#smoke x lesion

[speebledorp]

quick guess my fav color

(these were twt requests for valentines day but i forgot to post here wahhhh)

[cancer-specialist-in-pune]

The Importance of Getting a Second Opinion in Lung Cancer Care

If you or someone you care about has recently been diagnosed with lung cancer, it’s natural to feel confused and unsure about what to do next. It’s completely normal to have questions and concerns during this difficult time. One helpful step you can take is to seek a second opinion. Dr. Pratik Patil is a well-respected lung cancer specialist in Pune. He understands how important it is to provide personalized care, especially in complicated cases like lung cancer. Dr. Pratik Patil, Who has extensive experience in diagnosing and treating this illness, offers second opinions to make sure patients get the most accurate information about their condition and the best cancer treatment options available. Getting a second opinion can give you more clarity and confidence about your treatment path. It ensures that you’re fully informed and can make the best decisions for your health.

Understanding Lung Cancer:

Abnormal growth of cells, in the lungs leads to the formation of tumors that may spread to surrounding tissues and impact lung functionality—a typical beginning of lung cancer treatment is characterized by Small-cell lung cancer and non-small-cell lung cancer are the two main varieties. The primary risk factor associated with this condition is smoking; however; other contributory factors include exposure to radon gas asbestos and air pollution. To improve results, early detection and treatment are essential.

Lung Cancer Diagnosis:

A number of procedures are used to diagnose lung cancer, including imaging tests that help find discomforting lesions,  similar to CT scans and chest X-rays. A biopsy is conducted to remove lung tissue for microscopic analysis in order to seek cancer cells, if irregularities are found. Blood tests can also help with treatment planning by relating inheritable abnormalities or tumor markers. Understanding the cancer’s stage after diagnosis is pivotal to determining a suitable treatment plan.

Why a Second Opinion Matters?

Getting Second Opinion can really make a difference, for someone dealing with lung cancer treatment decisions! It may confirm the original diagnosis or open up different treatment paths like chemotherapy, targeted therapy, immunotherapy, and radiation remedies from Dr.Patil, the best cancer treatment in Pune who specializes in these areas to give patients the personalized care they need depending on their specific circumstances. It improves individual accuracy, assuring that your lung cancer diagnosis is correct and comprehensive.

[breathclinic]

Diagnostic Tests for Chronic Cough in Smokers: What to Expect

When dealing with chronic cough in smokers, diagnostic tests play a crucial role in identifying underlying causes and guiding effective treatment strategies. A pulmonologist in Jaipur like Dr. Pankaj Gulati at Breath Clinic is instrumental in conducting these tests to provide accurate diagnoses and personalized care.

Initial Evaluation: Upon visiting a chronic cough doctor near me, such as Dr. Pankaj Gulati, patients can expect a comprehensive evaluation of their medical history and current symptoms. This initial assessment helps to understand the duration and characteristics of the cough, any associated symptoms like sputum production or shortness of breath, and smoking history—all crucial factors in determining the appropriate diagnostic approach.

Common Diagnostic Tests:

Spirometry: This non-invasive test measures lung function, assessing how well the lungs work by measuring airflow rates and volumes. It helps identify airflow obstruction typical in conditions like COPD.

Chest X-ray: X-rays provide images of the lungs, helping to detect abnormalities such as tumors, infections, or structural issues like bronchiectasis.

CT Scan: Computed tomography scans offer detailed cross-sectional images of the lungs, providing more information than X-rays and helping to detect smaller lesions or abnormalities not visible on standard X-rays.

Bronchoscopy: In cases requiring a closer look inside the airways, a bronchoscopy may be performed. This procedure involves inserting a flexible tube with a camera through the nose or mouth to examine the airways and collect tissue samples if needed for further analysis.

Sputum Culture and Analysis: Analyzing sputum (mucus coughed up from the lungs) can help identify infections, bacteria, or other microorganisms causing respiratory symptoms.

Pulmonary Function Tests (PFTs): These tests assess lung function comprehensively, including lung capacity, gas exchange, and responsiveness to medications. They provide valuable insights into respiratory health and help guide treatment decisions.

Importance of Timely Diagnosis: Prompt diagnosis of chronic cough in smokers is critical to initiating appropriate treatment and preventing potential complications such as lung damage or progression to more severe respiratory conditions. A pulmonologist in Jaipur like Dr. Pankaj Gulati ensures thorough evaluation and interpretation of diagnostic tests, offering patients personalized care plans tailored to their specific needs and health goals.

Patient-Centered Approach: Dr. Pankaj Gulati emphasizes a patient-centered approach, involving patients in decision-making and educating them about their condition and treatment options. This collaborative effort ensures that individuals understand the diagnostic process, feel empowered in managing their health, and receive the best possible care to address their chronic cough effectively.

In conclusion, diagnostic tests for chronic cough in smokers are diverse and aim to uncover the root cause of respiratory symptoms. Consulting a skilled chronic cough doctor near me like Dr. Pankaj Gulati at Breath Clinic in Jaipur ensures comprehensive evaluation and personalized treatment plans, leading to better outcomes and improved respiratory health for patients dealing with this challenging condition.

[sidshrek6]

Appointments Women Need to Make Every Year

PRIMARY CARE PHYSICIAN

ou should see your primary care physician once a year for your annual checkup. They will check your blood pressure, heart rate, reflexes, and update your vaccinations and your medical history. If you have noticed any changes to your health, your yearly checkup is the perfect time to talk to your doctor about them. Depending on your medical history and health, your doctor may order blood tests to check your blood sugar levels, cholesterol, kidney function, liver function, and other levels. Some blood tests require fasting beforehand, so your physician may have you schedule a follow-up appointment.

OPTOMETRIST

Depending on your eye health, you may need to see an optometrist once a year or once every two years. At your routine eye exam, the doctor will check for signs of eye disease, including glaucoma, cataracts, and age-related macular degeneration. If you wear glasses or contacts, your annual appointment is the perfect time to have your prescription updated. Early prevention is key in eye-related disease, so regular eye appointments are crucial to your overall health.

DENTIST

wice a year, you should visit your dentist for a routine cleaning appointment. During this appointment, the dental hygienist will clear plaque and stains from your teeth by cleaning and polishing them. If you have been experiencing any issues or pain with your teeth or mouth, you will also have the opportunity to discuss it with your dentist. Once a year, the dentist will also take X-rays of your teeth to screen for tooth or gum decay.

DERMATOLOGIST

At a regular dermatological visit, the doctor will perform a skin cancer screening and examine any moles, spots, or lesions. If you have a family history of skin cancer or you spend a lot of time in the sun, your dermatologist may recommend visiting more often than once a year. Additionally, if you notice a significant change to your skin or have a specific concern, do not wait until your next check-up; you should immediately schedule an appointment.

GYNECOLOGIST

Every year, you should receive a pelvic exam. At this exam, the physician will examine your uterus, cervix, fallopian tubes, ovaries, bladder, and rectum. The doctor will look for any abnormalities or changes to your pelvic health. If you are between the ages of 21 and 29, you will also receive a pap smear every one to three years. If you are 30 to 65, you will receive a pap smear every five years. Women older than 65 don’t need to receive a pap smear. If your pap smear yields abnormal results, your provider may recommend HPV testing.

If you are sexually active, you should also be tested yearly for STDs, including gonorrhea, chlamydia, hepatitis B, and syphilis. Every woman should be tested at least once during her lifetime for HIV, as well.

RADIOLOGIST

Women can begin receiving mammograms at age 40. If you decide to wait to start receiving mammograms, you should wait no longer than age 50 to begin. Depending on what you prefer and your doctor recommends, you can receive a mammogram every year or every other year. You should continue with regular mammograms until you are 75. Mammograms are crucial in screening for breast cancer.

OTHER APPOINTMENTS

One of your doctors may recommend follow up with another physician or a specialist based on the results of your visit with them. Many other things may prompt providers to recommend follow up, including family and personal medical history; habits such as smoking, drinking, or drug use; and age. If you have any questions about seeing another provider or any symptoms you are experiencing, do not hesitate to ask your primary care physician about it.

Regular check-ups with a doctors for women health are essential. It's also important for women of all ages to schedule an appointment whenever they experience changes in their health that concern them. Symptoms like persistent fatigue, unexplained weight loss or gain, abnormal bleeding from anywhere (vagina/breast/rectum), constant headaches etc., require immediate attention irrespective of your previous appointments.

Women must pay close attention to any symptoms that arise outside routine checkups and seek medical advice promptly if needed. Regular communication with healthcare providers helps ensure optimal health throughout life.

[sid-health-care-blog]

The 6 Appointments Women Need to Make Every Year

PRIMARY CARE PHYSICIAN

ou should see your primary care physician once a year for your annual checkup. They will check your blood pressure, heart rate, reflexes, and update your vaccinations and your medical history. If you have noticed any changes to your health, your yearly checkup is the perfect time to talk to your doctor about them. Depending on your medical history and health, your doctor may order blood tests to check your blood sugar levels, cholesterol, kidney function, liver function, and other levels. Some blood tests require fasting beforehand, so your physician may have you schedule a follow-up appointment.

OPTOMETRIST

Depending on your eye health, you may need to see an optometrist once a year or once every two years. At your routine eye exam, the doctor will check for signs of eye disease, including glaucoma, cataracts, and age-related macular degeneration. If you wear glasses or contacts, your annual appointment is the perfect time to have your prescription updated. Early prevention is key in eye-related disease, so regular eye appointments are crucial to your overall health.

DENTIST

wice a year, you should visit your dentist for a routine cleaning appointment. During this appointment, the dental hygienist will clear plaque and stains from your teeth by cleaning and polishing them. If you have been experiencing any issues or pain with your teeth or mouth, you will also have the opportunity to discuss it with your dentist. Once a year, the dentist will also take X-rays of your teeth to screen for tooth or gum decay.

DERMATOLOGIST

At a regular dermatological visit, the doctor will perform a skin cancer screening and examine any moles, spots, or lesions. If you have a family history of skin cancer or you spend a lot of time in the sun, your dermatologist may recommend visiting more often than once a year. Additionally, if you notice a significant change to your skin or have a specific concern, do not wait until your next check-up; you should immediately schedule an appointment.

GYNECOLOGIST

Every year, you should receive a pelvic exam. At this exam, the physician will examine your uterus, cervix, fallopian tubes, ovaries, bladder, and rectum. The doctor will look for any abnormalities or changes to your pelvic health. If you are between the ages of 21 and 29, you will also receive a pap smear every one to three years. If you are 30 to 65, you will receive a pap smear every five years. Women older than 65 don’t need to receive a pap smear. If your pap smear yields abnormal results, your provider may recommend HPV testing.

If you are sexually active, you should also be tested yearly for STDs, including gonorrhea, chlamydia, hepatitis B, and syphilis. Every woman should be tested at least once during her lifetime for HIV, as well.

RADIOLOGIST

Women can begin receiving mammograms at age 40. If you decide to wait to start receiving mammograms, you should wait no longer than age 50 to begin. Depending on what you prefer and your doctor recommends, you can receive a mammogram every year or every other year. You should continue with regular mammograms until you are 75. Mammograms are crucial in screening for breast cancer.

OTHER APPOINTMENTS

One of your doctors may recommend follow up with another physician or a specialist based on the results of your visit with them. Many other things may prompt providers to recommend follow up, including family and personal medical history; habits such as smoking, drinking, or drug use; and age. If you have any questions about seeing another provider or any symptoms you are experiencing, do not hesitate to ask your primary care physician about it.

Regular check-ups with a doctors for women health are essential. It's also important for women of all ages to schedule an appointment whenever they experience changes in their health that concern them. Symptoms like persistent fatigue, unexplained weight loss or gain, abnormal bleeding from anywhere (vagina/breast/rectum), constant headaches etc., require immediate attention irrespective of your previous appointments.

There is no one-size-fits-all answer when it comes to how often women should see their doctors but scheduling annual exams at least once per year could be beneficial for most women. Women must pay close attention to any symptoms that arise outside routine checkups and seek medical advice promptly if needed. Regular communication with healthcare providers helps ensure optimal health throughout life!

[writerscampus]

57-year-old Caucasian male presents with generalized abdominal pain

New Post has been published on https://writerscampus.com/2023/06/09/57-year-old-caucasian/

57-year-old Caucasian male presents with generalized abdominal pain

57-year-old Caucasian male presents with generalized abdominal pain and fullness, urinary frequency, urgency, and nocturia for two months.  He has unintentional weight loss of 40 pounds over the last six months and he has been experiencing fatigue, malaise, general body aches, polydipsia, and polyuria.  He has not seen a physician since he was a child. His past medical history is negative. His past surgical history is negative. He quit smoking five years ago but smoked four packs a day for eight years. Denies any alcohol or drug use. His family history is positive. His mom had some type of cancer but does not know what kind. She also had Parkinson’s disease and pneumonia. His father had diabetes, chronic kidney disease and hypertension. Physical exam.  His temperature is 98.6, Heart rate is 82, respiratory rate is 18, blood pressure is 160/90 and O2 sat is 98% on RA.  He is alert and oriented x 3. He is obese and in no acute distress. His head is normocephalic and atraumatic. Pupils are equal, round, and reactive to light. There’s no nystagmus or scleral icterus. His neck is supple, there is no JVD. There’s no tracheal deviation, or thyromegaly, or thyroid nodules. His rate is, uh, normal. His has an S1 that is normal and S2 that’s present without any S3, S4, gallop, friction rub or murmur. There’s no edema in the lower extremities. The brachial, radial, dorsalis pedis and posterior tibial pulses are 2+/4+ bilaterally.  Respirations are regular and even. Lungs are clear in the anterior and posterior bilateral lung fields. Abdomen is obese and soft. Bowel sounds are active. There’s generalized tenderness. We’re unable to palpate the liver due to his body habitus, and there’s no rigidity rebound or guarding.  There’s no cervical lymphadenopathy. Cranial nerves II-IV are intact. The skin is warm, dry, and intact. There are no rashes, lesions, or abrasions.  Mood and affect are normal. He has a calm and cooperative behavior and judgement is intact. As you recall, he’s not on any medications. During your first visit, you ordered labs and a CT of the abdomen, and now more labs are available. Unfortunately, the liver function tests, lipid panel, TSH are still pending. If you remember his CT of the abdomen/pelvis shows hypovascular liver masses consistent with metastatic disease of unknown primary.  His available lab results are here. His sodium is 125, potassium 5.7, creatinine is 1.5, BUN is 35, Glucose is 350, his serum bicarb or CO2 is 15. Anion gap is 22. Osmolality is 302. WBC is 5,000. RBC is 3.0. Hemoglobin is 8.0. Hematocrit is 24%. MCV is 72 and the platelets are 200,000. 

What type of anemia does patient most likely have? 

What additional lab work would be helpful with helping you determine the type of anemia?

What is most likely cause of his anemia? 

What is patient at risk of developing? 

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[vampsquerade]

Requests Rules (Current Status: Open)

Characters Per Request for headcanons: Maximum of 2.

Characters Per Story: Maximum of 4 (all characters will be partners with the reader; exceptions can and will be made if i like it enough).

Characters Per NSFW Alphabet: Maximum of 1

Characters Per SFW Alphabet: Maximum of 1

Please be as specific as you can when requesting as it helps me with my writing

Please specify whether you want headcanons or an x reader, so I don’t accidentally write something you didn’t want

Requests are now open for a short time! Please just read my rules and request accordingly!

Characters I’ll Write For: Rainbow Six Siege/Extraction and Call of Duty. This may change later on, however, once I feel like branching out!

Rainbow Six Siege/Extraction:

Chul Kyung “Vigil” Hwa

Olivier “Lion” Flament

Erik “Maverick” Thorn

Jordan “Thermite” Trace

Miles “Castle” Campbell

Gustave “Doc” Kateb

Gilles “Montagne” Touré

Julien “Rook” Nizan

Saif “Oryx” Al Hadid

Dominic “Bandit” Brunsmeier

Elias “Blitz” Kötz

Marius “Jäger” Streicher

Sébastien “Buck” Côte

Håvard “Ace” Haugland

Mark “Mute” Chandar

Mike “Thatcher” Baker

James “Smoke” Porter

Seamus “Sledge” Cowden

César “Goyo” Ruiz Hernández

Masaru “Echo” Enatsu

Liu Tze “Lesion” Long

Collinn “Warden” McKinley

Aleksandr “Tachanka” Senaviev

Maxim “Kapkan” Basuda

Timur “Glaz” Glazkov

Shuhrat “Fuze” Kessikbayev

Ryad “Jackal” Ramírez Al-Hassar

Call of Duty:

John “Soap” MacTavish

Simon “Ghost” Riley

Kyle “Gaz” Garrick

Captain John Price

Phillip Graves

Talon

König

Hong-jin “Horangi” Kim

Zhiqiang “Zimo” Wong

Jesus “Chuy” Ordaz

Enzo Reyes

Sobieslaw “Gromsko” Kościuszko

Rodolfo “Rudy” Parra

Sebastian “Krueger” Krueger

Hans “Golem” Blaustein

Benjamin “Otter” Lee

Jackson Wyatt

Valeria “El Sin Nombre” Garza

Alejandro Vargas

Alex Keller

Gary “Roach” Sanderson

Sergio “Morte” Sulla

Vladimir Makarov

Thibault “Riptide” Lefebre

Roland “Swagger” Kaminski

What I Will Write:

Fluff

Light Smut (Vanilla)

Heavy Smut (Hardcore: dubcon, consensual non-con, and somnophilia are allowed under the circumstances that you explicitly specify that reader in the scenario will be consenting to it. if you aren’t comfortable requesting or reading that there will be time for you to scroll away. Doing this has helped me with my trauma.)

Angst (good, neutral, and bad endings)

NSFW Alphabets

SFW Alphabets

Character/Reader: Friends to Lovers

Character/Reader: Enemies to Lovers

Sick Character or Sick Reader

Gender Neutral, Female, and Male Readers

Mental Health (c-PTSD, Depression, Insomnia, and Anxiety will be the only ones I write about because those are of the few things I have been diagnosed with. I am not romanticizing these at all, keep that in mind)

Omegaverse (Alpha/Beta/Omega Character or Alpha/Beta/Omega Reader)

Monsterfucking

Multiple Partners (Exceptions will sometimes be made if I like the prompt enough)

Substance Use (only weed and alcohol)

Cheating and Toxic Relationships (My therapist has recommended I try to write stuff that helps ease off the trauma I’ve gotten from these)

Stalking

What I Will NOT Write:

Incest

Blatant Rape

Domestic Abuse

Child Abuse

Animal Abuse

Racism

Transphobia

Homophobia

Torture

Comforting Self-Harm (I used to allow this one but I’ve been in therapy for this for a good while now and it will trigger a relapse if I ever write for it again. Very slim chances of me writing for prompts like these ever again)

Suicide (Very, very, very slim chances of me ever making an exception for it)

Any obscure or gross fetishes/kinks

Character/Character (Exceptions can be made for this though!)

Pregnancy (I never properly addressed or clarified any of this and would like to apologize for what it was previously listed as. I am avoiding fetishization of anybody who can get pregnant because I have received 2 asks by the same person back in August and as you can tell, I never wrote them because they were offensive fetish prompts centered around stereotypes. There are no exceptions for this one)

Thank you very much for requesting!!

[subwaysurf45]

Tech problems (bucky x reader)

Summary: bucky doesn’t know how to work the TV, his new phone, anything. After getting made fun if he wants to quit but the reader helps him out.

Pairing: bucky barns x reader

Warning: mentions of death near the end, but it’s mostly fluff

Masterlist!

Bucky stood at the counter in the kitchen, full weight leaning on the concrete slab that most people ate off of. His eyebrows were basically touching as he fiddled with his phone that Tony just gave him, he just couldn’t figure it out for the life of him.

“Hey, old guy!” Tony walked in, “whatcha doing?” He walked over and peered over Bucky’s shoulder.

“Trying to…” his brain wasn’t focused on completing the sentence, more on creating an e-mail.

“I see,” Tony snatched the phone from Bucky’s hands and turned his back to him, Bucky tried to see what he was doing but Tony kept walking around. A little bit of anger grew inside him because Tony seemed just fine at working with tech- everyone did.

Steve had walked in, “Tony, what are you doing?” His voice was tired and annoyed, he already knew what was happening simply from the way Bucky looked longingly at Steve. “Tony-“

“Ah-ta-ta, let me help him.” Tony smirked, his voice dripping in sarcasm. “I’m doing it all for him, aaaand- done!” He turned and slapped the phone in the table, it looked like everyone else’s.

“What did you do to it?” Bucky asked, his anger coming through in his tone.

“Nothing, tin man- old man- silver hair, just nothing.” He seemed like he was telling the truth, “i just did it so you wouldn’t keep annoying me and asking so many god damn questions, jeez.” Tony scoffed and walked away, Bucky didn’t pick up the phone, rather stare at it.

“How stupid am I?” Bucky asked, “really, like you got this figured out in less than a week, Tony told me when I asked for the Bluetooth password.”

“Wifi.” Steve corrected.

“What?” Bucky looked over, “same thing, who cares…” Bucky waved him off, his head snapped up at Steve suppressing a laugh, his stomach sank, “what?” His voice light and almost a whisper.

“It’s not the same thing, very much not the same thing.” He laughed, Bucky sighed, he’d had enough of this. Bucky picked up the phone and walked down the hall, “oh, come on! I’m having fun with you!” Steve laughed.

~~~

You wiped the sweat from your forehead, training with Nat had just ended and you were heading back to your shared room with Bucky. As you walked past the kitchen you saw Steve looking at nothing, he hand kept his head up.

“Why the long face?” You panted, still needing to catch your breath.

“I made fun of Bucky, he’s mad now.” His mouth barley moved, the sentence was muffled.

“About what?” You asked softly but you were still mad, he made fun of your boyfriend.

“Him not knowing how to use tech,” Steve looked up and saw your jaw drop, “what?”

“Literally last night he was so upset because he called me when I was training and he used the emergency signal, so I came running to our room and he had no idea.” You looked towards the bedrooms, “he was so upset with himself that he made me scared, he was all in his head. I need to go check up on him,” you sighed and turned to go to your room; that hot shower had to wait.

Once you made it to your room you softly knocked on the door, “Bucky?” You called, when you heard a hum you opened the door a jar, seeing him slumped over with his phone in his hands. “Hey, babe.” He seemed to break out of his thoughts when you placed a hand on his back.

“Hi, doll face.” He tried to smile, “how’s training?” He looked over to you as you sat beside him.

“Very long and very tiring,” you chuckled, you knew if you asked how he was doing he might get mad or breakdown, “Steve told me what happened, he seemed sad when I was in the kitchen.” Your hand started to rub his upper back, making sure you didn’t hit any scars through the shirt. “You wanna talk about it?” His phone was still on the home page, all the apps were downloaded but you knew he didn’t do that himself.

“I don’t know anything,” he sighed, “i don’t know how to work my phone, the microwave, the TV…I don’t know how to use the system thing in here properly, I can barley understand cars these days, that’s why I use the motorcycle because they didn’t change much but-… y/n, everyone thinks it so funny, the old guy who doesn’t know jack shit about tech.” He slumped forward.

“I don’t think it’s funny,” you moved up to the back of his neck, knowing he likes when you get under into his scalp.

“You’re different.” He stated.

“How so?”

“Because you’ve never been mean to anyone, you’re this shining star, you’re a light and you’re never mean.” His eyes left his phone and he looked at your leg, not wanting to make eye contact after saying that.

Your heart melted, his lips turned up at the quickly kiss to his cheek. He looked over and kissed you back, your hands wrapped around his neck and his pulled your waist in. After pulling away your foreheads rested on one another’s.

“Let me teach you, yeah?” You whispered, “no jokes. No funny business. As long as you need, I’ll go through it all.” You leaned back and waiting for his response.

“I don’t wanna make you go through-“

“Nope. Final rule, no self-doubt.” You smiled, his lip pouted out and he tried to cover his face and blush.

“Okay,” he nodded, “teach me.”

“Not right now,” you laughed, Bucky quirked a brow, “I’m tired and sweaty and I feel gross, also, I would like some cuddles.” You stood and grabbed your towel and a change of comfy clothes, “tomorrow.”

~~~

It was the next day, Bucky sat on the bed as you walked around the TV in your shared room, deep down he wanted to take some notes but he knew if anyone found them, he’d never hear the end of it.

“So let’s start basic,” you stood in front of the blank TV, “let’s say you’ve lost he remote, this is how you control it. Right here,” you pointed to the circle with a line through the top symbol, “that is the universal signal for on and off, look for that. Then, once you’ve pressed it here is the little notches for the volume and then the channel notches.” You pointed as you went along the bottom of the screen.

“Sounds easy,” Bucky muttered more to himself.

“But we have a remote, here, same little symbol, on and off. There, that’s the volume, and the big circle can help navigate up and down, side to side.” You showed him up close, “lots of these buttons will never be used, so I won’t really go through them.” You waved it off. “Okay, test number one, turn of the tv.” You passed the remote.

“Okay…” bucky clicked the button with the symbol he now knew and the screen lit up, some random cartoon played, “yes!” He shit up and jumped, quickly catching himself he sat back down.

“Can you change the channel for me?” You asked, a smirk on your face from his reaction before, he clicked the channel button and it went to the news. “And turn it up, please.”

“Easy,” he smiled and clicked, no sound came out. “What?” He clicked again and the sound came back, but not louder.

“You hit the mute button, use the long button here,” you pointed, he clicked up and it went up one level, after catching on and holding it the volume kept going up, “Bucky-“ you tried to warn but the volume cut out completely.

“Shit.” He stood up, Bucky fiddled with the notches on the actual TV but nothing happened. “What did I do?” His face i genuine terror, “did I break it, oh god, Tony’s gonna get some mad.”

“You blew out the speakers,” after observing the smoke coming out from the side of the TV that was the only possible answer.

“I knew i’d mess it up, I get so cocky, I really thought I had it.” He paced around, tugging his hair.

“Don’t worry, it’ll all be fine,” you calmed him and sat him in the bed, “it’s hard at first but it will only get easier.” You smiled before pulling him into a hug, you could feel his sigh of defeat as he hugged back.

You both headed out to the kitchen, Bucky still in a mood from breaking the TV a couple minutes ago. You both had some coffee, yours with a little milk.

“Hello, lovebirds.” Tony walked in, Bucky looked right at his feet and tried not to look awkward. “What’s up with cyborg over here?” Tony giggled.

“Nothing,” you dipped your coffee, Bucky just nodded along.

“I got a notification that the speakers in your room were blown out,” Tony teased, Bucky stiffened and inches closer to you, “what happened?”

Bucky looked up, his mouth open and about to talk. You gently placed a hand on his chest and looked him in the eye, a way of saying ‘I got this’.

“I sat in the remote, turns out my ass poked it right at the volume and I couldn’t figure it out in time.” You laughed, Bucky looked at you crazy before forcing one out.

Tony hunched over, “I can picture that, oh wow- I wish I was there!” He cackled before turning away and walking down the hall, “it’ll be fixed by tomorrow!” He called over his shoulder.

~~~

It was lonely without you, it was very rare you’d go in missions without Bucky but also rare you’d go alone. It was a simple infiltrate, you were more on the espionage rather than Captain America side of powers. 

Bucky had tired to talk to Steve about letting someone go with you, this mission would involve zero contact with the base. But no one listened, it was always going to be you.

It had been a month, three quarters done with the they needed. The tech lesions had to be halted, you weren’t there to teach and Bucky refused to let anyone tell him anything about the tech in his room.

“If only you could see me, babe…” he whispered as he worked the TV, that was the only thing he knew, and he was great at it. Last week he recorded a show, he was never going to watch it, but it as recorded. He almost had a heart attack when the remote stopped working, but it just ran out of batteries.

After doing all the cool tricks he knew he looked over to your side of the bed, it was neatly made and seemed untouched. Whenever you’d be fine for even a night he’d sleep on the ground, but he promised he’d sleep on the bed, but he never rolled over or even sat on your side.

The one thing he missed was the way your shampoo stunk up the whole bed in a good way, when he’d wake up the morning after you’d showered he’d could smell your lavender shampoo right away, it almost puts him back to sleep. But as the days went on, it faded.

Bucky looked around before gently placing his face your pillow, almost like an afterthought of your sent came through; just barley there. His face hovered before he gave in and relaxed on it, he knew if he’d roll around the sent would fade quicker, he didn’t really care.

There was a hard spot on your pillow, he reached under and found a green spiral notebook. It didn’t have anything in the cover, once he opened it a gasp fell from his lips.

It was a notebook, for every piece of tech in the house. From his phone to how F.R.I.D.A.Y. works, it was all there. Intricate diagrams that where labeled, one page had everything he needed to know.

Bucky’s phone sat face down in his bedside table, he flipped the that page and looked it over. He picked up his phone and read through it all, slightly muttering then words that were written to himself like he was being taught.

“Okay, you got this,” he said as he pressed the on button, as he navigated around he learned how to add a contact, send and text, google, the a picture, send an email. Everything.

~~~

You walked into the compound completely exhausted, one black eye layer, the base had been infiltrated. You went to your mission report computer and Tony was there, he gave you your phone.

“Connect back to the wifi,” he nodded before leaving you to connect.

Once you were fully back online your phone began to buzz, over and over. Tons of notifications rolled in. You went to emails first.

From: bucky

To: y/n

Subject: test?

Hellooooooo this is a test, don’t worry about it!

You laughed and scrolled through the other emails, finding out they were all kind of the same, then you went to text messages.

There was a selfie of him holding the green book, his smile couldn’t have been wider. He sent three, probably by accident. But they were still cute.

So I figured hit text!

Kinda cool

I found the book, it was like Christmas

Anyway, I know you won’t read this but I think I’ll try the oven next, I’ll ask wanda about it.

As the texts went on, your heart started to drop and your stomach swirled. They had been getting progressively sadder.

Hey doll face, I hope you’re well, miss you

I miss you

I love you

I wanna marry you one day, maybe live on farm and have a few kids

If you want

Sent: two months ago

I finished your book, I think I know it all now, I’ve been going over those tests you put in the back sleeve, they’re really good

You’re very thoughtful

I know you can’t see this

I don’t know what to do with myself, this is very hard.

Sent: one month ago

Are you dead?

I had a dream you died in my arms, and I can’t tell if it was a flashback or a dream

I hope you’re not

I love you too much

Please come home

Please

I really need you

I wish I never learn how to use this shit, honestly, I can’t seem to put my phone down because this is all I have if you right now. I keep checking it to see if you’ve responded but I know you haven’t, but part of me wants you to respond so I know you’re alive.

I’m not ready to say goodbye to you yet.

Sent: 24 hours ago

You slammed the phone down and raced down the hall, you passed the kitchen and everyone who smiled at you because they hadn’t seen you in three months, they probably also thought you were dead.

You stopped right before the door, you could hear soft whimpers coming from inside.

“I miss you,” the voice was muffled.

You opened the door silently, you saw Bucky lying right next to your side of the bed, it was still perfectly made. You also saw what looked like glass shattered by the wall, a closer look and it was his phone.

“Bucky?” You asked.

His head shot up and he sat up straight, after wiping his face he ran right over to you. His hug pushed you back on the floor, he just stayed there.

“Don’t ever do that again, please.” His voice was still shaken, “I can’t go through that again.”

“Never again, i was so worried when I saw your text a minuet ago.” You whispered and ran your fingers through his hair.

“Your name in my phone, your the only one.” He sniffled, “it was like it was taunting me, I got really mad and I threw it.” He hugged you tighter, “you were supposed to come home two days ago.” He cried.

“I know,” you housed him and sat up, as he pulled away he saw your bruised face, his thumb gently traced the purple mark.

“I don’t want a phone, I like knowing about it, but I’ll only ever borrow yours.” He seemed like he was pledging something, like an oath.

“Done deal,” you pulled him in for a long kiss, hoping it would never end.

[anniesocsandgeneralstore]

If I Go, I'm Goin' On Fire - Part 2 (Rick Flag x OC)

Summary: Trapped in her Sight, unable to pull herself out, Delphia tumbles through visions of the future that she does not want to see. But what if there was someone, somewhere, who could help her before it was too late?

Pairing: Rick Flag x OC / Squad Family & OC (Delphia Holman)

Word Count: 3513

Warnings: ANGST (like I'm so sorry), multiple character death (not canon tho), canon-typical violence, gore (blood, burns, gunshot wounds, a singular car crash), various weapons mention, suicide mention

Timeline: April 2022

if i go masterlist

A/N: I'm even more terrified to post this one it's so different and sad and please like it i beg you

Whiteness. Like a cold, icy, baron landscape with no end and no sun. Wait — when did this happen? Hadn’t she just been standing in the front garden, waiting for Abner with trowel in hand? No matter. Must have been an accidental slip.

Delphia concentrated, tried to focus on her self in the present. In the back of her mind, tugging at her like a forgotten dream, she heard Abner’s voice:

“It’s me — Abner. Er….We gotta get weed-eating so if you could just stop doing that now that’d be cool.”

Yes, go towards that, she prompted her mind as she felt — like a ghost on her flesh — Abner shaking her shoulder.

The whiteness faded from her vision like dissipating smoke. But she wasn’t back in the front garden with Abner.

She was in some abandoned warehouse. Drab and dark and dilapidated, lights from a bustling metropolis shining through the broken windows. Most definitely not their country house in North Carolina. There was water dripping somewhere. The drip drip echoing off the glass and concrete walls. There were old crates and wooden pallets tossed about the large open room. Tarps draped over certain areas like they hadn’t even finished building the place before deciding to call it quits.

“What the fuck?” Delphia mumbled to herself.

Why had she not gone back to the present? To her actual body? She tried to concentrate again but it was as if that entire world was blocked to her. She could no longer hear any noise at the back of her mind or feel the ghosts of those around her physical form. A sickening feeling dropped low in her stomach.

Was she stuck here?

A howl of pure anguish ripped through the quiet of the warehouse. And after nearly jumping out of her skin, Delphia edged slowly towards the noise. Unsure if she even wanted to see what was happening in this future. But then she saw a white and polka-dot patterned costume hanging mid-air and she froze.

Abner.

No, no, no, no. She didn’t want to see this. Not this. He was strung up from the ceiling. Hands and feet clamped up in metal shackles. The dots. Oh, God. That interdimensional virus — it was eating him alive. With his hands and feet covered, he had no way to expel them. They were burning away at his flesh from the inside, creating colorful acid-burn lesions all over his body.

“Why are you doing this?” Abner shouted as he wreathed.

“I like to call this — “ A man with a beard and perfectly coiffed hair stepped out of the shadows. “Prodding the bear. Your little super family has become a ripe pain in my ass. And you — you just so happened to be the easiest one to capture.”

“They’ll come for you, you know?”

“Oh, yes, that is the plan.” The man nodded. “For them to come seeking revenge and I’ll pick them off one….By….One.”

“You plan fucking sucks,” Abner laughed before groaning in pain again.

The man cocked his head to one side. “And why’s that?”

“Because — “ Abner picked his head up from his chest and stared down at the man, full of malice and determination. “How do you plan on living through killing me?”

Delphia watched, horror-struck, as the glowing dots beneath Abner’s flesh grew and multiplied. As sweet Abner, so quiet and caring, screamed in agony. No — he was doing this to himself. To stop the bearded man. But still, Delphia couldn’t stop the protest that fell from her lips just as the dots exploded from Abner’s flesh. The warehouse began to fall apart — support beams melting and tarps caught on fire. There was no sign of the bearded man or Abner. Even the very shackles that held her friend in place were gone, reduced to molten metal.

“No, no!” Delphia screeched as she looked around desperately, “Get me out! I want out!”

Her mind couldn’t focus. Wouldn’t focus. It was only this future she didn’t want to see and the pained grief that gripped her heart. This couldn’t be Abner’s future. It couldn’t be. He was safe in the squad house with a good job and plenty of books to keep him occupied. What had made him put on his suit again? Who was this bearded man who wanted him dead? Who was this super family that he had mentioned?

That was, until she felt a distant but sharp slap against her cheek. Delphia put a hand to her skin that stung like a distant memory. There was a similar sensation against her other cheek.

Then Harley’s distinct voice at the back of her mind as she stood in a burning room: “Dee? This ain’t a time for playin’ games. You gave Abner and me a good scare — so you can stop now. Very funny. S’a good prank.”

Concentrate. Concentrate. Concentrate. Harley. The house. Of course Harley slapped her. Harley. Harley. Delphia screwed her eyes shut. Yes! Whiteness. But then she heard the loud rumble of a car engine.

And when she opened her eyes again, she was sitting in the passenger seat of a speeding sports car. Sliding through the streets of what looked like Gotham at breakneck speeds. Delphia gripped the door handle tight even though she was in no true danger. Though it certainly felt like it as the car drifted around a sharp corner. There was a cackle from the driver’s seat. Delphia snapped her head over to see Harley at the wheel, a wicked grin stretching her red-painted mouth and a fury in her eyes.

But this wasn’t the Harley Delphia knew. This Harley was manic, even more than usual, with short-cropped pigtails dyed red and black. With new tattoos and fresh bruises on her face. She was escaping something. Delphia just knew it.

“You can’t catch me!” Harley sang out the window as she chucked a live grenade behind her car.

Delphia watched, dumbfounded, as the grenade went through the slipstream the car created and went under one of three vehicles that were following them. It exploded with a ball of fire and shrapnel. Sending the car up into the air to land on its top with a sickening crunch.

“Holy shit!” Delphia yelled.

The other two vehicles remained hot in their pursuit, however.

A cellphone began to ring over the din of the engine and Harley picked it up with a smile. “Oh, hey Flag.”

Rick.

“Yeah, I made ‘em pretty mad. You guys ready and waitin’?” She looked behind her at the following cars. “I’ll be there in twenny seconds.”

But then Harley slammed the gas through a red light intersection. Not even noticing the incoming semi-truck honking his horn. Thinking that she could make it. Delphia braced for impact, her shoulders scrunching up around her ears and a scream echoing around her skull. One that couldn’t possibly be heard as the truck rammed into Harley’s side of the car.

Glass flew in every direction. Tires slid against concrete as the truck tried to come to a screeching halt. Blood spattered across the spiderwebbed windshield. And all Delphia could do was sit there and watch as Harley’s skull caved in and her heart stopped beating. A wicked smile still etched into her face.

A strangled, desperate cry cracked like a whip from Delphia’s mouth as the car and truck finally came to a stop. Harley’s lifeless and limp body laid right beside her. All horrible and mangled and blood-soaked. With ragged, groaning breath, Delphia slid through the car door and out into the street.

This couldn’t be. This couldn’t be it for Harley Quinn. She swore against a life of crime. She — She had a job she loved, she was planning her bachelorette party, she was happy and free. Not driving speeding cars through Gotham being chased by goons. Delphia fell to her knees, unable to look away from the horrific scene. She didn’t want to see this. Didn’t want to see this tragic end.

“Please stop,” she whispered, trying to concentrate on the present, tears streaming down her face, “Please make it stop.”

“What a lucky accident, eh boys?”

It was the bearded man. And from the looks of him — he had survived the warehouse explosion with Abner. His beard and hair only growing where his glistening burned skin would allow.

When the scene blurred and changed again, this time to an underwater landscape, Delphia gave up. She felt like her insides had been scooped out. All hollow with nothing left. She had been able to stand seeing all that death before because, at the end of the day, she could leave those visions of the future behind. She could come home at the end of the day to her warm apartment. To Rick. With his kind, gentle eyes and loving arms that made it all seem like forgotten dreams. But this. There seemed to be no way out of this. No matter how hard she tried, the visions wouldn’t stop. She couldn’t stop seeing the deaths of those that she loved most.

She was trapped. Just like her biological mother all those years ago. Her greatest fear come to life.

Defeated and tired and full of an ache that she couldn’t prescribe to anger or fear or sadness, Delphia curled up in a ball and hid her face in her arms. It was better to only hear the visions than to see them. A tactic left over from her childhood when she had so little control of her powers. To only listen as Nanaue was murdered by a man wearing an orange and turquoise suit. As Cleo was left alone to die in the streets of an unknown city. As DuBois was shot dozens of times in the middle of a forest where no one else would see.

But then, quite suddenly, she was laying on a hardwood floor. Wait. She knew this hardwood floor. Delphia sat up instantly. Yes, she was right. She was back home! There was that familiar set of stairs and the white-painted foyer that she only finished decorating last week.

Was she back? Was she really and truly back? Hope lifted in her chest like a flower freshly blooming. A smile tugged at the corners of her mouth as she rushed from the foyer to the living room.

Rick was sitting on the couch. Yes! She was back!

Delphia opened her mouth to call his attention, to rejoice with him. But all sounds and feelings of joy died in her throat when she noticed the state of the room. There was dust coating all the pictures on the mantel. The couch was tattered and stained. There was a white cloth over Rick’s favorite armchair. And Rick….

He looked thin. Worn and beaten. His sunken eyes looked puffy with tears. His beard had grown out. And in one hand he held a nearly empty bottle of whiskey and in the other, he had a crumpled photograph.

No. She wasn’t back at all.

“Rick?” she whispered quietly as she approached him.

“Dee,” he mumbled, jaw quivering, “I’m so sorry.”

He was looking at the photo in his hand. Delphia edged just a bit closer. It was her in the picture. She could remember when it was taken. Their vacation to the beach a few years back, before she had gotten so burned she had to stay inside for the rest of it. In the photo, she was sitting on a rock, sunhat held on her head due to the wind, red hair going every which way and a smile bright on her face. She remembered Rick telling her that it was his favorite picture of her. She remembered seeing it folded up in his wallet from time to time. It made her smile every time she did. But now it only made it feel like she’d been shot straight in the chest.

Rick straightened up, dropping the whiskey bottle on the floor as he tucked the picture away in his shirt pocket. He must have heard something that she didn’t. Delphia turned to see a group of men in black military uniforms, rifles raised and pointed at Rick, walk into the living room. And from behind them, in strutted Amanda Waller.

“Waller,” Rick scoffed as he settled back into the couch, “Shoulda known.”

“Glad to see I didn’t take you by surprise, Colonel.” Waller smirked.

“Why’re you here?”

“I made a mess.” She shrugged, looking around at the house. “I’m here to clean it up.”

Rick stood to his full height. Still so intimidating and strong looking despite his current state. “You call what you did a mess? You killed her!”

“I didn’t kill Delphia Holman, Colonel. You’re the one who did that by getting her pregnant.”

Delphia placed a protective hand on her belly. No. It couldn’t be.

“You’re the one who didn’t say anything — who didn’t tell her that — that having a baby would kill her. You knew and you said nothing.” Rick stepped closer to Waller, a fire in his eyes like Delphia had never seen.

“I knew that was what happened to her mother. I did not know that would happen to Delphia.”

Rick snapped. With one step he had Waller’s throat in his hands. The armed guards swiftly reaimed their weapons. But Waller told them to stand down with a flick of her wrist.

“I could kill you. Right here. Right now,” he hissed between his teeth.

“Hasn’t that been your plan, Colonel? Isn’t that why you sicked all your deranged dogs on me any chance you got? Shaving them down until there was nothing left. Just you in this big ole’ house.” Waller narrowed her eyes and smirked. “And besides — she made you too soft to kill.”

Rick tightened his grip. His voice came out mangled, like a broken thing too weak to stand. “I loved her.”

“I know.”

Waller pulled a pistol from behind her back. And before Delphia could even blink, pressed it under Rick’s chin and fired.

“No!” The word was yanked from Delphia’s throat violently.

His blood and brains went so high it spattered the fucking ceiling. The entire top of his skull was blown out into little pieces. Rick fell back to the floor with a deafening thud. Hazel eyes wide open.

“No, no, no, no — Rick!” Delphia cried.

She scrambled to the floor, holding his head between her hands. This wasn’t the first time she’d seen those lifeless eyes staring back at her. But she couldn’t run from this. She couldn’t go back to a Rick filled with life this time. Her hands trembled as she stroked his cheeks. She couldn’t feel the flesh and hair of his physical body. She couldn’t feel him. All she could do was weep and beg herself to be released from this hell.

Shaking, she watched as Waller wiped her fingerprints from the gun and placed it in Rick’s hand. Then she said casually to the rest of her team, “Fix the blood spatter — and put gun powder residue on his hand. Rick Flag killed himself alone in this house after the tragic death of his fiance and unborn child. Make it happen, people.”

Then Waller walked out. Delphia looked back at Rick’s unmoving chest. At the blood there and the imprint of his dog tags through the fabric. He gave those to her for her to wear once. When she first moved into his apartment and he was going away on his first mission. Apparently, after her death, he had taken them back. Every breath was a burden — a wheeze or a groan. There were no more tears. Only a sorrow so whole and all-consuming that even the truly wretched wouldn’t wish it upon their enemies.

The guards — with ARGUS stitched into their tactical vests — closed in on Rick’s body.

“No! Get away!” Delphia barked, all snarling teeth and wicked rage as she curled herself around Rick’s form.

And something happened then that Delphia didn’t notice. A white ether, like flashing smoke, emanated from her. The guards immediately jumped away from the body, looking around at one another in horrified confusion.

“The fuck was that?”

It was all too much. All of it. It was as if a darkness was welling up inside her. A hatred. A sorrow. An impossible terror. It rose up and up her throat until it escaped from her in a scream. Blood-curdling and ringing in the guard’s ears.

So loudly they clapped their hands on either side of their heads in hopes to make it stop. The white ether exploded from her again in a thick ring. The guards gave a shout of surprise and fear. And then to Delphia’s eyes — it was all whiteness again.

Delphia sat up and looked out over the expanse. The neverending white. So this was her fate. Her mind to be stuck in visions of the future while her body withered away. While the child she carried inside her faded along with her. Which would then cause the deaths of everyone that she knew and loved. A future set in stone, it seemed.

Tears slipped down her cheeks as she cradled her barely formed baby bump in her hands.

“I’m so sorry — little one,” she whispered shakily, “You didn’t deserve this.”

However, the whiteness was beginning to fade. As if she were being moved through some invisible tunnel. The edges going from pure white to grey. And suddenly, she was somewhere else. But like nowhere she had ever seen before.

It was definitely a room. That much she knew. With grey, metal walls and floors that danced with ripples of light like reflections of a crystal clear pool of water. Delphia looked up and yes. There was a glass panel in the ceiling with water on the other side. What was this place?

“We’ve been expecting you, Delphia Holman,” a deep voice spoke.

She looked towards what could only be the front of the room to see four creatures sitting before her. Four aliens. They looked near enough to humans. The only difference being their pure white skin, flat noses, and scaly ridges all along their body. Delphia was too shocked to form any words.

“You just destroyed your first timeline. How does that feel?” another of the aliens asked.

“I — “ Delphia cleared her throat awkwardly. “I what?”

“With your power, Delphia Holman, you have destroyed a timeline for this dimension. Made all that occurred on it from a certain point forward cease to exist.” The alien who spoke narrowed their eyes at her. “Are you aware that you’ve done this?”

“N-No.” She got shakily to her feet.

“How were you feeling just moments ago when this event occurred?” The first alien questioned, waving their hand in front of themselves, drawing a piece of white ether with it — looking at the mist as if it could tell them something.

“Sad,” Delphia instantly replied, “Alone. Scared.”

“Makes sense.” One of them nodded. “These are strong emotions — strong enough to bring about such an event in someone with…Latent powers.”

Latent powers? The fuck?

“No — no. This just proves that humans are too emotional to have our abilities. We never should have allowed our kind to stay with them.”

“I agree. Our power is too great for such a sub-standard race.”

The first alien to speak, seemingly the leader of the group, smiled down at Delphia. Though it did nothing to comfort her in her mounting confusion. “I believe the humans to be the perfect heirs to our power.”

“Um, excuse me?” Delphia piped up before their bickering could go any further, “I just — um — who are you? Where am I? And can you get me back to my body?”

The lead alien smiled again. “We are the Lords of Time — an alien species that visited your planet some time ago to bestow our ability to see and wield time itself onto the people of Earth. You are on our ship, wheeling through space.”

“We can see you and speak to you because we exist both in the present and the future.”

“We came to Earth seeking a species that could possess our abilities with all fairness and a lack of prejudice — not wanting to use these powers for their own gain. We are the only four left of the Lords of Time.”

“And yes, we can turn off your Sight — as you call it — and put you back into your corporeal form.”

“However,” one of them spoke with a glare, “You must prove that you are worthy to have these powers. If you do not prove yourself we will send you back to the abyss and let you rot there. Killing off the last of your bloodline and allowing us to start anew.”

Delphia had no further questions. Only one simple utterance to make:

“Shit.”

Taglist (if you would like to be tagged in future installments of this series, please let me know!): @bbygrgu @a-reader-and-a-writer @slayerx147 @xoxabs88xox @kasey-puff @witchygagirl @the-pink-petite-princess @blooo0ooop @woodlandmouth @csigeoblue @rexorangecouny @h-hxgirl @thisisthewayrose @blondiekook @darkestbeforethedawn16 @runic-belova @weallhaveadestiny @oopsiedoopsie23 @nerdgrrlramblings @ocfairygodmother

[mcatmemoranda]

There are multiple risk factors for the development of osteoporosis. These include but are not limited to advanced age, cigarette smoking, chronic glucocorticoid therapy, low body weight, previous fractures, history of rheumatoid arthritis, and excessive alcohol intake.

Antiepileptic drugs (AEDs) are associated with adverse effects on bone health. The AEDs most commonly associated with altered bone metabolism are those that induce the cytochrome P450 enzyme system. Specifically, the AED phenytoin has a direct inhibitory effect on intestinal calcium absorption and can stimulate osteoclastic bone resorption.

A score of less than -2.5 on DEXA scanning would indicate osteoporosis, a score of -1.0 to -2.5 would indicate osteopenia, and a score greater than -1.0 indicates normal bone density. Additionally, a fragility fracture (fracture from minor trauma such as a fall from a standing height or less) is diagnostic of osteoporosis without any further workup.

Bottom Line: The risk factors for osteoporosis include advanced age, cigarette smoking, chronic glucocorticoid therapy, physical inactivity, poor intake of calcium and vitamin D, body weight less than 127 lb, previous fractures, anticonvulsant use, hyperthyroidism, celiac disease, rheumatoid arthritis, and excessive alcohol intake.

The characteristic need for the child to use his hands to push himself to an upright position when arising from the floor is the Gower sign. It results from weakness in the proximal lower extremity muscles. Physical examination reveals pseudohypertrophy of the calf, lumbar lordosis, a waddling gait, shortening of the Achilles tendons, hypotonia, and hyporeflexia or areflexia. Patients usually use wheelchairs by age 12 or 13. Additional complications include delayed growth, dilated cardiomyopathy, increased fractures, progressive scoliosis with impaired pulmonary function, cognitive impairment, and eventual respiratory insufficiency.

Bottom Line: Elevated laboratory markers in the setting of Duchenne muscular dystrophy include serum creatine kinase, aspartate aminotransferase, and alanine transaminase.

COMBANK Insight: DMD is a progressive, myopathic disorder inherited in an X-linked, recessive fashion and caused by a defective gene on the X chromosome responsible for dystrophin production. Dystrophin normally serves to stabilize and prevent the breakdown of muscle fibers. Loss of dystrophin thus leads to muscle fiber degeneration, resulting in muscle weakness.

Wilson Disease, also known as hepatolenticular degeneration, is an autosomal recessive defect involving an ATPase, Cu2+ -transporting, β-polypeptide. In this disease state, copper is deposited in tissues of the brain, liver, kidneys, and Descemet membrane of the cornea (known as Kayser-Fleischer rings, which are seen in the exhibit). Parkinsonian-like tremor and dementia may be evident when the nervous system is affected. Renal tubular damage occurs in the kidneys and cirrhosis can develop in the liver. Diagnosis can be made with the observation of decreased serum ceruloplasmin. Treatment includes penicillamine, which creates a soluble complex with the metal that can be excreted through the urine.

Bottom Line: A Kayser-Fleischer ring is a golden brown ring observed in the Descemet layer of the cornea as a result of copper deposition and is seen in Wilson disease. Labs reveal low serum ceruloplasmin and treatment with penicillamine can stop the progression of this degenerative disease state.

The types of cancers that metastasize to the bone most commonly are lung, breast, thyroid, renal, and prostate. Multiple myeloma and lymphoma can both form lytic lesions from their origins within the marrow.

A SPEP and UPEP are sensitive for multiple myeloma and should be obtained along with a measurement of the patient's total protein and globulin levels.

Bottom Line: The initial workup of a new lytic lesion generally involves a CT chest/abdomen/pelvis, SPEP/UPEP, bone scan, basic labs, and mammogram or PSA

[cancer-specialist-in-pune]

The Importance of Getting a Second Opinion in Lung Cancer Care

If you or someone you care about has recently been diagnosed with lung cancer, it’s natural to feel confused and unsure about what to do next. It’s completely normal to have questions and concerns during this difficult time. One helpful step you can take is to seek a second opinion. Dr. Pratik Patil is a well-respected lung cancer specialist in Pune. He understands how important it is to provide personalized care, especially in complicated cases like lung cancer. Dr. Pratik Patil, Who has extensive experience in diagnosing and treating this illness, offers second opinions to make sure patients get the most accurate information about their condition and the best cancer treatment options available. Getting a second opinion can give you more clarity and confidence about your treatment path. It ensures that you’re fully informed and can make the best decisions for your health.

Understanding Lung Cancer:

Abnormal growth of cells, in the lungs leads to the formation of tumors that may spread to surrounding tissues and impact lung functionality—a typical beginning of lung cancer treatment is characterized by Small-cell lung cancer and non-small-cell lung cancer are the two main varieties. The primary risk factor associated with this condition is smoking; however; other contributory factors include exposure to radon gas asbestos and air pollution. To improve results, early detection and treatment are essential.

Lung Cancer Diagnosis:

A number of procedures are used to diagnose lung cancer, including imaging tests that help find discomforting lesions,  similar to CT scans and chest X-rays. A biopsy is conducted to remove lung tissue for microscopic analysis in order to seek cancer cells, if irregularities are found. Blood tests can also help with treatment planning by relating inheritable abnormalities or tumor markers. Understanding the cancer’s stage after diagnosis is pivotal to determining a suitable treatment plan.

Why a Second Opinion Matters?

Getting Second Opinion can really make a difference, for someone dealing with lung cancer treatment decisions! It may confirm the original diagnosis or open up different treatment paths like chemotherapy, targeted therapy, immunotherapy, and radiation remedies from Dr.Patil, the best cancer treatment in Pune who specializes in these areas to give patients the personalized care they need depending on their specific circumstances. It improves individual accuracy, assuring that your lung cancer diagnosis is correct and comprehensive.

[hawkspet]

✧･ﾟ: *✧･ﾟ:* 𝕠𝕦𝕔𝕙

ukai keishin x reader

warnings ♡ humiliation, punishment, branding

word count ♡ 159

#🩹milkbowl

whimpering, you feel the pitter of fallen ash land on your leg. your arm burns; a small, circular lesion in a deep rouge shade marks your skin. the electric, slow burn sends tears streaming down your face as your skin is left dry and itchy.

standing up from his crouched position, keishin surveys your distressed state. your arm is starting to blister, he knows that the warm sensation will last till the early hours of the morning.

relighting a ciggy, he stands to his full height, towering over your shivering frame as you hold your burning, itching arm. he stretches, glancing to the shop door and smiling, a billow of smoke puffing from his lips.

“closing time.” he grins, rolling his head, his gaze eventually landing on you; his weak angel. lifting your chin with the toe of his boot  - the smell of dirt and leather in your nose - he locks eyes with you.

“what’ya say ?”

[tauruscookie]

It’s The WIP Game

Thank you so much @r6shippingdelivery for tagging me! You basically tagged all the other writers I know so Imma just allow anyone else who write to just say that I tagged them cause why not!

Anyways! It is time for the game!

Rules: Post the names of all the files in your WIP folder, regardless of how non-descriptive or ridculous. Let people send you an ask with the title that most intrigues them and then post a little snippet of it or tell them something about it. Tag as many people as you have WIPs

The files’ name are:

[Development/Currently writing/ just writing a summary] - No One Prepared Me For This : Thermite x Thatcher (angst) - Fatal Accident - Smoke and His Daughter (angst) - These Memories Feel So Empty - Thatcher x Thermite (Extraction, angst) - Tattoo Appointment - Mute x Vigil (Wholesome/fluff)

[Completed] - You Were Once A Brother To Me: Thermite x Thatcher (angst) - Frozen and Alone - Thatcher x Thermite (angst) - Seven Minutes In Heaven - Mute x Vigil (smut) - You Got me Roses and Chocolates? - Mute x Vigil (fluff/event) - Decided to Have Fun Without Me? - Thatcher x Thermite (Smut) - These Aren’t Groceries - Sledge x Mozzie (Smut)

[Ideas i’m finding hard to work on/ It’s difficult to start/ just the basic ideas on what I want the story to be about] - Echo x Lesion - Vampire smut - Ash x Mira - Vacation - Bandit x Blitz - snow day - Vigil x Mute - Wedding day - Sledge x Mozzie - Racing 

Tags? Anyone who wants to join cause I don’t have many friends on tumblr who are writers :’)

[sciencespies]

Medieval skeletons might be hiding a cancer rate far higher than expected

https://sciencespies.com/humans/medieval-skeletons-might-be-hiding-a-cancer-rate-far-higher-than-expected/

Medieval skeletons might be hiding a cancer rate far higher than expected

Cancer isn’t just a modern-day affliction. A new archaeological analysis suggests malignant growths in medieval Britain were not as rare as we once thought. 

Even before widespread smoking, the Industrial Revolution, and the modern surge in life expectancy, it seems cancer was still a leading cause of disease.

Scanning and X-raying 143 medieval skeletons from six cemeteries in and around the city of Cambridge, archaeologists have predicted cancer cases between the 6th and the 16th century were roughly a quarter of what they are today.

That’s 10 times higher than previous estimates, which had put cancer rates at less than one percent.

“Until now it was thought that the most significant causes of ill health in medieval people were infectious diseases such as dysentery and bubonic plague, along with malnutrition and injuries due to accidents or warfare,” says archaeologist Jenna Dittmar from Cambridge University.

“We now have to add cancer as one of the major classes of disease that afflicted medieval people.”

Past analyses of medieval skeletons in Britain have only focused on the exterior of the bone, but Dittmar and her colleagues decided to look for evidence of metastases within the bone, too. 

CT scan bone from a medieval skull with a white arrow showing metastasis. (Bram Mulder)

Scanning parts of the skeleton that are more likely to hold cancerous growths, such as the spinal column, the pelvis, and the thigh bone, the team found signs of malignancy in five individuals from medieval times. 

Most cases were confined to the pelvis, but there was one middle-aged man that had lesions scattered throughout his skeleton, which is indicative of blood cancer. 

Excavated medieval spine, with white arrows showing cancer metastases. (Jenna Dittmar)

“Using CT scans we were able to see cancer lesions hidden inside a bone that looked completely normal on the outside,” says Dittmar. 

This type of scanning can detect bone metastases in patients about 75 percent of the time, and over a third of people today who die with cancer show evidence of these growths in their bones.

Based on these statistics, the authors think the minimum prevalence of all cancers in medieval Britain would have sat somewhere between 9 and 14 percent.

In the centuries since, that rate has surged. In modern Britain, where people live far longer, breathe more pollutants, and face more viruses, up to 50 percent of people have cancer by the time they die.

Figuring out how much cancer incidence has increased in recent years is important because it allows us to know where our greatest threats are coming from. Currently, it’s still not completely clear how much tobacco smoking and pollutants have impacted our rates of disease as a whole because we don’t have a baseline to work off.

Historic texts are not particularly trustworthy and are hard to compare to modern data, whereas archaeological remains are much more reliable, especially with the technology we’ve got today.

The sample size of the current study was obviously small and focused on only one region. It’s also tricky business diagnosing cancer so many centuries later.  

Yet even with these caveats in mind, the findings suggest we have been missing many cases of medieval cancer by not looking within the bone.

“We need further studies using CT scanning of apparently normal skeletons in different regions and time periods to see how common cancer was in key civilizations of the past,” says first author of the new research, archaeologist Piers Mitchell from Cambridge University. 

The study was published in Cancer. The paper is unavailable as of the time of publishing, but a pre-press proof of the study can be reviewed on Academia.edu.

#Humans

[r6s-imagines]

jackal x reader >> miscommunication

•••

requested: no

word count: 1,428

warnings: cursing, unnecessary spanish, sexual tension

•••

summary: jackal tries his best to get you in the mood for new year’s with his heritage

side note: considering jackal’s psychological description mainly noted his continuous hunt regarding his past and lack of sleep. i went off of what that told me and added some of my own quirks based on voice line delivery. i am also fluent in spanish (mexico) as well as english, but i attempted to keep the spanish as simple as possible.

•••

it started with a less-than-obvious gift to your doorstep. it was a small, purple gift bag stuffed with white tissue paper.  you were so unfamiliar to a gesture of kindness that you nearly called it for a bomb squad to make sure someone wasn't on your ass.

you stuck a finger into the bag, careful not to trigger anything unwanted.

you saw red, and lace.

now who the hell sent me a set of crimson lingerie? you asked yourself. clearly this had some joke or meaning.

you went straight to your computer, undergarments by your side as you played a process of elimination the further you got into your articles.

red as a symbol of lust in america, pulse would never, luck in china, you couldn't name a chinese person you knew.

new year's romance in spain? mira wouldn't—oh, that son of a bitch.

a meeting was called in the next day, something about a potential mission from the fbi. you found your marked seat at the debriefing table, conveniently text to ramírez's. reluctantly, you awaited the arrival of your coworkers, in doubt that jackal would arrive to the meeting due to his unusual sleep schedule. you smiled to yourself, knowing the little purple bag awaited to be thrown onto his desk for an ass-kicking confrontation.

your suspicions were proved correct when the seat remained cold. you lifted your hand for a brief moment, politely gesturing to excuse yourself to ash's approval. your smirk was hard to hide as you strode to jackal's housing, marked by his name. wordlessly and soundlessly, you entered his room to find him reading a book on his bed. he ceased reading his novela for only a moment, peering above the pages to meet your gaze.

"sí?" he lowly asked, a smile in his stare. you frowned.

"red panties, hm?"

he waved a hand, rolling his eyes.

"it's a—eh— tradición, y/n," he nonchalantly explained. "if it's any consolation, you could see my calzoncillos, we're matching."

"gross," you retorted. "i don't want any part of this perverted tradition of yours, ramírez. leave me out of it."

"it's all in good fun!" he protested, standing up. he placed his book on his shelf and laid a hand on you, smiling. "decade's about to end, live a little!"

"and my foot is about to end up in your ass," you spat. "unless you've got money or sweets to offer up, i don't want to know the extent to your new year partying." you spun on your heel and returned to the meeting, heated just thinking about the audacity of ryad.

lo and behold, a party was to be announced later that night. it was described as a "night away from troubles," but your stomach couldn't help but flip at the thought of confronting jackal again. surely it wouldn't be a problem, right? there'll be fifty something other people you could connect with and you'll never have to cross paths with the spaniard.

night fell during the time you took to warn yourself of other strange traditions, spanish or not. it would be your first new year's with the crew and you were unsure of just how wild everyone can be with the clash of cultures and alcohol.

you turned to your bed, noticing the bag unopened. caving in, you investigated the products inside. the price tag seemed hefty judging by the quality and consistency. you checked the back of the bra.

how did ryad know your cup size to the t?

no matter. laundry was overdue and it's not like you had time nor effort to fixate your own undergarments in time. you decided to make a good impression, donning a white jumpsuit with a misty purple jacket. your hair was down for the first time in months as opposed to your tactical pinup. makeup was minimal; you had not spent time in your life training to be a beautician, you were an operator for christ's sake!

you arrived at the party alone, later than expected but present nonetheless. smoke and mozzie welcomed you with a huzzah and a drink practically thrown into your hand. porter wrapped an arm around you and led you to the main room, covered with operators of various organizations.

mira, lesion, doc, blitz, sledge... no jackal. you found it strange, considering his reversed sleep schedule called midnight his prime work hours. you almost wanted to locate him and thank him, but you stopped yourself and took a fat swig, feeling the chilled alcohol slip down your esophagus.

"you're so cute when you're buzzed," mozzie slurred, stumbling to grab my hand. "if only i could kiss you at midnight, but you'll never know my fantasies."

"hey, max," you responded, stabilizing his balance. "how much have you had? it's only ten thirty. and for the record, i did not pregame this time."

"i'm right pissed," he admitted, laughing. "oh, that spaniard was lookin' for ya? whasisname...? martello?"

"martello is italian, pal," you replied, smiling. "d'you know where jackal is?"

"his quarters~~" max said. "probably waiting for a pretty little lady like you." you giggled and pat his back, sending him off to pester ela or dokkaebi. you snuck out of the venue area into the silence. you retraced your steps from the meeting room and into the lined up personal rooms.

"ryad... ramírez," you read aloud, noticing the closed door. you knocked twice.

"vete," he unenthusiastically replied. your hand hovered over the doorknob, ready to face him... but you paused. you recalled something from the various articles you perused. swiftly, you prepared two glasses of champagne. reaching into your jumpsuit, you exposed your necklace, the pendant being the gold ring your mother used to wear. you placed the necklace into your glass, leaving ryad's empty to use at his own discretion.

you returned to his door, knocking again. you heard a groan, followed by footsteps.

"dije ir—" he hissed, making eye contact with me halfway through opening the door. "y/n."

"ramírez."

"just ryad. please," he opened the door further, stepping aside. "what brings you around, cariña?"

"i don't know what that means," you admitted. "is that, like, car, or something—"

"darling."

"hm?"

"anyway, what brings you here? i thought you'd be out with that porter kid or that cabrón goose," he kicked back in his desk, beginning to type away. his weathered features became more evident through the artificial lighting and you began to wonder why a man in his late middle ages seemed to have gone through the struggles of a century old man.

"i wanted to thank you for the..." you paused, cheeks flushed.

"it suits you."

"i'm sorry?"

"you wore a red bra under a white jumpsuit."

"shit!" you covered your chest with your outerwear, face feeling hot.

"it's alright, you look nice. you know what the red means, no?" he raised an eyebrow. you nodded softly.

"were you serious about matching?" you inquired. finally handing him his glass. he chuckled, leaning back in his chair and hooking his pants with his thumb. he exposed his v-line, flashing his red boxers labeled with the same brand as yours.

"increases your chances."

"for?"

"for a romantic connection. una novia."

time passed by so fast you had not heard the clamor of the other operators preparing to count down to the new decade.

"they're getting ready to count down," you observed, peeking outside. "last chance to join them."

"i'd rather go into the new year here," ryad admitted quietly. "i prefer the quieter festivities." he reached down to his hand, removing a gold ring on his middle finger. he dropped it in with a satisfying splash.

“ten!”

he raised his glass, nodding to you with a smile.

“nine!”

“i’m sorry for being a dick,” he apologized.

“eight!”

“it’s alright,” you answered.

“seven!”

“you’re just so beautiful, y/n.”

“six!”

he moved in closer, and you could feel his hot breath.

“five!”

your eyes flicked to his lips, then to his eyes. you nodded.

“four!”

“to good fortune,” you said.

“three!”

“and to romance,” ryad added, clinking your glasses.

“two!”

“i love you, y/n.”

“one!”

your lips collided following the cheers and shouts. he pulled away, grinning. his mouth made contact with his glass and he took it down in one swig.

“thank you for distracting me from my work,” ryad thanked, looking into your gaze. “i can be a real hijo de perra when i’m behind on personal work.”

“but you just said—“

“it’s better you than anyone else, y/n. happy new year.”

[blog-of-a-multitude-of-fandoms]

Tub- Geralt

Pairing: Geralt x Reader

Characters: Geralt

Warnings: N/A

Request: N/A

Word Count: 496

Author: Aaron

“You couldn’t grab me some more hot water, could you?” Geralt let his beaten and bruised body slowly sink into the heavy oak tub, as much as it pained him, he allowed the soapy water to seep into his fresh lesions and grazes.

“All you have to do is ask.” A small column of light grey smoke slowly rose from your fingertips and at a click the water slowly began to bubble and spew. Geralt’s last few bounties had been particularly challenging and he had often come home soaked in blood and groaning in pain, fortunately for him you were always there with a moist flannel and a fresh pestle of healing balms. “Lucky me.” He sunk deeper into the ebbing and flowing waters until little more remained then his flowing white hair and a trialled, aged face. “All these people in this shit hole of a world and I’m blessed enough to be betrothed to the only good thing in it.” You let the water heat up just a little more before he asked you to stop.

“There is plenty of good here and you know it.”

Geralt winced and pulled away at the introduction of harsh but healing salts that you had thrown into the seemingly self-stirring water. “You really need to start looking after yourself more.” His rugged and scarred fingers grasped onto the burly hardwood and he pushed himself from the depths and out of the tub.

“My apologies for the inconvenience y/n, I did not expect to be straddled by a wraith today.” You threw a towel at him, expecting him to use it to protect his dignity but not surprised when he wrapped it around his sopping hair in favour of air drying himself on the balcony. “I shall tell the people of Carsten to keep their sacks of crowns and to deal with their issues themselves. It is what I do, I can handle a few cuts and bruises here and there.”

“You just worry me.” He outstretched his arm and you fell perfectly into the space it had created overlooking the nearby mountain range.

“I’m a Witcher, there is no being or no person that is not at least a bit uneasy in my presence.” The sun fell perfectly onto the balcony and illuminated the deep valley below. “Unfortunately, it is was I was put on this world to do, if I could get a normal vocation I would but as a wielded of the arcane you know as well as I do how limiting vilification can be. At least you can get away with it.”

“You don’t scare me Geralt. You never have and you never will.”

Slow cascades of rain speckled down from the grey clouds that crested around the burning ball. “I know the atrocities you’ve seen, and I know what you’ve done.”

“Everybody is scared of the Witcher’s.”

“Well I know mine would lay his life down to protect the few people he loves.”