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Weird when you first start paying attention to animal noises and realize they don't actually sound like the words we use

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broooo did you seriously disturb my eternal rest & bring me back to this mortal coil just because my ancient enemy the eternal night has returned? after i sealed it away and everything? which one of you tampered with my binding runes 🙄

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▬▬ι═══════>✧*:･ﾟ✧

Reblog to give a trans man a kickass magic sword this pride month

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discussion about right wing radicalisation focuses near-exclusively on men becoming white nationalists but i wonder how it might manifest elsewhere. like, imagine a heavily online subculture of mostly women and they're dedicated to rooting out degeneracy, maintaining a rigid social order, refusing to acknowledge scientific consensus, being violently paranoid of a dehumanised other, adhering to exclusively eurocentric standards of beauty and politically dedicated to exterminating a minority group (possibly one that was already historically targeted for genocide). that'd be fuckin crazy lol

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Happy 10th birthday to the best tweet of all time.

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all i wanna do is eat nectarines and think about aurora borealis st. elmo’s fire gigantic jets ball lightning green flash earthquake lights and will-o-the-wisps

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“Hot and bothered” in the sense that it is 90 degrees out and I am extremely annoyed

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YOU HAVE ENTERED

RADICAL SATURDAY

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Romantasy and dark romance authors need to stop making big brooding guys whose only personality is "touch her and you die" and consider the appeal of creating a hero whose face is likened variously to a worm wriggling out of old cheese and an adjutant stork and who says things like "don’t let’s bring Socrates into this” and “I had found you beyond all hope or expectation, at a time when I thought no woman could ever mean anything to me beyond a little easy sale and exchange of pleasure and I was so terrified of losing you before I could grasp you that I babbled out all my greed and fear as though, God help me, you had nothing to think of but me and my windy self-importance, as though it mattered, as though the very word of love had not been the most crashing insolence a man could offer you."

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can you all tell me and be haters for a bit

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For Pride Month, I would like to throw my very long and pointy green hat in the ring.

[Disclaimer: this is 100% a joke and not a real audition unless you like me, in which case, I am very serious]

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i have a croissant related grievance

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Personality test, is 80f/26c too hot for you?

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I had a patient come in the other day because she wanted her IUD replaced. It was at the end of it's life and she loved having her IUD, this was her second one. My MA let me know that the patient was very anxious about getting the IUD replaced, she'd had painful experiences in the past with her other replacements and was dreading this visit for that reason.

I spoke with the patient and she was literally shaking with anxiety. I asked her to describe her prior experiences as well as what she liked about her IUD and what she didn't like. She said that she wished she didn't have to get it replaced so often, so I recommended we place a Mirena instead of just inserting a new Kyleena IUD. She was nervous about this because she didn't want an IUD that was big. I explained that the Mirena and Kyleena are essentially the same size but the Mirena lasts 3 years longer and would likely bridge her to menopause given her age whereas with the Kyleena she'd probably need another replacement to get there. She was okay with trying the Mirena.

I then talked to her about pain control during the procedure as this was what she was most worried about. I asked about her prior experiences and then laid out what I wanted to do to try and improve her experience during this procedure. I told her I planned to give her prescription strength ibuprofen, a heating pad, and a very dense anesthetic block in her cervix to hopefully make it a better experience. If she had had someone to drive her home I would've also given her an ativan because we have studies that show patients who report higher rates of anxiety surrounding a procedure also report higher rates of pain associated with it.

She was down for this plan. I gave her a very dense block, she only felt three small injections and then nothing else. She was shocked when I told her that her old IUD was out and the new one was in. She didn't believe me when I told her it was over.

I don't tell this story because I wanna brag about how amazing of a doctor I am because I'm not. I tell this story because this is the way IUD insertions SHOULD go and I want people to know that IUD insertions do not need to be traumatic. And I want other providers who may insert IUDs to know that a paracervical block should be your standard when it comes to IUD insertions.

When people find out I'm an OBGYN, complete strangers, acquaintances, etc. , the two things they like to tell me immediately are their horrible birth trauma story and their terrible IUD insertion story and I'm trying to at least make the latter one a little less common.

If you place IUDs and aren't doing a cervical block, you need to start. This should be the standard but over 90% of OBGYNs in the US aren't doing them and it's unacceptable. We are traumatizing people and it's entirely avoidable. We are scaring people away from one of the most effective and long lasting forms of birth control in a time when people are losing their ability to end unwanted pregnancies all for no justifiable reason.

"It takes too long:" No it doesn't, that visit took me 20 minutes with a highly anxious patient from start to finish.

"It's not worth it for such a short/small procedure." It's worth it for the patient.

"It's too expensive." You can do a paracervical block with just normal saline. You don't even need lidocaine if you use a generous amount of volume. And if you place Nexplanons I know you stock lidocaine in your office, stop being fucking cheap at the expense of women's pain.

"Patient's don't need it, they'll get over it." I'm telling you they do need it and they aren't getting over it as evidenced by literally everyone wanting to tell me about their terrible IUD insertion experience as soon as they find out I'm an OBGYN.

We should do better. The cervix has nerve endings, stop acting like it doesn't.

Make cervical blocks your standard of care, there's no excuse not to.

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The kids on TikTok think that just because he was a classic country singer, Johnny Cash was conservative??? My babies he covered a Nine Inch Nails song in his seventies.

Classic country singers (the majority of which came from poor roots) were always talking about how much The Man sucked because they were taking money from poor rural folk. You’re gonna tell me that’s conservative?? Get outta here.