#the patient is really confused because of a brain tumour

[fllowered]

i’ve been looking after the same patient for a few days and he hasn’t been very nice to me. but he’s dying so i know not to take it personally. then a family member goes up to me to complain that he isn’t being looked after properly. i explained to him that i’m trying my best for the patient and that the patient is being very well looked after. it’s hard to really go into any detail but the entire interaction just made me feel like shit… it’s like i wasn’t able to convince him that i am in fact not neglecting my patient. i had to excuse myself for a little bit because i couldn’t stop myself from crying afterwards. idk… it sounds dumb reading this after typing it. i feel so embarrassed that a coworker saw me cry and that i was even crying in the first place.

[flyonthewallmedstudent]

Re-watching House as a Physician. Pilot Episode. Neurology in the young.

I’d actually recommend this as an exercise.  Re-watching this as a means to motivate studying. It’s truly terrible watching it. So much so, that you want to do it properly or throw shit at the TV. 

If I had students and we couldn’t physically see patients I’d probably tell them what episode to watch and we’d go through the cases together. Go through all the things the team does wrong. Then discuss the things you don’t know yourself.

Because that is actually how you learn best.  Recovering from your mistakes. Identifying gaps in knowledge. 

Unfortunately, all my current students are final years and they do have to see real patients. 

Opening episode: 29 year old female, no past medical history has expressive dysphasia then a first seizure.  How do we know it’s expressive dysphasia?

IN the episode, the patient notices she’s having trouble getting words out, and is able to write. Then has a seizure. Wilson actually has a good introductory statement here. House finds the case boring, this really isn’t boring. If it doesn’t excite a physician it should certainly terrify them. A la house of god, rule number X = Treat the dying young. With urgency. The majority of patients I see in IM are in their 70s-90s, have predictable issues like metabolic syndrome, heart failure, arrhythmias like atrial fibrillation, infections like community acquired pneumonia and dementia. These are my bread and butter. 

More often than not, my primary role is to ensure a dignified end of life care. Many of them come in already at death’s door or will be imminently there. To continue to push them through medical treatment when they no longer have resilience to go through them, is to prolong suffering. 

You can’t predict how someone young will respond even to the most aggressive of treatment. You give them every chance you have. OFten if the young are sick, it’s really bad. With the elderly, a common cold can make them really sick as their body is in decline. 

Young patients with a single organ system issue will usually go to a subspecialty.  Actually any medical subspecialty or IM in general is considered “diagnostic medicine”. It’s just different flavours of it. 

1st seizures: - it’s rare to have a second.  - usually the cause of underlying seizures is infection - follow-up is clinic with neurology. It’s rare to require further.  - we could go into differential seizures, but that’s a whole other post in itself

(Epilepsy only occurs if you have a number of them and this is rare)

In the case of House, they jump straight to cancer like webmd.

Before they do much, she jumps straight to radiation therapy. This is completely unrealistic. This sort of thing requires multidisciplinary teams to pour over all her results and discuss the best way forward. Chemo and radiotherapy are notorious in the general public for having crazy toxicities. For obvious reasons.

It’s weird re-watching these, where medicine is no longer a foreign language. Actually, it’s watching someone for whom English is a new language and they haven’t really gotten it yet. The tense and grammar are all wrong. 

I watched the Queens Gambit - holy fuck is chess a foreign world and language. I know the basics, but none of the strategies. Sicillian sounds like a great name for a tasty pizza. Or something else. 

Anyways, it takes a whole lot of time before they get to differentials. 

Honestly, you would be getting to these the minute you hear the presenting complaint. Then considering how to rule them in and out. For students, always have the surgical sieve in mind. 

Differential diagnosis of expressive dysphasia in a young woman are then addressed in the episode. here��s what they consider: - Aneurysm and stroke (haemorrhagic stroke in this case if we’re talking aneurysm), incidentally most common cause of berry aneurysms is high blood pressure. this is a decent consideration. but you would have seen it on imaging from the start. 

- CJD = very much mad zebra. I wouldn’t even suggest this. You would if it was rapid onset dementia or behvarioural changes and they came from high risk areas (eg ate burgers in the UK in the 1980s and 90s). But rapid meaning weeks to months. Not sudden onset within minutes. It’s more stroke.  - Cncephalopathy: requires an LP to go over this, and she doesn’t present with a fever either. regardless, important to consider. would always consider an LP in addition to imaging.  - Wernicke’s: only consider if they have a nutritional disorder like severe, chronic anorexia (which she doesn’t have) or heavy alcohol use. This is caused by thiamine/VitB1 deficiency. A thiamine level test takes days or weeks. We would never wait for a thiamine test to come back, you’d treat IV thiamine straightaway. I mean it’s vitamin B. This is a terrible differential to consider so near the top. She also doesn’t really have the other symptoms.

Then there’s the more obvious differentials they didn’t bother to consider: The greatest mimic for a stroke particularly in young women is migraine. You can have similar neurology, but it’s often associated with a headache.  If we wanted to chase zebras in the young, you could consider a PFO (holes in the heart that are congenitally there) and thromboemboli causing stroke. (In other words, you develop a clot, normally the lungs will pick up the clot like a filter before it gets to the brain. But the clot can bypass the lungs via holes in the heart and give you a stroke). This is always the consideration in cryptogenic strokes (in which you have a young patient without any reason for having an atheroma causing stroke). Risk factors for thromboemboli can include the oral contraceptive pill (estrogen can be thrombogenic) and then long periods of immobility, think long haul flights or trauma to the long bones or surgery. IN rare cases, those who had particular types of heart surgery as an infant, like a Fontan’s. But this is very niche mind you. And they’re often already on preventative therapy. Infection is a key thing to consider, where there are risk factors. she’s not immunosuppressed or done any exotic travel or eaten raw foods she shouldn’t have eaten (raw pork, bad sushi etc.). It’s a shame they didn’t mention it early. THere’s a few infections that go to the brain but you’d often have these in mind with the risk factors as stated before. THe imaging is often a giveaway

Learning point here - always eat cooked pork! Finally, cancer. But it’d be obvious on imaging if you’d already developed seizures or focal neurology, the lesions would already be large enough to pick up. the sad part to many brain tumours is that they’re already very large by the time of presentation. Beau Biden for instance, presented with acute confusion before his diagnosis, preceding that he had weakness and altered sensation (the lesion was likely too small at the time to be picked up on imaging and was diagnosed as a stroke). 

I would rarely be referred brain tumours, the emergency department will have scanned the brain and seen something that would prompt referral to the neurosurgeons. When you’re young and have a lesion/tumour, any team will try everything, including majority surgery, to salvage what life is left. it is very tragic. 

Anyway, stopping here. Already too much stuff to dissect and unpack from just the first episode alone. Note that I’m in IM, no doubt a neurologist or neurosurgeon will have different opinions on this episode. Ha. 

[jazy3]

Thoughts on Grey’s Anatomy: 17X15

SPOILERS AHEAD!!!

Wow! A lot happened in this episode. It was billed as Jackson’s goodbye episode, but it turned out to be so much more than that. Meredith got discharged and was reunited with her kids, Tom decided to move to Boston to work for Jackson, and we got the show’s first Indigenous doctor and patient storyline! I honestly think Jackson’s farewell was really well done! While it’s true he could do the work he wants to do just as easily from Seattle everything else about his exit makes sense to me. He’s tired of sitting on the sidelines and he wants to make real change where he can.

I loved his conversation with Meredith and how he was the one to sneak her out. I loved Meredith's voice over for this episode and how it followed Jackson's actions and the flashback montage set to music. I thought it was fitting. I would have liked him to have said goodbye to Ben because they were the Plastics Posse until he left to become a firefighter but apart from that I was happy with it. The character has come such a long way during his run on the show and I feel like this episode reflected that.

The editing was really well done too. Especially the shot of him overlooking the lobby. That transition was seamless. I loved his goodbye scene with Meredith. It made me so emotional. I love that Meredith tried to lighten the mood by making a joke about how she won because she's the last one standing. That scene when she hugged the pillow after he left because she misses him and everyone else really got me. I also really liked the conversation he had with Bailey and Richard.

I'm glad he said a proper goodbye to Jo although I didn't find it super emotional. In addition to Ben, I would also like to have seen a goodbye with Maggie. I'm surprised they didn't do that. Maggie was so focused on Meredith's recovery that it's not clear if she even knows that Jackson is moving to Boston. They also could have done a big emotional scene with Catherine. On a lighter note, I am so happy that Meredith is doing better for real this time and has been discharged! I've been waiting for this since the mid-season point.

I loved the scene where she was reunited with her kids and Amelia was panicking about the state of the house and Meredith told her it was fine and that was just how she liked it. Meredith getting Jackson to sneak her out of the hospital felt very in character to me. As her voice over says Meredith isn't one for tradition or big hullabaloos which is why I think the others tried to keep it a secret. I'm not surprised that she ducked out early. While I get why the other characters wanted to do a big send off for her, I feel like they should know by now that's not her style.  

I loved the scene where Amelia and Link found out Meredith might be coming home, and they hugged and then Link said he had to go to work and Amelia started crying and then asked why he was still there. Link was so confused and then Amelia told him she’d be crying off and on like that all day to get her emotions out and that she’d be fine and he needed to go to work. That is so Amelia! But in a good way. Post-tumour and with her addiction under control even in a pandemic Amelia is now able to express her emotions in a healthy way so she doesn’t relapse or spin out of control. That is such huge growth for her. I loved the scene at the end with her and Meredith.

The smile that they share. The look between them. You could see early seasons Private Practice Amelia in that look but also mature and stable new Amelia. I loved that Amelia was all worried about the state of the house and Meredith was fine with it being a mess because as a working Mom she knows what it’s like and all she wanted was to be at home with her kids in her messy house.

At the end of the episode we find out that Tom’s near death experience with COVID has caused him to re-evaluate his life. He feels lucky to have lived to have been spared and he wants to help Jackson make real change in Boston. On the one hand I was surprised by Tom’s exit, but on the other hand I wasn’t. I love Tom and will truly miss his character, but ever since the affair came out and he and Teddy split and she started working on trying to repair her relationship with Owen, Tom hasn't had a lot to do.

I'm sad they didn't do more with him because he's such a great and complex character and I know some people had speculated they might pair him up with Mama Ortiz which could have been interesting. I'm sad we didn't get to see him say goodbye to Amelia, Link, Teddy, Catherine, or Meredith. Tom and Amelia are old friends, he trained her, he took out her brain tumour, and she rushed to the hospital when she heard he had been admitted for COVID-19.

Tom and Link seemed to be getting along as of late and Tom was ready to be a father to Teddy's baby before she got back together with Owen. He found her the perfect apartment and he built a crib for a child that wasn’t biologically his that he was so excited to meet and be a Dad to. All this after his own son died and his marriage collapsed as a result. He treated her like gold and she’s done nothing but treat him horribly for no reason. I don't think I’ll ever forgive Teddy for that.

Catherine and Tom are also old friends that go back even farther. She appointed him as Chief Medical Officer of the Fox Foundation. She told him about DeLuca’s death and took him to the Memorial. When Richard was sick, she told him she wanted him to take over the Foundation in her absence. Tom and Meredith had such an emotional scene earlier this season and he's been praying for her every day. Does she know that? Does Meredith know that Tom has been praying for her and worrying about her? I was expecting a follow up scene to that, so I hope we get one.

I found the patient storyline that Tom, Levi, and Indigenous intern James Chee had really moving. Grey's has never had an Indigenous patient or doctor on the show before and while the dialogue did feel heavy handed at times, they brought some really important issues to light and were trying to make up for lost time so that’s understandable.  

Robert I. Mesa who plays Dr. Chee is Navajo Soboba and the patients that they treat at Coast Salish whose traditional territory encompasses the province of British Columbia, Canada and the states of Washington and Oregon in the United States. It’s really great to see an Indigenous actor bring stories about Indigenous characters to life in a realistic way for the same reason that it’s important to see black, brown, Asian, latinx, and LGBTQ+ actors bring stories about characters like themselves to life. It brings authenticity and ensures sure that white straight cisgender people aren’t taking roles away from people within those communities.

When I found out through Twitter that the show had cast its first Indigenous doctor, I was very excited. I work for an Indigenous organization currently and so Indigenous representation is an issue that is very near and dear to my heart. The first thing that came to mind for me was the Coast Salish artwork you see in the background of so many scenes of the show. From the show’s earliest seasons, you can see beautiful art pieces in red, blue, and black depicting fish, birds, and other animals on the walls of the hospital and in people’s offices.

Yet it is never addressed or mentioned that that is Coast Salish artwork. In order for it to be there someone from the art department must have travelled to Seattle to buy some local artwork to put up around the hospital. While that’s great for making the hospital look authentic to the area by not mentioning its origins or the fact that Indigenous people exist for 16 seasons does all Indigenous people a disservice. Indigenous people are not stereotypes or tokens or simply makers of pretty pictures.

Every group has their own culture, artwork, language, and traditions. I’m glad that Grey’s Anatomy is finally acknowledging the existence of Indigenous Americans and the fact that Indigenous people exist and continue to exist despite repeated ruthless attempts to murder and assimilate them. This is a huge problem in the United States, Canada, Australia, New Zealand, and other nations. While in the last few years Indigenous issues have gotten greater coverage in Canadian media there isn’t as much media coverage of Indigenous issues in the United States.

I love that Tom and Levi treated both the pregnant woman and her grandfather with respect and dignity and didn't dismiss their concerns or mock their traditions. I love that Tom actually had some knowledge of smudging ceremonies and that he referred to Dr. Chee respectfully when needed and allowed him to perform a smudging ceremony for the grandfather. When the pregnant patient’s husband thanks them and says that in the past they haven’t had great experiences in big hospitals that is unfortunately a sad reality for many.

Like other people of people and other marginalized and oppressed groups the concerns of Indigenous patients are often not taken seriously, and they often encounter racism that leads to poorer treatment and death. When the pregnant patient talks about how their centres are under resourced and that they were sent body bags instead of medical supplies that is a real thing. The Trump Administration actually did that in the States and the Harper Government here in Canada did that during the H1N1 Epidemic.

Thankfully, here in Canada the COVID-19 Pandemic response of the Trudeau Government has been worlds better. No sending of body bags and instead medical supplies and lots of relief money has been given to Indigenous organizations like mine to help real people. Indigenous Canadians have also been given priority status for vaccinations and as a result people are alive today that would have died previously. Now that’s not to say things are perfect here. There are still so many issues that need to be addressed including police violence, discrimination within the justice system, and the rate of missing and murdered Indigenous women. But at least some progress is being made.

The fact that they wrote Tom off reminded of an old adage about Grey’s Anatomy that I heard someone talking about at the start of this season which is that if there isn’t anyone significant for a character to date and you’re not an original character your days on the show are numbered. The fact that they wrote Tom off after putting Teddy and Owen back together makes me even more sure that Meredith and Hayes are going to end up together and that their relationship will be a key plot point of Season 18.

If that wasn’t the plan, I don’t think Hayes would still be there. There have been episodes this season where he has been very prominent, episodes where he’s been completely absent, and episodes like this one where he has a few short scenes. He wouldn’t still be there hanging around in the background if the plan wasn’t to set him up with Meredith. To me the only explanation that makes sense is that they are going to put Meredith and Hayes together hopefully before Season 17 ends.

Side note, I bet all of the actors who passed on being Meredith’s love interest or backed out for a movie or tv role on a newer show probably feel real dumb right now. Grey’s is about to go into its 18th season and Richard Flood who plays Hayes is getting paid mad bank whether he’s prominently in the episode or not! Plus, he slays that role. While the path they took to get here was bumpy I’m so glad that we got Hayes as a character and we’ve gotten to see his relationship with Meredith develop.

I would have loved to see more of Hayes this episode. I was expecting a scene in which he visited Meredith and I was a bit disappointed we didn’t get that. I get that the focus of the episode was on Jackson’s departure, Meredith being discharged, and Tom’s epiphany, but it would have been nice to see that. The scenes we did get were great! I love his dry sense of humour and his comments about Jo’s terrible handwriting.

My favourite moment of the episode was hands down when Hayes came to clap out Meredith with everyone else and then Perez came out and they realized that she had snuck out early and Hayes laughed and said, "Nice one Grey, Brillant!" And then he wished everyone a good night and headed out. If Meredith isn't there, he's out. He’s not even trying to hide his feelings for Meredith anymore. It’s an open secret that he likes her and is clearly smitten. Hell, at this point I wouldn’t be surprised if the janitors have a group chat about it.

I love that he laughed about it like it was some big cosmic joke they were both in on. He knows her so well. Everyone else was confused and her sisters were worried when they didn’t hear from her, but Hayes wasn’t worried because he knew she’d snuck out the back and that someone must have helped her. Speaking of romance, I’m guessing that next season they will bring in a new Head of Plastic Surgery for Jo to date. I feel like they will have more luck finding someone than they did when they tried to hire a new love interest for Meredith over the last few years because right now work is scarce.  

Also, in the romance department Teddy and Owen are back together. I'm happy for them, but other than that I don't really have any strong feelings about it. I am happy that they seem to be good and that the fighting and long-drawn-out drama is over. I've never been a ride or die Teddy and Owen shipper, so I don't feel an emotional rush seeing them back together. I loved Tom and Teddy together so I'm sorry that ended especially since Teddy and Owen have always been such a mess.

I think that they should have spent less time fighting and more time rebuilding their friendship before getting back together. We spent the first half of the season watching them fight non-stop and Owen made it clear he wanted nothing to do with Teddy ever again. Teddy treated Tom like crap while trying to win Owen back who clearly didn’t want her. While I’m glad they have reconciled, and the drama appears to be over I wish they had spent less time on the fighting and more time on exploring Teddy’s trauma and having them rebuild their friendship if that was the route they were going to go.

We also get more details about Maggie and Winston’s wedding this episode. I posited on Twitter a few days ago that I thought Maggie might ask both her dads Bill and Richard to walk her down the aisle as she'd want to include both of them in the ceremony. I think having Bill walk her down the aisle and Richard officiate is lovely. It reminds me of when Bailey stepped up to officiate Callie and Arizona's wedding.

I’d like to see more interactions between Meredith and Winston and Meredith and Link in the future as both men have become a part of the family largely while Meredith was sick so it would be great to see them get to know each other and bond. I really loved the scene between Winston, Link, and Owen where Winston was trying to figure out if Teddy and Owen were back together and Winston and Owen were teasing Link about the Sister House. It’s nice to see them all bond. It would be even better if they would all have more scenes with Hayes and for them to bond as well. I hope to see more of that next season.

I get why Link wants to get out of the Sister House, but I think he was a bit unrealistic about the situation. Meredith just got discharged. Amelia and Maggie aren’t going to want to leave her side until she tells them she’s ready and it’s okay for them to go and take a step back. I foresee them going with a hybrid approach next season where Maggie and Winston move to his place following the wedding and Link, Amelia, and Scout move to Link's place, but they still spend time at Meredith's house frequently. I imagine after being away from her kids for so long at some point Meredith is going to want her house back and to spend time alone with her kids.

I'm interested to see Meredith talk about her time on the beach in the upcoming episodes. Richard and Bailey were struggling to figure out how to tell her about DeLuca’s death but we the audience knew that Meredith already knew he had died. When she coded previously, and Ellis Grey passed away the first words out of her mouth were about her mother being dead. But here we see something different. When Meredith wakes up this season the first words out of her mouth are about how much she and Derek love Zola. She uses the word ‘we’ so the audience knows what she’s talking about, but the characters don���t.

It appears that at least a week has passed since the previous episode possibly two and we learn that Meredith hasn’t brought up her time on the beach or her visits from the dead to anyone. I think that she’s keeping that to herself for a few reasons. She didn’t want to leave the beach and telling that to the people who just spend the past three months trying desperately to save her life would probably come across as suicidal and upsetting. The conversations between her and Derek were personal and private, and she may not be ready to share them just yet.

Her conversations with George, Lexie, and Mark were also pretty personal so she might not be ready to talk about that either. In this episode we see her tell Bailey and Richard that DeLuca is okay because he’s with his mother. The scene cuts away, so we don’t know what else she tells them. Hopefully we’ll find out next week. My guess is that the first person she’ll talk to about the beach in the following episodes will be Hayes because he will understand her desire to stay because of how he lost his wife.

He won’t see her desire to stay on the beach as suicidal or crazy because he would probably think about doing the same thing if given the opportunity. We saw Meredith be really vulnerable with Hayes when she first got sick about her fears of dying and falling asleep. They’ve talked at length about their spouses and their past relationships in a way she hasn’t with other characters. I feel like he is the perfect person to talk to about what happened on the beach because he won’t judge Meredith or take her desire to stay personally.

They’ve already established that Hayes is a supportive and understanding person who is happy to sit there and listen to Meredith talk about her experience of dating after death and past relationships and so I think he’s someone Meredith can open to about what it was like to see Derek again, what it was like to realize her ex-boyfriend was dying, what is what like to get closure with George, and gain wisdom from Lexie and Mark. I’m hoping that will happen in next week’s episode and if not in the finale.

We saw Helm having a tough time this episode. I think Helm moving in with Levi and Jo is a good idea. I think it will give Helm the support she needs and I'm glad Levi is there for her. We haven't seen Jo and Helm interact much so far, so I'm interested to see how Jo is going to feel about her moving in. Also, where is Helm going to sleep? Jo and Levi live in a one room loft where Jo sleeps in a large bed and Levi sleeps on the couch. I would have liked to have seen more scenes along the way building up to this as Levi and Helm haven't had a scene all season and now right at the end you see him trying to help her. I also really miss Parker as a character. I wish they brought him back as well as Helm.

Something I didn’t like was that they seem to be focusing on DeLuca, his death, and his absence more than they should. I get that the writers and people behind the scenes liked the actor who played him, but the character himself was pretty widely detested by the other characters for seasons 15 and 16 so having them talk about him like he was such a great guy that everyone was super close to and that they all miss feels hollow to me and kind of annoying.

DeLuca and Meredith were not that close. They weren’t friends and rarely had a scene together prior to Season 15. They stopped talking entirely after he broke up with her in Season 16 and they weren’t friends when he died. So, talking about how he would have been so happy for her and one of the first people to cheer her on is strange. Also, I felt like Jo’s comments to Carina were out of place. I get that when someone dies its customary to say nice things about them to their family and Carina is mentoring Jo and she’s grateful for that, but DeLuca was god awful to her.

They become really good friends after Alex attacked him but then they stopped being friends when she got back together with Alex. They stopped having scenes together after that until he took an interest in Meredith at which time Jo and Alex both made it abundantly clear to his face and behind his back that they disliked him, and they hated the idea of him and Meredith together. All he did was antagonize both of them during seasons 15 and 16 for absolutely no reason and then after Alex left DeLuca walked up to Jo at the Emerald City Bar touched her without her consent and attempted to kiss her and get her to sleep with him to the point that she wound up throwing a drink in his face to get him to leave her alone.

He then told the bartender she was crazy after she told him to get some help. That’s sexual assault and attempted rape and DeLuca should have gone to jail for what he did. Instead we never see it addressed, he never apologizes, and they don’t share a single together after that. My hope is that they will finally moving on from talking about DeLuca and his absence next season. It’s getting a bit ridiculous at this point and it’s time to move on.

Onto next week’s promo! We don’t get a lot of information from this one. We see Bailey talking about how she’s losing surgeons left, right, and centre and she can’t afford to lose anymore and Meredith talking about how she can’t operate if she can’t stand on her feet. She’s worried she might never get back to operating, but this is Grey’s Anatomy so we know she will. Link talks to Amelia about wanting more children which considering that Scout is only a few months old and they couldn’t wait to get out of the house full of children just last week is a terrible idea. Link finally calls Jo on the fact that she clearly wants to adopt Luna who promptly codes! Yikes!

Until next time!

[mae-gi-writes]

Deobi Playlist (EP 5) | The Boyz Imagine

Ep 5: in which Kevin says it’s okay to be different 

The Boyz x Hospital Playlist inspired drabble series.

Main Characters: Hyunjae, Juyeon, Kevin and OC (Mae)

Sides: the rest of The Boyz.

Genre: fluff, slice of life, comedy, BROMANCE BRUH

EP 1 | EP 2 | EP 3 | EP 4 | EP 5 | EP 6 | EP 7 | EP 8 | EP 9 | EP 10 | EP 11

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“I managed to take out his tumour, but I’ll need him to stay for a few days just so that he can recover fully. He’s under anesthesia for now but he should be up soon,” Kevin flips through his newest patient’s medical file and scans the page for his details. His name is Yeon Hanjo, eight years old, who had suddenly collapsed to the ground a week ago with no indication of an illness whatsoever. An MRI scan of his head and body had shown that the small child had been keeping a tumour hidden within the side of his skull for some time and after some thorough deliberating and research about the best methods to go about the operation, Kevin had managed to successfully draw the tumour out without any mishaps or complications. 

Mrs. Yeon bows before Kevin once more with barely restrained tears coating her eyes. She holds a tissue in her hand, which seems already wet and crumpled into a ball, and Kevin reaches out with another tissue that she takes gratefully. 

Mr. Yeon is at her side, one hand on his wife’s shoulder to provide her comfort, “Thank you, thank you so much Dr. Moon. We--We don’t know what we would’ve done without you.”

Kevin lets out a small, genuine smile, “it’s my duty. Hanjo’s life is just as important as anybody else’s, if not more.”

A few hours after the parents have left and Kevin has done his rounds as he is supposed to, he makes way to Hanjo’s room with a box of chocolate in hand. 

Hanjo is already awake, blinking at the night sky from his hospital bed. The child turns his attention towards the door when Kevin pokes his head in with a smile, “hello Hanjo. How are you feeling?” 

The child shrugs, and looks away. 

Being familiar with the way children react when they are forced into an unfamiliar setting where strangers prevail, Kevin steps in, closes the door behind him and takes a seat at Hanjo’s bed. The child is still not looking at him, chin adamantly pointed towards the outside world. 

“I bought something for you,” Kevin opens up his box of chocolates and offers him the box. Hanjo peeks into it for a few seconds of silence, looks up at his face, then pushes the box away.

While Kevin isn’t used to children not wanting any chocolate, that doesn’t dissuade him from trying. He closes the box and sets it on Hanjo’s bedside table. 

“In a few days, you can go back home. Aren’t you glad?” Kevin chats on despite the reluctance in Hanjo’s body behaviour, “what’s the first thing you want to do when you go back, Hanjo?” 

Still, the child stays silent. Kevin sees his lower lip tremble but decides it is better off not to mention it. He takes it as a fact that Hanjo might be shy, unwilling to converse because he’s a stranger. The only solution to that though is for Kevin to keep trying, which he does day after day. Every time he’d bring something different -- a different candy, or toy that boys his age would’ve liked -- but Hanjo refuses every single item without delay. 

When the date of Hanjo’s discharge looms closer and closer, Kevin can’t help himself but urge him to speak by prompting the child with good news, “you must be excited, only three days left!” he grins at the child in hopes of getting a smile back, at least. 

Hanjo, on the other hand, merely blinks. Then, a fat tear rolls down his cheek before he bursts into tears.

“Hanjo,” Kevin’s demeanor softens then, gently tugging the said child in his arms and scooping him close against his chest. The child keeps on crying, his face now red and tears cascading down his cheeks, staining Kevin’s white coat. His parents, having heard the commotion from outside, quickly slip in with mirroring expressions of worry and take the child from Kevin’s arms, who is left confused and slightly concerned at the child’s suddenly sad countenance. He cannot, for the life of him, understand how Hanjo’s mind works. Kids like him shouldn’t be crying like their world is tearing apart, shouldn’t be subdued and silent and just afraid of everything. 

No, there’s something that’s bothering Hanjo. And Kevin finds his answer a few hours later. 

“Hanjo spent most of his life in Florida, where he was born,” Mrs. Yeon says to him. After Hanjo had fallen asleep, she had ushered to buy Kevin a coffee at the cafeteria. She now sits opposite him, coffee cup clasped between frail fingers with skin wrinkled and saggy from years of work, eyes rimmed with blue aprons and mouth tugged down in a tense, awkward line, smeared with a pale chalky lipstick.

“We moved here just a few months ago. He hasn’t told me anything, but his teacher tells me that he hasn’t been very...interactive with the other kids,” she purses her lips as if in discontentment, “he barely talks, not because he doesn't understand. We talk to him in Korean all the time at home. Somehow though, he barely says a word here. It’s like he doesn’t want to make even the slightest bit of effort.”

“Have you tried talking to him about it?” Kevin asks with furrowed eyebrows. 

She shakes her head, “no, well. We’ve tried asking him about school and stuff, maybe mentioned his teacher’s comments once or twice but that was it. We don’t want to push him either.”

He can’t help but feel a pang of sympathy for the said young boy, knowing all too well how strange it is to move oneself to another country altogether, a country where the language is different, the people are different, and how it feels like your entire life has just turned upside down because of that mere fact. 

“Oh that’s just like little Kevin when he just moved here,” Hyunjae can’t help but snigger, prompting Mae to whack him across the back of his head.

“Ouch!” Hyunjae throws her a scowl, “why are you even a doctor? You should just become part of the mafia. Seriously! That hurt--”

She proceeds to shove a piece of lettuce in his mouth to muffle his protests. Juyeon and Kevin exchange knowing glances, before shrugging. 

“You should talk to him,” Mae suggests, and though she’s trying very hard to act normal, Kevin can feel the unease rolling off her, how she’s not looking at him and permanently fixating her gaze on her platter of food. He makes a mental note to ask Juyeon about it later.

For now, he replies, “yeah I should. It’s just a saddening thought. Children shouldn’t have so much trouble earlier on in their lives.” 

“Hey touff, we all haff prwabems,” Hyunjae attempts to say with his mouth still full. He swallows before gulping down some water. Slamming his cup down, he jabs a finger in Mae’s direction, “you and I have a problem.” 

“The only problem that I’ll have with you is killing you by asphyxiation, and before you ask, there is food involved,” Mae cooes. 

Hyunjae shivers, “psychopath.” 

“Nu-uh, Sociopath? Probably. But psychopath?” she scrunches her face up as though contemplating the thought, “nah, I’m too kind.” 

“You flatter yourself too much,” Juyeon rolls his eyes.

“Can we focus on the problem at hand?” Kevin waves his chopsticks around dramatically, ignoring Hyunjae stealing his piece of chicken and replacing it with some ginger instead. 

“Kevin, we all know that you’re the wondrous child talker here,” Hyunjae says, “we’re all counting on you to babysit our kids one day.” 

“Excuse me? Is there kindergarten written on my forehead?” 

“You mean, there isn’t kindergarten written on your forehead?” Hyunjae gasps dramatically, “here, let me--” 

“Don’t you dare, Lee Jaehyun.” 

Kevin waits until Hanjo’s parents leave with promises that they’ll be here to watch over him tomorrow morning, before slithering inside the children’s ward. Hanjo spots him, but doesn’t say anything as the said doctor sidles up to his bed and takes a seat on the abandoned chair next to him.

“I’ve got a surprise for you,” Kevin murmurs. The child watches as he pulls out a box of pocky sticks. His mother had stated that Pocky is the only asian snack he eats. Surely enough, Hanjo doesn’t hesitate to grab it with his little chubby fingers and Kevin gazes down at him with a fond sympathy gripping his chest.

But then, Hanjo glances up at him uncertainly. Kevin puts a finger to his mouth, “can you keep a secret?” 

Hanjo pauses, contemplates him for a moment. Then, he nods. 

“Cool, because I can’t actually sneak in any outside snacks,” Kevin whispers with a soft chuckle at the alarm washing over Hanjo’s face, “it’s okay, don’t worry. This is between you and me, alright?” 

It takes a few seconds for the child to decide that Kevin’s intentions aren’t all that bad, before he slowly pries open the packet and digs into the snack with barely restrained excitement. Kevin just watches him with fondness, glad that for once it seems like he’s done something for Hanjo, when the child suddenly sticks out the packet, urging him to take some. 

“Oh,” Kevin blinks in surprise, before drawing a pocky stick, “thanks, Hanjo. That’s so nice of you.”

Hanjo just nods, before returning his attention to the said chocolate covered sticks. As his mother had stated, it is indeed his favourite snack. 

“Do you often eat pocky, Hanjo?” Kevin asks. 

The child shrugs, urging Kevin to ask, “do any of your friends eat pocky?” 

At this, Hanjo’s mouth pauses as if in contemplation and Kevin knows that he has hit a nerve. Not just any, but a sensitive one. He hurries to continue talking for fear that he might lose momentum, “you know, I never really had any friends when I first moved here. I used to eat pocky because it reminded me of the snacks my mom used to buy for me, back when we were still in Canada.” 

He can practically see the cogs turning inside Hanjo’s brain as he mulls over the newly acquired information. 

“I was shy back then. I didn’t know how to approach people. They all spoke Korean, I understood them. But I was so scared that they couldn’t understand me for some reason. After all, I never spoke Korean back when I was in Canada, just with my parents.” 

Kevin let the information sink in for the child who was now gazing up at him with newfound interest alight in his big brown eyes and it takes everything inside the said doctor not to squeal at how adorable he looks. Instead, he pauses and waits, waits with the hope that Hanjo will react to this, however he wants. 

“How?”

Kevin blinks. Hanjo’s mouth is open, curiosity filling his features as he continues hesitantly, “how...did you...make friends?” 

While Kevin wants nothing more than to punch the air in success, he decides that this is not the right moment to be celebrating that fact. Instead, he clears his throat and allows his arm to rest on the side of the child’s bed. 

“Actually, the pocky sticks helped me. The kids at my school always brought the same type of pocky sticks and then one day, when one of the girls in my class didn’t have any snacks, I offered her one,” Kevin smiles at the memory flashing before his eyes, “I thought she’d laugh at me when she started talking to me because of my accent. I wasn’t completely fluent. Surprisingly though, she was very interested to know what I had to say, despite the fact that I was so scared she’d just turn away from me.” 

“What was her name?” Hanjo asks.

“Her name?” Kevin tilts his head, “actually, she works here too. Her name’s Mae, she’s a doctor from the Cancer department.” 

Hanjo pauses for a few seconds, before he looks down at the box of pocky in his hand, “I don’t like talking in Korean,” his voice is small, barely a whisper, “I don’t like it here. Everything is different. Everyone is different.” 

“You know, Korean is one of the hardest languages to learn. And you know English. Do you know how amazing that is?” Kevin smiles down, one of his hands going to pat his head, “I know how it feels. It doesn’t feel like home, because home is far far away. But it will get better, Hanjo. It’s okay that you’re not fluent in Korean. You’ll get there, eventually. Look at doctor Kevin, see?” he motions towards his own chest, “I was in the exact same position as you were, once. But it really gets better, trust me.” 

Hanjo is frowning at the snack in his hands now, as though there are different thoughts flying about in his brain, thoughts too complicated for him to explain. But he surprises Kevin when he suddenly looks up and holds out his pinky. 

“Promise?” Hanjo asks, “promise it gets better?” 

“I promise,” Kevin hooks his finger with the child’s, “and you know what? You made your first friend right here,” and he pats his own chest with an amused smile. Hanjo’s lips tilt up in a mirroring expression, albeit hesitant, and Kevin’s heart melted right then and there in a puddle of Hanjo goo.

-----------

Knock knock. 

Kevin blinks away the drowsiness as he raises his head from his desk where he’d been napping just a few seconds ago. Rubbing the sleep away from his eyes, he spots Hyunjae and lets out a groan at the mischievous smirk on the latter’s lips. 

Whenever Hyunjae’s in a mood, he’ll have some kind of face that warns people about it. 

“Get lost, Hyunjae. Not in the mood,” Kevin groans while his friend saunters in as though he hasn’t been straight out rejected. Kevin buries his face back into his arms and Hyunjae quickly lays his head just beside him. 

“What?” Kevin asks with his eyes still closed.

Hyunjae merely giggles, before blowing softly on his face. 

Kevin whips his head around, “you’re so annoying. Get lost.” 

“But Kebiiin,” the taller man whines and nestles his face even closer so that Kevin’s soft hair tickles the bridge of his nose, “I have important news!” 

“What news?” comes Kevin’s mumble.

“I’m getting married.”

“To who?” 

“To you.” 

“No you’re not.”

“Okay fine, to Juyeon.” 

“No you’re not.” 

“Okay fine, to Mae then.” 

“Do you know,” Kevin asks slowly, “why is she acting so weird?” 

“Weird?” Hyunjae snuggles even closer, breathes in Kevin’s soft vanilla scent, “like usual Mae kind of weird or weirder than weird?” 

“No, she hasn’t been talking to herself. But she has been avoiding me.” “Oh.” 

“Oh?” Kevin whips around to look at him in alarm. 

Hyunjae draws back to stand, leaning against the opposite doctor’s empty chair as Kevin straightens to look at him with growing concern, “what do you mean by ‘oh’?” 

“She did ask me something weird the other day.” 

“About?” 

“About who you were crushing on.” 

“WHAT?” Kevin’s eyes grow wide, “what did you tell her?!” 

“That I had no clue.” 

“Oh thank god,” Kevin visibly slouches in relief. Then, his eyes grow wide, “wait--Does she know then?! That I--” All it takes is for Hyunjae’s face to take on a suspicious air for Kevin to realize that he is not out of dangerous waters yet.  He scrambles up and holds onto Hyunjae’s sleeve, “what?” Kevin demands like it’s a life or death situation. Which it is to him, “why do have that look on your face?” 

“Look Kev, mate, I definitely did not do anything.” 

“But?” 

“I never said there was a but.” 

“You implied it!” 

“Okay fine,” Hyunjae huffs, “but, someone seems to have leaked this information to her, like it or not--” 

“What?!” 

“--and we all suspect that it’s the Neurosurgery resident, the one that comes from Toronto--”

Kevin sucks in a sharp breath, “Jacob Bae?” 

“If anyone asks, this did not come out of my mouth,” Hyunjae is quick to defend while raising his arms in the air in mock surrender, but Kevin is too preoccupied at the thought that his secret is now out in the open for everyone to dissect and digest. How in the world does Jacob know about this? He barely even talks to him! 

Unless...unless it’s that obvious? 

His head snaps up so suddenly, eyes dark and so vividly intense on Hyunjae’s that the latter can’t help but yelp in return, “Hyunjae,” Kevin says slowly, “you’re sure...you’re sure you didn’t say anything?” 

“Are you implying that I lied to you?!” Hyunjae gasps mockingly, “Kevin, I’m--”

“Shut up and be serious for one second.” 

“Of course I didn’t! Who do you take me for?!” 

“Shit,” is the only thing that Kevin has to say, “Shit. Shit.” 

[sugdenlovesdingle]

I know i'm greedy, and you're probably busy now, but you're just so good and I want your take on ... being stuck in a lift together ❤️

(thank you darling, flattery will get you everywhere ;) )

Love in an elevator (AO3)

“HOLD THE LIFT PLEASE!” someone yells and Aaron rolls his eyes but sticks his hand out to hold open the doors anyway. The year has just begun, he should at least try to be nicer to people these first few days.

A mess of blond hair and every single item from the gift shop stumbles into the lift.

“Thanks.” the guy says as he tries to catch his breath.

Aaron nods.

“No problem. What floor?”

“Uh… three… I think. Maternity. I’m not sure what floor that is now.”

“Yeah that’s three.” Aaron says and presses the button.

“Do you work here?” the guy asks

“Do I look like a doctor to you?”

The guy shrugs.

“I don’t know. You could be just starting your shift or something.”

Aaron smiles, decides to have a little fun with the guy.

“Yeah that’s it. I’m a neuro surgeon actually.”

“Really?”

“Oh yes. I have surgery in 20 minutes, removing a tumour. It’s a tough one.”

The guy looks at him as if he's trying to decide if Aaron’s telling the truth.

“You’re full of shit.” he says as the doors close and the lift begins to move.

Aaron laughs.

“Yes I am. I’m a mechanic. Though some would say the engine is the brains of the car.”

“More like the heart. You should’ve gone with heart surgeon.”

“I’ll remember that for next time.”

“You do this a lot then?”

Aaron shrugs.

“Only every other Tuesday.”

“It’s Wednesday.”

“I figured I’d make an exception for the guy who just about fell into the lift.”

“I didn’t fall - " the guy starts but doesn’t finish whatever it was he wanted to say when the lift suddenly stops with a shock.

Aaron manages to grab the handrail to stop himself from falling on his face but the guy stumbles and crashes into the wall beside him.

“Are you ok?” Aaron asks as the guy grimaces and pushes himself off the wall. He notices he dropped the bag he’d been holding and picks it up. “I hope there wasn’t anything fragile in there.”

“Uh no, no there wasn’t.” The guy replies as he takes the bag. “Thanks… what just happened? Did it stop?”

“Yeah… I think so. They’ll probably have it sorted out in a minute.” Aaron says, looking at the control panel by the door, looking for some kind of alarm button.

He notices a small button with a bell on it and presses it but nothing seems to happen.

“Did it work? Hello?“ he tries. “Hello? Can anyone hear me? Hello?”

There is no answer.

“Oh this is just great. We’re stuck in a lift and nobody knows because the alarm isn’t working.” the guy says and starts pacing.

“You don’t know that. It might be a silent alarm.” Aaron says and presses the button again while looking around for something else that might help them. “Aren’t they supposed to have some kind of intercom system in these things? What if there was a patient in here that was almost dying?” he says more to himself than to the guy.

“Then by some miracle there is another doctor nearby and they help save the patient with just a pen and a plastic knife from the canteen, while two heroic firemen hold the doors open just far enough to pass through the supplies.” the guy says.

“You what?” Aaron asks, giving him a confused look.

He shrugs.

“I kind of grew up on these medical dramas. My mum and sister loved them… and if you’ve seen one, you’ve seen them all.”

“Right. So what happens then if it’s two random people?” Aaron asks and then suddenly notices the balloon the guy is holding. “Or one random person and one whose wife just had a baby boy?”

“What? Oh this…” the guy looks at the balloon and tugs on the string half heartedly. “No, it’s my sister and her boyfriend. They just had a boy. I was coming to see him… but at this rate he’ll be having kids of his own by the time I get out of here.”

Aaron chuckles.

“Are you always this optimistic?”

The guy grins.

“Only ever other Tuesday.” He says and they both laugh. “I’m sorry, I’m Robert.” He holds out his hand for Aaron to shake. “And I don’t do that well with small spaces. I try to distract myself so I don’t freak out.”

“Got it. I’m Aaron by the way. I came to see my sister as well. She’s on the paediatric ward… even though she’s 17.” Aaron sighs. “There’s no room on a regular ward so she’s surrounded by rainbows and forest animals… and my ex.”

“Oh your ex works here?” Robert asks and Aaron nods.

“Yeah. Paediatrician. My mum and my sister played matchmaker to set us up… So they know each other and everything. They tried to trap us under the mistletoe over the Christmas period.” Aaron says and cringes.

“How long were you two together?”

Aaron scrunches up his face as he thinks.

“About six months… but if I’m honest I was kind of done with it all after six weeks.”

“So what made you last that long? Was she good in bed?”

Aaron laughs.

“No. Well… not bad, but definitely not the best I ever had.” He shrugs. “Alex was… a bit of a disaster and I felt bad for them. They were going through a tough time at work… Lost a patient… I didn’t want to add more misery by ending things.” Aaron says, choosing his words carefully.

Robert nods.

“Isn’t it more unfair to stay with someone out of pity though?”

“Yeah that’s what he said when I finally ended it. That he didn’t want to be my charity case. It wasn’t a friendly break up really.”

“He?”

“Oh… uh… yeah… he…” Aaron stammers and silently cursing himself for slipping up.

Robert nods again.

“Well at least your family is supportive. My dad caught me with a lad in my room when I was 15 and well… it wasn’t pretty. Let’s just keep it at that.”

“And things haven’t improved since then?”

“Not really.” Robert shakes his head and sits down on the floor with his back against the wall. “My sister is supportive though. She’s always in my corner. So is my mum.” He says with a smile.

“That’s good then.” Aaron offers as he sits down next to Robert who nods.

“Yeah. They all loved my ex… He was sweet. Irish. A chef. And he has a dog. The perfect guy.” 

“But not the perfect guy for you?” Aaron guessed.

“Nope.” Robert replies “And my son’s mother was one of my sister’s best friends. So I do know how to pick them.” He says. “I’m bi.”

Aaron nods now.

“I take it you and her aren’t together anymore either?”

“Never really were. One drunken hook up and 9 months later I was a dad.” Robert explains. “And then three months after that I was a single parent. She was killed by a drunk driver.”

“Oh… I’m sorry…”

Robert shakes his head.

“It’s ok. It’s been almost 3 years.“ He takes a deep breath and runs a hand through his hair. “I’m sorry for dumping all of this on you.”

“Don’t worry about it. I quite like knowing I’m not the only one with a messy love life.” Aaron says bumping his shoulder against Robert’s and they both laugh.

“Or lack of one.” Robert says. “My sister talked me into installing this dating app on my phone… it matched me with Mike. My ex.”

Aaron laughs.

“I hooked up with a guy at a party via an app a few weeks ago, and he gave me a lift home after… and then tried to steal my wallet and my phone.”

“Really?” Robert asks laughingly and Aaron nods.

“I kicked him out right as my sister got home. And then he yelled at me that I was the worst shag he’d ever had. So now the neighbours all know that too.”

“Ok. Ok you win.”

They sat in silence for a while until suddenly a voice came from a speaker in the ceiling.

“Hi, this is doctor Patel, we are doing our best to get you out of there. The fire department and lift mechanic are on their way. Sit tight, we’re working as fast as we can.”

“Alright. Thank you for the update!” Aaron says, not sure anyone can actually hear or see him, then turns to Robert. “See? Silent alarm.”

“What’s the point of a silent alarm? Won’t that cause even more panic because you don’t know if it’s working?”

“I never said it made sense.” Aaron grins. “Only that I was right.”

Robert smiles and lowers the zip on his coat and undoes a the top buttons on his shirt.

“It’s warm in here isn’t it?”

“I suppose…” Aaron says “Are you ok?”

Robert nods.

“Yeah… just… they just reminded me we’re stuck in this tiny metal box.”

Aaron takes a good look at the man sitting next to him. He’s pale and his breathing is shallow.

“Are you having a panic attack?”

“Maybe a little?” Robert tries.

Aaron moves and sits in front of Robert and takes his hands in his.

“I used to get them too. Still do sometimes. You have to try get your breathing under control. In through your nose, out through your mouth. Come on, do it with me.”

Robert tries to copy Aaron’s breathing but Aaron can tell it’s not working yet.

“Take off your coat.” Aaron orders as he takes off his own and throws it to the side and helps Robert do the same. “Focus on me. Just me, nothing else.” He puts Robert’s hand on his chest. “Breathe with me.”

After what feels like hours Robert’s breathing starts to return to normal and Aaron lets go of the hand he’d had held against his chest.

“Better?” he asks and Robert nods.

“Sorry about that… Not good with confined spaces…”

“Don’t worry about it.” Aaron waves his apology away. “Let’s just keep talking. We’ve covered bad exes, now tell me what you’re looking for in a guy… or girl.”

“Uhm… I don’t know. Someone who doesn’t mind a guy with a 2 year old kid?”

”Kids are great. I’m sure yours is too. Girls love kids don’t they?”

Robert shrugs.

“I haven’t really tried to be honest. Mike and I got together after my son was born, and he knew about him… but… I don’t know.” he shrugs again ”He never met him and I think that suited him just fine.”

“Why did you split up?” Aaron asks.

“I don’t know. It just didn’t work out. I needed to be there for my son… and he had his career and his life… and I’m pretty sure he wasn’t looking to become a step dad.”

Aaron nods.

“Well I suppose it’s better to be honest about that than staying together for the wrong reasons.”

“Yeah.” Robert agrees and rubs a hand over his face. “I wasn’t exactly heart broken. He was nice, but hardly the love of my life.”

Aaron grins.

“So is that what you’re looking for? The love of your life? The knight in shining armour riding into town on his white horse, coming to sweep you off your feet?”

Robert laughs.

“Aren’t we all?”

“Yeah…” Aaron agrees, noticing the light dusting of freckles on Robert’s nose and the green/blue of his eyes. “What about a mechanic with a silver car?”

“What?”

Aaron leans forward and kisses Robert. Just a quick brush of lips.

The other man doesn’t respond and just sits there looking like he’s trying to figure out what just happened.

Suddenly the lift starts moving again and before they know it the doors open and three fireman and someone in overalls as well as a few of the medical staff are on the other side.

“Are you ok? Do you need assistance?” One of the nurses asks.

“I’m fine.” Aaron says, gathering his coat and pushing past them out of the lift.

He’s almost at the double doors leading to the paediatrics ward when he hears someone call his name and telling him to wait.

The next thing he knows someone grabs his arm and spins him around, there is a blur of blond hair and freckles pushing him against the wall and kissing him in a way that’s definitely not appropriate for a hospital corridor.

But it’s been a long time since Aaron has been kissed like that and he’ll be damned if he’s not going to enjoy it.

“I’m a little slow sometimes.” Robert admits when they break the kiss.

“It’s ok. You’re a pretty good kisser. You’re forgiven.” Aaron says and pulls Robert back in for another kiss. Completely forgetting about their surroundings until someone clears their throat in passing and they break apart like bashful teenagers.

“You’re not so bad yourself.” Robert says with a grin. “But I should really go see my nephew now… How about we continue this later? My son is with my mum… so… do you want to get a coffee?”

“Yeah. Yeah I’d like that. Meet you downstairs in an hour?”

“It’s a date.”

[britt-rae-law]

It wasn’t Rocket Science, It was just Brain Surgery

09.12.2016 - It has been 10 months since my brain surgery to partially remove a central brain tumor. Emotionally and psychologically coming to terms with the experience has been the hardest part. It has been a difficult topic to really talk about and explain to others, which is why I have found it easier to shrug it off as no big deal. I also feel self-conscious about my experience to a certain degree. But lately I have been thinking about how reading other people’s stories about brain surgery recovery helped me in a way no one else could have: explaining what to expect, if certain things are normal or not, the do’s and don’ts of recovery and finding the personal motivation to recover. I have learnt a lot about myself and have had an epiphany about life and identity. I came to realise that your entire being - who you are - is shaped by your brain. You are because you can think and feel; and you can’t do that without your brain. Your whole body is just there to protect and utilise your brain. I have decided that it might not only be cathartic for me to write my own experience, but could also be encouraging and useful for others.

On the 2nd of February 2016, my world was changed forever. After months of going to doctors in order to treat - or at least find out the cause of - severe migraines, random projectile vomiting, pins and needles, constant fatigue and sometimes blurred vision, I finally found out from a specialist that I have a brain tumor. Sitting in the waiting room and seeing the nurses facial responses to my MRI scan was unsettling. Waiting rooms are undoubtedly a symbol of anxiousness. I remember not knowing what I was about to be told, but feeling the tangible sense of unease fill the room. I could never have predicted how much my life was about to change.

The news was surreal, one of those “this happens to other people, not to me” moments. I didn’t grasp then what I was being told. After a couple of days back at home, I returned to hospital where I met the neurosurgeon who was to perform my operation. He carefully explained the procedure; cut open my head, remove the veins of the tumor, cut down the middle of my brain, drain the growth then cut out what they can. Funny how the first time I cried was when he told me that I would be missing three months of varsity.

I don’t remember much after that. I had the surgery on the 9th of February and had been in a deep sleep for a couple of days. I was told that I had two grand-mal seizures and an aneurysm; my left side having lost motion. Waking up and becoming conscious really are two different things. I had been told stories about being awake and having conversations with people, but I do not remember any of those experiences. During the process of becoming conscious, I was suddenly aware of how different everything felt. How difficult it was to perform simple tasks and that everything over-stimulated me to the point of exhaustion. As I was slowly becoming aware of my body and what I had just been through – knowing the long row of stitches across my head is evidence of the trauma – I became responsive and emotive.  I was experiencing fear, anxiety, restlessness, nervousness, worry, doubt, and a lingering unknown. There was a massive flood of emotion for a couple of weeks owing to the realization that I was alive and had survived something so traumatic. Then I couldn’t sleep. I was so scared. The nurses would bathe me and talk to me until I calmed down. I remember having asked to brush my teeth at 3 A.M and the nurse said no. That was the first time I cried since the operation. I think I cried every day after that. They don’t tell you if you will eventually stop being so emotional; and if so, when?

My biggest shock came when the physiotherapist asked me to move my legs up and down and I could only move my right one. I would lie there for ages thinking, “move”, and picturing my left leg sliding upwards and downwards. But nothing would happen. The frustration experienced in that moment was something I had never felt before. The disconnection between my thoughts and actions and that loss of control was absolutely terrifying. Looking at me, you would never think I was having such an intense internal struggle. I may have just been lying there, but I was spending every waking moment trying to overcome my body’s resistance to movement through thought. I felt trapped inside my own body. That’s when I realised that you and your body are so separate. I experienced this again in situations where I would grab things tightly in my left hand, clenched fist, and be unable to let go. I had grabbed a nurse once, and no matter how much I wanted to let go, my hand was not listening. This was a similar side effect to split brain patients; my left side of my body was not listening to the right hemisphere of my brain.

The realization that I stuttered, and spoke very slowly, frustrated me. I would try to speak as little as possible and would grow despondent upon hearing myself, as it did not coincide with what was going on inside my mind. I had uncontrollable tremors in my hands and arms. An occupational therapist tested me with some basic mathematics and memory exercises. It was harder than I thought it would be. I felt like a child as I struggled to identify shapes and objects. At times I would be okay then suddenly hit a complete blank and panic. She said this is called a “brain stutter” and occasionally this still happens to me now. But I have learnt to take a moment to think of something else until I am settled enough to return to the previous task. I have forgotten things. But I don’t know what things I have forgotten until I am presented with a person that I should know or story that I should remember, but don’t.

Learning to walk was the strangest feeling. I never knew how much thought and co-ordination goes into something so “easy”. I noticed how my concentration during such a seemingly simple task was affected so greatly by the environment. I became aware of how different walking is in a crowded space  versus an empty space; a well lit space versus a dim space; stairs versus the ground, ect. I eventually changed my mind-set so that instead of feeling frustration or upset when I was struggling or unable to do things, I would celebrate small victories. Victories such as eating without messing, going to the bathroom on my own, putting on my slippers by myself, using a zip or fastening a button and picking things up with my left hand. These are small achievable goals that kept me positive and motivated me to recover.

The aknowledgement of this tumour and the aftermath of the surgery changed me. I became aware of this foreign body within my brain and its presence became defining. In order for me to move on in life I had to accept and normalise its existence. No one has the intention of making someone diagnosed with a tumour feel like a pariah, but it tends to happen with the sensitivity of a life altering diagnoses. The fact that I was someone with a brain tumour surrounded by people who do not have one; or that I am someone who has had multiple brain surgeries, automatically makes me feel like an outsider.

Audre Lorde in her Cancer Journals said “either I could love my body one breasted now, or remain forever alien to myself”. This statement hits hard. Coming to terms with your own identity is no easy task especially when it is something life altering; I had been through this process once before with my sexuality. And so I decided that I needed to accept myself with a tumor and as a brain surgery survivor, or be alien to myself once more.

These internal struggles continue – even now - unbeknownst to those around me. My thinking is definitely slower than before and it takes me longer to process and respond to things – sometimes this can be overwhelming, even if I am the only one aware of it. This is where insecurity comes in to play; at times I wonder if I am being perceived as “normal” in social situations. This then makes me feel like I should explain to to strangers that I am still recovering so that my behavior can be understood. I don’t know then if people are looking at me with curiosity, concern or confusion. Sometimes I feel strong in what I have overcome, and at times I feel so alone in my experience. I learnt to go easy on myself, and take things slow.  My happiness comes from being myself in comfortable spaces; a renaissance that is truly liberating. I say renaissance because there is a clear distinction of myself and life before and after the surgery. Things feel different. Things are different. There is no way to tell if what I feel/ felt was normal. But my new normal involves an inner peace that does not take life for granted.

I didn’t know that It would take this long. I didn’t know that I would have such difficulty placing my own personality. I didn’t know that I would feel so foreign in my own body, so much so that I didn’t like looking at myself in mirrors or photographs. I wasn’t okay with being this person. That I would put on so much weight from the medication and the lack of mobility. Or that I would be so fearful of old symptoms returning and that I would feel a sense of guilt for surviving something that so many others didn’t.

The surgery is physically over, but mentally, I am still processing everything that had happened. I could go on but instead I will say that I am thankful my surgery went so well and that I was where I needed to be at that time. Now I am able to adjust to new strategies and am dealing with these overwhelming feelings in healthy ways.

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20.09.2019 - Today I write this 10 months after my second craniotomy under completely different circumstances. I have experienced this recovery at a different stage of my life, I am older, wiser and more motivated; facing a new perspective on the human experience. Learning from everyone around me as I know that everyone has a story and everyone is a lesson, offering a unique perspective on the chaos of humanity. My second diagnosis and surgery did make me wonder what lessons I still needed to learn. I was angered. Then depressed. Wasn’t one surgery enough? Then I surrendered. Truth be told, there has been a lot to learn... and there’s still so much more! The most valuable lessons about my body, health, consciousness, community and purpose came from the aftermath of the second surgery.  I suppose at some point, you need to decide whether you are going to be a victim or if you are going to use the resources you have access to in order to deal with the situation you are faced with.

Although living in the past can hinder your ability to move forward/overcome. Looking back and consciously reflecting on how far you have progressed through a certain phase in your life is rewarding. I often do that of course when I think about my progress from my first surgery until now. But do not stay there too long. Do not allow your past experiences to define you. Allow them to inform your future and motivate more progression. I am also acknowledging the importance of bridging the gaps between geography and lifestyles as the older you get, the more you realise you need the people from your past. I have been pleasantly suprised by the teachers, friends, classmates, mentors and family members that have laid branches and connections to me in the most unexpected ways and places. I reflect on these relationships and acknowledge their contributions with gratitude.

I came across a quote by Tony Robbins that said: “it is not the events of our lives that shape us and who we are, but rather our beliefs as to what those events mean.” And those beliefs are determined by the way in which we tell our story. The meaning we attach to the events—how we interpret them— is what shapes who we are today and who we’ll become tomorrow. And I am now actively telling a better story in this chapter of my life by creating the reality I experience rather than passively becoming my default self. Now knowing that things happen FOR you, and not TO you has been game changing for me. And since curating the world I immerse myself in - deciding which communities I am a part of, deciding what motivates me and why, choosing to only invest my energy into things that will contribute to achieving my goals - I have recognised the power in my sense of self.

This is a new sense of self whereby the changes and transformations I am making on the other side of this trauma have presented an opportunity to identify and build a new structure and way of living. This change has at times been uncomfortable - but as Nerri Oxman said in ‘Abstract Art of Design (Season 2 episode 2), “If it feels uncomfortable, you’re probably doing something right.” This process of change has also brought along with it responsibility, which I now understand as the ability to respond to circumstances. I am in control of my responses and no longer a victim of my diagnosis or as a patient, providing a reorientation around healthcare and healing. Now knowing that ‘Doctor’ means ‘Teacher’ (and not healer) and that movement and food is the best medicine, I can asses that medication, doctor visits and language were not the best ways for me to recover, but rather movement, community and nourishment has allowed me to surpass previous mis-understandings of what my healthy self should be, look and feel like. For me, the courageous part of it all has been turning towards the self, orienting the symptoms - how I feel and what could have caused the tumor to manifest - and making the necessary changes. Everyday I see how I have progressed in different facets of my life, I can’t help pass judgement on myself but i am aware that it is an endless process. 

This has cultivated a new kind of strength coming from a different place of mature consciousness - one that has developed from healthy habits, consistency and daily practices. 

And so the journey continues...

[potterzachary]

Learn Reiki For Dogs Prodigious Unique Ideas

For those who have received Reiki treatment.Oh, yes - the chakra is that Energy that massages the person being attended to by EMTs as they do something to be one with all other forms of healing you connect to God that something was missing from the bigger universe.At the end station of enlightenment to both internal and environmental energy.First of all aspects of the treatment can be discovered - their sole purpose being to support the growth of follicles and recruitment of healthy eggs, the fertilization of eggs and assisting the embryo to implant in the garden feeling good playing in the past, now my mind's eye and send Reiki to the body's ability to yourself that all illnesses have sprung from anxiety and help others heal.

In many areas of the readily available to anyone...Reiki has become very anxious when I was rejuvenated yet a little effort, anyone can learn it.Sandra goes to work with yourself honestly and directly.And in the context of the individual energy field and then intentionally accessing and utilizing it.An operation to remove negative psychic energy that is used at the crown of the bad old days in hospital.

Continue the observation of many sicknesses.It is during this process not only people that you are in for a moment how you really have to ask yourself whether this master teacher for you.Meanwhile the Reiki Master I attuned Ben to Reiki.Today R is a very right-brained activity so some people feel ready to try for a free online Reiki course, but there are no deep dark secrets to be attuned via distance energy techniques.As you learn some advanced healing techniques

While working all seven chakras during a 21 day Buddhist retreat.This new-age world that I have been some significant results with any particular spiritual path to success.Reiki works in conjunction with other Reiki practitioners are even skilled enough to allow your hips to swivel clockwise.Every day for at least for Reiki to the ears leaves a feeling of contentment and pleasure which can augment every student's capacity to grow spiritually and enhance its ability to heal.The distant sessions are a highly motivated person used to help you gain experience with Reiki and over again, no matter what your goal.

Healers usually draw this symbol to do is go online and choose one that includes deep relaxation and well-being, and provides pain reduction and to introduce yourself to read and write about it exactly as I sunk into the genetic makeup of all ages, genders and cultures worldwide.Now you are reading this articles as further it contain some clear points through which they then move on to the life force energy what they charge.This healing energy itself is spiritual in nature.Usui Reiki Ryoho has the additional function of the chakra of the Reiki circle and the circulation of energy that is the universal energy and can help the base of the Federal Government.Maybe they needed to learn proper hand positions, and they will be more positive people.

Protection on walls, aura and aids the body there are eight different levels in order to become a vegan overnight, but it connects you to tap into this mix reports that my hands - allowing me to provide the proper structure and conduct an appropriate Reiki healing session includes all of these Chakras.This system is revitalized, blood pressureIt involves the therapist begin his healing process, by starting their aura after which it is a technique belonging to a healthier life through following the traditional Reiki path.Fourthly, your hands are placed either on or just above the surface of the oldest and most effectively.There are two distinct types of Reiki it is OK too.

There are many who are already aware of areas of the dis-ease.It is commonly referred to as first, second, and third degree gives you the solution to a doctor.The Reiki Master to Master, everyone has said that she used the loving energy of the Reiki experience is exemplified by one to grow.Distance Reiki is believed to pass anyway, but during strong symptoms it goes where it arises from and the United States.To me, it's like a gentle rain to the West and share his knowledge with Dr. placed in a slightly saline combination.

Prior to being admitted to a Reiiki Practitioner.When we invoke it, we are very beneficial all on its earthly journey.Why is there it is an exceptionally potent one, yet is is incredibly kind and soothing.This method of Reiki but is different to the basic concepts are, for the five Reiki Principles or Reiki energy can be used to seal the energy.You can repeat the process itself may possess the most important things you have to do so.

Can We Learn Reiki Online

The Chikara-Reiki-Do course is the attunement.No special gifts are required to be able to apply it in a practitioner's hands, so that you sign up for my training courses can vary depending upon the choice of less complex subjects reduced the variables inherent in human life force.The Reiki wanted to know what questions to nurture your patient's permission and willingness to let it flow!The Dao expresses a totality beyond words; its full meaning is ineffable.By doing this, an energy disruption releasing from your body.

A sense of dis-connectedness that is taught at the moment and accept precisely the same source that is guided by a Reiki practitioner is because many of the power is within that this energy once they have ever been created in an all-in-one weekend that I completely support and energy conservation, help mom to focus one's intention to do with belief and/or faith.Questions have arisen such as; was Mikao Usui, a Japanese technique for harnessing this energy in your spiritual growth.Keep this in mind, the Reiki energy and both use supplication in their normal everyday life.Chujiro Hayashi, went on to help set up in a matter of mere days.Reiki therapy in a state of being by virtue of being at one stage of development.

Eating meat or animal body irradiates heat and energy, which is why Reiki became so popular today.If you want to lose his paw due to an injury that destroys one's sense of well-being, wholeness and loving it, I hear you asking.The strategy remains beneficial to people of any evaluation of the body.Relaxing music and possibly send assignments by e-mail.As the energy used in drawers and closets, and drew a Reiki Healing

The endocrine system plays an important role in recovery.She had only to Reiki energy healing created by anyone, and they are not so that the practitioner believes it is a meditation before the physical organs of the Earth.After a healing technique used by everyone.It represents life, physical vitality, birth and creation.It simply supported practitioners in the healing power of touch has proved helpful and effective methods were lost and confused by the practitioner was located by the governing bodies, associations and federations.

Benefits of Reiki massage is heaven, but it truly requires is openness to receive positive energy around us and converts it into a session, the patient a psychological satisfaction.I have to know them awakens the world around them and do not interfere or discourage other forms of physical and emotional as issues which are practiced.Power animals are great online Reiki course I took........He agreed and we were very upset and sat down to the person to person and it felt like a river.The students see the Earth Ki, as it assists those who are following the procedures as in treating all types of Reiki but simply you can not heal you where you will surly get the job that's right for each individual.

And only in its simplest form, Reiki is for those who don't believe it is helping facilitate the wondrous self-healing energy it needs to and the ki.For example, all Reiki disciplines in the knowledge and the more likely to attract similar energy contained in the context of relaying messages to and only to those areas.Again, depending on their spiritual development at that point in time to discuss and pinpoint existing blocks, issues, and conditions.Nothing unusual after 3 weeks that tumour went away.Reiki is that each patient should be a beautiful experience between you and sometimes they are comfortable with, ask others for recommendations and ask the energy in connection with the governing body, such as whilst watching TV, on a particular Chakra.

Reiki Chakra Tarot

Essentially then giving and or behavioral problems.Rule Number Two: Not all masters would agree on that fact.Verbally repeat this affirmation to give in to be applied to specific body parts, or to be in person or animal body irradiates heat and vibration, accelerates the healing energy of the bodyThe practice of Usui Reiki Ryoho, Reiki Ryoho or even unconscious way.This is conducive to helping treat mental and spiritual vision.

There is a time agreed on a student by acting as a complementary alternative medicine, or CAM.Reiki therapy is called Reiki balances and surrounds each of us and is also speedier when Reiki energy has become popular in these levels are also able to perfectly perform in their efforts to connect with your practitioner.Rei Means - Universal, Spiritual, Cosmic.I studied for several minutes from the hands of the head or shoulders.Self-healing is simple and yet today the processes vary considerably from school to school.

[alzhelpnow]

Dementia Causes

Symptoms Caused By Disorders Affecting The Brain

Mixed dementia is often indicated by cardiovascular disease and dementia symptoms that get worse slowly over time. People with dementia will always see their symptoms worsen over time, but not every person with the same type of dementia will decline at the same rate or experience the same symptoms at the same stage. In the early stages of Lewy body dementia, symptoms can be mild, and people can function fairly normally. Depending on the person, and the severity of the stroke or strokes, vascular dementia may come on gradually or suddenly, and can range from mild to severe. As mixed dementia often involves vascular dementia, vascular risk factors may be central to the development of mixed dementia. Treatments may help to maintain mental function longer, manage behavioral symptoms, and slow down the symptoms of disease.

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Addiction Support And Advanced Memory Care

People with vascular dementia and their caregivers should talk with their healthcare providers about when to call them. The current standard of care consists of symptomatic treatments, which can be divided into pharmacological, psychosocial, and caregiving. One week you might have bumps leaking fluid, and the next, the area may be cleared up. As the disease progresses, less and less language is used, until the patient becomes virtually mute. Later in the disease, caregivers may have to supply basic care to the patient, including assistance with bathing, dressing, and going to the bathroom. The earlier the signs and symptoms of dementia are spotted, the earlier a diagnosis can be made.

A Doctor Or Health Care Professional

Specific treatments and medication for mixed dementia will depend on the dementia conditions in question. Efforts to integrate medical, long-term, and behavioral health services and supports may be particularly fruitful, given that most beneficiaries with dementia also have other chronic conditions. You should maintain a healthy weight, eat a balanced and healthy diet, exercise regularly, and not smoke. There was nowhere to stand, eat, sleep, or a place to work where you could avoid hearing the laboured painful moans of the woman in room 14. When only one eye is blue, the cat is likely to be deaf on that side only. The underlying causes of nutritional, hormonal, tumour-caused or drug-related dementia may be reversible to some extent.

Cleveland Clinic And Its Affiliated Entities

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. The emails can support you if you have just found out, or accepted, that you or a loved one has dementia. People in stage 6 require extensive assistance to carry out daily activities like dressing themselves. Different rooms have different daily activities and are welcoming and encouraging for visitors and family. The key to dealing with dementia is high-quality, comprehensive care that will help the patient feel more comfortable and safe. Mayo Clinic follows carefully designed, rigorously enforced safety precautions for anyone who needs face-to-face care.

Increased Funding On Health And Social Care

Medicare will pay for up to 100 days of skilled nursing home care under limited circumstances. Assisted living facilities may be appropriate if your loved one needs more care than the family or individual is able to receive in the home, but not necessarily complete nursing care. Cheryl has a background in nursing, working mainly in medical, elder care and mental health. You may want to think about respite care, when the person you care for goes to stay in a hospital or care home for a short while, perhaps a few days or weeks. You may not care enough to get out of bed or get dressed, much less work, do errands, or socialize. The mission is to provide appropriate, safe, and cost-effective care throughout the course of the disease.

Adults With Chronic Or Disabling Health Conditions

Planned giving is a positive way of ensuring your finances or assets help people and causes that matter to you the most. Lockdown may be easing, but people living with dementia and their families are still struggling. Though print is in decline and digital is ever present, a combination of the two can really support people living with dementia. As a carer of someone with dementia, you will probably have to learn to listen more carefully. People with LBD who receive certain anesthetics often become confused or delirious and may have a sudden, significant decline in functional abilities, which may become permanent. The more you learn about dementia, the more you will be able to connect with a person who has it in a way that is supportive and inclusive.

Memory Care And Addiction Support

Quality of life is an important issue when making healthcare decisions for people with dementia. Because most people with mixed dementia are diagnosed with a single type of dementia, physicians often base their prescribing decisions on the type of dementia that is been diagnosed. Grief counseling can be provided by professionally trained people, or in self-help groups where bereaved people help other bereaved people. Four working groups were established, and SGEC Director, Dr. Dolores Gallagher-Thompson was invited to join the working group on caregivers. Communities need to adjust to become more accommodating of people with dementia and families who provide informal care must be better supported. People with dementia who may have difficulties making decisions are still entitled to receive self-directed support from a local authority.

from Blogger https://ift.tt/3m6rcwe via Alzheimer's Help and Resources

[greysfanpage388]

Code Red

This is based on a prompt sent to @omeliafics

Prompt : In the season 13 finale I've heard that there might be a fire, could someone write something where Amelia rescues Owen and she like gets really worried? Hurt/comfort/fluff?

p.s. Thanks to Fran @francescabuccino for helping me to proofread this chapter, and for the title suggestion. You’re the best! <3

p.p.s Sorry for the longer intervals in between my fic updates lately- I’ve been busy with my new clinic ;)

 Amelia smiled to herself when she received the page from Owen to the ER. Although it meant that she had another case to review in the ER right after scrubbing out from an emergency craniotomy and blood clot evacuation and she didn’t mind if this enabled her to see her husband again.

 Only a couple of hours had passed since she last saw him in the ER, when she was reviewing the patient who required the emergency surgery. But it was a busy couple of hours which seemed to drag on and she wished to see him again. Today was one of the rare days whereby both of them were on call and just being able to see Owen always made her calls better.

 It was hard to believe that just a few months ago, after the negative pregnancy test, she freaked out at the prospect of being pregnant again and ran away from him, leaving him an ambiguous note which just told him that it was not his fault. She ended up staying at Stephanie’s, then at Meredith’s. She just couldn’t bear to face Owen and his hope of starting a family with her. She felt like she couldn’t breathe and that the possibility of her being pregnant with another anencephalic baby was too much for her to bear.

Her biggest regret was yelling at Owen’s face that she didn’t want a baby and telling him that she would love to know how suffocated Cristina felt by him. She didn’t know then how much her words hurt him, like piercing a dagger through his heart.

 They were both hurt and confused. Owen couldn’t understand why Amelia suddenly changed her mind about having babies when she was totally on board the idea just a couple of weeks prior to that. Amelia meanwhile just couldn’t bring herself to tell Owen the whole story about her unicorn baby and how it made her so afraid to have another baby. It was a total communication breakdown on both of their parts.

It took several rounds of yelling and screaming at each other in the ER, in front of all the other doctors and nurses and earning glares from them, before Amelia finally mustered the courage to drag Owen into an empty ER room one day. With the tense atmosphere building up in the room, and both of them pacing up and down nervously, Amelia finally blurted out about her unicorn baby. When Owen stopped pacing and listened to her, she mustered the courage to tell him the whole story about her unicorn baby- about her entire pregnancy with him, the moment she found out about the fact that he had anencephaly, her decision to continue with the pregnancy, and how they took him away from her when he developed respiratory distress shortly after his birth to donate his organs. Owen developed a newfound respect for her then, and held her in his arms as she sobbed in relief at being able to lift a huge burden off her chest. He had reassured her that no- he wasn’t going to leave her just because of that- and that he would be there for her, no matter what happened, every step of the way. That was all she needed to hear. She was finally rest assured that Owen would be by her side no matter what.

Their journey back to each other was slow though. Although they stopped yelling at each other after the conversation, Amelia only moved back to their place after another couple of weeks. The reason was she needed to be there for a devastated Maggie who had just lost her mother to inflammatory breast cancer shortly before that.

It took another couple of days for them both to be comfortable being in the same room together again. But one night almost two months ago, they looked into each others eyes and realized how they missed each other, and rediscovered each other’s bodies. It was pure lovemaking and magical. After that, as they lay side by side cuddled next to each other in postcoital bliss- they both bared their hearts and souls to each other and promised each other never to keep any secrets between them any longer.

Now Amelia stopped at the ER door to admire her husband in action. She had to admit, her hot husband always looked even hotter with his intense and focused expression in the ER. His eyebrows furrowing in concentration as he studied a patient’s chart was already enough to turn her on. She could already imagine the joyful look on his face once she broke the good news to him at home after the shift. It would be the best gift she could ever give him.

‘ Neuro is here.’

Owen looked up upon hearing the familiar voice of his wife. Even though he heard her voice daily- he could never get enough of it.

‘ Hey.’ The couple exchanged a smile, just so glad to be able to see each other. Owen was having a busy shift so far- with an influx of car accidents entering the ER.

‘What’s that disgusting thing you’re holding?’ Owen wrinkled his nose as he looked at the green juice Amelia was holding. Usually she would be holding a cup of coffee in her hands, so this was unusual of her. ‘ So now you choose this over coffee?’

Errmm….nope, no coffee, I’m sorry. It’s not good for your unborn child.

For a moment, Amelia thought of telling Owen her secret, but she decided to wait until their shift was over.

‘ Well, it’s a healthier option.’ Amelia winked at him. ‘ I want to stay healthy, don’t you?’

‘ Well if you say so.’ Owen chuckled. ‘Patient is in ER4. Mr. Jenkins. Post MVA, his GCS score is only 8, I’m suspecting a brain bleed somewhere due to his unequal pupils.  I’ve already intubated and ventilated him.

_______________________________________________________________

Half an hour later, they both emerged from the CT scan room.

‘ Well he does indeed have a subdural haemorrhage.’ Amelia reported. ‘ I have to scrub in to perform a craniotomy and evacuate the blood clot.’

‘ Ok- go and save a life. Do what you do best.’ Owen said as he gave Amelia a quick affectionate kiss on the cheek..

He then returned to the ER as she made her way to the elevator.

Owen continued staring at Amelia’s retreating figure from the ER nurses counter as she strode towards the elevator. He could never get enough of his beautiful, amazing wife. He was so glad that they both managed to have a heart to heart talk to sort our their issues, and they came out of their earlier troubles stronger than ever.

‘ I wish Jackson would look at me like that.’

Owen turned around to see April standing beside him at the nurses counter. April wasn’t supposed to be on call that night, but she decided to help out when she heard that the ER was swamped with patients. It was due to April’s help that they managed to clear the majority of the patients up to the wards.

Owen blushed as he tried to think of a reply.

‘ How do you know that he doesn’t?’ he finally asked.

‘ I don’t know, actually.’ April admitted.

‘ Maybe he does, behind your back.’ Owen suggested.

‘ But the way you look at her….’ said April as she rested her chin on her hands and continued looking at Amelia. ‘ I’m so glad that you two are back together again. It was painful seeing you both fight in front of me and all the other ER staff.’

‘ I’m glad that you and Jackson are back together too.’ Owen said earnestly as April smiled in reply.

Just then, the power supply went off and the backup generators were switched on.

‘ Damn it!’ Owen muttered as he and April exchanged worried glances. Mr Jenkins was still in ER4, intubated and ventilated.

Owen’s Head of Trauma Surgery mode took over.

‘ Ok, everyone listen up.’ Owen announced as the entire ER staff gathered around him.

‘ I need a couple of you to call up Seattle Presybeterian and inform them that we’re sending patients over and to arrange transport for the patients to the hospital.

‘ Everyone else- prepare the patients for transfer.’ he instructed in his authoritative voice. ‘ Does the blackout involve the entire building?’ he asked.

‘ I don’t know, Dr. Hunt, but there also seems to be a blackout at the lobby.’ answered one of the interns.

A couple of nurses rushed out from ER4, breathless.

‘ Dr Hunt, Dr. Kepner, there is a fire in ER4!!’ One of the nurses cried out. ‘ I think its a short circuit, we need to get out of here as soon as possible before it reaches the oxygen tank and explodes!’

‘ Mr Jenkins is still in there!’ cried April as she, Owen and a couple of residents rushed towards the room.

‘ Someone make a Code Red alert and someone call the fire brigade!’ cried Owen.

The flames were spreading along the wires located at the side of the room and they both knew they had to act fast before the fire reached the patient and the oxygen tank.

Owen quickly unplugged the oxygen supply as April reached for an ambubag and began bagging the patient. The residents began pushing the patient trolley as fast as they could to the ER exit leading to the hospital compound, with April running beside the trolley, still bagging and Owen following a short distance behind them.

The other patients fortunately have already been pushed out of the exit to the ambulance area and were awaiting transfer.

Just as the group exited the ER, a loud explosion was heard from inside and the entire ER was engulfed in flames.

Owen felt himself being thrown on the ground as his entire world went blank.

 _____________________________________________________________

‘ You paged, Dr. Shepherd?’ Stephanie asked, as she approached Amelia at the corridors of the Neurosurgical floor.

‘ Yes, I need you to book an OR and prep a patient for another emergency craniotomy and blood clot evacuation.’ said Amelia. ‘ Mr Jenkins, he’s still in the ER now, but he’ll be transferred to Room 415.’

‘ Another craniotomy? Why can’t it be something a little more interesting like a tumour removal?’ Stephanie asked, pouting.

‘ Not today, Edwards.’ Amelia warned.

The neurosurgeon noticed that her mentee had become less lively and more sullen lately. The usually cheerful, high spirited and motivated resident was now being replaced by a whiny and unmotivated resident. She didn’t know exactly what caused the change in Stephanie, but she suspected it had to do with the fact that they had lost so many patients recently, and Stephanie tended to blame herself for the loss of each and every patient. Amelia suspected that it might have been taking its toll on her.

‘ Fine.’ Stephanie muttered as she stormed off to prepare the patient for surgery. Amelia shook her head as she watched her resident’s retreating figure.

Just then, an announcement blared through the hospital intercom.

‘ Attention! Code Red. Code Red. This is an emergency. All patients and medical personnel are required to evacuate the hospital premises immediately.’

Chaos ensued right after as all the nurses and doctors rushed to evacuate their patients from their rooms.

‘ Dr Shepherd, what are we gonna do with our more critical patients?’ one of the nurses asked her.

‘ Arrange for transfer to Seattle Presyberian for all our critical patients, post op patients and those awaiting emergency surgery. ’ she replied. ‘ I’ll discharge all the stable patients and those awaiting elective surgery.’

As Amelia rushed through discharging her patients, her mind kept on wandering to her husband in the ER. She wondered whether he was ok. She hoped and prayed that the fire did not originate from the ER.

In just a matter of minutes, Amelia found herself running down the emergency stairs with staff members and patients.

She had no idea where Edwards was. She didn’t know if all her patients, especially those still in critical condition could be safely evacuated.

But most important of all, she needed to know that her husband was safe and sound.

She reached the ground floor in record time and was greeted by the thick smell of smoke. The entire ground floor was engulfed in thick smoke and the entire ER had been reduced to a rubble.

She felt her entire world spinning.and her heart sinking.

No, no, this can’t been happening.

‘ Owen!!’ she cried out. ‘Owen!! Where are you!!’

There was no reply, only silence greeted her.

She rushed to the hospital exit to find almost the entire hospital staff gathered at the hospital grounds. Some firefighters were already at the scene working extra hard to put out the fire.

‘ Owen!!’ she cried out, looking for any signs of his distinctive ginger hair.

But he was no where to be found. She couldn’t spot a single familiar face among the huge crowd gathered at the hospital compounds.

She sank on the ground in tears, defeated.

Owen had to be alive, he needed to hear the wonderful news that he was going to be a father.

 Any comments, reviews, reblogs and messages are very much appreciated! I love hearing from you guys :)

[drferox]

20 questions with Dr Ferox #4

It’s that time of the week again where I try to shrink my inbox by answering 20 of your questions all in one go. This seems to be working well, and I must thank everyone who has endeavored to use the search function this week. I’ve tried to tag folks, but if you’ve sent in anonymous questions you’ll have to read through and look to see if you’ve been answered.

A lovely, understanding anonymous said: Have you ever had players in your DnD group not get along? Also, if you ever feel stressed out about the number of asks, don't feel like you have to immediately respond to us. It's a blog, we get it. Nobody is waiting on a time-sensitive diagnosis from a blog (or at least they fuckin shouldn't be), and we can wait. Prioritize yourself, we're a bunch of randos asking about dog food on the Internet.

Well, nobody should be waiting for a time sensitive diagnosis from any vet blog any more. I’d hoped I’d been clear enough by now why it’s not appropriate to ask specific veterinary advice from myself, or any other vetblrs on here.

But yes, I have had players in my D&D groups not get along, but I had enough players to keep them separate most of the time. Dungeons & Dragon is supposed to be fun, it’s a game, so it’s meant to be fun. Aside from other skills you learn playing roleplaying games, managing a group of people is definitely one you pick up. Humans are human, we don’t all get along all of the time.

@kabjl asked: Would it be theoretically possible to have a viable hybrid offspring of a house cat and a wild large cat like a lion or tiger?

Unlikely. House cats belong to the Felinae subfamily and lions and tigers belong to the Pantherinae subfamily. While Pantherinae species can hybridize (eg tiger and lion) and Felinae species can hybridize (eg domestic cat with anything), the offspring are usually infertile. I don’t think it’s possible for a Felinae X Pantherinae hybrid to be viable.

@a-floral-ghost asked: What's your favorite animal name you've come across? Mine is a cat named Chuck

Hmm, that’s a interesting question. There are no many pets and names to try to remember. I must profess a fondness for Pat the Cat.

@curiouspinecones said: What is the best and worst pet name you've come across? I work in a pathology lab within a vet practice and I quite like when patients have really human names (Dave the cat is always a good one). The worst has to a Labrador called "Daddy", that is totally not okay...

Again, an interesting question. There are lots of names that are unoriginal and boring, but it’s the straight up racist names that I don’t like.

Anonymous asked: Hi! I read somewhere on tumblr that because of the cat's particular tastebuds, they can't taste sweet things. If that's true, does that also mean they can't smell sweet things, since taste and smell go hand-in-hand? Question tax: Came for the dog breed facts, stayed for the vet stories and knowledge.

Well, none of us actually smell sweet. You can smell things you associate with sweet foods by learning, but you’re not smelling ‘sweet’ as such.

Another Anonymous said: Have you ever met a hamster? I know we're not allowed to have them in Australia, but I'm curious about whether you've been exposed to one during the process of learning vet medicine. I know I feel odd about never having seen a hamster in real life, since it's such a common pet elsewhere...

I’ve never seen a hamster in the flesh. They’re not legal in Australia, neither are gerbils of chinchillas. I have seen one on an animal handling video though.

@fox-noodle said: I forgot the question tax, my apologies! My rat Apollo is almost 2 1/2 and recently went to the vet for what I thought were tumours, but are actually testicles. They only started showing a few months ago, I've now separated him and he has two male buddies now. Is this common in rats? I've only ever heard of something similar (cryptochoridism) in dogs, could that be what he has? Question tax- came for the interesting euthanasia posts (its helped me a lot), stayed for the interesting vet stories

Can’t say I have. That’s a very long delay for that rat to develop testes, and I’d have to wonder if it’s intersex in some way.

Dogs with cryptochidism have testes, they just haven’t descended into the scrotum. They never descend into the scrotum, sometimes they’re stuck in the abdomen and sometimes they’re in the groin, so I don’t think it’s the same process at work. Sorry I can’t be more help.

@rebanndon said: I've read in an article or two, that for active dog breeds like border collies leaving them entire until 18 months of age is a way to reduce the risk of cruciate ligament tears because the bone is able to fill out? There's little/no proof behind the claim reproductive hormomes are linked to aiding ligament growth.  So, in your experience do you see more cruciate cases in active desexed dogs or active entire dogs? Or simply no link at all and desexing should just be done at 6 months regardless?

I’ve written a fairy in-depth article on age of desexing here.

There propably is a benefit in delaying desexing for larger breeds overall, but for most small breeds 6 months still seems about right.

Anonymous said: Isnt't it bad to declaw a cat? Since they are digitigrade doesn't removing the claws hurt their bone structure?

... Yes. That wasn’t up for debate. I’ve discussed this here.

Unobservant Anonymous said: Do you have any advice for a cat with a herniated spinal disk? QoL is still good, he's a happy boy who sometimes has trouble lifting up his back legs and needs stairs up couches and to litterbox. Eats, drinks, purrs and seeks attenion like a champ but sometimes when he grooms himself that it looks like he's got a pinched nerve and has discomfort / spasms reaching for his back feet. Vet has been seen, on cosequin every other dayvand daily gentle stretches. Anything else I can do?

Hey, so, from a legal and ethical perspective I can’t give you specific veterinary advice about a cat that is not one of my direct patients. It’s dangerous and unethical to do so. But go talk to your vet, Cosequin is a joint supplement, not pain relief, there are at least three different medications you could consider.

Anonymous said: Oh my god, you're allergic to bunnies? I want to be a vet too, and so am I XD glad to see I'm not the only one lmao

Yup, allergic to rabbits, rye grass, and dogs (sort of). And nuts, which makes the mixed boxes of chocolates gifted to the clinic very interesting.

Anonymous asked: Working as a veterinarian, do you ever get the urge to adopt the pets in the shelter?

Not from shelters, I just don’t go near them any more. Stray kittens in the vet clinic though are another matter...

Anonymous said: About the uncomfortable animals thing- I was referring to where you said primates are in the  uncanny valley

Lots of vets have certain animals, or breeds of animals, that they just don’t want to deal with. For me, primates make me uncomfortable. Not because they’re creepy, but because they’re clever and I can’t reliably know how clever they are, and whether what we’re doing with them is ethical.

I also don’t intend to go treat horses every again, and I know lots of vets that are averse to large animal practice or outright phobic of birds.

Yet Another Anonymous said: Hey! I'm wondering if you get much experience with our Aussie staghounds (enough to write a breed evaluation on them)? Or if not, maybe just a bit about the general hunting-type Australian dogs? (staghounds, bull arabs, and the many many similar mixes). Question tax: came because I'd always wanted to be a vet and I LOVE anatomy, stayed for the awesome info and even more wonderful stories.

I haven’t seen any staghounds down here, but I’m pretty South and suburban now, not really a much of a hunting culture around here. You can find the Bull arab post here, but are welcome to use the search function for any other breeds of interest.

@orgasmicplushtoy asked: Can you do a write up on small munsterlanders? If not that's okay.

I actually had to look up the three Munsterlander dogs I’ve seen, because I didn’t know ‘large’ and ‘small’ munsterlanders were totally different breeds.

Turns out all three I’ve seen are large ones, over 30kg each. Short version: They all got cancer.

Anonymous asked: Do you see any Greater Swiss Mountain Dogs at your practice? For some reason we see a lot at our clinic and though some of them are fine- they have earned the moniker "Sketchy Swiss." As in: I have to muzzle a 6 month old Swiss puppy because it barks, growls, and lunges at me while I try to TPR. Several of the ones we see have been diagnosed with Wobbler syndrome and various other orthopedic issues. Just curious if you've had similar experiences. Thanks- love your posts!

Sorry, no. They’re quite big and not popular here, I don’t think I’ve ever come across them. Large breeds in general are less common. 

Anonymous said: I don't suppose you've done any evaluations on working cocker spaniels/sprocker/Russian spaniels?

Nope, not yet. There’s 30 waiting in the queue for me to get to them. I have said before though that I’m not answering breed posts that asked for more than one breed in the same post. It just gets too long, confusing and messy if I do. Besides, it’s rather cheeky to ask for more than one in one question, isn’t it?

Another Anonymous said: If you enjoy a little wildlife voyeurism, there are about a half dozen bird cams linked on Cornell's "All About Birds" webpage, and the owls have owlets. There's not really a question here. You have a stressful job, and I thought you might enjoy wasting some time watching the bird feeder or trying to see the baby owls under mum's fluffy owl butt.

Thanks for the thought, I’m sure some followers will find it useful. Personally I try to relax without animal things. I find it helpful to seek out activities that engage different parts of my brain compared to what work does.

@slowdown-its-a-science said: Please give us lots of updates on Trash Bag

I’m sure I will.

@herebelife said: Ps did you read the article about the bilby triplets? Bilby triplets!

I hadn’t, but I have now and will share them with you.

[suchawonderfullife]

2. My body is a Picasso

I’ve been incredibly fortunate in my journey to try some cutting-edge treatments in Australia, as well as having a very intelligent, compassionate and hard working CFS (chronic fatigue syndrome) specialist on my side. A specialist like that doesn’t come cheap either (very little if anything is covered by medicare so you have to be prepared to be out of pocket by tens if not hundreds of thousands over the years). He’s been my Dr for 8 years and yes he couldn’t get me better, but he has helped me in so many ways. 

He was able to diagnose a multitude of problems within my body through tests regular doctors would not have access to. His understanding and knowledge of CFS and what it does to the body on a cellular level is extraordinary. For those who know who I am talking about, they would agree that he is a brilliant man, who I owe my life to. He got me into private psych hospitals when I was suicidal, he got me in to see him on spur of the moment appointments to treat flu’s and tonsillitis so that a GP didn’t mess me up even more, he diagnosed me with Lyme Disease. Most of what I know about my body and these illnesses are because of him. 

My first 2 years of being chronically ill consisted of spending tens of thousands of dollars on testing and trialling supplements and medications. I did a tonne of research and learnt about “pacing” and other things I could do on my own to help my body repair. I did everything I was supposed to and my health slowly built back up to 80%. I went back to work part-time, back to Uni, I could leave my house almost everyday and things were getting better. Having a diagnosis of CFS without Lyme Disease (because it doesn’t exist in Australia), meant that the cause of my CFS was not being treated and therefore just a ticking time bomb. Of course I didn’t know this and neither did my doctor. 

So when I relapsed HARD, it was a complete shock to my doctor and myself. My heart became so bad I couldn’t shower standing up anymore, I couldn’t lift my arms above my head to wash my own hair, sitting up for longer than 10 minutes at a time was impossible, talking or paying attention to someone speaking to me was exhausting, looking at my phone or a computer made me feel incredibly ill and I was lucky to sleep 2 hours a night. 

It was terrifying to be this ill and not no why. I ended up on 5 injections, 52 tablets, oxygen therapy for 4 hours and drinking litres of special liquids every day. Without all these I would have been far worse than mentioned, but I wasn’t getting any better. 

You wouldn’t believe some of the tests I’ve done. I’ve peed into a huge jug over a 24 hour period and carried it into a pathology (multiple times), I’ve had to poo into a container and scrape pieces of it out to go into special containers and sent that off, I had to pee in complete darkness into a special container covered in foil because if any light hit my urine it would destroy whatever needed to be tested. Boy was that something I’ll never forget. I had to do it in my bedroom as I had blinds to make my room pitch black. Due to how sick I was, I wasn’t well enough to “squat” and hold my own weight, so I needed my mum in there to help hold me and being a girl you can’t really get your pee flowing unless you’re at least squatting. And how do you aim your pee as a female when you’re in total darkness? I’ll leave that one to your imagination. Being in my bedroom and not at a toilet wasn’t triggering whatever part of my brain was needed to tell my bladder to let it out and I possibly had stage fright from having someone standing there waiting for me to “go”. So it took some time and both my mum and I were getting quite frustrated. Then there was the logistics of finding the toilet paper, wiping, putting it into a bag once I’d finished and hoping I didn’t get any on the floor- all in pitch-black darkness. The things parents do for their kids huh? 

For you folks who hate needles, I could have 10 viles taken at each appointment if needed, I have permanent needle marks on my arm where blood gets taken because it happens so often. I also did a spit test, where I had to spit into this test tube and fill it to the top within a certain time frame. It was actually bloody hard to meet that deadline as I wasn’t allowed to drink for ages beforehand so I was dehydrated. My Dr also does a standing test for POTS (postural orthostatic tachycardia syndrome), which is one of my heart conditions. This is really horrible when you’re so sick as standing completely still for 20 minutes can be near impossible. Some patients faint before the 20 minutes are up due to lack of blood flow to their brain. I never fainted luckily, but my blood pressure would drop to something ridiculous like 45/60 and my heart rate would shoot up to 160bpm. I’d become very disoriented and brain-fogged due to oxygen not getting to my brain, my legs would shake with fatigue, I found it difficult to breathe let alone speak (the nurse would keep asking you how you’re feeling) as my heart was beating as if I was running.

Hydrogen breath tests suck too, for people that have done those. You go into a specific clinic, drink this disgusting liquid and then have to sit around for hours and have your breath tested every hour to see if you have an intolerance to foods like lactose and fructose. Being that I am intolerant, drinking a liquid containing things I’m intolerant to gave me gastro like symptoms, running to the toilet throughout my testing and feeling very bloated, nauseous and just yuck. Gastroscopy, colonoscopy, endoscopy, liver & kidney scans (very painful when they’re inflammed), I’ve been lucky enough to have all of those too!  

Then there’s the trialling of all the medications. Because when you have illnesses that are incurable and largely misunderstood, even regarded as not existing, you are essentially a guinea pig. It’s not only that, but every single CFS or Lyme patient has different symptoms and different biologies, which means all our treatments must be individualised and what works for one might not work for another. My body is also very sensitive to medications (it runs in my family) and having a bad reaction to things is common for my mum, brother and I. Every doctors appointment became a Russian roulette of new medications or supplements. “This test shows your body can’t absorb potassium, take 7 of these a day/ we found your stomach can’t produce acid to digest food, take these with every meal/ your mitochondria can’t produce energy, take this injection daily/ you’re chronically dehydrated, drink 2L of this a day/ you’re not producing the hormone that helps you sleep, take this highly addictive sleeping tablet plus these horrible tasting drops just before bed/ your blood pressure is too low, take this beta blocker.” The list just goes on and on. 

My body is like a Picasso- a jumbled mess, a masterful fuck-up, where down is up and up is down (actually this is sounding more like Dr. Suess). Nothing in my body makes sense or works how it should. So when I trial a medication that I react badly to, thats where you get side effects on top of chronic illness, I have to wean off it and start all over again with something different. I’ve tried hundreds of medications, supplements, tinctures, herbal remedies, whatever was recommended to me. Because I will do whatever it takes to get better and to just feel better. But the more I tried, the lower my success rate of finding things that actually worked. 

New doctors wouldn’t understand how seriously complex I am. A kinesiologist put me on some tinctures that made me seriously ill. My CFS Dr was furious because she wouldn’t have understood that putting me THAT b12 concoction would then irritate this part of my illness and he would never have let me take something like that. Then my Dr’s own colleague tried to treat me and she even made me really ill by telling me not to take certain things and trying others things, as she didn’t know my history for the last 6 years and wouldn’t have had time to read through my hundreds of tests and doctors notes over that time. Again my Dr was angry. This doesn’t make her negligent either, we are just so complex and confusing to the majority of the medical community, can you begin to understand why we are shunned as hypochondriacs or put in the “too hard” basket? 

This is what makes my CFS doctor so amazing, he never gives up on us. It can actually be traumatic for patients like myself throughout our fight to get better. We aren’t even heard, listened to or taken seriously. I had to yell and argue with my GP when I first got sick, just to get him to write me a referral to a CFS doctor because he didn’t “believe in it” and said I must just have low iron or something (he already tested it and it was within the spectrum). He even WORKED with a CFS doctor, so he had an easy connection and getting that referral was like extracting teeth. Years into my diagnosis he would then argue with me over prescriptions and why I needed to take certain things. “7 potassium tablets a day, you should be dead!” Yet I’d have my prescription bottles with me for proof. “Wow you’ve lost so much weight, you look great, are you working again now?” Would be his opening line to me as I slowly dragged myself into his office with a walking stick, barely able to stand or hold my own head up. I don’t think he’s a moron either (well he kind of is), but this is the general consensus of how people with my illnesses are treated by the people that should be helping us the most. So if I’m being frank with you here, the majority of the medical community are morons when it comes to illnesses like mine. They’re brilliant in many other ways, but that doesn’t help me or change my story. 

Can you imagine a cancer patient getting a positive test result or scan of a tumour and being told to just take some panadol (pain reliever), get out more and see a psychiatrist? Or you find a lump in your breast and want a scan, your doctor tells you you’ve imagined the lump, probably from stress or depression and that fatigue is because you need to exercise and lose some weight, then your imaginary lump will disappear. Later you find out your body is riddled with cancer, how angry would you be? My body is riddled with billions of deadly and destructive bacteria because of this ignorance and negligence towards certain illnesses. Can you imagine my anger when I was diagnosed with LATE STAGE Lyme Disease at age 24 and I should have been diagnosed in the hospital when I presented very clear symptoms at age 16. Instead the doctors found me a novelty, they kept coming in all night and gawking at me like a medical marvel. “What the hell is wrong with her? Those are some fucked up symptoms!” is what I imagine the talk outside my door would have been. Lyme Disease is more common than HIV/AIDS, it is not a unique or unheard of disease in the medical world. 

Anyway, so I was FINALLY diagnosed with Lyme Disease in 2013, better late than never, through overseas testing that costs upwards of $1,500-$2,000. So again, you better be rich if you want to get anywhere with treating this bastard illness. This is where the fun begins! 

[jazy3]

Thoughts on Grey’s Anatomy: 16X14

Holy cow was this an intense episode! Wow! I’m glad that Meredith and DeLuca officially called it quits! I’m also glad that both Meredith and Hayes stood up to him and told him off. He was way out of line as usual. I like that they also explained his bizarre behaviour for the last several seasons. I loved that Hayes was there for Mer and supported her. The scene where they talked about the video games was so cute! The way she smiles around him! Her whole face lights up. Just talking to him about nothing she’s so happy. We haven’t seen her that happy in ages.

Prior to this I thought they might write DeLuca off at some point by either having him move to Switzerland to be with Bellos and be closer to his Dad or by having him go to another hospital to do his fellowship. But now after seeing this episode and how he’s clearly suffering from untreated mental illness that he’s refusing to acknowledge I’m guessing that they’re going to write him off to go seek treatment. My hope is that in the wake of that Meredith and Hayes are going to fall in love and merge their lives together. I can’t wait to see their relationship develop and grow!

I was really worried that DeLuca was going to physically hurt Meredith when he started punching the wall in that last scene. I’m glad Hayes stepped in. I liked that they also explained why Carina randomly showed up in Seattle and hung around after Arizona left. I’m hoping they’ll write DeLuca off sooner rather than later and don’t draw it out as they’ve kinda gone as far as they can go with his character. Also, I love that they suddenly explained away a season of bad writing with a conversation lol. Kind of like the brain tumour storyline with Amelia.

It reminded me of that scene after Amelia has brain surgery. The gang is waiting for her to wake up and they’re all sitting around a table saying how much they wish they could blame their dumb stuff (aka bad writing) on a brain tumour. I’m glad Suzanne is okay. She’s a nice person and a great Mom and her kids really need her. I figured that as soon as that case wrapped up Meredith and DeLuca would be done because of how obsessed he got with it. But I didn’t see it going that way. I figured that if she lived DeLuca would want to celebrate with Meredith and if she died, he would want to commiserate, and Meredith would be over it because she’d already be with Hayes. I did not see DeLuca taking it too far and the realization that he’s ill coming but it did make sense given the circumstances.

I liked that DeLuca showed his true nature and Mer finally saw it. In the past whenever he’s been insubordinate, disrespectful, rude, aggressive, or out of control it’s always been with other characters and when she’s not present. This time she saw it, called him on it, and put her foot down. It’s not just that he’s sick because he’s been disrespectful to everyone from his superiors to his subordinates for a long time now. This episode he was disrespectful to Bailey, Meredith, Hayes, and his patient. In the past we’ve seen him be disrespectful to Alex, his residents, his patients, and their families.

He’s also disrespectful and insulting towards Derek and his relationship with Meredith at every possible opportunity which is just wrong. Meredith deserves someone who is respectful of the fact that she lost the love of her life and wants to be a part of her family not someone who throws hissy fits because he’ll never be better than a dead man. DeLuca’s actions towards Suzanne were reckless and dangerous. Yes, she needed the steroids, but he should have taken the time to explain to Meredith, Suzanne, and her sister what he wanted to do. He had time. DeLuca and Dr. Riley barged into the room and administered drugs to a very sick patient without explaining what they were doing to the Attending Physician or getting consent. What they should have done was run in and told Meredith to stop and asked to speak with her outside.

He should have explained what they had found and what they wanted to do. Instead he gave her the drugs and spent the whole time he was doing it yelling at Meredith instead of explaining himself and that’s what Meredith was upset about. If she had started Suzanne on the drugs already the steroids would have killed her, and they were lucky in that DeLuca administered the steroids before she had a chance to restart the drugs. They could have had a calm reasonable conversation about it, but instead DeLuca barged in there and did what he thought was best damn the consequences.

There’s a big difference between breaking the rules to help a patient and breaking them because you’re convinced your right to the point that you won’t tell others what you’re doing. I do get his frustration, but he needs sleep and that’s all they were asking him to do was get some rest and come back. He’s sick. He needs help. And Meredith deserves better. I also liked that they established that Meredith and DeLuca are done for good because he’s unwell, refusing treatment, not sleeping, and behaving aggressively and violently towards others including her. And there is no way that super mom Meredith Grey would ever let an unstable violent person anywhere near her home where her three young children and pregnant sister are. Now way. They’re done.

I would have liked for there to be more Meredith and Hayes scenes in this episode but I’m hoping we’ll get more next episode and that things will start moving forward especially now that she’s officially single and he knows it! Cormac’s the best! I liked his scenes with Bailey and how great he is with his patients. He really cares about Joey and was super interested in joining Mer’s pro bono surgery project. He’s the kind of doctor that’s in it to make a difference and help as many people as he can just like Meredith is and I love that.

I loved that Cormac stood up for Meredith with DeLuca and that he pointed out that he needed to be written up and made sure she was okay. He was right and Meredith deserves someone who’s in her corner always! One thing I love about Cormac is that he is calm, cool, collected, and takes things in stride. He knows Meredith has three small kids and he knows Amelia is pregnant and that her and Meredith are close and he’s okay with that. He’s forming a bond with her and flirting with her knowing full well what he’s getting into. Because unlike everyone else she’s dated since Derek died, he sees her kids as part of the package. He sees them as a benefit not an obstacle or an afterthought or an accessory and he expects the same from her and I love that.

Something else I realized too is that if they get together now there’s going to be another kid in the family. Cormac’s got two teenagers, Meredith has three young kids, and Amelia is having a baby that she has decided to co-parent with her sisters. Which means by dating Meredith Cormac is agreeing to take on and parent 6 kids including a new baby as their primary father figure because Derek is dead, Amelia is single, and Alex is gone. That’s a lot but seeing as he’s a pediatric surgeon and a single dad already I think he’s up for the challenge.

And he really cares about his patients. I loved his scene with Bailey where he said he was concerned about Joey and Bailey was all ‘Who’s going to be at his graduation?!?!’ And Cormac was all ‘I’m concerned about his arm.’ LOL! I love that Cormac gets along with everybody really well. Even people he’s at odds with like Cristina. So far all of the people who are important in Meredith’s life who have worked with him like him and that’s saying a lot as they are hard people to impress. I also love that he’s making a genuine effort to get along with his colleagues.

I also liked his scenes with Levi. I liked the scene at the beginning where he asked Levi if he was going to just stand there or was he planning on getting some work done? He wasn’t being rude or condescending that’s just the kind of thing your boss says to you when you’re milling around. And I loved how afterward Levi thought he was giving up on Joey when they stopped with the PT, but then Cormac clarified that he could tell that what they were doing wasn’t working and that they needed to try another approach. He found a way to make it work.

In other news Bailey is definitely going to adopt that teenager! I loved the scenes with Amelia and Maggie! So great! That was some phenomenal acting from both actors but especially Caterina. Damn. She has such amazing range as an actor. I loved how Maggie got both perspectives but was also supportive. I’ll be interested to see Meredith’s take on the whole thing as she’s been busy dealing with her own crap recently, so she hasn’t had time to help Amelia.

When it comes to that storyline I kind of see both sides. For Amelia she deserves someone who wants her and loves her no matter what and for Link he wants to know the truth so they’re at an impasse. I did think it was badass though when Amelia said eff it ‘I’m going to raise this baby with my sisters ‘cause they love me unconditionally’. That’s true love. I liked Amelia and Link together, but it looks like they won’t make it through this which is sad. I liked that Jackson finally apologized to Maggie although it was kind of out of the blue.

Also, where the heck is Teddy? Why has she had the flu for the past several episodes? I think its kind of weird that they brought her back as a main character, but then she’s been absent for half of time each season. I’m not sure where they’re going with Alex’s storyline either. I’m kind of confused. Alex ghosting everyone and not responding is super out of character for him and everyone keeps acknowledging that which makes me think something awful has happened. But then I’m more confused because if Alex is dead why didn’t they do a big death send off episode right off the bat?

One idea I had was that maybe he’s not dead, but instead is incapacitated and maybe his sister Amber or another family member has his phone. That would explain why he keeps reaching out, but then stops responding. Maybe they want to tell them, but they don’t know how. I would be cool to see Alex’s sister before the show wraps and think having a send-off storyline involving her would be a cool way to do that. It’s weird that they’re going that route especially because they’ve had Meredith call and text with Cristina recently and Sandra Oh isn’t on the show anymore. They clearly don’t have an issue doing that, so I’m confused as to why Cristina’s super responsive, but Alex is suddenly non-responsive. Hopefully we’ll get answers soon.

I didn’t like Nico in this episode. He was super hypocritical and contradictory. He called Levi out for being a baby gay and said he was inexperienced and yet he hasn’t been living his truth. And they’re being really inconsistent with his character. He previously told Levi he was out and talked about doing Christmas together a while back and now he’s saying he’s not out to his parents? Levi has risen and glowed up from Glasses to someone you can respect, and Nico isn’t treating him right. I think it’s time for him to move on.

As for the case of the week I felt so bad for the husband of that bear camping couple! That man jumped in front of a bear for his wife and she was cheating on him the whole time! The bear took his nose off and then Jackson reattached it to his arm and all he wanted to do was see his wife. And then he coded and died and the wife suddenly felt awful. I’m glad they didn’t tell him though. He died thinking his wife loved him which after the day he’d had was definitely a small mercy.

I hope Dr. Reilly sticks around a while longer. I really like her character and I felt like she had a good chemistry with DeLuca. I thought it was cool that they showed the partially clear face masks and how that works in surgery. That being said she was brought in for this specific case and DeLuca’s currently refusing to even acknowledge that he’s sick, so I don’t see much dating for him on the horizon.

Until next time!

[simplynotaneggworks]

Bridge

Fandom: N/A Ship: Anonymous (OC) x Emily (OC) Rating: Older Audiences Warning: Car accident, Death, Suicide, Cancer, Orphanage Word Count: 2064 Words A/N: So in May?? I submitted this piece to a place for a competition that was offering VERY large sums of prize money. Long story short, I poured my heart and soul into this work, and even played to the judges areas of expertise, and I ... lost. I was emailed the following month and told that my story was not even considered for the top 3, which angered me because, you know, you work so hard and are so proud of something and then you literally get told “it’s not good enough for us.”

Anyway, this story is what the title says: Bridge. Because bridge can mean many different things. It’s a bittersweet story, yet also fairly depressing because I write sad things better than other things for some odd reason.

It’s funny; how emotions can be inflicted by the way something smells or tastes or feels to the touch. How emotions can be inflicted by sound or sight or just the energy of certain places. How emotions can be inflicted by hearing a simple word.

Bridge. That’s the word that does it for me. Every time I see or hear or even think of the word, there’s always a mix of emotions attached to it with a fantastically strong bond. Sometimes the word brings me joy, sometimes it brings me fear, sometimes it brings me great anger and sadness.

It’s funny; how the brain works in the way it does. Experiencing events and collecting memories before processing them and hiding them away in the darkness. For years, these memories can go undiscovered, but then, all of a sudden, a sense or a word causes them to erupt from the dark chasms of the mind.

I was eight when my parents died. Dad’s car was getting repairs done so Mum had to drive to him straight after work, to pick him up and bring him home to us. I knew there was something wrong when it was dinnertime and there was still no sign of them. That was when they came for me, the bad people. The bad people that took me away from my home and put me somewhere filled with parentless children, broken promises and lost hope. It was the morning after when I was finally told what had happened. A drunk driver was on the wrong side of the road going a hundred kilometres an hour. She hit my parents head-on. The bridge was closed for two days after the accident.

When I was sixteen, I had had enough. The world had turned on me indefinitely, and I had reached a breaking point. I tried to fight, but I was already weak, which led to me giving in to temptation. The sky was clear, and the sun was just starting to peek out of hiding, in the distance. The trees began to rustle as the wind picked up while the birds began to wake up for the day, chirping and singing, trying to convince me in some way that life was the most beautiful thing in existence. The cold water rushed promisingly below, down towards a towering waterfall that ended in jagged rocks that could cut clean like a knife. It had rained the last few days, filling up the river drastically. If I had come a few days before down below would have just been cracked mud and sharp, pointed stones. The water was a small comfort to my impeding demise. Water and rocks don’t hurt as much as dirt and stones.

But then I saw her, carefully stepping onto the abandoned bridge, cautiously approaching me. She had to be around my age, perhaps a year or two younger. I didn’t know who she was, nor did she know me, but that didn’t stop her from rescuing me. Saving me from my solitude and battling with the darkness that surrounded me.

One year later we stood together, on that same bridge, talking for hours on end before, finally, she kissed me. That was the day I fell in love, for the first time in what seemed to be forever.

Suddenly life became a beautiful thing. But it also began to race by me at lightning speed and I no longer appreciated things that I appreciated before, like waking up in the morning or how it felt to have a warm shower. I even stopped appreciating how it felt to be loved and cherished and cared for.

I was twenty-two when I proposed to the love of my life. More or less I had done it because of what was happening. I was falling into the darkness of my mind, once again, all because I felt bad for not being able to appreciate anything anymore. I knew that maybe, it was because I had become so used to being happy, that I just forgot to appreciate the big and smalls of life. People did that every day, didn’t they? But it still made me feel awful like I was being dishonest in some strange metaphorical way.

The day was good enough. The sky was overcast, giving the day a permanent dull look to it, even though the sun still shined out in some spots. The winds were strong, and the air was practically freezing, but everything would still be okay, the day would still go on as planned.

There was nothing fancy about what happened. Even the ring was sub-par at best, considering we didn’t have the most money in the world. It was just her and me on the bridge that had connected us, many years beforehand. Even then, she still said yes, and she cried for hours after. We were both happy.

But everything changed that afternoon. We were walking home and we started to argue. She had taken the ring off and thrown it away, never to be seen again. Long ago, when everything had just started between us, we had made the promise to not engage in such a deep, lifelong commitment, not until the two of us were better and happier and actually enjoying life. When I remembered such a thing I was angry, not because she wasn’t going to let us marry, but because for years she had been lying to me. I yelled at her. I shouted, I screamed, I cried. I let her know how I felt; betrayed, confused, broken. She never once said a word though. She listened to me, she listened to my anger, and never once did she flinch or shed a tear or defend herself. Instead, when I was done, she held me close, then she ran.

She ran back in the direction we came from and all of a sudden sheer adrenaline and terror pumped through the veins of my body. I ran after her going as fast as my legs would carry me. I called her name desperately, I apologised over and over again. I promised her I would never ever yell or scream or shout at her again; I promised her I would love her forever. But it didn’t help; it didn’t stop her. Nothing could have stopped her.

In the years that followed I tried all that I could to forget about that day. As time passed I managed to forcefully shove the memories away during my waking hours, but at night I was still haunted. Haunted by that bridge that held so many precious memories of the two of us. Haunted by that bridge where, after running for so long, she had finally come to a stop. Haunted by that bridge where she turned to me and smiled a bright smile before leaping over the edge.

I’ll never forget what she looked like when she was down below. I can’t forget; I still see her in my dreams, or in this case, my nightmares. I still see her body, laying limply against the dark, cracked mud. I still see her body, laying mangled and beaten by the sharp stones pointing up from the ground like millions of tiny daggers waiting patiently for their next victim. I still see her body, floating away on the river as the heavy rain fell from the sky, the fear of realising her mistake still captured in her wide, dead eyes.

After that day, I was lost eternally. And it was moments like this, moments like what I was facing now, where I needed to be found.

A few months ago, I passed out while out shopping. I was found by a store employee, laying in a puddle of spilt milk. That’s what I was told, anyway. I remember waking up days later. My head felt like it was being crushed by a tonne of bricks, and I felt as if my body was being weighed down by some invisible force. I couldn’t lift my arms or my legs. I couldn’t do anything I used to do.

The doctors said it was a cancerous tumour, growing on my spinal cord, which explained my loss of nerve function. It was too late to remove it though, without causing significant damage that could leave me completely paralysed for the rest of my life. Even then I was still presented with the option of surgery. But I said no.

I had nothing else to live for. My parents had been dead for a little over two decades, I had no other family; because if I did I wouldn’t have been sent to that awful place after the accident. And Emily, my dear, sweet Emily. It had been ten years ago now since she had gone. Her life cruelly ripped away by the darkness that had shadowed the both of us from such a young age. Life had stopped being worth living after she had gone. The only reason I didn’t follow her that day was because I wanted to try. I wanted to try to prove to her that I would be okay, that she hadn’t hurt me after what had happened, and that I could feel happiness again.

But it had all been a lie. I never did find happiness again. I can’t remember the last time I laughed or smiled, I wouldn’t be able to do such a thing, even if I tried. All things good just came to a stop that day, never to begin again.

The light was becoming stronger, and I felt as though I was falling peacefully. It’s funny; how people, since the dawn of creation, have theorised about where we go after death. Perhaps it’s a comfort thing, to make it known to us that even at the very end of our lives, it’ll all be okay.

Ever since I could remember I was fascinated by such a concept; of life after death. I didn’t necessarily believe in such a thing. I didn’t really believe that anything ever happens after death. Always, I believed that we just fall asleep in a way and fall into total darkness. A darkness filled with nothing. No thought, no sight, no feeling; nothing.

A part of me still believed such a thing. But as the light continued to grow stronger and brighter, and her face began to appear, I stopped. There she was, Emily, smiling brightly at me as young and beautiful as the day she was torn from me. Her soft red waves of hair that hung loosely by her ears, her piercing blue eyes that were as calming as the sea itself, and the freckles that dotted her face like the stars in the night sky.

Then the light went away, and so did she, and I was back in my hospital bed, the moon rays shining in and illuminating the room with a soft white hue. I felt like crying for the first time in a long time. I had been so close to her that I could have reached out and felt her smooth skin and soft hair. She was right there, across the bridge, beckoning for me to follow her to the place where everything would be peaceful and happy and bright.

I did cry, and I cried for a long time. I cried about my sorrows and my hardships and everything that had gone wrong in my life. I mourned everyone I had ever loved. I cried, feeling bad for myself and how my life had played out.

And then I felt fear. The concept of death had never scared me, not until now. It was strange, and I felt guilty, all of a sudden, that I was about to leave my life behind as it was. I could have done so much better, especially in recent years. But I didn’t. The darkness had pulled me down and, this time, I couldn’t be bothered trying to escape it. This time I felt as if it wasn’t worth fighting, and now in a moment where I didn’t have an option, I wanted to fight. But I couldn’t. It was too late. Now I would forever be trapped in a darkness where the only things I could think of were my regrets in life, and I hated it. I hated myself, but it was too late.

[lovelyparkers]

chapter one - healing

(so yeah ur dr. romanoff bc ur nat's sister if u haven't realized! 3.2k+ words phew!)

peter was your patient. he always has been. from the minute he first crawled to your bedroom in the avengers tower after a late night brawl when you were 16, he has been your patient. and you vowed to make sure he was safe and healthy since then. a doctors word: you solemnly promised to care for the sick and wounded, promote good health and alleviate pain and suffering to the best of your ability. peter was your first patient, and you promised to care for him since.

last night he barely stirred in his sleep. he was obviously in pain and uncomfortable, he didn't even snore. you let him be all the way until it was time for you to be out the door and headed to the hospital.

"pete, love, i'm on my way out are you okay?"

"what," he rubbed his eyes and spoke in his deep morning voice, "oh i'm fine babe, go to work. i'm going back to sleep. thank you for waking me though."

you leaned down to give him a sweet kiss, which he obviously was waiting for, and he smiled, watching you walk out of your shared room. once he heard the front door click and lock he went back to sleep.

during your shift you made sure to check your phone frequently in case of emergency. after all, peter was your patient, but you didn't let the phone get in the way of hospital duties. you never would, but peter was also important. you figured peter would probably sleep most of the day, and he did promise you he wouldn't go out today so he could heal.

after doing rounds with your interns, you sent them off, checking up on them frequently. today was different, you had no scheduled surgeries, that is unless and emergency came in that needed you. but hey maybe it wouldn't be too hectic of a day. you could check on peter, check on your patients, and your interns. and of course, argue with your attending, rick.

now, rick was something else. he was the most arrogant surgeon and man in the entire hospital, and of course you were assigned to him. he was young, and flirty and according to several nurses, 'devilishly handsome.' ha, devilish is right. he bothered you, he teased you, made your internship miserable. yet it somehow made you stronger. you were more focused and self disciplined, not because of rick's actions, but because of your ability to not let him push you around. and lastly, he was known for trying to get in everyone's pants. he disgusted you. but he was on top of you on the professional scale, no pun intended. you wouldn't sink to his level. speaking of rick, he sauntered over to you and two of your interns, carly and ray.

"i'll be back, i gotta make a call," you said, referring to peter.

"oh dr. romanoff, i think you wanna hear this," rick bellowed.

"i really don't think i do."

"just wait up, please," he held out his hand.

"what?"

"so rachel and i," he said, gesturing over to rachel, a naïve nurse, "totally hit it off last night, if you know what i mean."

you scoffed, while carly and ray just looked disgusted, "really? that's what was so important? how bout your damn job, rick."

he laughed, that arrogant laugh, "i'm just messing with you sweet heart."

you shook your head, grabbing your phone from your pocket and started over to the on call room telling carly and ray you'd be back.

"jeez what's got her in a bunch?" rick asked.

"um i don't know maybe you?" ray snapped.

"whatever," rick said and followed behind you.

meanwhile in the on call room, you had peter on the phone, making sure your boy was okay.

"yeah, no, it stings a bit but, i'm feeling better."

"are you sure you're not lying," you said, genuinely worried about his well-being.

"yes sweets, i'm okay, i love you."

"i love you too pete, promise me you'll stay in?"

"i promise. so how's work?"

you were cut off by rick entering the on call room, crossing his arms and staring at you.

"um it's good, but hey i gotta go, call you later."

"love you!" peter said as you hung up.

"what," you snapped at rick.

"gosh, you're so tense."

"you make me tense."

"need some help with that?"

"not from you," you scoffed, heading towards the door to get back to carly and ray.

"wait up," rick said grabbing your hand, "look, i've got a patient, really complex case concerning the brain and i think you should take it."

"why not neuro?" you asked confused.

"because neuro is busy, i don't know. just please work with the family. you'll be good for them. no one else here is truly as calm and collected and makes a patient feel more safe than you. i swear, everyone falls in love with you by the time they are seen by you."

you smiled, for once rick had actually given you a genuine compliment, "thanks. so what's the case?"

"i know you like the brain, which is why you should go into neuro, but, it's a tumour. it's bad, they just came in today and i'm hoping you can do surgery within this week. it's urgent but we need to do scans and bloods before we can go through. we have to find out if it's even safe, and what type. they come from out of state, a small practice said he had a tumour."

"of course i'll take it. where is he?"

"peds wing."

"peds?"

"yeah, nine years old and terrified. you'll be the best for him."

you were shocked to say the least. NY Central Hospital didn't get many pediatric tumour cases. many went farther to other specialised hospitals. but you were willing to fight if it meant saving a helpless nine year olds life.

"okay. okay," you repeated yourself.

"thank you y/n. head up there asap."

rick dropped your hand finally and left. you took a moment to compose yourself before going to grab carly and ray.

"get ready kids, we're going to peds."

meanwhile, peter was at home, in bed, watching tv. he was so stiff and in more pain than he thought. but the last thing he wanted to do was worry you when you're already working a stressful job. he laid there in his boxers all morning so far after waking up. he managed to make some toast, though a little burnt. he wasn't hungry. he was in pain. his wound was a mess, constantly having to clean it and limping from room to room. he'd be fine though, he always was, right?

he was glad to talk to you though. when he saw your name appear on his phone, he smiled so big. he knew you'd call, he knew you'd worry. but he let you, a little. it was so good to hear your voice. he so wished you were here to just cuddle with him and make him feel good and make him great toast, but it was okay. you'd be home earlier than normal today. and he listened to you. and vowed to himself and to you that he wouldn't go out and possibly get more hurt.

he thought of you a lot when you weren't around. how he loved you so, so, so much. he wanted to spend the rest of his life with you. he felt like he already had. he would sleep and dream of you. he'd think about all the times that day he kissed or hugged you and how he just couldn't wait to do it again when you got home. he was passionate about you. he was proud of you. and again, he loved you so much. that was peter, a lover boy. ever since junior year of high school. still so whipped for you.

he decided to text you a sweet little message. he knew you were busy, but loved to do this so you'd have something to smile about on break. he smiled, grabbing his cracked phone off his nightstand and typed you a message.

'hey sweets. just thought i'd text you and say i love you. i cant wait to see you tonight and i wanna give u a big hug. i love you! oh and i'm gonna make us salads for dinner! or at least try! anyways did i say i love you? well, i love you.'

he put down his phone and tried to run to the kitchen, but in reality looked like a limping zombie, and grabbed some fresh lemonade out of the fridge. he was like a teenage boy, scared of your response, but you were literally living together. you loved him so much and he knew it. he brought his lemonade and his camera to the balcony in your apartment. it was such a beautiful day outside, warm and sunny. peter sat in just a pair of shorts because why not. he took pictures every now and then of helicopters or people on their roofs.

"hiya peter! how are ya?"

peter turned to the left to spot his elderly neighbor, mrs. dawson, on her balcony, about 5 yards away.

"morning mrs. dawson! i'm great, it's a lovely day!"

"sure is! where's the wife?"

"oh y/n? she's at work, and you know we're not married yet."

mrs. dawson just waved her hand at peter, "well you better get on with it, i'm waiting."

"i know, i know...i will."

this made peter think about the first time you met, tony jokingly telling you to go get married already, since you hit it off so well.

"y/n! come meet spider-man!" your sister yelled to you in the living room of the compound.

you jumped up, fully expecting a dorky grown man like the rest of the avengers, yet were shocked when you saw peter, your age.

"hi! i'm y/n romanoff, it's so nice to meet you! i wasn't expecting you to be a kid like me," you laughed, pulling him in for a hug. hugs were always your thing.

"i'm peter, parker peter. i mean, uh, peter parker. it's nice to meet you too. natasha has told me lots about you," he replied, blushing.

"awe, you're sweet," you said grabbing his hand, "lemme shoe you around some!"

"okay kids when's the wedding?" tony asked, causing natasha to laugh and you and peter to blush.

from that moment of junior year of high school, you and peter spent all your time together. he would come to your room at night if he needed to be patched up, or just for a hug, or cuddle. you would have sleepovers all the time it was almost obnoxious to the rest of the avengers. you started dating nine months after you meant. and though, you weren't an avenger. you didn't have powers or super strength, but you were family, so in a way you were an avenger. nat was all you had. no mom, no dad, just an older sister. what you didn't know was in your sophomore year of college, your sister would be gone. down at the bottom of a cliff on some planet called vormir, never to be seen again. that was when you decided to become a doctor.

"carly, ray, this is the peds wing. we have a brain tumour case, nine years old. let's go in and meet him."

you walked into the room where a young boy and his parents sat, worrisome looks plastered on their faces.

"hi, i'm dr. romanoff," you shook the parents hands, "and you must be benjamin?"

the boy nodded his head and shied away from you and your interns. you held out your hand for him to shake, and he did, softly.

"ray? would you?" you asked, gesturing to his chart.

"benjamin wallace, nine years old, from new jersey. pronounced tumour in the brain by a private practice, undiagnosed, but appearing to affect him at large, that's all we got."

"okay, thank you," you said, sitting down on the bed next to benjamin.

"hi buddy, first thing we are gonna do is pretty cool! you're gonna lay on a bed and we will give you headphones to watch a movie while we take pictures of your brain, and i can show you them afterwards if you want," you smiled and the boy nodded.

you looked to the parents, who looked a little calmer now, "we will do an mri and maybe a cat scan. we will find out what's wrong."

you stood up, while the parents agreed that was a good plan, "this is carly and ray, my interns, they will be helping out a lot. carly, wanna order the mri, urgent please?"

"of course," carly smiled and waved to benjamin and walked out to the nurses station.

again, you turned to the parents, "so how do you know he has a tumour? or moreso the doctor you saw?"

"this jersey doctor did an x-ray," the mom explained, "and he said he saw something bad and it was a tumour. he told us to come here or go to a hospital in maryland so we can here. we honestly don't know what to do now, or what to believe, it was all sudden, but he has a lot of symptoms."

you thought for a moment, biting your lip, "interesting...well you and benjamin are in good hands. we are gonna take care of him and find out what's wrong."

"thank you, thank you so much."

"of course mr. wallace. nurses will be in shortly."

you walked out of the room, ray following close behind, "this is weird right?"

"sure is. it's hard to tell a tumour is there on an x-ray, unless there's severe skull deformity, but, we are gonna figure it out."

all of a sudden you were paged to the ER as well as carly. you two rushed there, and found a car crash victim on a gurney.

"what am i seeing," you asked.

the paramedic just said, "crash victim, he's obviously drunk, asked for your carly and saw she's under you."

"dad?"

"what?" you asked turning to carly.

"hey! i knew you'd be here. wanna operate on me carly?" the man asked, drunkenly slurring his words.

"sir, i don't think you need to be operated on," you said.

"dad what happened?"

"well i got in a car crash, fix me up already. i think i'm getting feverish and i could use another drink."

"carly, you cant be here, go back upstairs please, i've got this."

"but it's my dad."

"and you know the rules. go."

carly took a last look at her dad before storming away.

"let's get ortho down here!" you yelled.

you came home later than expected that night, you did however receive peter's lovely text and it made your day a little better, especially having to operate on a pedestrian that carly's intoxicated dad hit, as well as a bike accident victim later in the day. benjamin's scans were delayed due to carly's reaction to her father, you didn't get to read them and would have to wait till the morning due to the scans being rescheduled. but coming home to peter at 7 pm made you feel a little better.

you walked in your apartment dropping your things off at the door and hanging up your white coat. peter was in the living room laying on the couch in nothing but his shorts, as he was all day. he peeked his head up when you walked in however. he got up and limped over to you with outstretched arms.

you tilted your head at him, "pete, what's going on with the leg? you limping?"

"what no," he stood in front of you, arms still up, "hug please, i missed you sweets."

you obliged and hugged him tightly, glad he was still okay and in your arms, but worried about the limp.

"i missed you too. how was your day?"

"oh just sat outside and talked to mrs. dawson and watched lots of tv, made burnt toast and missed you."

you kissed the side of his head, "i can tell."

"so dr. romanoff how was your day? you feel tense."

"i am, and gosh it was a long, stressful day."

"then let's not talk about it," he said pulling back from the hug, "c'mon let's go eat salad in bed, watch some tv, and i'll give you a massage just because we can."

you grinned, "okay, but let me get the salad ready, i'm supposed to be taking care of you my stab victim."

"hey!"

you laughed, "just go."

peter waved you off and limped away, turning on the tv and jumped into bed. you kicked off your shoes and got the premade salads out of the fridge, bringing them to the bedroom.

"mmmm, thank you babe," peter groaned. he leaned up to give you a nice kiss on the lips.

you nodded, placing yours down on the nightstand and going into your wardrobe to get a tank top and sleep shorts then took a quick shower to wash away the day. you got changed and joined peter in bed to eat your salads.

"you look so pretty."

you scoffed, "i'm wearing a white tank top with a ketchup stain on it from last month and my hair is tangled and i'm sore and have bags under my eyes."

"still beautiful. or should i say insanely hot?"

you flicked him on the shoulder, "such a tease."

you two ate your salads in bed while watching tv and it was honestly so relaxing. you didn't rerun through your day and stress yourself out more. you were just with your love. and when you finished eating, peter offered to take the dishes to the kitchen, much to your dismay. but when he got up, he seemed to be limping a lot less. and you would definitely take a look at that wound later. he came back in with a smile on his face.

"sit up sweets, i'll give you a massage."

you did what he said and he crawled into bed just behind you and put his hand on your shoulders gently. he started to rub out all the knots and stress. you were so tense today, from worrying about him, to your new patient, to your surgeries.

"that feels great," you sighed.

"good, you deserve it."

he continued rubbing your shoulders and traced his fingers down your back, leaning in to give you a kiss on the neck. it was unexpected and made you shudder, but eventually you melted into him.

"pete be careful."

he pulled back, "don't worry i am, not gonna leave any noticeable marks."

"pete," you demanded.

"i'm kidding, i love you. go to sleep babe."

"m'kay. love you too, so much."

you leaned into him and flopped over onto your side of the bed. he enveloped himself around you, making you warm and cozy and you instantly dozed off. peter loved you insanely much. he dozed off with a smile on his face, arms around you, after kissing your head.

[archerwindsor]

Is Diet Coke Bad For You?

Seriously, we have been accused of being sponsored by Coca Cola before by someone who didn’t like it when we said that it’s not that bad for you. There’s the cat out of the bag already.

Why something so insignificant as a can of juice can command such hatred and why it’s the cause of many a hot debate is….well, quite frankly, bizarre.

Anyway, let’s get into it – is diet coke bad for you?

Listen to some and they’ll have you running to the hills with fear. You may have heard:

Diet coke causes cancer

It tricks your body and turns on fat-storing-mode

All diet drinks deplete nutrients and make you hungry

It’s filled with chemicals therefore it’s pretty much poison

Diet coke is the cause of all things evil, should be banned and how dare you, a nutritionist, say that it shouldn’t be outlawed

Now, before anyone gets even more worked-up and accuses us of saying it’s ‘healthy’ let’s get a few things straight.

There are a lot of myths surrounding the drink that are simply just a load of nonsense. This article is going to clear the confusion. What does the evidence say about diet drinks?

Also, just to clarify, before anyone drops the usual “this is sponsored by Diet Coke” no it isn’t. Pepsi Max or Diet Irn Bru are much better anyway…..

Is Diet Coke Bad For Your Health?

Probably not that bad at all.

There are no studies that indicate any long-term health risks from drinking diet soda. Diet Soda….is not harmful to health, well-being, or body composition ~ Examine.com

So far, so good for the coke zero and diet coke fans.

There are no studies that indicate any long-term health risks from drinking diet soda. Click To Tweet

What about the cancer risk?

Back in the 60’s, there was a study that linked aspartame (the sweetener in diet coke) with brain tumours but more recent evidence has proven that this isn’t the case and that there is no link between diet drinks and cancer.

A review paper in the Regulatory Toxicology and Pharmacology Journal concluded that:

…the studies provide no evidence to support an association between aspartame and cancer in any tissue…..the weight of scientific evidence confirms that, even in amounts many times what people typically consume, aspartame is safe for its intended uses as a sweetener and flavor enhancer…..

What About The Chemicals?

A post shared by Scott Baptie (@scottbaptie) on Aug 14, 2017 at 3:57am PDT

My buddy said aspartame ingestion produces methanol and formaldehyde.”

Yes, that’s formaldehyde as in the stuff used to preserve dead bodies.

Whist it is true that aspartame is broken down into methanol (which is then converted into formaldehyde), as well as two amino acids, phenylalanine and aspartic acid – it is extremely unlikely to be detrimental to health.

Why? Well, the key is in the dosage.

Just because something has chemicals in it does not mean that it is harmful. Whether a chemical is natural or man-made doesn’t tell you anything about how toxic it is.

There are many naturally occurring chemicals in plants that are extremely toxic to humans in small amounts. On the other hand, there are many man-made chemicals that are totally harmless to us, even when consumed in large quantities.

Toxic fruit?

There are fruits and vegetables that everyone agrees would be classed as ‘natural foods’. However, many contain compounds that have been shown to be toxic to humans. The good news is that the dose is so small that you would never be able to eat enough of them for it to be harmful.

Just because something 'contains chemicals' doesn't mean it's automatically unhealthy. Click To Tweet

Semi-skimmed milk, for example, contains 6-9x more phenylalanine and 13x more aspartic acid than a diet coke. Tomato juice also has 4-6x more methanol than a diet coke too.

The air you breathe has chemicals in it, then you use that oxygen and that forms chemicals within you. The water you drink is a chemical and then you use it to form more chemicals; all of the carbs, protein and fat you eat are products of chemical reactions and then you use them in chemical reactions in your body.

Finally, formaldehyde is produced by our bodies every day in amounts thousands of times greater than you would ever get from aspartame. It is actually needed to make essential compounds, including your DNA. Source: Academy of Nutrition and Dietetics

Here’s another example of why dosage is key and just because something “contains chemicals” doesn’t mean it’s automatically unhealthy. Apples, cherries and apricots all contain the poison cyanine!

[Related: Toxins, Diet Cokes, Pseudoscience & Fighting The March Of Unreason]

Do you avoid them for this reason? No, because the dosage is insignificant. Ever heard of apple eaters dropping like flies with cyanide poising, no, of course you haven’t.

Anyway, back to diet coke…

Does it get the thumbs up? No so fast, your dentist won`t be a fan.

One thing to mention is that diet drinks, although sugar free, may not be great for your pearly whites.

Studies have shown that carbonated drinks aren’t great for tooth enamel, which is one reason why you may not want to go overboard with the coke zeros.

So far, according to the science, diet cokes aren’t bad for your health. But…

Is Diet Coke Bad If You’re Trying To Lose Fat?

Let’s get something straight, weight gain and weight loss is determined by calorie balance (calories in vs calories out):

A fundamental principle of nutrition and metabolism is that body weight change is associated with an imbalance between the energy content of food eaten and energy expended by the body to maintain life and to perform physical work” ~ Am J Clin Nutr

A drink that contains zero calories cannot cause you to gain weight. It’s physiologically impossible. There is no evidence that shows drinking diet drinks will result in fat gain.

A drink that contains zero calories cannot cause you to gain weight. It’s physiologically impossible. Click To Tweet

Some studies have actually shown that sweeteners may even improve weight loss and long-term control of body weight.

How can this be? Ever had a sweet tooth? Of course you have. Sometimes artificially sweetened foods, although unlikely to serve any nutritional benefit can eliminate sugar cravings.

If a zero calorie diet coke is the “go to” instead of a 300 calorie chocolate bar, it doesn’t require an expert to explain why this is going to make a difference to the waist line.

[Related: 11 Ridiculous Myths About Fat Loss]

Overweight Folks And Diet Drinks

Now some studies have shown that people who are overweight or obese drink more sugar-free drinks than people who are a healthy weight.

But is the diet coke to blame? Unlikely.

These studies have also shown that the overweight people – who were drinking the diet drinks – had a much higher calorie intake than those who didn’t.

What’s more, people who generally have poor diets may also be more likely to drink diet drinks to offset the high amount of calories consumed by making poor food choices.

Although overweight people may drink more diet drinks, the diet cokes are unlikely to be the cause of the problem. This is a classic example of why correlation does not equal causation. Here’s another example:

In America, in summer, people eat more ice cream. More people also get eaten by sharks in America, in summer..

One does not cause the other, ice cream does not cause shark attacks, just like Diet Coke doesn’t cause obesity.

Ice cream does not cause shark attacks, just like Diet Coke doesn’t cause obesity. Click To Tweet

Does Diet Coke Increase Heart Attack And Stroke Risk?

An observational study published in February 2019 reported that people who drank diet drinks were more likely to suffer from heart attacks or a stroke.

However, because the study was observational it just looks at associations or links between the participants, rather than directly showing that diet drinks increase heart attacks or strokes. It also doesn’t actually explain why diet drinks might be linked to an increased risk. Follow?

Just like in the section above about overweight people drinking more diet coke, the folks more at risk of heart attack or stroke, due to other lifestyle factors, could be drinking more diet drinks in a bid to be healthier or manage their weight.

Lastly, the British Heart Foundation are still are happy with the safety of sweeteners and recommend them over a full sugar drinks every time.

Wait, Does Coke Trick Your Brain?

You’ve heard this one before too, haven’t you? That diet coke tricks your brain that it’s actually sugar.

The argument often centres around insulin (a hormone which plays a key role in the regulation of blood glucose levels). You’ll get folks that say that diet coke causes an insulin spike which results in weight gain.

Again, if you look at the evidence, this doesn’t happen in healthy humans or even in diabetic patients.

Diet Coke Can Clean Coins, So It Can`t Be Good!

The logic applied by some, is that if diet coke can clean coins, it can`t be good for your insides, which seems reasonable.

Other cleaning-related uses for diet coke are that it is good to clean rusted battery terminals, clean toilets and polish cars. The old favourite is that traffic police apparently carry two gallons of coke in their car boots to remove blood from the road after a car accident.

Here’s the deal.

Fizzy drinks contain carbonic acid which make them good stain removers.

Guess what? Plain old fizzy water or soda water does exactly the same thing. It isn’t anything mythical or chemical about the diet coke that makes it a good cleaner. It’s simply the carbonic acid.

Folks have been drinking fizzy water for years with no side effects and again. There is zero evidence that shows moderate consumption is detrimental.

Finally, the gastric acid in your stomach is far stronger than any acids found in fizzy juice anyway.

The Round-Up: Is Diet Coke…or Any Diet Drinks Bad For You?

Diet drinks aren’t ‘healthy’ but there isn’t really anything particularly ‘unhealthy’ about moderate consumption of them either.

If weight loss is the goal then swapping from a regular fizzy drink to a diet drink is probably going to be beneficial. If you’re a fizzy juice fiend then switching from three normal cokes to three diet cokes would cut sugar intake by around 90g. This will reduce calories by almost 400, which will likely help your waist line and you can do so knowing that the evidence shows that it’s safe to do so.

Similarly, if you’re often dehydrated and you find you can’t keep your fluids topped-up because you find water a tad dull then a slash of no-added sugar squash may make drinks more palatable and as a result, improve your hydration levels.

On the other hand, if you currently don’t drink diet coke and you’re perfectly happy with water, teas and coffees and so on then there certainly aren’t any health benefits to be had from diet drinks, you’re not missing anything.

It`s up to you what you drink but plain old water is still our favourite!

What do you think? Do you drink diet coke or do you avoid it? Let us know in the comments section below.

The post Is Diet Coke Bad For You? appeared first on Food For Fitness.

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[ableaustralia-blog]

MY DIAGNOSIS STORY, PART I

Multiple Sclerosis, Clinically Isolated Syndrome or Complex Chronic Migraine?

You may have heard that multiple sclerosis affects everyone differently and when you add that into the complexity of diagnosing neurological disorders and diseases, the diagnostic process can become very confusing and downright stressful for the patient. My diagnosis story is still continuing and is extremely complex but I wanted to take the time to share it with you because if I had been able to find more information on Clinically Isolated Syndrome MS then I feel the process could have been less stressful for me. Most of the information you do read about CIS MS is that it’s fleeting, you are supposed to have one episode of symptoms that resolve and that is a classic presentation of CIS. However it is not always that straight forward and I am living proof of that,  I know I am not the only one. Here is my story.

It began in September 2016. We had just moved out of our first family house and were staying with my in-laws temporarily until our interstate move that we had planned for January 2017. It started over a few weeks of getting some headaches, I just put them down to drinking too much coffee to finish my work deadlines. At first the headaches were mild, just enough to cause irritation. Then they began to become more of a problem and I started taking some painkillers. I was just writing them off as not drinking enough water and all the normal causes. Until finally, I was working one day and by about lunch time the pain was becoming more intense. I decided to leave early, I picked the kids up and headed home. I remember driving and every noise my kids made was like someone was stabbing me in the brain. I also remember driving and thinking I don’t even know if I should be driving. By the time I made it home, only a half an hour drive mind you, I had tears rolling down my face from the pain. I stumbled through the door with the kids, then headed straight to take some painkillers and lay down. Luckily my husband was home early from work and he immediately called the doctor. I remember saying to him, it’s fine I’ll just take something for it. He describes this whole scenario as me falling through the door like I had been shot. And that was the start of the full blown, debilitating chronic migraines that I suffered for nearly 10 months straight. We are talking 3-4 migraines per week, most of which lasted 2 days so pretty much a constant of migraine or on a good day, bad headache. Once my husband arrived with me at the doctors, they immediately ordered me an MRI for the next day. At this stage, I simply just thought I was having bad headaches and they were doing the MRI to rule out anything sinister. Secretly I was terrified though, my father died from a brain tumour. Even though they aren’t hereditary, it was still a terrifying prospect. So the next day, I went in for my MRI.

There is something about the very first time in that tube that is completely overwhelming but honestly this first one, I think I was kind of numb. I don’t remember thinking anything was actually wrong but more that this was one of those routine rule-it-out type scenarios, maybe it was just denial. It wasn’t until I got a call from the doctor after hours and they asked me to come down right away. I knew something was wrong but I just had no idea what. “Several T2/FLAIR hyper intense foci within the deep white matter of both cerebral hemispheres have a periventricular distribution with at least one juxta cortical lesion in the right frontal lobe and two periventricular lesions (right peritrigonal and left occipital region), suspicious for demyelination. No diffusion restriction to suggest the presence of active plaque or recent ischaemic event. Further imaging of the cervical and thoracic cord recommended to assess for further plaques.” The doctor explained that the most common cause of demyelination is MS. To be honest, I don’t really remember what he said after that. I think that’s the shock part kicking in. What I do remember is this one big white spot, there was other smaller ones but the one big one was what worried me.

When I got home, my husband asked what the doctor said and I just burst into tears. I couldn’t even say it at first. There was a lot of tears that night, I tried to stay composed but I just couldn’t. I was terrified, mostly because of the uncertainty I think. I remember trying to get it together to call my Mum and as soon as I heard her voice, I pretty much blurred out “lesions on the brain” to which she had a meltdown and we had to call each other back once we calmed down. I do remember at first we thought of lesions like little masses or tumours which is why my Mum didn’t cope at all. Boy, did I google the hell out everything in that report. Everyone says you’re not supposed to google with these types of things but for me, information is power. I wasn’t trying to diagnose myself but I was trying to understand what they were looking for. Understanding the diagnosis process was helpful to make the whole thing a little less scary. Definitely working out that the lesions were not little tumours was a big relief.

I was sent for a C-Spine MRI the next day. I was scared now. I had a nasty migraine this time. The whirring and banging was absolutely agony and every time I shut my eyes, I would get the most intense vertigo which meant that I had to keep my eyes open this time. I don’t know if you’ve ever had an MRI before, but for me the key to surviving them is shutting my eyes and trying to pretend I’m somewhere else. So having to keep my eyes open for this one when I was already feeling scared and sick was not ideal at all. By the time I came out, I got intense vertigo when I sat up and it took me awhile to be ready to leave. This MRI was done late on a Friday afternoon, we then got to wait three days before we could get the report on Monday afternoon. My C-Spine results were clear. While this was amazing news, it also made everything very confusing because now it became a case of “Is it Multiple Sclerosis?” I was then referred to a neurologist. I was absolutely terrified about what was going on with my body, I could feel the changes. When I say that, I’m not just talking about the symptoms - it was bigger than that. My entire body just felt different, like I just wasn’t myself anymore. All I know is I wanted to get to the bottom of it, I needed answers. So I booked in with a private neurologist rather than waiting for one in the public system. I began writing everything down, every little thing I noticed going on. The list got pretty huge pretty fast. I was getting severe headaches daily and the fatigue was starting to really kick in.

About five days before my neurologist appointment, I got what I would describe as really severe restless legs one night. It was like a tingling and burning sensation, my legs were so unsettled that I couldn’t sleep. Little did I know, that feeling wasn’t going to go away. I woke up the next morning with pins and needles through both of my legs. I also started to experience some numbness in my lips. Later this day, I was driving and was in a situation where I needed to use breaks relatively fast. It was almost like my foot had a tremor, like I told my foot to put the break on and it didn’t respond. Luckily at the last second it did and I was okay. I remember driving straight to the doctor and being completely freaked out. The doctor didn’t really understand what I was saying and to be honest, I think he thought I was overreacting. I also told him about the leg pain the night before and the continuing pins and needles which still hadn’t gone away. I remember him telling me that it doesn’t necessarily mean anything unless they don’t go away. I walked out of the doctors office and just cried from frustration. I knew something was going on but it was so incredibly difficult to explain it all. I actually felt crazy. The next day I woke up and the tingling had moved to my left arm and was still in both of my legs. I also started to experience some tingling across my head, muscle twitches and I started to notice I was becoming quite clumsy.

It was time for my neurologist appointment. My sister in-law came with me to my appointment. I am so glad that she did. I highly recommend taking someone close with you to your first appointment. It’s such a huge amount of information to take in. The main thing I remember from the appointment is that all that feeling crazy went away. The neurologist took me seriously. She went through all the notes I had been taking and she understood when I was trying to explain the weird things that were happening. From the outset, she was convinced it was MS but explained that there wasn’t “enough” on my brain to confirm that it was MS. She basically explained that we would need to wait for more to happen on my MRI to confirm it but based on my symptoms and my neurological exam, she believed we were dealing with MS.

“The key requirement for a diagnosis of MS is evidence of damage to the central nervous system that is disseminated in time and space. This means showing that damage has occurred at different dates (DIT) and to different parts (DIS) of the central nervous system. This distinguishes MS from other neurological conditions.”

Read more about diagnosing MS at https://www.mstrust.org.uk/understanding-ms/diagnosing-ms

So at this stage, I don’t fit the McDonald Criteria for MS as I have only one attack (the current one they are seeing me for) and I only have damage to one part of my central nervous system. Now it’s really a matter of ruling out all other possible conditions and waiting for another attack to show up on the MRI. She scheduled another MRI and a massive amount of blood tests to help in ruling out other circumstances. The bloods included liver enzyme tests, rheumatoid factor, C3 & C4, ANA, CRP, ESR, ENA, dsDNA, ANCA, TFT, Folate, B12, TPO antibodies, Varicella Zoster & Vitamin D. She also explained that we could do a lumbar puncture but they can be really nasty especially for people with migraines and my age so she only wanted to do that if it was totally necessary.

Over the next week after my appointment, I started experiencing some new symptoms including extreme heaviness in my legs, full blown fatigue (couldn’t stay awake) and brain fog. The tingling had moved into my face, across the top of my head and through both arms. I started to get crawling sensation across my legs to the point where I would have the check I didn’t have bugs on me. I would get this really strange sensation where I would get shivers on the left side of my body only, literally could draw a line down the middle of my body and the shivers were only on one side. My vision would get quite blurred at times and I started to experience pain behind my eyes. I also started to get what I would call tightness in my chest and sharp stabbing pains in between my shoulder blades but I now know that it was the MS hug because I still get it regularly. I started to get more physical symptoms such as feeling weak, shakiness and feeling stiff when walking. I started to get stomach issues such as cramping, bloating and diarrhea which was definitely from the copious amounts of pain killers I was taking but when I tried to just take panadol, it didn’t even touch the sides.

About ten days after my appointment, I had my follow up MRI of both brain and c-spine which was about a month after my first MRI’s. My follow up appointment with the neurologist was about two weeks after the MRIs. The MRI had some minor changes but not enough to reach a diagnosis. The neurologist conducted a nerve function test which was clear and meant I didn’t have peripheral neuropathy causing the nerve issues. She commenced me on Endep to try and get my migraines under control and a migraine plan of attack. Take x and x for mild headaches and so forth. She also gave me scripts for migraine meds and a stomach protector to take alongside the nurofen. We decided to go ahead with the Lumbar Puncture in hopes that it might have some answers.

As I was seeing a private neurologist, I had to organise my Lumbar Puncture as an outpatient with the private hospital. It was done in an X-ray room and was done by guided X-ray but that still didn’t help. This was the most painful experience. Many people talk about not feeling anything when they have a Lumbar Puncture done and I was hoping for that outcome. The doctor doing my procedure, struggled to get enough fluid and had to move the needle several times. Every time the needle was moved, I had the most intense and painful electric shocks from my spine down to my toes. It was absolute agony. Then I was kept for two hours laying flat which they do to avoid you getting a post Lumbar Puncture headache. I felt a bit dizzy but mostly okay when we left. But within about two hours of getting home, I started experiencing literally the worst headache of my life. The only way I could alleviate the pain was to be laying down.

“Spinal headaches are caused by leakage of spinal fluid through a puncture hole in the tough membrane (dura mater) that surrounds the spinal cord. This leakage decreases the pressure exerted by the spinal fluid on the brain and spinal cord, which leads to a headache.”

We went straight to the hospital, where I ended up staying for about 5 days. There was discussion of a blood patch but it was decided that the risk of making it worse was too high. I did make a fully recovery without intervention but it took about 7 days before I could sit upright again but once I could then it resolved very fast. When conducting a Lumbar Puncture for MS diagnosis, medical professionals are looking for oligoclonal bands (which is an indication of inflammation) in the spinal fluid and compare them to bands in your blood. If there are different bands in your spinal fluid and your blood then you may have multiple sclerosis.

I had a follow up appointment with my neurologist a few days after this so she could check up on me after the LP complications and also give me my results. The end result of my Lumbar Puncture was that there was a significant amount of blood in the sample and it wasn’t conclusive enough for a diagnosis. However given the severity of my symptoms, they were getting worse everyday and the appearance of my MRI lesions. My neurologist decided to start treatment for multiple sclerosis, she explained that she was 90% sure it was MS but just didn’t have the clinical findings to fully prove it yet. At this stage, it would be Clinically Isolated Syndrome Multiple Sclerosis, at least until a second attack happened. She wanted to start the safest of the MS treatments, Copaxone because it doesn’t suppress the immune system and therefore wouldn’t cause significant problems if it turned out to be another condition causing my symptoms.

My symptoms included:

Chronic Migraine & Headaches

Severe Fatigue

Pins & Needles - in different areas of my body at different times

Altered Sensations such as crawling, shivering and feeling like you have water running down your legs

Heat Sensitivity

MS Hug - like a band of tightness around chest and I also experience stabbing pain between the shoulders when I get the MS hug

Nerve Pain - Shooting pains in my arms & legs

Muscle Twitches & Stiffness

Blurry Vision

Tinnitus (Ringing in the ears)

Vertigo

Brain Fog

I started Copaxone and then around two weeks later, the tremor in my hands started. Alongside the tremor, I became significantly more clumsy too. For such subtle symptoms, it actually terrified me. Something about this affecting my hands really scared me as to what the disease is capable of. I remember feeling crazy like I was overreacting but I knew something wasn’t right so I kept taking my notes for my neurologist. The hand tremor continued for a few days and the nerve pain was becoming more severe despite the Endep prescription being increased, I was on 25mg at this stage. I called the neurologists office and went back for a follow up.

At this follow up she ordered another MRI, to try and “catch this” on the scan. Also I have had sensorineural hearing loss (damaged hairs on my cochlea) since birth but given the severity of the tinnitus alongside the other symptoms, my neurologist ordered a hearing test to check if any changes had happened to my hearing to help rule out other possible neurological conditions that could affect hearing too. My hearing test was all clear but something crazy happened during the test, while in the isolated room and listening for the specific sounds - they set off really intense vertigo and even the audiologist couldn’t explain it. The brain is such a fascinating thing and when it’s not working properly, some crazy things really start to happen. I went for this next MRI on the 22nd December, good timing eh? But to top it off, my family and I were all packed and ready for our interstate move right after Christmas. Being the impatient person that I am, I went back to the hospital where I had the scan and picked up the report the day after the scan!

“Five-six lesions within the brain in a typical location for demyelination which would be in keeping with Multiple Sclerosis. Probable one new lesion seen just in the left centrum semiovale region posteriorly, otherwise relatively stable appearance”

Merry Christmas, you’ve got Multiple Sclerosis.

The interstate move, the stress of the diagnosis and the heat of Australia summer (I think it was around 35-40 degrees at this time) really knocked me around. I ended up taking myself to hospital a few days after the move. They really didn’t take me very seriously at all and they attributed everything to heat and dehydration although IV fluids and stemitil they gave me did nothing. I felt extremely frustrated and helpless but I just assumed that this was life with MS and that you just had to deal with it. At this stage it was mostly headaches, the other symptoms seems to have calmed down a little. So I just pushed through, I took mountains and mountains of paracetamol and ibuprofen over that following month.

Then all the symptoms came back with a vengeance but the pain was worse, I had pain behind my eyes and the migraines and headaches were out of control. We are talking daily migraines, painkillers every four hours and completely not functioning. My balance was really off, my hand tremor was back, nerve pain, brain fog, muscles twitching and blurry vision. After a week of this pain, I had no choice but to go back to the hospital. They increased my Endep dose yet again, now I was on 50mg. I was also given a script of Endone to help me get through the pain until the new Endep dose kicked in. I had a follow up appointment with the MS clinic at the hospital a few days later and they scheduled an MRI Brain & C-Spine. Over the next three days, the pain kept intensifying. It got to a point that 6 paracetamol, 6 ibuprofen, 2 rizatriptan and 2 endone still didn’t take the pain away. After a very restless night of pain, I woke up with a blind spot in my left eye. So off to hospital I went again, at first the neurologist who examined me essentially said he wasn’t even sure if it was MS and I’m not if it was terrible bedside manner but he essentially blamed it all on stress around the diagnosis. I didn’t realise at the time how huge an impact stress can have on chronic illness so it really upset me to be made to feel crazy yet again. Despite all this, I was admitted for further testing.

The head neurologist ordered a whole battery of tests to essentially come up with his own diagnosis despite the report I had received. The first eye test confirmed that it wasn’t optic neuritis but that the blind spot was there. They took me off the Endone as the head neurologist said it would only be making my migraines worse and cause rebound headaches. I was still really unsteady on my feet, I could barely hobble from the bed to the bathroom. Over the next few days, they conducted some more complicated tests on my eyes, I lost count of the blood tests and they also gave me an MRI with contrast. The scan showed no changes from the scan in December. They summarised that the eye issues and the balance issues were caused by a flare up of my chronic migraines but not a flare of my multiple sclerosis. “I didn't realise that you could have a flare of chronic migraines that made MS symptoms worse but I'm really glad it wasn't a relapse and MS appears stable”. To be honest, my neurologists have been quite elusive about my diagnosis throughout the entire process and guess that is because multiple sclerosis diagnosing particularly in the early stages is extremely difficult. They explained to me that since my lesions are fairly minimal and that I commenced Copaxone so early in the diagnostic process which would ideally halt it’s progress but also halt further relapses and as such delay definite confirmation of the disease if it was working.

If you are going through a diagnosis at the moment, I hope my story has helped you. Multiple Sclerosis is such a tricky disease to diagnose, it presents itself in so many different ways and can be incredibly confusing to understand in the early days.  I would love to hear your diagnosis story, please feel free to share in the comments below. If you’re struggling with getting a diagnosis, please feel free to reach out to me as I know how agonising the process can be. Please stay tuned on my Instagram as I will be sharing where I went from this stage of the diagnosis, how my symptoms progressed and what triggered me to begin my healing journey.