#topical anesthetic

[creativeera]

Lidocaine Ointment Market is pegged to witness expanding globally

Lidocaine ointment is a topical local anesthetic that works by blocking nerve impulses. It is applied to the skin to numb the area before medical procedures such as injections or minor surgeries. The benefits of lidocaine ointment include ease of application, rapid onset of action within 5-10 minutes, and duration of anesthetic effect up to 2 hours. It is used for procedures such as suturing of lacerations, insertion of intravenous catheters, and minor dermatological surgeries.

The global Lidocaine ointment market is estimated to be valued at US$ 1,275.2 million in 2022 and is expected to exhibit a CAGR of 7.7% during the forecast period (2022-2030).

Key Takeaways Key players operating in the Lidocaine Ointment market are Glenmark Pharmaceuticals U.S. Inc., Teligent Inc., Taro Pharmaceutical Industries Ltd., CENTURA PHARMACEUTICALS INC., Neon Laboratories Ltd., ASTRAZENECA CANADA INC., Novocol Pharma, Amneal Pharmaceuticals LLC., Alembic Pharmaceuticals Limited, Ascend Laboratories LLC, Liberty Pharmaceuticals, Inc., Hi-Tech Pharmaceuticals, Aspen Pharmacare Australia Pty Ltd., Sandoz AG, Zydus Healthcare Limited., Quagen Pharmaceuticals, Zuche Pharmaceuticals Private Limited., and SEPTODONT, Inc. The growing Lidocaine Ointment Market Demand for pain management products from the surgical and diagnostic centers along with increasing number of minor surgical procedures performed globally are propelling the lidocaine ointment market growth. Manufacturers are exploring opportunities in emerging markets through partnerships and collaborations to strengthen their global footprint in the lidocaine ointment industry. Market Key Trends The rising geriatric population suffering from arthritis and joint disorders is one of the key trends driving the lidocaine ointment market. As age advances, the chances of developing musculoskeletal conditions increases significantly. Lidocaine ointment offers effective pain relief to elderly patients with conditions like osteoarthritis. Furthermore, increasing awareness about minimally invasive procedures and surge in medical tourism are also fueling the demand for Lidocaine Ointment Companies worldwide.

Porter’s Analysis Threat of new entrants: Low barriers to entry due to regulated nature but established players dominate distribution channels. Bargaining power of buyers: Large number of buyers but individual buyers have low purchasing power due to undifferentiated nature of products. Bargaining power of suppliers: Commodity ingredients are supplied from few suppliers giving them moderate power. Threat of new substitutes: Low threat as lidocaine ointment has well-established use in treatment of pain. Competitive rivalry: Intense competition among established players to gain higher market share through pricing strategies and new product launches. Geographical Regions North America accounts for the largest share of the lidocaine ointment market currently, owing to the high prevalence of pain-related conditions and availability of reimbursement for prescription drugs in countries like the US and Canada. According to some estimates, the North American region held over 35% market share in 2024 in terms of value. The Asia Pacific region is expected to witness the fastest growth during the forecast period from 2024 to 2031. This can be attributed to the improving access to healthcare in emerging economies like India and China coupled with growing awareness about pain management. The rising geriatric population susceptible to osteoarthritis and other causes of pain indicates strong growth potential for lidocaine ointment market players seeking to expand into Asia Pacific region.

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Vaagisha brings over three years of expertise as a content editor in the market research domain. Originally a creative writer, she discovered her passion for editing, combining her flair for writing with a meticulous eye for detail. Her ability to craft and refine compelling content makes her an invaluable asset in delivering polished and engaging write-ups.

(LinkedIn: https://www.linkedin.com/in/vaagisha-singh-8080b91)

[itattooi]

Client Comfort during their Permanent Makeup procedure

Don't rely only on your topical anesthetics to keep the pain away for your clients.

Important factors to create a pain free experience for your clients.

STRETCH THE SKIN Keep a good stretch on the skin tight "like a drum" and you will have an easier time implanting your pigments with less pain for the clients.

BE GENTLE with your application.  You don't need to push down on the machine or manual tool. 

 Let the machine do the work.  The machine needle will repeat the in and out movement, you don't have to.

 Manual hand method gently snag and rock your needle.  Repeating the movement will develop a great implanted line. Be sure not to poke the skin with the pointed angle of the needle.  Instead, place the needle points onto the skin at the exact same time.  Very gently move the needle forward and snag the skin then rock back the hand tool which will release the skin, repeat.  Keep your touch light.  Microblading is a different movement.  Using the same style of needle inserted into the��handle at a slight angle.  The movement is more of a slicing action.  You are relying on the row of sharp needles to create a slice into the skin to create a line to mimic a natural hair.  

Set your NEEDLE DEPTH on your rotary machine no longer than the thickness of a dime.  This will implant the pigment into the correct depth of the skin with far less pain.  The results will last for years.

DO NOT OVERWORK the skin this will create a very sore to the touch feeling. Making the whole process painful and unable for you to do a good job. Over working the skin can be painful and the skin doesn't retain the pigment.

GET IN AND OUT, the longer you work on any one area the more sore the skin becomes.  Be sure  you are using your tools at the correct angles to give a good implant.  Make your implanting process count, the better your technique is for implanting pigment the faster your results will be seen = less time = less pain. 

TOPICAL ANESTHETICS works wonders, they will help you control your client's pain.  Please remember to also use all this information to create  a wonderful experience for your clients.  If it is pain free they will be back and they will share the great experience with all their friends.  If it hurts they probably will not return and they will definitely tell all their friends.  

Topicals for sale @ EZPMU.com

LIPS can be one of the most sensitive areas you will work on.  Use these techniques to help you create a more pleasant experience for your customer

Technique for numbing the lips

I use 4” cotton lip rolls, Benefits are:  *stretches the lips easier to implant pigment, *cushions the gums for a more comfortable feeling and it *absorbs saliva (wet mouths) I have even changed to fresh cotton lip rolls during a procedure so the client is kept quite comfortable.  Mouth sizes are also important.  You may use 1 upper & 1 lower.  Sometimes adding another one prevents the lip rolls from moving around.  If I am working on a larger size mouth I have used 2 up and 2 lower with 1 in the center to prevent slipping or moving around.  I will also apply Topicain® or Adult Orajel®  (sold in drug stores for sore gums, and the taste of the Orajel®  is more pleasant, because it is made for inside the mouth),  right to the cotton lip roll before inserting into the client's mouth.  This method of numbing the inside as well as the outside really does provide a more comfortable experience for the client.

1. Topicain 5%® applied liberally or whichever topical you have and cover with “Glad Wrap®”.  Some techs will apply a layer of Vaseline over the topical instead for the same effect. This helps the Topical work well.  If you are using a liquid topical such as Vasocaine® use a round cosmetic pad and peel the top layer off.  Saturate this thinner layer with your liquid topical Vasocaine®.  Lay this moisten pad on customer’s lips for same amount of time 20 minutes, along with a cover of cellophane like Glad wrap®

2. Allow Topicain® to stay on the skin for at least 20 minutes.  In class we will do an eyelash perm on this client so that it has a long time to numb.  If it looks like the topical is absorbing into the skin we will apply a little more.

3. After 20 minutes have passed, begin to outline your shape with either the hand method or machine method. I usually start on the top lip. At this point we are just creating what I call a “whisper of a line”.  The outline is visible but light.  What you have done is open the skin so that we can put the “NumQuick® Gel” on the upper lip outline (open skin area only).  Let the NumQuick® Gel stay on the upper lip while you are working on the lower lip. No need to cover with plastic wrap.

4. Begin your whisper outline on the bottom of the lip.  Then apply NumQuick® Gel to the bottom lip and let sit while you go back to the upper lip.

5. Look at the upper lip and notice how “White” the skin is near the opening of the skin.  This is how you can tell it is numb.  You can now proceed to define the upper lip line and the pain should be tolerable for the client.  By the time you are finished outlining the upper lip you will need to open up the skin on the upper lip so you can let the NumQuick® sit on the upper lip while you are working on defining the bottom lip.  You can do this with either method 1. Manual hand method or the 2. Machine method.  Gently travel over the lip area opening up the skin.  You are not trying to implant color, only open the skin.  Then apply the NumQuick® to the open lip skin.

6. Start defining the lower lip. Notice how  “white” the skin appears on the outline. The upper lip will be numbing while you are working on the lower outline.  This way there is no down time.  Repeat opening of the skin on the lower lip like you did the upper lip and apply NumQuick® to the lower lip.

7. The upper lip should look whitish or blanched in color.  This is a good indication the lip is numb and you will have a much easier time implanting the color because the client won’t feel it as much.  You can always re-apply throughout the procedure.

8. Repeat the bottom lip in the same method. 9. Finally we finish off the corners of the lips at the very end.  Remember to have your client open up their mouth when finishing up the corners.  This allows you to have easy access to create the desired shape and radiant color.  You will want to create a soft gradual color towards the inner corners of the lip.  You should be careful that you don’t  end up creating lips that resemble a “fish mouth” appearance. Shocking I know but  I hope you get the visual.  Because if you aren’t careful you will not be happy with the final result. 

[icpa]

Nummit Spray Dental | ICPA Health Products Ltd.

Introducing ICPA Nummit Topical Dental Spray,  It is used to produce local numbness (anesthesia). It works by reversibly blocking nerve transmission when applied to a limited area of the body. Local Anesthetics like lidocaine bind to the sodium channels in the nerve membrane and prevent the entry of sodium ions in response to the membrane’s depolarization. For more details visit a website.

[miamibrowshopp]

Tattoo Numbing Cream: Everything You Need to Know

Nowadays, more and more people are choosing to express themselves with tattoos and permanent makeup. Even with the most advanced permanent makeup machines, getting a tattoo can be a painful experience. To reduce the discomfort, most people turn to tattoo-numbing creams.

This article discusses tattoo numbing creams in detail covering their benefits, application methods, and safety precautions.

What is Tattoo Numbing cream?

Tattoo-numbing creams are topical anesthetics that can be over-the-counter medications used to desensitize the skin temporarily to reduce pain and discomfort. The cream works by blocking the sensory nerves of the area to be tattooed.

How does Tattoo Numbing Cream Work?

Tattoo numbing cream can be directly applied to the skin and gently massaged until absorbed. A plastic wrap or occlusive dressing may be used to cover the area to enhance the absorption and effectiveness of the cream.

The cream enters the skin to block the sensory nerves from sending pain signals to the brain. Once the sensory nerves are blocked, the person cannot feel pain in the area of the skin where the cream was applied. This allows the tattoo or PMU artist to start the procedure without causing pain and discomfort to the client. The cream doesn't take effect immediately and can take up to 30-40 minutes to start working. 

However, the numbing cream may not completely eradicate pain, but it makes the procedure less painful and reduces discomfort.

Topical anesthetics would be used during the permanent makeup procedure to completely eliminate any pain sensation. Topical anesthetics are used as a secondary numbing agent and are stronger than pre-numbing agents.

Benefits of Tattoo Numbing Cream  

Tattoo-numbing creams have several benefits for permanent makeup artists as well as clients. While clients experience reduced pain and discomfort, artists can achieve better precision due to minimized client movement. It also reduces stress levels and facilitates shorter procedures.

Minimum discomfort and pain for clients

Increased satisfaction for clients

Enhanced precision of procedure by minimizing patient movement

Facilitates shorter appointments and allows for seamless procedures

How Potent is Tattoo Numbing Cream?  

The effectiveness of the cream depends on a range of variables including the person's pain threshold, area of the skin, the kind of numbing cream used, etc. For some people, tattoo numbing cream may eliminate the pain completely, while others may still experience little discomfort. It is also recommended to not consume alcohol within 24 hours prior to tattooing which can reduce the effectiveness of the topical anesthetic and cause more bleeding during the tattoo procedure.

Safety Precautions

It is important to adhere to the directions when using tattoo numbing cream. A generous and consistent coating should be applied to dry skin up to 30-40 minutes before the procedure. For tattoo numbing creams and topical anesthetics, please visit the product pages and read their descriptions on how to best use them. Permanent makeup artists have the training and experience to apply tattoo numbing cream correctly. Also, some parts of the body are more sensitive so the numbing cream may have a lesser effect on such areas or re-application may be required during the procedure.

Conclusion: Tattoo numbing cream is a topical anesthetic that helps reduce the pain and discomfort associated with getting a tattoo before and during the procedure. However, it is important to make sure that the cream is applied correctly to reduce the possible risks and side effects. Also topical anesthetics (secondary numbing) should always be used during permanent makeup procedures to increase the overall effect of the tattoo numbing cream. Moreover, it is recommended to have a clear discussion with the client about their expectations before the procedure commences.

[sturnsdoll]

𝖶𝖨𝖲𝖣𝖮𝖬 𝖳𝖤𝖤𝖳𝖧 -`♡´- -C.S

(HEADCANNONS!)

pairing: chris x (gf) reader, some reader x bsf matt and nick <3

summary: how chris would support his girlfriend before, after, and through wisdom teeth removal, as well as being under the influence of anesthetics!

warnings: fluffy!headcannons, dentist, mention of teeth pulling, little blood, slight mention of needles, anesethetics, established relationships.

authors note: kind of a blurb more than hc's tbh? it was a little rushed! sorry!

₊⊹⤑ you had been talking about how nervous you were for a couple weeks now..

₊⊹⤑ so it was no surprise when the whole car ride there, you were holding your boyfriends hand and avoiding the topic of what you knew was coming.

₊⊹⤑ chris had been reminding you everyday that besides the needle, the rest of it you wouldn't even remember. he ensured that him matt and nick would be there the entire time if you needed a hand or two.. or three to hold.

₊⊹⤑ with some encouragement (and chris lending you his grey zip up to wear for emotional and physical comfort) you did manage to enter the building just to get it done and over with.

₊⊹⤑ while the IV was intruding your skin, chris stayed next to you, asking about what flavour of ice cream you'd be getting after as a distraction from the needle.

₊⊹⤑ from there on, the process itself you had no memory of but chris stuck close by the entire time incase you needed anything or for some reason woke up.

₊⊹⤑ "hey sweetheart how'r ya feeling?" chris would ask while gently holding your hand when you come to your senses

₊⊹⤑ confused, your instinct was to sit up but chris would immedietly usher you to lay back down, letting you know that they're done working on your teeth.

₊⊹⤑ "why dtha fack is this bullshit still in my fucking arm then HUH?" your words wonky from the cotton in your mouth and the haze of anesthetic.

₊⊹⤑ "shh, were in public stop cursing like a sailor" "dude, nobody under like 100 says 'cursing like a sailor'" "yeah, what he thsaid!"

₊⊹⤑ chris would of course glare at you for agreeing with matt. but his thumb soothingly rubbing your hand tells you that he's obviously not too mad.

₊⊹⤑ you would leave later then you should have because everytime a password was given to you, you'd forget less than five seconds later..

₊⊹⤑ "it was ass right?" "no, it was GRASS sweetheart...."

₊⊹⤑ everything that came out of your mouth had the doctors and the triplets giggling.

₊⊹⤑ when it came time to take the IV out, chris thought that a 'got your nose' joke would be funny to distract you with. it was... definetly distracting at least???

₊⊹⤑ usually you were sweet to your boyfriend but something about anesthetic had you more than arguementative today.

₊⊹⤑ chris would try complimenting you "you look pretty even like this"

₊⊹⤑ "i KNOW i do. stop being corny you sthtoopid fuck" chris's jaw drops like he's offended but you don't care because nick's contagious laugh brings out your own laughter out as well.

₊⊹⤑ "i thought i was supposed to be the stupid one right now, not you"

₊⊹⤑ "maybe YOUU need to see the dentist about all those terrible jokes that come out of your mouth."

₊⊹⤑ you had no filter, just having fun rebelling against your usual niceness to your loved one.

₊⊹⤑ then finally the car ride came.

₊⊹⤑ now you leant on chris' shoulder to take a nap

₊⊹⤑ "thought i was stupid?" he questions, arm coming around to pull you in closer. "shhhh i'm sthleeping" the inpedament on your speech makes him giggle. "I SAID SHHHHHH" "jesus. my bad sleepyhead"

₊⊹⤑ the whole car ride he was making sure you didn't need your gauze changed, asking if you need water, offering you chapstick. you had to tell him to shut up at least 100 times before he'd relax, telling him you could put your own damn chapstick on. (you ended up asking him for help two minutes later...)

₊⊹⤑ the whole rest of the car ride was filled with you zipping up and down the zipper of your boyfriends sweater you had on, mixed with your favourite artist playing as you attempted to sing along

₊⊹⤑ the second you entered the triplets home, you rested on the couch with your legs over your boyfriends lap, singing a song that everyones pretty sure doesn't exist..

₊⊹⤑ "i love... YOUUUUUUU, i lovovovovovee YOUU, all three of YOUUuUuU-" "someone sedate her again." nick jokes while handing you an ice pack you'd previously asked for.

₊⊹⤑ "want me to hold it on your jaw for you bab- oh" before he can finish speaking you're gripping his wrist, leaning toward him "wanna know something?" you ask eagerly "hm?" "I LOVE YOU!" "i love you more"

₊⊹⤑ matt and nick didn't enjoy the next 30 minutes of the predictable arguement at all. ₊⊹⤑ once the delusion of the anesthetic wore off, you were just plain tired. nick and matt had both chosen to chill in their own rooms by now.

₊⊹⤑ the second you mentioned wanting to lay down, chris curled up behind you with a blanket over the two of you. he held you tight, muttering in your ear about how good you did today and how proud he is that you went.

₊⊹⤑ "sorry for calling you stupid" you apologize with a sweetly apologetic smile.

₊⊹⤑ "aw, it's okay. i know you didn't mean it-" "wellll sometimes.." "nevermind i don't forgive you."

₊⊹⤑ he'd make sure your favourite cartoon was on and that he held your ice pack on your sore jaw till you eventually drifted into sleep.

tags ᥫ᭡: @pettydollie @mattsrod @sturncakez @sturniololovesss @sturniolosstar @sstvrnioloo @watercolorskyy @sturniol0s @6ix9inewiturmom @sonicsmacks @orangela

[bubblegumgothglados]

Do you want to hurt your victim?

Like really really hurt them? Like worst pain they've ever felt? And you want to do it with minimal risk of permanent damage?

Have you considered pulling their fingernails out? Here's a guide

What you'll need

Restraints. You probably want them supine in case they faint. You definitely want the hand you're working on well restrained so they can't flinch half way through and hurt themselves. You also probably want to gag them so they don't bite their tongue off by accident.

Tourniquet. To cut off the blood supply before removing the nail and then to help reduce the blood loss afterwards.

Pliers. For the actually pulling, you want maximum surface area but you also don't want to be flattening the curved edges of the nail because snapping it would be bad. So the exact size that'll be best will depend on the nail you're trying to pull. In any case make sure you can get a really good grip on it.

Anesthetic and pain killers. I'm assuming you only have access to over the counter stuff but get the best you can. If your victim uses their safe word when their nail is half way off dose them with pain meds and apply a topical numbing agent. From there you can either get them to a doctor to finish the job with proper local or finish it yourself because once its half way off it has to come all the way off it will not reattach.

Wound care supplies. Antiseptic, gauze, bandages, etc. I'm assuming you know wound care already.

Method

Restrain them as much as you feel necessary, sterilise the area and your tools, have your wound care supplies ready, clamp pliers down onto the nail, apply firm steady pressure up and away from the finger, wiggle slightly as it comes off. Pretty simple really.

As always if anything goes wrong be ready to call emergency services and get your victim to the ER. But really there's very little that can go wrong here. The only complication would be the nail snapping in which case you would finish removing the piece of nail you still have a hold of and then remove the snapped pieces.

Aftercare

Apply pressure until bleeding stops. Slather on antiseptic, wrap in gaze, and bandage. Do not apply ice, ice does reduce swelling but swelling is part of the healing process and ice impedes that process increasing total heal time. Re-bandage after a day or two, if the bandage has stuck to the wound run it under water until it loosens, do not soak (do not let them go for a swim). Keep an eye out for signs of infection.

Normal aftercare rules apply I.e. snacks, fluids, rest, and whatever emotional aftercare you both like and need.

Make sure your victim keeps their hand above heart level as much as possible over the next five days to stop blood from pooling in the wound.

There is the risk of damaging the nail bed causing the nail to grow back not quite the same. I've had this happen to me and it's slightly annoying not actually a problem

The nail should grow back in about six months, and then of course you can rip it out again

[schmergo]

Today I learned a fact that kinda blew my mind, and I'm almost astonished I didn't know this before as someone whose chief interests include zoo animals, the U.S. Presidency, true crime, and D.C. history. What an opener, right? How could those topics possibly combine?

Well, buckle up and get ready to hear how negligent National Zoo leadership potentially could have killed a US President or started a local epidemic. Spoiler alert: They didn't. But only because luck was in their favor.

First, the part that I DID already know. In 2004, Lucy Spelman stepped down as the director of the National Zoo after a spate of controversial zoo incidents, including a string of unfortunate (and often preventable) animal deaths, misleading and missing zoo records, and other signs of negligence. The AZA even "tabled" renewing the National Zoo's accreditation for a year until they made some significant improvements. Spelman was also a vet and some of the cases she was accused of bungling happened at her own hands, not just under her supervision. It was a major disgrace for a zoo that was meant to represent the nation's capital.

I was in elementary school during these fraught years and I remember devouring articles about this in the newspaper, riveted with shock and dismay. Some of the deaths were just bad luck, but others were obviously negligent. The most infamous case was two red pandas killed by rat poison shallowly buried in their enclosures as a slapdash solution to the zoo's pest problem. A young zebra died of starvation and hypothermia after Spelman ordered the zebras' feed be cut in half, an orangutan was euthanized due to a recurrence of cancer that didn't exist (she actually had salmonella), a lion died after being administered over twice the usual amount of anesthetic, and more. I remember the names and details of these animals from when I first read these cases 20 years ago. But the one I'm talking about today is that of Nancy the elephant.

Nancy was a 46-year-old African elephant whose health had been steadily declining for several years. She suffered from a bone infection in her foot that seriously affected her mobility and quality of life. She had lost a lot of weight, she was fatigued, she even lay down at times. Nobody could be blamed for deciding to euthanize the obviously ill animal.

But they could be blamed for what was discovered in the necropsy after she was euthanized. While she did indeed have a diseased foot, the bone infection was only "moderate." Why, then, was she so obviously unwell? Her lungs had been destroyed by the effects of untreated tuberculosis. It was the tuberculosis, not the sore foot, that most contributed to her decline in health.

Here’s the scary part: nobody knows how long she'd had it because she hadn't been tested for tuberculosis, a known concern for zoo elephants, in TWO YEARS. All this despite the fact that it's MANDATORY for all zoo elephants to receive a tuberculosis test once per year-- and in fact, it was a National Zoo staff member who pushed for that reform in the first place. And the elephant was on Prednisone for her foot issues, which zoo staff noted in her records made her more vulnerable to illnesses like TB. In fact, none of the zoo's elephants had been tested recently, which meant any of them, including one who was pregnant, may have had tuberculosis, too.

There are documented cases of humans catching tuberculosis from elephants. Now, Nancy the elephant had bovine tuberculosis, which seems to be less contagious to humans and which elephants haven't so far spread to humans... BUT it has spread to humans from black rhinos, a fairly close relative, so it seems likely that elephants COULD spread it. It can also take a while for TB for incubate (and can also be latent without symptoms), especially for elephants, so the elephants OR keepers who were around Nancy were at serious risk for TB.

NOW HERE IS THE PART THAT I DIDN'T KNOW ABOUT UNTIL TODAY:

Spelman actively tried to COVER UP the situation, potentially putting many more people at risk. The elephant house was closed to zoo guests, but they were only told it was for "renovations." (The actual renovations, incidentally, were to improve ventilation so that illness would be less likely to spread.)

A BBC news crew that came to film the elephants was asked to keep a healthy distance from the elephants for their emotional health and the crew's safety-- the explanation given was that the elephants' group dynamics had been thrown off by Nancy's death. Spelman instructed zoo staff not to mention the TB situation to the BBC crew and, if asked why Nancy died, they were to respond that it was for multiple reasons and that the official test results weren't all back yet.

And here's the most shocking part of all, the part that made me GASP out loud. Spelman still personally gave some special VIP behind-the-scenes tours of the elephant house during the months that the elephant house was closed, a time when the remaining elephant inhabitants could potentially still develop active TB.

One VIP who received an elephant house tour was PRESIDENT BILL CLINTON and five family members!!!!

BILL. CLINTON. THE GOSHDARN PRESIDENT.

While zoo staff says that the tour was deliberately distanced and nobody got close to an elephant, there are photos of Bill Clinton's nephew about a foot away from an elephant's trunk. You know, their nose. The part they can spread disease with. So, uh, definitely in the danger zone there.

Hillary Clinton's brother, Tony Rodham, was on the tour and he said that nobody in the party was warned about TB risk or asked if they had any medical conditions that might (a. make them susceptible to communicable disease, or (b. be contagious to the elephants. This is especially egregious because according to zoo guidelines, all behind-the-scenes tour participants MUST be asked these questions-- not just when there's a very real possibility of a TB outbreak at the zoo.

Fortunately, none of the zoo's other elephants OR keepers ever tested positive for tuberculosis. But it was certainly a close call! And imagine what would have happened if a US President caught TB from a close encounter with an elephant thanks to poorly managed zoo staff.

Presidents meet a lot of people. In fact, this zoo visit happened only 2 weeks before the inauguration of President George W. Bush, which Clinton attended. He very well could have started a TB outbreak there. Heck, TWO US Presidents could have been infected!

Now THAT is something I will be thinking about for a long time!

[fatliberation]

I totally understand and can empathize with fat activists when it comes to medical fatphobia. But I do think its important to provide nuance to this topic.

A lot of doctors mention weight loss, particularly for elective surgeries, because it makes the recovery process easier (Particularly with keeping sutures in place) and anesthetic safer.

I feel like its still important to mention those things when advocating for fat folks. Safety is important.

What you're talking about is actually a different topic altogether - the previous ask was not about preparing for surgery, it was about dieting being the only treatment option for anon's chronic pain, which was exacerbating their ed symptoms. Diets have been proven over and over again to be unsustainable (and are the leading predictor of eating disorders). So yeah, I felt that it was an inappropriate prescription informed more by bias than actual data.

(And side note: This study on chronic pain and obesity concluded that weight change was not associated with changes of pain intensity.)

If you want to discuss the risk factor for surgery, sure, I think that's an important thing to know - however, most fat people already know this and are informed by their doctors and surgeons of what the risks are beforehand, so I'm not really concerned about people being uninformed about it.

I'm a fat liberation activist, and what I'm concerned about is bias. I'm concerned that there are so many BMI cutoffs in essential surgeries for fat patients, when weight loss is hardly feasible, that creates a barrier to care that disproportionately affects marginalized people with intersecting identities.

It's also important to know that we have very little data around the outcomes of surgery for fat folks that isn't bariatric weight loss surgery.

A new systematic review by researchers in Sydney, Australia, published in the journal Clinical Obesity, suggests that weight loss diets before elective surgery are ineffective in reducing postoperative complications.

CADTH Health Technology Review Body Mass Index as a Measure of Obesity and Cut-Off for Surgical Eligibility made a similar conclusion:

Most studies either found discrepancies between BMI and other measurements or concluded that there was insufficient evidence to support BMI cut-offs for surgical eligibility. The sources explicitly reporting ethical issues related to the use of BMI as a measure of obesity or cut-off for surgical eligibility described concerns around stigma, bias (particularly for racialized peoples), and the potential to create or exacerbate disparities in health care access.

Nicholas Giori MD, PhD Professor of Orthopedic Surgery at Stanford University, a respected leader in TKA and THA shared his thoughts in Elective Surgery in Adult Patients with Excess Weight: Can Preoperative Dietary Interventions Improve Surgical Outcomes? A Systematic Review:

“Obesity is not reversible for most patients. Outpatient weight reduction programs average only 8% body weight loss [1, 10, 29]. Eight percent of patients denied surgery for high BMI eventually reach the BMI cutoff and have total joint arthroplasty [28]. Without a reliable pathway for weight loss, we shouldn’t categorically withhold an operation that improves pain and function for patients in all BMI classes [3, 14, 16] to avoid a risk that is comparable to other risks we routinely accept.

It is not clear that weight reduction prior to surgery reduces risk. Most studies on this topic involve dramatic weight loss from bariatric surgery and have had mixed results [13, 19, 21, 22, 24, 27]. Moderate non-surgical weight loss has thus-far not been shown to affect risk [12]. Though hard BMI cutoffs are well-intended, currently-used BMI cutoffs nearly have the effect of arbitrarily rationing care without medical justification. This is because BMI does not strongly predict complications. It is troubling that the effects are actually not arbitrary, but disproportionately affect minorities, women and patients in low socioeconomic classes. I believe that the decision to proceed with surgery should be based on traditional shared-decision making between the patient and surgeon. Different patients and different surgeons have different tolerances to risk and reward. Giving patients and surgeons freedom to determine the balance that is right for them is, in my opinion, the right way to proceed.”

I agree with Dr. Giori on this. And I absolutely do not judge anyone who chooses to lose weight prior to a surgery. It's upsetting that it is the only option right now for things like safe anesthesia. Unfortunately, patients with a history of disordered eating (which is a significant percentage of fat people!) are left out of the conversation. There is certainly risk involved in either option and it sucks. I am always open to nuanced discussion, and the one thing I remain firm in is that weight loss is not the answer long-term. We should be looking for other solutions in treating fat patients and studying how to make surgery safer. A lot of this could be solved with more comprehensive training and new medical developments instead of continuously trying to make fat people less fat.

[chaifootsteps]

Honestly, Watching/Reading Lackadaisy made me realize that Viv puts, like… no effort into researching the history of her characters. Like, at all.

Almost all the main characters in Hazbin died during a specific time period, but despite that, they all speak like how relatively modern 20-30 somethings and dress the exact same (Cool it with the Striped Suits, Top-hats, and Bowties, Viv, I swear to God) when it would’ve been way more fun and interesting to have the the era they died in reflected in their designs and dialogue. But I think my biggest gripe with Viv’s inability to do more than google one topic and call it a day is the circumstance surrounding Angel’s death. Angel died of an overdose of Angel Dust (the drug) in the 1940s. Angel. The guy who died in the 40s. Died of a drug overdose. Of a drug that wouldn’t have been invented until the 1950s. Years after his death caused by the nonexistent-at-that-point drug. Yeah, great research there, Viv.

Meanwhile, Lackadaisy/Tracy wears the extensive research smack dab on the sleeve. And she kinda has to, seeing as Lackadaisy is technically a period drama, and the whole gimmick of it is “1920s America, but now everyone’s a cute lil kitty cat”. If the historical context in the historical period piece isn’t accurate, then the whole thing falls apart, and Tracy takes great care in making Lackadaisy as accurate to the era as humanly possible.

What really sold me on Tracy's commitment to period accuracy was the art book that just came out, specifically the page where she talks about Mitzi. There's a little drawing of her early design, and most people would agree it looks absolutely fine, but Tracy insists it's not and that she drew it before she did research. I just thought it was super impressive.

(For the record, PCP was invented in 1926, but it wasn't really used as an anesthetic until the 1950s and didn't take off as a street drug until the 1960s. It's also hard to overdose on because you'll tear off your clothes and run screaming into the streets long before you get to that point.)

[liminalmemories21]

WIP Wednesday

tagged by @reyesstrand, @carlos-in-glasses, @lemonlyman-dotcom, @paperstorm, @strandnreyes, and @whatsintheboxmh. Thank you!

"You were shot?" TK's hands are pulling at his shirt before he's even finished speaking.  "What?  When?  Where?  Why didn't you call me?"  He stares at the bandage, pulls it back to look at the neat line of stitches.  "Why didn't you call me?" he asks again more slowly. And Carlos grabs for his hands before he can step back.  "I'm fine.  It was barely a graze.  Topical anesthetic and seven stitches."  None of which answers TK's question.  "I needed time."  Takes a breath.  "I needed time to sit with it before I talked about it.  And if I called you and told you I'd been shot you'd have driven down to San Antonio, and I wasn't ready to talk about it.  I needed time."  He begs TK to understand what he's saying, that it wasn't him.  That Carlos had just needed a minute in his own head to sort out what he was feeling. TK takes a step back, but his hand is still on Carlos's waist, and he'll take the victory.  "And now?" He takes a breath.  "I thought I'd feel different.  I thought I'd get here and it would feel different.  Better."  TK's face crumples in sympathy.  "I spent all this time."  Stops.  "I know this year hasn't been what you, we expected.  I know I haven't always been here, given you, us, the time we deserved. But I needed an answer." TK nods.  "And now that you have it?"  He hasn't asked who it was.  Carlos supposes in a way it doesn't really matter, and maybe that's what TK's been trying to tell him all year - that it won't bring his father back to have a name. Still.  "It was Bridges."  TK's eyes go wide. "I thought I'd feel complete now.  But," he falters.  "He's gone, and it's like the part of him that was still here while I was looking for his murderer is gone now too.  And-" TK brushes a hand against his cheek, and then folds Carlos into him.  "Sweetheart." "He's gone.  And I don't have anything left now."

tagging @freneticfloetry, @actual-sleeping-beauty, @heartstringsduet, and @guardian-angle22

[uispeccoll]

From the John Martin Rare Book Room

De nivis usu medico observationes variae by Thomas Bartholin, and printed in Hafniae [Copenhagen] by Matthias Godiche for Peter Haubold [bookseller], 1661.

Happy December, friends. With winter comes snow and frigid temps, of course. As you walk around, breathing in the crisp air and having your face go numb from the wind and snow, you may think to yourself, "Hmm, I wonder if anyone ever considered using snow as anesthesia?" The answer is a stone–cold "yes."

We're highlighting the work from the prodigious 17th–century Danish physician Thomas Bartholin (1616–1680). Beyond looking like Billy Joel in his heavy metal days (yes, that was a thing), Bartholin rocked a strong scientific mind and was a prolific writer. He corresponded with many of the greatest thinkers of his day, wrote over 20 books (including one on unicorns!), and conducted many experiments.

One area he dabbled in was refrigeration anesthesia (the application of cold to deaden sensation, known today as cryoanesthesia). The application of something cold has long been known to help reduce pain. Medieval physicians, such as Ibn Sina, were the first to write about it.

In De nivis usu medico observationes variae [Various observations on the medical use of snow], Bartholin picks up where those medieval writers left off, thoroughly examining all the medical applications of snow, including as a topical anesthetic.

Chapter XXII makes the first known mention of the use of mixtures of ice and snow for freezing to produce surgical anesthesia, crediting the Italian physician Marco Aurelio Severino for the technique. To avoid killing the tissues and causing gangrene, the ice–snow mixture was to be applied in narrow parallel lines to the area designated to be cut. After a quarter of an hour, feeling would be deadened and the part could be cut without pain.

Along with about 200 pages detailing all the medical properties of snow (who knew there were so many!), there is also a treatise on snow crystals by Bartholin's younger brother, Erasmus. This is the earliest publication on crystallography and preceded Boyle's Essay about the origine & virtues of gems (1672) by eleven years.

It should be noted that we do not suggest trying Bartholin's methods out for yourself this winter.

--Curator Damien Ihrig

[this-sapphic-paradise]

Continuation of this ask

Sharp pain emanated from Kate's side, but thanks to Yelena's magical and definitely not FDA approved anesthetic, it was quickly fading to a dull pulsating that she could mostly ignore as she watched the former Black Widow meticulously arrange on the coffee table everything she would need to stitch her up.

"I didn't know you were back in the city." Kate said, looking away from her own body as Yelena began sewing her up.

"What kind of spy would I be if you knew about my comings and goings, eh?"

"True."

After a beat, Yelena answered truthfully, "I had a lead about a person I've been investigating. Thought I'd drop by and check in you while I'm here."

"I'm glad you did." Kate smiled softly, momentarily distracting Yelena from the task at hand.

"Yeah, I mean, you clearly can't survive without me."

"Pfft!" Kate scoffed playfully. "I could totally do that myself, you know!"

"Has nobody told you it's bad to lie, Kate Bishop?"

"Pot, meet kettle!"

Yelena frowned and looked around her. "Are you making tea?"

Kate chuckled and shook her head. "It's an expression."

After quick work with the stitches, Yelena cleaned up and grabbed two beer bottles from the fridge, offering one to Kate as she joined her on the couch.

"Thanks for patching me up." Kate said, holding her bottle up to Yelena who clinked it with hers.

"Any time."

The two drank and chatted, catching each other up on their very eventful lives. As the hours ticked by and the topics to keep their conversation going naturally dwindled, Yelena asked abruptly, "Do you go out with women, Kate Bishop?"

At Kate's completely befuddled expression, Yelena clarified, "Sexually, I mean."

"Oh, no, no. I got you..." Kate blinked, trying to wrap her head around the sudden shift in conversation.

"It's okay if you don't."

Yelena's nonchalant tone was making Kate even more perplexed, but she tried to play it cool by taking a swing of her beer before answering.

"I mean... I haven't. But...."

"But?"

"I wouldn't be opposed to."

Yelena grinned at the cute blush on Kate's cheeks, but she chose to not comment on it.

"Great." Setting her empty beer bottle down, Yelena stood and said, "You're taking me on a date tomorrow night, then." And she kissed Kate's cheek before heading toward the window. "I'll meet you downstairs at 7. Plan something fun, Kate Bishop."

With a wave and wink, Yelena stepped off the window leaving a stunned Kate to plan their date.

[mypurrrecious]

[tinfoil-jones]

Gravity Falls: For Your Own Good, Ch. 16

Summary: A few years after moving to Gravity Falls and having his lab built, Stanford Pines happens upon his estranged twin brother, Stanley. He mentally prepared himself to be suffocated by his brothers neediness all over again - what he wasn't prepared for was Stanley walking right past him like he didn't even notice him.

Rating: M for language, violence, and adult implications

Preface: Dialogue only, but some actions will be annotated for clarity. Cross-Posted on AO3 Here.

When Bill and Ford are in the dreamscape together, their dialogue is written normally. But if Bill and Ford are communicating in Fords head without the mindscape, Bills dialogue is in "italics", and Fords dialogue is in 'apostrophes and italics'.

First - Prev - Next

CH.16

“Stan?”

“What’s up, stretch?”

“To my understanding, you’re familiar with a… sizable number of illicit substances?”

“Why, you looking for a plug?”

“A… plug?”

“Ya know, a guy who can hook you up with stuff.”

“...Stan, I’m not looking for a drug dealer.”

“Good, because all of the ones I know hate my guts.”

“Are you familiar with a substance called Ketamine?”

“Special K? Haven’t used it, but I’ve heard of it. I heard it kinda does what magic mushrooms do, but without all the visions.”

“It’s a dissociative non-opioid, anesthetic, and analgesic.”

“So it’s like heroine, but it isn’t heroine?”

“Ain’t exactly like that, but you can think about it that way.”

“What about it?”

“I’ve reached out to a colleague in psychology about your case - don’t worry none, I didn’t use names or details - she told me about a hypnotherapy that’s assisted by ketamine.”

“Hypnosis? Like, mind control?”

“That’s a popular misconception - hypnotherapy has been called hypnotic suggestion, but the goal is to bring the patient in question into a greater state of focus with less peripheral awareness, so they may relax and turn their attention inward. Are you following me, Stan?”

“It… blocks out background noise?”

“In a way, yes, just with thoughts. I don’t believe your memories are gone, they’re just buried under a lot of mental clutter and distractions.”

“And ketamine helps with that?”

“It’s a dissociative drug, it’s meant to help with trauma by approaching it without connecting to it. Would you be interested in something like that?”

“I thought you said you weren’t an actual therapist, where would you even get-.”

“I’m not going to be conducting the session, it’s going to be that colleague I just mentioned.”

“... I dunno F, I don’t have the greatest history with shrinks.”

“You’ve seen therapists before?”

“Seen is…a word.”

“What happened?”

“Do the words ‘padded room’, ‘cozy jacket’, and ‘solitary confinement’ mean anything to you?”

“... Institutions don’t do sol-.”

“That’s what they want you to think. Anyways, half of the therapists I ever had quit because of me.”

“What about the other half?”

“Ended up in the same looney bin.”

“That can’t be true.”

“Your friend turned crazy as soon as we met.”

“Stanford is not crazy.”

“Can you say that with a straight face?”

“He’s eccentric.”

“Wait, he's gay? I thought he wasn’t anything.”

“That isn’t what eccentric means. And- back to topic, please. What if myself or Stanford were there with you and we didn’t leave you alone with the therapist? Would you agree then?”

“...Alright, if you really think it’ll help.”

“Excellent! Thank you, Stan; we’ll get you right as rain before you know it.”

“...Did we really need to talk about this in the afterglow?”

“Yeah we did.”

(...)

“You guys are on your own, I’m not getting in that thing.”

“Stanley, it is just a boat.”

“So was the Titanic, and it disappeared forever.”

“There have been talks about another expedition to find it.”

“Fiddleford, please. Stanley, this isn’t the ocean, this is a mere lake. Scuttlebutt Island is only accessible by boat.”

“I told you I’d help you on your monster hunting bullshit, but you didn’t mention we’d have to get on the water to do it.”

“Come on, at least get closer than the tree line.”

“No!”

“You are being ridiculous right now. You have faced drug lords, Mothman, loan sharks, and the actual Jersey Devil, and this is where you draw the-.”

“I wouldn’t make you do something if you didn’t want to, PhD.”

“...Fine. Stay here and watch over our campsite at least. If we’re not back by tonight-.”

“Yeah, yeah start arranging your funerals, got it.”

(...)

“What are your theories so far on this cryptid, Stanford?”

“Based on descriptions I’ve gathered from local reports, and limited sonar exploration, I believe the description most closely matches a marine reptile that disappeared in the Cretaceous–Paleogene extinction event; a plesiosaur. Or, at the very least, a distant descendant.”

“Sounds less like cryptozoology and more like paleontology. Maybe we should call it something else.”

“Such as?”

“How about Oddopoddo?”

“No.”

“Scuttlebdis?”

“A mouthful, really.”

“The Gobblewonker.”

“We’ll workshop it.”

“Well kettle my corn, it looks like we’re close to the shore; sure are a lot of big muskrats here.”

“Fiddleford, we both know those are beavers and not nutria.”

“Wait- Stanford, stop. Is that big rock formation over there… moving?”

(...)

“Heya Fordsy! You’re invoking Think Fast?”

“Think Fast?”

“You know, when you meditate into the Dreamscape so you can think faster than the time around you. What you’re doing right now.”

“You’ve never called it that before, my muse.”

“I know but for exposition purposes I need to call it something. Whattaya need to Think Fast for?”

“The cryptid we’ve termed “The Gobblewonker” chased us on our boat and trapped us in the islands cove. In an attempt to catch us, the creature slammed itself into the cave wall and triggered a rock slide. We’re trapped in a cavern and it is filling up with water, and the entrance was the only exit we knew of. Fiddleford is also unconscious, and cannot assist me.”

“Ooh, how dangerous. So, what are you going to do about it?”

“I need to be out-of-body while my perception is sped up so I can check for more exits without worrying about water or gravity. 

“Out-of-body experience coming right up, IQ!”

(...)

‘Man, those guys have been gone for a while. They shoulda been back at least an hour ago.’

‘Whatever, PhD’s the monster hunter here, whatever trouble they get into he can probably handle it.’

‘...’

‘And even if he couldn’t, it’s not my problem. I’m only staying with him so I have a bed to sleep in and a roof over my head. It’s not like I actually care.’

‘He did kidnap me and stick me in his basement after all. And sure his friend is hot and gives great benefits, but it's not like he tried to free me even when he knew it was wrong.’

‘...’

‘So what if they might be in danger?'

'It doesn't bother me.’  

‘It doesn't bother me.’

‘It bothers me!’

‘IT BOTHERS ME A LOT!’

(...)

“Fiddleford! Fiddleford, wake up!”

“Ow… my achin’ noggin-. Wha happened?”

“You saw the cryptid and fainted.”

“Where are we? Why’re we all wet?”

“We are trapped in a cavern that the Gobblewonker chased us into. There’s only one exit left - there’s a tunnel through and up this ridge, but it tapers off from loose rocks from a rockslide. You might be thin and flexible enough to squeeze through the hole that remains.”

“What about you?”

“On the other side I’d need you to manually move enough of these rocks so I can slide through as well. We can’t waste any time - the cavern is filling up with water faster than the exit could drain it.”

“Okay, I’ll get through slicker than owl sh-.”

“Fiddleford, this is no time for Southernisms.’

“Right, right. Yeeow, that’s smarts- I got most of both shoulders through Stanford but I’m gonna need a boost.”

“Alright, I‘ll push you on your count of three.”

“Gotcha. One, two, thre-! SWEET BABY JESUS-!”

“Are you okay?”

“I-. I think I w-wrenched out my damn shoulder…”

“Can you relocate it?”

“L-lemme try- HRK! No, not by myself. I’ll try to clear out the rubble with my good arm.”

“Alright but please, with the best of your ability, be quick.”

“Just keep talking to me, friend, I need to know that you’re still breathing back there.”

“It is not getting easier.”

“I’m moving, I’m moving. Just stay with me. We can do this.”

“I’m running out of headspace…”

“Come on- just a few more more rocks to go, I- Stanford? Stanford!”

“Sixer, I’m going to put your body in hibernation, it’s the only way you can preserve oxygen. It’s not cold enough for you to go into that state naturally.”

‘How much time does that buy me, Cipher?’

“About five more lines.”

‘Lines of what?’

“You’re about to find out.”

*water suddenly starts rushing out much faster, and a hand grabs Ford by the collar, dragging him out of the tunnel forcefully*

“-ay? Can you hear me, Stanford?”

“S… Stanley..?”

“Oh good, you came to on your own. I wasn’t gonna ‘kiss of life’ you.”

“Lord have mercy, you gave us a real fright there! You’re still shaking like a leaf on a tree, though.”

“Can you stand, Doc?”

“Y-yes, yes of course. Just- just help me up, please.”

“Yeah yeah, I gotcha.”

“It’s a good thing you came when you did, Stan, I wasn’t getting those rocks cleared fast enough.”

“What’s up with your arm, specs?”

“I dislocated my shoulder going through the tunnel.”

“Need help putting that back? It’s happened to me a couple times.”

“Actually, I think I’d rather- Stan?! Stan no-!”

POP

“There you go, good as new.”

“Ow…”

“Stanley?”

“What’s up?”

“Why’d you come here?”

“You guys were taking too long, figured something was up.”

“But… we are on an island, how did you get here?”

“Details ain’t important.”

“You’re also soaking wet.”

“Can it, PhD. I said details ain’t important.”

To be continued…

[darkficsyouneveraskedfor]

Unexpected 39

Sequel to Unsolicited

Warnings: non/dubcon, pregnancy, pegging, Lloyd being the worst, post partum, csection, and other dark elements. My username actually says you never asked for any of this.

My warnings are not exhaustive but be aware this is a dark fic and may include potentially triggering topics. Please use your common sense when consuming content. I am not responsible for your decisions.

As usual, I would appreciate any and all feedback. I’m happy to once more go on this adventure with all of you! Thank you in advance for your comments and for reblogging.

The doors of the operating room fade behind you as the anesthetic takes you under. The splitting pain dulls as you sink beneath the veil of artificial sleep. Laced within the clouds of your unconscious you hear the beeping of machines, the clinks of metal tools in the tray, and the deep voice of your unshakeable pest; Lloyd Hansen.

The dread and horror are equally muddled by the intravenous flow. You feel a distant tugging, a plucking deep within, and somewhere beyond, you hear squalling. You’re vaguely aware of the sudden weight taken from you, and that new one that settles in its place. Tight and tender.

You float back to the surface slowly. Wading up above the layers of oblivion until you hear that steady rhythm, feeling it in your chest. That incessant tempo of your pulse mirrored by a digital beep. You groan and suck back a dribble of drool along your lip.

A longer, louder noise rolls from your throat. The pain nips its way through and your lashes flutter lightly, giving short glimpses of the world that awaits you. You hear fussing, low whispers and the soft murmur that responds. Hushing and humming that draws you in.

“Grhhhhsh,” the gibberish slips from your lips and your hand bounces off the rail clumsily.

You open your eyes, vision fuzzy and ears thrumming. A shadow approaches as you turn your head, blinking as you try to see past the sheen of sleep. You smile dopily as your head swims. Your other hand lingers on your thigh and you cautiously feel higher; you’re now doughy where the flesh was once taught.

“Bay-bee,” you pronounce, “girl.”

“Ah, sweet cakes, yes, you have a beautiful daughter,” Dottie’s voice drips into your ears, comforting you as it pools in your chest, “she was just lookin’ for ya.”

“Dot,” you utter weakly.

“Yes’m,” she touches your arm gently, “you want the precious bean?”

“Dot,” you open and close your hand, reaching for her without finding her, “where… Lllllll.” you swallow and lean back heavily, “tired.”

“Here,” Dottie leaves you, returning in an orb of red and pink. She takes your arm and hooks it around the warm bundle she eases onto your chest, “there, there. Look at that cute little peach.”

You look down. You feel the tiny form squirm and your eyes pinpoint on her face. A baby. Your baby? Yes, your daughter. The girl without a name.

“Harlan’s just gone to get the nurse,” she comforts as she stays close, “we’re just waiting to get the paperwork done. She needs a name and all that.”

You stare at the infant. Your heart feels like iron. Still and cold. You curl your lip and turn your chin up.

“Take her,” you murmur.

“You okay, darling?” She rubs your shoulder.

“I said take it. Now,” you demand harshly, “I don’t… I can’t.”

“It’s alright,” Dottie lifts the child from your arm, “you been through a lot, we’ll just give you some time to get your bearings.”

You scowl and don’t say how you don’t think you’ll ever want to hold that thing again. The way it wriggles and whimpers, so quietly. It’s so light and small, it may as well be nothing. 

“Well, whatcha wanna call her?”

“I don’t care,” you sniff, “ask him.”

“Well, we had some ideas but Marion didn’t say which he liked,” she explains as she lays the baby back in the small rolling crib.

“How about Marion? After the father?” You snap dryly.

“Hmm, I dunno,” Dottie hums, “you want some water, I got some here–”

“I don’t want to be here,” you retort and immediately cringe, “I’m… sorry, I’m just…”

There’s no way that baby is yours. You can’t remember anything more than the gripping agony in your gut. And now, the pain persists. All that and for what?

“I’m tired. Hurting,” you lie, only in that it’s not the reason you lashed out.

“Right, honey, that’s okay,” she assures once more.

“Just going to doing a check,” The nurse enters.

You glance up and see Harlan dip in behind her. You smile at him and search behind him, expecting another to follow. Nothing but an empty doorway.

“How’s the pain, scale of one to ten?” The nurse asks as she fiddles with your IV.

“Ten,” you grit out.

“Mmm, we’ll see what we can get you for that,” she says, “gotta make sure you’re able to feed your daughter.”

You frown. Feed? You look down at your swollen chest and moan at the fullness that throbs in your tits. Fuck.

“We can have an advisor come to help you with latching,” the nurse offers, “you should feed soon.”

“Fine,” you shrug. “When can I leave?”

“It’ll be a couple of days so we can keep an eye on your recovery. We’ll make sure you know the proper aftercare before you’re discharged.”

“Days?” You grumble.

“Yes, you have a new incision so you can’t be moving too much. Once you’re home, you’re going to be limited, no lifting, no strenuous activity…”

“Great,” you shake your head.

You stare at your body, deformed beneath the flannel blanket. You can feel it. You're totally ruined. You weren't ever a supermodel but the damage is done. Worn and loose and gross.

“Baby’s getting hungry,” Dottie says softly, “please send in the therapist so we can get her fed.”

You stay silent. The nurse leaves as you glare at the door. He has to show up any minute now.

“Where’s Ll–”

“Now we were just talking about names,” Dottie interjects, “Harley, why don’t you tell her the one you liked.”

“Oh, uh, hope I’m not to forward sayin’ so,” he says.

You look at him. Just say it. At this point, they can choose.

“I liked Luna,” Harlan says, “cause that little moonlight in her nursery, ya see… always liked the looka the moon.”

You nod. It’s pretty. You can’t think of much else and they definitely wouldn’t want you calling her the leech.

“I like Luna,” you agree flatly, “fine with me.”

“Well, that’s a nice name,” Dottie chimes, “yeah, Luna, it suits her. Shining and all.”

“Where is Lloyd?” You ask curtly.

Dottie smiles and looks at Harlan. His lips are straight and set. He swallows tightly.

“Now, hon, he… just went out to deal with some stuff, to make sure you can go home,” she explains, “I’m sure he’ll be back soon.”

“Oh.” You accept bluntly. “Right.”

“Too bad you didn’t see him,” she takes out her phone, “but I got a picture.” She holds up the screen to show you the image of Lloyd holding the bundle child. His eyes are wide as he stares at her. “Baby looks just like you, sweetheart.”

“Does i– she?” You ask.

“Well, I think so,” Dottie says, “but you know, babies always take after their daddies early on.”

You nod and play with the string of the linen gown. You watch the door. Waiting. This isn’t your mistake, it’s his.