lungs via the ventilation machine and down through the tube. His natural instinct was to try and breath on his own but the machine wouldn’t allow it. Sometimes he would feel ready to take another breath but couldn’t until the ventilator was ready to pump that beautiful oxygen into him.

He was hooked up to so many machines he couldn’t move more than a few inches without tugging on a wire here or a tube there. He was being fed liquid or medication, he wasn’t sure, through his IV in the crook of his arm, the suprapubic catheter was still lodged in his stomach.

There was something in his nose too which he could only assume was sending nutrition to his painful stomach. The little tacky pads on his chest were hooked up to the heart rate monitor which was beeping steadily, probably because he couldn’t succumb to his fear while sedated like this.

He’d gagged initially when he’d come around after the general anaesthetic. He’d tried to cough, tried to speak but of course he could do neither. The doctor - Doctor Wells he thought he remembered - explained everything to him although a lot of it got lost in his foggy brain.

Gave me diuretics to clear the fluid in my lungs. Sedated. Ventilator. Need to monitor my blood, oxygen levels, and respiratory rate. Other things. She said other things…

Can’t move without help. Nurse will sit me up. Might make me walk. Something about bronchoscopy? Multiple of them, frequent. A camera down my throat to check my lungs.

I know what this is. Think, think Reid. You know exactly what this is, Doctor Ryan said your brain wasn’t soup so just think…

ARDS? Acute respiratory distress syndrome? Even with treatment only 25 to 40 percent of people survive. If I’m one of the minority it’s likely I won’t ever retain full lung function. I’ll need physical therapy. Might never live a normal life again.

Goddamn my stomach hurts, why does my stomach hurt so much? Am I still not fucking peeing properly? More comfortable than the one in my dick though, that’s for sure.

You had surgery, it hurts because you’re probably bruised around the incision site. Don’t need to urinate, don’t think so anyway. Must have been. Must be working.

No wait. Fuck, no I do need to go. Feels like my bladder is vibrating. What the fuck do I do? How do I make this thing work?

He ran his fingers over the tube he could feel beneath his gown, trying to convey to his bladder and the catheter that he needed them to work together.

What is happening, what is happening? Is it…oh my gosh its leaking…no that’s gross, it hurts! Oh so gross, this is a living hell. Someone please just put me out of my…

The door opened and a nurse he didn’t recognise walked in. He made eye contact with her, frantically pointing at his stomach. She frowned at him a little, coming closer to the bed.

“Is everything okay?” She asked softly.

He whined around the tube in his throat, pointing again at the catheter insertion site beneath his gown. The woman followed his hands and rolled down the bed sheet, rolled up his gown and Spencer tried not to be embarrassed about being naked from the waist down but it was ingrained in him.

“Oh it’s okay, it’s just a little leakage. It might happen from time to time as you get used to the catheter.” She cleaned him off before going about replacing the dressing holding the tube in place.

Time to time? No, no please this should never happen!

“You’re probably experiencing bladder spasms which is a normal symptom of your UTI. It will pass, sweetie, the antibiotics will just take a little time.”

Normal? How the hell is any of this normal?

She finished redressing his incision before standing back and smiling at him.

“Aside from the bladder discomfort are you okay? Can I get you anything?”

A shotgun with one bullet or a bottle of your strongest pills? How the FUCK am I supposed to answer you?

He simply shook his head against the pillow, closing his eyes as he no longer wanted to partake in this incredibly one sided conversation.

Soon he heard her leaving, humming as she went. When Spencer opened his eyes again the tears came streaming out.

Is this just my fucking life now? Am I destined to forever be hooked up to a series of machines? Can’t eat, can’t talk, can’t even having a fucking a piss out of my cock.

Jesus Christ why am I not dead? How the fuck did I end up here? I was alone, how could I have survived? Someone must have…

As the realisation started to present itself in his thickly veiled brain, those eyes he remembered seeing when he’d been spitting up water and turned onto his side, the door opened again and suddenly Spencer found himself looking into those same eyes that had saved him.

Luke? Luke, are you really here? Luke please tell me I’m not dreaming. Luke!

“Hey, you.” Luke croaked as he stepped into the room. “Wasn’t sure you’d be up for visitors but I couldn’t stay away. You mind me being here?”

Mind? Do I mind? Of course I don’t mind! Oh Luke this is so horrible, you have no idea. I feel like I’m trapped inside my own body, I hate it, I HATE IT. Please stay, please don’t ever leave.

Oh right, I can’t speak.

Spencer shook his head instead.

Luke smiled sadly and padded across the room, he slid into the chair next to the bed and Spencer rolled his head to the side to look at him.

Spencer’s fingers twitched at his side, alerting Luke’s attention. He looked like he was trying to mime something, holding a pen? Writing?

“You want to write?” Luke asked and Spencer nodded.

For lack of a pen and paper, Luke pulled his phone from his pocket and opened the notes app before handing it to Spencer. Spencer fumbled a little with it, his hands weak and shaky. It took him a few minutes to write out a simple message before showing the screen to Luke.

Why are you here?

“Uh, Y/N called me.” Luke rolled his lip between his teeth.

Spencer’s eyes grew wide and the heart rate monitor picked up to show his signs of distress. Luke gently placed his hand on Spencer’s shoulder, thankful the young man didn’t try and push him away this time and didn’t seem to think he was someone else.

“It’s okay, Spencer, just breathe.” Luke realised his error as soon as he said it Spencer attempted to type out another message while his heart continued to race.

Can’t breathe, machine is doing that for me.

“Yeah, that was a dumb thing to say. Sorry. But don’t panic, please.”

Spencer frowned back at the phone and typed furiously.

How can I not panic? Why would she call you? Why would she put herself in danger like that?

“Spence, it’s all gonna be fine, I swear. You just need to focus on yourself right now.” Luke tried to calm him.

Little hard to do that when you’re going to arrest my fiance.

Luke sucked in a deep breath at the sight of the word fiance. Clearly he still had a few things to work through.

“Everything will be fine, I promise you.” Luke smiled shakily.

You saved my life?

“Uh, I guess so. Do you remember anything?”

Spencer frowned deeply at the phone, fingers still trembling and causing him to make multiple mistakes which he insisted on correcting before showing Luke.

Kinda remember you being there when I was on the floor in the bathroom. Everything else is a blur. Not sure what’s real and what’s not.

Luke nodded slowly, inhaling shakily.

“I was here when you first woke up, I think you thought I was someone else.” Luke glanced down at his lap and Spencer frowned in confusion.

He wasn’t even sure when he first woke up, his dreams and his reality blurring into one. Was he awake when he thought he was here? When he ripped off what he thought were restraints but must have been…his catheter. He was awake then, but who was…oh.

Frantic tapping at the phone caused Luke to look back up at Spencer’s pinched brows and his flying fingers.

Oh fuck Luke I am so sorry. I was delirious. I wasn’t with it. I’m so, so sorry.

“It’s okay,” Luke waved a dismissive hand. “Don’t worry about it cari…Spencer.”

Are the rest of the team here?

“No, they’re on a case. I didn’t think you’d want them to see you like this either.”

Thank you. Where is Y/N? What happened after she left the ranch?

Luke inhaled again before telling Spencer everything he knew of what had transpired to lead you to New Mexico where he met you and the deal the two of you had made. He ended things with saying you were back at the ranch taking care of the horses but he could call you if he wanted to see you.

Spencer shook his head. He didn’t want you to see him like this, even less than he wanted the rest of the BAU to see him like this. His tears rolled down his cheeks as he slowly typed out another message.

I love her Luke, please don’t take her away from me.

Luke’s lips puckered, his eyes sad and downturned as he took the device back which Spencer was handing over to him.

“Just don’t worry about it for now, you have to focus on yourself. Are you, uh, are there any…voices right now?” Luke dared to ask.

Spencer closed his eyes tightly and shook his head.

“Good, that’s good. I know Doctor Vikram wants to give you some medication to help but maybe they’ll go away before then. Perhaps it was just temporary and maybe they’re gone now?”

Spencer nodded, rolling onto his back and keeping his eyes shut tightly. Oh how he wished Luke was right. But he knew he wasn’t.

“Lying is a sin, boy.”

“Just because you can’t talk right now, doesn’t mean they won’t find out. You’re as crazy as your mother, and crazy always finds its way to the surface.”

Goddamnit, please? Please just let me rest. I just want to rest.

“He really does look similar to me, aye cariño?”

Stop please, please don’t call me that? You ruined my relationship with him, was that not enough? Do you have to ruin all my memories of him too?

“Spencer? Spence, are you okay?” Luke’s voice cut above the racket in his head and he opened his eyes suddenly. Luke was standing, leaning over him. “Your heart is racing again, is everything okay?”

Spencer lifted his hand, made a grabbing motion and thankfully Luke realised what he meant and handed him back his phone. A few moments later he turned the screen back to Luke and the words staring back at him on his own device shattered the older man to his core.

For the rest of his life, Luke Alvez would never get over reading those words typed at the hand of the man he still held so much love for. If his own heart rate were being monitored, the machine might just malfunction given how frantically his heart beat seeing those gut wrenching words looking back at him.

Nothing is okay. I wish I were dead.

***

“Still not sold the old ranch?” Grant’s voice carried across the stable from where he was filling Rusty’s food trough.

You glanced up from where you were shovelling hay in the next stall.

“How could you possibly know that?” You cocked an eyebrow at him.

“My place hasn’t sold, it was an educated guess.” His lip quipped at the corner.

“I guess people just aren’t in the market for all that land these days.” You sighed wistfully. “I’m gonna miss this place.”

“I don’t think you gotta worry about that, little lady.” He walked out of the open paddock, past you towards Willow’s where he started replenishing her food.

“What do you mean?” You followed him with your eyes curiously.

“Contrary to popular belief, me and Luke did find some time to do some talking last night. All he wants is for Spencer to be happy and he knows you make him happy. I’m not making no promises or nothin’ but Luke’s a softy, a romantic at heart. I think you might find yourself able to stay here longer than you planned.” Grant smiled knowingly at you but it only added to your confusion.

“I’m a fugitive wanted by the FBI. He’s not just going to give me a pass because I’m in love with Spencer.” You scoffed, leaning against the fence that separated you.

“You willingly put yourself in danger for him. You put Spencer’s needs above your own freedom. It might not be ethical or hell even legal, but Luke is a kind soul and he can be awful forgiving if he wants to be.”

“Don’t say things like that.” You sniffed back your tears that had suddenly accumulated. “Don’t say things like that and get my hopes up. It’s his job to arrest me. He’s not just going to let that slide.”

“Hmm,” Grant shrugged. “Whadda I know, I’m just a simple cowboy?”

He smiled at you before turning away and going back to his task at hand. You stared at the back of his head as he acted as if nothing had happened.

You couldn’t get your hopes up. There was no way Luke was going to let you off the hook for murdering your step father and escaping prison.

But he had proven he would do just about anything for Spencer. Would that go as far to include allowing you to get away so the two of you could have a life together?

You couldn’t even let yourself entertain the idea for fear of everything coming crashing down around you.

***

Time is moving so slowly. Does time always move this slowly? Need something to do, a book or a chess board or something. Anything. I’m going to lose my mind.

The nurse comes in every half hour give or take. It’s been twenty two minutes since she was last here, suctioning my airway. God I hate that, makes me feel sick. Makes me want to cough but I can’t cough because of this fucking tube.

Checks my blood, my oxygen levels. Checks my heart rate and my respiratory rate. Medicine every few hours, that horrible aerosolized spray through my breathing tube. Hate it. Hate everything.

Doctor comes every hour. When was the last time she was here? Probably give me another bronchoscopy, maybe take some tissue samples.

I’m so tired. Didn’t I just sleep? Why am I so damn tired? How long has it been since Luke was here? Hours, it’s been hours. Days? Guess he’s not coming back.

Spencer had well and truly lost track of time. His medicine had him in and out of hazy sleep and he had long ago passed the point of knowing what day it was. In reality he had been back on the ventilator for six days, and just because he didn’t remember seeing Luke again after his first day back in the ICU, Luke had been to visit every day.

Most of the time Spencer would sleep during his visits but even when he was awake he was never lucid, and never Spencer. One day Luke had an entire conversation via his phone's note app with Cat Adams. Another he had a very confusing exchange in which Spencer flitted between Benjamin Merva and Raphael.

The most horrifying experience had transpired yesterday when Spencer presented solely as one of the men who had attacked him in prison.

He’d gone into hideously gory details about the assaults he and his partners had inflicted upon Spencer. Luke wanted to smash his phone into tiny pieces by the time the man who wasn’t Spencer typed out, don’t you remember how good he is at sucking cock? Ay dios mio, it should be illegal.

It had taken everything in Luke’s power not to vomit reading those messages typed by Spencer’s hand but not his mind.

You and Grant went with him everyday but Luke was the only one who braved going in his room.

“You told him you wanted to die, of course he’s not coming back, estúpido.”

Oh god not you again. Why are you always here? Send someone else, Tobias, Cat, even my dad. Not you, please.

“I’m always going to be here. Why would I ever leave you?”

I can’t do this, I can’t spend the rest of my life seeing you., hearing you. I thought it might be temporary, but you’re never going away are you?

“I’m not going away because you don’t want me to go away, cariño.”

Please stop calling me that. Please?

Tears snuck from his eyes as he laid there in the shell of a useless body, allowing his breathing, the one thing he’d always been in control of, be dictated by a machine.

This was an all time low for Spencer Reid. If he couldn’t even do something as simple as pull oxygen into his lungs, what was the fucking point of anything?

“You did this to yourself. I told you, suicide is a sin and you’re being punished for trying to take the cowards way out. It’s God’s will.”

Tobias? Tobias, please don’t leave.

God I never thought I’d say that.

“How many times did you think about doing that after what we did to you? How many times did you want to kill yourself after prison, querido?”

No, no I didn’t. Wouldn’t let you win, couldn’t let you win.

“Hmm is that why you brought that dilaudid two weeks after you were released? Just enough to end it all. Woulda taken it too if you hadn’t found that ring. He saved your life and he never even realised, hijo de puta.”

A phantom memory encased him then, the dilaudid vials in one hand, needle in the other. He’d been looking for something to use as a tourniquet when he’d opened a drawer and found the ring box hidden inside.

He never told Luke that he’d seen it and no surprise, Luke had never given it to him. But it had been enough for him to want to try. He’d flushed the dilaudid down the toilet before Luke had any idea.

It was my fault. All my fault. Would have married him in a heartbeat. Still would, wouldn’t I?…

No. No I wouldn’t. I love him, I’ll always love him. But she’s the one I want to spend the rest of my life with.

“Not gonna happen now though is it? Because of you, you idiota. Because of your stupid decision to stop taking your meds she had to seek help from the only person she could. And now he’s going to arrest her and you’ll be all alone again. Well, apart from me. I’ll always be here, mi corazón.”

Goddamnit I wish you wouldn’t be. How do I make you go away?

“I’m a part of you. I’m in arraigado - ingrained - in you. I’m just as much a part of you as you are me.”

Fuck, this is so unfair. Fucking Christ the nightmare will never be over, will it?

“Shh cariño, it will be okay.”

Spencer’s tears continued to roll down his hollow cheeks, focusing on the discomfort in his dry throat at the tube lodged inside it.

He laid there in his husk of a body, listening to the steady beep beep beep of the heart monitor, the loud pumps of the ventilator as it kept him alive when his uncooperative lungs wouldn’t work for themselves.

The almost imperceptible drip drip of the IV as it delivered antibiotics and fluids to his spent frame. The soft spasming of his stomach as the catheter worked constantly to remove every drop of liquid from his bladder before he could even register the need to urinate.

How long could a person live like this? At least when they had him in a coma he wasn’t aware of all these things being done to him, wasn’t coherent of his total lack of autonomy over his own body.

This must be what hell is like, surrounded by ghosts and being able to do nothing about it. Maybe I am dead after all, maybe this is just what death feels like.

The door opened almost right on cue and the doctor walked in, followed closely by a nurse. He knew the drill by now and laid back and allowed it to happen, not that he could do much else.

“Are you feeling okay, Doctor Reid?” Doctor Wells asked as she glanced at his vitals.

By way of communicating he tapped the bedrail once. Once meant yes, twice was no. It was a lie and they probably all knew it.

The nurse set up next to his bed, a small silver tray of instruments. A catheter was threaded down inside of his breathing tube so she could suction out any mucus that might have gathered in the tube and impede the machine's ability to do its job.

As always, he gagged at the intrusion, tried to cough but couldn’t. He laid back and took it, hating the way it felt and knowing he would never get used to that sensation even if he was on this machine the rest of his life.

After suctioning came the medication, the spray which was administered down his tube and also made him gag furiously. He knew the bronchoscopy was coming, that was why Doctor Wells was here. She finished noting down his vitals before she turned to him with the tiny camera in hand.

“We’re just going to take a few more tissue samples okay?”

Tap.

He closed his eyes while she went about her business and tried to ignore the way it made him want to vomit. It was all over in no more than five minutes but Spencer hated every second of it.

“Your respiratory activity has been improving greatly, I’m hoping once we get the results back from these samples we might be able to start weaning you off the ventilator. Does that sound good?”

Tap.

The nurse was cleaning him with a damp cloth, he always tried to go to another place for this. His dissociations usually happened so easily he wasn’t even aware of them but this was one mortifying task his brain would not let him detach from.

She moved him around like a goddamn rag doll manoeuvring him so she could remove the clothes he’d been dressed in, he assumed brought in by Luke in a last ditch attempt to help Spencer feel something akin to human.

He had to admit it was better than the scratchy hospital gown, his flannel pyjama pants were soft and cosy and the t-shirt he wore he had a suspicion was one of Luke’s old FBI Academy shirts although he couldn’t really see it over all the equipment he was plugged into.

He could have been more help, he could move his limbs and make the whole thing slightly less degrading but he didn’t. Instead he allowed her to lift his shirt, wash under his grossly smelling armpits, over his chest, around his catheter insertion and then his neck.

Replacing the shirt she gave the same gentle attention to each of his arms, careful not to disturb his IV port.

It was what came next that Spencer found incredibly dehumanising.

The sheet was removed from the bed and his pyjama pants tugged down his legs. The way in which she cleaned his genitals, lifting his sad, flaccid penis as she wiped the cloth in those hard to reach places made him shudder.

It felt like a violation and tears never failed to leak from his eyes but there was nothing else he could do.

It was clinical, of course it was, she was a professional. But it didn’t stop Spencer from screaming internally at what his ravaged brain perceived to be an assault.

Stop touching me! I don’t want it! Don’t want it! Please stop touching me!

They’d noted early on that this part of the cleaning ritual caused his heart rate to skyrocket. It was understandable given what they knew about his traumatic past. No one had said as much but the doctors had all seen his full medical history, including the reports from Milburn infirmary.

All they could do was to try and keep him calm, Doctor Wells mumbled soothing epitaphs while the nurse went about her business in an attempt to distract him. Judging by the heart monitor, it never worked.

Finally she was finished and redressed him, covering his lower half with the sheet and steadily his heart rate lowered again once he was no longer being touched.

“We want to try and get you moving, is that okay? We don’t want you to develop bed sores or for your muscles to atrophy.”

No, no please don’t make me move. I’m so tired, so, so tired. Don’t want to move, just leave me here to die.

Tap. Tap.

“Doctor Reid, I’m sure you understand that once we can get you moving and off the ventilator you will have a lot more freedom. You might be able to wash yourself. The swelling in your urethra is settling nicely too, you might even be able to use the bathroom. But you won’t be able to do any of those things if you don’t first let us help you move.” Doctor Wells was no nonsense. He liked that about her.

She’s right, dumbass. You wanna be stuck in this bed forever? At least once you’re back on your feet you can put yourself out of this godforsaken misery once and for all.

Tap.

“That’s what I thought.” Doctor Wells smiled. “Okay, we’ll start by raising the bed and then we’ll help you up okay?”

Tap.

Doctor Wells nodded to the nurse who was suddenly back at his side, pressing the button on the side of the bed to raise it.

Spencer felt the bed shudder and jolt a little before his top half was being lifted so he was in more of a seated position.

From this angle he had a direct line of sight out of the window into the corridor. A set of beautifully familiar eyes were staring back at him, hidden deep inside an oversized hood.

He blinked multiple times in quick succession as he tried to ascertain whether or not he was imagining things. But he wasn’t. You were really there.

His heart monitor started frantically beeping again and Doctor Wells glanced from the machine to Spencer with a frown on her face. Spencer was staring out the window, one weak arm raised a few inches off of the bed as he tried pointing to the apparition in the window.

He made a pathetic whimpering sound through his tube, trying to explain without his words what he was trying to communicate.

Tap tap tap. Tap tap tap.

Please someone get her, I need her, please someone understand.

Doctor Wells looked out the window and saw you standing there, arms hugging your waist. It was the first time you’d ventured out of the waiting room, the first time seeing Spencer since you’d found him in the tub.

Doctor Wells nodded to the nurse to wait a moment while she made her way across the room and out of the door. Spencer stared dumbly through the window as he watched the two of you conversing but couldn’t hear what was being said.

Your body trembled and he saw you shake your head a few times. He felt more of his own tears falling.

“She doesn’t want to see you, of course she doesn’t. She hates you, you put her through hell. She wants nothing to do with you.”

Then why is she here?

He closed his eyes, leaning his head back against the pillows, not wanting to know what was going on. He’d only be disappointed and he’d dealt with far too much disappointment in his life.

“She’ll never look at you the same. She hates you, she’s terrified of you. You tried to kill her, do you remember?”

No, no that wasn’t me! That was you, one of you, not me. I would never…I love her. I wasn’t myself, wasn’t me. I would never hurt her.

“You were very much you when you threw her up against the wall and slapped her, Spencie.”

I didn’t…didn’t mean to. I was a wreck, my mind wasn’t working properly. I didn’t mean to hurt her.

“But you would probably do it again. You aren’t well, you can’t be trusted to be around her. She’s too good for you.”

The voices were once again blurring into one loud tone, he couldn’t decipher who was who.

She is too good for me, of course she is. But I would never hurt her again, I wouldn’t, I WOULDN’T.

“It doesn’t really matter either way. She’s going to prison and you’ll never see her again.”

He didn’t hear the door open again over the barrage of voices in his head screaming for attention. He didn’t realise Doctor Wells had returned until he felt a soft hand on his forearm, immediately silencing all of the yelling and throwing him into a deep quiet.

The hand on his arm wasn’t sheathed in a latex glove like he’d grown used to from the doctors and nurses. It caused him to still, his heart monitor betraying his viciously thumping heart.

He knew that soft touch, he would know it anywhere. It was emblazoned in his mind, solidified to his memory. He swallowed around the tube and almost gagged at the feeling. His forehead creased deeply in thought.

Y/N, is that you? Princess, are you here? Please say something, let me know it’s really you.

As if you could somehow read his thoughts he heard a breath being sucked in and then your shaking voice met his ears.

“S-Spence? Spence, it's me. Can you o-open your eyes?”

Yes, yes I can do that.

Slowly he lifted his lids and there you were at his bedside, gently brushing your fingers against his arm and staring down at him from the large hood hanging around your face. It didn’t take his full brain capacity to figure out why you were hiding yourself in this way.

More tears fell from his tired eyes and he tried to smile at you but it was just a little too much effort. He wanted to speak, needed to speak but the apparatus keeping him alive dictated he couldn’t.

Instead he shuffled a little, rolling his arm on the bed so his palm was facing upwards. You glanced at it with a soft frown but it didn’t take long for you to realise what he meant. You cautiously slid your hand in his, his weak fingers curling around your own as his heart monitor continued to beep frantically.

His fingers twitched against your hand, you didn’t understand why. You didn’t realise that he was trying to communicate with you the only way he knew how. His fingers tapped and brushed against your own in a strange series of what seemed to be dots and dashes, as though he was trying to tell you something.

He knew you didn’t understand morse code, but he allowed himself to pretend as he spelled out the only thing he wanted to say to you in that moment.

dot-dot. dot-dash-dot-dot. dash-dash-dash. dot-dot-dot-dash. dot. dash-dot-dash-dash. dash-dash-dash. dot-dot-dash.

I love you.

@kalulakunundrum @katrina0-0 @bakugouswh0r3 @prettyboyandthefangirl @zooni92802 @babyspiderling @pleasantwitchgarden @djsjjsjsjsjsnsnsns @bringitonhomejohnb @chineray1234

#spencer reid #spencer reid angst #spencer reid fanfiction #spencer reid fanfic #spencer reid x fem! reader #spencer reid x reader #spencer reid x you #spencer reid x y/n #criminal minds #criminal minds fanfiction

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macgyvermedical · 9 months ago

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Hey babe, wanna hear something hot? *whispers* history of metformin

Ok okay I'll talk

So metformin is commonly thought of as the most boring of diabetes drugs. Like, everyone who has ever thought about maybe having type 2 diabetes is taking it unless it gives them diarrhea, and even then their doctor still probably wants them to take it. But it's a first line because it's old, it's cheap, it doesn't often cause hypoglycemia, and it has relatively few side effects compared to other diabetes drugs. Also, like a lot of older drugs, it does way more than it says on the packaging. And a lot of stuff we're still learning about.

In order to talk about metformin, we have to talk about a plant called goat's rue. Goat's rue is a plant native to Europe, Africa, and Asia, and currently grows just about everywhere. In ancient times it was used as an anti-parasitic, a plague remedy, and to relieve the excessive urination caused by what might have been diabetes. In 1918 it was found to contain a chemical called galegine, which did lower blood sugar. Galegine as an anti-diabetes medication is probably too toxic to use long term. However, with a few chemical tweaks, it could become a drug that lowered blood sugar without the toxic effects. Metformin was born.

Metformin came out in 1923 and is a type of drug called a biguanide. it's actually the only type in it's class still available as an anti-diabetic agent, because the other drugs in it's class that came out in the 1920s and 30s caused lactic acidosis and liver problems (similar to the types of reactions seen with galegine), and were taken off the market.

Metformin (and pretty much all oral antidiabetic agents in development at this time) didn't do well initially, probably because they came out the same decade as insulin, and insulin was a lot more effective at treating any kind of diabetes.

It fell out of use extremely quickly, and didn't get picked up again until the 1940s, when US access to antimalarial drugs was cut off, just as a war in the pacific was ramping up. Metformin was evaluated as an antimalarial during WWII, and while noted to have some anti-malarial properties (particularly as a malaria preventative) it also was noted to significantly lower blood sugar in diabetic patients- while not lowering blood sugar very much at all in non-diabetic patients.

This effect, rather than it's antimalarial properties, was what got scientists really interested. Unfortunately, it would not be until 1957 in France that metformin had its first major studies to determine that it did, indeed, work against diabetes. Metformin lost the race to the "first" (successful) oral antidiabetic agent by a year, to a different drug that was found while looking for a new antibiotic- Diabenese.

Metformin became a commercial success in France, while Diabenese became successful in the United States. Metformin would actually not be approved for use in the US until 1995.

But now we get to talk about what metformin does and why it's so freaking cool.

Type 2 Diabetes- lowers A1C (a measure of blood sugar control) by 1-2 full points

Prevents/reverses weight gain due to antipsychotics

Prevents and treats malaria

Makes the flu shot work better

Decreases severity of respiratory illness and complications related to the flu

Changes gut microbiome for the better

Regulates periods and reduces other symptoms in people with PCOS

Lowers risk of breast, colon, and prostate cancer

Lowers risk of dementia

Lowers risk of stroke

May increase lifespan

#whump reference #writing reference #diabetes #metformin #chronic illness

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anexperimentallife · 9 days ago

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Sometimes the problem is that the various medications fight each other, but other times it's that they reinforce each other too much. And depending on the meds in question and how many different ones you're on, sometimes it's both at the same time. Like, opposing effects don't cancel each other out; they just interact in weird ways so that you can (for example) be sleepy af while too agitated to sleep.

Like, most bronchiodilator (sp) and decongestant medication has a stimulant quality, but most antihistamines and pain medications have a make-you-sleepy quality, so mix those with anxiety and sleep and blood pressure medication and a nice, healthy dose of the glorious god that is caffeine, plus some inhaled steroids to fight mucous tissue inflammation, then aggravate your lower spine injury by walking egregious distances on egregious slopes five days in a row because It Is Needed, and you can attain a unique state of WTF (which is not very much fun for you or anyone trying to help you care for yourself).

All this is to say that trying to treat the effects of long covid (like the aforementioned high blood pressure), a persistent allergic reaction, a viral respiratory illness, bipolar-related anxiety, insomnia, and pain from both nerve damage and joint injuries--especially when ADHD, a traumatic brain injury, and autism are also involved--is (to use a technical term) a motherfucker.

As I keep promising, though, I WILL be back on a regular basis eventually, and I AM recovering; it's just taking much longer than expected.

#uncle rob says stuff #uncle rob gets medical

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leviathan-supersystem · 2 years ago

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Mike DeWine, the Ohio governor, recently lamented the toll taken on the residents of East Palestine after the toxic train derailment there, saying “no other community should have to go through this”.

But such accidents are happening with striking regularity. A Guardian analysis of data collected by the Environmental Protection Agency (EPA) and by non-profit groups that track chemical accidents in the US shows that accidental releases – be they through train derailments, truck crashes, pipeline ruptures or industrial plant leaks and spills – are happening consistently across the country.

By one estimate these incidents are occurring, on average, every two days.

“These kinds of hidden disasters happen far too frequently,” Mathy Stanislaus, who served as assistant administrator of the EPA’s office of land and emergency management during the Obama administration, told the Guardian. Stanislaus led programs focused on the cleanup of contaminated hazardous waste sites, chemical plant safety, oil spill prevention and emergency response.

In the first seven weeks of 2023 alone, there were more than 30 incidents recorded by the Coalition to Prevent Chemical Disasters, roughly one every day and a half. Last year the coalition recorded 188, up from 177 in 2021. The group has tallied more than 470 incidents since it started counting in April 2020.

The incidents logged by the coalition range widely in severity but each involves the accidental release of chemicals deemed to pose potential threats to human and environmental health.

In September, for instance, nine people were hospitalized and 300 evacuated in California after a spill of caustic materials at a recycling facility. In October, officials ordered residents to shelter in place after an explosion and fire at a petrochemical plant in Louisiana. In November, more than 100 residents of Atchinson, Kansas, were treated for respiratory problems and schools were evacuated after an accident at a beverage manufacturing facility created a chemical cloud over the town.

Among multiple incidents in December, a large pipeline ruptured in rural northern Kansas, smothering the surrounding land and waterways in 588,000 gallons of diluted bitumen crude oil. Hundreds of workers are still trying to clean up the pipeline mess, at a cost pegged at around $488m.

The precise number of hazardous chemical incidents is hard to determine because the US has multiple agencies involved in response, but the EPA told the Guardian that over the past 10 years, the agency has “performed an average of 235 emergency response actions per year, including responses to discharges of hazardous chemicals or oil”. The agency said it employs roughly 250 people devoted to the EPA’s emergency response and removal program.

[...]

The EPA itself says that by several measurements, accidents at facilities are becoming worse: evacuations, sheltering and the average annual rate of people seeking medical treatment stemming from chemical accidents are on the rise. Total annual costs are approximately $477m, including costs related to injuries and deaths.

“Accidental releases remain a significant concern,” the EPA said.

In August, the EPA proposed several changes to the Risk Management Program (RMP) regulations that apply to plants dealing with hazardous chemicals. The rule changes reflect the recognition by EPA that many chemical facilities are located in areas that are vulnerable to the impacts of the climate crisis, including power outages, flooding, hurricanes and other weather events.

The proposed changes include enhanced emergency preparedness, increased public access to information about hazardous chemicals risks communities face and new accident prevention requirements.

The US Chamber of Commerce has pushed back on stronger regulations, arguing that most facilities operate safely, accidents are declining and that the facilities impacted by any rule changes are supplying “essential products and services that help drive our economy and provide jobs in our communities”. Other opponents to strengthening safety rules include the American Chemistry Council, American Forest & Paper Association, American Fuel & Petrochemical Manufacturers and the American Petroleum Institute.

The changes are “unnecessary” and will not improve safety, according to the American Chemistry Council.

Many worker and community advocates, such as the International Union, United Automobile, Aerospace & Agricultural Implement Workers of America, (UAW), which represents roughly a million laborers, say the proposed rule changes don’t go far enough.

#longpost

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a-little-revolution · 9 months ago

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Hi - I'm a relatively new follower, but I love the variety in what you put out.

I work in healthcare and regularly give talks on very basic disability concepts (why eugenics is wrong, how to get AAC access in hospitals, shut the hell up about parents' rights, don't use slurs in educational talks, etc.).

Is there anything you'd recommend specifically for doctors, nurses, and other care providers in terms of a) not creating problems, and b) actually providing quality healthcare for little people? Assume the target audience knows nothing.

Hello! Welcome!! Thank you so much, I try ^^

I gave a talk a while ago on trans inclusive healthcare, and included a lot of disability related things since there's plenty of intersection. As I'm sure you know, the medical system still has a long way to go when it comes to treating disabled folk (and frankly anyone who isn't a thin, white, cishet male).

With dwarfism specifically, the learning curve is astronomical - here's my thoughts: (And note, I am someone who's had roughly fourteen surgeries, countless scans, and endless doctors visits - so I think I can call myself an expert lol)

The first thing is just establishing basic knowledge on dwarfism - how it presents in a person, how it affects mobility and range of motion, what the terminology is etc. Knowing the related conditions is vital as well - my Achondroplasia for instance comes with sleep apnea, respiratory conditions, arthritis, club foot, loose knees, etc. I'm often the expert on my own condition, but I shouldn't have to be relied on as a teacher in traumatic situations.

Make waiting rooms, doctor's offices, surgical rooms, etc. accessible to those bellow 5 feet! Most of the time I cannot get up on an exam table as they are too high and I am not provided a stool without making a special request. The same goes for xray tables, gurneys, etc. I cannot express the frustration of coming into every medical room and not being able to sit or lay down without assistance.

Respect and autonomy are big things that get missed - assumptions that my life isn't worth living, that my pain isn't real, that I don't participate in daily activities, that I don't have sex or want children etc. are just some of the misconceptions I come across with medical professionals and their assistants. Last year during and x-ray was the first time a medical professional ASKED before touching me.

For now this is what I can think of, I thank you for your patience as I do have CPTSD from my medical trauma. I've talked more on being a patient with dwarfism here! Hope this helps!

-Elliot (they/them)

#asks #medical #dwarfism #medical discrimination #dwarfism medical #disability #disability in hospitals

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blumenbiovital · 1 year ago

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Our probiotic formulations are a testament to Blumen's dedication to quality, research, and your overall wellness. We believe that a balanced gut is the foundation of good health, and our probiotics are designed to promote a harmonious gut microbiome.

#best nutraceutical products #best nutraceutical products in mumbai #how to choose the right #respiratory related problems with medication

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gallifreyinstituteforlearning · 5 months ago

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Hi!

I would like to know what oxygen levels would be comfortable and/or survivable for a Time Lord.

Like if they were to travel to a planet with a different atmosphere, would an either too high or too low oxygen level be a problem? And how?

Would it be slightly uncomfortable for a while and then they would get sick? Or would it be dangerous from the start?

I would love to get your opinion on this.

How do Oxygen levels affect Time Lords?

🫁 Gallifreyan Respiratory System: Overview

Gallifreyan respiratory systems are extremely efficient. They can absorb every molecule of oxygen inhaled, and their respiratory and circulatory systems are independent, meaning they have pulmonary tubes running parallel to other body systems. This setup allows them to function with about a quarter of the oxygen humans need, taking only 5-10 breaths per minute.

🌀 Low Oxygen Levels

Gallifreyans can comfortably breathe in atmospheres with oxygen levels as low as 10-12%, compared to humans who struggle below 19.5%. In extreme conditions, such as at altitudes equivalent to Earth’s Mount Everest (oxygen levels around 6-7%), Gallifreyans might feel mild discomfort but can manage without supplemental oxygen for extended periods. However, their limit is probably around 5-6%, where prolonged exposure would lead to hypoxia.

In situations where oxygen is scarce:

Carrier Cells: Their carrier cells ramp up activity to maximise oxygen absorption.

Respiratory Bypass: Used in emergencies when atmospheric oxygen is dangerously low, this system slows down their metabolic needs, allowing them to conserve every molecule of oxygen available. It can't be used indefinitely.

😤 Symptoms of Extremely Low Oxygen Exposure

<20 minutes: Normal presentation.

20-40 minutes: They might feel a bit lethargic and nauseous, similar to humans at high altitudes.

40+ minutes: Prolonged exposure can lead to extreme fatigue, impaired cognitive function, and even unconsciousness. They should ideally be using their Respiratory Bypass before this point.

🏔️ Side Note on Altitude Sickness

Gallifreyans can still experience altitude sickness, though at much higher thresholds than humans.

2,500 metres: Humans start experiencing symptoms; Gallifreyans remain unaffected.

5,500 metres: Gallifreyans might start feeling mild symptoms like nausea and headaches.

9,000 metres: Their bodies are fully compensating now, but coping.

11,000 metres: They would need to use their respiratory bypass system fairly quickly and get the heck off that mountain before they pass out.

💨 High Oxygen Levels

Gallifreyans are probably comfortable with oxygen levels up to around 65%, beyond which they might suddenly start experiencing symptoms of oxygen toxicity. For comparison, humans can start experiencing oxygen toxicity symptoms at levels above 50%.

When there's too much oxygen:

Carrier Cells: These cells will decrease their activity to prevent over-oxygenation.

Filtration: A specialised organ helps regulate oxygen flow, but it can be overwhelmed if sustained over a long period, meaning the decline is very fast.

😤 Symptoms of High Oxygen Exposure

<30 minutes: Normal presentation.

30+ minutes: Sudden onset of respiratory issues, visual disturbances, and seizures due to oxidative stress on their cells.

🏥 Medical Notes

Oxygen doesn't travel in their blood as it does in humans, meaning human oximeters will always show an error code or 0%. If your Gallifreyan ends up in a human hospital, there is a staggeringly high risk of them being over-oxygenated - devices like a non-rebreather mask could be extremely damaging or fatal.

🏫 So …

Their compensatory mechanisms for respiration work better in low-oxygen environments than in high-oxygen environments. The low is a slow and recognisable decline that can be managed, while the high could be a very quick snap and crash.

Factoid: Is there a gas Gallifreyans are particularly sensitive to?

Guide: Gallifreyan Assessment Scoring System (GASS): Guide for assessing vital signs.

Guide: ABCDE Assessment: Guide for quickly assessing and treating a sick Gallifreyan.

Hope that helped! 😃

Any purple text is educated guesswork or theoretical. More content ... →📫Got a question? | 📚Complete list of Q+A and factoids →😆Jokes |🩻Biology |🗨️Language |🕰️Throwbacks |🤓Facts →🫀Gallifreyan Anatomy and Physiology Guide (pending) →⚕️Gallifreyan Emergency Medicine Guides →📝Source list (WIP) →📜Masterpost If you're finding your happy place in this part of the internet, feel free to buy a coffee to help keep our exhausted human conscious. She works full-time in medicine and is so very tired😴

#doctor who #gil #gallifrey institute for learning #dr who #dw eu #gallifrey #gil biology #gallifreyans #ask answered #gallifreyan biology #whoniverse #time lord biology

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lunarlianna · 1 year ago

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Medical astrology

This article draws inspiration and is based on information found in two notable books: "Complete Practical Astrology" by Edward Lyndoe, published in 1938, and "Complete Herbal" by Nicholas Culpeper, dating back to 1652. It's not uncommon for individuals with a stellium in a specific zodiac sign to experience health issues associated with that sign more prominently compared to those with just one planet in that sign. The concentration of planetary energy in one sign can intensify the characteristics and tendencies associated with it, including health-related aspects.

The history behind it

In early-modern Europe, people held a deep fascination with the connection between celestial bodies and our well-being. This belief traced back to ancient notions of the Four Elements and the Four Humors, forming the basis of humoral theory in medicine. Originating with Hippocrates and evolving through Galen, this theory centered on balancing bodily fluids: blood, phlegm, black bile, and yellow bile. Men were seen as hot and dry, while women were considered cold and wet. Dietary choices and flavors were believed to influence humor balance.

These ancient ideas were intricately linked to Zodiac signs, seasons, cardinal directions, qualities, temperaments, and life stages. People believed that our health relied on maintaining a delicate equilibrium among these factors, shaping a complex system that demanded precise language to explain.

As interest in astrology grew in the 16th century, printed books, such as "Planetary Books" and "Folk Calendars," became popular sources of knowledge. These texts provided valuable insights, bridging the gap between celestial and earthly realms. They aimed to empower readers with wisdom about their place in the universe.

Aries: rules over the head, face, eyes, and the brain's cognitive functions, influencing the distribution of both mental and physical energy. This sign is associated with health concerns like headaches, fevers, neuralgia, eye issues, skin eruptions, inflammations, wounds, and accidents. Individuals born under Aries may have an abundance of energy, often exceeding their mental and emotional balance. Many health issues can be traced back to factors such as excessive physical exertion or bouts of intense anger. It's advisable for Aries individuals to prioritize maintaining a sense of balance and inner poise to promote their overall well-being.

Taurus: you should know that your sign is linked to certain areas of your body like the neck, ears, throat, larynx, and tonsils. These body parts might need a little extra care. Your sign is also associated with your ability to recover from health issues. However, it's important to be mindful of diseases that can specifically affect your throat. One thing to keep in mind is that Taurus individuals often have a love for indulgence and comfort, which can sometimes lead to health challenges. Additionally, your tendency to dwell on problems might make you more sensitive to minor health issues. So, remember to strike a balance and take good care of your well-being.

Gemini: For those born under the sign of Gemini, certain areas of the body require attention. Gemini influences the arms, shoulders, muscles, and bones, as well as the respiratory system, including the trachea and bronchi, and even the hands. People with this sign may be more prone to health issues like bronchial complaints, lung conditions such as pneumonia and pleurisy, nerve-related diseases, asthma, and anemia. These health challenges can often be traced back to nervous reactions and restlessness, which are characteristic of Gemini individuals.

Cancer: you have an influence on various parts of the body, including the stomach, breasts, solar plexus, diaphragm, and the upper portion of the liver. These areas are closely tied to matters of nutrition and digestion. Health issues that commonly afflict those born under Cancer often originate from emotional factors, triggered by mental irritants. These emotional disturbances can lead to nervous reactions and a general decrease in vitality. Interestingly, it's been suggested that more often than not, the health of a Cancerian is affected by external factors and the actions of others rather than self-inflicted harm. So, it's important for Cancer individuals to prioritize their emotional well-being and maintain a harmonious environment to support their overall health.

Leo: you have a special connection with the heart, spine, and vital forces carried by the blood. This makes you particularly susceptible to issues like heart troubles and poor circulation. Remember, many of these health challenges can be linked to overexertion or pushing yourself too hard. So, take good care of your energy levels and avoid unnecessary strain to keep your health in top shape.

Virgo: you have a unique connection with your own digestive system, which encompasses your intestines, alimentary canal, and the lower part of your liver. However, it's essential to recognize that individuals born under this sign might also be more prone to experiencing digestive issues and complaints, especially concerning the intestines. For you, these digestive troubles could occasionally stem from nervous causes, potentially leading to discomforts like acidity and other digestive challenges. It's a part of your unique astrological makeup, emphasizing the importance of taking extra care of your digestive well-being and managing any stress or anxiety that might contribute to these issues.

Libra: you are associated with specific areas of the body, including the kidneys, loins, appendix, lumbar vertebrae, and the skin. These are related to the body's liquid processes. Health challenges that often affect Virgos include kidney problems and issues related to the spine. These troubles are frequently linked to nervous exhaustion. To maintain your well-being, it's crucial for Virgos to manage stress and avoid situations that lead to nervous strain.

Scorpio: your zodiac sign governs several vital areas of the body, including the organs of reproduction, bladder, gallbladder, colon, and rectum. These parts are closely tied to procreation and reproduction. Health issues frequently associated with Scorpios involve the organs mentioned earlier. Problems may arise due to excessive worrying and the influence of others on the individual, which can break down resistance. To maintain good health, it's important for Scorpios to find ways to manage stress and emotional pressures effectively.

Sagittarius: you have a connection to certain body areas like the hips, thighs, and sciatic nerves. These parts are linked to your senses and how you perceive illnesses through your nerves. Health issues that Sagittarians often face include conditions like gout, rheumatism, and sciatica, as well as accidents. Restlessness can be a contributing factor to these problems, and individuals under this sign may have a propensity for accidents and injuries. Therefore, it's essential for Sagittarians to cultivate a sense of caution and mindfulness to prevent such mishaps and maintain their well-being.

Capricorn: you have an influence on the knees, joints, and hair. These are connected to processes related to preservation and conserving energy. Health issues commonly associated with Capricorns include skin complaints and diseases affecting the parts of the body influenced by this sign. Such ailments often have their origins in inhibitions. Therefore, it's important for Capricorns to focus on finding a balance between preserving energy and addressing any emotional or mental inhibitions that may impact their well-being.

Aquarius: your influence goes to the lower legs (calves and ankles), teeth, and blood circulation. These areas are interconnected with the body's circulation and eliminative processes. Health issues often associated with Aquarians include accidents affecting the ankles, as well as complaints related to this part of the body. Conditions such as varicose veins, blood poisoning, and certain nervous diseases may also be relevant. Many of these health challenges may have nervous causes, often tied to the highly sensitive nature of those born under the Aquarius sign. Therefore, maintaining emotional balance and managing stress is crucial for overall well-being.

Pisces your zodiac sign influences specific areas of the body, including the feet and toes. These are related to perspiration and the lymphatic processes within the body. Health challenges often associated with Pisceans include conditions like influenza, colds, and diseases accompanied by mucous discharges. Many of these complaints may have their origins in an overactive or overheated mind, possibly with perceived injuries from others. Additionally, individuals born under the Pisces sign tend to exhibit a high level of physical and mental sensitivity, which can contribute to various health issues. Therefore, it's important for Pisceans to manage stress, maintain emotional balance, and address any perceived injuries to promote overall well-being.

#astro observations #astro community #astro placements #astrology #all signs #astro notes #asteroid #astrologer #for you #zodiac placements #medical astrology

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j-nor · 1 year ago

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What’s the average lifespan of a clown? How quickly do they mature?

Also I still haven’t gotten my new clown girl yet >:(( I’ve been waiting patiently lol

Hello! Thank you for the question, clowns lifespans vary drastically from breed to breed and their rate of maturity is still under some debate from professionals, but regarding teacup-circus breeds I can offer my knowledge.

Teacups are often assumed to be short term commitments, much like how people see hamsters compared to dogs, but this is false. Teacups don’t typically live quite as long as larger breeds of clown, (scare-clowns, jesters, ect, are known to commonly age into their late 110’s) but they can easily live as long as a human, their average life-span is around 75-85. It’s not certain exactly why this is, there are a multitude of reasons, but even though teacups don’t typically live quite as long as larger breeds, they are still lifelong commitments and most importantly lifelong friends.

As for how teacups mature, it can depend a lot on what their crossed with, so general statements are not hard and fast rules, rather a rough estimate for the majority of teacups. They are typically considered chucklets (clownlets, chuckles, baby clowns, all common names) for the first 1-2 years of their life. This stage is where the most rapid development takes place.

After that they enter the juvenile stage and continue slowly mature until they reach adulthood. Some teacups grow slightly in size during the juvenile stage, some stay the size they reached during their chucklet-hood. That’s one difference between teacups and other breeds, their juvenile stage doesn’t contain major physical development, teacups spend their juvenile stage developing their brains and immune systems. Porcelain teacups develop a hardened shell when they’re chucklets and slowly build up more and more layers over the course of their juvenile stage. This is why younger porcelains heal better than older porcelains.

Once they’ve been through their juvenile stage they reach adulthood and are full-fledged clowns. Like humans, their development doesn’t necessarily come to a complete halt, but all their major changes have been completed and they’ve developed a core personality. Just like us, they will still learn and grow through the course of their whole lives, simply less in the sense of physical growth and more in the sense of personal growth.

During their later years, 50-70, they begin to slow down and become elder clowns. Sometimes they develop respiratory problems and joint issues, which can be managed easily with the help of a vet. Towards the very end of their lives, many experience certain pains because of age-related conditions and require medication. Some people tend to be scared of medicating their teacups because teacups are so small and seem as though their systems might be overwhelmed by medication, but keeping an elderly clown from pain management is needlessly cruel and with the help of a vet teacups will be able to enjoy their last years without trouble.

I won’t go into huge detail about end-of life care for a teacup because that’s a whole other topic that I could write on and on about, but it’s a process determined by you and your clown together.

So that’s the teacup life, roughly outlined, they are incredible creatures and surprisingly not as different to humans as one might think, in terms of lifespan and maturity. I’m so looking forward to when you get your newest clown, she really seems like something special, and tysm for the asks <33333 good wishes to all your little guys and best of luck with your new clown!!

Happy clowning :o)

#clown husbandry #clownblr #clown posting #clowncore #clowns #clown #clown care #clown doll #txt post #unreality #clownhusbandry #asks #clown asks #clown info #tytytyty for the asks #<333333

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covid-safer-hotties · 2 months ago

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Old News (Published Sept, 2022)

Also preserved in our archive

It's disgusting how little movement has been made since this article was published. Biden declared a victory only to be forced to step down by a covid infection this summer. We're done being ignored.

By Jamie Ducharme

Dr. Ezekiel Emanuel is used to feeling like the only person in the country who still cares about COVID-19. He ignores the side-eye he gets for wearing an N95 mask at parties—a self-imposed policy that makes him “look odd” but kept him safe after a recent work dinner turned into a superspreader event. The oncologist, bioethicist, and professor at the University of Pennsylvania provides each of his students with an N95 and runs four HEPA air filters during lectures. He rolls down the windows when he gets in an Uber and goes hungry on planes so he can wear his mask the whole time. He’s given up one of his favorite pastimes—dining at restaurants—even now that many people don’t think twice about eating indoors.

Emanuel, 65, takes these precautions even though he’s vaccinated and boosted and thus well protected against severe COVID-19. The acute disease doesn’t scare him much—but what could come after does. “The only thing that’s preventing me from leading a normal life is the risk that I’ll get Long COVID,” Emanuel says. “I can’t say why people aren’t [reacting like] their hair’s on fire. This is a serious, serious illness.”

Emanuel’s not totally alone. In a July Axios-Ipsos poll, 17% of people said their biggest fear related to COVID-19 is the possibility of getting Long COVID, a potentially disabling condition in which symptoms linger or emerge well after an acute infection. But at a time when the majority of U.S. adults think there’s little risk in returning to normal, mask wearers, test takers, and social distancers walk a lonely road.

Even public-health agencies seem over it. Throughout 2022, the U.S. Centers for Disease Control and Prevention (CDC) has rolled back many of its recommended COVID-19 precautions. CDC guidance no longer recommends social distancing, mask-wearing, or screening tests for most people who don’t have symptoms, and unvaccinated people don’t need to quarantine if they’re exposed to the virus. In a 60 Minutes interview that aired Sept. 18, President Joe Biden said “the pandemic is over,” even though “we still have a problem with COVID.”

The following day, chronic disease advocates protested in front of the White House, arguing that Long COVID and the related condition myalgic encephalomyelitis/chronic fatigue syndrome constitute a public-health emergency and demanding that the Biden Administration improve its public-education campaigns, financial support for patients, and research efforts.

The CDC says its COVID-19 guidance is meant to prevent “medically significant COVID-19 illness,” which includes both severe acute disease and Long COVID. The agency contends its lighter touch is warranted now that the vast majority of the U.S. population has good protection against severe disease from being vaccinated, contracting COVID-19, or both. “Our emphasis on preventing severe disease will also help prevent cases of post-COVID conditions, as post-COVID conditions are found more often in people who had severe COVID-19 illness,” Dr. Barbara Mahon, who oversees work on coronaviruses and other respiratory diseases at the CDC, said in response to questions from TIME about the agency’s Long COVID guidance.

But even with high levels of population immunity, Long COVID cases continue to pile up. By the CDC’s own estimate from June, one in five U.S. adults with a known prior case of COVID-19 had symptoms of Long COVID. Having COVID-19 also raises a person’s risk of developing chronic conditions including heart disease, asthma, and diabetes, according to CDC research.

Long COVID can take many forms, including exhaustion, cognitive dysfunction, neurological issues, and chronic pain. People can develop it whether they’re young or old, sick or healthy, vaccinated or not. And while some people get better in a matter of months, recent studies and many patient experiences show symptoms can last years. There is no known cure for Long COVID, and the only way to prevent it is not to get infected at all.

That, a vocal group of experts and advocates say, is why people should resist the U.S.’ collective shrug to the unchecked spread of COVID-19. The virus may not kill or hospitalize as many people as it once did, but it still upends lives every day. Around 1.2 million people in the U.S. became disabled as a result of the virus by the end of 2021, according to the Center for American Progress, a progressive think tank. Up to 4 million people in the U.S. are out of work because of Long COVID. Specialists who treat Long COVID report months-long waitlists. And in the current “let it rip” phase of the pandemic, all of that may get worse.

“We’re in the middle of the greatest mass-disabling event in human history,” says Long COVID patient and advocate Charlie McCone. And unless people wake up to the long-term consequences of COVID-19, it is “going to continue taking folks out like fish in a barrel.”

President Joe Biden ran on a promise to defeat COVID-19. And for a while, it looked like he would deliver. In the spring and early summer of 2021, the U.S. was recording about 12,000 cases per day. Vaccines were working. Masks were coming off. Life was good.

Then Delta hit, followed by the tsunami of Omicron, and the path out of the pandemic no longer looked clear. The messaging began to shift: the U.S. would learn to live with COVID-19, rather than defeating it. We couldn’t stop all infections, but we could defang them through vaccines, boosters, and treatments like the antiviral Paxlovid. The masks could stay off, even if the virus wasn’t gone.

Many Americans welcomed the return to normalcy. But to McCone, 32, that approach is “a crime against humanity,” given what we now know about Long COVID.

McCone got sick in March 2020. COVID-19 knocked him flat. He almost went to his local emergency room because he was so short of breath, and it took weeks for his respiratory symptoms to improve. After about a month, he finally felt well enough to ride his bike. “I just fell apart,” McCone remembers. The 15-minute ride left him with unshakeable exhaustion—and a sign that this would be no ordinary recovery.

More than two years later, McCone barely leaves the house, except for medical appointments. He still has severe fatigue, chest pain, shortness of breath, and nervous system dysfunction. He can’t work because of his symptoms, and his partner has become his caretaker. His symptoms got even worse after catching COVID-19 again in September 2021, so he’s “petrified” of getting reinfected—a fear he wishes more people shared.

“We’re letting millions of Americans and people across the globe walk, unwittingly, straight into this pit,” he says.

Hannah Davis, a machine learning expert who began researching Long COVID after her own diagnosis, also got sick in March 2020. Davis has testified about Long COVID before Congress and advised federal health officials about the condition. She says those experiences have shown her that health officials understand that Long COVID is a substantial problem, and that, while vaccines reduce the risk of developing it—by some amount between 15% and 50%, studies suggest—they are not failsafe. The U.K.’s Office for National Statistics recently reported that roughly 4.5% of triple-vaccinated adults developed Long COVID after being infected by Omicron. But the government doesn’t seem to want to dwell on these scary stats, Davis says. “It really looks like it’s being hidden intentionally,” she says.

Davis believes that’s because the Biden Administration leaned heavily on vaccines as a ticket out of the pandemic and is wary of walking back that messaging now, even as fully vaccinated and boosted people contract Long COVID. A representative for the U.S. Department of Health and Human Services (HHS) did not directly respond to that allegation when asked by TIME, but emphasized the importance of vaccination and said the department is still working “to understand this new post-infectious landscape.”

“Individuals, communities, and organizations must make decisions that create the right balance between the need to protect themselves and others from the effects of COVID-19 and the need to stay healthy in every sense of the word—such as mental health, getting an education, preventive and chronic disease care, and social interaction,” the CDC’s Mahon said in a statement.

Health officials are not doing enough to prevent transmission of the virus and help people understand its risks, says Kristin Urquiza, who founded the advocacy group Marked By COVID after her father died from the virus in 2020. “Leaders have thrown their hands up in the air and basically said, ‘You do you,’” she says.

The federal government has taken some action on Long COVID. In late 2020, Congress gave the National Institutes of Health (NIH) more than $1 billion to study it. But so far, this funding has yielded no treatments, no preventative tools, and little research that is immediately useful to patients. The NIH’s cornerstone Long COVID research project aimed to enroll 40,000 people; as of August, it had enrolled only about 8,000. That’s in large part because of the complexity and scope of the trial, according to the NIH.

Lawmakers have introduced bills meant to improve research and support for Long COVID, but they’ve reportedly stalled due to a lack of support in Congress. And in August, HHS released two highly anticipated reports on Long COVID—one describing resources available to patients, the other outlining the government’s research agenda—that were largely panned by Long COVID advocates as more symbolic than substantive.

“Many of the resources provided in the reports seem like cold comforts and temporary Band-Aids when a tourniquet and emergency surgery is needed,” Urquiza said in a statement to Rolling Stone about the reports.

The HHS representative told TIME the reports are just the beginning, and the Administration’s work on Long COVID is ongoing. For people with Long COVID, “It can feel like the world is moving on, while leaving them behind,” the spokesperson wrote in the statement. “The Administration’s message to them is that, ‘We see you, we hear you, and we are taking action to help.'”

Some Long COVID advocates and scientists have called for an initiative like Operation Warp Speed—the Trump Administration program that quickly yielded multiple effective COVID-19 vaccines—for Long COVID treatments. But the NIH hasn’t built anything of the sort, says David Putrino, a Long COVID researcher at New York’s Mount Sinai health system. Despite its $1 billion budget for Long COVID research, “There’s been no process change between how they fund things outside of a health emergency and how they’re funding things in the midst of a health crisis,” he says. “We’re still following the same grant application procedures, the administrative load is the same if not more, and they have not hired additional people to program manage the grants.” In a statement, the NIH said application review is handled by an “ample and diverse set of experts.”

Dr. Eric Topol, founder of the Scripps Research Translational Institute and a prolific parser of COVID-19 research on Twitter, says the NIH is doing good research on the underlying science of Long COVID, but he’d like to see more trials focused on treatments. “You need to do both, because we can’t wait another year or two for the biology to be better defined,” Topol says. (The NIH says it will begin treatment-focused trials this fall. Mahon says the CDC also continues to research Long COVID symptoms, prevalence, and risk factors.)

Research delays are not for lack of intriguing leads. A tremendous amount of Long COVID research has been published in the last two years, most coming out of independent laboratories, Putrino says. From this work, scientists have found multiple possible explanations for Long COVID symptoms: SARS-CoV-2 virus lingering in the body, abnormal immune system activity, reactivation of other viruses previously lying dormant, tiny blood clots throughout the body, and more. These disparate findings suggest that there may be different root causes or subtypes of Long COVID, which means all patients might not respond to the same therapy. But each one suggests a possible path to treatment worth testing sooner rather than later, Topol says.

Nobody knows exactly how prevalent Long COVID is, and some researchers argue that the CDC’s estimate of one patient per five COVID-19 cases is high. But, even using more conservative prevalence estimates, the volume of infections in the U.S. means the scale of the problem is massive. About 60,000 people in the U.S. currently test positive for COVID-19 daily. Even by more modest estimates, that means the seeds for a possibly debilitating condition are planted in thousands of people every day. During just the first two years of the pandemic, at least 17 million people in Europe developed Long COVID, according to a Sept. 13 report commissioned by the World Health Organization.

“If we have millions of people being infected, we’re going to have millions of people getting Long COVID,” Emanuel says. “That’s going to be an ongoing, serious national problem that is going to weigh down the economy, weigh down the disability insurance system, and be tragic for people.”

Journalist and author Katie Hafner, 64, was one of the unlucky people to develop Long COVID after being vaccinated and boosted. She got infected in May and was left with significant fatigue and brain fog. Her Long COVID symptoms were on the milder end of the spectrum and have improved with time, but Hafner says she can still manage only a few hours of work per day and has to carefully monitor her physical and mental energy levels. Her anxiety has also escalated since getting sick.

Hafner’s husband is Dr. Robert Wachter, chair of the department of medicine at the University of California, San Francisco. Between his wife’s experience and his close monitoring of COVID-19 research, Wachter is concerned enough about Long COVID to avoid indoor dining and wear a good mask in crowded areas. For people who aren’t immersed in the research, though, “the cognitive load of doing all this three-dimensional chess [around risk calculation] is too much,” he says. “To me, the CDC hasn’t been very vigorous on Long COVID,” providing less guidance about prevention and risks than it did for acute infections.

Those risks are substantial. Wachter says he’s worried about Long COVID’s impact on the health care system—not just in already overloaded Long COVID clinics, but system-wide. “If it turns out that it markedly increases the rates of some of the biggest medical hazards we have in life”—including organ failure, heart disease, and dementia, as research currently suggests— “the toll of that over years and years will be tremendous,” Wachter says. “I don’t think [the CDC has] done a good job explaining that at all.”

The economic toll could also be massive. Up to 4 million adults in the U.S. are out of work because of Long COVID, costing the economy at least $170 billion in annual lost wages alone, according to a Brookings Institution report published in August. A Kaiser Family Foundation analysis suggests just 44% of people who worked before they got Long COVID are now fully employed, with the remainder either out of a job or working reduced hours.

Many long-haulers who are unable to work have turned to the disability system. But, anecdotally, many have had trouble getting their claims approved, either because they’re outright denied or forced to jump through hoops to prove they’re truly unable to work. A representative for the Social Security Administration said in a statement that, as of August, it had received about 38,000 applications that mention COVID-19, representing about 1% of recent claims—but since decisions are based on functional limitations, not diagnoses, it’s difficult to say how many people have sought support due to Long COVID.

Experts say there is more that can be done, even before new therapies are discovered or developed. To slow transmission and thus lower rates of Long COVID, Topol says the CDC should tell people to isolate for longer than five days after getting infected and campaign harder for people to get booster shots. Emanuel, meanwhile, would like to see better communication about which masks protect wearers from infection; respirators like N95s are more effective than surgical or cloth masks, but many people still walk around in droopy blue surgical masks. Public indoor spaces, like restaurants and schools, should also have enforceable requirements for ventilation and air filtration, given the virus’ ability to spread in the air.

A return to mask mandates would also be a good step, Davis says. But even if none of those changes are enacted, she says the government should at least emphasize how common Long COVID appears to be and that it can affect vaccinated people. She fears many vaccinated people think they’re in the clear and can’t get Long COVID, because the Administration has sung the shots’ praises so much. “We’re just drowning in this sea of misinformation that is not only causing people to poorly think about their own risk, but also putting other people at risk,” Davis says.

Those with Long COVID often say they feel like they’re screaming into the void, trying to get through to people who either aren’t aware of or don’t care about the condition and the possibility it could affect them, too. In grocery stores, Hafner marvels—and seethes—at the bare faces she sees. Sometimes, when she’s the only person wearing a mask, “I think, ‘Am I a pariah?’” Hafner says. “We’re at that point where the people in masks are the outliers.”

For many people who are done with the pandemic and the caution that came with it, a maskless supermarket may seem like a sign of progress. But for those with an intimate understanding of Long COVID, it feels like a bad omen.

“It’s no way to live,” McCone says of his day-to-day existence since developing Long COVID. His worst fear, and one that looks like it may come true if progress isn’t made soon, is that millions more people will have to learn that the hard way.

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