#surgical resection.

[lalunanymph]

୨୧ zayne's unusual method of coercing lulling your baby back to sleep

✧･ﾟpapa!zayne, husband!zayne, mom!reader, talks of medical research, babies, you both have a little girl named 'jasmine' (iykyk), mild spoilers for lads if you squint, pure fluff, spoilers for the good night video call with zayne, he calls you 'my aurora' (also iykyk)

✧･ﾟhelp me plz i have fallen for this man and i cant get up

night falls, bringing with it a peace no wish in the world could.

it's the type of peace which echoes gentle snowfall during the dawn; a hum of wintry wind on the back of weak sunlight.

for now, the household is quiet, everyone catching up on precious minutes of sleep.

or, as much as they could before your daughter's piercing wail shatters through the night.

"i'll go get her," the fatigue roughened voice of your husband, zayne, reassures you. his large palm reaches across the bed, clasping your own for a single second, a silent order for you to go back to sleep.

"zayne," you murmur, rubbing your eyes. "i'll go with you—"

"you need rest," he cuts you off, though the look in his emerald gaze is eclipsed with a special softness reserved just for you. "i don't have any surgeries lined up tomorrow until after lunch. i'll do it."

stoic yet kind, your husband volunteers to take up the mantle; hurrying towards the nursery to tend to your fussy baby.

you sink back into the soft sheets, exhaling in exhaustion. it must've been hours or minutes, your consciousness dipping in and out of the pool of wakefulness.

when you turn to the side, zayne still wasn't back. curiosity propelled you to sit up, stuffing your feet into a pair of blue, fuzzy slippers. you tightened your robe around your shivering body, shuffling down the hall towards the nursery.

"... common treatment is a myectomy of the hypertrophic IVS. however, surgical treatment of midventricular is usually challenging. the hypertrophic area cannot be reached via a transaortic approach. for that reason, a transapical ventriculostomy has been described as preferred access for surgical correction..."

zayne's voice piques your interest. as you turn around the corner, you nearly burst out into a fit of giggles.

your husband, baby in one arm and large research book on his knee, was trying to read a "bedtime" story to your sweet jasmine.

"—in some cases of diffuse myectomy has been performed via trans-mitral septal myectomy with a video-assisted minimal invasive 2D technique—oh, look, it's your mama."

he moves your little girl to the other arm, her shimmering emerald eyes clasped on the hook of his nose. she bubbles and squeals, trying to swipe at his chin—definitely not drowsy or ready to fall back to sleep.

"come on now," zayne remains stern with her. "it's time for you to sleep. you've been keeping me up for almost an hour."

as much as your husband's antics were drawing your mirth, you could sense the despair in his tone wasn't fabricated.

"perhaps you're reading her the wrong bedtime story." you tease, walking into the room. you take jasmine from her papa's arms, cradling her close to your chest.

your daughter fusses, gummy mouth gaping and closing, cooing her agreement.

"the resection of hypertrophic papillary muscles and mitral valve replacement is a good bedtime story," he quips. snapping the heavy research book close, he sets it down to the floor. "she's just being like her mama, that's all."

fighting back the urge to smirk, you shake your head. "at least you've never given her a lecture on fusion guidance."

his brow crinkles, and eventually, a small smile decorates his lips. "you remember?"

zayne's voice is unexpectedly soft, and you nod; delighting in sharing this memory with your husband.

"how could i forget? it's my go-to bedtime request from you."

he stands, coming behind you and jasmine. a long, calloused finger traces down her chubby cheek. one arm around your waist, the other supporting your own arm under your baby.

"if only i could know what hers is," zayne sighs. "then, you wouldn't have to check up on us."

"i want to," you interject, nudging your face back to give his cheek a soft kiss. "i love seeing you with her."

"hmm."

your husband goes quiet for a few more moments. you almost fall asleep standing up, the warmth of his broad back emanating through your thin cotton nightdress; lulling you into comfort. jasmine, soothed by your steady breathing, droops off; her shell pink lips puckered like a bud about to bloom.

"she's finally asleep."

"your heartbeat," zayne says, barely above a whisper. his warm breath touches your neck, making gooseflesh rise on your arms. "she's soothed by it."

you touch your gaze to her puffy cheeks; the thin wisps of dark hair on her head she inherited from the one man you adored with every beat of your heart.

"i'm glad you saved me," you whisper, remembering the day when zayne performed the life-changing operation on you; finally stabilising your condition after years of distress and anxiety.

"i owe my heart to you."

"keep it," your husband is quick to dismiss his role in saving you; a man of little words with the biggest impact.

"but, take mine if you need it. my heart is all yours, my aurora."

sobs iykyk the spoilers for mr. love: queen's choice (lads predecessor) you'd know that zayne's hea—[gunshot]

©️ all works belong to lalunanymph. do not copy, repost or claim as your own.

[tzaraat]

[image ID: a sketchbook page spread. on the right page, a watercolour sketch of Drew Parker during a match. he sits on the mat, facing the right, grabbing the bottom rope. blood runs down his arms and across his neck and torso. his mouth hangs open, and his eyes are closed.

on the left page, a black-pen sketch of a surgical operation. it depicts a stage in the resection of the rectosigmoid. at the top of the page, the sketch is labelled "figure 8: found in plate 84, page 187". on the bottom right, there is more handwritten text, going over some details of the procedure. the hatching is dense and relatively measured. /.End ID]

connect nothing.

procedure referenced from Mildred Coddling's illustrations for the atlas of surgical operations.

[static-sugar-pop]

reblog and tell me how you're doing/how your day went :-)

[religion-is-a-mental-illness]

By: Eric W. Dolan

Published: Sept 20, 2024

A new study published in Proceedings of the National Academy of Sciences suggests that specific networks in the brain, when damaged, may influence the likelihood of developing religious fundamentalism. By analyzing patients with focal brain lesions, researchers found that damage to a particular network of brain regions—mainly in the right hemisphere—was associated with higher levels of fundamentalist beliefs. This finding provides new insight into the potential neural basis of religious fundamentalism, which has long been studied in psychology but less so in neuroscience.

Religious fundamentalism is a way of thinking and behaving characterized by a rigid adherence to religious doctrines that are seen as absolute and inerrant. It’s been linked to various cognitive traits such as authoritarianism, resistance to doubt, and a lower complexity of thought. While much of the research on religious fundamentalism has focused on social and environmental factors like family upbringing and cultural influence, there has been growing interest in the role of biology. Some studies have suggested that genetic factors or brain function may influence religiosity, but until now, very little research has looked at specific brain networks that could underlie fundamentalist thinking.

The researchers behind this study wanted to address a critical gap in understanding how brain lesions might affect religious beliefs, particularly fundamentalism. Prior research suggested that damage to the prefrontal cortex could increase fundamentalist attitudes, but this work was limited to small sample sizes and focused only on one part of the brain. The authors of the study hypothesized that instead of a single brain region being responsible, religious fundamentalism might arise from damage to a distributed network of connected brain regions.

“My primary interest is and has been mystical experience. But in the process researching the cognitive neuroscience of mystical experience, I came across brain network associations with religious fundamentalism,” study corresponding author Michael Ferguson, an instructor in neurology at Harvard Medical School and director of Neurospirituality Research at the Center for Brain Circuit Therapeutics.

To explore whether damage to specific brain networks could influence the likelihood of holding religious fundamentalist beliefs, the researchers used a method called lesion network mapping, which helps identify how different regions of the brain are connected and how damage to one area might disrupt related brain functions. The study involved two large groups of patients with focal brain damage, giving the researchers a unique opportunity to analyze how different types of brain lesions might be linked to religious beliefs.

The first group consisted of 106 male Vietnam War veterans who had sustained traumatic brain injuries during combat. These men, aged between 53 and 75 at the time of brain imaging, were part of a long-term study conducted at the National Institutes of Health. The second group included 84 patients from rural Iowa who had experienced brain injuries from various causes, such as strokes, surgical resections, or traumatic head injuries. This second group was more diverse in terms of gender and had a broader range of injury causes.

Both groups completed a scale designed to measure religious fundamentalism, which asked participants to respond to statements reflecting rigid and inerrant religious beliefs, such as the view that there is only one true religion or that certain religious teachings are absolutely correct and unchangeable.

For each participant, the researchers mapped the precise locations of their brain lesions using advanced imaging techniques like computerized tomography (CT) and magnetic resonance imaging (MRI). These scans were then analyzed using lesion network mapping to see how damage to certain brain areas was connected to changes in religious fundamentalism scores. The researchers also compared the brain lesion data to a larger database of lesions associated with various neuropsychiatric and behavioral conditions, which helped them understand how the brain regions linked to religious fundamentalism overlap with those involved in other psychological traits.

The researchers found that damage to certain areas of the brain, particularly in the right hemisphere, was associated with higher scores on the religious fundamentalism scale. Specifically, lesions affecting the right superior orbital frontal cortex, right middle frontal gyrus, right inferior parietal lobe, and the left cerebellum were linked to increased religious fundamentalism. In contrast, damage to regions such as the left paracentral lobule and the right cerebellum was associated with lower scores on the fundamentalism scale.

“The strength and reproducibility of the signal between psychological self-report measures of religious fundamentalism and the functional networks we identified in the brain surprised me,” Ferguson told PsyPost. “It increases confidence in the results.”

Interestingly, the researchers noted that the brain regions identified in this study are part of a broader network connected to cognitive functions like reasoning, belief formation, and moral decision-making. These areas are also associated with conditions like pathological confabulation—a disorder where individuals create false memories or beliefs without the intent to deceive. Confabulation is often linked to cognitive rigidity and difficulty in revising beliefs, characteristics that are also found in individuals with high levels of religious fundamentalism.

The researchers also found a spatial overlap between brain lesions associated with criminal behavior and this fundamentalism network, which aligns with previous research suggesting that extreme religious beliefs may be linked to hostility and aggression toward outgroups.

“It’s sobering, but one of the takeaway findings is the shared neuroanatomy between religious fundamentalism, confabulations, and criminal behavior,” Ferguson said. “It refocuses important questions about how and why these aspects of human behavior may be observed to relate to each other.”

The researchers emphasize that damage to this brain network does not guarantee that a person will develop fundamentalist beliefs, nor does it imply that individuals with strong religious convictions have brain damage. Instead, the findings point to the possibility that certain brain networks influence how people process beliefs and how flexible or rigid their thinking becomes, especially in the context of religion.

“A major caveat is that these results do not indicate that people with strong religious beliefs confabulate or that individuals high in religious fundamentalism commit crimes,” Ferguson explained. “Rather, our data may help us understand the style of cognitive or emotional processing that increase or decrease the probability of holding fundamentalism attitudes.”

The authors suggest that future research should explore how this brain network influences religious fundamentalism in more diverse populations, including people from non-Christian religious traditions or from different cultural backgrounds. It would also be valuable to study patients both before and after brain injuries to better understand how changes in the brain might affect religious beliefs over time. Additionally, research could investigate how this brain network relates to other types of belief systems, such as political ideologies or moral convictions, to see if similar patterns of cognitive rigidity or reduced skepticism emerge in these contexts.

“The personal beliefs of the authors span a broad continuum from adherents of religious faiths through agnosticism to atheism,” Ferguson noted. “We approach the weighty subject matter of this research as earnest seekers of scientific data and encourage readers to receive our results in the spirit of open-minded empirical inquiry driven by scientific curiosity and without prejudice or malice to any group or faith.”

The study, “A neural network for religious fundamentalism derived from patients with brain lesions,” was authored by Michael A. Ferguson, Erik W. Asp, Isaiah Kletenik , Daniel Tranel, Aaron D. Boes, Jenae M. Nelson, Frederic L. W. V. J. Schaper, Shan Siddiqi, Joseph I. Turner, J. Seth Anderson, Jared A. Nielsen, James R. Bateman, Jordan Grafman, and Michael D. Fox.

--

Significance

Religious fundamentalism is a global and enduring phenomenon. Measuring religious fundamentalism following focal brain damage may lend insight into its neural basis. We use lesion network mapping, a technique that uses connectivity data to identify functional brain networks, to analyze two large, independent datasets of brain lesion patients. We found a network of brain regions that, when damaged, are linked to higher religious fundamentalism. This functional network was lateralized to the right hemisphere and overlaps with the locations of brain lesions associated with specific neuropsychiatric and behavioral conditions. Our findings shed light on neuroanatomy that may influence the emergence of religious fundamentalism, offering implications for understanding the relationship between brain networks and fundamentalist behavior.

Abstract

Religious fundamentalism, characterized by rigid adherence to a set of beliefs putatively revealing inerrant truths, is ubiquitous across cultures and has a global impact on society. Understanding the psychological and neurobiological processes producing religious fundamentalism may inform a variety of scientific, sociological, and cultural questions. Research indicates that brain damage can alter religious fundamentalism. However, the precise brain regions involved with these changes remain unknown. Here, we analyzed brain lesions associated with varying levels of religious fundamentalism in two large datasets from independent laboratories. Lesions associated with greater fundamentalism were connected to a specific brain network with nodes in the right orbitofrontal, dorsolateral prefrontal, and inferior parietal lobe. This fundamentalism network was strongly right hemisphere lateralized and highly reproducible across the independent datasets (r = 0.82) with cross-validations between datasets. To explore the relationship of this network to lesions previously studied by our group, we tested for similarities to twenty-one lesion-associated conditions. Lesions associated with confabulation and criminal behavior showed a similar connectivity pattern as lesions associated with greater fundamentalism. Moreover, lesions associated with poststroke pain showed a similar connectivity pattern as lesions associated with lower fundamentalism. These findings are consistent with the current understanding of hemispheric specializations for reasoning and lend insight into previously observed epidemiological associations with fundamentalism, such as cognitive rigidity and outgroup hostility.

==

Two of the authors of the above paper also published the following:

Abstract

Background

Over 80% of the global population consider themselves religious, with even more identifying as spiritual, but the neural substrates of spirituality and religiosity remain unresolved.

Methods

In two independent brain lesion datasets (N1 = 88; N2 = 105), we applied lesion network mapping to test whether lesion locations associated with spiritual and religious belief map to a specific human brain circuit.

Results

We found that brain lesions associated with self-reported spirituality map to a brain circuit centered on the periaqueductal gray. Intersection of lesion locations with this same circuit aligned with self-reported religiosity in an independent dataset and previous reports of lesions associated with hyper-religiosity. Lesion locations causing delusions and alien limb syndrome also intersected this circuit.

Conclusions

These findings suggest that spirituality and religiosity map to a common brain circuit centered on the periaqueductal gray, a brainstem region previously implicated in fear conditioning, pain modulation, and altruistic behavior.

--

For reference, I previously posted about a similar study from 2017:

Abstract

Beliefs profoundly affect people's lives, but their cognitive and neural pathways are poorly understood. Although previous research has identified the ventromedial prefrontal cortex (vmPFC) as critical to representing religious beliefs, the means by which vmPFC enables religious belief is uncertain. We hypothesized that the vmPFC represents diverse religious beliefs and that a vmPFC lesion would be associated with religious fundamentalism, or the narrowing of religious beliefs. To test this prediction, we assessed religious adherence with a widely-used religious fundamentalism scale in a large sample of 119 patients with penetrating traumatic brain injury (pTBI). If the vmPFC is crucial to modulating diverse personal religious beliefs, we predicted that pTBI patients with lesions to the vmPFC would exhibit greater fundamentalism, and that this would be modulated by cognitive flexibility and trait openness. Instead, we found that participants with dorsolateral prefrontal cortex (dlPFC) lesions have fundamentalist beliefs similar to patients with vmPFC lesions and that the effect of a dlPFC lesion on fundamentalism was significantly mediated by decreased cognitive flexibility and openness. These findings indicate that cognitive flexibility and openness are necessary for flexible and adaptive religious commitment, and that such diversity of religious thought is dependent on dlPFC functionality.

--

It should be noted that fundamentalism is not exclusive to (traditional) religions.

“… fundamentalism, properly understood, is not about religion. It is about the inability to seriously entertain the possibility that one might be wrong. In individuals such fundamentalism is natural and, within reason, desirable. But when it becomes the foundation for an intellectual system, it is inherently a threat to freedom of thought.” -- Jonathan Rauch, “Kindly Inquisitors: The New Attacks on Free Thought”

Flat Earth, anti-vax and wokery (modern feminism, "anti-racism," "gender identity" ideology, fat activism, etc) are all fundamentalist in nature. There is no evidence you can present to disabuse them of the tenets of their faith.

This phenomenon creates a problem for society in dealing with fundamentalist and false beliefs, especially when they have attained cultural dominance and institutional power. And particularly when they're held to be inerrant and absolute, and those who hold them regard dissent as heresy, and those who follow available evidence as evil heretics.

A good test for this is to look at the reaction when the belief is questioned; is the questioner regarded as factually wrong or morally suspect?

[endless-summer-soldier]

dr. feelgood - chapter four

pairing: Surgeon!Bucky x SurgicalIntern!Reader

summary: Y/N has a one night stand with a handsome stranger the night before starting her new job as a surgical intern. Little does she know, the handsome stranger also happens to be her new boss

warnings: must be 18+, drinking, some surgery descriptions, smut, self-pleasure, praise kink, very minor character death, unprotected sex, rough sex

word count: 2.1k

series playlist: here

taglist: @sebsgirl71479 @ozwriterchick @notmeddy @drewsuncrustables @lokidokieokie @hextech-bros @nats-whore @m4nulup1n @arcanebabe @tanyaspartak @jackiehollanderr @princezzjasmine @fallenlilangel99 @pono-pura-vida @mavrellover91 @milanaasblog (message me to be added!)

series masterlist

It had been two weeks since the “incident” with Bucky. I had been avoiding him as much as possible but managed to keep things professional when I did have to interact with him. 

Today most of the interns were sitting in the gallery preparing to watch Dr. Stark perform an open heart surgery. This was the most intense surgery since I started and we were all eager to watch his technique.

As Stark finished scrubbing, he entered the OR and started dancing around the patient, jamming to Metallica. And then I smelled it. Honeycrisp apples. I had an immediate reaction, remembering my tryst with Bucky, and I felt my underwear dampen ever so slightly.

“Did I miss anything?” Bucky whispered in my ear, as he took another bite of his apple.

“He’s just getting started,” I replied, refusing to look at him.

Stark cranked up the music as he called for the ten blade.

“Why don’t we get to listen to music and dance in your OR?” I joked.

He scoffed, “I hate that he does this. He loves to put on a show and entertain. He’s brilliant but he thinks more about himself than his patients.”

“Mmm,” I said, snacking on a pretzel and trying not to engage further.

“When I was in Afghanistan, there was no music. Hell we barely had the proper tools. We were operating on the battlefield with whatever we could carry on our backs. And he will never understand that. So yes, it drives me crazy that he takes all this for granted.”

He seemed worked up and he made a really great point. While it seemed fun to be in Stark’s OR, he did seem a little flashy considering he was conducting heart surgery.

“How long did you serve?”

“I was enlisted for twelve years, but some of that time was spent in medical school. I was overseas for…six years.”

“Thank you for your service,” I said, looking at him for the first time.

“Thank you. I really appreciate that.”

“As fun as it looks in there, I’d much rather be scrubbed in with you,” I said. It was a genuine comment, not flirty. I respected that he valued everything at his disposal and worked with the sole interest of the patient in mind.

“You just like watching me scrub,” he flirted, changing the tone.

“There’s nothing I like more than a clean man,” I joked. He genuinely chuckled and took another bite of his apple.

As Stark continued on with the surgery, he kept looking up at his crowd and making eyes with all of us, as if showing off. I could practically feel Bucky rolling his eyes next to me. A few minutes later he leaned in and said, “I think I’ve had enough of this.” I felt him stand up and leave the room, bored with the procedure. I found that I wasn’t far behind him. Bucky had shown a light on this surgery that I hadn’t thought of before. And so, I finished my bag of pretzels and left to go check on some of my patients. 

As I reached the nurses’ station, Bucky appeared at my side and said, “We got a case coming into the ER. A homeless man was sleeping in a dumpster and got picked up by a trash truck. Multiple injuries, you want in?”

“Absolutely.”

It was my first bad day in the hospital. It was bound to happen eventually, but I didn’t think it would impact me this much. I was assigned to Dr. Strange’s service today to complete a tumor resection. Our patient’s name was Jarvis. Despite having the name of a butler, Jarvis was in his early forties and was an absolute delight of a patient. He was polite and asked good medical questions, but he also made an attempt to get to know all the doctors and nurses tending to him. He shared with me that he was a computer programmer and was fascinated by all the technology we used at the hospital. He somehow managed to gain the respect of Strange, which was impressive considering most doctors in the hospital hadn’t even tackled that feat.

And after spending the last week in the hospital, greeting me warmly every morning, he died in surgery. I knew better than to get attached, and I wouldn’t say that I was, but I was fond of the guy. He was young and had his whole life ahead of him. He was planning to express his feelings to the woman he was secretly in love with after his surgery. But he would never get that chance; he wouldn’t wake up. Strange called time of death cavalierly, as if we hadn’t been joking around with him hours before. I wasn’t sure I’d ever be able to dissociate like that.

After my shift ended, I went to Pym’s, the bar across the street. The last thing I wanted was to ponder my thoughts alone in my apartment.

“Whatcha havin?” Scott, the owner of the bar, asked. A lot of the hospital staff frequented the establishment which meant we were all on a first name basis with Scott.

“Tullamore Dew, neat.” Scott gave me a surprised look before pouring the Irish whiskey.

“Long day?” he asked.

I nodded, “Something like that.” He gave me a sad smile and added a little extra to the rocks glass in front of me.

“Thanks Scott.”

��Let me know if you need anything else.” He read people so well. When I came in with a smile on my face and ordered tequila, he would chat with me and ask about my life and the hospital. But today he gave me some space, which was appreciated.

I took a long swig of whiskey and let out a deep breath, trying to forget the events of the day.

“Drinking whiskey? That can’t be good.” I felt someone sit in the seat next to me and glanced over to find Bucky.

“Hi Dr. Barnes,” I said, turning my attention back to my drink.

“Doll, we’re outside of work. Call me Bucky.”

“Yeah whatever,” I muttered. He flagged down Scott and pointed to my drink, as if to say I’ll have what she’s having.  

Once the drink was in front of him, he said, “So what are we drinking to tonight?”

I stayed quiet for a while, searching my whiskey for answers, before I decided to talk.

“Does it ever get easier?” I asked, turning for the first time to face Bucky.

He looked into my eyes and seemingly understood my predicament. 

He shook his head and looked down to his drink, “No it doesn’t.”

“I just didn’t think it would be this hard, you know? They covered all this in med school. We talked about the emotional toll this job takes and we practiced breaking the news to family members, but…I don’t think anything could’ve prepared me for the real thing.”

“It’s by far the worst part of the job. And everytime it happens, you feel like shit. Sometimes it's worse than usual. And then sometimes you sort of become numb to it. But no matter how numb you get, there will always be another case that makes you question your career.”

“Is this supposed to make me feel better?” I asked, taking another sip of my drink.

“Hey, I’m just telling you the truth.”

“I do appreciate that. Better than sugar coating it.”

“There is one thing I’ve found that helps me.”

“What’s that?”

“I either come here or I make myself a drink at home. And I think about that person’s life. The highs, the lows, their family, friends, and then I think through the surgery. And I ask myself, is there anything I should’ve done differently. Sometimes there are things you could’ve changed, other times it was bound to happen. And you learn from it. You give yourself time to be upset, let it out. And then you move forward.”

His advice was oddly insightful.

“You're welcome for sharing that, by the way. Took me years to get into a good routine. And maybe that doesn’t work for you, but you need to find a way to reflect productively.”

“Thank you, really.”

“Do you want to talk about them?”

I nodded, “His name was Jarvis. He was an absolute pleasure to be around. He was so respectful of everyone working on his case. He never buzzed the nurses when he needed something because he knew how busy they were and he didn’t want to give them more work to do. He asked really insightful questions when we walked through the procedure; he had clearly done his research. And everytime I went in to check on him before the surgery, he asked me how I was doing. He asked what my plans were for the evening. He saw me as a human being, not just a doctor.”

“What was he in for?”

“Brain tumor. Not easy to remove, but Strange was confident he could get it. And he was close, but…” I couldn’t continue, and Bucky seemed to understand.

I was surprised to feel his hand on my back, gently rubbing up and down.

“I’m sorry, Y/N.”

“Thanks for sitting here and listening to me.”

“Any time. And hey, just remember how many people we do help. This job isn’t easy, but the wins are what keep us going.”

I nodded and finished my drink, and thought about my next move. 

“You heading home?” he asked me. He had nearly finished his drink.

“I’ll stay for one more,” I smiled. He nodded and called to Scott, asking for another round. “Why don’t you tell me about your day?”

“Oh well, strap in because you are about to be very impressed.” I appreciated him changing the mood to one of levity. It served as a great distraction, even if he was over exaggerating his successes. He continued to throw in jokes, and compliments, in an attempt to make me smile, which worked like a charm.

We spent the remainder of the drink talking about the surgery he completed that day. I asked him questions and pictured his procedure in my head, wishing I had been with him in the OR instead of assigned to Strange.

Our glasses were empty and Bucky instinctively handed over his credit card to pay for our rounds, despite my protests. “You’re an intern, I know how much you make. Take the free drinks,” he argued. He settled up the bill and we collected our things, departing our local bar.

“Can I walk you to your car?” he asked me.

I thought about protesting, declaring myself an independent woman who could care for herself. But I found I didn’t have the fight in me today. 

“Sure,” I smiled. We walked toward the parking lot of the hospital in comfortable silence. When we reached my car, there was a moment. We looked at each other and I could sense him reading me, trying to figure out his next move. The tension between us was high, and I genuinely considered giving into my pining. It would be nice to have some company tonight, even if it was just to share a glass of wine and partake in some innocent cuddling. But there was nothing innocent about Bucky Barnes, and inviting him into my home would be like asking in a vampire: my defenses against his seduction would be useless and I’d wake up with bruises on my neck.

“Thanks Buck,” I eventually said, unlocking my car.

“Any time,” he said, as he took a careful step backwards. “You working tomorrow?” he added.

I simply nodded and gave him a soft smile.

“Good, I’m requesting you for my service. We’re gonna save some lives.”

Despite my best efforts, I couldn’t sleep. I contemplated another whiskey, but was keen to avoid a hangover in the morning. Instead, my eyes were affixed to the ceiling as I half-heartedly listened to a podcast in an attempt to lull me to sleep.

What puzzled me was that I wasn’t up thinking about Jarvis, I was thinking about Bucky. He provided the exact support that I needed in my moment of despair, proving he was more than just a good lay. Suddenly, the line between personal and professional didn’t seem so clear.

Sure, it was unethical to get involved with a superior, but it must’ve happened in hospitals all the time. Surgeons spend a majority of their time in the hospital, fraternization must be commonplace. It didn’t seem like such a big deal anymore. Who cares about what other people think, shouldn’t my happiness come first?

Before I realized what was happening, my fingers were inside of me and a moan was escaping my lips. Bucky was on my mind, in every position imaginable. Pumping vigorously, then slowly. His lips on my neck, his tongue circling my ear. His musky scent penetrating my nasal cavity. The thought of it was all too much, and I came undone so easily. As I was gently overcome by sleep, I knew that things had changed and I was in trouble.

next chapter

[angelsaxis]

"Conclusions: In our one-year follow-up study, it was seen that even after surgical correction of congenital gastrointestinal malformations, children born of COVID-19-positive pregnancies can suffer serious growth and developmental delays, and gastrointestinal health issues might be more common. Since the long-term effects of COVID-19-positive pregnancies are not yet clear, larger cohort-based studies are required in this domain. Antibiotics destroy gut microbiota, especially in cases of gastrointestinal malformations and surgical resections. Growth and developmental milestones can not only be affected by CGIMs but also be further delayed by COVID-19 infections."

[miss-anthropyxx]

Abdomino-pelvic impalement x3 in a 17-year-old who somehow managed to not die

[Original medical journal case report] [Credit to how this was found]

A 17-year-old female fell from second floor directly over iron rods of an under-construction building at midnight. Although three iron rods penetrated inside her body, she was conscious and oriented but cried in pain. Neighbours cut the rods from the iron pillar with drilling machine and shifted the patient from accident site to the emergency department of our hospital which took 5 hours. During this interval, she was in sitting posture and could not lie down fearing additional trauma due to the penetrating rods. On examination, she was conversant and had a pulse rate of 126/minute and pallor. Two iron rods could be seen penetrating her abdomen and pelvis while the third one went through and through her gluteal region [Figure 1].

A part of her cloth also went inside the path of the iron rods. Blood clots could be seen at the entry and exit wounds. Abdomen was not distended, and child had passed clear urine once on her way to the emergency department. There was no evidence of any injury to the chest, head, neck, spine or the extremities. At arrival, along with the primary survey, an intravenous line was secured to start fluids, antibiotics and analgesics. Tetanus toxoid and tetanus immunoglobulin were administered. Simultaneously, samples were sent for routine blood investigations and cross match. Haemoglobin was 8.9 and haematocrit was 27. Chest, abdominal and pelvic skiagrams were taken to assess the passage of the rods and any bony injury. One of the rods could be seen penetrating through the right iliac bone. Another rod went through and through the ascending colon just distal to the ileo-caecal junction and also the right iliac bone. There were no major vascular or urinary injuries. All the solid organs were spared. Resection of the jejunal segment containing the two perforations was done followed by end-to-end jejuno-jejunostomy.

Patient was shifted to the operation theatre and was put in left lateral position between the operation table and shifting trolley, so that the rods came in between the trolley and the operation table. In this position, patient had induction of anaesthesia using 100% oxygen for 3 minutes followed by Etomidate (100 mg), Fentanyl (75 mcg) and Succinylcholine (75 mg) [Rapid sequence induction], followed by intubation using cuffed oro-endotracheal tube of size 7.0. Following this, patient was maintained on Oxygen, Air and Sevoflurane, then patient was shifted to operation table in sitting posture and surgical procedure was started. Rod in the gluteal region was removed first after increasing its entry and exit wounds slightly. It was seen to pierce only the gluteal muscles. The passage was washed with hydrogen peroxide and saline and packed with betadine-soaked gauze. She was then turned supine and laparotomy was done through midline incision. One of the rods was seen to pierce the jejunum twice at approximately 30 and 40 cm from the duodeno-jejunal junction [Figure 2].

Ileo-ascending anastomosis was done after excision of the caecum along with the perforated ascending colon. No orthopaedic intervention was needed for the rod penetrating the right iliac bone. Tension suturing was done after insertion of drains in pelvis, right and left paracolic gutter. She received three units of packed cells in the peri-operative period. Patient was transferred to the Intensive Care Unit post-operatively and was there for 5 days following surgery for intensive monitoring and management. Antifungal agents were added when positive fungal blood culture was seen following fever on 3rd post-operative day. Patient passed flatus on 5th post-operative day and tolerated oral food from the next day. Drains were removed on the 5th post-operative day. Wounds over gluteal and iliac regions were conservatively managed on dressing and antibiotics. The total duration of hospitalization was 24 days and patient were discharged with advice of daily dressing of these wounds. First follow-up was after 15 days of discharge and subsequent two follow-ups were after one and three months of discharge. She has been asymptomatic on follow-ups. Figure [3] shows her scars after 3 months of discharge from hospital.

[love-and-deepspace-wiki]

Akso Hospital Expert Introductions: Dr. Joelle

We're starting off with Dr. Joelle, the Chief of the Division of Cardiac Surgery! The display covers her educational background as well as her professional career milestones. Here's the best look at her picture that I could get!

And here are all the details they wrote in her biography. My notes/observations included below:

Dr. Joelle

Division of Cardiac Surgery

Chief of the Division of Cardiac Surgery

Expertise:

Coronary artery bypass graft (Evol-based)

Aortic valve replacement

Surgical treatment of infective endocarditis (Evol-assisted) and constructive pericarditis

Cardiac tumor resection

Biography:

Dr. Joelle studied at Beiyang University Medical School from 2021 to 2029. She started as a fellow at Linkon Central Hospital in 2032 and has been invited to a number of cardiology centers for academic exchanges since then. She served as an attending surgeon, chief medical officer, and chief surgeon in the Division of Cardiac Surgery at Linkon Central Hospital. She is now Chief of the Division of Cardiac Surgery, Professor of Cardiac Surgery, and Chair of Cardiac Surgery under the National Medical Association.

Since Dr. Joelle became Chief of the Division of Cardiac Surgery in 2043, she has been fully committed to clinical work, scientific research, and teaching Cardiac Surgery. She successfully performed innovative surgical operations for many complicated cases and co-authored several monographs on Cardiac Surgery, such as “Establishing the Cardiopulmonary Bypass Model in the New Medical Environment” and “Aortic Disease Guide”. Thanks to her leadership, the division has numerous national first and international first achievements. In addition, she also performed multiple lectures and live streamed surgeries for various medical institutions and universities. She has won many awards for the Division of Cardiac Surgery.

My Notes:

I've noticed throughout some of the in-game info, the terms "Akso Hospital" (AH) and "Linkon Central Hospital" (LCH) are used interchangeably on occasion. Maybe it's an unintended artifact from game development, the original name being LCH before AH was chosen? I've yet to see any evidence that the two being separate entities, but will update if that happens.

So far, this is the only mention of Beiyang University I've found in the game. But I'm so curious about it

They don't list out any of her specific awards like they did on Zayne's display, but I wish they did lol

I haven't spotted her face among other hospital staff, but I'm keeping my eyes peeled!

[killed-by-choice]

“Madame A, 38” (France ~1975)

A woman identified only as “Mme. A” in a medical journal was killed by a legal abortion in France, reported at the end of the year that abortion was legalized essentially on demand. She was six weeks pregnant when she went to an abortionist only identified in the medical journal as “Dr. X.”

Mme. A’s pre-op examination showed no health problems. As a precaution, she was prescribed antibiotics in advance. She was led to believe she was in the hands of an expert, who claimed to have carried out over 1,400 abortions without complications. However, this claim would soon prove to be suspicious given what he failed to recognize.

The aspiration abortion was done in only three minutes with no anesthesia. Nobody noticed even the slightest anomaly and Mme. A was discharged from the abortion facility two hours later. Dr. X. reported that she wasn’t in pain even though she herself said that she was, albeit that the pain wasn’t severe at that point and she wasn’t worried.

Over the next two days, Mme. A’s pain increased. On the third day, she got a referral for a different doctor. This doctor observed her for a few hours and then performed emergency surgery, realizing the condition she was in.

Dr. X. had failed to notice even the slightest anomaly during the abortion or any pain after it, but he had inflicted serious injuries. He had torn a hole through Mme. A’s uterus, then perforated her small intestine through the hole. She was now suffering generalized peritonitis and needed a resection of the small intestine along with drainage for abscesses.

The day after her emergency surgery, Mme. A worsened. She was developing dypsnea and large bilateral hemorrhagic pleural effusions. On the fifth day, she was admitted to the ICU at Antoine-Béclère Hospital. She was under constant intensive care for 15 days, but this was further complicated by pulmonary embolism and digestive bleeding from stress ulcers. Just as her condition seemed to be somewhat under control, she suffered a recurrence of the pulmonary embolism. She died on her 16th day in Intensive Care, leaving a 10-year-old and a 9-year-old without their mother.

The medical journal that documented Mme. A’s death labeled her course of complications as “unfortunately classic” when operating on a patient with peritonitis, partial evisceration, pulmonary embolism, abscesses and internal bleeding. It was noted in the review of her case that suction abortion is a surgical operation and should not be treated as trivial. It was recommended that abortion clients be monitored in a real hospital setting for 2 to 3 days afterwards. The surgery department of the hospital submitting Mme. A’s case stated that, “the official and even legislative publicity of the safety of the method also has a certain responsibility in our eyes.” Even though it was now legal and done by a self-proclaimed “expert,” abortion was still not a safe operation or one to be taken lightly.

[jcsmicasereports]

Myxoid liposarcoma of the spermatic cord: A rare entity by Emmanuel E. Sadava in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

An 81-year-old man consulted at our hospital for evaluation of a long-established left inguinal mass. The patient denied experiencing pain, food intolerance, constipation or urinary tract symptoms in the past. A physical examination revealed a 15x10cm painless mass in the left inguinal region, distinct from the testicle, with no palpable changes during Valsalva´s maneuver. Magnetic resonance imaging (MRI) showed a 79mm heterogeneous lesion of the spermatic cord which projected itself through the inguinal canal into the scrotal sac, displacing the testis inferiorly. Laboratory testings were negative for testicular tumor markers such as α fetoprotein and human chorionic gonadotropin-β. A surgical resection of the inguinal tumor with an “en-bloc” inguinal orchiectomy was performed. The inguinal floor was repaired with a modified Bassini technique without the use of a mesh. The histopathological report confirmed findings were consistent with a myoxid liposarcoma. No further treatment was indicated and the patient continued follow-up with bi-annual MRIs. 18 months later, the patient continues with no signs of recurrence.

Key words: liposarcoma, liposarcoma of the spermatic chord, abdominal wall surgery, inguinal mass.

Introduction

Sarcomas constitute a heterogeneous group of rare solid tumors of mesenchymal cell origin. Collectively they account for approximately 1% of all adult malignancies with an annual incidence of 2.5 cases per million population[1]. In adults, the most common soft tissue sarcomas are liposarcomas. Overall, they account for approximately 17% of all soft tissue sarcomas. Most cases arise from de novo, therefore, the development from a preexisting benign lipoma is rare. Liposarcomas usually appear as a slowly enlarging, painless mass in a middle-aged person with a slightly higher incidence in men.

These tumors are classified in three main biologic forms: 1) well-differentiated liposarcoma; 2) myxoid and/or round cell; and 3) pleomorphic. The latter being a rare high-grade with a high recurrence rate and poor prognosis. The well-differentiated and myxoid types have favorable prognoses. However these tumors locally recur after incomplete excision[2].

The anatomic site of the primary disease represents an important prognostic factor, influencing treatment and outcome. Extremities (43%), the trunk (10%), visceral (19%), retroperitoneum (15%), or head and neck (9%) are the most common primary sites. Scrotal location is relatively rare, accounting for 3.6% of all liposarcomas. The origin of intra scrotal liposarcomas include the spermatic cord (76%), testicular tunic (20%), and the epididymis (4%).

Case Report

An 81-year-old man with a medical history of follicular cutaneous lymphoma and an open left hemi-colectomy for colon cancer consulted at our hospital for evaluation of a long-established left inguinal mass. The patient denied experiencing pain, food intolerance, constipation or urinary tract symptoms in the past. A physical examination revealed a 15x10cm painless mass in the left inguinal region, distinct from the testicle, with no palpable changes during Valsalva´s maneuver. Magnetic resonance imaging (MRI) showed a 79mm heterogeneous lesion of the spermatic cord which projected itself through the inguinal canal into the scrotal sac, displacing the testis inferiorly. Laboratory testings were negative for testicular tumor markers such as α fetoprotein and human chorionic gonadotropin-β. Ultrasound-guided biopsies of the mass were requested and their histopathology analysis revealed myxoid stroma with fusocelular proliferation.

A radical resection was suggested but, a week prior to the surgical procedure, the patient was diagnosed with COVID infection during which he intercurred with myocardial infarction and ischemic stroke. He underwent a double coronary angioplasty with drug-eluted stents and required anticoagulation and antiplatelet therapy posteriorly. The case was discussed at a multidisciplinary meeting and a conservative management of the inguinal tumor was decided. The patient was reassessed 12 month later with a new MRI, which showed the inguinal mass increased in size (99mm) compared to the previous study, and a computed tomography (CT) with no evidence of metastatic disease. A surgical resection of the inguinal tumor with an “en-bloc” inguinal orchiectomywas performed. The inguinal floor was repaired with a modified Bassini technique without the use of a mesh. The patient had an uneventful recovery and was discharged from the hospital on postoperative day two.

The histopathological report confirmed a 130x120x120mm low-grade fibro myxoid neoplasm. The surgical margins were negative. Immunohistochemistry showed strong reactivity for S100 and vimentin, whereas SOX10, desmin, CD34 and estrogen receptors were negative. These findings were consistent with a myoxid liposarcoma. No further treatment was indicated and the patient continued follow-up with bi-annual MRIs. 18 months later, the patient continues with no signs of recurrence.

Discussion

Liposarcomas invade through local extension and rarely invade through the lymphatic route, making regional lymph node dissection lose its value and having no impact on survival. Nevertheless, high-grade subtypes are associated with high rates of recurrence and hematogenous spread; lungs, liver and peritoneum being the most common sites of metastasis.  Surgical resection (with appropriate negative margins: >1cm) is the standard primary treatment in most patients with stromal cell sarcomas. Complete tumor resection is the primary prognostic factor for local recurrence, and liposarcomas are not the exception. Performing an “en-bloc” resection involving a high orchiectomy (including the surrounding tissue) is important to obtain negative margins [1].

Local recurrence rates for sarcomas, including liposarcomas of the spermatic cord, have been reported to be as high as 30-50%. Because of this, and despite the patient’s disease-free status, long term follow-up remains a crucial step in the detection of recurrences that might still be potentially curable. Current controversy arises on the use of adjuvant chemotherapy or radiotherapy. Being a rare and infrequent entity makes it hard for a single institution to accumulate enough cases to perform prospective randomized controlled trials. Extrapolated data from retrospective analyses support the use of adjuvant radiation on selected high-risk situations (tumor recurrence, high-grade tumors or residual disease). Concerning the role of chemotherapy, the use of adjuvant chemotherapy remains controversial and there is no definitive role in the management of localized liposarcomas[3].

In conclusion, myxoid liposarcomas of the spermatic cord are infrequent entities. As most soft tissue sarcomas, they have an indolent course and should be considered as a differential diagnosis of inguinal masses with no palpable changes during Valsalva´s maneuver. Complete surgical resection with high-orchidectomy “en-bloc” is encouraged.

[satyadevhospital]

Satyadev Superspeciality Hospital: The Best Hospital in Patna for Urological Care

When it comes to urological health, Satyadev Superspeciality Hospital stands as the Best Hospital in Patna, providing exceptional medical care under the leadership of Dr. Kumar Rajesh Ranjan, a renowned General Surgeon and urologist. The hospital is equipped with advanced technology and offers comprehensive services to diagnose and treat various urological conditions. With a team of highly skilled medical professionals, Satyadev Superspeciality Hospital ensures that patients receive top-quality care for a wide range of conditions, including Kidney Stones, Ureteric Stones, Bladder Stone, Prostate (BPH), and more.

Services They Offer

1. Kidney Stone Treatment

Kidney stones are a common issue that affects many individuals, causing severe pain and discomfort. At Satyadev Superspeciality Hospital, specialized treatment options are available to provide relief from this condition. The hospital utilizes advanced diagnostic techniques and minimally invasive procedures to manage kidney stones effectively. Whether it's through extracorporeal shock wave lithotripsy (ESWL) or endoscopic surgery, patients can trust that they are in the hands of the Best Hospital in Patna for kidney stone treatment. Dr. Kumar Rajesh Ranjan, the best urologist in Patna, ensures a swift diagnosis and effective treatment plan for every patient.

2. Ureteric Stone Removal

Ureteric stones, which form in the tubes that carry urine from the kidneys to the bladder, can cause excruciating pain and urinary complications. Satyadev Superspeciality Hospital offers advanced procedures like ureteroscopy and laser lithotripsy to remove ureteric stones safely and efficiently. With a high success rate and a patient-centered approach, the hospital guarantees fast recovery times and minimal discomfort. This commitment to patient care makes it a leading choice for those searching for the Best Hospital in Patna.

3. Bladder Stone Treatment

Bladder stones often develop due to a variety of underlying conditions, including urinary tract infections and an enlarged prostate. Satyadev Superspeciality Hospital offers state-of-the-art treatment for bladder stones which is a procedure that breaks down stones and removes them via the bladder. With the expertise of Dr. Kumar Rajesh Ranjan, the best urologist in Patna, patients can rest assured that they will receive top-tier care. The hospital's emphasis on accurate diagnosis and minimally invasive treatments reinforces its status as the Best Hospital in Patna for urological care.

4. Prostate (BPH) Management

Benign Prostatic Hyperplasia (BPH) is a common condition among older men that causes the prostate gland to enlarge, leading to urinary difficulties. Satyadev Superspeciality Hospital offers cutting-edge treatments, including medication, minimally invasive therapies, and surgical interventions like transurethral resection of the prostate (TURP). Dr. Kumar Rajesh Ranjan, a leading urologist in Patna City, ensures that patients receive personalized care tailored to their specific needs. The hospital's comprehensive approach to BPH management has made it the Best Hospital in Patna for treating this condition.

5. Laparoscopy

Laparoscopy is a minimally invasive surgical technique that offers numerous advantages over traditional open surgery, including reduced recovery times and less postoperative pain. Satyadev Superspeciality Hospital excels in laparoscopic procedures for various urological conditions, allowing patients to experience faster healing and shorter hospital stays. Dr. Kumar Rajesh Ranjan, a skilled urologist doctor in Patna, utilizes the latest laparoscopic techniques to ensure precise and effective treatment. This commitment to excellence has solidified the hospital's reputation as the Best Hospital in Patna for laparoscopic surgery.

6. Urology

As a dedicated urology center, Satyadev Superspeciality Hospital offers a wide range of services to address male and female urological issues. From urinary tract infections to incontinence, the hospital is equipped to handle both common and complex cases. Under the guidance of Dr Kumar Rajesh Ranjan, the best urologist in Patna, patients receive customized treatment plans that focus on long-term health and well-being. The hospital’s commitment to high-quality urological care makes it a standout choice for those seeking the Best Hospital in Patna.

7. Andrology

Andrology, the branch of medicine concerned with male reproductive health, is another area of expertise at Satyadev Superspeciality Hospital. Whether it’s erectile dysfunction, infertility, or hormonal imbalances, the hospital provides comprehensive care tailored to male patients' needs. Dr. Kumar Rajesh Ranjan, a leading urologist in Patna City, ensures that patients receive sensitive, personalized care for their andrological concerns. With a focus on privacy and compassion, the hospital has established itself as the Best Hospital in Patna for men’s health.

8. Urological Oncology

Urological cancers, including those affecting the bladder, prostate, and kidneys, require specialized care and early detection for optimal outcomes. Satyadev Superspeciality Hospital is a leader in the diagnosis and treatment of urological cancers. Using advanced imaging techniques and surgical options, the hospital ensures that patients receive the best possible care. Dr. Kumar Rajesh Ranjan, a highly experienced urologist doctor in Patna, works closely with oncology specialists to provide a multidisciplinary approach to cancer care. This comprehensive care model positions the hospital as the Best Hospital in Patna for urological oncology.

Why Satyadev Superspeciality Hospital is the Best Hospital in Patna

At Satyadev Superspeciality Hospital, the focus is always on patient care. With cutting-edge technology, a compassionate team of experts, and the leadership of Dr. Kumar Rajesh Ranjan, the best urologist in Patna, the hospital ensures that patients receive the highest level of medical care. Whether you are dealing with kidney stones, bladder issues, or prostate conditions, you can trust Satyadev Superspeciality Hospital to provide world-class treatment.

With its wide range of services, from general urology to specialized cancer care, Satyadev Superspeciality Hospital has earned its reputation as the Best Hospital in Patna. The hospital's dedication to innovation, patient comfort, and successful outcomes make it the top choice for those seeking a urologist in Patna City or a urologist doctor in Patna.

Whether you are facing a simple urological issue or a complex condition, Satyadev Superspeciality Hospital offers the best medical solutions, making it the undisputed Best Hospital in Patna for urological and general health care.

For More Info: https://www.satyadevurology.com/

[she-karev]

Trying to Get Pregnant (Andrew DeLuca x Alex Karev’s Sister)

Previous Part Here

Age Rating: 12+

Chapters: Three of Five

Fandom: Grey’s Anatomy/Station 19

Ship: Andrew DeLuca x Amber Karev (Alex Karev’s Sister)

Canon Episode: Season 18 Episode 17/Season 5 Episode 17

Summary: Andrew discovers a devastating diagnosis on Link’s patient. Amber helps take care of a patients baby at the station where Jo overhears her talking about trying to get pregnant.

Words: 1764

February 18th, 2022

Andrew is in the final stages of breaking through the intestinal wall to allow him access into the infected section of the small intestine. Link is assisting and making sure that Andrew covers the steps to the general attendings annoyance.

“Okay now use the cautery pen-”

“To break through the wall and allow us visual access into the small intestine.”

Link nods and probes more, “Right and the scans show the tumor-”

“Around the lower ileum I know and assuming the tumor isn’t wrapped around any major organs I put clamps on both sides of the diseased tissue and resect it. After I resect the tumor I use the GIA stapler to connect the two ends of the small bowel together. Is that a good enough plan or do you want to hover some more?” Andrew’s tone makes it known that he is getting agitated by Link undermining him.

Link looks at his friend blankly seeing he is pushing it, “You want me to back off?”

“If you please.” Andrew continues his surgery when his phone rings by the surgical tray that the scrub nurse picks up.

“It’s your wife Dr. DeLuca.”

“Put her on speaker.” The nurse does that and Andrew speaks to Amber from his position, “Hey babe what’s up?”

Amber speaks from the phone inside the ambulance at Station 19, “Hey quick question, how do you feel about having sex in the back of an ambulance?”

Andrew’s eyes widen in shock as the whole OR hears that with Link looking at him in shock before chuckling under his breath to not give himself away to Amber.

DeLuca chuckles uneasily before breaking it to Amber, “You’re on speaker with OR 3.”

Amber frowns at that, “Oh…that would have been nice to know before I humiliated myself.” Andrew grins at her bashfulness, “Well it’s too late now so might as well continue. The gurneys aren’t as uncomfortable as they look and assuming nobody get’s hurt we have an ambulance all to ourselves when we get off shift.”

“And as a former EMT I should tell you ambulances carry more than one communicable disease in between calls. I mean it’s the reason ambulance chasers are employed.”

“Fair enough, I just thought we could spice things up a bit but a trip to the isolation bubble might stop it short.” Amber hears someone calling out to her outside the ambulance, “I gotta go babe, I’ll see you at home, I love you.”

“I love you too bye.” The nurse hangs up the phone and Link looks at Andrew in amusement causing him to grin, “Sorry about that.”

“No it’s fine man you and Amber are still in the honeymoon phase a year later which makes me bitter but I am choosing to be happy for you two. Do you want to continue?”

Andrew nods and finally has access to the small intestine that shows the tumor is worse than the scans showed, “Damn it. It's wrapped around the vascular structures.”

Link looks at the tumor in sadness for his patient, “I see it.”

Andrew sighs and puts away the tools, “Okay, everyone, change of plan. We're gonna divert the bowel, buy him a little more time, make him more comfortable.”

Link is surprised at this course, “No, no. Hold on, you're not gonna resect any of it?”

“The tumor is wrapped around major bleeders, even taking out a small portion could make him bleed out, it’s too risky.”

“So he's just supposed to live with this in his bowel?”

“I didn't put the tumor in there, Link.” Andrew bitterly reminds him.

Link is still mad, “So you're just gonna close him up with a stool bag and that's it?”

“The other option is I close him without doing anything. He's dying, Link. I’m sorry.” Link looks down sad, “This will help him with his pain. He'll live a better life, even if it's just for a few weeks.”

Link sighs, “He wants to meet his son.”

Andrew closes his eyes feeling sympathy for Simon knowing how much he wants to have a child as well but keeps his emotions in check, “Okay. Let's prep for an ileostomy.”

Later at Station 19

Amber enters the exam room in her lab coat and casual clothes holding a tablet for the lab results. Her patient is a three-month-old newborn baby boy named Conor who came in with his mother, Sara, after crying all night and presenting with a fever this morning. Sara is young and working on becoming an accountant while her boyfriend is a truck driver who spends most of his time on the road. The mom rocks the crying baby up and down as Amber enters the room.

“The labs came back. Conor has RSV, it’s a virus common on babies it affects the breathing mainly.”

Sara looks at her baby in panic, “Oh my god, is he gonna be okay?”

“RSV typically goes away after two weeks with at home treatment. You should give him fluids so he doesn’t get dehydrated, fit his room with a humidifier so the mucus in his nose can break up, and give him infant Tylenol for the fever.” Amber writes down instructions on the tablet, “Now if none of that works, go to Grey Sloan memorial and ask for Dr. Alex Karev. He’s the chief of pediatric surgery and he’ll do an antibiotic drip on Conor to flush his system of the infection.”

Sara sighs as she holds the baby, “I don’t have insurance, I’m trying to finish school so I can get a job and my boyfriend is trying to find his footing.”

“Don’t worry I know him personally, he’s not in it for the money he’s in it to make sure boys like Conor can go home healthy and happy.” The mom looks relieved by that as Amber prints the instructions. Conor begins to calm down causing Amber to smile at him, “Can I ask you, what are babies like at Conor’s age?”

Sara exhales, “Oh you know, they eat, cry, poop, not sleep and then rinse and repeat. Do you have kids?”

“Um no not yet.” Amber says longingly, “My husband and I just started trying and I am anxious for the stick to be positive. I’m impatient by nature.”

“So am I.” The mom grins, “But this little guy has helped me a lot in that department. It turns out a crying baby can help you be friendly towards awful customers who claim I put a cockroach in their food.”

“That will definitely help me with the next patient I have who thinks they know more about medicine that I do.”

Sara chuckles, “Are you hoping for a boy or a girl?”

Amber thinks for a moment, “Honestly? I’m fine with either. I grew up with two older brothers so a part of me yearned for a girl I can relate to. But as much as I complain about them, I got used to being around boys, so it helps prepare me if I have one. And I don’t really care as long as my baby is happy and healthy.”

“It sounds like you got this then.” Sara’s phone rings inside her purse slung over her shoulder that she tries to reach but can’t with Conor in her arms, “I’m sorry can you hold him for minute? It might be his dad calling to check on us.”

Amber is taken back but nods, “Yeah sure I need the practice anyway.” Sara puts the baby in Amber’s arms and the young doctor takes him outside the tent where she smiles at the cute baby, “Hi, how are you? Do you think you might be a firefighter or a doctor? I strongly recommend doctor, don’t tell the other firefighters.”

Jo exits the tent next door and approaches her sister-in-law with a grin, “Cute baby.”

“Thanks, it’s my patients, she’s talking to her boyfriend over the phone. I am watching this little cutie in the meantime. I gotta say this place is a lot more relaxing than the hospital. Maybe I missed my calling at the fire station.”

Jo smiles holding the baby’s tiny hand, “Well firefighters don’t get to work while pregnant. It’s the one advantage you have as a resident when the time comes.”

Amber’s eyes widen at that, “How did you find out? Did DeLuca tell you?”

“Nope you did.” Jo informs her with a happy smile, “The tents are thin and I was right next door treating a sprained ankle when you told Sara about you and Andrew trying to have a baby.”

Amber groans at that, “I knew we should have sprung for cubicles.”

Jo squeals in joy, “I can’t believe it you’re gonna be a mom, I’m gonna be an auntie. This is amazing!”

Amber chuckles at Jo’s excitement, “Calm down please, we literally started trying last night so it could be a while before we see results.”

“Still aren’t you guys excited? I mean you’re gonna be parents.”

Amber looks at the baby in her arms with a grin, “Yeah, we’re pretty happy to start this new chapter of our lives.”

Jo squeezes Amber’s arm in joy, “Seriously though Luna is the best thing that happened to me and Alex. I hope everything works out and you guys get a little bundle of joy of your own.”

“Me too.” Amber rocks the baby in her arms before she realizes she needs to clarify things with Jo, “Listen you’re the only one who knows about this so we would appreciate it if you kept this to yourself until we’re ready to tell people.”

“You guys haven’t told anyone? Not even Carina?”

“I love her as much as a I love you as a sister but ever since she started hormone treatments she’s been agitated at every inconvenience. I don’t want her pissed off at me because I’m trying when I’m young and don’t need a turkey baster to conceive. God knows I’m never gonna hear the end of it until I pop out a kid.”

Jo nods, “Yeah when I was on her service, she told me I was wiping a baby wrong. I get it and if she tells me that she’s finally pregnant I will tell you, so it’ll soften the blow when you tell her about your attempts at having a baby.”

“You are the best seriously.” Sara approaches Amber free handed and she hands Conor back to her and the young mom leaves the fire station. Amber and Jo go back to their other patients.

Next Part Here

[sheydboots]

[image ID: a collage-style digital drawing, mostly using a pencil brush. featured is a thin person wearing a torn garment that appears to be made of raw meat. it is framed by a poem which has been transcribed below. at the top of the frame, various tools (pliers, nails, an ice pick, a cheese knife, a hammer, a screwdriver) are pictured, all drawn in a vague, clay-like way, and colored bright red. a knife with a handle in the same style is pointing at the person's throat. there is a staircase ascending from the person's head; near the peak of it, the silhouette of a cat can be seen. the person's mouth, and part of their left eye, are obscured by red circles, which connect to images of a mouth grimacing and grinding its teeth (left) and an eye with a red iris (right). there is a mouth and an eye above the person, resting in a black void, looking into its eyes. there is a hand descending from the void, and it lies splayed to the right of the person's head. the bottom half of the frame is taken up mostly with black and white stripes with text overlaid; some of the text is in boxes, which are light indigo in color, and is overlaid above the image of the person. /end ID]

text transcript: whatever hope in these hollowed halls lived. shell of a shell of a shell of a shell. questions blink in stalks of antennae and. billows and bleeds. the windows and the walls know what surely you did. the deserts and the plains know. the seas on each coast know. whatever winds called here this place a home in a head. less than ten thousand tunnels couldnt be done. whatever you said the limit was. the big nothing you put in the walls with your boot fist shout thrash burst implosion shattering throwing wailing crawling bleating seething. the mountains know, too. and here is the part you know you should know. all my scars still hurt. i need to get your hands out of me. i need to get your stains out. excision; noun: the act or procedure of removing by or as if cutting out... especially surgical removal or resection... /end transcript

[medixocentre1]

Unlocking The Potential Of Lenvatinib A Comprehensive Guide Understanding Lenvatinib Price

In the field of cancer treatment, where targeted medicines are changing the landscape of care, Lenvatinib 10 mg stands out as a promising medication for patients suffering from certain types of cancer; however, the lenvatinib price fluctuatesoccasionally. This article will provide a thorough examination of Lenvatinib 10 mg, providing light on its applications, mechanism of action, dosage, ability, side effects, and revolutionary effect on cancer treatment.

Introduction to Lenvatinib 10 mg

Lenvatinib is a tyrosine kinase inhibitor with demonstrated success in the treatment of a variety of malignancies, including thyroid cancer and hepatocellular carcinoma (HCC). The 10 mg dosage of Lenvatinib is a specific method geared to meet the healing needs of patients undergoing targeted treatment.

Mechanism of Action

Lenvatinib works by inhibiting a few receptor tyrosine kinases (RTKs), as well as vascular endothelial growth problem receptors (VEGFRs), fibroblast increase detail receptors (FGFRs), and platelet-derived boom element receptors (PDGFRs). Lenvatinib exerts anti-cancer effects by focusing on the major signaling pathways involved in tumor angiogenesis, development, and metastasis, which are ultimately necessary for tumor regression and advanced impacted character outcomes.

Uses of Lenvatinib 10 mg

Thyroid Cancer

Lenvatinib 10 mg is approved for the treatment of differentiated thyroid cancer (DTC) that is resistant to radioactive iodine therapy. It has demonstrated efficacy in slowing disease progression and improving improvement-free survival in patients with advanced or metastatic DTC. You can purchase it by obtaining information on lenvatinib prices from medical clinics or online.

Hepatocellular Carcinoma (HCC)

For patients with advanced HCC who are not candidates for surgical resection or network ablation, Lenvatinib 10 mg provides a valuable therapy option. It has demonstrated superiority over sorafenib, an excellent tyrosine kinase inhibitor, in terms of overall survival and progression-free survival in patients with unresectable HCC.

Dosages and Administration

Lenvatinib 10 mg is typically delivered orally once per day, with or without food. The dosage can be changed based on the affected person’s characteristics, such as frame weight, renal function, and tolerability. Healthcare personnel regularly monitor patients getting Lenvatinib medication, including regular examinations of tumor reactions and adverse effects to optimize treatment outcomes.

Potential Side Effects

While Lenvatinib 10 mg is generally well tolerated, it may produce adverse outcomes in certain patients. Common side effects of Lenvatinib medication include elevated blood pressure, lethargy, diarrhea, decreased appetite, nausea, and proteinuria. Patients are advised to immediately report any new or worsening symptoms to their healthcare providers for proper management.

Wrapping Up

Finally, Lenvatinib 10 mg represents a significant development in the treatment of thyroid cancer and hepatocellular carcinoma, providing improved outcomes and increased survival for patients with advanced or metastatic disease. Its concentrated mechanism of action, combined with its broad range of medical warning signals, emphasizes its importance in modern oncology. Patients are recommended to consult with their healthcare providers to learn more about the lenvatinib price, for personalized guidance, and for adapted control strategies when using Lenvatinib 10 mg. People can begin their treatment path with confidence and hope for a better future by understanding the intricacies of most cancers and investigating available therapy alternatives. Source:-

Unlocking The Potential Of Lenvatinib A Comprehensive Guide Understanding Lenvatinib Price