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jcsmicasereports · 1 month ago

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Acute Myeloid Leukemia In Pregnancy: Difficult Journey From Diagnosis To Delivery And Treatment by Vina Kumari in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

The incidence of Acute Myeloid Leukemia in pregnancy is about 1 in 75,000 to 1 in 100,000. Owing to the therapy attributable risks to mother and fetus, the management of AML in pregnancy is very challenging, both for the parents and the medical fraternity. Furthermore, the diagnosis of leukemia in pregnancy is very difficult owing to vague presenting symptoms like fatigue and weakness which are confused with physiological changes during pregnancy.

Case Report: Primigravida, 33 weeks 6 days gestation age, with history of weakness and fatigue for 15 days and fever, cough and cold for 3 days was referred to our hospital with blood reports of raised total leucocyte count. The lab reports showed thrombocytopenia, anemia and leukocytosis with increased circulating blasts in the peripheral smear. As she was in her third trimester, plan of induction of labor and delivery followed by chemotherapy was taken. She delivered a live healthy baby. Post-delivery, she was advised chemotherapy. She had an immediate remission after the chemotherapy. The disease relapsed after 10 months and she succumbed to the disease due to unavailability of facilities during the COVID pandemic.

Conclusion: AML during pregnancy is rare. There is no fixed protocol for management of AML during pregnancy .The aim of management should be to take care of the initial concerns regarding fetal well-being according to gestation age and commence chemotherapy as soon as possible. This would give the best survival chances to the mother.

Keywords: Acute myeloid leukemia, pregnancy, chemotherapy.

Introduction

The association of leukemia and pregnancy is very rare, rather under-diagnosed and sparsely reported. The prevalence based on diagnosed and reported cases is one in 75,000 to 100,000 pregnancies. Most of the leukemias diagnosed in pregnancy are myeloblastic.

Acute myeloid leukemia (AML) is characterized by excessive proliferation of blast cells of myeloid lineage. This results in hematopoietic insufficiency like anemia and thrombocytopenia. The symptoms are related to complications of the pancytopenia, such as infections or hemorrhagic diathesis. The mentioned initial symptoms of leukemia in pregnancy are easily attributed to physiological changes related to the pregnancy and hence are either missed or diagnosed late. We report a case of Acute Myeloid Leukemia in a pregnant patient, its management and outcome.

Case Presentation

18-year-old primigravida presented at 33 weeks 6 days gestation. She was referred with history of weakness since 15 days and fever, cough, cold since 3 days associated with raised leucocyte count. She belonged to low socioeconomic status, was unbooked and had two antenatal visits during her pregnancy. She visited the facility when she had symptoms of gross weakness.

Her first trimester was uneventful. She was registered at a local hospital but was not compliant. Dating scan, trisomy screening and anomaly scan was not done.

On examination, her pulse rate was 88, blood pressure 100/60, respiratory rate 20 per minute, and temperature 99 degree Fahrenheit. She was pale but there was no jaundice, icterus or edema. She had angular stomatitis, and glossitis indicating malnutrition. Lymph nodes were not palpable.

On per abdomen examination, Uterus was relaxed, 33-34 weeks size and fetal heart 143/min. Ultrasound showed a single live fetus in cephalic presentation with effective fetal weight of 2.4 kg and liquor 12.7cm. Placenta was in upper posterior position. The fetus had overdistended urinary bladder with hydronephrosis of fetal kidneys suggestive of bladder outlet obstruction. Moderate hepatosplenomegaly was present. She was moderately anemic with hemoglobin of 8.3 gm/dl. The leucocyte count was very high 2,66,000/cu mm with neutrophils 4, lymphocytes 1, eosinophils 1 and basophils 1. The blood picture showed marked leucocytosis with blasts cells predominating 86% and 2 myelocytes and 1 metamyelocyte. The blast cells typically showed large nuclei, opened up chromatin, prominent nucleoli and cytoplasmic blebs. This picture raised the suspicion of Acute Myeloid Leukemia in pregnancy. Her platelet count was 96000/cu mm. LDH was raised 995 U/L signifying cell lysis. Liver enzymes were also borderline raised. Dengue serology was found negative. Her blood group was O negative. Serum Creatinine - 1.05 mg/dl and Serum uric acid - 10.9 mg/dl were also raised. The blood picture thus indicated towards normochromic normocytic anemia, thrombocytopenia and leukocytosis. On further examination of the peripheral blood smear, a leukoerythroblastic formula was noted with the presence of predominant blast population (86%).

Peripheral smear showed mostly Monoblasts (red arrow), promonocytes (green arrow) and few myeloblasts (blue arrow) under the oil immersion object 100 X, Leishman stain.

Monoblasts are large cells with abundant cytoplasm, moderately to intensely basophilic, scattered fine azurophilic granules, round nuclei with lacy chromatin and one or more large nucleoli.

Promonocytes have moderate cytoplasm, less basophilic, granulated with occasional large azurophilic granules. Vacuoles are more irregular. Nuclei are delicately folded.

Myeloblasts have large nuclei, fine chromatin, 3-4 prominent nucleoli and few Auer rods in the cytoplasm.

In view of suspected Acute Myeloid Leukemia, she was advised Bone marrow aspiration, biopsy and immunophenotyping, flow cytometry and translocation (15:17) study by oncologist.

The obstetrical examination was normal. All cardiotocographies were reactive. She was started on IV antibiotics, Inj Ceftriaxone 1 gm IV BD and steroids, Inj Betamethasone was given for fetal lung maturity. In view of malignancy with pregnancy, the case was discussed in tumor board on 10/9/19 and a decision for delivery followed by chemotherapy was taken.

She was induced with one dose of intracervical dinoprostone gel following which she went into labour and delivered live baby 2.8 kg weight with good apgar. The baby was shifted to nursery in view of premature delivery and mother was planned to transfer to medical oncology department for Induction chemotherapy.

Repeat investigations three days after delivery, haemoglobin decreased to 7 g/dl, TLC increased to 3,81,000 cells per cu mm with neutrophils 2, lymphocytes 5 and myelocytes 5. The abnormal blast cells had increased to 88% and platelets decreased to 21000 per cu mm (TABLE 1). Serum creatinine also increased to 1.43 mg/dl and e-GFR decreased to 54 ml/min/1.73 m2, indicating compromised renal function. The peripheral picture showed mostly agranuloblasts with moderate to scanty grey blue vacuolated cytoplasmic nuclei showing convolutions and 1-3 nucleoli occasional myelocytes, metamyelocytes seen, findings in favour of Acute myeloid leukemia (M4/M5). On myeloperoxidase staining, only 40 % took up the stain indicating AML-M4 lineage. She was transfused with one packed cell and one single donor platelet, following which her condition improved. She was transferred to medical oncology ward where she received chemotherapy and had immediate remission of the disease.

Discussion

The Incidence of Acute Myeloid Leukemia is 1 in 75,000 to 100,000 pregnancies with maximum 40% presenting in third trimester and 23% and 37% in first and second trimester respectively. In a population based study by Nolan et al [1], out of total acute leukaemia cases, two thirds are myeloblastic and one third lymphoblastic leukemia.

The rarity of disease during pregnancy, might also be due to very low reporting in view of confusing diagnosis. The symptoms of AML can easily be confused with symptoms of anaemia like malaise, easy fatigueability, low grade fever. Thrombocytopenia and anaemia are relatively common findings in pregnancy. Although, Neutropenia is rare and merits further investigation or close monitoring. But in the developing country like India, it is majorly missed. Thus, whenever there is presence of circulating blasts in a blood film, it suggests a diagnosis of haematological malignancy and is an indication for bone marrow biopsy. The other differential diagnosis that should be kept in mind are Thrombotic microangiopathy, HELLP syndrome and Cytopenias of deficiency or immune origin [2].

The tests to be done before bone marrow aspiration are Full blood count, blood film examination, Vitamin B12, folate and ferritin measurement, Coagulation screen, Renal and liver function tests. All these were done for our patient and further bone marrow aspiration was suggested with studies directed at Immunophenotypic, cytogenetic and molecular analysis for accurate subtyping and understanding of prognostic features.

Once diagnosed, a Multidisciplinary approach comprising of hematologists, obstetricians, anesthetists and neonatologists is the key to appropriate management. Consideration should be given to health of both mother and baby. The woman should be fully informed about the diagnosis, treatment of the disease and possible complications during pregnancy , clearly implying that any treatment delays might result in compromised maternal outcome without improving the outcome for the fetus [3].

The risks of Leukemia, disease per se, to pregnancy is miscarriage, foetal growth restriction, perinatal mortality, premature labour and Intrauterine fetal death [4].

Due to the high risk of the disease, there are different recommendations for management of AML in pregnancy in the three trimesters owing to the urgent need of chemotherapeutic agents and the adverse effects of the drugs involved .

If it is diagnosed in the first trimester, the patient should be counselled for elective abortion, medical/surgical and starting of chemotherapy. Between 13- 24 weeks, the Induction chemotherapy should be started while pregnancy is continued [5]. Preterm termination of pregnancy is indicated after fetal viability. Similar conclusions were derived by Nicola et al and Farhadfar in a single centre study of 5 and 23 case of AML diagnosed during pregnancy respectively [6,7].

Between 24 - 32 weeks, chemotherapy exposure to the fetus must be balanced against risks of prematurity following elective delivery at that stage of gestation (Grade 1C). At gestation age more than 32 weeks, the fetus should be delivered prior to Induction chemotherapy.

Chemotherapy with anthracycline based regimens are favored. According to a meta-analysis done by Natanel A Horowitz et al, anthracycline based regimens were associated with maximum remission but overall maternal survival was very low (30%)[8]. Even in our case, although the mother immediately had remission with chemotherapy. There was a recurrence after disease free 10 months and she succumbed to the disease during the COVID pandemic. Quinolones, tetracyclines and sulphonamides are better avoided in pregnancy(Grade 1B).

In one case report by Abdullah et al, a trial of 5- azacytidine has shown promising results [9]. The antifungal of choice in pregnancy is Amphotericin B or lipid derivatives (Grade 2C). If blood transfusion is needed, the blood should be screened for Cytomegalovirus (Grade 1B). Supportive therapy like a course of Corticosteroids given if delivery is between 24 and 35 weeks gestation (Grade 1A) [10]. Magnesium sulphate should be considered 24 h prior to delivery before 30 weeks gestation (Grade 1A).

Delivery should be planned for a time when the woman is at least 3 weeks post-chemotherapy to minimize risk of neonatal myelosuppresion (Grade 1C). Planned delivery is preferred, like Induction of labour (Grade 2C). Caesarean section is indicated only for obstetric indications. Epidural analgesia is better avoided.

The Dose of chemotherapy is calculated on their actual body weight with dose adjustments for weight gain during pregnancy owing to various pregnancy changes.

The Chemotherapy agents have a MW of 250-400 KDa and hence can cross the placenta resulting in detrimental teratogenic effects on developing fetus.Sunny J. Patel et al have done a comprehensive analysis on outcomes in hospitalized pregnant patients with acute myeloid leukemia and come to conclusion that a multidesciplinary, holistic approach leads to quick remission of the disease [11]

After delivery, histopathologic examination of placenta to rule out placental transfer to fetus is advisable. Cytologic examination should be performed in both maternal and umbilical cord blood and neonates should be clinically examined for palpable skin lesions, organomegaly or other masses. If the baby is found to be healthy, a follow up after every six months for two years is recommended. In each visit, physical examination, chest x-ray and liver function tests should be done.

Conclusion

Acute myeloid leukemia in pregnancy is a Rare diagnosis and even rarely reported. With the trend for delaying pregnancy into the later reproductive years, we expect to see more cases of cancer complicating pregnancy. Presently, there are no clear management guidelines to address timing and dosing of anthracycline/cytarabine based regimens especially in pregnancy. The potential drug toxicity to mother and fetus and transplant considerations in intermediate and highrisk patients during pregnancy has not been addressed.

What we also need today is a National registry for leukemia patients, treated in pregnancy. This will help us to answer many unanswered queries and improve maternal and fetal overall survival rates. Although we have few comprehensive studies, but further studies and references are needed. Finally, a Multidisciplinary team is needed to provide comprehensive care to patients.

#Acute myeloid leukemia #pregnancy #chemotherapy #jcrmhs #Clinical decision making #Journal of Clinical Case Reports Medical Images and Health Sciences submissions

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myrawjcsmicasereports · 6 days ago

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5-year survival and prognostic factors for resectable colon cancer: a single institution experience in Lebanon by Ernest Diab in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Background: This study aims to analyze the 5-year overall survival (OS) and the progression-free survival (PFS) of patients with localized colon cancer (CC) and study the impact of various prognostic factors. It is the first study evaluating survival and prognostic factors for resectable CC in the region.

Patients and methods: The medical records of 79 patients at Hotel-Dieu de France (HDF) hospital were reviewed. OS and PFS were analyzed using the Kaplan–Meier method. Results: Advanced stages, advanced grades, and vascular invasion at the time of colectomy were correlated with lower 5-year OS and PFS, showing a statistically significant association. No significant association was observed between cancer sidedness and survival after colectomy.

Conclusion: Survival and recurrence after CC resection remain important problems. Tumor stage, tumor grade, and vascular invasion are prognostic factors that affect survival after colectomy.

Keywords: colon cancer; colectomy; survival analysis; overall survival; progression-free survival; recurrence.

Introduction

Colon cancer (CC) represents a significant public health concern due to its high incidence and severity. It ranks among the leading causes of cancer-related morbidity and mortality globally. In terms of frequency, it is the third most commonly diagnosed cancer in men and the second in women. Furthermore, it stands as the third leading cause of cancer-related mortality in both men and woman (1). The survival of CC depends on the stage of the disease at the time of diagnosis and the response to treatment. The 5-year survival rate decreases as the stage increases: it is greater than 90% for stage I and less than 15% for stage IV. Early detection would therefore be important and effective (2). About 90% of patients with CC are treated surgically (3). Radical surgical resection is the standard treatment for AJCC stage I to III CC. Adjuvant chemotherapy (CT) is given to patients with high-risk stage II and stage III (4). High-risk patients are those with the following characteristics: stage T4, perforation or obstruction, low grade, lymphatic and vascular invasion, less than 12 nodes examined and a high preoperative carcinoembryonic antigen (CEA) (5). Although most patients diagnosed at localized stages (stages I, II and III) recover, 35% develop a recurrence, mainly within the first 5 years (6). Published rates of survival and recurrence after colectomy vary widely (7). In the Middle East, and more specifically in Lebanon, there are very few studies on this subject. Lebanon ranks second in terms of incidence of CC among countries in the Middle East and North Africa (MENA) region with increasing incidence over the past few years (8). Data collection is not easy in Lebanon and the National Cancer Registry (NCR) was inactive for many years due to unstable political and economic situation. Indeed, several data are missing in the Lebanese NCR such as overall survival (OS) and progression-free survival (PFS) after surgical resection of CC.

Our objective is to study the OS at 5 years and the PFS of patients with CC at localized stages after surgical resection in our institution, and this by analyzing the impact of several prognostic factors such as tumor stage, sidedness, grade, size, patient's age at the time of colectomy and adjuvant CT.

Material and methods

Study estimates and sampling

This is an applied survival study in patients who underwent surgical resection for CC at localized stage between January 2015 and December 2016 at Hotel-Dieu de France (HDF) hospital (Beirut, Lebanon). The medical records of 95 patients who underwent primary CC resection were reviewed. The information was collected from the medical records of the patients, present in the archives of the hospital and in the clinics of the attending physicians. The patients were followed and included in a database until January 2022 or until their death if this occurred before January 2022. Primary tumors located at the level of the cecum, ascending colon and transverse colon were defined as tumors of the right colon, while those located at the level of the splenic angle, descending colon and sigmoid colon were defined as tumors of the left colon. The AJCC TNM staging system (8th edition) was used for staging.

OS was defined as the time from resection of the primary tumor to death from any cause. PFS was defined as the time from the date of surgery to the date of detection of recurrence, last follow-up, or death. We excluded patients who underwent surgical resection for stage IV CC, and for a non-neoplastic cause as well as those who had rectal cancer. The final sample included 79 patients who underwent curative resection for stage I, II or III CC (Figure 1).

Flowchart of patients included in the study

Ethical considerations

The protocol and all the study procedures were approved by the ethics committee of Saint-Joseph University in Beirut. The Helsinki declarations of 1963 were considered: respect, confidentiality, and patient anonymity.

Statistical analysis

Data were analyzed using SPSS software version 29. The categorized variables were compared by Pearson’s χ² test, and quantitative variables were compared by the Student’s t-test. OS and PFS were analyzed using the Kaplan–Meier method. P values less than 0.05 were considered statistically significant.

Results

Basic patient characteristics

Among the 79 patients included in the study, 42 (53.2%) were men and 37 (46.8%) were women. The median age of patients at the time of colectomy was 66.1 ± 13.3 years. Table 1 represents the clinical and pathological characteristics at the time of colectomy. Conventional adenocarcinoma (74.7%) was the predominant histological type of resected tumors followed by mucinous-type adenocarcinoma (22.8%) and signet ring cell adenocarcinoma (2.5%). Grades 1 and 2 tumors (79.7%) predominated over grades 3 and 4 (20.3%) and median tumor size was 4.78 cm ± 1.6 (2 - 8.5) (table 1). Most patients had stage II-A CC with a frequency of 34.2%. The distribution of patients by stage is shown in table 1. Most patients presented an absence of lymphatic invasion (82.3%), vascular invasion (88.6%) and perineural invasion (89.9%). In addition, the majority (84.8%) presented a conservation of mismatch repair (MMR) protein expression (table 1). 14 patients (17.7%) presented a recurrence with a predominant hepatic location (62.5%). The 5-year OS of the patients included in our study was 88.6% with a median survival time of 64.8 months. The percentage of deaths was 11.4% (table 1).

Impact of cancer stage on survival after colectomy

The OS rate at 5 years was 100% for stage I tumors, 92.7% for stage II and 73.9% for stage III, with a significant difference (p = 0.02). The median 5-year survival was 76.7 months for stage I tumors, 66.9 months for stage II and 53.0 months for stage III. The PFS was 74.6 months for stage I, 64.6 months for stage II and 48.2 months for stage III. Patients with stage I CC had higher 5-year OS (figure 2-A) and PFS (figure 2-B) than patients with stage II and stage III, with a significant difference (p = 0.003 for OS and p = 0.01 for PFS)

Kaplan-Meier curves of OS (A) and PFS (B) of CC after curative surgery, at stages I, II and III.

Impact of cancer sidedness on survival after colectomy

Clinical and pathological characteristics depending on the sidedness of cancer

Among the patients included, 42 (53.2%) had a right-sided colon cancer (RCC) and 37 (46.8%) had a left-sided colon cancer (LCC). The baseline characteristics of patients with RCC and LCC are shown in table 1.

Patients with RCC were older at the time of colectomy than patients with LCC (67.7 years versus 64.3 years, p=0.26) and the majority were females (57.1% versus 35.1%, p=0.05). A lower BMI was noted in patients with RCC compared to those with LCC (24.6 ± 4.3 vs 26.8 ± 4.7, p = 0.04) (table 1).

The distribution of the different histological types is shown in Table 1. Conventional adenocarcinoma has a higher tendency to occur in the left colon (89.2% vs 61.9%) rather than in the right colon. However, mucinous-type adenocarcinoma has a higher tendency to occur in the right colon (37.5% vs 8.1%) rather than in the left colon. This trend is statistically significant with a χ² test giving a p-value equal to 0.01. The most frequent location was in the cecum (20%) for RCC and in the sigmoid colon (42%) for LCC (table 1).

Tumors of patients with RCC had larger size (5.1 ± 1.7 (2 – 8.5) vs 4.4 ± 1.3 (2.5 – 8), p = 0.05) and more advanced histological grade (31% vs 8% at grades 3 and 4, p = 0.012) than tumors of patients with LCC. The tumors of patients with LCC were mostly stage T1 and T2 (37.8% vs 11.9%, p = 0.05) while those of patients with RCC were mostly stage T3 and T4 (88.1% vs 62.1%, p = 0.05). Patients with RCC had more advanced N stage (38.1% vs 18.9% at stages N1 and N2, p=0.13) and more advanced AJCC cancer stage (38.1% vs 18.9% at stage III, p=0.03) than patients with LCC. Regarding lymph node involvement, the number varied between 0 and 10 positive nodes for RCC, and between 0 and 4 positive nodes for LCC (p = 0.006). No significant difference was observed regarding lymphatic, vascular or perineural invasion between RCC and LCC. A higher percentage loss of MMR protein expression was observed in patients with RCC (23.8% vs 5.4%, p = 0.023) compared to those with LCC (table 1).

Among the operated patients, 8 patients (19.0%) with RCC and 6 patients (16.2%) with LCC developed a recurrence after colectomy (p = 0.74). Regarding the location of metastases, liver metastases (66.7% vs 60.0%, p = 0.7) and peritoneal carcinomatosis (33.3% vs 20.0%, p = 0.7) were more frequent for LCC, while pulmonary location was more frequent for the RCC (20.0% vs 0%, p = 0.7) (table 1).

Survival analysis of RCC and LCC after colectomy

The OS rate at 5 years was 83.3% for RCC and 94.6% for LCC (p = 0.1). Patients with LCC showed higher survival time (69.4 ± 10.1 (45 – 83.8) vs 60.7 ± 16.1 (4 – 84), p = 0.01) than those with RCC. For PFS, the median duration was 57.7 months for RCC and 66.3 months for LCC. Patients with LCC had a higher 5-year OS (figure 3-A) and PFS (figure 3-B) than patients with RCC (p= 0.296 for OS and p = 0.380 for PFS).

Kaplan-Meier curves of OS (A) and PFS (B) of RCC and LCC after curative surgery, at any stage.

Impact of cancer grade on survival after colectomy

Concerning the distribution by grades and the impact on survival after colectomy, the median 5-year survival was 68.8 months for grades 1 and 2 tumors and 48.7 months for grades 3 and 4 tumors (p < 0.001). Figure 4 represents a box plot showing the difference in survival between the 2 groups of grades.

Box plot showing median survival in months as a function of cancer grades at the time of colectomy.

Impact of tumor size on survival after colectomy

Regarding the impact of tumor size at the time of colectomy on survival, we obtained a weak negative correlation with a correlation coefficient equal to -0.2. This result is represented by a scatterplot showing a non-significant correlation (p = 0.09).

Scatterplot showing the relationship between tumor size at the time of colectomy and median survival in months.

Impact of patient age at colectomy on survival after colectomy

By studying the impact of the patient's age at the time of colectomy on survival, we obtained a moderate negative correlation with a correlation coefficient equal to -0.1. This result is represented by a scatterplot (figure 6) showing a non-significant correlation (p = 0.60).

Scatterplot showing the association between patient age at colectomy and survival in months.

Impact of different tumor factors on survival after colectomy

The presence of lymphatic, vascular or perineural invasion at the time of colectomy was associated with a lower median survival at 5 years (table 2). This association was significant for vascular invasion only (p = 0.02).

Association between survival and various tumor factors. Values are presented as mean ± standard deviation. The values in bold are those considered significant for a p value less than 0.05.

Impact of taking adjuvant treatment on survival after colectomy

Patients with stage II CC who received adjuvant CT had a higher 5-year OS (figure 7-A) and PFS (figure 7-B) than patients with stage II CC who didn’t receive CT (p= 0.287 for OS and p = 0.206 for PFS).

Kaplan-Meier curves of OS (A) and PFS (B) of stage II CC depending on taking adjuvant CT.

Discussion

CC is a deadly disease whose spread has accelerated in recent years. Regarding Lebanon, the country has one of the highest colorectal cancer (CRC) incidence rates in the MENA region. Limited knowledge exists regarding the epidemiology and pathological characteristics of CC in the Middle East, including Lebanon. Additionally, there is a lack of data concerning the OS and PFS outcomes after colectomy in this region. The main objective of our study was to analyze OS at 5 years and PFS after colectomy by studying the impact of several factors.

Our study includes slightly more men than women with a ratio of 1.14. This difference in frequency is already described in Lebanon with a higher prevalence of CC in men.

The majority of CC in our study were in the right colon (53.2%). Indeed, since the 1990s, researchers have begun to observe an increase in the prevalence of RCC compared to LCC in several countries and this can be explained by an improvement in the screening system. However, the low percentage of patients with stage I CC in our study (19.0%) is an indicator that the screening system in Lebanon is not yet fully established, and justifies the need for public health interventions (9).

RCC was more prevalent among women in our study (57.1% vs 35.1%, p = 0.005) than LCC. Indeed, women have been shown to have a higher risk of developing RCC than men (10).

Patients with RCC had lower 5-year OS and PFS than those with LCC. But this association between sidedness of tumor and patient survival was not statistically significant (p = 0.296 for OS and p = 0.380 for PFS). Even though several meta-analyses have demonstrated that RCC has a worse prognosis than LCC, recent studies have shown that there is no significant difference in 5-year OS and time to recurrence between patients with RCC and LCC after curative resection (11) (12).

Indeed, a simple comparison of the characteristics of patients with RCC and LCC reveals several significant differences. Patients with RCC in our study had older age at colectomy, lower BMI, more advanced tumor grade, more advanced AJCC stage, higher number of lymph node metastases, higher percentage of lymphatic and vascular invasion and higher loss of MMR protein expression than those with LCC. In fact, patients with RCC have a worse prognosis than those with LCC because they have a worse clinical background. Therefore, to really be able to assess the impact of the sidedness of the tumor on 5-year OS and PFS, it would be necessary to homogenize the history of the two groups.

There was a statistically significant association between the presence of a higher tumor stage at the time of colectomy and a lower 5-year OS (p = 0.003) and PFS (p = 0.01). We can therefore conclude that tumor stage is a prognostic factor for CC.

Regarding tumor grade, patients with a grade 3 or 4 tumor had lower 5-year OS than those with a grade 1 or 2 tumor with a statistically significant difference (p < 0.001). Among our patients, we demonstrated that there was a significant association (p = 0.02) between the presence of vascular invasion and the reduction in 5-year OS, which is consistent with the results of several other studies (13). We can therefore conclude that the tumor grade and the presence of vascular invasion are prognostic factors in CC.

Patients with RCC in our study had a more advanced tumor grade and a higher percentage of vascular invasion than those with LCC, which is consistent with the results of several other studies (11) thus explaining the poorer prognosis of RCC.

We obtained a higher percentage of mucinous-type adenocarcinoma in RCC than LCC. We have not studied the impact of the histological type of cancer on survival, but studies have described a poorer prognosis for mucinous adenocarcinomas (14).

Regarding the size of the tumor, there was a weak correlation between a larger size at the time of colectomy and a lower 5-year OS. But this association was not statistically significant (p = 0.09). However, a recent study showed that tumor size was associated with a poor prognosis of CC and was considered a risk factor for recurrence and metastasis (15).

The median age of the patients was 66.1 years. Investigating the impact of patient age at colectomy on survival, we found a moderate correlation between older age and lower 5-year OS, but this association was not statistically significant (p = 0.60). This can be explained by the fact that intraoperative complications and postoperative morbidity are higher in elderly patients.

Among the patients included in our study, a total of 34 patients (43.0%) received adjuvant CT. To study the impact of taking adjuvant CT on survival, we focused on patients with stage II CC. Among the 41 patients (51.9%) who had stage II CC, 16 (47.1%) was at high-risk and received adjuvant CT: 10 (62.5%) had stage T4 cancer, 5 (31.3%) had lymphatic or vascular invasion, and 1 (6.3%) had an occlusion. We found that adjuvant CT improves the prognosis of patients with stage II CC, result that is supported by previous studies (16). However, detailed date on the type of CT have not been taken into consideration in our study.

Loss of expression of MMR proteins was more frequent in RCC (23.8% vs 5.4%, p = 0.023) than in LCC, which is consistent with previous studies (11).

Indeed, we did not analyze the impact of the loss of expression of MMR proteins on survival, but a recent study showed that adjuvant CT was a poor prognostic factor for stage II RCC with loss of MMR protein expression and therefore patients should know the MMR protein expression status before receiving adjuvant CT (11).

A significant difference (p = 0.04) in BMI between patients with RCC and LCC was observed. Indeed, it has already been shown that patients with RCC have a lower BMI than those with LCC, probably because most patients are women and have an advanced age (11). In our study, we did not analyze the association between BMI and survival, but studies have shown that a high BMI is a good prognostic factor for CC (11) probably because patients who have a low BMI have very little visceral fat to cover the tumor which can cause it to spread rapidly.

Conclusion

CC is a major public health problem in Lebanon and the incidence is likely to increase over the next few decades. Survival and recurrence after CC resection remain important problems, and early detection is very important. Our study is the first evaluating survival and prognostic factors for resectable CC in the region. Although there was no significant association between cancer sidedness and survival, patients with RCC have worse prognostic factors. We found that tumor stage, tumor grade as well as vascular invasion at the time of colectomy are prognostic factors that affect survival after colectomy in the Lebanese population. However, further studies would be interesting to carry out on larger samples.

#colon cancer; colectomy; survival analysis; overall survival; progression-free survival; recurrence #Journal of Clinical Case Reports Medical Images and Health Sciences

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dallasfertilitycenter · 11 months ago

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Fresh vs. Frozen Embryo Transfer: Exploring the Differences

There are many decisions to make on your journey to becoming a parent. Which infertility clinic is a good fit? What treatments are you willing to undergo? Is it better to transfer fresh or frozen embryos for IVF (In Vitro Fertilization)? Luckily, your treatment team can help guide you to the choices that are right for you, and Dr. Walid Saleh of SIRM Dallas in Dallas, Texas can give you some insight into the pros and cons of fresh versus frozen embryo transfer below.

A Fresh Perspective

All embryos start out fresh. In a woman’s initial IVF cycle, she takes medication to first “quiet” the ovaries followed by medication to stimulate them to produce extra eggs. After the eggs have been surgically retrieved, they are fertilized. The resulting embryos grow in a special incubator until they are ready to be transferred to the uterus. In most cases, one embryo is selected for transfer and the remaining embryos are frozen. Fresh cycles were, for decades, the gold standard…until the last few years when rapid advancements in freezing and cryopreservation methods improved the outcome of frozen embryo transfers.

Back in the Day

First, a little history on frozen embryo transfer (FET). Embryos were initially frozen slowly which caused intracellular ice to form; unfortunately, the ice often damaged the embryos. Many damaged embryos didn’t survive, and those that did had very low potential for successful implantation. However, in the last several years we’ve seen a dramatic increase in the quality of frozen embryos due to the introduction of vitrification. Vitrification is an ultra-rapid freezing method that freezes the embryo approximately 60,000 times faster than the older method of freezing. This process takes ice formation out of the equation, resulting in a significant increase in viable embryos with successful implantation and pregnancy potential equal to fresh embryos.

If you think frozen embryo transfers may be right for you, schedule an appointment at SIRM Dallas in Dallas, Texas to learn more.

Timing is Everything

Another reason we see markedly higher FET success rates now than several years ago is that the timing of when the embryo is frozen has changed. It’s been shown that freezing blastocysts (embryo at day 5-6) has a better outcome than freezing early-cleaved embryos (day 2-3). In many cases embryos that don’t successfully develop to the expanded blastocyst stage are aneuploid (chromosomally compromised) and don’t result in healthy babies. An additional benefit of frozen embryo transfers using expanded blastocysts is that fewer embryos – because we’re able to determine which are most viable – need to be transferred. This means we can minimize the chance of a multiple pregnancy, along with the inherent risks to both mom and baby.

Fresh or Frozen?

At this point, studies show that successful outcomes using frozen embryo transfers are about equal to those of fresh embryo transfers. The slight edge that fresh embryo transfer may have is that, typically, the best embryo is selected for the first transfer. However, there are some key benefits that make FET appealing:

Because you underwent ovarian stimulation and egg retrieval for your fresh cycle, you won’t have to go through it again. The medications necessary to prepare your body for FET have fewer potential side effects and take less of a toll on your body.

Many patients report that FET cycles are not nearly as stressful as fresh cycles since they already know they have viable embryos.

It’s easier to schedule and plan for FET cycles than fresh cycles.

If you’d like to learn more about how fresh and/or frozen embryo transfers and IVF may benefit you, schedule an appointment at SIRM Dallas in Dallas, Texas to meet with Dr. Saleh and discuss your options.

#fertility clinic dallas #dallas fertility center #fertility doctors in dallas #best ivf doctors in dallas #ivf clinic dallas #fertility center of dallas

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jcrmhscasereports · 2 years ago

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ACUTE MYELOID LEUKEMIA IN PREGNANCY: DIFFICULT JOURNEY FROM DIAGNOSIS TO DELIVERY AND TREATMENT by Vina Kumari in Journal of Clinical Case Reports Medical Images and Health Sciences

ABSTRACT

Keywords: Acute myeloid leukemia, pregnancy, chemotherapy.

INTRODUCTION

CASE PRESENTATION

Her first trimester was uneventful. She was registered at a local hospital but was not compliant. Dating scan, trisomy screening and anomaly scan was not done.

Peripheral smear showed mostly Monoblasts (red arrow), promonocytes (green arrow) and few myeloblasts (blue arrow) under the oil immersion object 100 X, Leishman stain.

Monoblasts are large cells with abundant cytoplasm, moderately to intensely basophilic, scattered fine azurophilic granules, round nuclei with lacy chromatin and one or more large nucleoli.

Promonocytes have moderate cytoplasm, less basophilic, granulated with occasional large azurophilic granules. Vacuoles are more irregular. Nuclei are delicately folded.

Myeloblasts have large nuclei, fine chromatin, 3-4 prominent nucleoli and few Auer rods in the cytoplasm.

In view of suspected Acute Myeloid Leukemia, she was advised Bone marrow aspiration, biopsy and immunophenotyping, flow cytometry and translocation (15:17) study by oncologist.

Table 1: Sequential Investigation Reports during hospital stay

DISCUSSION

The risks of Leukemia, disease per se, to pregnancy is miscarriage, foetal growth restriction, perinatal mortality, premature labour and Intrauterine fetal death [4].

The Dose of chemotherapy is calculated on their actual body weight with dose adjustments for weight gain during pregnancy owing to various pregnancy changes.

CONCLUSION

For more information: https://jmedcasereportsimages.org/about-us/

For more submission : https://jmedcasereportsimages.org/

#Acute myeloid leukemia #pregnancy #chemotherapy #AML #cytoplasm #leukoerythroblastic #hematologists #obstetricians #anesthetists #Vina Kumari #jcrmhs

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wherelibertydwells · 4 years ago

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COVID killed by sunlight

No direct evidence of airborne spread

Surface spread very rare

Asymptomatic spread low

Masks ineffective

Lockdowns don’t work

Herd immunity real

Miniscule risk to children

Survival rate 99.97%+

1. “When researchers at the National Biodefense Analysis and Countermeasures Center exposed SARS-CoV-2 in simulated saliva to artificial sunlight (equivalent to a sunny day), 90% of viruses were inactivated within seven minutes.” https://www.forbes.com/sites/jvchamary/2020/06/29/light-coronavirus/

1. “The present study is the first to demonstrate that UVB levels representative of natural sunlight rapidly inactivate SARS-CoV-2 on surfaces”… https://academic.oup.com/jid/article/222/2/214/5841129

2. “[The CDC] has reversed an update made to its coronavirus guidance that stated COVID-19 is an airborne virus. The health agency said that update, posted to its website… was made in error.” (It later said it was “possible.”) https://www.huffingtonpost.co.uk/entry/coronavirus-airborne-in-aerosols-cdc-says_n_5f689b89c5b6480e8972428d?

2. “There is absolutely no evidence that this disease is airborne”… https://bc.ctvnews.ca/absolutely-no-evidence-that-covid-19-is-airborne-b-c-health-official-says-1.4964156

3. “[The CDC] just released a new scientific brief that says your risk of contracting COVID-19 from a surface is about 1 in 10,000. That means, on average, you have a 0.01% chance of actually picking up the virus from, say, touching a counter.” https://news.yahoo.com/risk-getting-covid-19-surface-194600830.html

4. “[A] meta-analysis of 54 studies with 77,758 total participants… found that secondary attack rates were higher for symptomatic people than asymptomatic people — an 18% rate for symptomatic people and a 0.7% rate for asymptomatic people.” https://tallahasseereports.com/2020/12/31/asymptomatic-covid-spread-unlikely-but-possible-according-to-study/

5. “We did not find evidence that surgical-type face masks are effective in reducing laboratory-confirmed influenza transmission, either when worn by infected persons (source control) or by persons in the general community.” Analysis of COVID mask data. https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article

5. “Researchers in Denmark reported… that surgical masks did not protect the wearers against infection with the coronavirus in a large randomized clinical trial.” https://fee.org/articles/new-danish-study-finds-masks-don-t-protect-wearers-from-covid-infection/

5. “Recommendation to wear a surgical mask when outside the home among others did not reduce, at conventional levels of statistical significance, incident SARS-CoV-2 infection compared with no mask recommendation.” https://www.msn.com/en-us/health/medical/first-randomized-control-trial-shows-face-masks-did-not-reduce-coronavirus-infections-with-statistical-significance/ar-BB1b8zo2

5. The top 10 states in case rates over the past 7 days all still have mask mandates

5. “In the first 20 days after implementing mask mandates, new cases slowed by 0.5 percentage points… COVID-19 death rates dropped by 0.7 percentage points…” Thus, not even a 1% difference in one CDC study. https://eu.usatoday.com/story/news/factcheck/2021/03/12/fact-check-cdc-study-links-mask-mandates-slowed-covid-infections/6938262002/

6. “A study evaluating COVID-19 responses around the world found that mandatory lockdown orders early in the pandemic may not provide significantly more benefits to slowing the spread of the disease than other voluntary measures”… https://www.newsweek.com/covid-lockdowns-have-no-clear-benefit-vs-other-voluntary-measures-international-study-shows-1561656

6. “We do not question the role of all public health interventions, or of coordinated communications about the epidemic, but we fail to find an additional benefit of stay-at-home orders and business closures.” https://onlinelibrary.wiley.com/doi/10.1111/eci.13484

6. “188 countries that have declared at least one case, only those counting a minimum of 10 deaths due to Covid-19 were included… Stringency of the measures settled to fight pandemia, including lockdown, did not appear to be linked with death rate.” https://www.frontiersin.org/articles/10.3389/fpubh.2020.604339/full#SM6

6. “[Tel Aviv researchers] found no statistical correlation between the severity of a lockdown and the number of Covid-19 fatalities in the country.” https://www.israel21c.org/distancing-not-lockdowns-prevents-covid-19-deaths-says-study/

6. “We in the [WHO] do not advocate lockdowns… The only time we believe a lockdown is justified is to buy you time to reorganize, regroup, rebalance your resources, protect your health workers who are exhausted, but by and large, we’d rather not do it.” https://www.msn.com/en-us/health/medical/who-official-urges-world-leaders-to-stop-using-lockdowns-as-primary-virus-control-method/ar-BB19TBUo

6. “During the study period, states allowed restaurants to reopen for on-premises dining in 3,076 (97.9%) U.S. counties. Changes in daily COVID-19 case & death growth rates were not statistically significant”… https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e3.htm?s_cid=mm7010e3_w

7. “Fauci has been saying that the country needs to vaccinate 70% to 85% of the population to reach herd immunity from Covid-19. But he inexplicably ignores natural immunity. If you account for previous infections, herd immunity is likely close at hand.” https://www.wsj.com/articles/herd-immunity-is-near-despite-faucis-denial-11616624554

7. “Experts believe that if no other measures are taken, herd immunity could kick in when between 50% and 70% of a population gains immunity via vaccination… the number most people are looking at (for herd immunity) is about 60-65%.” https://graphics.reuters.com/HEALTH-CORONAVIRUS/HERD%20IMMUNITY%20(EXPLAINER)/gjnvwayydvw/

8. The CDC reports that 251 patients under 17 years old have died with COVID since the pandemic began.

There are 74.2 million Americans under 18. That is a survival rate for that age demographic of about 99.9997%. The survival rate for 18-29 is about 99.997%.

9. The average age of COVID death is 78.6 years old. The average age of life expectancy for those patients was 78.6 years old. Overall survival rate 99.97%.

“CDC data also show that Americans, regardless of age group, are far more likely to die of something other than COVID-19.”

#presented as information only #I am not a scientist

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wanderinginksplot · 4 years ago

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Hiya, I was wondering if I could please request 3 (Echo) with B+O (Injury/sickness recovery + first kiss)? I don’t really mind who’s in recovery or whether it’s 501st echo/bad batch echo, I just thought these prompts would lead nicely into a confession between our two main characters; also I just want to say I love your writing!! ❤️

Aww, thank you so much for the request and for being so kind, Anon! Sorry this took forever, but I’ve been stuck in an idea block for a week or two, and I ended up writing about four different versions of this. You’re very sweet, but you probably shouldn’t be nice to me, because apparently, it makes me write one-shots that are way too long. So here’s a 2700 word one-shot...

Also! It ended up being a tad spicy toward the end. Nothing anywhere close to M-rating, but more than I usually write in one-shots.

Echo + Injury/Sickness Recovery + First Kiss

The first time you met Echo, you didn't like him very much.

You were in the medbay for a sickness that was taking Coruscant by storm, hitting nat-born GAR members especially hard. As a nat-born intelligence officer, you had been ordered to the GAR's main medbay, which had been sub-divided into large bays full of cots. Almost every cot was filled with GAR personnel who needed treatment for the same sickness.

It wouldn't have been bad if you had been able to take the meds right away and start the healing process, but you had been on a dangerous mission and fought the sickness off for longer than you should have. It had worked and you had survived your mission, but you were severely dehydrated. The medics - all clone troopers, by that point - had ordered you to stay until you were fully healed and they could get your fluid levels back where they should have been. Faced with no other options, you had agreed.

And then the 501st had arrived.

Through your IV, you had gotten through half a bag of a liquid you preferred not to think too hard about. The medics promised that your meds would be kicking in soon, and you would feel much better before the day was over. For the moment, you felt nauseated and every part of your body ached, especially your head.

When the troopers came in, their white armor painted with blue accents in various styles, they were so loud that the rest of the medbay went quiet.

One of the medics, his hair shaved short to show off a set of intricate tattoos, hurried up to them as he pulled off his gloves. You could hear his hissed question from your bed on the other side of the large room. "What are you idiots doing here?"

One of the men beamed at him. "We're in trouble!"

You scoffed to yourself. You had no difficulty believing they had gotten on someone's bad side.

The tattooed medic rubbed his temples. "Hardcase… what did you guys do now?"

You had heard stories about the rowdy 501st from other operatives. They were supposed to be a nightmare to work alongside, all explosions and heroics without any grasp of subtlety.

One of the other men stepped forward and seemed to be offering an explanation, but he did it in a voice pitched low enough that you couldn't hear him. You were grateful for that, and did your best to fall asleep.

It wasn't to be, however, as one of the 501st made his way down the row of beds in your direction. He chatted with some of the other patients, laughing loudly at their responses. By the time he reached you, you could have cheerfully put a blaster to the 5 tattooed on his temple.

"And how are you doing today?" the trooper belted out.

"In a lot of pain, actually," you snapped at him, a visceral response to the effect his voice had on your roiling stomach. "Can you please talk more quietly?"

There. A please. You were being polite.

"If I'm quiet, does that mean I can stay over here with you, pretty lady?" he asked with a wink, settling onto the foot of your bed.

You eyed him stonily. You felt revolting from the effects of the sickness, and you were wearing a GAR-issued medical gown besides. ‘Pretty’ was an attempt at flattery, and not even a believable one.

"Fives," the medic with the head tattoos admonished, stepping up to your bedside as well. "Stop. She doesn't feel well and she doesn't need you hanging around, making it worse."

"Me?" Fives asked, sounding both shocked and offended. "We both know I only make things better, Kix."

You sighed and wished with your whole soul that they would both go away. You just wanted to sleep.

"Besides," Fives continued, "We were ordered to help in the medbay. You wouldn't want me to disobey orders, would you?"

From the look on Kix's face, he had lined up a scathing retort that you were dying to hear, but you needed to make a brief announcement. "If this conversation continues right here, I am going to vomit."

You had never seen two grown men move so quickly. You would have smiled if you didn't feel so rotten.

"Echo," Kix called softly with a worried glance in your direction, beckoning yet another trooper over.

This one had no tattoos, but you vaguely recognized him as the only trooper you hadn't been able to overhear earlier.

"Get Fives away from here," Kix ordered. "Keep him productive and occupied, but don't let him talk."

Echo nodded and gave you an apologetic nod. "I'm sorry about him," he said, indicating Fives, who looked deeply offended.

"Please," was the only response you could muster, cradling your head delicately in your hands. From the bit of your peripheral vision that wasn’t blocked by your palms, you watched his shoulders slump slightly as he towed his brother away. When you finally fell asleep, your dreams were full of Echo’s disappointed face along with strong feelings of guilt.

The second time you met him was only a few hours later. You were having fever dreams. The medication had apparently worn off and no one had noticed. In your dreams, you had called a medic over a dozen times, but you always woke to find that you hadn’t said a thing, and fell asleep again before you could.

It was one of these shallow, fitful dreams that Echo interrupted. “Hey. Hey! Shhh, you’re having a nightmare. Wake up.”

Thoroughly confused by the world of the surrounding medbay, you squinted up at him. “Echo?” He nodded and you launched right into the speech you had prepared in your sleep. “I’m sorry I was rude earlier. I just… my head hurt, and you guys are loud, and-”

“You don’t have anything to apologize for,” Echo assured you, crouching by your bedside to put himself on your level. “The 501st - and Fives in particular - is very loud. It’s our best quality.”

You snorted at that and Echo’s kind face broke into a warm smile. “You should get back to sleep. It’s really late. Or early. I’m not sure which, but everyone else is asleep, and you should be, too.”

“I think I need some meds, actually,” you admitted. “I feel like death.”

Echo frowned and reached up to brush his fingers over your forehead, flinching back almost immediately. “Kriff, you’re burning up! Hang on, let me grab a medic for you.”

You nodded, but grabbed his wrist before he could leave, “If you bring me some water, I’ll love you forever.”

It was just a childish hyperbole, something you and your family had said whenever you had asked for a favor, particularly a minor one. Echo didn’t seem to have the same connection with it, based on the way he had frozen in place and was staring at you with wide eyes that flashed between your face and your grip on his wrist.

Clearing your throat, you released him and corrected yourself. “I mean, please? I’m very thirsty.”

Echo turned around a moment later and you sighed, hoping your hot face looked like the flush of a fever.

You were half-drowsing when Echo came back with Kix in tow. You jumped a bit when Kix said your name, and Echo was quick to soothe you. “Easy, easy. It’s just us.”

He handed you the biggest glass of water you had ever seen and retreated halfway across the medbay before you had chugged half of it.

The next day, you were actually feeling better. Granted, ‘better’ was a relative term, but you didn’t actively want to die any more, and that was something. The only thing messing up your day was the lingering awkwardness between you and Echo. Every time his circuit around the room took him past your cot, he would avoid your eyes.

From your calculations, he looped around the gigantic medbay room every six minutes or so. On his next lap past, you softly asked, “Echo?”

You had meant to be subtle and quiet, but you were still a bit less hydrated than you should have been, and it came out as a horrifying croak. If someone had called your name in that voice, you would have immediately run away, but Echo just turned slightly and looked your direction.

“I’m sorry for last night,” you apologized.

“You already said that,” Echo reminded you gently. “The 501st is loud. I understand why you weren’t happy with us.”

“Not about that,” you forced out, half-wishing you could just let him think you had been delirious with fever and thus not responsible for anything you had said or done. “I mean that I’m sorry for saying the whole love you forever thing. It was a joke, but I feel like it landed poorly.”

“There’s no need, really,” Echo told you. He smiled then, a small sad smile. “We clones don’t get to see much good in the universe. Not with this war going on. Even though you were joking, it was nice to hear something like that.”

You stared at him, trying to keep the poker face the GAR had hired you for.

“Besides,” Echo said with a laugh, “if you want to see how a bad joke really sounds, hang out with Fives for a few minutes. You’ll have plenty of opportunity to see the difference!”

You chuckled at that and the smile he gave lit his whole face as he continued his patrol. You watched Echo leave, thinking hard. It was ironic that this was the conversation where your heart had melted just a touch. It wasn’t love, not yet, but this third exchange left feelings that were inappropriate considering that you had known him for less than a day.

That night, you couldn’t sleep, betrayed by all of the napping you had done during the day. Echo was patrolling the room again and noticed you on his fourth lap.

He crouched by your bedside once again. “Can’t sleep?”

“Nope,” you admitted with a sigh. “Can you?”

Echo frowned. “I can, but I’m on watch right now.”

“On watch,” you repeated skeptically. “For what?”

“Someone has to make sure the patients are doing okay while the medics sleep,” he explained. “It’s a very important job.”

“Your brothers are all playing sabacc in the corner,” you pointed out. “Go join them. Or, better yet, get some sleep. I haven’t seen you take a break yet.”

“You were unconscious for over half of the day,” Echo reminded you. “I could have been on break then.”

“You weren’t,” you told him confidently. “Because you wouldn’t have known that I slept the whole time.”

Echo frowned. “You’re too smart to work for the army.”

“Intelligence officer,” you explained simply.

Lifting his eyebrows in exaggerated shock, Echo leapt to his feet and gave a dramatic salute. You pretended to aim a kick in his direction and you both dissolved into muffled giggles in an attempt not to wake any of the other patients.

“If you won’t try to sleep, at least sit down?” you requested, indicating the foot of your cot as you struggled to sit up so you could move out of his way. “You’re stressing me out. I can’t be expected to get better if I’m stressed.”

“We can’t have that,” Echo teased. He helped you sit up before he did anything else, but the awkwardness of the position left him hauling you up by your armpits. You were thankful that you had found the strength to walk to the sonic shower that day, at least. “Not like I can get sick from you, anyway.”

Echo sat talking with you for hours, even after his brothers had all drifted off at their sabacc table. Before you fell asleep again, he brought you another giant glass of water. You accepted it with a smile. “Thank you, I really appreciate it.”

He nodded and left so you could get some sleep. By the time you had finished the glass, he was on the other side of the medbay and couldn’t hear you mutter, “Love you forever.”

For the next few days, Echo lived by your bedside. The conversations you had made you laugh so hard that you went into the occasional coughing fit and got the evil eye from Kix. So, you were less pleased than you had expected to be when Kix told you that you could be discharged the following day.

That night, you couldn’t sleep. Getting your sleep pattern back under control was going to be the biggest struggle, you reflected, staring at the massive beams supporting the ceiling.

“Excuse me, ma’am,” Echo teased, walking up. “Shouldn’t you be asleep?”

You waved a hand around dramatically. “I’m trying to commit these beautiful surroundings to memory. If I’m leaving tomorrow, I’ll need to remember the enchanting way the dust clings to that wall over there.”

Suddenly serious, Echo asked, “You’re leaving tomorrow?”

You nodded, and couldn’t tell if it was your imagination, or if he really looked disappointed. Still, he mustered a smile. “I’m glad.”

With a falsely offended gasp, you replied, “You’re glad I’m leaving? That’s rude!”

“No, I mean-!” Echo sputtered, grimacing at you when you started to laugh. “I’m glad you’re getting better. Even if you’re just as mean as the day I met you.”

“Yeah, I’m terrible,” you agreed with a grin.

“You are not,” he countered immediately. “You’re sweet and funny and- I’ll miss you. Selfish, huh?”

“I’ll miss you, too,” you admitted. “I guess we’re both selfish. But, hey, you’ll finally get some sleep now!”

“I suppose I will,” Echo said with the ghost of his usual smile. “At least we can have one last overnight conversation. Unless you’re too tired?”

You rolled your eyes at him. “Sit down, Echo.”

The two of you talked for hours that night. The medbay steadily got more silent and your eyes began to ache. Try as you might, you were still recovering from your illness and the point came when you couldn’t fight it off any longer. You fell into a light doze as Echo was talking.

You were dimly aware as he finished his sentence and waited for a response, but you couldn’t make yourself say anything. Echo gave an amused sounding hum and stood from your cot. You immediately missed his warmth, but felt like he was still standing by you.

Soft lips pressed against your forehead and left as Echo started to move away. “What was that cop-out bantha dung?” you asked blearily.

Echo jumped a bit and stared down at you, but you were half-asleep, impulsive, and you knew what you wanted. You sat up to grab his shoulders and brought him back down to you, kissing him with as much fervor as an extremely tired person could muster.

He kissed you back, opening his mouth to release an almost-soundless groan, and you were suddenly wide awake. With both of you actively participating in your embrace, it didn’t take long for the pair of you to get carried away.

When you finally broke apart, it was only because someone had cleared their throat sharply.

Echo pulled back, bracing on his forearms to look up at Kix while you peered at the medic from under Echo’s chest. When had he gotten on top of you? His hip brushed against your upper thigh and you abruptly didn’t care anymore.

“I take it you’re well enough to be released from here?” Kix asked, a raised brow accentuating his smirk.

You glanced around to find that half of the medbay was awake and staring at you and Echo with expressions ranging from bleary bewilderment to amused approval. Some of Echo’s brothers were awake as well, though their faces ran heavily to outright shock.

“Uh, yeah. I’m ready to go home,” you agreed, glancing up at Echo. “Wanna come with me?”

Echo nodded and glanced up at Kix. The medic shrugged and looked at the ceiling. “No, I have no idea where Echo went. He worked several around the chrono shifts and then he disappeared. I assume he went to get some well-deserved rest. Sign here.”

The last part was directed at you and you obligingly scrawled your name on the datapad he was holding out in your direction.

“Your personal effects are in the front room,” Kix informed you. “Drink some water now and then, would you?”

“Of course, thanks,” you said absently, attention already stolen away by the fascinating blush creeping up Echo’s cheeks. You slipped out from under him and grabbed his hand to tow him behind you. “C’mon. You’re gonna love my apartment.”

---

A/N - ahh, why did this end up being such a novel? Sorry about that! If you want to read similar works, check out my masterlist or make a request based on this post (or make something up and I’ll do my best!). Thanks for reading!

#star wars #star wars the clone wars #sw tcw #tcw fanfic #tcw #echo #echo x you #echo x reader #kix #fives #illness #first kiss #star wars fanfiction #fic request

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oftenderweapons · 4 years ago

Text

Mold Me New (5) — Kim Taehyung

A Small Town Swoons Story

Pairing: Taehyung x reader (nicknamed Frog — for now)

Wordcount: 5.2k

Genre: ceramic artist!Taehyung, divorced!reader, Strangers to Lovers, Fluff, Smut, Slice of Life

Rating: 18+

Hello to my readers!!! Welcome to the Small Town Swoons Universe!🥰✨

In this episode: Frog gets to see the final results of her hard work. Taehyung, feeling extremely proud of her, is in the mood for celebation. He invites her for dinner, but eventually the lasagna in the oven is not the only tthing getting hot — and the cheesecake is not the only sweet thing on the menu.

TRIGGER WARNINGS: swearing. mentions of alcohol. smut: making out, grinding, humping, groping (ass, breasts) hair tugging, fingering, very soft overgrown teenagers being inappropriate and horny and tenderly feral on the sofa. Also cramps cause topping ain't easy folks.

A special thank you to @taegularities, my cutest, most adorable, Taehyung stan, The Radiant Rid. I love you, babe. Can't wait to read your next masterpiece 💕

In case you like my writing, here is my directory for idol!AUs, scenarios and imagines. And in case you need it, here’s the Spotify music companion.

Navi: Chapter 1 — Chapter 2 — Chapter 3 — Chapter 4 — Chapter 5 — Chapter 6 — Chapter 7

Enjoy 💜✨

You were falling for Kim Taehyung.

This was by far an undoubtable truth, like the butterflies in your stomach, like the softness of his hair and the plump curve of his lip, like the excruciating, painfully perfect beauty of his face.

He was a gift to humankind, you realised.

You were sure that by now your heart eyes showed in a three-mile radius, and from the way he looked at you in return, you could tell the sentiment was somehow returned.

What made you insecure was his lack of initiative.

You noticed he enjoyed being on the receiving end — which had actually shown a few days before, when he’d fallen asleep in the comfort of your lap, you reading your book while he recovered from the stressful day.

You could still remember the soft golden light coming in through the window, the way his breath got heavy with sleep, his hand laying just an inch above your knee, growing clammy with sweat as he heated up under the blanket. And the feel of his fluffy locks under your fingertips.

He’d looked adorable, a gentle blush on his cheeks, his cherub face relaxing, chubby and plump with the sweet abandon of sleep.

His hands suddenly laid delicately atop yours. “The kiln has cooled up. Would you like to see?” Taehyung asked quietly, trying not to wake you from your reverie too abruptly.

“Oh, yes!” you replied as briefly as possible, hoping he didn’t catch you daydreaming while staring at him with a fond expression.

“Be very careful, they’re hot,” he said, lifting the top of the kiln slowly and letting the remaining hot air come out a bit at a time, without having to feel the heat hit his face.

“Are they going to be good?” you asked curiously. Not all your pieces had made it through bisque firing, and the idea of having something that actually looked like a finished, real work of art was getting you excited. You had been taking lessons for six weeks now and it felt about time to see some results.

“I think I can spot a good one,” he mused as he lifted the lid, bright blue glaze immediately catching your attention.

“Did the bowl survive? The one with the golden swirls? Please, tell me it did, I love it so much!” You felt ready to beg, pray, cry if something had gone wrong.

“It’s on the middle shelf. Be patient, you golden retriever,” he joked, wearing a pair of latex gloves to make sure the temperature was okay without damaging the glaze.

“It was my first to survive bisque, I am invested!” you argued back, peering from over his shoulder, noticing that your vase for Terry had survived.

“Vase accomplished, Frog. You should be excited about that one,” he said, moving it to a shelf. “It means you worked it nicely.”

You shrugged. It was one of your latest pieces, so you weren’t too surprised about it. Still, considering that shaping a vase with consistent walls is a feat in itself, you smirked. “You taught me well.”

“I did,” he replied, lifting a large, low bonsai plate. “Ready to see your bowl, Frog?”

“If anything happened to it, I’m going to kill you.”

Taehyung turned to you, grinning, his nose scrunched in a way that made you sure you would never lift a finger on him.

Your eyes closed: because you were nervous about the bowl, you told yourself — not because you couldn’t stand Taehyung’s expression without pressing your lips to his.

He lifted the shelf from the kiln. He turned to look at you.

He did not resist.

It was like you were waiting for him to kiss you, fist pressed underneath your chin, eyes screwed shut in excitement and fear.

He touched his lips to the apple of your cheek. Your eyes shot open, but the gentleness on his face calmed you. “Congratulations, miss Frog, you have a beautiful blue baby,” he declared in a very medical fashion.

You threw your arms around him, jumping up and down as you giggled hysterically.

“And she cheers for the bowl,” he said, shaking his head in disappointment. “As if she could mess it up after that vase.”

“Screw the damned vase, show me my baby,” you said, going grabby hands to the kiln.

“No, Frog. Wait,” he said, picking up the piece and bringing it to the table, you in tow like a tail-wadding, restless puppy.

“It’s so pretty,” you mused as soon as he set the bowl down. “It’s so sparkly. So glittery. Taehyung, it’s perfect,” you whispered in awe, feeling tears well up in your eyes as you turned to him.

Fondness overwhelmed him as he saw your amused look, so dreamy and happy and satisfied.

It was your baby. Your special creature. Selfishly, he felt like he had contributed to the creation.

For a second he thought that’s what it must feel like to be a father. “Watch over it while I finish the rest,” he said, taking a step away.

You grabbed his wrist.

He turned, waiting for you to explain.

“Thank you,” you murmured, voice emotional.

He twisted his arm in your grip until his hand could reach for yours, engulfing it.

And right in that second, he felt he belonged. Somehow crazily, stupidly, innocently, he felt at home. “Anytime, darling.” He rubbed his thumb against your inner wrist before letting you go. He still had half a kiln to unload.

Bowls and mugs came out easily, some of them even presenting unintended variations that would for sure attract buyers. He felt proud.

But most of all, he wanted to go back to your bowl, to you worshipping it like a little miracle, the poor vase sitting unattended on a high shelf, out of harm’s way.

He closed the lid and took the vase, bringing it to you and placing it on the table.

“You did a very good job, Frog,” he complimented you, placing his hand close to yours, hoping to rekindle the affection he had felt only a few minutes ago.

“It’s not like I did it by myself,” you admitted, beaming up at him.

“Stay for dinner,” he blurted out, “Seokjin brought a cheesecake this morning, I still have half of it. And I have his lasagna in the freezer. We could cook it and eat that — I don’t trust myself making anything edible.”

You snickered. “You don't want me to cook?”

He shook his head. “I wanted to… To celebrate.”

You smiled, standing up, his mouth right before your eyes, “What are we celebrating?”

He looked at your lips as they moved. “The vase,” he replied seriously, although the tone of his voice meant a thousand other things.

“Of course,” you conceded. “Let’s go. I’m hungry,” you confessed, grabbing his hand, tugging at his arm.

Taehyung could swear he was floating a foot off the ground out of happiness. He realised he’d been happier than usual lately; he’d been selling more pieces and his part time job was finally giving him some satisfaction.

He felt like he was drifting across the kitchen as he put his phone in a wooden box as an amplifier, playing an old jazz tune as he put the lasagna in the oven.

You sat at the table, watching him move around with a small smile, your head leaning on your palm. You were such a sucker.

“Wine?”

You shook your head. “You’re gonna get me drunk,” you smiled.

He sat at your side, “why not,” he teased, “just vaguely tipsy. I promise I’ll be a gentleman.” He placed a hand on his heart and bowed his head slowly.

“It’s not you I’m worried about,” you murmured, looking down before meeting his eyes again.

He licked his lips. “Who is it, then?”

“Me.”

“What about you?” His fingers skimmed the surface of the table, sliding all the way to your elbow and tracing your inner forearm.

A shiver ran down your spine. “I get clingy. And slightly inappropriate,” you chuckled embarrassedly.

“I could never be bothered by that,” he whispered, wrapping his fingers around your wrist. “I bet you’d look so adorable.” His hand opted to cup the back of yours before you slipped your hand away, making his palm touch your cheek instead, your face leaning in. “Which would make you absolutely irresistible,” he admitted, nodding fondly at your display of trust.

“Thank you,” you replied to the compliment, feeling your face heat up.

“Let’s lay the table.”

Let’s lay down and make out for three hours and fall asleep under the stars in the back of a pickup.

You gave your brain a second to calm down. “Sure. How can I help you?”

In twenty minutes, the tasty smell of lasagna began drifting in the air, making your mouth water as you and Taehyung talked about his other job — the one that actually paid the bills and brought food on the table. “I just love them, they’re adorable. I managed to practice when my granny used to babysit.”

You pouted, starry eyed as he talked about the children, going on and on about the five year old that always wanted to curl his hair and paint his nails.

Most of all, you loved the idea of him sitting on a baby chair, all curled up, giant hand sprawled on the table while the girl spread lacquer on his pretty nails.

“Your granny babysat?”

“She raised a few of us, yes, and then she was the babysitter for all the kids of the street,” he explained.

“I thought you grew up with your mom?” you said confusedly.

“Yes, we stayed with my mom until we turned four, but then she went back to her job and we started staying with my grandmother. And when I was ten, my mom started dating a good man. He’s one of the greatest people I know, but unfortunately, he was transferred out of state and my mom decided to go with him. I didn’t want to leave and my granny let me stay with her.”

You nodded, taking in more details about him. “Are you happy about the situation with your mom? Do you miss her?”

He shrugged. “Sometimes. But I like seeing her happy. She got married and she’s safe. Her husband spoils her, he takes care of her and he’s well off. She won’t need to worry about her health.”

“That’s a good thing,” you nodded, getting startled once the timer rang.

“Thank God,” he muttered, getting an oven glove as you stepped away quickly.

Dinner was a quiet ordeal, with easy chatting and small pauses. Silence was more than welcome as you slipped into the quiet comfort of sharing a meal. It was all so natural, effortless. And the food was delicious, filling your stomach but also pleasing your tastebuds; Seokjin was famous for his culinary skills, but he really outdid himself with the cheesecake, so creamy and perfectly sweet that you asked for a second serving, Taehyung more than happy to comply.

You kept chatting as you helped him clear the table, washing the dishes while he dried them.

“Last one,” you called, rinsing a plate before passing it to him.

You watched him as he diligently dried it, your gaze meeting his in his peripheral.

You tried to find something to say as his stare focused on you, his hands placing down the plate as he fully turned towards you.

“What?” you murmured hesitantly.

“I might do something stupid,” he said, his voice deep and barely audible, his face getting closer to you. “But I haven’t done it in a very long time.” His hand landed on your waist. “Stop me if you find it outright idiotic.”

There was nothing idiotic in the way his mouth looked so inviting from up close, all its curves too inviting for you to stop staring.

The mole on his lower lip teased you in ways that made you want to throw yourself at him. You couldn’t even understand how the attraction worked, you were simply needy, praying for his mouth to finally meet yours.

“Close your eyes,” he breathed out, trying to find courage.

You followed his suggestion, putting yourself out of misery and standing on your tiptoes before leaning in, finally joining your lips with his.

He didn’t even pretend to keep calm, both arms wrapping around your waist as he held you, delivering a string of small pecks with his lips slightly ajar, offering you the soft plumpness of the inner flesh, vaguely humid and hot.

You loved it.

All you could do was exhale, a tiny cry leaving your throat as your vocal cords caught the breath leaving your lungs. Your hands flew to his hair, hiding in him as embarrassment set you aflame.

A low grunt echoed through his chest as he felt you tug the locks at his nape gently, your body pressing harder against him.

He tried to hold you back, not sure he was ready to admit the carnal way his body reacted to you. He wanted to be gentle, delicate, cautious, but the tightness of his trousers around his crotch was anything but.

“Darling, I need a minute,” he mumbled against your lips in an almost tickling motion.

“Just one more,” you replied, your voice so heated and thin.

He tutted. “Let’s not go too fast.”

You stood straighter and chased his mouth as he tried to retreat, your eyelids lowered as you stared at the sweet, tempting mole.

“Just one…” you whispered before sucking his lower lip, licking it with the tip of your tongue.

His hand moved to your tailbone, pressing you closer. Rational thought abandoned him as he pushed his tongue against the seam of your lips, rubbing it against your palate before letting it tangle with yours.

That’s when you noticed the hardness between your legs, his thigh slotted there comfortably as you pressed your hips to it, eliciting a moan from Taehyung.

“Sofa,” you murmured, trying to hold him to you as you walked backwards to the door.

“Wait,” he breathed out, trying to part from you, causing you to whine.

“Don’t go,” you said with a pout. “I need you,” you almost whimpered, touching his nape, his neck, his chest.

“I’ll be there in a second. Don’t go all cute grumpy on me, I just need to grab my phone,” he explained, unglueing your body from his. Reluctantly made your way to the kitchen door, waiting for him before heading to the sitting room, refusing to let him out of your sight anytime soon.

Once he’d pocketed his phone, he turned towards you, his eyes getting dark and lascivious as he studied your frame while you leaned against the door jamb.

He strolled casually towards you, your eyes following his sinewy limbs.

You realised you were eager to see him naked, the thought making you pause mid-breath.

Once he stood in front of you, his arm slipped between your back and the wooden frame of the door, holding you as he leaned down. “Smartest thing I’ve done in a while.”

“Even smarter if you’re gonna do me,” you quipped, biting your lower lip and cringing once you realised you had said it out loud.

He snickered and kissed you, your hips pushing forward to grind against him, his cock too hard and large for you not to notice it. His hand wrapped around your asscheek, helping you grind even harder, his lean, strong fingers squeezing and kneading your flesh deliciously. Carefully walking towards his destination, he helped you navigate the corridor in a slight penumbra, a thin ray of moonlight slashing the floor before he pushed the door open and entered the sitting room. The space was illuminated in a blue-grey light coming from the full moon shining outside the windows.

Haphazardly, you managed to sit down, pulling him with you, making him lose his balance and stumble a little.

“Are you okay?” you asked, worried about the stupefied look on his face.

“Yeah, just thinking how to…” he fixed his stance, wondering if he should pull you on his lap or make you lay down or…

“Come here,” you murmured, kissing the mole on his cheek. “I’ve got so many kisses to give you.”

“They’re all mine,” he cooed, turning adorable for a second.

You melted. “Yes, now come here, don’t make me beg.”

He turned and leaned into you, cupping your jawline and holding you still before he slipped his tongue across your mouth. “You’re too far like this,” he complained, ignoring the fact that your bodies were literally touching shoulder to ankle.

“Wait.” You quickly bent your legs underneath you, thankful for the no-shoes rule in his house as you sat on your heels. “Like this?” you asked as he mirrored the motion almost too rapidly, his body rocking dangerously.

He immediately realised his trousers were tighter like this. He tried to ignore it, his only goal being for his mouth to meet yours, feeling the hot, milky taste of your tongue that still held some memory of the cheesecake. “Come closer,” he breathed, hoping to get some friction, the softness of your breasts against his torso, crying out at how much he missed the stand-up position, allowing the front of his body to adhere to yours with alarming precision.

“Can’t get any closer,” you chuckled desperately. “Can I lay down?”

He nodded, he needed close.

You untucked your legs from beneath you, bending them at each of his sides. “We can go to my room—”

“I like it here,” you replied, tugging him into you, his eyes shooting open once he’d risked falling from the sofa.

You managed to catch him, thankful for the wide cushions of the seats. “Be careful,” you giggled fondly, kissing his brow, his nose, following his moles like fire flights. The whole night felt magical. It felt even more magical once you managed to get his playlist to play again, placing his phone on the ground and enjoying the round fullness of his backside.

“You really have hands made for pottery,” he mused as he kissed your brow, your cheeks, the bridge of your nose, your chin, the shell of your ear. “I like them there,” he confessed, pushing his pelvis against yours, meeting it mid-thrust and coaxing a whine from your throat and a growl from his.

One of his arms lifted from beside your head. “Can I?” he asked politely, letting it hover just a few inches over your breast.

“Please do,” you replied, leading his hand with yours, his wrist and fingers immediately catching up on how to grab it, squeeze it, roll it in his palm and toy with the nipple.

“Harder? Softer? Just like this?” he checked in, attentive and concerned.

“Just slightly harder,” you panted. “Slower too, please.”

His pace changed immediately, getting you to whine as you completely connected with his touch. The soft, slow massage was making you hyper-aware of every inch of skin, every single part of your breast, every nerve ending and hard edge and soft curve.

“I wanna take off my bra. Can I?” you asked in the heat of the moment.

Taehyung was vaguely confused for a second, so lost in the feel of you that he barely understood the question. “If you want that, I want that,” he replied, his breath laboured.

Quickly, you arched your back, Taehyung’s lips reaching the column of your throat and peppering it with soft pecks. “Do you need help?”

You tutted and moaned as his teeth scraped your skin lightly.

With some gymnastics, you managed to tug the garment out of your shirt, Taehyung moaning at the increased softness underneath his palm. “Goodness, they’re incredible,” he murmured, pressing his face against one, rubbing it as he turned his head side to side.

“Please, keep touching them,” you mumbled, your voice rough with the way you struggled to breathe.

He changed the arm propping him up, switching sides as he started to tease your other breast. “Does it feel good?”

“Yeah,” you managed to confirm before your hands grabbed his ass to push him against you.

He paused for a second.

“I’m getting out of control,” he warned you.

“And?”

“I’m gonna cum in my pants if we keep this up,” he confessed, purring as you nibbled his jaw. “Slow down, please,” he panted, lifting his hips away from you.

“Tae,” you called, breathing heavily, almost begging him.

“I want you a lot, ____, please tell me you do too,” he was almost feverish with need, his brow furrowed, his beautiful eyes glittering in the dark.

“Isn’t it clear?” you asked in return, trying to chase him on his retreat.

He tutted and pushed you down. “I want to hear it.”

“I want you, Taehyung. I need you. I want to see you lose control.” Your mind was gone, far far away, your brain malfunctioning as his curls tickled your upper chest.

“I don’t wanna go all the way,” he murmured, “I just… I just wanna—” he huffed out frustratedly. “I just want to make you feel good. And to feel you close to me.”

You bit your lip. “Maybe—”

“It’s not that I don’t want to make love to you. I really want to. But this is going so fast and I wanna savour every step. Take my time.” He pressed his forehead against your chest. “I just like you so much and I want you to know it means something to me.” He paused and you waited for him. “I don’t want you to think this is just a random thing to me, and I don’t want to be a random thing to you.”

“You’re not.” You cupped his cheek and pressed a soft kiss on his lips. “We can take our time—”

“You must think I’m a coward,” he murmured, voice filled with self-hatred.

You held him closer, trying to convey all your affection. “No, it’s okay. You’re okay. You’re safe with me. I get you, baby.” You rubbed the tip of his nose with yours. “Let’s take baby steps. We can just mess around. You want to make me feel good, and I you. No need to have sex to go there.”

He nodded. “I wanna keep touching you,” he murmured. “I wanna feel you with my hands.”

You blinked slowly, eager to feel his fingers on you, inside you. “That sounds great, baby,” you encouraged him, watching his shy smile and the gentle blush on his cheeks, out of exertion and shyness.

“Tell me if you need to stop,” he whispered in your ear before kissing the soft spot underneath it, his free hand moving down, from your breast to your stomach, slipping underneath your shirt, moving up against your naked skin.

You gasped once his palm cupped the underside of your bosom.

“Did I hurt you?”

You shook your head. “Feels very good,” you answered, caressing his hair out of his face, his eyes moving from your chest to your lips to your eyes.

“Are you okay with this?” he asked, reaching for your nipple with the pad of his thumb.

“Bless you, yes, baby. So good.” It was natural to trace his mouth with your finger, his lips parting to welcome it into his mouth. Your hips arched up, meeting his thigh to grind against him. You needed more pressure against your clit, your entrance clenching and widening as you felt wetness coat your folds uncomfortably. You refused to pressure him into leading his hand downwards, still you thanked several deities when his gentle fingertips started making their way to your belly button, dipping his digit in to study its shape, feeling all the ridges and tender skin. “It feels so cute,” he said after letting your finger out of his mouth, watching as you brushed it against your neck to dry it up. “I wanna make a little sculpture out of it.” He giggled. “Sorry, that’s so childish.” He shook his head.

“It’s adorable,” you replied, “it’s— Mmh, Tae. Yes.” He managed to scatter your thoughts across the universe once his fingers dipped into your jeans.

“Undo the button please,” he growled, reaching for the wet spot on your panties. “Darling dearest, you’re fucking drenched,” he said, a deep cry giving away just how desperate he was. “Can I get in your panties, precious?”

Mouth gaping, you nodded, an embarrassing mewl echoing across the room as he touched a slightly delicate spot. “That’s too sensitive,” you keened, a strangled purr leaving you once your back arched, his thumb relieving the disturbing pressure and wetness.

As slight friction began to build, Taehyung bit his lip, the vision of you so erotic and calming at the same time. It felt right, oh-so-right, to have you underneath him like that — maybe slightly overdressed, but adorably pliant and needy.

“Want them inside, darling?” he asked you, your head nodding yes quickly, without a shred of doubt. “Here, talk to me, sweetheart. Like this?” he murmured, waiting for your feedback.

“Yes,” was all you managed to utter, his digits hitting your sweet spot without even trying. “Rub there, please, stretch me,” you told him, guiding him as your hips started to roll, his thumb meeting your clit and causing a small whimper to exit your mouth before you clamped your lips around his neck.

“You feel amazing, darling. Soft and so hot and so velvety. You’re so dang slippery, it feels insane.” He kissed your head. “Want to make you cum so fast. I want to keep you up for hours like this, and then kiss you until you fall asleep. You’re spectacular, ____. I can’t take my eyes off you, my precious.”

You felt overwhelmed with the way he pushed his fingers inside you, pressing his long, strong, skilled, digits against your walls, stretching you so impossibly wide that you felt like you could probably fit four fingers in to the knuckles. But you didn’t have time to think much, simply arching your hips up and pushing your jeans and panties to your mid-thighs, trying to give him more space for action.

“Is the angle alright?” he checked in, binding his wrist a little lower, getting better leverage to finger you harder.

“Keep going like this,” you exhaled, your hand moving down, fixing his thumb as he struggled to find the right spot, “let me handle this, focus on the inside, please.”

He nodded and kissed your lips. “Sorry.”

You kissed him again. “No need to apologise— Yeah, right… there…” you said, starting to thrust up in earnest. “Clits are complicated but you’re doing so good inside,” you licked your lips, trying to ease the pain of them drying up with your and his breathing.

He bent down and chased the tip of your tongue as you ran it across your mouth, drinking in your soft hiccups and gasps as you neared your climax, his mouth crashing onto yours as you finally came apart underneath him, his kisses muffling your moans and cries.

Taehyung felt desperate as he slipped another finger inside you, giving you as much fullness as he could offer while you clenched around his digits, actually sobbing once you processed his generous offer.

It took you maybe thirty seconds before you could calm down, taking your fingers off your clit, whispering an “okay, slow down” to Taehyung, who halted the arching and pistoning of his fingers to simply press against your g spot and cup your mound with his palm.

“All good?” he asked, grunting a little as his arm cramped up.

“Yeah, are you?” you murmured back, noticing his wince.

“Cramp,” he huffed, squeezing his eyes shut.

“Want me on top? You’ve strained yourself already as it is,” you scolded him apprehensively.

He shook his head and withdrew his hand from your crotch, cleaning his fingers with lewd, erotic swipes of his tongue. You felt ready to begin all over again. “I need to be on top,” he said, drying his hand against his t-shirt before propping himself up on both elbows before bending down, hiding his face in the crook of your neck. “I kinda want to grind on you, if you’re okay with it.”

Nodding, you helped your hips up, fixing your clothes back in place but also leaving your zipper and button open. “Clothes on?”

You felt his head move in an affirmative motion, his hips starting to press against you. “I know I must look like a teenager to you.”

“It’s adorable. Makes me feel very young,” you said before chuckling. “It’s been so long since I felt this good with anyone,” you confessed, holding him to your chest, assisting his motions by moving your own pelvis in a wavy pattern. “It’s so comfortable. So familiar and nice,” you whispered in his ear before biting it gently. “You make me feel like I’m not an utter mess in this attraction thing.”

“You’re not a mess. You just feel attraction differently.” He managed to gather his thoughts and words long enough to reply to you. He thought it was important for you to feel that it was okay, that he didn’t mind, that all he cared about was how happy he felt by your side. “You’re hot, you’re smart. And you’re so…” He grunted as he found the perfect angle and pressure, his high rushing towards him. “So magnetic. And good…” Another purr left his mouth as he started humping you in earnest, going so fast you doubted you would survive having him inside you, his torso crashing on you as he hummed and bit the crook of your neck, crotch attached to your thigh as he pushed, harder and harder, his glutes impossibly tight under your palms.

“Yes, baby. I’m here, Tae. It’s all okay, babe.”

“So good,” he rumbled, still hiding against you. “So, so good,” he moaned again, your face tensing in a kind, elated smile.

“Lay on me, baby,” you kissed the crown of his head. You felt as if you were on cloud nine, and it had little to do with the orgasm and the freaky show. You loved his tenderness, his gentle approach, the way he had checked in on you throughout the whole night, wide puppy eyes staring at you in focus and adoration and wonder. And the way he had asked to take it easy, the way you had felt no pressure, no need to search for attraction, but finding it there, in the way his hands felt familiar and welcome and so, so loving, in his face and his smile and his stupid, stupid, ridiculously fluffy hair. There was attraction and even though you had asked yourself why at the beginning, you didn’t dare doubt it now. It was just like oxygen in your blood, like black holes and shooting stars and the moon phases. Undoubtable. Solid. Proven. Undeniable. It had become a main axiom to your existence.

I’m in love with Kim Taehyung.

It was like the world suddenly spinned the other way around. You let the revelation sink in, your hand running up and down Taehyung’s spine.

“You’re safe with me, babe.”

He nodded and nuzzled in closer. “Are you staying?”

“Yes, sweetie. You’ll be sleeping in my arms tonight, baby.”

You felt him smile against your neck before he found a comfortable position and closed his eyes.

Taglist is open

Navi: Chapter 1 — Chapter 2 — Chapter 3 — Chapter 4 — Chapter 5 — Chapter 6 — Chapter 7

#taehyung x reader #taehyung fluff #taehyung smut #kim taehyung x yn #thebtswritersclub #bangtansorciere #thetruthuntoldnet

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letsunity · 3 years ago

Text

The Lucky Batch

Relocated

Foxy had many ideas, most of them could be perceived as terrible.

This wasn’t one of those moments. This was worse.

“We’re going to die!” Mozzarella screeched, clinging to the tank cannon for dear life. “Why do I always listen to you!?”

“Because I’m lucky!” Foxy grinned, swinging onto the head of the tank. He pushed up the hatch, smiling down at the droid inside. “Begone, Bot!” he yelled, pulling the head off.

He dropped inside, looking at all of the blinking lights. Mozzarella fell in after him, landing upside down as usual.

“What do we do?”

“Dunno, didn’t think I’d make it things far,” he shrugged, starting to press buttons.

--------------

With blaster fire raining from all around them, the clones did whatever they could to hold their ground.

“You’ve got another one, CT-2002!” yelled his brother, dragging in an injured shiny.

Pepper wiped the sweat from his brow, the heat and stress gnawing at his jugular. With supplies dwindling by the minute, he was resorting to primeval methods of saving his patients.

As he looked down at the latest patient, he found the body of the Commander. The Padawan was a child, having only served Master Laverna for only a few weeks.

The wounds were to her leg, burning and festering, blood leaking through cracked skin. A blaster shot from the looks of it, a direct hit.

He investigated the wound, the heat bearing down on them without mercy. He felt the leg, trying to ignore the girl’s cries of agony. The bolt cut through her clothing and through the bone and out the other side.

She needed a bacta tank in order to save the leg. As it wasn’t possible, he had to do what he could to keep her alive.

He doesn’t have a saw, but Springer has a knife.

Biting his lip, he gave the girl some cloth to bite on. She looked at him teary eyed, knowing what he was going to do.

Pepper held her hand as he prepared to cut through, Springer holding the leg still, shaking in fear.

The cloth did little to muffle her cries as Pepper cut through her flesh, removing the sickly part from her body. It’d infect her bloodstream, something even the jedi can’t heal.

As the bone was already separated, Pepper managed to cut through without hacking. He ripped a piece of metal from outside the tent and pressed it against the wound, burning and cauterizing it.

“Next,” Pepper panted, not wiping the blood from his hands.

“You need a break,” Springer said, worried for his brother.

“I’m the only one here with a modicum of medical training. I break when we’re off this pit of a planet,” CT-2002 answered, feeling sorry for the young padawan.

The General entered the tent, looking for their injured student. Dolos pounced to the girl’s side, looking over her injuries and Pepper’s improvisation.

“You cut her leg off,” Laverna scowled, disgusted by Pepper.

“Unless you’ve gone blind, General, I worked with what I have, which is nothing. I have more patients,” the medic sighed, walking away from the Cathar.

--------------

As the night started to fall, Foxy looked for his twin, excited to tell him about his big day. When he entered the barracks, however, Peppy wasn’t there. Mozzarella and Springer were, however, which was still cool.

“The moron is gonna kill himself at this rate,” Springer sighed, unaware that Foxy was standing there. “I don’t think he’s even eating.”

“It’s that hyperfocusing thing. When he’s in the zone, there’s no coming out of it,” Mozzarella added, rubbing his eyes. “General Laverna has been pissy all evening. Know what that’s about?”

“Aye. Commander Teles lost her leg in combat. The General has been upset over it. I mean, I can get why. I overheard from the Captain that he lost his last Padawan to something similar.”

Foxy made his way to the medic tent, looking for his twin. He walked through the narrow path in the middle, bodies packed next to each other. He could smell the gangrene, the infections and death.

He saw some fellow ARCs lift a clone, taking them outside to a pit with fire. A way to keep the bodies from infecting other people as they didn’t have time to bury.

They didn’t have the recourses for a lot of things.

In a corner, he saw the shape of his twin, able to recognise him from a mile away. Guessing that this was a bad day, Foxy carefully sat next to his twin, looking over a body covered with a sheet.

The body of a kid missing a leg.

“The cut was too low,” Pepper stated coldly, staring at the sheets. “It was too low.”

Foxy rested his head on Pepper’s shoulder, providing some support. He didn’t know a lot about medical things, but he knew when Pepper was sad. He hated his brother being sad.

The girl was nice to the clones, a sweet thing who didn’t deserve this. She wasn’t trained like the clones were.

“Where’s Teles?” the General yelled, disturbing the patients still alive.

The cathar stepped to the twins’ location, pausing and staring at the covered body. He shook with emotion, something that Jedi aren’t supposed to show.

When Foxy turned to face the Jedi, he’d already grabbed Pepper, dragging him outside by the braid.

“What the fuck is your problem?” Foxy yelled, grabbing the Jedi’s wrist. “Let him go!”

“He killed her!” the Jedi hissed, using the force to shove Foxy away. He threw the medic outside, seething. “You killed her!”

“I did what I could. That’s more than what you did,” CT-2002 yelled back, looking behind the cathar to see Foxy, relieved that his twin was alright. “She wasn’t even a teenager and you pulled her into the front lines. She died from your actions - all of us have suffered from your orders!”

Mozzarella and Springer exited the barracks with a few others, listening to the argument. The clones focused on the fight, failing to pay attention to their surroundings.

“I’ve done everything I could!”

“And we both failed. A whole lot more of us are going to be dead if we don’t leave this damned jungle!”

“We won’t abandon our post!”

“Then Teles died for nothing!”

Foxy started to panic, unsure of what to do. The Kaminoans never prepared them for this scenario, this wasn’t part of their training. Geonosia didn’t have this much tension.

He wasn’t this panicked since Padme Amidala fell from that cruiser. He wasn’t this scared since Locke died a week ago.

His heart pounded against his chest when his twin was in the air, clutching at his throat. His twin is in danger, his best friend was being hurt by their own General.

Foxy never was one for self control.

Without even realising he’d been holding his breath, Foxy had jumped the Cathar, causing them to drop Pepper. He held on, furious that the Jedi turned on not only his twin but their only remaining medic.

The Cathar threw him off, Foxy’s back colliding with the muddy ground. Of course, it was only right for the rest of Clover Squad to attack.

Springer and Mozzarella pounced, jumping the Jedi to the ground.

Master Laverna activated his lightsaber, cutting into Mozz’s chest.

“Mozz!” Foxy shouted, horrified to see another batchmate die.

Springer picked the knife from its holster and stuck it into the cathar’s shoulder, furious over his brother’s demise.

Foxy tacked the Jedi while they were too distracted with Springer. With a snarl, Laverna lifted Foxy into the air, their first like a phantom hand over Foxy’s neck. With Springer alarmed, Laverna twisted the lightsaber into the abdomen.

Pepper ripped the knife from the cathar’s back, aiming to stab their shoulder, freeing Foxy. Instead, the mud gave way.

Laverna’s concentration fell when the knife was torn away, causing him to drop Foxy. As they fell, Foxy instinctively kicked, hitting Pepper’s arm.

The knife cut right through the cathar’s neck.

In a moment, Foxy was on the ground. Shaking his head, he ran to his twin, hoping that he was ok.

The lightsaber had caught his lip, it’ll definitely scar over.

Finally, with the fight over, the other clones started to come over to them.

His twin is still alive, that’s what mattered. Foxy assumed that the exhaustion finally kicked in, including the stress and heat.

They killed a Jedi. They didn’t mean to, he was just trying to protect his brother.

His dark eyes met the Captain’s, horrified.

“He was going to kill him,” Foxy mumbled, holding his twin to his chest. “We would’ve all died...”

“It was the heat,” Captain Impact stated, looking away from the trooper. “Prolonged heat exposure and dehydration can cause hallucinations. You did what was necessary for the whole platoon’s safety.”

It wasn’t the truth, though it wasn’t exactly a lie, either.

---------------------

“You’ll be stripped of your position of ARC Trooper,” Mace Windu stated, looking down on the traumatised twins. “You’re being transferred to Clone Force 37. Hopefully, your new General will last longer than the others.”

They didn’t look at him, thinking over Mozzarella and Springer’s demise.

A Besalisk and little Wookiee met with the Jedi, likely their new commanding officer.

With his one job done, Mace Windu left, abandoning them to their new squad.

“Can I see your faces?” Master Bastet asked, kneeling to their level gently.

Foxy and Pepper removed their helmets, Pepper with a new hairstyle and scar on his lip.

“Aye, you’ve been through much. I promise you now, young ones, you’re safe now. Clone Force 37 is a family, one you’re very welcome to.”

The Wookie padawan handed something to Pepper, a little star that stuck to his fingers. His eyes was wide and amazed by the small thing, his mind blow.

“It’s a sticker,” Freyja gurgled, only able to speak her native tongue. “Do you like it? I heard what happened and got one to make you feel better.”

“He loves it,” Foxy nodded, feeling a little better. “We’re not good soldiers, but we’re loyal. Aren’t we, Peps?”

“Not to mention stupid.”

“You’ll fit right in with the others. Jackal has been bouncing off the walls since he heard that we were getting new members,” Bastet smiled, already motherly to the pair.

Maybe this’ll work out? So long as Foxy is with his twin, he’ll survive.

Not only what happened to their last Jedi and what happened to the other batchmates, but Pepper’s scar, too!

inspired by my awesome twin’s brilliant work :D

@monako-jinn-stories @just-another-dreamerr @foxlock @radbatch @generaltano @lusiawonder @catboy-tech @lavenderstaars @maygalodon @cosmicghostie @lynnpaper @oo-hazel-oo @namesmox @mango-peachjuice

#The Lucky Batch #Clone Force 37

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whump-a-la-mode · 4 years ago

Text

Villian-Sicle | Part 3

I didn’t expect to continue this beyond part 2, but I’ve come to love these characters. I hope you guys enjoy! Heed the warnings, this one contains a lot of medical stuff.

CW//Superhero whump, villain whumpee, hypothermia, hospital setting, cardiac arrest, blood, dialysis, talk of death, talk of “pulling the plug”

Taglist:

@whatwhumpcomments

@sola-whumping

@professional-idiocy

The machine was too loud.

Talking over it made Leader feel that they were tearing apart their vocal chords. Then again, the stress of the situation wasn’t exactly aiding in that respect-- they could practically feel their tense muscles tightening around their windpipe.

“They’re going to be okay, then?” Their tone was rushed and pressing.

“I don’t want to guarantee anything.” The Head Doctor bit their lip. “Really, I can’t guarantee anything. By all accounts, the patient should already be dead. Human body temperatures shouldn’t be able to get that low...”

“Humans shouldn’t be able to fly, either.” Medic shook their head, gesturing at Leader, who tucked in their wings, not even realizing that they had unfolded. “But here we are.”

“There’s nothing particularly unusual about their physical anatomy, though?” Head Doctor raised an eyebrow.

“Enhanced people have different anatomy by default. Higher heart rate, for one thing.” Medic provided, glancing towards the heart monitor sitting next to the hospital bed. The spikes were shallow, and abnormally close together, but none the less steady.

“Yes.” Head Doctor dipped their head. “Well, then, that would explain how our patient is still breathing.”

“They should remain that way, then, right?” Leader fretted.

“I have high hopes. We’re doing everything we can. It’s up to them, now. If their body temperature can raise before it’s too late.”

The conversation ended on the same worried note as it had began, and the groups’ gazes seemed to unanimously drift downwards, as if they had simply forgot that they were standing over a body halfway between humanity and corpsehood.

Villain’s skin was horribly pale, translucent, even, as if it were on the verge of melting away. The restraints on their wrists and ankles-- Leader had insisted as to their presence-- seemed far too loose around their captive’s thin structure, but they simply couldn’t be tightened any further.

The only patch of Villain’s body that did not lack color was their chest, in which a catheter of at least an inch in diameter had been inserted. The skin around was red with irritation, resisting feebly against the roaring machine drinking blood from the line, only to return it at the same access point.

The whole spectacle was horribly grisly, with tubes filled with scarlet draped over Villain’s chest in a gruesome web. The machine itself, sat off to the side, seemed to whine and groan with every feeble heartbeat its victim managed to make.

Hemodialysis, the doctor had called the process. Manually warming the blood in an attempt to warm the body. Despite its vampiric appearance, somehow, the process was keeping Villain alive.

A chill ran through Leader’s body at the very thought. Villain was a stubborn asshole, one they’d been pursuing doggedly for months. Somehow, regardless of what trap they placed or what situation they were thrown into, Villain made it out.

Now...

The machine was plugged into the wall with a single cord. Just a wire, just some electrons passing through metal. Something that could so easily be severed. A single tug, a clumsily placed foot. The fight would be over. Would it be so wrong? Villain had done such wrong... and they wouldn’t feel a thing. They’d part in an unconscious pool of their own delusion.

Leader bit their tongue.

━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━��━━━━━━━━━━━━━━━━━━━━━━━━━━━━━

“You okay?”

Hero watched the small flame of force flicker between their fingertips, their eyes nearly crossed with focus. They had hardly realized that somehow had spoken to them, and it took several awkwardly long seconds for them to look up.

“Hm?”

“Are you okay? You looked distracted.” Counselor furrowed their brow.

“I think I’m... always distracted.”

“I know. Just... that was a lot, back there. And you looked stressed.”

“Just worried, I guess.”

“About Villain?”

“There’s not much else to be worried about.”

“I’m worrying about you, right now.”

“I think... Villain is the one that we need to worry about, right now.” Hero chewed their cheek. “You were in there, right?”

“For a minute, yeah.”

“Are they okay?”

“Alive. They were alive. But with Medic there-- well, I don’t think there’s a better authority on Enhanced biology on the seven continents. I think it’ll turn out okay.”

Hero chuckled humorlessly.

“That’s another thing I’m worried about.”

“What? Medic?”

“Yeah. Medic kind of. More Leader. Medic is... I mean, I love ‘em, and they’re the biggest hardass out there, but they’re a doctor more than anything else. Hippocratic oath and all that. But Leader...”

“You’re worried because Leader... isn’t a doctor?”

“No, no, it’s not that. Leader just seems so much more worried about the fight, and the mission, and the good of humanity, than, well, than anything that’s right in front of them. I’m just worried that...”

“That Leader’s going to make a bad choice?”

“Something like that.”

“I agree that they can be... a hardass. But they’re not a bad person. I don’t think they’d execute someone. Not like this. Not after everything.”

Hero’s gaze turned to Counselor. They hadn’t expected their friend to come to the base of their concerns with such speed.

Counselor gave a small smile in return.

━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━

Head Doctor left the room.

They had made their leave hurriedly, ensuring that they would be back in just a few minutes, to press the Code Blue button if anything happened. Leader had nodded along, hardly processing any of it.

They were focused on the person before them.

Over the last few minutes, by some miracle or curse, Villain’s heart rate had begun to stabilize. Though the beats came just as quickly, they were stronger than they had been. Not quite normal, but on their way.

Medic seemed fixed on the monitor, eyes narrowed as though they watched prey. The screen had more than just a heartrate reading. Alongside that, it showed a series of other graphs-- breathing rate, oxygen levels, among some that Leader was clueless as to the meaning of.

They glanced to the door. It was firmly closed. Certainly, the rest of the hospital would be too busy with the recent break-in to intrude.

“Medic?”

The doctor raised an eyebrow, but continued their fixation on the readings.

“Yes?”

“What would you say is the... the percentage we’re working with here.”

“The percentage?”

“Of survival.”

“Well... I suppose I can’t make an exact predication, but it’s climbing every minute. 80 percent? 85? They’re not completely out of the woods, yet, but their temperature is raising steadily. The dialysis is working.

“80 percent.” Leader hummed. “So... 20 percent chance that they don’t make it?”

“That is how math works, yes.”

“That’s not an insignificant percentage.”

“We’re doing everything we can. As I said, it’s rising, and quickly. If we can get their temperature back up into the 90s, I would say that continued survival is almost guaranteed.”

“Is that so?”

“What’s got you acting so weird, all of a sudden?” Medic finally turned from the screen, glancing to Leader.

Leader gulped.

“Do you remember when we were in Denver?”

“At the telecommunications hub? Yeah.”

“And in Vancouver?”

“Yes?”

“And at the bank, in Phoenix?”

“Leader, I assure you, my memory is fine.”

“No, no, I mean, Villain did all those things, right?”

“They had help.”

“But they led the charge?”

“I suppose so, yes.”

“They’ve hurt a lot of people. Destroyed a lot of places... brought them to the ground. Leveled a city block, once.”

“Seriously, what is this about?”

Leader’s gaze glanced down to the Villain, pale, restrained, with a tube skewering their flesh, then back at Medic.

“No.”

“What?”

“No. No, no, no. I let you restrain them like some kind of beast, which, for your information, is completely against medical protocol. I’m not letting you kill Villain.”

“And why not?”

━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━

Outside the hospital room, in a pair of plastic chairs, Hero and Counselor sat with far more relaxation between them. They watched passively as Head Doctor left the room, hurrying off to another room.

Hero took a fidget rope from a coat pocket and began twisting it between their hands.

“What do you think they’re going to do with Villain, then?” Counselor’s voice was considerably quieter, as if they were telling a secret. They stared off, down the hallway, instead of meeting Hero’s eyes.

“I just hope they let us have some input in this whole thing.”

“Me too. But... what would you prefer? If you had the choice?”

“I mean...” Hero sighed. “They haven’t been the best person, I think we can all agree on that. They’re dangerous. But I also think that... they’re scared. They’re scared, Counselor, really scared.

If it was up to me, I think we should help them. While in our custody, but, I think they need help. And maybe then, they can help us? I mean, they must know something about Supervillain. It’d be nice to have an informant.

Really, I just want to see them okay again. Even if it does mean that they go back to being an asshole.”

“That’d be nice.”

Hero nodded.

“I think Medic mentioned that, once Villain’s stable, we’re gonna move them back to base. Where we have the special medical equipment, the Enhanced care stuff.”

“Yeah. I think Leader is definently going to want to keep them in custody.”

“If they try to hurt them, though... I’m not gonna let that happen. If we have to keep them prisoner, we can at least be humane about it.”

“Yeah. Yeah, of course.”

“I just hope Leader agrees.”

“Me too.”

━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━

“It’d be a waste.”

The answer was too analytical. Leader had expected to be yelled at, to get an earful about morality and ethics and other crap. Not something so simple, so factual.

“What do you mean?” Leader’s tone wasn’t accusing, at least they didn’t intend for it to be. It was far more dumbfounded in nature.

“Everything in this world runs on technology. Those lights, that door, this machine, everything. Everyone has a phone. Every building has a network, of both electricity and information. Villain can patch into all of that. You said it yourself, they leveled a whole city block. What else can they do?”

“What are you... what are you implying?”

“We keep them, and we use them.”

A garbled voice resounded throughout the room. Leader whirled around, half expecting Supervillain to be right behind them, before turning back.

“Was that y-” They began to ask, but didn’t quite get the chance.

“Code Blue! Code Blue!” Medic snapped. “Don’t be useless, press the damn button!”

It took Leader’s confused mind a moment to note the emergency that Medic was responding to-- that of a horrible, electric screech. The heart monitor was no longer showing a steady pulse.

At the sight, Leader’s own heart rate sped up. They nearly tripped over their own feet as they rushed to the blue button on the wall, jabbing it with their finger multiple times in a frenzied panic. Once they were satisfied that they spiraling terror had been registered properly, they returned to Medic’s side.

The doctor had their hands positioned on Villain’s chest, one over the other, slamming downwards repeatedly. In between, Leader could see a sharp rise in the chest-- they were still breathing. But for how much longer?

Dammit, dammit, don’t think like that, it’s someone’s life!

A resounding crash burst through the room as the door was slammed open. They rushed to the bedside, seemingly ready to continue CPR, before Medic raised an arm, preventing them.

“No, no, they’re okay.” Medic panted breathlessly. Leader raised their eyes to the heart monitor-- sure enough, a slow, steady rhythm was returning.

They’d made it.

“Mmm..”

Leader panted for breath, trying in vain to calm their racing heartrate.

“Mmm... whaaa...”

Leader’s shaking gaze shifted to the source of the noises--only to find their eyes locked with the wide ones of Villain.

#whump #whump prompt #whump community #villain whump #oc whump #villain whumpee #blood tw

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chews-erotically · 4 years ago

Photo

Waxing Gibbous

Pairing: Ezra + femNurse! Reader

Rating: Hard M / 18+ ONLY

*****As ALWAYS, if I have added you to the tags and you wish to be removed, just ask and I will do so immediately******

* Warnings: SMUT (mutual masturbation, PIV sex), some plot too, comfort

* Summary: Ezra’s recovery continues. You introduce him to a new way of living, one he cannot immediately embrace.

* Word Count: 2800

*Part ONE* *Part TWO* *Part THREE* *Part FOUR* *Part FIVE* *Part SIX* *Part SEVEN* *Part EIGHT*

PART NINE

Ezra spent an additional three weeks in the hospital after he’d awakened. His recovery was arduous, but his medical team remained impressed by his sheer determination. The same drive he’d shown on the cursed moon to harvest, to succeed, to survive, he showed to recover. Recover he did, working diligently with doctors and physical therapists seemingly around the clock.

You only went back to your loft to shower and change. You had rented a cot, not dissimilar to what you’d been used to before, and you slept beside him each night. You couldn’t stop yourself from awakening several times in the night to ensure he was still there, still breathing. He’d long since been moved out of the ICU and into a room on the Med-Surg unit. He’d proceeded to charm each doctor, nurse, custodian and aide with equal amounts of wit and candor. They would make special trips to his room to sneak him his favorite treats and second helpings of his favorite meals under the guise of “needing to put weight back on.” Ezra would thank them graciously, grinning conspiratorially.

The first time he’d walked three laps around the unit without any assistance was the day you finally knew he was going to be okay. He was told that afternoon that he would be going home in a week. You had thrown your arms around him as he’d laughed and knocked sideways into his bedside table.

That night, you’d crawled into his hospital bed, squeezing in beside him. You nestled yourself into his warmth, his arms reflexively winding around you to pull you closer. Ezra sighed and hummed into your hair. You’d thought him still asleep, until he whispered softly into the darkness.

“.....Dove. Can’t wait to be home with you….” His large, warm hand rubbed up and down your back before circling around your hip, then your waist.

“....can’t wait to be in a bed with you. A real bed.” His fingers spread, his hand coasted lazily up your abdomen and palmed your breast. Your soft gasp echoed into the dark hospital room as you arched into his palm. His fingers zeroed in on a nipple, tugging through the thin material of your tank top. You mewled, hot explosive breaths against his chest. When he craned his head down to bring his mouth to yours he kissed you slowly, deeply, his tongue darting and curling. You bit at his bottom lip and gasped into his hot, sinful mouth.

“Ezra, you’re killing me.” You felt his lips curl wickedly upward. He began to speak to you lowly, in hoarse whispers, punctuating each thought with a nip to your throat, all the while pinching and pulling at you through the fabric of your shirt.

“....Been dreaming of you. How you lose the ability to speak when I’m splitting you open. The sounds you make. The sounds that cunt makes when I rock into it. The way you shake when you fall apart….”

He had nudged his knee in between your legs, and you found yourself rhythmically rocking your core against his thigh. The burning fullness between your legs was making you leak your fluids onto his skin, your clit grinding desperately onto him. You were certain he could feel you through your cotton shorts. You whimpered pitifully as he continued.

“It’s killing you that we can’t do any more than this right now, in this bed. Anyone could walk right in, Dove.”

He released a filthy groan against your mouth when you reached down to wrap your fingers around his hard length through his underwear.

“Careful...be careful, darling girl. I’m not in a mood to stay demure and restrained. I sincerely encourage you to continue if you wish for this whole building to hear our intimacy.”

“Ezra….fuck, I want you. Please, I need to touch you.”

Ezra knocked his forehead against yours. You knew his eyes searched to catch yours in the darkness.

“I need you to wait and be patient for me, sweetheart. When I take you next it will be in our own bed like you deserve.”

You leaned forward and bit his shoulder through his shirt. He gave a startled gasp before chuckling darkly. You groaned in frustration.

“I need something, anything…..s’been so long…”

“Lie down on your cot, Dove. Touch yourself for me. I want to hear how slick you are as you get yourself off to the thought of me buried inside your sweet little cunt. Touch yourself, and I will do the same. Let us fall apart for one another until I can express my desires to you properly.”

You barely hesitated before moving off his hospital cot to remove your shorts with shaking hands. No sooner were they discarded than you were splayed on your back on your cot, legs spread wide, wanton. You heard rustling from Ezra’s cot as he maneuvered his shorts down to free his cock. You heard the rhythmic, wet sounds as he began stroking himself in earnest.

You moaned when your fingers dipped down to your entrance, marvelling at how soaked your slit was. Scooping your arousal with two fingers, you began to circle your hard, aching clit. The wet, sinful sounds of your aroused core reverberated through the room as your fingers circled, pressed. Your breath hitched, your hips arched off of the cot and thrust of their own accord. You both moaned and gasped into the still air.

You could hear Ezra’s cot creaking. He was mumbling half- sentences, pausing to whimper and you could hear him stroking faster. You pictured his hips cana was as ting up as he fisted himself.

“Fuuuuuuuck. Fuck I’m so close. Can you hear me Ezra? I need you to hear what you’re doing to me.”

“Divine cunt. Mine….I can smell it. Smell you….. Holy shit. Holy shit. Holyshit…”

He stilled, screaming lowly as he reached his end. Gasping, breath hitching.

The fingers of your other hand pushed themselves into your passage as your other hand, still circling your clit, began fast, rough. The rhythm of your hips faulted as your orgasm suddenly slammed into you. You bit your lip so hard you may have drawn blood. You gasped and groaned as you felt your cum spill out of your seizing hole and coat your hand.

“Ohhhhh.. Oh fuck. Oh fuck…….” Your breaths melted into whimpers as your hips slowed their twitching. Finally spent, you yawned deeply and turned on your side to face Ezra.

“Still not the same,” you whispered up into the outline of his face. “But if we ever do this again, I want to see you.”

***

You got to the hospital as early as you possibly could on the morning of Ezra’s discharge. You had helped him pack what meager belongings he had the evening before to bring to your apartment. You’d cleaned every surface furiously, and adorned your balcony and interior surfaces with wildflowers and vining greenery you’d purchased from a local nursery.

You brought with you new clothing, something comfortable and casual for him to wear, as well as a pair of loafers lined with fleece. You did not know what he preferred to wear; as well as you knew him, you’d never really seen one another in anything other than threadbare sweats or protective suits. You smiled to yourself as you thought of Ezra being able to buy himself nice clothing, of purchasing music he’d talked to you about for hours on the Green. Large, glossy hardcover books whose spines cracked when you opened them for the first time.

You knew you still had a lot of firsts coming with Ezra. You walked into the bustling lobby and quickly found his room. Ezra was pacing back and forth, muttering under his breath. When you entered he’d immediately stopped and came to you with a wide, beautiful smile.

“I have dreamt of this day for countless stands, sweet love,” he crooned as he wound his arms around you, crushing you to his chest. “My feet will deign not touch the earth in my haste…”

“Slow down a bit, Ez. I brought you some clothing...I hope you don’t hate them.”

He gazed down and you saw how his eyes shone in the early morning light. You loved him so much that your chest ached.

“I could never hate a single thing that passes from your hands to mine, Dove. They are perfect, as are you.” He craned his head down to ghost a kiss across your parted lips. It was chaste, soft and brief, yet you still felt the jolt settling low in your belly, growing warm and tight. You had not forgotten his promise to you during that one desperate night.

Ezra changed quickly as you waited. There was no need to excuse yourself- you’d both been through too much to be bashful. When he’d finished, he stood before you grinning with hands on his hips.

“How do I look, Dovie?”

“Like an angel.”

***

You could tell that Ezra was overwhelmed by the bustling streets of Central. His head whipping around, unsure of what to focus on. Eyes darting, mouth set in a line. You’d grabbed his hand and led the way through undulating throngs of bodies that squeezed, nudged, jostled. Your heart ached with sympathy as you recalled the chaos of your own first experience. You knew he needed time, as you had.

You wasted no time when you arrived at your brownstone building, briefly greeting the doorman on your way through the lobby. Confusion crossed Ezra’s face as he took in lush carpeting and the ivy that wound itself up an exposed brick wall.

“Pray tell, who was that man at the door, Dove?”

You giggled, pressing the button on the elevator. “That is Brice. He’s the doorman, he’s very nice.”

His eyes were wide. “We have a doorman?”

“I know, crazy, right?”

You entered the elevator. As the door whooshed closed you noted apprehension on Ezra’s face. You reached out to squeeze his hand reassuringly, and his features smoothed once more when he caught your small smile.

Soon enough you were at your door. You turned to Ezra and handed him a thick metal keycard.

“This is yours. Try it.”

He paused only momentarily before swiping the card. He reached out to the door handle, holding his breath. You bounced on your heels like a child, pushing him forward.

For one of the few times in all the days you’ve known Ezra, he was speechless. He roamed slowly through the wide open foyer, basking in the natural light streaming through the windows. He reached out a hand to gingerly caress a granite countertop. He caught site of the doors to your balcony and stood before them, hands hanging motionless at his sides.

You sidled up next to him, winding your arm through his.

“Do you like it, Ezra?” you asked softly, looking out over the city beside him.

Ezra turned to you, holding your eyes steadily. His hands moved down to grasp yours.

“I could never have imagined something so grand. This hardly feels real. Truthfully, I am unsure that I did not perish on the Green…” His hands moved up your arms to cradle your face. He leaned in slowly, exhaling into the cup of your ear.

“Show me our bedroom, Dove. It’s been long enough.”

You grabbed his hand, pulling him behind you down the hallway. He reached out to grasp your shirt as you stumbled and bumped into walls, desperate to feel you. You assisted him as best you could, and when you entered a room easily four times the size of your former tent, you heard his gasp.

You had spent an especially long time considering what you had wanted in a bed. It had been far too long since you’d had a proper bed, and so you spared no expense in finding the softest mattress, the sturdiest headboard. Your bed extended down an expanse of wall, covered by soft, downy blankets and piled with pillows.

“It’s...magnificent,” he murmured, reaching down to run his hand across the silken texture of the coverings. His hand moved up to hastily push aside the pillows and pull down the blankets. He hastily disrobed, shoving his shirt up while you joined him in freeing him from his pants. You divested yourself of your own and he caught your lips in a desperate kiss as he tumbled you backward onto the bed. You rolled him onto his back and straddled him, grinding your hips against his hard, swollen length. Ezra was moaning loudly, straining up to maintain contact. Between the sinfully soft blankets and mattress at his back and the heat from your cunt as you spread your arousal on the throbbing skin of his cock. You leaned forward to capture his lips, your hands restlessly moving over his shoulders.

“My beautiful man,” you crooned. “This is what we deserve. You are worthy of this. I need you.”

“Then take me. Ride me, sweet girl. Bless and baptize my cock with your heavenly slick.”

You positioned your dripping core over his head. You sank down slowly, feeling his thickness stretching you open, breaking you. You could not hold back the low moan bursting out of you as his cock reached the end of you. You stilled, after so long you had to allow yourself a moment to adjust to his size. You panted in low groans as your walls twitched and fluttered around Ezra’s incredible length.

Ezra gazed up at you reverently, biting his lip. He whimpered when your cunt squeezed him, hands reaching out to fasten on your hips.

“Fuck….f-fuck, sweatheart. Forgot how fucking perfect you feel. Sweet Kevva. Use me, sweet girl...take what you need.”

You drew yourself up until he was almost out of you, keeping his head trapped in your leaking hole. Without warning you slammed your hips down. The sound that left Ezra’s mouth was feral, animalistic. You began a steady pace of lifting and dropping, eventually falling forward onto Ezra’s chest. You started babbling in between your desperate whimpers and sobs. He hit that one spot inside you in this position, you quickly discovered. It made you roll your eyes back in ecstasy, mouth hanging open between bursts of speech.

“Hngh….oh...my...fucking Gods, so good, you feel so good how is this soo goooood…”

Ezra met your gaze with his eyes wild, teeth gritted. He threw his head back, his hands gripping your hips as he urged you to move faster, harder, while he spoke out into the air in a broken, shaking prayer.

“So good for me, please come for me. Come on my cock, sweet Dove, mark me, soak me before I paint this fucking perfect cunt…”

You were covered in a sheen of sweat, movements faltering from the sustained effort of using him the way you needed. Sensing this, Ezra wrapped his arms around you and crushed your chest to his. Shifting under you, he began to piston himself into your slick, hot sex as your cries became sharp and loud. You lost the power of speech as your breath left your body in explosive gushes against the side of his straining neck. You came with a strangled scream, Ezra struggling to keep you atop him as your limbs shook and bucked of their own accord. You dimly felt the gush of your come running out of you to soak his swollen cock

“That’s iiitt, let it happen, so good for me, taking your pleasure with me so…..deep….insideyouSHIT….” He stilled as his own orgasm crashed around the both of you, head back and groaning loud enough that his voice rattled your soul, your racing heart beating a staccato beat within your chest. You worked through your highs, your bucking hips and shaking legs slowing down incrementally. Your breath eventually slowed, and you stayed nestled against his neck as he, too, came back to himself.

You stayed like that, with him softening inside of you, as he reached down to cover you both with a blanket. You felt limbless, untethered, so mortally sated that you did not care if the world around you was burning to the ground. You barely felt the ghost of Ezra’s lips on your forehead as you drifted out of consciousness. One word, repeated through the haze of dwindling thought was your anchor to everything around you that you had killed and bled and cried for, unbelievably real and soft and unflinchingly kind.

Home.

#chews-erotically writes #ezra x reader #ezra prospect #ezra fic

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scripttorture · 4 years ago

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I have a character who was a slave but was rescued and freed after about 2 years in slavery and eventually goes on to rescue other people in slavery. While in slavery, he was punished often with denial of food as well as being whipped and beaten when he refused to work. He also had his tongue partially cut out as a punishment. I already have a good idea about the psychological effects he is going to have, but I’m struggling with the physical effects and how long it would take to recover

Part of the answer here depends on this character’s age because while adults can generally make a good recovery from periods of starvation the effects on children (especially young children) are a lot more long lasting.

The best places to start for the effects of starvation on adults are probably the Minnesota Starvation Experiment and the World Health Organisation (WHO, general link here, 1999 pamphlet on malnutrition in all ages here).

Recovery is generally pretty quick unless someone’s at the point where they’re near death.

Refeeding syndrome can be an issue in some cases (especially famine or forced labour camps) but it doesn’t have to be one here. If the character is eating normally (as opposed to being fed by IV for instance) then refeeding syndrome is less likely. My understanding is that this is because the body suppresses appetite during starvation so that it only takes in what it can manage (appetite recovers quickly as the patient regains weight.)

There’s a detailed NHS guide to refeeding in adult here. It should give you an idea of how at risk your character is and how much food he’ll be able to handle in his first few days of recovery.

A physical recovery period of around 1-3 months depending on the degree of starvation is reasonable. In this case by ‘recovery’ I mean being able to do normal physical activity, a return to previous healthy weight, or higher weight, return to normal appetite and nutrient levels.

Recovery can be delayed by additional illness: it’s easier for starving people to contract diseases or infections and it takes longer for them to fight them off.

There’s also a difference depending on whether you’re talking about a character who is consistently under fed and forced to work versus a character who is usually provided with enough food but sometimes denied food completely/on very reduced rations for periods of a few days. Consistent starvation and malnutrition is much more usual in slavery and… much more likely to be fatal.

A character that has short periods where food is denied them (no more then two days) and is then allowed to eat as much as they want is probably not going to need hospital supervision/treatment for starvation. If that doesn’t sound like your character then the procedure is usually just to let the person eat as much as they want of whatever they want. The difficulty for people at this sort of stage is more about organising giving out food then it is about keeping doctors on hand to monitor them.

Now I know less about this but I think there is some evidence that this sort of pattern of intermittent starvation (ie periods where the character is starved, then allowed to eat and this is repeated) can cause some pretty serious health effects. It can also make disordered eating behaviour more likely.

On a cosmetic level it’s also linked to weight gain.

Which ever option you’re picturing the following effects are all likely:

loss of muscle mass

lack of coordination

weaker bones

higher chance of hypothermia or heat exhaustion

fainting

poor circulation

higher chances of disease and infections

longer recovery time and more difficult recovery from disease and infections

A survivor can get to a point where they’re no longer at immediate risk before they’re back to full health. It takes time to recover bone and muscle mass. It takes time for the internal organs to get back to normal. It takes time for enough fat to build up so a person’s body can regulate heat properly.

There’s also a difference between someone being at peak physical fitness and getting back to average. My understanding is that if someone’s survived significant periods of starvation they’re… unlikely to reach peak physical fitness. If this character was an athlete or a super hero or otherwise had a physically demanding profession, they’re likely to notice a difference even when they’re ‘better’.

They could improve with time and practice but they may never get back to their prior ability level.

There’s evidence of epigenetic effects; the children of people who recover from starvation are likely to be shorter then the children of people who have never starved.

The Minnesota Starvation experiment theorised that after a successful recovery there were few long term effects of starvation. There’s some evidence now that this was an optimistic conclusion but it’s difficult to get a clear picture because of the ethics around studying starvation.

For young children starvation results in an adult who is:

physically weaker

less intelligent

more prone to illness

less able to fight off illness

has a shorter life expectancy

is physically smaller

Starvation of children represents a blunting of potential: they will never reach their full strength or intelligence even if they may be stronger/smarter then some individuals. And there is really nothing that can be done to treat that. They needed food over a crucial period and did not receive it. The damage is done and can not currently be treated or healed.

Beatings over a long period of time and forced labour both have a tendency to cause chronic pain in the joints. Shoulders and knees seem particularly common.

There are a lot of possible causes for this sort of chronic pain. Ligament and muscle damage s possible. Beatings with objects can cause bone fragments to uh break away and lodge in soft tissues. Soft tissues around joints can be damaged.

And there are also psychological causes or combinations of both physical damage and psychological causes.

For instance this is something I saw in an account from a survivor of child abuse. The survivor had been punished using standing stress positions and he found as an adult that he got shooting pains in the backs of his legs while stressed at work. With the help of his doctors he found that when he was stressed he leaned forward on to his toes, mimicking part of the stress position he’d been subjected to as a child. This put more strain on his legs and caused the pain.

These kinds of responses can be very difficult to stop.

What I’m trying to illustrate here is that disabling pain is really common in survivors and you don’t necessarily need to know a specific cause for it.

Chronic pain can cause long term problems to do with mobility and performing everyday activities. Most often it means that survivors need to rest more often, they may have less stamina and they might need to do things in ‘odd’/unusual ways in order to comfortably perform the activity.

For instance someone with chronic pain in their shoulders might struggle to hang wet clothes on a line that’s above their heads. So they might get in the habit of lowering the clothes line, attaching the clothes and then raising it by pulling on the cord at waist height. They might have trouble moving their shoulder to put on jackets, so they could use their body weight to ‘flip’ the arm joint to the correct position without involving the muscles of the shoulder.

Someone with knee pain would probably be more particular about the height of chairs in their house. They may stop keeping things in low drawers or shelves.

Consider where your character might have pain, what activities might make it worse and life style adaptions you can work in to your story.

These can actually be a great world building/character detail. Especially because healthy people have a tendency to assume these adaptions are eccentricities rather then necessity, prompting conversation between characters.

There is one part of this scenario that worries me: mutilating the tongue.

Cutting out tongues is one of those things that comes up a lot in fiction and is generally… less survivable then people assume. Tongues are not just for verbal communication: they’re a pretty essential part of how we swallow food and water, not to mention detecting whether said food/water is edible and they contain a lot of blood vessels. There’s a reason things like tongue splitting and tongue piercing don’t tend to show up as traditional body modification practices.

The process of partially removing a tongue is life threatening in and of itself. Victims can drown in their own blood. Inflammation can block the airways causing suffocation. Infection can make breathing, eating or drinking impossible (increasing the chance of death from infection.)

If the victim survives (some definitely did) they’d have trouble eating and drinking for the rest of their lives. This means malnutrition is likely, leading to shorter life expectancies and higher chances of disease (apart from the conditions malnutrition itself causes.)

It also means recovery from starvation would be significantly longer. Which means a longer period when the character’s more at risk from infection and disease as well as the general uh ‘problems’ starvation causes.

I’m not saying you’ve created an unsurvivable scenario. We know from history that some people have gone through stuff like this and survived.

What I’m saying is the survival rate is low. Those survivors (and your character) got lucky.

Keep that in mind when you write this scenario.

In terms of long term recovery I honestly have no idea how a removed tongue is treated, I’m not a medic. I can guess at some lifestyle adaptions though.

Because it makes eating more difficult I think it’s likely a survivors would have smaller meals and more frequent meals rather then large portions that might be cold/unpleasant by the time they’ve finished eating. They’d probably learn to cut their food into smaller pieces and might avoid tougher foods that require more chewing. Their sense of the taste and texture of food would be impaired which might effect their enjoyment of food which could in turn effect their motivation to eat and their recovery.

Overall I think the take away message here is that while most of the physical long term effects of slavery are not immediately life threatening they have a massive effect on long term quality of life.

A lot of survivors of modern slavery come out of similar time frames to this disabled by a combination of chronic pain, joint problems and untreated injury or disease.

One of the recurring themes in Kara’s interviews with slaves is that slavery physically ages people. The combination of extreme distress, physical abuse, overwork, sleep deprivation and malnutrition makes survivors appear much older then they are.

But the reasons why, the injuries and marks of abuse are often not immediately obvious.

I hope that helps :)

Available on Wordpress.

Disclaimer

#writing advice #tw torture #tw slavery #tw starvation #tw scars #scarring torture #cutting out tongues #starvation #forced labour #writing recovery #writing survivors #writing slavery #writing victims #time frames #effects of starvation #chronic pain

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thewaytoaclonesheart · 4 years ago

Text

Embers and Flames ✨

Rated: M

Warnings: clonecest, vanilla smut, unprotected sex (wrap it up people!), fluff, angst (very little), slightly graphic description of injury and blood, more fluff!

Summary: “Jesse was usually the one to initiate anything sexual between them, but Kix found, he could, and would, wait no longer. And as he pulled Jesse towards him, roughly sealing their lips in a bruising kiss, it was with a deep carnal desire to celebrate life with his Riduur.”

Kix needs to feel alive after treating injured and ill. Fives is recovering, and Kix finally lets go in the safe embrace of his Riduur.

_______________________________________________

The problem with rain, especially when it occurred as a massive downpour, wasn’t that water seeped through dureplastoid armor, or that their bodyglove beneath became wet as well. No.

The problem, was that despite their modified immune system, they were no less susceptible to a common cold. Which in turn, made Kix’s role as CMO, karking difficult. More so than usual, when taking into account, that several of the 501st officers, clone and nat-born alike, seemed to avoid the ships medbay, or medical tent if at all possible.

To state that Kix was tired, would be an understatement. He was exhausted.

More than a hundred vode were already showing symptoms of a common cold, and nearly as many had injuries sustained from the treacherous terrain and subsequent mudslides.

Fives was the worst of them all, and had been a too close to lost for Kix’s comfort. Luckily, they had managed to raise his temperature from freezing to slightly below standard. Though the biggest issue, and the one that was assessed first, was the major wound around his ribcage. While the injury had, bless the force, not damaged his lungs or respiratory system, it had dealt a large amount of damage to his lowest rib on the wounded side, causing a severe fracture. Along with this was substantiel blood loss, and combined, these facts had had Fives’ life hanging by a thin thread.

The worst part of it, however, had been Echo. The proud, intelligent and kind man, having been reduced to little more than a heartbroken, shivering, and terrified mess, all to realistically minded to not understand the situation in full. He was losing not only his last batchmate, his best friend, he was loosing his Riduur.

It was Kix that had told Echo that Fived had survived, and that a short time in a bactatank would make him right as rain again. Kix would later regret using that particular phrase, but without caf, descent sleep, and with nerves more frayed than usual, it had slipped out before he could stop it. Thankfully Echo had found it worthy as a pun, and had simply smirked, then quickly made his way to Fives’s bedside. He hadn't left in the near two-and-a-half hours since. He was sitting, now without the upper half of his armor, holding the hand of his cyare.

Kix was forced out of his own thoughts, as the transport landed onboard the ship, carrying the worst of the wounded, ill, and those whom held important roles within the structure of the 501st.

As CMO, Kix was among the first to be brought back to the ship, alongside the the two ARC troopers, and several other vode. Amongst them, was Jesse, his riduur.

They had sworn their vows rather quickly after becoming involved, though this seemed to be the norm, considering the often short life and brutal ends troopers would meet. And so, hastily spoken vows had become the norm, not only within the 501st legion, but within the entirety of the clone army. The record was currently held by two troopers in the 212th, though Kix didn’t know their names or designations.

Kix knew Jesse had been on a previous transport, and would therefore already be on the ship. It took less than ten seconds to send a message his way, asking him to join Kix in the small medics office off to the side of the medbay. Kix needed Jesse, needed to see him again, even though they had been shoulder to shoulder mere hours ago. It wasn’t enough. Kix needed to feel alive, to let go, to feel something. He quickly made his last round, checking every trooper laid up, including Fives, now in a bactatank, Echo’s hand pressed against the tank, not wanting to be separated from his love.

As Kix made his way towards the room, he sent a quick message to his General, informing him about the wounded, and thanking the man for his assistance. Without him, Fives wouldn’t be here. The General wasn’t a Jetii healer, he knew just enough to use it in dire situations. He had gone as far as informing Kix, that he had secretly sought out Master Che in the healing halls of the temple, wanting to learn the basic force-healing, due to his master constantly getting himself, and therefore General Skywalker, into situations where a healer would have been ‘Wizard’ to have on hand.

It didn’t register to Kix, that the door to the small quarters was unlocked, nor that the light was turned on, until two hands grasped his own, forcing a small surprised gasp from him.

“Easy Cyare, its just me“ Jesse spoke, in a low tone, as if speaking no louder than a breath.

“I was already on my way here when I received your message, are you alright?” A simple question had Kix’ mind reeling, caught up in the eyes of his patients, filled to the brim with unsteady tears of pain, the flushed cheeks not due to a flirty comment or recent shag, but due to illness, leaving only hoarse voices and wicked fatigue in its wake.

Jesse was usually the one to initiate anything sexual between them, but Kix found, he could, and would, wait no longer. And as he pulled Jesse towards him, roughly sealing their lips in a bruising kiss, it was with a deep carnal desire to celebrate life with his Riduur.

A single gasp had been Jesses response, surprised only a short moment, before grabbing Kix’ hips, and holding him as close as possible. Gentle love would follow in the embers left behind by the all consuming fire of lust and desire that had enraptured them.

And as many times before, armor, now unfastened, was thrown hastily to the floor, with little care as to how. And as more and more pieces fell, the two men were left standing in their blacks, only now having to catch air on quickened breaths, holding each other so close they seemed to be sharing the same air.

“Cyare, I need.. please, just.. I need to feel you” it was rare that Kix asked, usually more in control of himself, more cocky and more likely to tease. While Jesse wouldn’t mind teasing Kix, it seemed out of place now, with the other man as vulnerable as he was.

“Are you sure Mesh’la?” Calling Kix beautiful was a nickname he had given the other man long ago, when he had first started to shave his head and show of his tattoo, now it was his favorite way to refer to Kix. “I don’t want you to regret this. So I need you to be sure”

Kix loved this part of Jesse, the one that always asked for consent, even if Kix had initiated the intimacy, Jesse would always make sure.

“I want you Jesse, I need you.” Those words, were all it took.

Hands grasping, mouths meeting skin, sucking marks on collarbones and just beneath the line of their blacks. And as hands grasped clothing, only to pull it away from the other, revealing beautiful dark brown skin beneath, only broken by tattoos and white-lined scars, they came together in a cocoon of love and desire.

It didn’t take long for Kix to be prepared, lying front down on the singular cot in the room. Nor did it take long for Jesse to have the other man, his amazing and wonderful man, ready.

As Jesse entered Kix, little by little, they both panted and gasped through, enjoying the tightness and the easy glide, made so by using a bacta-based lube. And as seconds passed, the tempo quickened, panted breaths became moans of pure carnal pleasure, and words reminiscent of begging intermixed, as they both reached for their climax. Kix was the first to fuel the flames, for as Jesse had grasped his member in hand, and hit his prostate simultaneously, he had come near instantly. And as he clenched around Jesse, the other man had followed shortly, groaning and realizing all he had into Kix, marking him as his own.

They knew each other’s bodies as if their own, having spend many nights like this, in the throes of passion, fueling the flames of desire until an explosion of pleasure had those flames explode and fizzle to embers of love and care.

It was only after Jesse had found a moist cloth and wiped his Riduur down, that the tiredness sat in. And as he lay down next to Kix, taking him into his arms and holding him tight, that words were uttered just as they reached the edge of sleep.

“Ni kar'tayl gar darasuum, Mesh’la”

“Ni kar'tayl gar darasuum, Cyare”

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chaoskirin · 4 years ago

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The CoViD Vaccine

I first posted this to facebook because of the high number of anti-vaxxers on the media. But I figured I’d post it here, too. This is a quick study of why the CoViD-19 vaccine was developed so quickly and why it’s likely safe. Sources at the bottom of the post.

===

Part 1: Why was the CoViD vaccine developed so quickly while other vaccines take years?

Some people cite the inability to produce an HIV/AIDS vaccine after so long as a justification for stating that the CoViD vaccine could not possibly be developed in such a short time. However, there's a very good reason with the HIV/AIDS vaccine is taking so long, and it's found in the genetic makeup of the virus.

HIV is a strange virus, in that it completes its cycle insanely fast (within 24 hours in some cases) and because of this, it's prone to mutations. Because little to nothing was done about the AIDS epidemic in the 1980s, the virus was allowed to spread, unchecked, rapidly mutating and developing into HUNDREDS of strains.

You know how we have to get a new flu shot every year because the virus has mutated into something new? That's HIV, but instead of a new strain appearing once a year, a new strain can appear in the course of one single viral generation. When HIV is transmitted to someone else, it may already be a slightly different virus than it was in the transmitter. This means that a vaccine developed to work in the person who transmitted the virus would not work for the newly-infected person.

That's why, at this point in time, antiretrovirals (drugs that disrupt the replication of the virus by preventing it from attaching to RNA) actually work better than a vaccine.

As well, HIV/AIDS specifically attacks the immune system, hampering any efforts at strong immune response. That is, by the time a vaccinated immune system recognizes the virus as a threat, it has already destroyed part of the immune system AND mutated itself, meaning the even a vaccine that would otherwise work can no longer be effective. This is a known phenomenon called "immune exhaustion."

Lastly, HIV is really good at hiding from detection as a dormant phase of the viral particles (called provirus) can remain within cells for years before lysing from/destroying the cells they're inside. And HIV creates these provirus particles every single cycle, which means even if a vaccine is developed and destroys all free-floating viral particles, the dormant particles will always be around to start a new phase of infection, once again leading to immune exhaustion.

In the case of HIV, the hope of a vaccination lay within the blood of people with a natural immunity to HIV, which is a brand new frontier of vaccine development that is poorly understood.

Conversely, CoViD-19 does have a semi-quick mutation rate, but not as fast as HIV. It was also immediately taken seriously by medical professionals, and the development of the vaccine started soon after the virus's discovery. Unlike HIV, CoViD does NOT attack the immune system (instead, it triggers a massive immune response called a cytokine storm) and it also does not hide undetected within cells. (...Probably. We are still learning about the virus.)

Part 2: Genome Mapping

First, it's important to note that data sharing and sequencing equipment is much more sophisticated than it used to be. This means that several labs can work on the genetic mapping of CoViD at the same time, and share that data in real time. Powerful software allowed the geneticists to connect the various strands of viral RNA gathered from patients presenting with the virus, and it was quickly determined that CoViD-19 (AKA SARS-CoV-2) was remarkably similar to SARS-CoV years before. The viruses share between 88%-90% of the same genetic code; some scholars refer to both viruses as the same "species."

The full method used to determine the genome can be found here: https://www.thelancet.com/.../PIIS0140-6736(20.../fulltext (very long, but pretty cool!)

During the sequencing, it was also determined that while CoViD-19 showed mutations between each case, the faithfulness of the virus to the control was about 99%--suggesting that it was mutating slower than expected. This meant that a quick response could prevent the evolution of the virus to a point where vaccines would be ineffective. While there are multiple strains of CoViD-19, it's likely that they are all currently very similar.

The genome also showed that, like SARS from years past, the CoVid-19 virus contained the same protein receptor--known as ACE2--which had already been studied. The receptor (or spike, as it's called) is what allows the virus to bind to a host cell and release its RNA.

Other factors to consider that are related to the genome mapping itself is that the COST of mapping is far less than it has been in the past, and it also faster and more accurate. Development of vaccines for other diseases (such as chicken pox and HPV) were often hampered by cost, time, and inaccuracy. Conversely, every time the CoViD-19 virus was mapped, the resulting data was nearly the same.

In short, one of the hindrances to vaccine production is often the genome mapping. It's impossible to create a vaccine without knowing the full details of the virus, as a vaccine's purpose is to produce an immune response. That's essentially tricking the immune system into believing it's fighting a virus. The hardest part of vaccine development for CoViD-19 is already done, and it was done in record time.

Part 3: Messenger RNA and synthetic RNA

Before discussing the vaccine, I need to talk about what messenger ribonucleic acid (AKA mRNA) is.

When a cell splits, it needs to make an EXACT copy of its DNA for both cells. Because DNA is fairly complicated, it can't just split in half like the rest of the cell. It needs a set of instructions, which is where transcription comes in.

An enzyme called RNA polymerase makes a near-exact copy of the DNA strand, except for the nucleotide thymine, which is found in DNA, is transcribed as Uracil on the mRNA strand. A lot of stuff happens after that, but the important part is that this mRNA strand is read by ribosomes and TRANSLATED into proteins.

There's... a lot more to it than that, but that's the basic gist.

Which takes us to the question: What is an mRNA vaccine?

It's taken a long time to develop synthetic mRNA. Katalin Karikó, a Hungarian scientist, believed messenger RNA could be harnessed to create all sorts of disease resistances, but the synthetic material was quickly identified and destroyed by the body's immune system.

Because Karikó was experimenting with an idea that other scientists had dismissed as impossible, it took her FIFTEEN YEARS to create something with such promise that she finally received grants to further her work. It wasn't until 2005 that Karikó discovered a way to trick the immune system into NOT immediately attacking the synthetic RNA.

Only 15 years ago. And even then, because many of Karikó's peers had already dismissed messenger RNA as a valid medical tool, it took them a long time to get them on board, and research crawled forward and a snail's pace.

Her accomplishments DID interest a post-doc named Derrick Rossi, who successfully used the synthetic RNA to create proteins in a petri dish out of various polypeptides. Most interestingly, an introduced immune contingent would ignore the mRNA, as if it was supposed to be there.

It was this work, in 2010, that made Rossi realize that mRNA could be used to create vaccines.

This inkling of an idea required "proof of concept" in order to receive funding for further research--which was slow in coming. Any new technology, even discoveries that are microscopic, carries risks, and it turned out that repeated doses of mRNA could produce unwanted side-effects. It wasn't until 2018 that Moderna (which should be a familiar name to everyone by now!) Developed a two-dose therapy that would not produce significant negative effects in humans.

Just in time, too. CoViD-19 appeared in 2019. And while Moderna, Pfizer, and several other companies had been experimenting with mRNA as a vessel for vaccines, nothing had yet been approved for use.

Remember when I talked about the genetic map of CoViD-19 in my last post? With that, scientists creating an mRNA vaccine did not actually need the virus in order to work on the vaccine. All they needed was the genome--and they could then synthesize RNA, which could then be used to build the protein shell of the virus, producing an immune response.

Unfortunately, companies developing the vaccines came under fire for essentially using the promise of a save, synthetic material to fill their coffers. But of course, that's capitalism, and that's a different story.

But essentially, rather than a traditionally-created vaccine which uses dead or modified live viruses, an mRNA vaccine has never touched a virus, has never been injected into an animal in order to synthesize more vaccine, and is able to be ready-made in a lab using messenger RNA.

Of course there is concern about possible long-term effects of this new type of vaccine. The cool thing about mRNA, though, is built into its very code. After it does what it's supposed to do (in the case of the CoViD vaccine, that job is "building a viral envelope that contains no actual viral RNA," it self-destructs. That's why it has to be stored at such low temperatures. anything higher than that and you'd have what's essentially a slurry of random synthesized polypeptides that wouldn't do a damn thing.

So the worry isn't really whether there will be long-term effects from this vaccine, but whether the synthetic mRNA will be able to survive long enough to produce enough fake virus shells to create an immune response. So far, trials have proved successful.

Part 4: Polio, and Why Most Vaccines Are So Extensively Tested

There's a good reason that the FDA requires such extensive, lengthy testing on vaccines, and it has to do with the polio vaccine.

I'm sure most opponents of vaccination cite the early polio vaccine as a reason not to vaccinate--that vaccines are inherently dangerous and should be approached with caution.

Trials of the polio vaccine went well, and were well-tolerated, which meant scientists were initially baffled when a vaccine caused 40,000 cases of polio in children, 200 of which were left paralyzed, and 10 of which died.

At first, people were convinced that this meant vaccines were dangerous--many blamed Jonas Salk for pushing the vaccine through R&D and dooming everyone who'd gotten the vaccine to polio.

So what happened? Did dangerous chemicals in the vaccine cause a weak immune system leading to polio? Was the process itself flawed? Was it time to give up on vaccines as a valid form of disease protection???

Fortunately, no.

Just like today, there were many nay-sayers about vaccines, and those who were against putting them into their body. See, Salk used formaldehyde to de-activate the virus, which people recognized as being very poisonous. despite the fact that the vaccine itself contained none of the chemical, the public demanded an alternative if they were to take it.

So a company called Cutter Labs decided not to use formaldehyde to deactivate the vaccine. In fact, they didn't de-activate the vaccine at all. Because of a lack of rigorous safety protocol at the time, the error was then missed by health inspectors, who ok'd giving a completely live virus to 40,000 children.

This incident, called the Cutter Incident, led to more rigorous oversight and testing when it came to vaccination. It also let to what's called "attunated" viruses, which are weakened, but still living viruses. These attunated viruses have been responsible for outbreaks of poliomyelitis around the world, all because people feared the process used to kill the virus.

The point is, the reason it takes so long to approve vaccines under normal circumstances is that you are dealing with a medication that contains actual viruses (albeit usually dead viruses) plus agents designed to provoke an immune response, such as aluminum. Deactivated vaccines also used to contain thimerosal as a binding agent preservative. While not elemental mercury, thimerosal was derived from mercury, and thus just as suspect as Salk's formaldehyde.

In any case, there's a lot of people concerned about what they are putting into their bodies. And while the use of aluminum adjuvants has been proven safe over decades of vaccinations, every single one still must be tested in order to determine efficacy and safety. Pushing a vaccine that doesn't work is just as bad as pushing a vaccine that causes harm to the patient.

To be fair, it is likely the alum compound that causes vaccine reactions, which means it's up to medical science to do better! Thankfully there are many new adjuvants on the market, including MF59, an oil emulsion which is derived from shark liver; most people consider this a much better option than heavy metal, and it is the most likely candidate for use as an adjuvant in the CoViD-19 vaccine.

If, that is, an adjuvant is needed at all. Currently, there's some speculation that the mRNA in the CoViD vaccine could alone provoke a strong immune response.

Part 5: Putting it all together!

1. Coronavirus was caught quickly and an immediate medical response was established. Using new genetic mapping technology that has only been developed within the last decade, CoViD-19's genome was mapped and made available.

2. CoViD-19 does not hide in, nor does it attack the immune system. For this reason, it's much easier to create an immune response to a vaccine as compared to, say, the HIV virus. Unlike the HIV virus and the common cold, CoViD-19 also currently has limited strains and mutations, making it the perfect time to create a vaccine.

3. The vaccine does not use viral particles. It doesn't need to be "incubated" and then tested after each incubation period. There is no chance for the vaccine to cause the virus in any dose. Instead, it uses synthetic messenger RNA in prompt the body into synthesizing the protein shell of the virus, which activates our immune system.

4. It contains a natural adjuvant found in shark liver oil, rather than heavy metal aluminum. This cuts down on the testing time. Adjuvants provoke an immune response more quickly than the virus alone, although Pfizer stated that the vaccine would likely work without one.

5. Lastly, this can't be overstated enough, the idea behind testing is to have a successful trial in as many people as possible. Other vaccines fail because of unfavorable trials. (For example, chicken pox took so long to develop a vaccine for because of the lack of technologies we had today leading to low efficacy rates in test subjects.) Compared with the MMR vaccine, which has an average efficacy of 90%, the CoViD-19 vaccine achieved a 95% efficacy rate in 10 months. There was very little "back to the drawing board" except in one case where the company developing a vaccine trial dropped completely.

I do want to state here that it is normal for medical science to work faster and better as time progresses. Vaccine science IS medical science, and has only been utilized for the last hundred years. All medical sciences progress and become more reliable as time goes on, including heart transplants, treatment of HIV, diabetes, hell--even Alzimers may have a cure in the next decade thanks to various breakthroughs in the last three years.

It is okay to be cautious. It is not okay to dismiss science because you're afraid or because you don't understand it. It's okay to ask for help learning about these things.

We science people aren't here to lie to you. We look forward to a future where serious disease is a simple hindrance, and not a life-changing event.

Sources:

https://horizon-magazine.eu/article/covid-19-how-unprecedented-data-sharing-has-led-faster-ever-outbreak-research.html?fbclid=IwAR2V_HfDaloTaNfBJ489f1fmdsBbWaYp5j72d3AYo9roKJNaiUATkYc3rA8

https://www.centerforhealthsecurity.org/resources/COVID-19/COVID-19-fact-sheets/200128-nCoV-whitepaper.pdf?fbclid=IwAR3p00yVtK16aduVIF5LV6dgetFEuho4CoxX7ifmVlDcSSPei6p79IyNzpQ

https://www.verywellhealth.com/hiv-vaccine-development-4057071

https://www.statnews.com/2020/11/10/the-story-of-mrna-how-a-once-dismissed-idea-became-a-leading-technology-in-the-covid-vaccine-race/?fbclid=IwAR0brQXhvrs4pMp9AwXOU5KT0z1B-VsbMn8R3RS65Hv_gLqo5gButRTftyg

https://www.jpost.com/health-science/could-an-mrna-vaccine-be-dangerous-in-the-long-term-649253?fbclid=IwAR1MM2vpKrUucLGwEb2T5OZAADMFp3oABJFTcG5F8xDfPfykx5gGwZIWHaE

(And apparently I forgot to save my sources about adjuvants. :|)

#covid-19 #coronavirus #vaccine safety #health and safety #not bestiary #i hesitate to tag it this way but #american politics #because you know people here #think this is political

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