#will go to the cardiologist this year! I put off doing the throat surgery for a full year and thaaat | Explore Tumblr posts and blogs

auswriteforyou · 4 years ago

Text

Undeserving. (Ethan Choi, Chicago Med)

It was burned into her brain. Medically speaking, she knew that was impossible. She knew memories were less medical and more mental. Maybe she should schedule an appointment with Dr. Charles. Maybe he could get the memory of her husband having sex with April in an exam room on the 4th floor while she was doing life-saving surgery down the hall out of her head.

She understood the location choice. It was rarely used, the only time they made it up there was when no other bay was available. She had left the room feeling incredible. It was a difficult situation, one that required far too much attention and far too little preparation was given but it had come out with the best possible outcome. She wanted to find Ethan immediately, tell him what she’d accomplished and about the patient she’d grown close to in this process. She didn’t expect to find him in the exam room she heard a crash come from.

She had figured it was just a patient having wondered from their room but no. It was such a nightmare that she had no reaction to it at all. The scramble of them untangling, the sound of scrubs being pulled on and apologies falling on empty ears.

She filed the divorce papers the next day. She put in her transfer request that afternoon. He refused to sign them. Imagine that. He was unfaithful for months, treated her like a stranger for months, literally had sex with her best friend and now he won’t sign the damn paperwork. And here she was, almost a year later of talking only through an attorney from her very expensive law firm in New York because she didn’t even want to hear his voice.

But she was tired of wasting money and her efforts on getting someone as stubborn as him to do anything without getting what he wanted first. She pulled on her big girl pants this morning and decided that today was a good day for a whole lot of baggage. She boarded her plane, she landed, she came straight to the hospital and she was Pissed. The week long vacation she had been planning to Bermuda had been interrupted for this.

“No way.” Will Halstead greeted her at the door, eyes bright and smile shiny. “Look what the cat dragged in.”

“Do I look that bad?” She smiled, knowing damn well she looked like a four course meal. She’d used this year to become someone she was proud to recognize, to grow the pain and assert herself in ways she never dreamed she would. She was a chairwoman on more boards than she could count. Lead cardiologist in the most sought after position in the most sought after hospital in the world. She knew who she was, she was sure of it.

“Honestly, you’re smoking hot.” He knew how to make a girl feel special. “Do I wanna know why you’re here? You looked like you were about to walk through the walls.”

She held up the file folder, a grimace on her face and he didn’t need any more context clues. They’d all heard the stories, how the papers got served to him in the middle of a surgery and the refusal to sign or send them back on his part. It was annoying honestly.

“Help a girl out, where might I find him?”

“Surgery Room 1.” Oh, good. He wouldn’t be able to run away.

The gallery was almost full, apparently a good surgery in their books. Thankfully, she’d timed it just right that they were beginning to close. She greeted her old coworkers, offering quick hellos and we’ll catch ups because she was always a business first kind of lady.

Ethan stepped more into view and that flutter she remembered from the first time they met flew into her chest. Had he managed to get more attractive? Her finger pressed the intercom. She cleared her throat.

“Ethan, if you don’t sign these papers you’re going to be the one who needs to be sewn up.” His head snapped at the speed of light to her in the gallery. She could tell it took him a minute to recognize her, or to make sure she was actually there. Could have been a mixture of both.

“Darling?” She rolled her eyes, waving the papers at him.

“Meet me at my car when you’re done. Bring a pen.”

He did not, in fact, bring a pen. He barely found her because he wasn’t expecting the Lamborghini rental car. He climbed into the passenger seat, eyes never leaving her face. It was kind of creepy.

“How have you been?” She snorted.

“A year of putting me through the political ringer and that’s what you start with?” She tossed the papers in his lap, trying not to let him see the hurt she still had lingering in her eyes. “Sign these. Please.”

“Talk to me.” He was quick to rebuttal. “Please. Let’s just have one conversation. I’ve spoken to no one but your lawyer for months.”

“Exactly Ethan,” He cringed at the lack of nickname, “I didn’t think I had to spell it out how much I didn’t want to talk with you.”

“Please.” He knew he had no right to ask her for anything but she was here on a mission. She wasn’t leaving without a resolution. “How have you been?”

“I’m head of Cardiology in New York, I have a dog, I bought a new car and recently found out I am allergic to fish. How’s April?” That was a low blow. She knew it, he knew it but she traveled far too many miles to not get her little jabs in.

“She moved away, I don’t know where she is. I haven’t seen her since that day.” At least he was honest. She used to pride herself on being able to tell when he was lying but after all that, she didn’t know what she knew.

“Awesome, glad to know it was all for nothing. Now that we’re all caught up, sign them.”

“No.”

“Ethan, the next option is to have it annulled by the court in which they give me half of everything you have.”

“You were the only thing I had that ever mattered.” She felt her mouth drop open, felt like he had slapped her in the face.

“You’re kidding right? That’s how you treat the most important thing in your life then? I’d hate to be the things you hate. Honestly, fuck that.”

“I fucked up, I take full responsibility. I won’t gaslight, I won’t say you did anything wrong because you didn’t. I was weak, I was the one who sought out something new because I was afraid of my own insecurities as a man, as a husband. I thought I would never be good enough for you and I set out to prove it. It’s not that you made me feel that way or made me feel like I should be more, I just convinced myself I wasn’t.”

It was silent for a long moment, the damage between them beginning to sew itself back up because, for once, he was opening up to her.

“I fought tooth and nail for us, from dating to engagement to marriage. I fought for you when your brain fought against you. I fought for you when you couldn’t fight for yourself. And at the first sign of me healing myself, of me choosing myself for once, you ran off with my best friend because you both felt insecure about things out of anyone’s control.”

“You’re right. You’re absolutely right. That’s the worst part. It’s the worst part because I took all the respect, all the trust, love, compassion you gave me and stomped on it. I treated you with such disregard and disrespect that it makes me sick and darling,” She looked at him for the first time since they decided to open up, “I am truly sorry.”

She stared at him for a long moment, the anger from earlier finding a lighter lull in her chest as she searched for any sign of a lie. She’d reinvented herself, made herself stronger through becoming who she had always wanted to be. He had reinvented himself by realizing where his mistakes were and how to better himself to be who he wanted, needed to be. She wondered for a moment if he was coming to the same realization as her. They weren’t the same people they had been. They had grown, sprouted leaves and vines and built themselves up from the roots.

“I forgive you.” Out of all the things to come out of her mouth, neither of them expected that.

“What does that mean?” His voice was almost a whisper, his fingers that had saved many lives toying with the edges of the file folder.

“It means we talk,” She took the folder from him, tossing it into the backseat without care. “And we figure out what this means, we don’t lie to each other and we try. Both of us this time. I can’t float this relationship, whatever it is or is not, we have to be on the same page.”

He looked at her like she’d put the stars in the sky, sewn him up with the tidal waves and took them to the moon. She wondered if he’d keep looking at her like that. It didn’t scare her to think that he would. They didn’t kiss, they didn’t jump into each others arms and scream at the top of their lungs about love and happiness. They let their pinkies brush over the console, their hearts and minds race at the thought of whats to be built and allowed themselves to begin to grow, with each other.

it’s been a hot minute but my fingers started tapping and that was that! This was a request from an Anon that I was happy to fill. I hope you enjoy, I apologize for the wait. It’s also been a LOOOOOOng time since watching the show, I don’t have any plot lines. I don’t even know who is still on it, hopefully I was vague enough to not deviate too far off script. (also I didn’t get to proofread this, I'm sorry). Thank you for requesting and happy new year!

#chicago med #Ethan choi #ethan choi fanfiction #Ethan choi imagine #ethan choi imagines #chicago med imagine #chicago med imagines #chicago series #chicago med fanfiction #I honestly just write whenever I want to huhh #anyways #enjoy!#auswriteforyou

133 notes · View notes

themarydragon · 4 years ago

Text

Break

I’m getting close to the breaking point again, I think.

The problem is I don’t know where it is, anymore.

Full-time student. Okay, I’ve done that before. Full-time grad student...? A bit rougher, but shorter and I’m almost done. I ordered my regalia today, I am almost done.

In October, I got an offer I could not refuse, and started working full time. I’m good at it - so fucking good at my job - and my clients and higher-ups all know it and they tell me and I realize I’ve never actually been respected at a job before. It’s incredible. And holy shit do they pay me a lot. It’s been a complete 180 on our finances and that makes the long hours and stress worth it, right? Right??

And then I tore the labrum in my left hip. It’s cool, I’ve got a hellova pain tolerance, and I’m working from home for the foreseeable future. It had a deleterious effect on my sex life, but it’s temporary, right? I have to do six weeks of PT that makes it worse before they’ll even start actual diagnostics, but it’s temporary, right? I’ve got a surgery in my future as the best case scenario, but I’ve got paid sick leave now so it’s okay, right?

And the PT is first thing in the morning and it wrecked my schedule and I’ve stopped sleeping like I need to no matter what I try, no matter what I give up or start taking, but it’s okay. It’s temporary, right? School’s out in May and my hip surgery will happen and the pain will stop eventually. Eventually. Right...?

And then Brian’s shop gets robbed and he sits down to try to work through his anger and anxiety and turns on the TV to a riot in the capital and goes into an abnormal heart rhythm and I have to take a half-day off work to take him to see a cardiologist but the medicine is working, he’s going to be okay. I mean, it’s just one more problem on his list, one more thing he has to suffer and I have to help him manage, one more condition on his already stupidly fucking long medical history and list of diagnoses but he’s okay for now. He’s young and his heart is strong and I have us all on a cardiac diet for Mom’s sake anyways. He’ll be okay. ...right?

And then it’s my birthday and work is rough and I have to say no. No, I am not working overtime. No, I took the next day off, I have to have tomorrow off, I am not starting this four-hour task at 6:30 pm. I’m not. My boss supports me and the client is angry but I’m respected and it’s fine. It’s fine. And I know nobody was being malicious but nobody did anything for dinner and Mom is standing there with my birthday cake (because she swears I will never make my own cake again, I have done it too many times) with tears in her eyes and auntie’s cancer came back, this time in her brain. Mom’s baby sister, her favorite, her friend. And I can’t hug Mom because Jay’s got a Covid test pending and she can’t stay and we can’t get close and I put the cheesecake in the fridge and go to bed and just weep. But we knew her cancer was coming back. We knew it was borrowed time. We know what metastatic breast cancer means.��

But you tell me a growth in the brain and my mind goes straight to Carly. It goes to collapsing on the floor two days before my birthday when the notification hits my phone that she was gone. Two days after last we spoke and she’s just -gone- Twenty five god damn years old and she was gone

And then my MIL is in the hospital with Covid because she & her husband still spend all their time at the bars and I’m suddenly the point person for the in-laws and she doesn’t even fucking like me but it’s my job and I will always take the high ground when it comes to her but it’s hard to tell his sister - my sister, the first time I really had a sisterly relationship like they’re supposed to be - that blood clots in the lung are a really bad sign. But she doesn’t like me, right? And she hasn’t been in our lives for years and she wants him to leave me and at least my mom is still safe, right?

So then Brian looks at me last night and says Adam has a growth on his kidney and I snap straight back 3 years to the same news about Steve. I’m in his living room again, calming Bear down when he sees Daddy’s “Zipper” and doesn’t understand what staples are. I’m in his bathroom again, helping him shower at home again for the first time since the surgery that removed his kidney and four fucking pounds of tumor. I’m in bed at 0430 and the phone chimes and Anna live-texts me his fucking death. I’m in the car driving home and rolling in 27 hours after I left (it’s 1400 miles) and they tell me they’re all done crying and I swallow the lump in my throat until they take me to visitation the next day and I break down with my head on his still chest. The last time she ever touches me was her hand on my shoulder and the soft question of “you haven’t cried yet, have you?” and then she was gone and Steve’s parents are to my left and right and we’re mourning their firstborn. I’m cleaning stray droplets of his blood out of the bathroom, sorting through his projects, putting his painting on my wall and his lamp on my desk and it’s not about Steve or Adam or Kathy or Carly or Roberta or Janet or my hip or school or work or covid or any one thing

it’s just pain

You can do this. You have to do this. You can, and you have to, so get up. Go.

And I can. I know I can. I have before and I will again.

I am just so fucking tired of having to

#me irl #tw: death #tw: cancer #pain and suffering #I am so fucking tired

13 notes · View notes

multifanficss · 4 years ago

Text

Emergency Room (BTS X Reader)-02

A/N: Sorry if it is a bit too long. Still hope you enjoy it! Also, If you think i can improve, please give me feedback! Thank you

-12 hours later -

Finally, I can have a lunch break. I head towards mina and Sarah. “Hey, how are you both doing?" I asked ” Good, finishing up some charts." Mina said. "okay, well, just wanted to let you know that I will be going on my lunch. In case you need anything just page me." I said. " Okay, you know where the cafeteria is?" Sarah said. " Um, is it down the stairs then take a left, right?" I said. Sarah nodded. " Okay, well I will get going." I said, " Have a good lunch break!" Mina said. I thanked her and headed down to the cafeteria.

Once I arrived at the cafeteria, I ordered some noodles and steak. I waited for it to be done. When they were ready I thank them, paid for my food, and made my way outside to the patio. I walked outside and saw many nurses and doctors looking at me. They stared and whispered. I decided to sit by a doctor who was sitting on his own reading a book. I walked up to him, " Hi, My name is Doctor L/N F/N and I just moved here, May I sit here?" I said hoping he would say yes. "Of course, I don't mind. My name is Kim Namjoon," he said as he extended his hand for a shake. I shook his hand and sat down to eat. " so what kind of doctor are you?" he asked. " General surgeon, and you?" I asked. "Orthopedic surgeon," he said and I nodded. " I am assuming it is your first day, correct?" he said. " yes, it is. It would have been tomorrow but they called me in." I said. He nodded and we continued to talk for some time.

Then someone came and sat down next to Namjoon. " Hey Joon, how's your day going?" he said. " Pretty good, not too much just working in the clinic and doing some surgeries here and there," he said. then the man turned to me. " oh, hello, sorry I forgot to introduce myself. My name is Jung Hoseok. I am a cardiologist." he said and extended his hand. " I'm f/n l/n, I'm a general surgeon. I just moved here about 2 months ago." I said and shook his hand. "where did you move from?" he asked. " From (your country)" I said. " wow, that's so cool. I have always wanted to go there." he said. I smiled. Then I felt my pager going off. It was Kim Taehyung. "Sorry, I have to go now, It was nice meeting you both. See you around," I said. They said goodbye and I left to the Emergency room.

Finally, I reached the ER and saw Kim Taehyung putting on his gown. " you paged me?" I said. "yes, hurry and put your gown on. We have four people coming in. There was a house fire but it was pretty bad. The roof fell on two firefighters. Two children, one is 13 and the other is 8. They were also impacted but differently. They have burns and are having trouble breathing. I want you to take the case of the 8-year-old." He said. I nodded and soon enough they came in. we quickly got to work.

I brought the 8-year-old to a room. " Hey sweetie, How are you doing, what's going on?" I said. "I can't breathe and my arm hurts." she said. "alright let me take a listen and look at your arms." I took a listen and it did sound like she was having a bit of trouble breathing. I took a look at her throat to see if she had any blockage there, it was clear. I looked at her arm and saw she had a pretty bad burn mark but it wasn't that awful that it needed surgery which is a good thing. " okay, sweetie, we will apply some treatment for your arms to help with the burns and as for your breathing, keep the mask on and we will also get a scan for your lungs to see how they are doing, okay?" she nodded her head. Her mother came in and I discussed what we were going to do and how she was doing and she nodded and sat with her daughter. I walked out to begin charting. Then a doctor came next to me. " hey, I'm Jeon Jungkook, a Pediatric surgeon. How is the child doing." he said as he charted for the other child. " Hello, The child is doing good at the moment, the burns are getting treated and she will get a scan on her lungs to make sure she doesn't have anything in her lungs. Oh, I'm F/n L/n. General surgeon." I said. he nodded and continued to chart. We talked for a bit and he asked me a lot of questions. not about the patient but about myself. After the scan came back, everything was normal and we let the parent know. However, we still had them in the hospital just in case her vitals changed.

After I finished charting Dr. Jeon came up to me, " I would like to be friends with you, if that's okay of course" he said. "Yeah, I would like to have more friends," I said. " Great, is it okay to have your number, just in case you want someone to hang out with, talk to or just want to know more about the hospital or country." he said nervous. " yeah I don't mind. I don't really have anyone to talk to." I said and gave him my number. Once I put in my number, I was being paged by Kim Namjoon. "Hey, do you know where Doctor Kim Namjoon would be at?" I asked Jungkook. " Oh, he's in the inpatient center," he said. I thanked him and told him I had to leave. He wished me luck and I walked quickly. Why would Kim Namjoon Page me?

14 notes · View notes

rory-of-nantes · 5 years ago

Text

P(e)acemaker // Rory & Marco

Location: Rory and Marco’s house, May 2022

Summary: Rory has been hiding the truth about why she returned to Vannes from Marco (@marco-pierre) since she first moved in. She’d asked her parents to promise not to tell her eldest brother for fear of how he’d react. But now she knows it’s time to come clean. It’s best he know the full truth, especially in the event of an emergency... Her opening up to Marco leads to some tears and some strong sibling bonding.

Triggers: Mentions of chronic illness

As soon as Gen went to bed, Rory knew it wouldn't be long until Marco reminded her what she'd signed to him earlier during dinner. There was no way he'd forget how she'd told him to remind her she had something she wanted to talk about. And as much as she was starting to dread the fact she'd even mentioned such a thing, she knew it was too late to take it back. If she put off this conversation any longer, she'd probably never talk to him, not until it was too late and he found out some other way... And that would be bad. Very, very bad.

Walking into the kitchen, she leaned against the doorframe, watching her brother do the dishes for a long moment before finally speaking up. "Um... Marco?" She began, waiting for him to turn around. As soon as he did, she switched to signing. Can we talk?

Marco had such a great night with Gen and Rory. He wasn't as sleepy as they were, so after he put Gen to bed, he came back out to wash the dishes and make sure Rory took her nighttime meds so she could go to sleep. Hopefully they would be able to talk before she went to bed. He wondered what Rory had to tell him, he couldn't lie, he was a bit nervous about what she wanted to tell him. He had a million thoughts running through his mind, but he was going to focus on the dishes right now. When he heard her voice he turned to face her, Hey you...we sure can talk, I'm interested in hearing what you have to say.

Once Marco turned around, Rory saw the pile of dishes in the sink. You can finish the washing up first. We can talk about it later. She hastily signed, hoping he'd let her use the dishes as an excuse to push the conversation off just a little bit longer. Besides, she wasn't even sure how she was going to go about tell him. Once he learned she'd been keeping the truth from him this long, he'd certainly be upset. And she was dreading that.

Marco shook her head, No it's fine, I can wash the dishes later. He didn't want to hold off any longer with this conversation. I really want to know what's going on with you. He put his towel down and walked over to the table, pulling out a chair for her to join him. So what is it sis? Talk to me.

Great. He wasn't going to let her put off the conversation... Rory let out a heavy sigh before slowly making her way to the table, taking a seat in the chair her brother had so gracious pulled out for her. She placed her hands in her lap, fidgeting with them for a long moment, her gaze shifted downward to a random spot on the floor. She wasn't sure how to begin. Did she just come right out and tell him? How did she even do that? Eventually, she glanced up and made brief eye contact with Marco; though she still kept her hands in her lap for a few moments longer. "Um..." She swallowed hard; the words weren't coming to her. So finally, she decided actions might be best. Hesitantly, she reached for the collar of her blouse, tugging the fabric down just enough so he could see the scar from her pacemaker placement surgery. Without saying a word, she let out another sigh, waiting for his response. After all, she wasn't sure he'd even know what the scar meant. So if she had to explain it to him, she was trying to mentally prepare herself to do just that.

Marco sat and waited for Rory to tell him what was going on. The longer she hesitated, the more he got worried what this was about. He didn't want to think about worst case scenario, but she was scaring the hell out of him. He watched as she started pulling her blouse down, and then he saw the scar. His mind starting racing, he wanted her to just tell him what this was about, because he didn't know what to think. He couldn't take his eyes off the scar, but his mouth wouldn't form any words. He shook his head, blinked his eyes, "W-what is..." He pointed to her.

And Marco had no idea what the scar was from. That meant Rory was going to have to try and find the words to explain. Pulling the collar of her blouse back up to cover the scar, she began to sign; though since there wasn't really a sign for pacemaker, fingerspelling it was. P-A-C-E-M-A-K-E-R. She knew she'd have to explain more than that. Tell him when and why. He'd pester her for all the details; so she'd be better off just being as straightforward as possible. My arrhythmia wasn't well controlled anymore. It's why I left America two months early and never made it Costa Rica. I got sick; and went back to London for the surgery... And before you ask, maman and papa already know. Paxton contacted them after I got sick. Once she'd finished what she could bring herself to say for now, she bowed her head and folded her hands in her lap.

Marco was speechless when she spelled out pacemaker, that was the last thing he would have ever thought. A p-a-c-e-m-a-k-e-r? He was shocked that it came to this for her. She had been through so much in her life already, to add this on top of it didn't seem fair. He was shocked to hear that their parents knew and no one told him. Why would no one tell him? And no one thought to tell me? Am I not part of this family? He stood up and started to pace around the room. Rory was his little sister, someone he spent so many nights taking care of. And now when something major happens in her life, no one says anything. He turned to face her again, So what does this mean? Is there something that I need to worry about?

Rory kept her gaze averted until she felt the vibrations of the chair moving and Marco standing up. She glanced up, noticing her brother now pacing back and forth in the kitchen; and instantly, she felt horrible. Chewing at her lip and wiping away a stray tear with the back of her hand, she tried to focus her attention on watching as he signed. She could see the hurt in his face, hurt that he wasn't informed of this sooner. I'm sorry. She began, letting out a heavy and somewhat pained sigh; though she tried her best to mask the pain. She didn't need to give him anything else to worry about in that moment. I know I should've told you sooner; but I wanted to tell you in person... And then I was just waiting for the right time to do so. She explained, hoping he'd forgive her for taking this long, especially since the pacemaker placement surgery had been nearly two months back. I'd be lying if I said it wasn't something you need to worry about... Right now, we're just seeing how this helps the arrhythmia. And if I still have issues, there are other options. But she wasn't going to get into those right now, partially because she didn't know all the options. All she knew was that the pacemaker was supposed to help regulate her heart rate. But if she was still dealing with the irregularity as well as the chest pains and shortness of breath such a thing brought about, her cardiologist would want to look further into the cause and look into other ways of helping manage things. And as much as she didn't want to admit it, she knew that could mean another bigger surgery at some point. Even if the pacemaker did its job, she couldn't help but feel like something was going to happen that would lead her to needing another big surgery... And to think, she'd gone twenty years without needing a fourth.

Marco knew he shouldn't be upset with Rory, but she couldn't help but feel hurt by this. He cared so much about her and he worried about her every time she traveled. Now hearing that she had undergone a serious surgery and no one thought to tell him broke his heart. He let out a sigh when she apologized, I get you wanting to tell me in person, but I would have wanted to be there with you. When you come out of surgery I would have wanted you to see my face when you woke up. He let out another sigh and shook his head. He sat back down and watched her sign out what this all meant and his mind was still reeling from the news. I just don't know what to think right now, I'm scared for you right now, not going to lie. He hated that she was dealing with this and that he was feeling like this. He should be supporting her, but his feelings were hurt. Other options? He wanted to know all the options but it was obvious that she really didn't know what they were. He took her hands in his, "Look, I may be overprotective sometimes but I care about you and I want to know what is going on with you. If you have a slight pain, I want to know."

Rory knew it was no use continuing to try and explain to Marco while she hadn’t told him sooner and told their parents not to tell him. The hurt on his face was too much for her; and knowing she was the cause of it was even worse. As he sat back down, she just kept her gaze on his hands, unable to look him in the face right now. Then when he took his hands in hers, she completely lost it. There was no keeping the tears welling in the corners of her eyes from beginning to course down her cheeks. Blinking them away did nothing except blue her vision. Pulling her hands away from Marco’s grasp, she wiped at the tears before speaking up, her voice shaking. “It hurts, Marco...”

Now with those words, Rory knew she’d have to elaborate to the best of her current ability. “It always hurts now, Marco; and it terrifies me... I-“ She choked, the words no longer coming out as she now felt like there was a giant lump in the back of her throat, like she was going to be sick. I guess this is my new normal; and I hate it. I fucking hate it... I don’t know what any of this means for me; and that has to be the worst part.

Marco didn't want to make Rory cry, that was the last thing he ever wanted. She was his sister that he would do anything for. There was nothing that he wouldn't do for her. And when she started to cry, he broke down as well. His heart was breaking for her. He didn't know just how much pain she was in till now, and that scared him so much. "Rory..." He could see the pain in her eyes and he never wanted to see her like that. He listened to her talk about her "new normal" and how terrified she was and he wished there was something he could do to fix this, but he knew he couldn't and he felt so helpless.I'll be here Rory, please know that, in whatever way you need me. I promise. The tears were steady coming down his face.

Rory tried to blink away her tears once more before deciding to just wipe them away with the back of her hand. But like before, that just blurred her vision, thus making being able to understand Marco’s signs a bit more difficult. So she didn’t respond to whatever he’d just said. Instead, she shut her eyes and bowed her head as she tried to stop herself from crying too much. Crying always made her chest hurt more and made her lightheaded, two things she really didn’t want to be feeling right then and there. She tried to focus on her breathing so she wouldn’t get dizzy; but it wasn’t really working. Unfortunately that meant she was now stuck where she was sat. As much as she wanted to just up and bolt from the table: she wasn’t about to chance stumbling and losing her balanced in front of Marco. She didn’t need to give him any further reason to worry, any further reason to be more of a protective big brother.

Marco didn't want to make this about him, if he felt this way, he could only imagine what she was feeling. She was crying and he wanted it to stop, so he wiped the tears from his eyes and knew he needed to be her rock through all of this. He got up from his chair and knelt down in front of her and hugged her tightly. She couldn't see his lips, so it would be futile to talk to her in this moment, all he wanted to do was hold her tight. She was going through so much, so all she needed was her brother, and he was going to give that to her. She was so important him, and he wanted to keep her happy and as safe as possible.

Rory only looked up as she felt the vibrations of Marco moving from his seat. And next thing she knew, her brother was kneeling in front of her, wrapping his arms around her in a tight embrace. Resting her head atop his, she carefully wrapped her arms around him and let out another heavy and pained sigh. "I'm sorry I didn't tell you sooner." She muttered into his hair, still feeling horrible after seeing how keeping this information from her brother had hurt him. That certainly hadn't been her intention.

Marco held her tight, he felt better having her in his arms. He wanted her to feel as safe as possible with him, so she didn't feel like she couldn't tell him things. He shook his head when she was apologizing for not telling him, still not talking because she wouldn't be able to see his lips. He couldn't let her go at this point. After a few minutes of holding her, he pulled away and looked at her, "It's okay, just know I will be here...no matter what, okay?"

Staying in that hug with her big brother was exactly what Rory needed to help put herself together in that moment. With his arms safely wrapped around her small frame, she was able to focus on regulating her breathing; and that helped with some of the lightheadedness as well as some of the chest pains. She still felt like she was going to be sick; but now she didn't feel like she'd fall over if she moved to stand. So when he finally pulled away, a deep frown began to find its way to her face. Then she noticed him start to speak; and she knew that was the only reason he'd broken the embrace. Watching his lips, she nodded softly. "O-Okay."

Marco was a mess, but he wasn't going to show that to Rory anymore. From this point on, he was going to be the Rock that she leaned on. He smiled when she saw what he was trying to say, *Good, now I think it's best if you go lay down and rest. I'm sure this took a lot out of you, and I don't want you to get sick or be in any pain." He stood up, Do you need help to your room? A small smirk came across his face, I can carry you like I used to do when you were a kid. He chuckled.

As Marco suggested she go lie down and rest, Rory just shook her head. I don’t want to lie down. While she knew lying down would be for the best, she didn’t want to go and rest just yet. If she felt her heart start racing like it had been on and off most of the day, she’d go lie down. Or if her chest pains increased or her shortness of breath increased, she’d go lie down. Otherwise, she felt like she’d be fine just curling up in front of the TV and watching a movie. If you try and carry me like you used to do when I was little, don’t think I won’t hesitate to bite you like I did when I was little. She pouted as she watched him move to stand. She wasn’t a child anymore; and she definitely didn’t wish to be treated like one. But do you think you could help me to the couch? She still wasn’t 100% certain she could stand up without wobbling and falling over. Whenever she got even a tad bit lightheaded, she knew she became high-risk.

Marco really wanted Rory to lie down, but he knew better than to fight with her. She was stubborn just like him, so he just let her decide what she wanted. He laughed when she threatened him to bite him, You better not bite me, but if it was necessary that I carry you, then believe me, I would. He was going to respect her space and her wishes, but if he had to do something extreme and carry her, he would. He smiled and helped her up, Yes I can help you to the couch, do you want to watch a movie? He really wasn't in the mood to watch a movie, he was going to turn in early, he was tired.

Rory was fairly certain there would come a time when Marco had to carry her. After all, she’d been prone to dizzy spells and even fainting most her life. And lately, both things had increased in frequency. Oh believe me. I know you would... And I suppose now’s a good a time as any to tell you that if I pass out, I don’t need to go to the hospital unless I’m unconscious for more than a few minutes, hit my head, or my heart rate or oxygen levels aren’t good. But if I just pass out for a minute or two, I’m okay. I’ll just need to ensure I rest afterwards. She tried to reassure him; but she knew her words most likely would cause further worry... She’d type up some whole reference sheet or something, everything he’d need to know about her health currently, include all the stuff she struggled with sharing. Letting him help her to her feet, Rory leaned into Marco’s side for support and switched to using her voice. “I’ll put a movie on; but I’ll probably fall asleep before anything good happens.”

Marco was glad that Rory knew that he was just as stubborn as she was and if push came to shove, he would carry her anytime he felt like she needed it. Her next comment had him stunned, he couldn't have read that right, did she say if she passed out? He wasn't going to believe it, but then she continued on about when it was okay to take her to the hospital and when not to take her. Pass out? Is that something that happens often? Do you have something that can alert help if you are alone and this happens? Now his worry factor just spiked to 1000% his mind was racing with things he needed to get for the house. This was a very heavy conversation and he was drained from all this information he was receiving tonight. He helped her to the couch, "Well if you do, I'll make sure you get to bed."

Once they were at the couch, Rory plopped down, situating herself so she was leaning against the cushions. Letting out a heavy sigh, she finally answered Marco’s inquiry about her passing out. It’s happened more often since the whole arrhythmia thing began. But I can usually tell when I’m starting to feel faint; and I can lie down or do something to prevent myself from full-on passing out. She explained, hoping that bit would lessen the worry she read all over her brother’s face. This is actually one of the main reasons I want to look into getting a service dog. I’ve wanted to get one for awhile now; but with all my traveling, it didn’t seem feasible. But now that I’m no longer able to travel... She bowed her head at the mere thought of no longer being able to travel. She hated it. Traveling and her blog had become her life. And now, the travel side of her blog was no more, at least for the foreseeable future. “If I start to feel dizzy or faint, I’ll be sure to let you or whoever is around know. I promise.” She then glanced back up, holding out her pinky towards Marco, offering up a small smile.

This was starting to seem like so much more than just a health issue, it was feeling like a health tsunami and he hated that for Rory. He listened as she talked about her situation and why she decided to get a service dog. Well we definitely have to look into getting that service dog as soon as possible because it would definitely ease my worry a little to have a dog with you. He could see the pain in her eyes when she mentioned not being able to travel, he knew how much that was part of her life and he felt so bad that she wasn't able to do that anymore. He sighed and nodded, "Okay, I'm going to hold you to that. I think I'm going to look into getting one of those alert bracelets that can sense when something is wrong and if you pass out and hit your head when I'm not here, or you're out in public."

It takes a little while to properly train service dogs. Like six months to a year. I’d mentioned the idea to maman and papa when I went back to London; and they said they’d start looking into things. Technically I could get the dog now and train him or her myself; but a professional trainer would be best. Little did Rory know, her parents already had a dog in training for her. They were planning on surprising her once the dog was trained or she started looking more into obtaining one. An alert bracelet? Seriously? That was the last thing she wanted. She had her medical ID bracelets she wore all the time; but having to wear another piece of jewelry because of her health... it would only make her feel even more self-conscious about things than she already did. At least a service dog would be cute. I think I’ll wait for the dog. Thanks.

Marco watched as Rory explained how long it could take to get a service dog, he was glad that she talked to their parents about the dog so hopefully she will get it sooner than later. I'm glad that you talked to them, and I hope they followed through with it so you can get the dog as soon as possible. He let out a sigh when she refused the alert bracelet, Come on Rory, I'm only asking you to do this to ease my mind a little. Can you compromise and wear one until you get the dog?

There would be no way in Hell Marco would drop the whole alert bracelet thing until Rory agreed to one or got a service dog, whichever came first. "Fine." She huffed, crossing her arms over her chest and slouched back against the couch cushions. "I'll wear an alert bracelet or necklace or something if it'll get you off my back... But it can't be all that noticeable." She didn't need another reason for people to treat her differently. She'd already dealt with enough bullshit throughout her life.

Marco knew Rory didn't want to do it, but he was grateful that she was willing to compromise. I know you hate this, but I would constantly worry if you didn't have it. He sat next to her on the couch, "It won't be noticeable and as soon as you get the dog, you never have to wear it again.* He wanted her to have a normal life and not be treated any differently from anyone, I'm only looking out for you, I promise.

Look, making you worry has never been my intention; so I'm sorry for worrying you so much. Rory knew he'd tell her she had no reason to apologize; but she couldn't help herself from doing just that. She knew she never had to apologize for anything related to her health; but it had almost become a habit at this point. She hated that she caused others to worry; and she hated constantly feeling like a burden because of her health. Thank you. "Thank you for always being there for me, Marco. For always listening... I don't think you realize how much it means to me." She began. "But know you don't have to treat me like I'm made of glass. I'm not going to break." While she obviously wasn't made of glass, she was definitely still very fragile; so in a way, she understood why people treated her as such. She just hated it, especially when it came from her family.

Marco knew that Rory wasn't trying to make him worry about her, but there was really nothing she could do to prevent that from happening. I know you don't want to make me worry, I just do. It's my nature to worry about you and I don't see that changing anytime soon. He waved his hand at her, Don't you dare apologize to me about being worried about you, I care so much about you and I would worry about you even if you didn't have any health issues. He knew more than anyone that she wasn't a fragile being and he would never treat her like glass, but he wasn't going to treat her like there was nothing wrong with her, she was sick, that was facts. He needed to make sure she was always okay, but he knew that she was also a grown woman and needed her independence from time to time. Listen, I will always be here for you, and I should be the one thanking you for allowing me to help you. You gave me purpose and help mold me into the man I am today, so I thank you Rory.

Rory could feel the tears welling up in the corners of her eyes as Marco signed. His words... A wide smile began to form upon her face; and without hesitance, she shifted her position on the couch and leaned forward so she could wrap her arms as tight as possible around her brother. “I love you, big brother.” She stated, staying in the embrace for several seconds longer before pulling away. Wiping away at the happy tears with the back of her palm, she then gestured towards the TV. “Um, could you do me a favor? There’s a green DVD case I put with the others. No label or anything. Just has 2001 written on it. Do you think you can pop the disc in, press play, and then come sit?”

Marco smiled and hugged Rory so tight, he would never get enough of hugging her. Once she pulled away, he smiled, "I love you too sis." They were always close and he liked that they were able to connect again and continue building their relationship. He sat back and looked at her when she asked if he could do her a favor, "Yeah no problem." She directed him to a green DVD case and asked him to put it in for him, but she wanted him to sit and watch it with her. "Okay..." He got up and found what she wanted, and popped it in the DVD player. After he sat back down, he grabbed the remote and turned it up some, "So what's this?"

Rory knew Marco would ask her what was on the DVD; but she wasn't going to tell him. That's why she wanted him to sit and watch it with her. It'd be much more effective to show him the DVD's contents. So after he popped in the disc and moved to sit, a wide smirk began to form upon her face as she read the question on his lips. Just watch. And with that said, she turned towards the TV, waiting for the first image to pop up and reveal what 2001 meant...

The DVD was a compilation of home videos from the year 2001. She'd gotten then from their parents; and with the help of her best friend from university who happened to be a tech genius, the videos were converted to a DVD with captions so she could enjoy them. And they were all in order. She had a few DVDs made for different years; but 2001 had been a big year in her life. She was 5; and it was the year she got her third and final open heart surgery. It was also a year that involved a lot of videos of her and Marco, videos that showed Marco being the most awesome big brother ever... So as the first image popped up, she sent a quick glance over to her brother to watch his reaction.

Marco should have known she was going to say that, so he just stuck his tongue out at her and sat back brat. He smirked and watched as the screen came on. When the first video started, he was instantly transformed back in that time when he was 16 years old and he was taking care of her before her surgery. His jaw dropped, he signed, When? How did you do all this? He wasn't sure how she was able to do this, but it was already tugging at his heartstrings.

He watched the DVD with a smile on his face and tears in his eyes, still not believing she had all this from 2001. He had some pictures of them, but nothing was like this. He couldn't stop watching, it was so sweet seeing all the pictures of them together. Seeing that beautiful smile of her, and even the ones where she was frowning. When another picture came up and he laughed, I remember this like it was yesterday. You had just come from the doctors and you were feeling a bit down, so I dressed up in my pirate costume and read your favorite story. All I wanted to do was make you smile, so I went all out and acted every part of the story. I always wanted you to have adventures in life and I am glad you were able to fulfill all those dreams. He smiled and continued watching.

Between the actual home videos, there were some pictures thrown in as well. All in all, it was just a nice trip down memory lane, even if some of the memories were ones Rory would've rather forgotten. She never liked seeing pictures or videos from when she was little and really sick. She hated how she looked with nasal cannula or even that stupid brace for her clubfoot... But putting the video compilation together had been a fun project; and she'd wanted to share it with Marco for years now. The opportunity had just never presented itself before now. You like? She asked, already knowing what the answer would be. My friend J-A-Y from uni helped me with this. He's into all that tech stuff; and he said as long as I got him the source materials, he could put all the videos and pictures onto a DVD and add captions to the videos so I know what's going on. Her friend's help had allowed her to enjoy old home videos for the first time in her life. She'd seen them before over the years; but she'd always had to ask her family to tell her what was being said. And that was always annoying. Turning her attention back to the TV screen, she smiled wide as an actual video of pirate Marco started to play. He looked ridiculous; and she could only image he sounded just as silly.

Marco couldn't stop looking at the screen, it was so many memories flashing before him, he couldn't believe that she had this made. The tears were welling up in his eyes, it was so nice to see all these pictures and videos again. Of course I like it, this is amazing. I can't believe you did this. He wanted to hug her, but he couldn't tear his eyes away from the screen. Not that I mind, but why did you decide to do this? I love seeing all of this but.... He was getting choked up, What made you do this? He turned just in time to see him reading her pirate story, Wow, I didn't even know someone was recording that. He laughed hearing his silly pirate voice, he couldn't stop himself from laughing at how silly he was. Seeing your face when I would do this was why I loved it so much. Look at how excited you get.

Rory only pulled her gaze from the screen as she caught Marco signing out of the corner of her eye. Turning to face him, she smiled at his words before momentarily shifting her attention back to the TV, her smile widening at the current video. As the video ended and some pictures started to pop up, she shifted her seat and once more turned to face her brother. You asked why I had this made? That's simple. She began. I was away at school; and maman sent me a box with a bunch of old pictures in it. There was a video in there too; and when I went to watch it... Well, let's just say I realized how much more enjoyable it would be with captions. So I decided to look into having that done. I wanted to be able to better follow along, know what was going on. While she could easily follow along when someone was signing in the video and was facing the camera so she could see their hands, there were plenty of videos where she couldn't make out the signs or there weren't any in the first place. It became a little project of sorts for me and J-A-Y... His name sign is— She stopped to demonstrate his name sign. He's like my third brother; so I talk about him a lot. He was also featured a lot in her blog posts about her three months in India, mainly because he'd been the one she'd gone with. He was born there and still had family in the country. I had maman send me more videos; and he compiled them into different DVDs by years and added captions where needed. There was also a secondary reason Rory had the video compilation DVDs made; but she didn't want to share that with Marco, at least not yet.

Marco couldn't stop watching the screen, it was so sweet that Rory would go through the trouble of getting this made. It gave him the confirmation that everything he did for her was special and she appreciated it. He loved her more than anything and he would act a fool anyday. He listened to why she had this made, and it made sense to want something like that. I wish I had something like this when I was in the military. He smiled looking at how they were when they were younger, I probably wouldn't have been so lonely. Next time you meet with J-A-Y, please tell him I said thank you for doing this.

We try and Zoom weekly. Next time we have a chat planned, I’ll call you into the room if you’re home. You can thank him yourself. It would be nice for Marco to meet Jay, even if it was just via a video chat. Since Jay was like a third brother to Rory, she definitely wanted him to finally meet at least one of her biological brothers. Otherwise, I may have to invite him to come visit over the summer.

Marco smiled, Great, then call me when you do so I can come say thank you to him. He did an amazing job. Watching this was bringing back so many wonderful memories and he wanted nothing more than to see more of the video. He laughed when she said she was going to invite him You should, I'm sure he misses you as well and would love to spend time with you.

Rory really did miss Jay. He’d become quite special to her during her university days and continued to be quite special to her ever since, even to the point he’d been there at the hospital in London when she’d gotten her pacemaker. Whenever she was in the hospital, he‘d been there. You know how you said you wished you had known about my surgery so you could’ve been there when I woke up? Well I had Jay there. So I did have someone making sure I was okay.

Marco looked back at the screen, laughing at him playing dress up with Rory, still not believing he did that. He turned and looked back at her as she signed at him, and he knew that hearing Jay was there for her when she had her surgery should be comforting, but it wasn't, he really wanted to be there. He didn't want to make her feel bad, so he smiled, I'm glad someone was there to be with you.

Rory could still tell that her not telling Marco about her surgery until now had hurt him. She could still see the desire to have been there for her behind his eyes. Even though his words said he was glad Jay had been there for her, she knew that wasn't the full truth. Letting out a small sigh, she returned his smile, momentarily turning her attention back to watching the current home video on the TV before speaking up. "I'm really sorry I didn't tell you sooner. And I'm really sorry I made maman and papa promise not to tell you either." If she had know her keeping this from him would've hurt him this badly, she definitely would've told him. It hadn't been her intention to hurt him. It had merely been her intention to not cause him further worry.

Marco hated that he couldn't shake his feeling of sadness when it came to not being there for Rory during her time of need. He had always been there for her no matter what, and for something like this happen and him not know about it upset him. He tried to keep his emotions to himself, but obviously Rory still picked up on it. He sighed when she apologized again, It's okay...you had your reasons and no matter what they were, it was your choice and I have to respect it.

"I just didn't want to worry you." Rory opted to continue to use her voice, knowing how Marco loved hearing her speak despite her own hatred of how she assumed she sounded. She figured letting him hear her speak when signing was clearly an option might make him happy. "It honestly wasn't even that major of a procedure. Could've been done outpatient and with local, um, anesthesia—" She paused as she hated fumbling over her words; and that was such a word she never failed to fumble over. "—if I wasn't allergic to the stuff." Her allergy to local anesthetics had always been quite inconvenient. Made even the smallest procedures 10x more complicated and risky.

Marco shook his head, "I understand why you felt it was necessary to do that, but I would be lying if I said I didn't still feel a little hurt by it. But you are a grown woman and can make your own decisions about your health and healthcare. I respect your choices Rory and no matter what, I'm going to always be there for you."

Rory watched as Marco spoke, still unable to feel a bit of guilt for upsetting her brother. But she just nodded at his words, offering up a small smile before shifting how she was sat on the couch so she could rest her head on his shoulder as she let out another heavy sigh. Thank you. "I love you, Marco."

Marco wrapped his arms around her shoulders, he could tell she was sincere about her apology and that meant a lot to him. He signed, I know you do, and I love you as well...always and forever. He leaned down and kissed her on the top of her head. They stayed like that for a little while longer, when he heard shuffling from his room, I'm going to head to bed, I don't want Gen to think I abandoned her. You should head to bed as well. He smiled and got up, kissing the top of her head, Night sis. He headed back to his room feeling better about things.

#{ para }#{ para: marco pierre }#{ para: p(e)acemaker }#{ marco pierre }#{ p(e)acemaker }#tw chronic illness mention

2 notes · View notes

mymisfortuneforyourenjoyment · 6 years ago

Text

March 8, 2019, 4:31pm

I have a chronic illness called POTS - that’s postural orestatic tachycardia syndrome. In simple words, my nervous system is broken and the biggest problem it causes is with my heart.

My doctors have sent me to cardiac rehab. Which, apparently, is something I’m supposed to be ashamed of? At least that’s the impression that I got when a 60-some year old woman also at the rehab clinic whispered, “Are you here for... cardiac rehab?”

By the way, I’m not ashamed. Not one bit.

I’m annoyed, though. The last time I saw my cardiologist, he said to me, “I can’t prescribe exercise in a pill. It’s up to you. I can’t do anything about it.” True, doc. That’s true. But my good dude, stop acting like I’m not trying. Stop assuming that I’m not doing what I’m supposed to be doing. I have been exercising, to the best of my ability. He doesn’t believe me, though.

I’m also just pissed, frankly. I’m in shape. I can do whatever the exercise doctors asked me to do. It’s the day after that fucks me up. The “postural” in POTS means that my symptoms are tied to what position I’m in - laying, sitting, standing, moving. The “tachycardia” bit means that the more vertical I am, (so the longer I’m standing) the higher my heart rate goes. Anyway, all that to say that the day after exercising, I can’t stand for more than ten seconds without fainting. I started this exercise program twice before, at home. Both times, I ended up in a wheelchair for a month after because when I stood, and sometimes when I sat up, I fainted.

So now I’m going to the hospital each time I exercise. Today was the first day. It’s a 36 week program, three times per week. This is basically how my day went:

Bought a bus ticket on my phone through an app. I rush my service dog to do her business before we got to the bus stop. She nearly makes us late. The bus driver and I make eye contact. The bus driver sees my service dog. I give a “what the fuck” face and throw my hands up because she’s not slowing down. The bus skids to a stop. I get on, show her the ticket on my phone and say, “Thanks.”

I get off at the right stop. I rush to the office - I have anxiety. A man snaps and whistles at my dog. “Please, don’t.” Got there a half hour early like I was told to, perfectly on time. I check in at the front desk. The receptionist calls me by the wrong name, my given name. I cringe and try to correct her, but she doesn’t let me speak. She ogles at my dog. The receptionist says I’m too early. She takes me back to the gym anyway.

She tells me to sit down but then blocks the chairs, talking to a nurse. I feel awkward so I let my dog sniff around the equipment, it’s a new place and all. She’s not very interested.

“Is that a dog we can’t touch?”

“Right.”

“Can we talk to her?”

“No. It distracts her.”

“There’s a new girl here. She has a dog.”

I want to die.

I sit down and tuck my dog under my seat. Good dog. I forgot treats. I feel bad because it’s a new situation and she could use the encouragement. She does wonderfully, though.

A woman wheels up and talks to the dog. She doesn’t ask to pet her. Another woman, the one that whispered cardiac rehab, insists on showing me a picture of her daughter because, to her, we look so much alike. We don’t. The daughter has kinda short brown hair that resembles mine. “She has an easy smile, just like you.” I smile and want to say thanks, but choke on my words because I’m anxious.

The woman teases and guesses that my name is Chip. I thought about saying yes, but told her the name I go by instead. Took her three times to hear me right. My name isn’t hard. Just a bit too masculine sounding for her to accept that it’s my name, I think. She introduces me to everyone there. She’s trying so hard to be welcoming, but no one will shut up about my dog and everyone’s assuming I’m a girl and I’m anxious.

A man sits next me. He’s three times my age and reminds me of my grandfather. He asks what breed my dog is, boxer lab mix. I’ve had this conversation with strangers so many times, I swear I need to start counting just so that I can add that bit of information in the conversation so that people can better understand my annoyance. He struggles with his phone, wanting to show me a picture of his dog, a labradoodle. I explain how to get to the picture he wants to show me. The woman from before insists on showing me her dog, a mutt.

Three doctors finally stride into the room perfecting in sync together in a little pack, which is funny to me. I watch them in the mirror. I can’t see around the huddle of ten people waiting for them.

I’m handed a packet of information. I take my time reading it. My doctor is annoyed that I’m actually reading it and taking so long - I’m dyslexic. She sits down and runs over it with me. It’s a lot of information and I can’t remember any of it.

She takes me into the gendered locker room, the women’s, and shows me how to put on the heart monitor. It’s a chest strap that correlates to a watch. I lift my shirt and show my scars from top surgery as she puts it on. I wanted to say that I’m transgender and I use they/them pronouns, but the words catch in my throat and I say nothing.

She walks me through the rest of the process. It’s long and confusing. She teaches me how to use the recumbent bike, with all of its functions on the screen. She’s impressed that I do so well. I told her that exercising is not the problem. It’s the day after. She bids me good wishes for tomorrow as I leave.

I walk to the bus stop. The bus comes very soon after I get there. I am the only one at the bus stop. I make eye contact with the driver. He speeds past. “What the fuck!” I swear more and pace around. I feel bad that I’m acting the way I am around a teen boy that cannot make eye contact with me and sits on the sidewalk with his legs bent up in at weird angles. I think I’m making him nervous.

I look up on my phone when the next bus will come. I sit on a cement base of a flagpole nearby. I take out my phone, texting friends about being passed up completely. That’s the second time it’s ever happened to me. My phone is at 30%. It dies. Probably from the cold. My fucking bus ticket is on my phone.

I try to get into an education building. It’s a Friday, the university campus should be open. The building was locked. I walk back to the hospital in the cold. My dog is shivering.

I ask the concierge if there is a way to charge my phone. He says that there are no charging stations and apologizes. I walk up to a group of four people sitting in a cluster of chairs in a waiting area. A woman is on the phone. I stand awkwardly until I get up the courage to say, “Excuse me, I’m really sorry, but does anyone have an iphone charger?”

The woman on the phone says that she does. Her daughter, sitting next to her, says that her charger won’t work because her mother has an android. The mother pulls out a universal charger. I thank her profusely.

I sit on the floor by a plug. I hold my phone up by the plug that’s 2 feet off the ground. The cord is only 6 inches long. My phone turns back on. It’s at 24%. I want to wait 15 minutes at least and leave in time to walk back to the bus stop. I charge for my phone for 12 minutes. My phone is at 30%. The woman’s car was brought up by the valet and she needed to leave. I thank her profusely.

I rush to the bus stop, even though my dog pulled towards the grass, wanting to do her business. I tell her that we’re in a hurry - I’m anxious. We get to the bus stop ten minutes early. I let the dog pee and sit on the cement block by the flagpole. There are other people around. The bus comes. I pull my phone out and the app actually turns on without loading for 4 minutes. I board the bus.

My phone is at 24%. I turn on music because I’m anxious. My phone dies but I leave my headphones in. I get off at the right stop. I decide to begin chronicling my bad days and my bad thoughts on a public social media platform. I don’t care if anyone read it or if anyone follows me.

#bad day #pots #service dog #bus #exercise #transgender #dyslexic

6 notes · View notes

spontaneoushiccups-blog · 7 years ago

Text

Because the 00′s are cool again, and also because a therapist thought it might be a good idea; I’m starting a blog.

In early October, just a few days after my husband Ryan’s birthday- we were given news that the genetic testing we had been going through for our 2nd baby was indeed abnormal, as we had feared and certain early markers had indicated. It was most likely Down Syndrome. I cried in the car to my Mom as my husband ran into the pizza shop next to the hospital to get me lunch on the way to my first day of working at my new job. It was raining. After a miscarriage last year that left us both reeling, we had struggled to connect to this pregnancy. To allow ourselves to get excited. We were hoping so much for relief and instead it felt like we were playing this game of poker that had gone all wrong and we couldn’t fold or leave and had no idea what terrible cards would be drawn next. The deck seemed stacked against us.

After some confusing and contradicting information from the genetic counselor and doctors and perinatologists- we decided to get an amniocentesis because it was the only thing that could actually give us a solid answer when it seemed like we were drowning in all the maybes of statistics that so often don’t end up meaning anything at all when you’re in that random 1%. I also figured out that while the amnio did carry with it a small chance of miscarriage, my chance of having a miscarriage anyway was actually higher. It’s funny the information they choose to tell women. We scheduled the amnio and did our best to think positively- something that at the time felt insulting. Sometimes still does.

We had been planning a trip to Disneyland for months for our daughter Rosy’s 4th birthday. We had no choice but to have the amnio just 2 days before we left. We promised ourselves we’d get lost in celebrating her, lucky to be in a place where they do all they can to shove the joy right down your throat. The morning of the appointment, I was nervous, numb. I mostly dreaded going back to that awful, poorly lit clinic where it seemed like nothing but bad things happened. They sat us down with Jenny the genetic counselor (with whom Ryan and I had both had multiple confusing, sometimes contradicting conversations and had concluded privately that most likely, was a moron.) As I sat at the little round table in her office and she rifled through pamphlets like she wasn’t selling us the disparate possibilities of a grim future, but instead was selling us insurance or some moderately used car, I noticed the framed certificates from Portland Community College certifying her as a genetic counselor. What a terrible job to have.

She told us they would do a detailed anatomy scan before conducting the amnio. They were looking for other indicators of a chromosomal abnormality. The Nuchal Measurement was already high and the blood work came back borderline, or possibly negative? It depended on who you caught on the phone to ask. It was enough to warrant concern and this new found ill-fated relationship with Jenny the genetic counselor. The biggest thing they were going to look at was the heart. Trisomy 21 (Down Syndrome) comes with a Congenital Heart Defect more than 50% of the time.

I was back on my back in that dark ultrasound room. Before the doctor came in I was cracking jokes with the technician, who seemed friendly. She told us it was a girl. We had been convinced it was a boy because I had been so sick, so much sicker than with our first. Ryan made a joke about being relieved because “boys just set shit on fire.” Once the doctor came in the technician and doctor began mumbling to each other quietly, deliberately so we couldn’t quite understand them. Then the doctor left for awhile and the technician wasn’t as friendly anymore. When she came back she told us it looked like there was something wrong with the heart. She couldn’t diagnose it- but thought that with everything else it was a very strong indication that the baby indeed had Down Syndrome. She highly recommended we get the FISH test- which would get us results on DS specifically within a few days. I held in soft hiccupy sobs and she stuck the 10 inch needle in my belly. Ryan watched the baby grab for it on the ultrasound as I kept my hands over my eyes.

So we went to Disneyland determined to show our Rosy, our sunshine girl- this human representation of our experiment gone “right”- the best time of her life. Not to let this dark sadness and confusion cut through her well deserved, whimsical joy. The universe could sucker punch me, but so help me I would protect my already living baby from this sorrow. A baby with Down Syndrome, guaranteed to have major heart problems, and likely other major health complications. We were at a loss, but as the days went by, we were drifting closer to the conclusion that maybe we weren’t cut out for that. Would I want to live that way? I wasn’t sure. But one DS diagnosis increases another. We had just recovered from a near second term miscarriage last year and it all just seemed...wrong. “Is there any chance we will have a.... healthy baby?” I asked her.

“No.” She said.

Rosy had disappeared into Goofy’s house in Toontown when 3 days later my phone rang. It was an Oregon number. We decided not to get any news until after we got back to Portland. I picked up anyway. There are few things worse than my imagination set wildly free in the dark unknown, at Disneyland. I felt so self conscious of my burgeoning belly. I wanted to just take it off and hide in a dark hole. “Well it’s not Down Syndrome” she said. My heart sank. “I know. We thought for sure it was too, but it’s not. We think you should move forward with scheduling an appointment with a cardiologist. There are 63 other chromosomal abnormalities we are testing for and should know about those by the time you come in for the Echo.” What? Wait. What?? What did we do with that information? “Is this... good news?” I asked.

“I don’t know. I mean what’s good news?”

10 days slowly passed and we were finally back at the dreaded poorly lit clinic where nothing good ever happens. Except we found out all of her chromosome tests came back normal. Was that good? I had lost my sense of expectation, direction or grounding. I guess it wasn’t bad? All it was was not what we thought it would be. Again.

The cardiologist eventually gave her the diagnosis of Double Inlet Left Ventricle. Click on that link if you want the dirty details but it basically means that she has 3 chambers in her heart instead of 4. She will require major, multiple reconstructive surgeries after she is born.

I am 29 weeks now. We have pretty much decided on naming her Iris. She is OK as long as she’s in my womb- but shortly after birth will require her first of 3 open heart surgeries at 5 days old. The second occurring between 3-6 months, the third between 3 and 6 years. After many conversations with our parents we decided to go home to Salt Lake City, UT to deliver her so she can have her first surgery, the Norwood, at Primary Children’s Memorial Hospital- a highly nationally ranking children’s hospital where 3 sets of our parents also happen to live.

They call babies with congenital heart defects, “heart warriors.” A term I’m trying to embrace. On days when I feel sad, when the worst case scenarios are painted in comic jewel tones dark and clear, or the haunting stupid statistics and the paranoid and unhelpful anecdotes that swing both ways creep into the heaviness in my chest, when people tell me how “strong I am” and I still don’t know what that means- I think about her genes. About the women that came before me; the babies they lost, the ones that survived, the husbands involved and not so involved, the dismal medical technology of yore, and I am grateful our Iris is coming to us, today and not last year or 30 years ago, or 50, that she has her woke-ass, non-toxically masculine Dad who cries with me, with us, and hopes with us, who put up her crib with his strong, gentle hands, like some physical way of taunting the universe, showing it that we aren’t scared, when we are. I think about the fact that she has the blood of Oakies and Mormon Pioneers, Sailors and Ranchers; of these people who had to survive their own journeys across different kinds of mountains and seas. I feel her flopping and kicking around in there and sometimes I think maybe she really is a warrior and maybe everything will be OK.

10 weeks from today she will be born.

#chdwarrior #chd #dilv #chdawareness #congenital heart disease #prenatal #diagnosis #momlife

4 notes · View notes

whatsupweinzimmers · 7 years ago

Text

ONE YEAR OLD!

November 1, 2017. HAPPY 1st BIRTHDAY, JACK! What a difference a year makes.

1 year ago today we entered Brigham & Women’s Hospital for a 9am induction. For months of my pregnancy, we were ”prepped” on what my delivery “schedule” might entail due to our baby’s known heart defect. But we really didn’t know. We really didn’t know how it would feel once rubber hit the road. We really didn’t know that we would torture ourselves for 12 hours after being induced over what the next day and month would look like. …As if we hadn’t done that enough already. It was all we could think about since we received the news at 20 weeks pregnant, and now we were at t minus a few hours of go-time. I had to give birth to this baby, send my baby away, have my baby undergo major surgeries, and then wait and wait to see how each day of the recovery went. There were so many if/then statements highlighted on our prepped delivery “schedule.” It seemed like it was every day of the second half of my pregnancy that Mike and I discussed our various conversations with the cardiologists to make us feel better that we knew and were “prepared” for all scenarios. We were supposed to be so happy and excited, but we ranged in emotions and were generally terrified.

And when we found out on the evening of November 1, 2016 that our baby was ready to enter the world, we really didn’t know that being escorted into an operating room and waiting for 20 doctors and nurses to enter before starting to push would be both remarkable and chilling. All 20 just watching and waiting, sending guidance to each other, pointing around the room, and readily positioned with each of their “tools” at arm’s length. Every person in that room knew their role, and the order that their duties had to occur. One nurse just standing next to the phone on the wall, waiting for a ring and to make her calls over to Boston Children’s. She intimidated me the most. What kind of phone calls were we expecting here?! Over the months prior, we often felt reality checks…together, alone, at work, in the car, in the middle of the night. But at that moment it was hitting me like a ton of bricks. It would have been impossible to actually be prepared for the emotional roller coaster we were hopping on for 14 days at Boston Children’s Hospital. We didn’t even know if this little lovebug inside of me was a boy or a girl, let alone whether or not he or she was a lion-hearted tenacious nugget of pure strength. We prayed for months that this baby would be ready to put up the fight of his/her life just minutes, hours, and days after he/she was born. We really didn’t know how it would feel to actually lay eyes on our very own baby. We had heard that this baby would instantly become the love of our lives. …That there is no greater feeling than seeing your child for the very first time, and no greater love than that of you for your child. We really didn’t know how it would feel to see that our precious child, who we did in fact instantly fall in love with, that we had prayed every day for was born blue and turning bluer by the second. In that moment, we did know from our collection of if/then statements that this would be a very time-sensitive situation, and that it meant our baby would need their first operation immediately. But we really didn’t know just how much it would yank on our hearts to see this boy taken from us after a mere 10 seconds, to the corner of the large operating room. That corner filled with a number of those 20 doctors and nurses waiting to track his stats, force tubes down his throat so he could breathe, and hook him up to unknown machines. And I really didn’t know that I would lay there waiting to hear my baby scream and cry because to me that meant he was “okay” and well, alive. I relied on the expressions, tones, and body languages of doctors and nurses, and it was petrifying. …All that before transporting him to the next round of doctors at Boston Children’s that would perform their operation to ensure he could get just enough oxygenated blood circulating until his big open heart surgery a couple of days later. I really didn’t know that I would turn selfish in those moments. I wanted my quality skin-to-skin time. And I wanted pictures, damn it. I wanted pictures of my just-born infant on my chest, nuzzled into my neck. I wanted pictures of raw emotion at the birth of our first child. I wanted all my tears to be made of joy rather than joyful tears being overtaken by saddened and panicked ones. I wanted pictures of Mommy and Daddy gushing over their baby. I wanted to put on a fancy maternity robe, touch up my mascara, and take those priceless first pictures with my son. Hell, I wanted a photographer in there, and I wanted all family members in there getting individual pictures with this treasure of a human. I just gave birth to a boy that I loved more than anything, and I really didn’t know that I would find myself laying on the other side of the room feeling completely helpless. My eyes followed Mike as he eavesdropped and peeked around doctor huddles, trying to get another glimpse of our boy. I can tell you that I read the body language and lips of every person in that room. Despite my thoughts of helplessness, I was focused, concerned, sensitive, protective, answer-seeking, multi-tasking…and I said “this is motherhood.” I really didn’t know that a year later I would still be able to see the image of that room I gave birth in, and every person in it, and every action that took place. I feel like I got a full dosage of motherhood in the first 30 minutes of my son’s life. And I really didn’t know that that maximum dosage was going to come again and again and again for the next two weeks. The sounds of hard-at-work nurses and doctors directing each other, and calling for an on-call doctor at Boston Children’s to prepare their operating room for Jack’s first procedure sounded like absolute panic to me. His big open heart surgery wasn’t even going to occur for a few days, and THAT is what I was “prepping” for all this time. It felt like I was emotionally and physically exhausted and really wasn’t prepared for this motherhood at all. So then we really didn’t know what was going to happen when Jack had to be carried off to his very first and very important “appointment.” …That his devoted resilient Dad would find room for his hand on the miniature hospital bed to help the nurses and doctors wheel him over to Boston Children’s. “Er, I’m going with him, I have my cell phone.” …And that his mess of a Mom would be forced to recover for a few hours before seeing her baby again. I really didn’t know that I wouldn’t be able to remember what he looked like just hours after he was born. I really didn’t know that my nurse and my Mom would be wheeling me back to my hospital room where my Dad and my brothers were, and that I wouldn’t be able to introduce them to my baby. They waited all day at the hospital for their grandson/nephew to be born, and all I could think is “why didn’t I know that they wouldn’t be able to meet him today?” I really didn’t know that I was going to be elated to see them and then weep in the next moment at the sight of their stress and worry and say: “He is supposed to be here with us now. We should be taking pictures.”

I really didn’t know that while my newborn was undergoing open heart surgery for 8 hours, we’d be sitting in a waiting room next to moms and dads waiting for their teenagers to get out of surgeries repairing broken wrists and torn ACLs. I really didn’t know that our updates every 90 minutes would be as brief and non-descriptive as “the first incision was made,” and “he is hooked up to the bypass machine.” I really didn’t know that throughout his stay in the CICU, we would be comparing our baby to neighboring babies saying “that baby is a couple days ahead of Jack, Jack should be out of here to the step-down unit in a few days if he progresses like that baby.” I really didn’t know that I would wake up in the middle of the night in our room at the Yawkey Family Inn bawling, needing to call the nurse at Jack’s bedside. I really didn’t know that for the first two weeks of his life, my baby would be “awake” for a combined few hours. The tiny body of our first-born under ‘paralytics,’ with breathing and feeding tubes…covered in cords and plugs and tubes and tapes and wires for two weeks. I really didn’t know that this whole “experience” we endured would continue to hit me and bring me to tears throughout his first year, and probably forever…together, alone, at work, in the car, in the middle of the night. There has always been special precaution taken by Jack’s pediatrician and by his cardiologists even when he has a simple “cold,” and it brings us back to our moments at Boston Children’s. When Jack was three months old, our pediatrician sent us to the hospital from his normal check-up. She said his spleen was enlarged and she wanted x-rays. Because if both his spleen and liver were enlarged, then his heart may not be pumping blood the proper way. There we were in the hospital again, waiting and waiting, but he was fine. We are thankful for the thorough nature of our doctors, but naturally, we don’t always want to be reminded that our son has congenital heart disease and that he is a special case, and though we have every right to believe his heart is perfect…that we don’t exactly know what may come in the future.

…Now I really do know some stuff! Essentially that we live and learn and adjust and persevere…with the help of exceptional support systems if we’re lucky. I know now that sometimes obstacles occur in the lives of those that can handle them. And Jack has handled this like. a. BOSS. And whatever comes at him in the future, he will continue to be a boss. I really do know that it’s best to be kind because everyone is fighting a battle that we may or may not know about. I know that hospitals are frightening and upsetting, but also humbling places. I know that empathy is so natural, and that we are damn lucky that we are not in the shoes of many others. And we should think about that from time to time. I remember thinking daily inside Boston Children’s that we were the lucky ones, and I can still remember the way my heart ached for so many children and families we saw in passing. I know that though it may sometimes bring a slew of unknowns, anxiety, heartbreak, and undesired emotions, the joys and love found in every day of parenthood far surpass the tearful and scary moments and make it all worthwhile. I know that Mike and I are stronger, and I think, a more “prepped” Mom & Dad for all that we went through. I know that genius and life-saving surgeons, doctors, and nurses have our back and will be with us forever and help guide us through anything that comes Jack’s way. I know that Jack’s tenacity, might, and fearlessness were instilled immediately and will live with him forever. I’ve seen that because of Jack’s preferred lifestyle (action-packed/full throttle/valiant/confident), he meets many floors and walls and objects with his noggin and various parts of his body. It seems there is very little that bothers him, and if it does, it’s for no longer than a few seconds…he is super strong, he overcomes, he is always happy (unless he’s very very tired), and he truly has a love for each day. He wakes up chatting to himself in his crib and patiently waits for us to enter his room…and we’re greeted with the biggest smile as he stands up stomping his feet. I know that Jack tackles things head-on, he dives right in. (He tries to crawl into the ocean. He speed climbs up full sets of stairs in 8 seconds flat. He takes the most direct route everywhere he goes, climbing over objects/people/animals.) He’s a force to be reckoned with, he takes the path of most resistance…because he knows he can. I know this sheer determination will be another one of his tremendous assets throughout life. I know that if his first year is any inclination of his future, this boy will not be held back by anything. He will overcome any hurdle that faces him, especially if it has to do with his heart because he has already fought so hard. He pushes himself until he’s satisfied. I know that our boy is going to make us happy and proud and amazed for the rest of our lives. Jack will tell his story and how he scared the poo out of his Mom and Dad. I know that Boston Children’s Hospital is THE best hospital for pediatric cardiology. And best of all, I know from the heart surgeon that we are forever indebted to, that performs his gift on hearts the size of walnuts, that Jack’s heart is perfect.

Thanks for listening, check back again in a year ;)

2 notes · View notes

samuelfields · 6 years ago

Text

Increase The Value Of Your Professional Network By Befriending These Five Archetypes

For 10 years I acted as a mentor to incoming analysts or associates at one of the two investment banks I worked for.

Being a mentor was rewarding and a way to help younger folks navigate the often terrifying waters of a cutthroat work environment.

One of the main pieces of advice I gave was this: You should spend as much time selling yourself internally as you do externally. 50/50.

What I noticed during my career was that those who zoomed up the corporate ladder always seemed to have the strongest networks, regardless of whether or not they were the best producer.

The majority of people hate to network. They believe hard work is enough to get ahead. Unfortunately, from a career and financial perspective, networking is vital if you want to outperform.

There is no true meritocracy.

The Rise And Fall Of A Network

At its core, a network’s fundamental reason for being is for survival purposes. When you have a group of people fighting for you, it’s much easier to avoid getting eaten by lions.

When I started Financial Samurai in 2009, nobody gave me the time of day even after a year of operation. A lack of recognition is why so many blogs or online businesses shut down within a year, despite the low operating costs.

Therefore, I started my own blogging network to help me and other nascent bloggers grow. We promoted each other’s sites over social media, allowed for each other to guest post, helped each other with technical issues, and shared advertising contacts.

At its peak, the network grew to 120 bloggers strong. To pay for my time and the operating expenses of running the network, the network took a 10% cut of all the advertising campaigns mostly I and sometimes other members created. It was a promising business model based on honesty.

The network was going great until one member decided to take the advertising contacts we had accumulated and started her own business creating blog campaigns. Then another member started doing the same.

Because of greed and selfishness, instead of having one strong network, we now had rival factions. Contract prices fell and chaos ensued. No longer was the network mainly about supporting the growth of each other’s sites.

The network created money monsters. I guess I can’t blame the two members who took my idea and created their own mirror image business because they only made about $36,000 a year from their day jobs. To them, they only saw dollar signs dancing around their heads.

Their intense focus on money and lack of loyalty disappointed me greatly. Consequently, I changed gears and decided to spend less time networking and more time writing on Financial Samurai. In retrospect, I’m thankful with how things turned out because running the network began feeling like I was working a day job again.

In case you’re wondering, neither of the two bloggers who took my idea is still around today. They are back to the grind. When you focus on making money first and providing value second, you tend to lose more often than you win.

What people may not know is that I still do an occassional “side hustle” of putting together blog campaigns for financial clients just like in the good old days. I just do so privately to keep things simple. Never stop side hustling! The opportunities are endless.

As for my network’s original intention of helping other bloggers grow, I’ve established The Financial Samurai Underdog Tour where anybody with an underdog story can sign up and tap my platform for exposure. The FS Forum is my new way to keep the camaraderie alive for personal finance enthusiasts.

Build These Five Relationships

It’s always good to network up and down. Those who’ve been around longer have more connections. Those with more connections tend to have more money and power and so forth.

Having 1,000 LinkedIn connections who won’t give you the time of day isn’t very helpful. Neither is having 10,000 Facebook friends who won’t show up to your birthday party.

Once you’ve built a network that won’t let you drown, it’s time to focus on building a network that will help you thrive.

Below are five types of people you should bring into your professional network. They will make you richer and happier.

1) The Life Giver

By far the strongest person to have in your professional network is someone who can give you or your children a job. In order to wield such power, the person must either be a C-level executive, a celebrity, or be the majority shareholder of a business.

Given growing anti-nepotism rules, more companies public and private, are not allowed to hire relatives. But that doesn’t forbid people in power to refer their friends and their friend’s children and push them through the system.

The most powerful Life Giver is the person or family who owns a large privately owned business. They can hire and promote whomever they choose at whatever salary they like. The most powerful family with a private business that comes to mind is the Mars family. They are the makers of M&M candies and are worth over $60 billion. True Stealth Wealth.

Then there are much smaller private companies owned by an individual or partnership that is quite powerful as well. For example, if you own a private online business that generates $1 million in revenue and $500,000 in operating profits, you could easily hire a handful of relatives for $50,000 – $100,000 each.

Your goal is to get to know at least one Life Giver. Once you do, the worst case scenario is that you’ll always be taken care of.

2) The Golden Retriever

It’s sometimes hard to meet C-level executives, celebrities, or private business owners. They tend to wall themselves off because so many people are always asking them for something.

The next best thing is to build a relationship with a Golden Retriever.

A Golden Retriever is someone who makes him or herself extremely useful to a Life Giver. Due to their usefulness, they have joined the inner circle and become one of the Life Giver’s most trusted confidants.

A Golden Retriever could be the executive assistant to the CEO who control’s her schedule. A Golden Retriever could also be the sidekick, like Turtle or Johnny Drama in Entourage who invite whomever they want to Vincent Chase’s parties and movie premiers. The most powerful Golden Retriever is the Life Giver’s spouse.

A Golden Retriever will help you get in the door, but he or she can’t make the final decision. Only the Life Giver can. It will be up to you to impress sufficiently the Life Giver in order to get the job, land the funding, or get invited to fabulous boondoggles.

Your goal is to get to know at least two Golden Retrievers. Once you do, you’ll always have opportunities to grow.

3) The Educator

If you have children, there’s nothing more important than your children. Parents often view education as the key investment they can make. As a result, some parents go to great lengths to ensure their children gain entrance into the best schools.

Although money can buy admission, you need a lot of money to legally buy your children’s way into the best private grade schools and private universities. Legal bribery is in the millions, not in the hundreds of thousands.

The best way to improve your child’s chance of getting into a great school without running the risk of a fine and jail time is to know Educators. Educators are the teachers, coaches, athletic directors, admission officers, school heads, and board members of schools.

If you can procure a letter of recommendation or a good word from an Educator, you drastically improve your child’s odds of getting into a particular school, especially at the lower school levels. Every recommendation counts.

Unlike public grade schools which must accept everyone, private schools can pick and choose the families they would like to join their fraternity. The more the very people who run the school can provide a good recommendation, the better your child’s chances.

Ever since I became an assistant tennis coach at a particular high school, I’ve noticed several people at my tennis club are much nicer to me. They know that even if I, as a lowly assistant coach, can’t help them get their child in, they must at least be pleasant to me out of fear I might say something bad about their family. Getting blackballed is a real thing.

Whether you have children or not, your goal is to know at least three Educators. Once you do, you’ll at the very least diversify your network so that it’s not all just rich and powerful people.

4) The Healer

Health is greater than wealth. Therefore, it behooves you to get to know as many health professionals as possible who you can ask for help.

Imagine if you had friends who are cardiologists, radiologists, optometrists, ophthalmologists, psychiatrists, orthopedic surgeons, podiatrists, earn, nose & throat doctors, nutritionists, physical therapists, gynecologists, nurses, pediatricians, and physical trainers. You could ask them anything and everything.

After getting an MRI on my knee 10 years ago, my radiologist friend whom I’ve known since 9th grade told me to send over the file so he could give me his opinion. His evaluation provided me tremendous peace of mind to not pursue arthroscopic surgery to fix a meniscus tear.

With the soaring cost of healthcare and the dwindling time we get with healthcare providers, it’s good to know as many Healers as possible.

Your mission is to get to know at least four Healers who specialize in different areas of health. Ideally, you are able to befriend a general practitioner, a physical therapist, and a psychiatrist.

5) The Unfiltered Genius

Life is easier if you are extremely smart. You can process information more quickly and make better decisions. Smart people also have the ability to better foresee opportunity where most cannot, which can make them extraordinarily wealthy. Unfortunately, not all of us are intellectually gifted, including myself.

The next best thing to being a genius is to befriend someone who is an Unfiltered Genius. The Unfiltered Genius is your sounding board for all of your life’s big decisions: joining a new company, getting married, buying a house, starting a business, negotiating a severance, and more. He or she will tell it like it is without being afraid of hurting your feelings.

We all have blind spots that lead us to walk off cliffs. The Unfiltered Genius will analyze every issue thoroughly and help you make better decisions in your life.

Everyone needs to know at least a couple Unfiltered Geniuses. If you don’t have one as your friend, it is worth it to hire one. If you can’t afford to hire one, then seek to read, watch, or listen to Unfiltered Geniuses over the internet who are experts in their field.

The easiest way to avoid saying, “If I knew then what I know now,” is to speak to an Unfiltered Genius who has been there before. At the very least, seek advice from your parents.

Not All Relationships Are Created Equal

Quality matters over quantity when it comes to building a valuable personal and professional network. The rich and powerful are getting more rich and powerful. At the same time, technology is enabling us to become more independent.

Go through your existing relationships and see if you can categorize each relationship into one of the five archetypes above. Then, systemically cull the relationships who aren’t real, never reach out, provide no value, or who only take and never give.

You need to proactively cultivate these five archetypes over time. Asking for help out of the blue is a great way to strain a relationship. Always focus on giving first.

If you are unable to befriend one of these five archetypes, then it’s up to you to become one. Once you do, you’ll find yourself naturally getting included into more powerful networks over time.

Are You Delusional? Let’s Talk Dunning-Krueger

Be Smart Enough To Act Dumb Enough To Get Ahead

Once You Have F You Money It’s Hard To Tell Others To F Off

Readers, do you have all five archetypes as part of your network? Which archetype are you? What are some ways in which you proactively cultivate your network?

The post Increase The Value Of Your Professional Network By Befriending These Five Archetypes appeared first on Financial Samurai.

from Finance https://www.financialsamurai.com/increase-the-value-of-your-professional-network-by-befriending-these-five-archetypes/ via http://www.rssmix.com/

0 notes

ronaldmrashid · 6 years ago

Text

Increase The Value Of Your Professional Network By Befriending These Five Archetypes

For 10 years I acted as a mentor to incoming analysts or associates at one of the two investment banks I worked for.

Being a mentor was rewarding and a way to help younger folks navigate the often terrifying waters of a cutthroat work environment.

One of the main pieces of advice I gave was this: You should spend as much time selling yourself internally as you do externally. 50/50.

What I noticed during my career was that those who zoomed up the corporate ladder always seemed to have the strongest networks, regardless of whether or not they were the best producer.

The majority of people hate to network. They believe hard work is enough to get ahead. Unfortunately, from a career and financial perspective, networking is vital if you want to outperform.

There is no true meritocracy.

The Rise And Fall Of A Network

At its core, a network’s fundamental reason for being is for survival purposes. When you have a group of people fighting for you, it’s much easier to avoid getting eaten by lions.

Build These Five Relationships

It’s always good to network up and down. Those who’ve been around longer have more connections. Those with more connections tend to have more money and power and so forth.

Having 1,000 LinkedIn connections who won’t give you the time of day isn’t very helpful. Neither is having 10,000 Facebook friends who won’t show up to your birthday party.

Once you’ve built a network that won’t let you drown, it’s time to focus on building a network that will help you thrive.

Below are five types of people you should bring into your professional network. They will make you richer and happier.

1) The Life Giver

Your goal is to get to know at least one Life Giver. Once you do, the worst case scenario is that you’ll always be taken care of.

2) The Golden Retriever

It’s sometimes hard to meet C-level executives, celebrities, or private business owners. They tend to wall themselves off because so many people are always asking them for something.

The next best thing is to build a relationship with a Golden Retriever.

Your goal is to get to know at least two Golden Retrievers. Once you do, you’ll always have opportunities to grow.

3) The Educator

Whether you have children or not, your goal is to know at least three Educators. Once you do, you’ll at the very least diversify your network so that it’s not all just rich and powerful people.

4) The Healer

Health is greater than wealth. Therefore, it behooves you to get to know as many health professionals as possible who you can ask for help.

With the soaring cost of healthcare and the dwindling time we get with healthcare providers, it’s good to know as many Healers as possible.

Your mission is to get to know at least four Healers who specialize in different areas of health. Ideally, you are able to befriend a general practitioner, a physical therapist, and a psychiatrist.

5) The Unfiltered Genius

We all have blind spots that lead us to walk off cliffs. The Unfiltered Genius will analyze every issue thoroughly and help you make better decisions in your life.

The easiest way to avoid saying, “If I knew then what I know now,” is to speak to an Unfiltered Genius who has been there before. At the very least, seek advice from your parents.

Not All Relationships Are Created Equal

You need to proactively cultivate these five archetypes over time. Asking for help out of the blue is a great way to strain a relationship. Always focus on giving first.

If you are unable to befriend one of these five archetypes, then it’s up to you to become one. Once you do, you’ll find yourself naturally getting included into more powerful networks over time.

Are You Delusional? Let’s Talk Dunning-Krueger

Be Smart Enough To Act Dumb Enough To Get Ahead

Readers, do you have all five archetypes as part of your network? Which archetype are you? What are some ways in which you proactively cultivate your network?

The post Increase The Value Of Your Professional Network By Befriending These Five Archetypes appeared first on Financial Samurai.

from https://www.financialsamurai.com/increase-the-value-of-your-professional-network-by-befriending-these-five-archetypes/

#Financial Samurai

0 notes

pen-cil · 7 years ago

Text

Renege Ch. 2

<Previous

When you step onto the training grounds, the sun was barely peeking out over the Swiss mountains. Any normal human being would hate waking up this early in the morning. But for someone with your experiences of getting up at ungodly hours or not sleeping for days at end, it was just another normal morning for you. Perhaps even a miracle, actually waking up during the day and not at night for those graveyard shifts. Jack was already there, stretching to warm himself up from the cold morning air. You couldn't help but stare as you approach him. Were all super soldiers built so fine, so cut from marble? Especially that well-shaped waistline peeking out of his shirt. The sound of you tripping over your own feet signaled your arrival. Hearing Jack’s muffled chuckle made you want to crawl in a hole, instead you settled for planting your face on the ground. On any other occasion, you would’ve like hearing his laughter.

After agreeing to work at Overwatch, Jack would video call you instead of writing emails as a way to get to know you and who to look for at the airport when you arrive. Your conversations were mainly focused on helping you transition and the current events. The first time you made him laugh was during the early hours of daylight and you had just woke up when he called. The day prior you had thought about the expectations of living at a military base, so you half-jokingly asked him if he liked the smell of munitions in the morning. He went silent before bursting out in laughter. It had surprised the sleep out of you, and after listening to him, you decided that it wouldn’t be so bad hearing his laugh every so often. But this, this wasn't really joke. It was rather an ‘I want to sink into the floor’ type of moment. You glance up to see Jack crouching down and holding out a hand. From his expression, you could tell he’s trying desperately not to crack up.

“You alright?”

Taking his hand with a nod, he effortlessly pulls you to your feet. He was stronger than he looked, you note before dusting yourself off and check for injuries. Your ankle and wrist rotated properly in its sockets, thankfully you're still intact with no serious bruising—it would be embarrassing if you gotten injured when training hasn't even start.

With that said, training wasn't any better. Jack was, unexpectedly, a strict coach. You powered through intense intervals of basic warm-ups without any pause in between. An hour in and you feel the amount of sweat and tears weighing you down. A part of you wanted to stop, but you didn’t want to embarrass yourself even more than you already have. The 5km run would be your breaking point. Your feet ache with each step you take. Your lungs are about to explode. Every muscle in your body burns, screaming for you to stop. And as a feeling of dizziness and nausea overcomes you. You know you had to stop.

So you stopped. Placing your clammy palms over your shaky knees, you tried to shout out to Jack. But your throat was too dry, the saliva in your mouth barely wets your tongue. No sound escapes your lips. Luckily, it didn’t take long for Jack to notice that you weren't following behind him. When he sees you far behind him, he finally calls for a break. The instant he does, you stagger to your water bottle. You could a pair of eyes watching you downed your entire bottle. How embarrassing. And what more, you’re still thirsty. When you head to the nearby water fountain to refill your water bottle, you could recognize Jack trailing behind you from the corner of your eye. The “sad puppy” blue eyes were too much to bare that you returned your gaze to the water filling your bottle.

“I’m sorry for not noticing that you were suffering. I should have asked for your opinion about the regimen beforehand. From my years of training soldiers, I forgot you were just a civilian doctor.”

“Oh, it’s not your fault. This is probably just a wake-up call telling me that I should have exercised more. I should apologize for being so horribly unfit.”

He chuckles at that and you hear the soft ruffling of his hair as he shakes his head. You smile at him and trying to imitate confident while still half-dead.

“I'll do my best to work up to your standard. But for now, do you think we take it down a notch?”

With a small laugh and an “acknowledge” from Jack, the two of you decide to stop for today. You never felt so excited to shower in your life. The blessing of being able to wake up, shower, and have breakfast normally all in one day. You could get used to this.

After a quick shower and breakfast, you’re freshen up and ready to face whatever happens next. Jack is leading the way to the medical center while giving you a rundown of everyone who works in Medic. From what you heard, you assume they’re a logical, respectable bunch. Though you were only half-listening since a wave of nerves ran through you, causing your hands to slightly tremble. The materials you were holding started to slip that you had to press them tightly to your chest. You tried to focus on your breathing, in and out. Large white steel doors slide open upon your arrival to the medical building. The inside was brightly lit from the glass windows that covered the white walls. Groups of doctors in white lab coats gather in the middle of the main floor; they’re all in their own little discussions. There are people walking around, taking the escalator up and down floors. A few feet from where you enter stood a warm caramel-skinned female doctor, looking up from her datapad. When you make eye contact, she smiles brightly at you and Jack as if she’s recognizing who you are. Quickly, the doctor fixes her hair bun before pacing up to the both of you.

“Hello, I’m Elena and I’m assigned to be your assistant. I’ve read a lot about your work and heard many wonderful things. It’s an honor to meet you.“

“Oh! Thank you, you’re too kind.”

As you shake her hand, you feel a warm hand landing on your shoulder, making you turn to look up at the owner.

“Well, I should get going. Message me if you have any problems, good luck.”

The last part he whispers before lightly squeezing your shoulder. With a wave to Elena, Jack walks out the door towards the direction of the main headquarters. You return your attention to Elena while she ushers you further into the building. She guided you through the rooms specific for all sorts of medical equipment. Rooms for radiology, therapy, and rehabilitation. Floors for surgery, dental, and laboratory. The ICU, MRI/CMI, and patient wing. Even the small cafeteria, library, and the many doctor offices. To you, it felt like a regular hospital, only more extravagant. During the tour, she introduced you to whoever you came across. You met all sorts of doctors, surgeons to cardiologists. Meeting the rest of your coworkers was more or less an emotional rollercoaster. Some greeted you with the same friendliness that Elena had, some were less cheerful, and some ignored you completely. Though it went better than you had expected. And once you settle down in your office, you hear the familiar rumble of your stomach. Just in time for lunch.

Crowds of people fill the cafeteria, it was double than the amount you had seen during breakfast. While standing in line, you had thought about bringing your food back to the office to eat so you could check the new messages that popped up on your computer. That thought had past when you remember agreeing to eat with Jack’s group from now on.

“Sleep well?”

It felt like your heart jumped out of your chest as a familiar deep sultry voice grumbles into your ear, breaking you from your thoughts. You quickly turn to the culprit, trying to calm your pounding chest. And there he stood, Gabriel Reyes, wearing the same sly and charming smirk from last night. You noticed how close he is. He somehow radiates warmth, like heater during a cold winter.

“Not as well as I hoped.” Your reply caused him to chuckle and move away. You almost miss his warmth. Almost. Changing the topic, you decide to focus on getting lunch. Being to eat solid food with substance is a lucky break from the usual bland supplement pills. You fill up your tray before glancing over at Reyes’s. The sight of sugary desserts made you gasp louder than you should have.

“Can you blame me for having a sweet tooth.”

It's kinda cute. Though you put away those thoughts away without a second to waste. Instead, you advise him from having too much sugar as it is bad for the body. And in return, he brushes you off with ‘super soldier’ and ‘I work out’ excuses. You could only shake your head at him, letting him off with a warning. Noticing he was heading towards the same direction you were, you ask him if he eats with Jack, Ana, and Reinhardt at meals.

"Torby's there too. And I sit with them if I have nothing else to do."

"Nothing else to do? Where were you yesterday?"

"I was... doing some research."

Before you could ask him about his "research" and who Torby is, you have arrived at the table.

“I didn't know you guys were already acquainted,” Jack said with an eyebrow raised as the two of you sit down.

Reyes held his stare for awhile before absent-mindedly returning to his meal.

“I’m giving the rookie a chance like you asked.”

Jack continues to stare at Reyes, with an unreadable expression. You didn't understand their interaction. So you chose to ignore them and went to give your greetings to Ana and Reinhardt, noting the new face sitting by them. Quick introductions went around and your list of friends (or acquaintances) grew.

“So they threw you straight into the fire huh?”

You aren’t sure what to think of Torbjörn, but Reinhardt gets along with him and if he’s one of Jack’s friends, he couldn’t be too bad of a person. The rest of lunch felt rather awkward with the tension you can feel between Jack and Reyes. As soon Reyes finishes his lunch, he walks out the door without another word aside from a parting greeting. Torbjörn leaves after, grumbling about urgent stuff he needed to attend to. You and the rest linger for a bit longer before going out in your separate ways.

Upon returning to your office, you read the new messages you saw earlier. The first one contains mandatory information and guidelines about Overwatch. Rules and even a map of the Switzerland headquarters. There was also contact information of the other watchpoints and bases. You archived the message as important in case you needed it for later. Others were welcoming emails from a few major positions in Overwatch. Most of them sounded formal, though there were a few that sounded genuine. Ana and Reinhardt wrote one as well which you saved. You made sure to remember to write a ‘thank you’ email back to every one of them at a later time. The last one was an update on a mission you’re partaking in. The mission was to solve territorial dispute between France and Italy. Italian and French citizens have been causing violence and sparking attacks against each other. The governments are still facing the aftermath of the Omnic Crisis resulting in little to no action being taken. If the conflict isn't fixed soon, it could eventually lead into another war. Originally it was decided to place you in the rear to gain more experience before you could be put on the front lines. However, your position is updated and you are now assigned to support the frontline. You had reread it multiple times to make sure you weren’t seeing things; because what shocked you the most was the person who suggested the change, Gabriel Reyes.

#renege #oh boy #finally #fanfic #Overwatch #reader insert #gabriel reyes

1 note · View note

scriptmedic · 8 years ago

Note

I'm writing a story in which a background character has a heart attack followed by surgery for it. I need a reason for him to stay out of communication for at least a few days after that. Would there be any sort of complication that would require him to be sedated? If so, how serious would it be long-term/would it be like coming out of a coma when he regained consciousness wrt emotional/physical/mental conditions? (FWIW, this character doesn't /have/ to survive if that would be too unrealistic.)

Hey there! So you need a critical illness as a side effect of a heart attack, huh? Well, let’s get this party started!

I’m going to give you a path that this character could go down, but not the one true only path this could happen. So keep in mind that things like pulmonary emboli, surgical site infections, internal bleeding, and much more can keep your character in the hospital for months after surgery.

First, a great reason to be out of touch would be if he had to be intubated for any reason. Putting a breathing tube down someone’s throat is a pretty good way to render them ineffective, especially because often times these patients are sedated, at least at first.

Now then. Your character has a heart attack. Boom. First step is (usually) calling 911.

Paramedics will arrive, perform an EKG, and diagnose something called a STEMI (ST-Elevated Myocardial Infarction; the kind of heart attack you can see with an EKG. Others require bloodwork to be sure; this is someone whose MI is BLATANT.)

He might be cool to the touch, pale, sweaty, and have his fist clenched over his chest -- this is an actual thing patients do. He may be convinced he’s going to die.

He’s right, but only temporarily.

Okay. So he’s having his STEMI. A particular kind of STEMI, an inferior wall MI, will produced EKG changes. (If you want some medspeak, have the medics give a notification: “I have 4-mm tombstone elevations in II, III and AvF” sounds smart, adding “... with a 2-mm elevation in V4R” sounds SUPER smart and will win you points with medical readers, trust me on this.)

He’ll be given aspirin, but not a medication called nitroglycerine, because Reasons(TM) . Medics may also give him an IV and some fluid, maybe 500mL.

Next he will arrive at the hospital. He may stop in the ER for a quick look by the ER doc and a few hundred mg of Plavix (clopidogrel). After that he’ll be brought very quickly to what’s called the cath lab, or cardiac catheterization lab. This is where your character will undergo catheterization. Namely, they’ll thread a catheter in through his groin up to his heart and try to clear the blockage by placing stents in his heart.

But before they can do that, they’ll take a look at his arteries by injecting contrast dye to see what’s blocked and what isn’t.

This is where your character goes from cath lab patient to surgical patient. If he has 3 or more vessels that are occluded by plaque -- triple vessel disease -- he’ll be going for a CABG instead (a coronary artery bypass graft, AKA a “bypass” or CABG, pronounced “cabbage”). In fact, he’s getting 3 of them.

Now, mind you, his blood pressure may continue to deteriorate all this while, because both sides of his heart are involved in the heart attack. He will be a very sick man by the time we’re done with him.

So next he’s brought to the OR, likely with some kind of pressor (dopamine, norepinephrine) hanging now to keep his blood pressure up. He’ll be anesthetized and intubated (breathing tube placed) in the OR.

And as they try to perform the coronary bypass, with his chest open on the table, he’s going to have a cardiac arrest.

Cardiac massage (aka “squeezing the heart to make it pump, literally, just grab it and squeeze”) will be done. If it’s a shockable rhythm, yes, they’ll apply paddles directly to the heart and shock it.

Anyway, let’s say they get the triple bypass done. Let’s say he lives. Let’s say he doesn’t even have massive damage to his heart.

He may still have trouble weaning off the ventilator. He may have developed some edema (fluid) in his lungs, and he may simply not be able to come off the vent right away. It may take a few days to get his pressures under control, to get him perfusing everything well again.

Meanwhile, he’ll be sedated, in a lot of pain, and unable to get up (because he’s had his chest opened up).

In the long term, he may be a relatively healthy man. Years down the road he may be able to exercise well, play poker with his friends, or volunteer at the shelter. But in the first few weeks after his surgery he’s going to have limited exercise tolerance and a lot of medication. He’s going to have some diet changes, some exercise changes, and he’s going to follow up with his cardiologist on a regular basis.

But he can live, and live well, and actually live long, after this event.

I hope this fulfills your requirements, and that others have learned from it too!

xoxo, Aunt Scripty

disclaimer

Consider becoming a Patron and see the freaking future!

FreeeBook: 10 BS “Medical” Tropes that Need to Die TODAY!

#cardiology #surgery #heart attacks #stemi #post op care #intubation #respiratory #somehowunbroken

146 notes · View notes

newstfionline · 8 years ago

Text

Global penicillin shortages are bringing back old diseases, and creating new, deadlier ones

Keila Guimarães, Quartz, May 18, 2017

Stella Ngubenkomo was 11 when she found out she suffered from rheumatic heart disease. “The doctor said I wouldn’t live long,” she says.

The doctor was wrong, but it hasn’t been easy; Ngubenkomo needs to get monthly penicillin injections to avoid heart failure and premature death. So once a month for the last 16 years, Ngubenkomo has gone to a local clinic in her hometown of Cape Town, South Africa, to get her dose of the antibiotic.

Benzathine penicillin G, a form of penicillin administered by injecting it into muscle, is the only medicine that can control rheumatic heart disease, which affects millions worldwide and kills thousands every year. It’s also a decades-old, proven drug, recognized by nearly all experts as an essential medicine for any country’s public health toolkits. And for the past few years, there have been global shortages of the medicine, putting Ngubenkomo’s life--and the lives of millions across the world--at risk.

At least 18 countries, including South Africa, the US, Canada, Portugal, France, and Brazil, have faced shortages of benzathine penicillin G over the last three years, according to the World Health Organization (WHO). With only a few companies in the world still manufacturing the medicine, countries can’t find enough supply of the drug that changed modern medicine 76 years ago.

Penicillin was discovered in 1928, but it really took off during World War II. In the early 1940s, a US government-led program brought together around 20 commercial firms, plus government and academic research laboratories, who collaborated to scale up penicillin production to supply the military. The goal, according to the book Sickness and Health in America, was to have enough penicillin for the troops landing in France in June 1944. In March 1945, penicillin was, for the first time, made available for consumers across the US. It’s efficacy made it popular: by 1949, the US annual production of penicillin was 1.3 trillion units--compared to the relative pittance of 1.7 billion units in 1944.

Penicillin was one of the great achievements of modern medicine. It was the first drug of its kind, considered a miracle, and ushered in the era of antibiotics. Before penicillin, any cut could kill if it got infected; surgeries of any kind could be fatal; and bacterial infections such as strep throat could kill. Gonorrhea, syphilis, and other sexually transmitted illnesses were basically a death sentence. But a single shot of benzathine penicillin G was enough to kill the first stages of syphilis, which had plagued humankind for over 500 years. It could also cure gonorrhea and other infectious disease. Today, benzathine penicillin G is still the most effective drug against deadly diseases such as rheumatic heart disease and syphilis.

Over the years though, penicillin descended from a wonder drug used on everything to a cheap, old antibiotic that pharmaceutical companies decided was no longer worth their while to produce for an ever-shrinking group of indications (gonorrhea, for example, is no longer treated with penicillin). Most moved on to more profitable products, focused on chronic diseases such as cancer and diabetes. Today, just four companies in the world still produce the active ingredient for benzathine penicillin G. Three are in China: North China Pharmaceutical Group Semisyntech Co., Ltd; CSPC Pharmaceuticals Group Ltd.; Jiangxi Dongfeng Pharmaceutical Co. Austria-based Sandoz GmbH is the only producer of the active ingredient for benzathine penicillin G in the Western world.

Together, these producers have the capacity to deliver up to 600 metric tons of benzathine penicillin G a year, but they produce less than 20% of that. “There is no money in penicillin,” says Amit Sengupta, the New Delhi-based global coordinator of the People’s Health Movement. A shot of benzathine penicillin G typically costs between $0.20 and $2.00, and usually all you need is one--strep throat and syphilis are both cured with a single injection of penicillin.

Meanwhile, global demand for the drug is not accurately captured because many poor countries don’t have the resources to quantify the true burden of diseases like syphilis and rheumatic heart disease. “There is not a lot of visibility of what the market for this drug looks like,” says Maggie Savage, from the New Market Opportunities Team at Clinton Health Access Initiative, which undertook a review of the global availability of benzathine penicillin G last year.

This is aggravated by the fact that nations with lower purchasing power tend to be the ones that need penicillin the most. “There is a market failure in the penicillin sector: there is a demand, but it comes from the poor,” says Ganesan Karthikeyan, a cardiologist at the All India Institute of Medical Sciences in New Delhi.

India has more rheumatic heart-disease-related deaths than any other in the world, with 111,000 fatal cases in 2015, according to the WHO. But there might be even more than that. Poor people in India do not typically have access to health care--there is no universal health care and the majority of treatment that does happen in the country is done by the private sector--which also means the country is not accurately tracking the illnesses afflicting the poor. Since rheumatic heart disease typically afflicts the poor, India is likely full of sick people who need penicillin that, essentially, no one knows about. With no clear forecasting and a cheap sales price, the drug has been in low supply in the country for the last 15 years.

India is just one example; it’s like this all over the world. Some 33 million people globally suffer from rheumatic heart disease and need monthly shots of penicillin; the WHO counts over 300,000 annual deaths due to the condition.

Another 5.6 million people around the world are infected with syphilis. And the WHO estimates that a single shot of penicillin could have saved over 53,000 babies in 30 countries who died from syphilis acquired in the womb in 2012.

In the US, a shortage of benzathine penicillin G since April 2016 has made treating syphilis nearly impossible, just when the illness seems to be developing into a major public health threat. Syphilis cases have more than doubled over the last decade in the US, and it’s no small thing; syphilis during pregnancy, when untreated, can leave newborns blind, deaf, and/or with serious bone malformations. It is also linked to a high rate of stillbirths and infant mortality. And benzathine penicillin G is the only antibiotic known to be effective in killing the syphilis bacterium in the fetus.

Pfizer, the sole provider of the medicine in the US, has been unable to meet the country’s full demand due to “manufacturing delays” in its plant in the US, where it formulates the drug with ingredients from an international supplier, according to the company. Pfizer would not disclose what’s caused the shortage or where it currently sources the active ingredient for benzathine penicillin G (an investigation by the London-based group Changing Markets found Pfizer used to source penicillin from North China Pharmaceutical Group Semisyntech until at least 2015). The US Food and Drug Administration says it cannot provide details about the manufacturing delays, “as this information is considered confidential.”

In the case of a low-profit medicine like penicillin, instead of going through the expensive process of making the drug themselves, local drugmakers will purchase the active ingredient for it from elsewhere, then formulate it for the local market. With lower labor expenses and cheaper utility bills, China has become the world’s largest supplier of active pharmaceutical ingredients, and the drugs assembled there--including benzathine penicillin G--are shipped everywhere.

“Penicillin production is difficult,” says Andy Gray, a pharmacologist at the University of KwaZulu-Natal, South Africa. “This is a product with no alternatives and you rely on a few huge global suppliers.”

That means a manufacturing delay or failure in one of these sites can affect several countries and millions of patients at once. For example, last November, the Chinese government told companies in Shijiazhuang, Hebei province, to halt production for 45 days as part of an anti-pollution measure. Two of the world’s four suppliers of the active ingredient in benzathine penicillin G--North China Pharmaceutical Group Semisyntech and CSPC Pharmaceuticals Group--had to shut down production.

Another problem in the supply chain of penicillin is compliance with quality standards. Semisyntech is part of one of the biggest Chinese drug groups, called North China Pharmaceutical Group Corp (NCPC). The conglomerate has over 25 subsidiaries manufacturing a wide range of pharmaceutical products sold to drug companies worldwide.

Over the last seven years, inspections carried out by drug agencies from various EU member-states have found NCPC’s companies non-compliant with good manufacturing practices multiple times. For example, in November 2014, inspectors from the French National Agency for Medicines and Health Products Safety visited the Semisyntech factory in Shijiazhuang, and found all sorts of problems: The factory had manipulated and falsified documents, its quality control lab lacked data integrity, and the plant had let standards slide to the point where the agency believes there was a high contamination risk.

The French authority recommended that the European Union prohibit the company from supplying penicillin to member countries. The European Directorate for the Quality of Medicines responded by revoking a number of NCPC’s Semisyntech “certificates of suitability,” issued to companies complying with strict quality standards set by the EU for safe medicines.

Other countries followed suit: Hong Kong, Ethiopia, and Liberia recalled local products made with ingredients from the Chinese plant and distributed by French drugmaker Laboratoires Panpharma. In 2015, Brazil decided to deny requests made by Semisyntech to sell benzathine penicillin G in their country--despite Brazil’s desperate need, thanks to a shortage of the medicine amid a syphilis outbreak at the time.

But things only worsened, and in April 2016, Brazil had no choice but to buy up an emergency stock of 2.7 million vials of benzathine penicillin G from the Pan-American Health Organization. And then, in July 2016, Brazil made the controversial decision to let NCPC’s Semisyntech ship penicillin ingredients into the country.

According to Brazilian law, pharmaceutical companies must submit documents outlining the manufacturing process of the materials they produce in order to receive a “registry,” which is issued to products considered safe and efficient. In the case of NCPC’s Semisyntech, Brazilian authorities granted a waiver allowing three Brazilian drugmakers to import the unregistered active pharmaceutical ingredient for benzathine penicillin G from the Chinese manufacturer.

Sourcing drugs from factories that don’t meet minimum quality standards increases the risk that contaminated medicines and poisonous ingredients ending up in hospitals, says Natasha Hurley, campaigner manager from Changing Markets Foundation, which has investigated drug company supply chains over the last few years.

Those risks can have fatal consequences. In 2008, a blood thinner formulated with ingredients from a Chinese manufacturer called Changzhou SPL Company Ltd. and sold by Baxter Healthcare Corporation in the US was connected with at least 81 deaths in the country. In Germany, there were reports of severe allergic reactions to a version of the blood thinner formulated by Rotexmedica, also with ingredients from China. The drug was recalled. After the incident, the US Food and Drug Administration reviewed the plant where the blood thinner was made and found the site was non-compliant with good manufacturing practices.

But with such a small number of manufacturers responsible for the global supply of penicillin, regulators find themselves in a tough position: restrict supply from a manufacturer with critical deficiencies on their site, or look the other way and avoid a shortage of life-saving medicines?

Meanwhile, the penicillin shortages continue, and when the drug is not available many doctors are forced to use substitutes--”second-line drugs, such as macrolides,” says Lola Stamm, a microbiologist at University of North Carolina, author of a recent paper on mutations leading to syphilis-resistant bacteria. That, in turn, is fuelling one of the globe’s biggest public health threats: antibiotic resistance.

Drug-resistant bacteria are a major public health threat worldwide. A recent report commissioned by the UK government estimates that, globally, 700,000 lives are lost every year to drug resistance. The problem is growing, the report says: resistant organisms will kill as many as 10 million people a year by 2050. This is the sort of doomsday scenario that prompted the WHO to name antibiotic resistance one of the three most important public health threats of the 21st century (along with foodborne diseases and outbreaks associated with malicious or accidental release of dangerous germs).

#penicillin #antibiotic resistance

0 notes

stillaliveinlalaland · 8 years ago

Text

Made it

If you would have told me 10 years ago I would still be alive today, I would have told you you’re wrong.

Actually, it all started almost 15 years ago with just a root canal. The dentist could not get my nerve numb to finish the root canal. Hate be graphic, but he even shot directly inside the tooth to try deaden the nerve. Yep, that was no help. I had to finish the root canal feeling everything.

This was just the start of my journey with this dentist and other oral facial pain specialist. My pain became bad in my face, that just breathing in on the left side of my mouth my teeth would hurt so bad it felt someone was putting ice on my teeth and face. I ended up with a total of 4 more root canals and a tooth pulled. Only to find out that was not my teeth.

Now the really fun stuff started. To be continued

I went to see a doctor, who I thought was a neurosurgeon. He had an MRI of my brain, pointed to an area and said, “This is your problem. You have Trigeminal Neuralgia”. I had no idea what he was pointing at, just looked like a bunch enhanced X-rays to me.

Trirgeminal Neuralgia is where you have an artery (vein) is dropping on your 5th cranial nerve, which is pulsating away the Myelin coating. By the way, your 5th cranial nerve is three branches of nerve on both sides of your head and face. The middle branch is the one that feels like it is affecting your teeth.

There was so much facial and teeth pain, I was will do do anything. Nothing relieved this pain. I tried all of the anti seizures drugs available. Not of them helped and pain medication did not help either. So I opted for what the doctor said was a minimally invasive surgery. This was in January, 2003.

This doctor had such an ego, he chose to remove me off of all the other medications I had been on for a year or more. Needless to say, I had a major panic attack and withdrawal symptoms at the hospital that night after the surgery. I asked who authorized lowering the doses of my medications from other doctors? Not one for of the nurses would reply, they just had the doctor call me. This was just the beginning of irresponsible behavior of this doctor.

A day later I left the hospital, still in pain and shaking from his imposed withholding of my other doctors medications. Most of these medications where for depression, so I don’t know what he think he was doing without consulting my other doctors. Turns out this doctor was not a neurosurgeon, he was a ears, nose and throat surgeon who performed these Microvascular Decompression Surgeries. This is brain surgery entering your brain behind your ears.

Within in weeks of the surgery, my pain was not getting better, just more severe. His office said I told him it was better, I doubt that. He said he could completely cut the nerve, but at this point I no longer trusted this doctor. Moving along, 2 ½ years later the pain was so excruciating I had to leave the job I loved and excelled at. I made an appointment with the head of neurosurgery at UCLA. He said it was difficult to determine from the current MRI what was going on inside my brain. His suggestion was to go back in, make sure the teflon sponge was wrapped around the vein and do a partial rhizotomy on two sections of the Trigeminal Nerve (v-1 and v-2).

Now the long repair surgery….. In July 2005, the chief of neurosurgery at UCLA thought my surgery would only take 1 hour. Unfortunately 4 ½ hours later, he was just finishing. What the original doctor did was place a teflon sponge directly on my trigeminal nerve from the brain stem completely over to almost the end. It should have been just a small teflon sponge wrapped around an vein that was supposedly dropped onto the trigeminal nerve. Not the case for me.

After waking up in the recovery room, I was in so much more pain. This was due to the nerve now becoming a live wire. It’s like removing the plastic coating off of a cord and you’re looking at the copper wire flickering. The flickering is the pain that hits the face directly. I also had a partial rhizotomy, which left me with my left forehead, left eye and part of my left face permanently numb. But, I also had a lot more pain. In January 2006, I applied for a deep brain stimulator. I had to go through a lot psychological testing. Finally was approved in late July 2006. In late August 2006, the new neurosurgeon put in a “testing” temporary deep brain stimulator. The surgery took for this took quite a while and is something I don’t recommend. Very painful.

The permanent stimulator was placed the follow week, which was the weekend before Labor Day. Unfortunately, I developed a psuedemonas infection in my brain. I was then hospitalized for 10 more days while the doctors tried to determine what antibiotic would work for the infection and that I would not be allergic to. Who knew someone like me would need an “ Infectious Disease” doctor.

After two more brain surgeries, another 3 week IV course of antibiotics, it was decided to remove the device from my brain. This was October 2006. Just in 3 short months, I had 4 brains surgeries with two rounds of double twice a day IV antibiotics. I was having just so much fun.

After waiting months for my head to heal, and no infections were left the neurosurgeon said he could re implant the device (Deep Brain Stimulator) for the permanent facial pain I was in. So on April 24, 2007, I went in for the re implant of the stimulator. I woke up the next day, which was my 20th year sober birthday is less pain. This wasn’t a fix all, it just helped with some of the major nerve damage done.

All was going better until July 2008. I started having this incredible abdominal pain. At first my doctors didn’t know what it was. I had a CT scan and it turns out both my gallbladder and appendix were kaput. So I’m the first week of August 2008, I had them both removed. The pain from both of these was just excruciating. Never thought you could hurt so much in the middle of your body.

On the road to recovery once again. In 2011, I again started having stomach problems. I kept seeing my gastroenterologist. He sent me for all sorts of tests. I changed my diet completely. Nothing helped. My gastro suggested I see a cardiologist. So I had a complete cardio work up. My heart was in great shape. Finally went back to my gastro and his reply was, “I don’t know what to do for you. Go see you pain doctor about your stomach pain”. I was so shocked. I just got up and walked out.

My pain doctor referred to me my current gastroenterologist, who I absolutely love. This new gastro is the one who told me that some individuals stomachs need serotonin and I was one of them. Within a month I was so much better. So the end of 2011 was the best since 2002. Now 2012. At the end of August 2012, I started having pain on my upper right side of my stomach. I saw my gastro and we increased my acid reducer, and PPI. This helped some.

By November I was in incredible pain from the upper right abdomen and around to my back. I started getting sick to my stomach. My gastro said get to the ER and will get you checked in. Turns out the my liver and pancreas numbers were skyrocketed. I found out that I needed a ERCP, which basically is a scope goes down your throat to your pancreas and bile duct. My bile duct was almost completely closed. The doctors opened it up and the pain left. Thank God!! This was just before Thanksgiving.

On Thanksgiving, the pain came back but this time it was on both side of my upper abdomen and going through to my back. I thought maybe I was also having a heart attack. I was back in the ER with my liver and pancreas numbers out again. The doctors checked me in and decided that I probably needed a stent at my bile duct. So another surgery. After the surgery this time, the pain was still there. The doctors just sent me home.

Now January 2013, I’m getting sicker. Can’t eat with getting sick. The only thing that helped the pain was a heating pad on high set directly on my stomach. I had to sleep sitting up, because every time I laid flat or to the side the pain was unbearable. I never have cried so much and I’m not a crying type of person.

I started seeing doctor after doctor. Not one could tell me what’s wrong. So one day I’m at my ophthalmologists office to have my eyes checked, since my left eye is numb from one of my brain surgeries. He suggested I be checked for autoimmune diseases. This April 2013.

I finally was able to get in to see a top rheumatologist near Cedars Sinai. He took a lot (10 vials) of blood and put me in 40 mg of prednisone, which is a steroid that helps reduce inflammation. At that point, I had already lost 30lbs. I looked so anorexic.

I had already paid for this convention in Maui and really wanted to go. Just before I left, as I was still in the extreme pain, the rheumatologist increased my prednisone to 60mg a day and started me on a immune suppressive drug.

#stivealiveinlalaland #Aliveandsurviving

0 notes