#to making the perfect protein supplement for Smith's recovery

[jtl-fics]

Fluent Freshman - Part 29

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“Neil, why do you have Smith’s phone?” Andrew asks as the two of them are setting out plates for lunch. Neil startled and looked down at the phone that he had just sat at the table and furrowed his brow.

“What do you mean? This is mine?” Neil asks. He knows his phone even if he’s not really the best with them.

The one that Andrew had given him his Freshman year had died after it got run over by the Maserati when Neil left it on the roof of the car by accident. The second one Andrew had gotten him had been destroyed in rather spectacular fashion earlier in the year when he’d had a bit of a freak out on January 19th. The team knew better than to text him on that particular day now but Andrew had said that he’d take custody of his phone this year. Wymack had stepped in with a phone that same day before Andrew could buy him a new one and that phone had been launched at the Baseball captain that summer.

All this to say, Neil is now looking at the phone in concern because it is highly likely he swapped his with FF’s.

“No it’s not.” Andrew sighs and points to a corner, “You cracked yours up here.” He opens the phone and then the contacts and sure enough Neil doesn’t see his own contacts but the ones that Nicky had programmed into FF’s the day before.

“Oh, I guess I switched them at the hospital.” He says with an embarrassed blush. Maybe he should get a little accessory to differentiate his phone from the other ones that Wymack has gotten.

There’s a slight commotion in the kitchen, “Kevin, stop trying to add vanilla protein powder to Smithy’s soup!” Nicky shouts.

“He needs protein to heal properly! That nutritionist might just feed him a loaf of bread since he is using an outdated model!” Kevin argues back.

“Kevin the doctor said clear soup also do you want to make Smiths sick? Vanilla protein powder and chicken broth?” Aaron asks disgust evident.

“I’d use unflavored but this is all that’s in the house and I am not going shopping until this weekend is over.” Kevin argues back.

“Smiths went out shopping on Black Friday and came back unscathed. He even went out into the worst of it just to get some groceries for baking and breakfast.” Aaron says with a huff.

“He still got stabbed!” Kevin returns.

“Kevin, he was definitely not grocery shopping when he got stabbed.” Nicky shoots back.

“He needs-“

“Przywiążę cię do krzesła.” Neil hears Smith’s Grandma cut Kevin off. Her tone is so sweet just like it has been the last couple times she has interrupted an argument between them all. She really has warmed up to them since Andrew confessed.

Nicky lets out a loud bark of laughter.

“Are you okay?” Aaron asks.

“Yeah, cutting onions make me laugh.” Nicky returns quickly.

Kevin walks out of the Kitchen with the same gooey expression he’s gotten every time Smith’s Grandma has said something sweet to him but considering how often and how hard Nicky laughs at what she says he wonders if she’s just sassing him in a sweet tone.

He really needs to pick up a phrase book.

He might like her even more if his theory is correct.

“It shouldn’t be a big problem.” Neil says but he is a bit more careful as he moves FF’s phone away from where it could get damaged. “Smith is definitely asleep. He looked really tired.” Neil says and it twists his own stomach to think about how FF looked in his hospital bed. FF wouldn’t take anything more than the bare minimum when it came to pain medication.

Each “I’m fine.” He gave had him coming to a deeper and deeper understanding of how frustrating it is to have someone who is CLEARLY not fine say they are.

“I’m more concerned about who might text you.” Andrew says.

Neil shrugs, “Ichirou is more the type to just show up.” Because it’s true. Every time he’s met Ichirou there had been very little warning.

Andrew frowns but then Nicky is coming out with lunch. It was nothing fancy but a home cooked meal always made Neil feel warm. Smith’s grandma had just been using what was in their pantry so far but the two other meals (and her pie) had been amazing.

“Lunch is ready. We’ll head back to the hospital afterwards to see when Smithy can get discharged.” Nicky says putting a large bowl of pasta in the center of the table. Aaron came out a moment later with the Parmesan shaker and the protein powder bottle.

“Here you go Kevin, add as much as you want to your own meal.” Aaron says in a sweet tone just like Smith’s Grandma.

“Eat shit Aaron.” Kevin scowls now knocked out of his gooey expression as fills his plate with pasta and reaches for the Parmesan.

Neil can’t help but let out a puff of laughter at the interaction and lets the worry of being away from his phone slide away. FF was sleeping, he was safe, and Ichirou had not expressed any interest in talking to him.

“Pass that to me when you’re done.” Neil asks pointing at the Parmesan as he fills his and Andrew’s plates.

***

There had been a plan.

Nathaniel Wesninski was supposed to be at this hospital at least according to his cell phone location. His future investment was not the best at keeping that device on him though so he was willing to wait when there were no signs of the Wesninski. There would, of course, be a cost for his patience. He had his men go seek out the uninvolved civilian. If Wesninski came back and found his friend threatened due to his lackadaisical nature with his phone perhaps he’d remember to keep it on him.

Except now that very uninvolved civilian is sitting in front of him. The ’Smith’ that Wesninski had spoken of.

He sees Wesninski’s phone sat on the table and his eyes go back to the young man in front of him. He wonders if this was some ploy by Wesninski, some statement. This young man in front of him took out one of the Butcher’s top men on his own.

He’d confirmed it when he’d gone to see Jackson earlier that day. He went to remind them what would happen if they tried to turn over anything to the Federal agents and to see how two of his biggest headaches had been taken out so suddenly.

Jackson talked about how Wesninski’s friend hadn’t seemed surprised to find him in the alley, had seemed like he had been expecting it and how swiftly he had been taken out. Wesninski’s guard dog had gone out afterwards and they’d lead Romero into a trap that resulted in his arrest and this civilian swearing up and down that Romero was the one that stabbed him even though Romero asserts that he never had a firm grip on the knife.

A great way to ensure he was held by the police while they were fully investigated. They wouldn’t have much time to investigate either of the Butcher’s remnants. Ichirou was only offering the choice between something painful or something easy.

The young man in front of him offered nothing, waiting for Ichirou to begin the talks. His expression clearly showing that he’d happily wait Ichirou out as if he was long used to tense silences. There is no doubt that this man in front of him knows exactly who he is but he still has the audacity to wait him out.

“Where is Wesninski?” He tightens his fist at having to ask first.

“That’s not Captain Neil’s last name anymore.” FF returns with the first hint of expression on his face being a frown.

The first piece of information given. So, loyal to Nathaniel and not to the Wesninski line. Loyal to Captain Neil.

“Captain Neil is getting lunch.” He answers, “I’m the only one here for you to talk to right now.” He adds after a moment putting his hands on the table.

Ichirou can understand what isn’t being said.

“Does, Josten, realize you’re here?” He asks taking care to use Wesninski’s new last name knowing he wouldn’t get his answers otherwise. He has a hard time imagining the man who was so loyal to his friends purposefully leaving this one to act as defense for him.

Wesninski had been very clear during his brief phone conversation with him, “Smith was just caught up in all of this. He’s not a threat to you Lord Moriyama.” He had said voice steady and without a hint of a lie.

“In the hospital? Of course.” He returns, “Down here talking to you? He’ll probably be upset.” he says after a moment.

“And yet, you’re here.” He says mirroring the man’s own relaxed posture.

Loyal but willing to do something that might displease the one he is loyal to if it would keep them safe. Ichirou stops himself from looking to his left where his most loyal man stood. Connor had stepped in front of threats he hadn’t seen coming plenty of times, had questioned him even when Ichirou had threatened to cut out his tongue for it, and had always had the courage to look Ichirou in the eye when he explained himself no matter how injured he was or how irate Ichirou was.

It’s something rare and it seems like it is something Wesninski has found unknowingly.

“Yes, I’m here to talk about Friday night.” He says, “I assume you’ve already spoken with Romero and Jackson.” He says moving the conversation away from Wesninski. Bringing Ichirou’s attention and possible ire to himself.

A truly rare find in his world.

“Yes, let’s talk about Friday night.” He agrees.

***

What was it about the Smith family and making great food?

It was just a simple combination of canned tomatoes, butter, pasta, onions, cheese, spices and garlic but it had Neil going for a third serving. Smith’s Grandma had really made enough to feed an army and when he’d commented Nicky had just reached over and tried to pinch his cheek fat only for his fingers to find little to grab onto, “You’re too thin! Eat more!” He exclaimed before repeating it to Smith’s Grandma in Polish who nodded earnestly.

Wymack was at the table after he took a shower. Kevin was still trying to convince Aaron of all people that he should be allowed to put protein powder into the clear soup that was simmering on the stove top for FF. The dietary restrictions someone faced while they were healing from stomach surgery was no joke.

The other Dealer had dropped despite Wymack and Neil’s best attempts to get Lisa to stay. Seemed determined to head back to her small town and rejoin the family cult she had escaped from. He’d been worried about her going home but she had insisted she’d be back.

It was unfortunate but it was also Lisa’s choice.

His stomach twists wondering if FF is going to go back to Washington with his Grandma when he gets released. There had barely been a whisper of danger from Neil’s past since Ichirou had put that bullet in Riko’s head and now one of his few friends that had been entirely uninvolved in that nightmare was in the hospital because of him.

Andrew elbows him.

Neil turns to look and Andrew is carefully putting a penne pasta on each prong of his fork, “I can hear you worrying.” He says in Russian.

“What if Smith leaves?” He responds back in the same language.

“He has the right to.” Andrew shrugs and shoves the pasta into his mouth.

“I don’t want him to.” Neil admits, FF is a friend. A good friend.

“He still can leave even if you don’t want him to.” Andrew says as he proceeds to once again put a penne pasta on each of his fork’s prongs. “I don’t think he will though.” He adds before shoving his fork into his mouth again.

Neil blinks, “Why?” He asks.

FF isn’t like how Neil was his Freshman year, he’s steady and sure but Neil wouldn’t blame the Freshman if ‘possibly being killed off by remnants of my Captain’s crime family’ is a step too far for FF. Wouldn’t blame FF if he runs.

“He still calls you Captain Neil.” He says reaching over and squeezing Neil’s knee with his hand.

Neil blinks.

He thinks.

FF laid out on the concrete as Andrew worked to stem the blood from his stab wound, “It’s a weird sex alley Captain Neil! I don’t know WHAT to tell you!” He exclaims ready to make a joke even as he’s bleeding because of a situation Neil’s existence put him in.

FF still floating from the initial large amount of pain medication he was on pulling on Neil’s sleeve, “I’m glad you’re okay Captain Neil.” Before falling back into his drugged sleep.

FF’s eyes softening as Neil offered to get a nurse to give him more pain medication, “Really Captain Neil, I’m fine.” He says.

He lays his own hand over Andrew’s.

“I guess he does.” He offers a small tentative smile.

“Eat your pasta Junkie.” Andrew says in English now.

“You’re too thin!” Nicky reminds him and Smith’s Grandma must have picked up on the terminology since she nods earnestly in agreement as the two of them were packing up leftovers and the soup Smith’s Grandma had made for him so they could head back to the hospital to keep FF company.

***

“Why did you go out into the alley?” Ichirou asks.

“Isn’t it better that I was in the alley?” The man across from him asks with a raised brow, as if Ichirou was asking a strange question. “If I had stayed in the club, who knows what would have happened or how many people would have been hurt.” He explains without Ichirou needing to lower himself to asking.

There’s truth to that.

It’s been on the news that the remaining Wesninski inner-circle had been captured but since there’d only been one injury it had been largely overshadowed by news regarding the mass injury incidents surrounding Black Friday. If Romero had started had gotten the general public involved this would be much harder for him to silence the ones involved.

Still…

“This has caused me quite a bit of trouble. It does not look good that I am not the one who found them.” He says because there’d been talks from some of the old men he had yet to rid himself of from his Father’s time. They had wanted the remaining Wesninski men to be brought back into the fold but there was little chance of that happening now. Ichirou planned on disposing them after showing that they were worthless and using it as an excuse to start removing some of the dead weight from his father’s time.

Ichirou was not a man who tolerated incompetence.

“Isn’t it better that they were taken into custody like this?” The man across from him asks, “They were some of the Butcher’s best from what Captain Neil has told me. The fact that it only resulted in me going to the hospital and they were taken out by Andrew and I is one of the better outcomes.” He says.

Ichirou pauses and considers it.

The two men that those relics had wanted for their ‘competence’ and ‘ability’ had been taken out in a way that showcased what Ichirou had thought of them. They were sloppy, they were over-confident, and worst of all they were incompetent.

“Before I forget.” Smith says and his hand goes to the bulge in his jacket pocket.

Ichirou can feel Conner tense behind him and he wonders where this had gone wrong or how the conversation had broken down but he doesn’t have long to wonder about it as Smith pulled something out that was unmistakable as a toy with it’s bright yellow coloring. Smith sets it on the table between them and Ichirou cannot help the confusion that must show on his face despite his many years of training to keep his face blank.

“What is that?” Conner asks sounding utterly bewildered behind him.

“I used this to temporarily blind Jackson during our fight. I figure it would be useful evidence for you.” Smith says.

He hears a bark of laughter to his right as Michael reaches for the toy.

Useful evidence indeed.

It would be easy to show this as a sign that those relics could hardly be trusted to have an opinion in how he ran his empire. Those men they so prized taken out by a children’s toy.

This has gone to his benefit.

“So it would seem.” He finally says, “I will make sure to reward your assistance.” He says wanting a stronger hold over the man in front of him, a tie of some sort to the Moriyama family.

Smith shakes his head in the negative. “I didn’t do anything noteworthy. Whatever it is should go to Captain Neil.” He argues.

Rare find indeed.

“It will be done.” He says and figures with the additional cash flow eliminating the search for the Wesninski men, the removal of his father’s hanger-ons, and the blood he can squeeze from the family Romero and Jackson had intended to go to ( a supposedly allied family) he could more than afford to drop what his three Exy investments owed him as a percent.

His eyes shift over to Smith across from him and finds that he was even more willing to lower those percentages if he could not only drop the dead weight of his father’s empire but perhaps gain someone useful. “Still, I like to reward those who have directly benefitted me. We will take care of any and all hospital fees related to this incident.” He looks to his right and Michael nods.

Smith’s face doesn’t give much away, his pokerface was quite exceptional.

“Thank you." He accepts and says nothing else so Ichirou decides to make his offer.

“I have heard that you are studying languages.” He says.

“I am.” Smith says.

“Which ones do you know?” He asks.

Smith blinks, surprised by the question, “Fluently? French, German, Spanish, Polish, Dutch, Italian, R-“ he pauses and shakes his head, “Recently, I’ve been studying Japanese, Chinese, and some Korean.” He says strangely stumbling over a word for the first time this entire conversation.

A useful skill.

“If you ever find yourself looking for work,” Ichirou snaps his fingers and Conner had a card in his hand in an instant, consider reaching out.” He says before he offers it with both hands and is pleased when Smith accepts it with a slight bow before taking it with both hands. “I see you are also studying the etiquette.” He adds.

Smith looks up from the business card and he looks paler but Ichirou chalks it up to the fact that bowing slightly with his current stomach status likely hurt far more than he had let on. “If you don’t know the etiquette you only know half of the language.” He says and Ichirou quite likes the sentiment.

“Tell Josten that I no longer need to speak with him. Our conversation was satisfactory.” Ichirou says as he rises to his feet.

“I will do that…Lord Moriyama.” Smith says bowing his head politely.

***

The sight of Ichirou Moriyama was always going to be one that made Neil nervous.

The only good thing about seeing him right now was that Kevin had gone with Coach and Aaron in a separate car so that the two of them could continue their argument about protein powder in FF’s soup and Andrew had snagged a spot up front while Coach would have to park farther back.

“Lord Moriyama, I did not expect to see you here.” He greets head down and he almost goes to his knees if it wouldn’t have attracted the sort of attention that Ichirou hated from the public. He just hopes that Andrew isn’t scowling and that Nicky and Smith’s Grandma can keep quiet.

“Perhaps if you kept your phone with you then my appearance would not be such a surprise.” Ichirou comments idly, “Though I suppose I did have a very beneficial conversation with Smith. Quite a bright young man you have as a friend.” He compliments and Neil’s head shoots up in surprise at it.

Ichirou had spoken with FF.

FF who was fading in and out of consciousness.

“I have faith that he will not reveal anything.” Ichirou adds and Neil clenches his fist and wants desperately to ask what happened. Wants to know what state he’s going to find his friend in. “I have not done anything to harm him, you are lucky to have a…friend like that.” Ichirou says as if physical damage was the only thing that Ichirou Moriyama was capable of.

“Yes Lord Moriyama, he is a very talented and skilled defenseman.” He says hoping that if nothing else Ichirou’s desire for Neil and Kevin’s future profitability would have him reconsider doing anything in the future to FF to ensure they would have good showings for the professional teams.

“Yes, he was quite talented in your defense.” Ichirou nods, “I will reach out with details of our new deal once some affairs have settled. Take care of your friend, Josten.” Ichirou says before continuing out of the hospital.

New Deal?

Neil banished the thought from his head. They needed to get up to FF’s room and he needed to make sure his friend was okay and find out what exactly had happened.

Andrew’s hand came to the back of his neck and squeezed, “Calm down.” Andrew ordered voice soothingly blank even if Neil could feel the way his grip stuttered. “Let’s go.”

***

The Nurses were saying something about ‘aggravating stitches’ and ‘lucky nothing tore’ but it was all white noise to FF as he continues to think about the business card burning a hole in his pocket.

Ichirou Moriyama.

He’d just had an entire conversation with Ichirou Moriyama.

His stomach was already hurting from his ill advised walk but the moment he’d seen that name on the business card he had accepted his insides had been pure acid. He missed his Pepto Bismol more than anything right now, what he would give for just a single hit of the sweet pink relief.

He couldn’t figure out what was worse.

The fact that he had given over EVIDENCE to the head of a Yakuza group (was it a yakuza group or was it a mafia group?).

The fact that he’d been right in his thoughts from the abyss that the man in the cafeteria looked like a Yakuza member (was it a Yakuza or Mafia?).

The fact that he’d just seen a Japanese guy and thought ‘Oh, must be the Japanese FBI guy I’m supposed to talk to’ which means he’d still been kind of racist.

The fact that he just realized that he had Captain Neil’s phone and not his own meaning that Ichirou had been telling Captain Neil to come to the cafeteria and FF just showed up like a dipshit trying to pitch their lie about the alley.

Finally there was the fact that Ichirou Moriyama had apparently been impressed enough to offer him a spot within his Yakuza group (Yakuza or Mafia?)

Would it be weird to ask during the interview process? Is there an interview process to join organized crime? Do they have benefits? Wait a crime family is paying for his hospital stay right now. This is too much.

He considers asking the nurse to yes please crank up the pain killers and just let him slip into a nice not embarrassing coma but then Captain Neil and Andrew were rushing into his room. “Smith!” Captain Neil exclaims.

Well, too late to ask for that coma.

MASTERPOST FOR ALL PARTS OF FLUENT FRESHMAN AU

NEXT

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The  requests to be added to the tag list keep being spread out across a few  different areas. If I missed you please just ask again in the replies I  promise I just missed you.

As stated before if you’re up here and I spelled it right but you didn’t get a notification there might be  something switched around in your settings that won’t let me tag you properly?

If you didn’t get notified on the last part it’s probably because I used tumblr mobile to post and our most beloved garbage fire site just didn’t like that.

Polish in this chapter:

Przywiążę cię do krzesła = I will tie you to a chair

[kristablogs]

Everything you’ve ever wanted to know about donating bone marrow

Bone marrow transplants might sound scary, but in some cases, it's just an amped up blood draw. (Photo by Allie Smith on Unsplash/)

For February, we’re focusing on the body parts that shape us, oxygenate us, and power us as we take long walks on the beach. Bony bonafide bones. These skeletal building blocks inspire curiosity and spark fear in different folks—we hope our stories, covering everything from surgeries and supplements to good old-fashioned boning, will only do the first. Once you’ve thoroughly blasted your mind with bone facts, check out our previous themed months: muscle and fat.

If you’ve ever given blood or signed up to be an organ donor there’s a chance you might’ve bumped into information about bone marrow donation. The procedure is shockingly simple, and for a lot of people, it’s free. For the folks out there with leukemia, myeloma, lymphoma, or other blood diseases lucky enough to find a match, the transplant is priceless.

And don’t worry—you don’t have to saw your bones open and give away the precious goo inside to save a life. Before you deep dive into figuring out how to donate, it’s essential to know what you’re actually giving.

Bone marrow 101

If you’re curious about what bone marrow looks like, crack open a bone after the next time you polish off some fried chicken. What you’ll see there is a magenta spongy material, the same you can find inside of your own bones and the bones of many living creatures, including mammals, fish, and even snakes.

Ken Cooke, director of the pediatric bone marrow transplantation program at Johns Hopkins Kimmel Cancer Center, calls the substance the “factory where all of the elements of blood and the immune system are generated.” The marrow manufactures red blood cells, white blood cells, platelets and more, which then make their way through a small capillary system and into the blood. There they are distributed to wherever in the body they’re needed.

What doctors look for in the marrow are called blood stem cells, or the “factory workers” in Cooke’s metaphor. These guys not only give rise to all the other kinds of cells in the blood and immune system, but they also replicate themselves over and over so your body’s blood can be continually renewed.

When someone suffers from sickle cell anemia, aplastic anemia or cancer, it’s like all their factory workers went on strike, which makes it pretty difficult for bone marrow to produce the cells your body needs.

Finding the perfect match

For patients to receive bone marrow from a donor, doctors have to find a “perfect match.” To determine that, Cooke says, they look at particular points on a potential donor’s genetic blueprint called human leukocyte antigens. There are twelve points in total—six inherited from the donor’s mother and six from their father. When all twelve points of a patient and a donor are the same, voilá—you have a match.

Siblings or direct family members are most likely to be a perfect match, so when a patient is diagnosed with a blood disorder, the first ones to be tested are the family. But sometimes there isn’t an ideal family member to link up with, or the sibling who turned out to be a perfect match is too old or sick to be a safe donor.

In those cases, doctors turn to organizations like Be the Match to find potential donors among the nationwide database. This is where you, reader, come in to save the day. If you’re between the ages of 18 and 44, all it takes for you to get in the registry—and potentially saving someone’s life—is answering a quick survey and getting a paid-for mouth swab.

Right now, certain ethnic groups are less represented in the registry than others, making it the perfect time to seriously consider becoming a donor, no matter your background. Ethnicity matters because our DNA is passed down from generation to generation, linking us to people of similar origins even if they aren’t directly related to us. Because people of color are underrepresented in the registry, finding a match for patients of color can be a long shot compared to a white patient.

“An African American searching patient has as low as a 23 percent chance of finding a perfect match, just because the registry is made up of four percent of African American donors,” says Lauren Mueller, PR representative for Be The Match. “Compare that to a Caucasian searching patient who has a 77 percent chance of finding a perfect match. You can see there’s a huge gap there.”

When—and if—you get the phone call

Becoming a donor is the first step, but actually donating bone marrow is a whole other story. In fact, the likelihood of you ever needing to do something beyond that original swab is quite slim—Be the Match estimates that only around 1 in 430 people on the registry will end up being a donor. But if you do get the call, this is what you need to be prepared for.

Before anything major happens, the potential donor will go through more tests to confirm they really are a perfect match. They’ll also be tested for certain infectious diseases like hepatitis or HIV, which can be deal breakers at the time of donation.

But a big part of getting that phone call is also making sure the donor is willing to go through with the donation, which may involve surgery, or a process similar to a blood draw. Which procedure the donor goes through will depend on what they’re willing to submit themselves to and the type of patient they’re benefiting: adult patients tend to need more bone marrow than pediatric patients.

“It’s so hard to find [perfect matches] that in a way, we will take what we can get as long as you’re a perfect match,” says Amir Steinberg, an oncologist at Mount Sinai, who is a lymphoma survivor himself.

The old school method

The tried and true method of bone marrow transplant has been around since the 1950s and it’s closer to that gruesome open-bone image that probably popped into your head when you first started reading this story.

The procedure is simple—the donor is put under anesthesia and laid on their stomach. Next, a pair of doctors known as “the harvesters,” use sharp needles to reach into the posterior superior iliac crests on your hip bone, also known as those dimples on either side of your lower back.

The needle makes its way through the bone and the marrow is syringed out. Depending on how dense in stem cells the liquid is and how much the patient needs, donors will be poked between two and four times in a procedure that lasts up to 90 minutes.

There are no more risks to the marrow extracting process than to any basic surgery involving total anesthesia, but there is something about it to keep in mind: it is particularly painful.

“It hurts. It is a very peculiar feeling,” says Ken Cooke from Johns Hopkins, who donated bone marrow while in med school. “There’s no way we would do this without some type of good anesthesia.”

Lauren Mueller says the feeling is similar to that of falling on your tailbone after slipping on ice—still a small price to pay for saving someone’s life.

In the aftermath of the procedure, donors are usually prescribed a good round of painkillers and at least a day or two of rest to handle discomfort. Limping and further pain is also expected, and it can take a few weeks for them to entirely subside.

According to Cooke, these days this procedure is mostly done for pediatric patients because of the decreased likelihood that other blood cells will make it into the patient. Foreign blood cells raise the risk of graft versus host disease, which is when a donor’s T cells spot a patient’s healthy cells as foreign elements and attack them. There’s always a chance this might happen, but the odds drop considerably the more alike are the DNA of the patient and the donor—the more perfect the match, the lower the risk.

But if the idea of someone drilling your bones for marrow gives you the willies, you shouldn’t give up on being a donor just yet. There’s another method that accounts for the majority of procedures that may be a lot less scary.

Peripheral blood transplants: the newer (less painful) way

If your doctor thinks the patient might need more stem cells than your hip bones can offer, you may forgo the old-school approach and go straight to a newer technique. Developed in the 1980s, peripheral blood transplants are pretty much just an amped-up version of blood donation, which makes them much less painful than regular bone marrow extraction.

For a few days, donors are given shots of a protein called granulocyte colony-stimulating factor (GCSF). This acts like a fertilizer for bone marrow, causing more and more blood stem cells to get into the bloodstream.

After a few days of that, a donor essentially has their blood drawn with a particular machine that siphons off those stem blood cells for donation. If the donor has big enough veins, they can place a catheter in their arm, and just watch Netflix and chill while undergoing the procedure. If the veins are too hidden, Steinberg says a catheter is placed into the neck to get the job done—don’t worry, if this happens to you, you’ll be sedated.

One significant advantage to this method is that you can get a lot more stem cells, so if a patient needs more bone marrow than the old-school surgical approach can offer, this is a reliable way to get it, Steinberg says. Not to mention, recovery time could be a few days, not weeks.

However, there is a major drawback. Peripheral blood transplants have a higher chance of the donor’s lymphocytes—the cells in charge of the body’s immune response—getting into the patient’s bloodstream. This poses an increased risk of graft versus host disease, compared to the bone-poking method.

Finding a home for those blood stem cells

So the doctor has your blood stem cells—now what?

The process is actually pretty unexciting, Cooke says. Essentially, an IV of the donor liquid is linked up to the patient’s bloodstream. From then on, the new stem cells will know what to do.

“They just know to go to the bone marrow, they hone in on it,” Steinberg says.

When bone marrow transplantation is part of cancer treatment, patients have to go through some serious rounds of chemotherapy to knock out the old, harmful immune system before the new cells get into the bloodstream, Steinberg adds. This makes room for the new stem cells to rebuild a patient’s defenses. This process is called “engraftment,” and takes two to three weeks.

For anonymity reasons, patients and donors may only meet and build relationships a year or so after all this goes down, creating some of the most heart-warming stories the internet has to offer.

The future of bone marrow transplantation

New developments come out all the time in the field of medicine and now there’s a chance that the entire bone marrow donation process could be flipped on its head.

Scientists at Johns Hopkins University have found a way to make transplants in haploidentical cases, meaning the donor and patient are only half-matched. This could be a lifesaver for people who’ve been long waiting to find a perfect match and have been unable to use alternatives such as cord blood stem cells.

“We are really breaking down the boundaries of donor selection and availability,” Cooke says.

This process is still in its early stages, which means there’s still research to be done before it becomes massively available. In places like Johns Hopkins, researchers have already succeeded at using bone marrow from a parent, sibling or other unrelated half-matched donors, which gives new hope to patients looking for a match everywhere.

[scootoaster]

Everything you’ve ever wanted to know about donating bone marrow

Bone marrow transplants might sound scary, but in some cases, it's just an amped up blood draw. (Photo by Allie Smith on Unsplash/)

For February, we’re focusing on the body parts that shape us, oxygenate us, and power us as we take long walks on the beach. Bony bonafide bones. These skeletal building blocks inspire curiosity and spark fear in different folks—we hope our stories, covering everything from surgeries and supplements to good old-fashioned boning, will only do the first. Once you’ve thoroughly blasted your mind with bone facts, check out our previous themed months: muscle and fat.

If you’ve ever given blood or signed up to be an organ donor there’s a chance you might’ve bumped into information about bone marrow donation. The procedure is shockingly simple, and for a lot of people, it’s free. For the folks out there with leukemia, myeloma, lymphoma, or other blood diseases lucky enough to find a match, the transplant is priceless.

And don’t worry—you don’t have to saw your bones open and give away the precious goo inside to save a life. Before you deep dive into figuring out how to donate, it’s essential to know what you’re actually giving.

Bone marrow 101

If you’re curious about what bone marrow looks like, crack open a bone after the next time you polish off some fried chicken. What you’ll see there is a magenta spongy material, the same you can find inside of your own bones and the bones of many living creatures, including mammals, fish, and even snakes.

Ken Cooke, director of the pediatric bone marrow transplantation program at Johns Hopkins Kimmel Cancer Center, calls the substance the “factory where all of the elements of blood and the immune system are generated.” The marrow manufactures red blood cells, white blood cells, platelets and more, which then make their way through a small capillary system and into the blood. There they are distributed to wherever in the body they’re needed.

What doctors look for in the marrow are called blood stem cells, or the “factory workers” in Cooke’s metaphor. These guys not only give rise to all the other kinds of cells in the blood and immune system, but they also replicate themselves over and over so your body’s blood can be continually renewed.

When someone suffers from sickle cell anemia, aplastic anemia or cancer, it’s like all their factory workers went on strike, which makes it pretty difficult for bone marrow to produce the cells your body needs.

Finding the perfect match

For patients to receive bone marrow from a donor, doctors have to find a “perfect match.” To determine that, Cooke says, they look at particular points on a potential donor’s genetic blueprint called human leukocyte antigens. There are twelve points in total—six inherited from the donor’s mother and six from their father. When all twelve points of a patient and a donor are the same, voilá—you have a match.

Siblings or direct family members are most likely to be a perfect match, so when a patient is diagnosed with a blood disorder, the first ones to be tested are the family. But sometimes there isn’t an ideal family member to link up with, or the sibling who turned out to be a perfect match is too old or sick to be a safe donor.

In those cases, doctors turn to organizations like Be the Match to find potential donors among the nationwide database. This is where you, reader, come in to save the day. If you’re between the ages of 18 and 44, all it takes for you to get in the registry—and potentially saving someone’s life—is answering a quick survey and getting a paid-for mouth swab.

Right now, certain ethnic groups are less represented in the registry than others, making it the perfect time to seriously consider becoming a donor, no matter your background. Ethnicity matters because our DNA is passed down from generation to generation, linking us to people of similar origins even if they aren’t directly related to us. Because people of color are underrepresented in the registry, finding a match for patients of color can be a long shot compared to a white patient.

“An African American searching patient has as low as a 23 percent chance of finding a perfect match, just because the registry is made up of four percent of African American donors,” says Lauren Mueller, PR representative for Be The Match. “Compare that to a Caucasian searching patient who has a 77 percent chance of finding a perfect match. You can see there’s a huge gap there.”

When—and if—you get the phone call

Becoming a donor is the first step, but actually donating bone marrow is a whole other story. In fact, the likelihood of you ever needing to do something beyond that original swab is quite slim—Be the Match estimates that only around 1 in 430 people on the registry will end up being a donor. But if you do get the call, this is what you need to be prepared for.

Before anything major happens, the potential donor will go through more tests to confirm they really are a perfect match. They’ll also be tested for certain infectious diseases like hepatitis or HIV, which can be deal breakers at the time of donation.

But a big part of getting that phone call is also making sure the donor is willing to go through with the donation, which may involve surgery, or a process similar to a blood draw. Which procedure the donor goes through will depend on what they’re willing to submit themselves to and the type of patient they’re benefiting: adult patients tend to need more bone marrow than pediatric patients.

“It’s so hard to find [perfect matches] that in a way, we will take what we can get as long as you’re a perfect match,” says Amir Steinberg, an oncologist at Mount Sinai, who is a lymphoma survivor himself.

The old school method

The tried and true method of bone marrow transplant has been around since the 1950s and it’s closer to that gruesome open-bone image that probably popped into your head when you first started reading this story.

The procedure is simple—the donor is put under anesthesia and laid on their stomach. Next, a pair of doctors known as “the harvesters,” use sharp needles to reach into the posterior superior iliac crests on your hip bone, also known as those dimples on either side of your lower back.

The needle makes its way through the bone and the marrow is syringed out. Depending on how dense in stem cells the liquid is and how much the patient needs, donors will be poked between two and four times in a procedure that lasts up to 90 minutes.

There are no more risks to the marrow extracting process than to any basic surgery involving total anesthesia, but there is something about it to keep in mind: it is particularly painful.

“It hurts. It is a very peculiar feeling,” says Ken Cooke from Johns Hopkins, who donated bone marrow while in med school. “There’s no way we would do this without some type of good anesthesia.”

Lauren Mueller says the feeling is similar to that of falling on your tailbone after slipping on ice—still a small price to pay for saving someone’s life.

In the aftermath of the procedure, donors are usually prescribed a good round of painkillers and at least a day or two of rest to handle discomfort. Limping and further pain is also expected, and it can take a few weeks for them to entirely subside.

According to Cooke, these days this procedure is mostly done for pediatric patients because of the decreased likelihood that other blood cells will make it into the patient. Foreign blood cells raise the risk of graft versus host disease, which is when a donor’s T cells spot a patient’s healthy cells as foreign elements and attack them. There’s always a chance this might happen, but the odds drop considerably the more alike are the DNA of the patient and the donor—the more perfect the match, the lower the risk.

But if the idea of someone drilling your bones for marrow gives you the willies, you shouldn’t give up on being a donor just yet. There’s another method that accounts for the majority of procedures that may be a lot less scary.

Peripheral blood transplants: the newer (less painful) way

If your doctor thinks the patient might need more stem cells than your hip bones can offer, you may forgo the old-school approach and go straight to a newer technique. Developed in the 1980s, peripheral blood transplants are pretty much just an amped-up version of blood donation, which makes them much less painful than regular bone marrow extraction.

For a few days, donors are given shots of a protein called granulocyte colony-stimulating factor (GCSF). This acts like a fertilizer for bone marrow, causing more and more blood stem cells to get into the bloodstream.

After a few days of that, a donor essentially has their blood drawn with a particular machine that siphons off those stem blood cells for donation. If the donor has big enough veins, they can place a catheter in their arm, and just watch Netflix and chill while undergoing the procedure. If the veins are too hidden, Steinberg says a catheter is placed into the neck to get the job done—don’t worry, if this happens to you, you’ll be sedated.

One significant advantage to this method is that you can get a lot more stem cells, so if a patient needs more bone marrow than the old-school surgical approach can offer, this is a reliable way to get it, Steinberg says. Not to mention, recovery time could be a few days, not weeks.

However, there is a major drawback. Peripheral blood transplants have a higher chance of the donor’s lymphocytes—the cells in charge of the body’s immune response—getting into the patient’s bloodstream. This poses an increased risk of graft versus host disease, compared to the bone-poking method.

Finding a home for those blood stem cells

So the doctor has your blood stem cells—now what?

The process is actually pretty unexciting, Cooke says. Essentially, an IV of the donor liquid is linked up to the patient’s bloodstream. From then on, the new stem cells will know what to do.

“They just know to go to the bone marrow, they hone in on it,” Steinberg says.

When bone marrow transplantation is part of cancer treatment, patients have to go through some serious rounds of chemotherapy to knock out the old, harmful immune system before the new cells get into the bloodstream, Steinberg adds. This makes room for the new stem cells to rebuild a patient’s defenses. This process is called “engraftment,” and takes two to three weeks.

For anonymity reasons, patients and donors may only meet and build relationships a year or so after all this goes down, creating some of the most heart-warming stories the internet has to offer.

The future of bone marrow transplantation

New developments come out all the time in the field of medicine and now there’s a chance that the entire bone marrow donation process could be flipped on its head.

Scientists at Johns Hopkins University have found a way to make transplants in haploidentical cases, meaning the donor and patient are only half-matched. This could be a lifesaver for people who’ve been long waiting to find a perfect match and have been unable to use alternatives such as cord blood stem cells.

“We are really breaking down the boundaries of donor selection and availability,” Cooke says.

This process is still in its early stages, which means there’s still research to be done before it becomes massively available. In places like Johns Hopkins, researchers have already succeeded at using bone marrow from a parent, sibling or other unrelated half-matched donors, which gives new hope to patients looking for a match everywhere.

[mmjjbbaannkkss]

2019 December 16-21 Body Recomposition

“Just because you are happy it does not mean that the day is perfect, but that you have looked beyond its imperfections.” ~ Bob Marley

>>> Light Reading

“Body recomposition: lose fat and gain muscle at the same time” = TLDR: people want to be skinny instead of gains, recomp increases strength, burns calories, focus on your body not your weight, scales can’t measure muscle loss. https://www.healthline.com/nutrition/body-recomposition#how-it-works Lesson: ditch the scale, use a mirror

Rates of protein metabolism vs consumption https://www.youtube.com/watch?v=tJpdPYedWjc&t=499s

https://www.bicycling.com/training/a30187965/abs-workout-full-body-workout/ engage the abs/core with locks/holds like twists or planks.

https://www.cheatsheet.com/health-fitness/lies-youve-been-told-about-your-diet-and-fitness.html/ can’t target fat; don’t starve yourself; recovery is more important; sweating doesn’t burn fat as fast as you think; sleep isn’t going to ruin your gains; big, strong, functional, are three different types of muscle; sugar imbalances insulin during a workout, electrolytes are befor duration training, not after; 

https://www.menshealth.com/fitness/a30213209/sebastian-stan-ab-workout/ leg lift holds, bear crawl, rotations/twists, 

https://www.wellandgood.com/good-sweat/how-to-stretch-your-feet/ heel raise, lift your knee and roll your foot, massage tennis ball; 

https://nationalpost.com/news/world/study-kids-should-eat-better-because-exercise-is-a-terrible-tool-for-losing-weight kids should eat better because it’s easier and smarter than chasing your next cheat meal on the treadmill. 

https://www.mindbodygreen.com/articles/heres-how-to-time-your-hiit-intervals-to-boost-workout-performance sprint for 20 to 90 seconds, stop, repeat

https://www.menshealth.com/fitness/a30273251/floor-press-workout/, if your shoulders hurt, press from the floor until you can bench properly, or use lighter weight and retrain your form/style

https://www.menshealth.com/uk/workouts/g30243713/christmas-day-workout/ x-mas inspired home workout = (10x) jump squats, body squats, push-ups (IDK why the British call pushups pressups), mountain-climbers;

https://www.cbsnews.com/news/creatine-bodybuilding-dietary-supplement-easy-for-teens-to-buy/ under 18yo’s can’t buy creatine in the US because it hydrates muscles, but dehydrates bloodstream and developing organs, including kidneys. Explaining the creatine maintenance dose practice. Flagged by self-checkout. 

https://www.t3.com/amp/news/get-big-arm-shoulders-dec-21 bigger shoulders make your waist look skinny; anterior, medial, and posterior deltoid; 

https://www.bodybuilding.com/content/mat-frasers-top-5-training-mistakes-to-avoid.html 5 mistakes: not sleeping, getting impatient or not working on progress, doing more than you can recover-from, avoiding range-of-motion or muscle activation, not warming up;

Week 2 (mixed: lite, slow)

#7 Slow Push  /lb

Treadmill warmup 10 >> Shoulder press 3x6r/10305070 >> Cable lat 3x6r/ 51015 >> Arnold press 3x6r/20303030 >> Chest press 3x6r/7090110/130150170~ >> Low incl DB Bench 3x8r/354045 >> Pec Deck forearms 3x8r/130130/ >> Dips 3x8r/88/88- >> Rope Triceps 3x8r/203040/404040 >> Pullover/down 3x10r/30303040- >> Tricep press? 3x10r/?90110130150170- >> Abs 3x10r/ rev row 405060708090 >> Treadmill cooldown/ 10

Work on left latissimus, and bring it backward to lateral; time-under-tension, and, 1sec/rest; fst do steady not heavy; bodybuild; add 5lbs, focus on strength, not PR

#8 FST Pull  /

Treadmill warmup 10 >> Wide Lat Pulldown 7x7/5070*390*3 >> Palms-In Pulldown     7x7/7085100*3120*2 >> b DB 1-Arm Row 7x7/25303540455055-

B4? Straight Pulldown 7x7/2030*349*3 >> DB Shrug 7x7/50,70*2,90*2,100,120,140- >> Delt Deck Fly 7x7/254055*470~ >> Row 7x7/3045607590105120 >> Pron EZ Curl     7x7/20*4,30*3 >> Preacher Curl 7x7/50*265*280*2-95- >> 1/2 preacher 7x7/  >> Treadmill cooldown 

Much easier with lighter weights; finished on time warm

#9 Slow Legs  

Treadmill 5 >> Horizon press *6/110,150,190,230, 270- >> Size bends *6/3550658095- >> Deadlift Smith 3x 8 >> Hack Squat *6/203040 >> LR Leg Curl *8/305050 >> LR Leg Ext *8/103030 >> LR Heel Raise *10/30305050 >> Tri-bar Crunch 3x 10 >> Rev Crunch 3x 10 >> Incl treadmill 2x15 min bpm

Sitw size saddle lat machine ½, scoping, ½ sided row machine standing; need to do a chest plate pinch maybe; Regard > Ride It = sounds like = Chimaira> Implements of Destruction 

#10 FST Push  /lbs

Treadmill warm-up 10 >> Shoulder Press 7*7/1030*350*3 >> Cable Lat Raise 7*7/5*410*3 >> B Shoulder Press Neutral *7/1030*550- >> Horizon machine press *7/304560*275*3 >> Upward machine press *7/50*270*290*3 >> Pec deck *7/85100*6 >> Crossover 7*7/2025303535- >> Pullover/down 7*7/30*340*350- >> Rope triceps 7*7/20*7 >> Triceps press + lock-crunch *7/70*290*2110*2130- >> Treadmill cooldown 10

Read that creatine draws water into muscle cells from blood, dry - developing underage organs, and taxing adults, only use a tablespoon at a time, or you'll drink more water and over hydrate, kidneys first, if you think it's important, eat meat for proper dosage or go lite; triceps locked crunch isometric, using muscle, abs seem having max stamina for size, plus not enough gains to push midsection in six months; consider cardio; 

#11 Slow Pull  

Treadmill warm-up 13 >> Lat Pulldown *6/507090 >> Chin Up neutral *6/66,6- >> High Row *6/658095- >> Low Row *8/100*3 >> **Smith shrug *8/60*3 >> DB Shrug *8/(2)60*3 >> *Delt Deck *8/557085! >> >Prchr 1-Arm *10/203040~ >> Cable Curl *10/5050-50 >> <Cable 1-Arm *10/30*7 >> Abs *12/Lock tricep crunch 7090110130150170-190- >> Cooldown 

*TENET; that norther has been running for 20 minutes; Bang drink has too much caffeine, been meditating all night with these songs 

https://youtu.be/JD9drDnyVzI 

https://youtu.be/gqf6nFgezz4

#12 Lite Legs  FST/lb/x

Treadmill 10 >> Body Squat *7/7- >> Side Bends *7/35,50*6 >> Horiz 1-leg *7/10*7 >> Horiz Pr "7/30*2,50*3,70*2 > Leg Ext *7/LR10*5,30*2 >> Leg Curl *7/70*7- >> Heel Raise *8/LR 30*8

Pullover/down *7/20*2,30*4,50 >> Tric press Crunch *7/70,90*2,110*4,130 >> Mach twist *7/LR50*3,70*3,90*?A >> Stairs 5 min, 

C4 Orange, sploded in shaker. Epic fail. Only the cams saw it tho. Siempre seran gente inocentes mientras las locuras gritandose. Haz la show. 

[theseorocket-blog]

The Secret of Bigger Pecs

New Post has been published on https://www.tipsonfit.com/2017/03/21/the-secret-of-bigger-pecs/

The Secret of Bigger Pecs

In this ultra health conscious world, fitness freaks have started paying more attention towards building a more toned and muscular body than to ensure the need of being a physically fit soul. A last few years faced a massive growth in the no. of freaks hitting the gym to achieve this. Bold biceps and triceps along with an enormous chest supported by extremely highlighted Pecs have become an essential need of the hour.

Pecs however, need extreme yet specific workout techniques to grow big. Although, these exercises might vary with gyms and the advice from fitness freaks, yet we bring to you the best things that you must include in your daily workout schedule to have strong and highly toned Pecs.

Please note that the irregular workout schedule won’t make any difference to your body. So be patient and determined to conquer.

So let’s get started.

1: Stay Patient

Building muscles and specially Pecs is a very slow process. It takes a year or so to achieve the best Pecs. This is because the process of building Pecs goes past through the ultimate chest exercises. So everything has to be achieved one after the other to start feeling the differences. Unlike where most supplement providers and fitness magazines drive you through, achieving huge Pecs can never take place in days or months unless you have a lightly toned body. So adopt patience and bang.

2: Start with the Squeezing and Pushing Exercises

Building up chest requires a blend of squeezing and pushing exercises. Both the tasks must be done altogether; otherwise it would lead your muscles, towards an indirect path of development. For faster gains, work that part of your chest, which you want to build up first. A mix of 50/50 (squeezing and pushing) for bench press, dumbbell presses and Flys (squeezing) can help you in this.

3: Avoid doing Triceps and Shoulder-tiring exercises

Prior to adopting the chest and thus Pecs building exercises, you should give a break to the triceps and shoulder tiring exercises. This is because the exhausted shoulders and thus the triceps hinder the maximum intensity that can be achieved after doing the extreme workouts for chest and Pecs.

4: Avoid the need of doing more Training

If you are into natural body-building, don’t over strain by adapting the same workouts multiple times. This would only exhaust your muscles and therefore restrict your body to achieve the maximum benefits. Instead, try instant strength builder techniques using Smith Machine. Explode a weight which is one-rep max upwards to build power quickly. Steroid users can have multiple chest workouts a week as they have chemically-triggered recovery benefits.

5: A well scheduled Chest Training- Reason for Bigger Pecs

Chest exercises are extreme and need time to properly add benefits to the body. Normally, the chest exercises should be done for about an hour and not any less. Before doing the actual workout, start with stretching your chest muscles. Also, the workout should not take place in parts/breaks. All-at-Once should be your main goal. Also, once-in-5days schedule is perfect to do chest and thus the Pecs exercises which, if you are into, must follow the schedule strictly.

6: A strong Underhand Grip and Anger diversion

An under hand grip while doing bench-press exercises is considered to be something top-level to achieve bigger Pecs. This activates 30% more muscles which finally bold abs/Pecs to the desirable extent. Moreover, investing an angry mind to the workout session might increase the outputs to 8% more, as said by the Journal of Strength and Conditioning Research. So take advantage of your negative things to achieve something positive.

7: The Plank, adding effects

It is recommended to tense your abs while doing any Chest-press exercises. 10 second sets of “the plank” between chest presses impart the maximum intensity to the core involving the chest and therefore the abs. This is how you can ensure bigger Pecs while mixing chest presses a few sets of plank in between.

8: Never forget taking Rests

Taking gaps between the varying chest exercises is must. The rest should vary from 1 to 5 minutes as it relaxes body muscles and prepares them for more exercises. Improper rest schedule might exhaust the shoulder muscles which thereby can restrict the maximum intensity to reach and tone the desired parts of the core. The rest period must vary with the intensity of sets involved in your workout schedule.

9: Never hesitate to drop the sets to increase the intensity

If you aim at making your Pecs bigger and bolder, you must include a habit of dropping sets whenever required. For example, if are performing 4 reps of a heavy weight, you can drop enough weight to increase the workout volume. The imparted intensity largely depends upon the workout volume and thus the repetitions of a specific weight lifter exercise, so you must have greater volume for more impact.

10: Squeezing the Barbell

For bigger Pecs and thus a strong core, try squeezing the bar bell as if you’d pull it apart. Squeezing barbell activates Pecs with isometric tension. This way, your Pecs get prepared for the upcoming weight/intense workout. So, a progressive approach is triggered using Squeeze the Barbell technique.

11: The Clap press-ups

Before actually undertaking any chest exercise, you can perform two clap press-ups. This would induce more weight lifting capacity and thus would be beneficial for your abs in total. Also, 44 degrees is the best angle to which the Bench-press must be inclined. This would recruit more muscle to the chest.

12:  Nutritious diet

This is an important thing every fitness freak should adopt to get the best results in the body. Building of Pecs and thus chest require a heavily nutritious and a protein-rich diet plan. A healthy diet is the key to bigger Pecs and thus should be kept as a priority without any fail.