#Office-Based Anesthesia

[indianapolisendodonticspc]

Indianapolis Endodontics, PC: Offering Office-Based Anesthesia for a Comfortable and Relaxing Experience

Indianapolis Endodontics, PC is a leading provider of endodontic care, including root canals and other specialized procedures. The practice is committed to providing patients with the highest quality care in a comfortable and relaxing environment.

One of the ways that Indianapolis Endodontics, PC achieves this is by offering office-based anesthesia. Office-based anesthesia is a safe and effective way to provide patients with deep sedation or general anesthesia during their endodontic procedure. This can be especially beneficial for patients who have severe dental anxiety or medical conditions that require special attention.

There are a number of advantages to having office-based anesthesia for endodontic treatment. First, it allows patients to remain in the comfort of their dentist's office, rather than having to go to a hospital or surgery center. Second, office-based anesthesia is typically less expensive than hospital-based anesthesia. Third, office-based anesthesia allows patients to recover more quickly, so they can return to their normal activities sooner.

Indianapolis Endodontics, PC has a team of experienced and qualified anesthesiologists who provide office-based anesthesia services to patients. The practice also has state-of-the-art monitoring equipment to ensure the safety of patients during their procedure.

If you are considering endodontic treatment, Indianapolis Endodontics, PC encourages you to ask about office-based anesthesia. It may be the best option for you to have a comfortable and relaxing experience.

Here are some of the benefits of having office-based anesthesia for endodontic treatment at Indianapolis Endodontics, PC:

Comfort and convenience: You will remain in the comfort of your dentist's office and be able to return home the same day.

Affordability: Office-based anesthesia is typically less expensive than hospital-based anesthesia.

Quicker recovery time: You will be able to recover more quickly from office-based anesthesia and return to your normal activities sooner.

To learn more about office-based anesthesia and whether it is right for you, please contact Indianapolis Endodontics, PC today.

[thevoidstaredback]

So, I had a dentist appointment two(?) weeks ago(ish) and they said I had to have a lot of work done, starting with getting my wisdom teeth out. Because of related ✨trauma✨, they have to knock me out. I told them "If I have to be conscious, I will bite you." The only thing I agreed to be awake for was the crown and that's because they glue that in place (or so I'm told)

The anesthesiologist will only come in on a Wednesday, so we have to work on their schedule. That's fine. Every Wednesday is open for me up until Aug. 7th, when I'll be out of the city.

Anyway, the anesthesia alone is gonna be a fancy $15,000. Add the labor cost on top of that. The receptionist said she'd figure out cost and stuff and how much insurance would pay and that she'd get back to us. Great, that's fine.

Unfortunately, my wisdom teeth didn't get the memo that we need to wait for her to call because the bottom left one is starting to hurt. As in throbbing hurt and it's starting to hurt my left ear.

Yay. Fun. I will might cry.

The office is closed until Monday 8am, so I can't even touch base for another day.

And before anyone says, I can't take medicine. I can choke down liquid and gummy meds, but I can't force myself to take pills. The only kind of pain meds in this whole damn house are pills.

Can someone come knock me out until Monday? I don't want to be in pain anymore

Edit: Fuck it! I'm in too much pain for this! I'm making mom take me to the store to get some medicine I can take. It's only 22:03

Update: Liquid ibuprofen isn't a thing for adults, so we got the kids stuff. When we got home, we asked my grandma (former nurse) how much I should take. She said 10 shots of the kids stuff would equal the normal adult amount for my age. I took 2 because that's what momther decided.

[pyr0lagnia]

Medic x reader ageplay headcanons? Maybe some drug induced regression or straight up just playing with your unconscious body like a baby doll lol

banger of a request i hope you have a good day nonnie ♡ i ended up leaning surprisingly sfw FOR THE MOMENT because medic is. he is so. its so hard to imagine him as much more than someone who would just mockingly infantilize u

( :̲̅:̲̅:̲̅[̲̅:♡:]̲̅:̲̅:̲̅:̲̅)

tw for : nonconsensual drugging, infantilization, sexual implications at the end

♡ it's not intentional by any means, he was really just playing around to see what happens. he tends to just drug people willy nilly if things start getting a little too boring around base. i mean, what else is there to do? well, plenty, but i digress.

♡ you, being fresher than the other mercs, weren't so used to it. while the others brushed it off or got irritated at Medic once they sobered up (or died), you were a bit less resilient.

♡ that just meant he wanted to drug you more though, oopsie! less tolerance meant more reactions yippee!

♡ he wasn't sure of what he had slipped in your cup when he called you to his office for a 'routine check up'. truthfully he loved plucking random pills, powders, and liquids just to fuck around and find out.

♡ your honest, trusting (at least, more trusting than the others...) expressions made him giddy!! explaining to you that it was just liquid vitamins, you took it with only a moment of hesitance. you weren't absolutely oblivious to his shenanigans you were just more hopeful!

♡ it was obvious whatever concoction of stray pills were strong, the way your body started to visibly lean into itself only a few minutes after consuming. you expressed drowsiness, but hey, you were with your doctor, it'll be fine.

♡ he would coo at you, brushing it off as "maybe its just the leftover cleaning chemicals in the air making you dizzy! don't worry about it, this will be quick!"

♡ with only a gentle protest from you, he would slip his arms under yours to lead you to an examination table.

♡ if you asked him why the table was necessary, if it was just a checkup, he'd reason that you looked faint and pale and a table would be easier on your body if you were that weak from leftover chemical fumes.

♡ that explaination didn't sit with you well, but you didn't know enough about his routine to object.

♡ speaking of faint, you would've noticed a small little giggle from the older man if you weren't busy focusing on how limp you were suddenly feeling.

♡ great, yeah, maybe those weren't vitamins. maybe it wasn't the convenient chemical fumes that were making you dizzy.

♡ if you trust anything Medic gives you to be edible/digestable and safe, maybe you kind of deserve this, reader. don't trust fluids from creepy older men!!!!!!

♡ at this point, you cursed yourself. okay, maybe the one who is supposed to be taking care of the team isn't as trustworthy as you felt he should be. maybe Scout wasn't making up total bullshittery to fuck with you.

♡ he hovered over you, not making any movment attempts to fool you into thinking this was a checkup. he could recognize the signs of paralytics anywhere!

♡ slacking limbs, loose jaw, the worsening disorientation in your eyes. and yet you remained so vivid in your expression.

♡ if you were mad, he knew, he could tell, he didn't care.

♡ usually, NMBAs were used alongside anesthesia. considering how many surgeries he partook in, he had an excess of these laying around. maybe a few scattered across the floor, waiting for any old idiot to impulsively eat them.

♡ he debated on whatever else was in that drink, watching your body language while circling the table. but, whatever else that was alongside it didn't pop its ugly head out over the symptoms of the muscle relaxer.

♡ " mm, " he would pick up your loose wrist, and shake your hand. your fingers twitched from the movement, " you're familiar with this, i'm sure, hard to misunderstand these symptoms, yes? you're smart, hase, i know you can guess. "

♡ DONK. he let go of your wrist, letting it fall loudly against the table.

♡ look, paralytics were fun and all, but what could he really do right now? theres only so much fun someone can have with a living, silent doll.

♡ hm. he thought about reconsidering that thought process. he just needed to be more creative this time around

♡ he stared over you, waiting for anything else. your pupils were thin, eyes squinted. you felt cold, achey, uncomfortable.

♡ you let out a whine at him, and he tsk'd and rolled his eyes. " now, now, don't be whiny like a little baby about this, it is just paralysis. "

♡ a small gap of silence. he leaned closer to your face. " unless you are a baby? are you, häschen? is that a little game you like to play? "

♡ the Medic would stand there, still, watching you try to fight what might be something else. he tried to pull information from his brain on what he had- oh! datura!

♡ he had kept a bit left of some ground petals from a little experiment with Heavy. he recalled he stored the rest of the powder in a little baggy in his desk, and mindlessly, earlier, he had snatched that same baggy.

♡ don't ask what he was doing with Heavy. curiousity about the gruesome hallucinations that could come from this plant drove him a little insane.

♡ with THAT knowledge....

♡ " you are quite like a little toddler right now, aren't you? all limp, stupid, probably couldn't even eat without my help, could you, häschen? " he would bark out a laugh, " who am i joking with? of course you couldn't! look at you! silly silly me. silly me." he grabbed both of your arms, and tugged you up into a loose sitting position, keeping you still with a grasp to your chin and a hand on your side.

♡ he would spend plenty of time fiddling with your loose limbs mockingly teasing you while he waited for the poison to settle in you.

♡ as anxiety started to swathe you like a blanket, unfocused eyes catching shadows where they shouldn't be, you were able to work yourself into being able to grind your teeth. the loud noise made him grimace, and he'd hold your jaw shut.

♡ " not sure what i expected from you. hah, there was a reason i could never be a father. " he gripped your jaw so tight, bruising formed easily under his fingers. " would be so easy to just- rip everything from you, ja? wouldn't you agree?" he forced your head to nod, and subsequently dropped you against the hard table when all support was focused onto your head.

♡ " as if to prove my point, i dropped an infant. " Medic would remark lazily.

♡ knowing he wouldn't get an answer, he would poke and prod at you to get you to 'tell him about your hallucinations', but it was debatable if you could even process his words, even without the inability to speak.

♡ his infantilizing words did sink into you, influencing your weak mind state as you drifted in and out of being aware of being an adult. you felt five, but the size of your body and the blood soaking your body made your belief quake a bit.

♡ he would eventually get bored of just fiddling with you limbs as you attempted to make noises in response to the stimuli. as cute as the very quiet babbling and soft whimpers of fear were, he didn't expect it to last so long.

♡ he had work to do, so eventually he'd kind of. toss you on the ground next to his desk. he would look around for anything for you to fiddle with, before throwing a scalpel in your general direction.

♡ luckily you just kind of laid there like a dead fish against the cold ground.

♡ just to really be a dick, he'd probably pull off your shirt so when you pulled back from the drugs, shame would hit you. maybe being partially nude would fuck with your hallucinations and mindstate, too?

♡ would probably spend the rest of the time doing paperwork, and then staring at your limp body, then going back to do paperwork.

♡ i don't think he'd end up doing sexual things the first time this idea strikes him, but that would not last long if he made this a habit. seeing someone so limp and worthless in front of him always made his guts turn. it was just a matter of time. just. a matter. of. time.

[fatliberation]

Do you have any resources on going to the doctors while fat? Im tired of not being taken seriously, and I dont want to potentially trigger an ED relapse cause my weight was measured.

Oh, you know I do!! ✨

So, you actually do not have to be weighed at your doctor’s visit! You can explain to them that it is triggering for you, or you can simply opt-out and say “I’d like to decline being weighed today.” If you have to be weighed for something such as anesthesia or medication dosage, you can request a blind weigh-in, where you step on the scale backwards and the nurse will not show you the number they write down. You can also close your eyes.

If you’re feeling uncomfortable, you can go home at any time. Get up and walk away. Not feeling good about the experience is enough reason to end the appointment. You can say:

“I’m really uncomfortable in this appointment. I am going to put my clothes back on and leave.”

“I’m feeling overwhelmed right now. Can we reschedule this appointment?”

You don’t have to explain yourself to your doctor, and don’t worry, they’ve likely experienced this before. It’s written in the patients’ bill of rights that you have the right to refuse medical treatment that’s recommended by your physician and that you should be able to work with your doctor on mutually agreeable terms.

You may also request an online or phone appointment instead of in person. It’s f*cking ridiculous that this is actually true, but since covid began a lot of fat people have been receiving better care over telemedicine because our bodies are less visible.

If you get pushback from your provider, I recommend finding a new doctor. Your boundaries should be respected. Health At Every Size has resources to help you find a practitioner who will focus on your health independent from weight. (And here’s a list of fat friendly practicing health professionals by fatfriendlydocs.com. If you’re in the U.S., you can look them up by state.)

In the meantime, setting boundaries is your last resort. Let your doctor know that you are uninterested in pursuing weight loss, that dieting is a predictor to developing an ED, (and in your case, severely triggering for the ED you’ve already been struggling with). Ask them what treatment they would recommend for someone in a thin body, and request that they treat you the same.

If they don’t, ask them to make notes of the conditions they’re dismissing based on your weight. “Can you please make a note that you refused to test me for X on my file?” This might change their mind, or at least when you see someone else it’ll be on your notes and that other GP will (hopefully) take you seriously.

Here’s a video by @classyfattybabe that shows an example of this and other specific phrases to set boundaries with your doctor.

I am so sorry you have to advocate for yourself at the doctor’s office. No one should ever have to go through this. My heart is with you. Best of luck at your next visit, love ❤️

[readingsquotes]

"Shortly after October 7, Israel imposed a new set of rules in its cell blocks. In some detention centers like Ofer near Ramallah, the Israeli army was reportedly handed over control of the prison, while the Israel Prison Services guards were given a free hand in dealing with Palestinian inmates inside the jail sections. This shift was accompanied by a dramatic increase in the number of Palestinian detainees who were arrested after October 7, doubling the prisoner population as early on as mid-October. This included prisoners from Gaza, for whom the hardest part of the treatment was reserved.

In mid-May, CNN released an exposé based on the testimonies of Israeli whistleblowers about the horrific treatment of Palestinians from Gaza at the Israeli military base of Sde Teiman, now containing a detention center. The whistleblower testimonies detail a number of medieval practices to which Palestinian prisoners have been subjected, including being strapped down to beds while blindfolded and made to wear diapers, having unqualified medical trainees conduct procedures on them without anesthesia, having dogs set on them by prison guards, being regularly beaten or put into stress positions for offenses as minor as peeking beneath their blindfolds, having zip-tie wounds fester to the point of requiring amputation, and a host of other horrific measures.

On June 6, the New York Times published another story about Sde Teiman based on interviews with former detainees and Israeli military officers, doctors, and soldiers who worked at the prison, bringing new horrors to light about the treatment of Gazan prisoners. Detainee testimonies repeated many of these same accounts but also included additional disturbing accounts of sexual violence, including testimonies of rape and forcing detainees to sit on metal sticks that caused anal bleeding and “unbearable pain.”

...

In February, a report by UN experts concluded that some Palestinian prisoners had been subject to sexual abuse and that at least two female prisoners had been raped in Israeli jails

[ace-trainguys]

Old Art October - saved a spooky one for Halloween! Based on a dream I had - Ingo is the latest in a series of mysterious kidnappings. The imagery was strong so I drew some bits. More images and story/context under the cut, because here be horrors.

Body horror/gore, nonconsentual body modification warning

The culprits of the kidnappings? Old decaying Five Nights at Freddy's style animatronics. It seemed like they were simple ai that went rogue, wanting humans for some unclear purpose.

Well, for most the purpose was unclear. The robots discovered Ingo's voice after kidnapping, and were impressed. They decided to utilize it, for instructions and announcements in the abandoned facility they resided in. Just asking Ingo to read things wouldn't be sufficient - what if he said the wrong thing, gave out info to help the other captives escape? No, it would be much better to use a machine to force Ingo to say exactly what they wanted him to.

And they had just the device on hand! Just hook it up directly to a human's vocal cords, and you could type in whatever you wanted to make the person speak those words!

It requires a little opening up the human's neck to install, but that's not a big deal.

To the robots. It is a big deal to Ingo, tied to a chair, prepped for a hack job surgery despite his desperate attempts to escape. The robots don't see a need for something like anesthesia, or sanitization, or sharp tools. What's a little rust on the saw going to hurt?

Mercifully, Ingo passes out very quickly.

For some reason the operation doesn't get blood everywhere. They wire the device into Ingo's neck before stitching it back up.

Elsewhere, Emmet joins a group of people investigating the disappearances in hopes of finding Ingo. They find their way to the dilapidated building and investigate. When they accidentally set off an alarm, the voice over the loud speakers is one Emmet knows well. (See the image before the cut)

In a small office, Emmet finds Ingo, bound to a chair and with a strange machine embedded in his neck. The machine, in addition to forcing Ingo to say whatever is entered in, prevents him from speaking otherwise. So all Ingo can do is mouth his brother's name.

[yanderes-galore]

Fandom: BioShock

Character: Steinman

Pairing: uhh god worship? God and mortal? Idk how to say it but Steinman sees reader as the reincarnated Aphrodite (and reader doesn't need to be female, sure Aphrodite is the GODDESS of beauty but that totally applies to all genders)

Type of Fic: concepts or headcanons. Like I said, Steinman sees the reader as his reincarnated goddess Aphrodite, which is odd to him because they don't look perfect how he wants. But then his mad mind tell him that there's beauty in imperfections and the darling is the spitting image of that. (Sorry if this one is also kinda specific. It's based on my own belief that there's beauty in imperfect things and I want Steinman to realize that too.

I think I can do something with this!

Yandere! Steinman who thinks Darling is a reincarnated Aphrodite

Pairing: Romantic

Possible Trigger Warnings: Gender-Neutral Darling, Obsession, Worship yandere, Stalking, Manipulation, Kidnapping, Drugging, Forced relationship.

I can see Steinman in general feeling like his darling is a reincarnation of Aphrodite or seeing them as a gift regardless of gender.

To him you feel perfect regardless on how you look.

However he may be taken aback at first when he first meets you.

You look nothing like the Aphrodite he knows and wonders if you really are a reincarnation or he's just seeing things.

But yes, his mad mind reassures him that this is his Aphrodite.

Steinman just needs to learn that this new form could be a test.

Perhaps his goddess is testing him to find beauty in both the perfect and the imperfect.

He takes a while to get used to your looks and soon falls for you all the same.

Your beauty becomes all he can think of and he decides he must worship you.

At first he admires you from a distance, he takes in every detail of your form and remembers it for later.

He makes a shrine dedicated to you and your beauty.

Steinman can only think of you an how to appease you.

I can see Steinman soon drugging you with some sort of anesthesia and then restraining you in his medical office.

He feels you'll be safest here and the blood really compliments your beauty.

He hates it when you scream and tries to keep you in a half drugged state.

Steinman dedicates most of his day, sometimes even his night, worshipping you.

He tells you you're beautiful, your looks are mesmerizing.

He bows before you on his hands and knees.

Even when he's covered in blood he looks at you with adoration.

He lightly touches you and holds you, he praises you in never-ending phrases.

He tells you he's your servant, he's your hands to bless the people with beauty.

You have no idea what this man is saying but stay quiet out of fear.

Plus, forming a coherent thought past all the drugs is near impossible.

You see all the blood, you hear all the screams, you feel all of his touches...

But you can't move.

You're just meant to be worshipped in his shrine, a pretty exhibit meant to be looked at and adored.

[tieflingkisser]

The genocide in Israeli prisons

Families of Palestinian prisoners are kept in the dark about the fate of their loved ones at a time when Israeli prison authorities are creating conditions unfit for human life.

Israel’s genocidal war on Palestinians since last October has extended beyond the daily mass death, displacement, and starvation of the civilian population in the Gaza Strip. Behind the bars of Israeli prisons, Israel has been waging war against Palestinian prisoners, creating conditions that make the continuation of human life impossible. The effects of this brutal campaign have reverberated among prisoners’ families outside of jail, who are watching their loved ones being systematically starved, beaten, tortured, and degraded. Shortly after October 7, Israel imposed a new set of rules in its cell blocks. In some detention centers like Ofer near Ramallah, the Israeli army was reportedly handed over control of the prison, while the Israel Prison Services guards were given a free hand in dealing with Palestinian inmates inside the jail sections. This shift was accompanied by a dramatic increase in the number of Palestinian detainees who were arrested after October 7, doubling the prisoner population as early on as mid-October. This included prisoners from Gaza, for whom the hardest part of the treatment was reserved. In mid-May, CNN released an exposé based on the testimonies of Israeli whistleblowers about the horrific treatment of Palestinians from Gaza at the Israeli military base of Sde Teiman, now containing a detention center. The whistleblower testimonies detail a number of medieval practices to which Palestinian prisoners have been subjected, including being strapped down to beds while blindfolded and made to wear diapers, having unqualified medical trainees conduct procedures on them without anesthesia, having dogs set on them by prison guards, being regularly beaten or put into stress positions for offenses as minor as peeking beneath their blindfolds, having zip-tie wounds fester to the point of requiring amputation, and a host of other horrific measures. On June 6, the New York Times published another story about Sde Teiman based on interviews with former detainees and Israeli military officers, doctors, and soldiers who worked at the prison, bringing new horrors to light about the treatment of Gazan prisoners. Detainee testimonies repeated many of these same accounts but also included additional disturbing accounts of sexual violence, including testimonies of rape and forcing detainees to sit on metal sticks that caused anal bleeding and “unbearable pain.” Other depravities have been documented in several other prisons, often gloatingly by Israeli news channels who broadcast scenes of the abuse, including degrading treatment, in what can only be described as snuff films. Israeli prison doctors have assisted in the torture of Palestinian detainees, both before and after October 7. Alongside these acts of torture and humiliation, prison authorities have severely restricted prisoners’ food intake to the point of near-starvation, giving 20 prisoners enough food for two people.

[keep reading]

[johnniestheme]

simon and stellas lore

heavily based off the hawaii pt ii album by miracle musical

(early summer) 

determined to impress his deadbeat father, simon sails off to hawaii on a fishing trip. he finds himself caught in a storm which destroys his ship and leaves him washed up on the beach with nothing but the clothes on his back. stella finds him and gets him help. the octangulas offer simon a place to stay, in return for working on the small family orchard.

(late summer now, simon and stella have established a relationship together)

the city holds a yearly ball to celebrate the end of summer. simon asks stella to go with him and she agrees. after a while they sneak out the back and run off to "their spot" 

(an abandoned stone lookout on a cliff, with a view of the ocean)

as they jog through the forest together, simon catches his foot on a small branch. not realizing her date is currently on the ground, stella keeps running. simon scrambles up and immediately starts yelling out her name. his shouts grow more frantic as he hears a scream in the distance. blood seeps from her chest as he finds her collapsed on the stairs of the lookout, a knife sitting not far from her body. he gives her one last quiet goodbye before running off to the local police station for help. the group of men follow him to the spot of her murder, and simon is detained as one of the officers notices the blood on his hands. 

uuruurgghhh the court stuff is boring but basically the evidence is stacked so high against simon that he decides to plead insanity for what he assumes will be a lighter punishment. he is sentenced to electro shock therapy (before anesthesia was common) and is to be shipped off back to the mainland of the states to spend the rest of his life in an institution. 

(mid/late winter)

simon escapes after months of enduring the torture of the asylum. by the time he got out, the electro shock therapy had done a number on him. he forgot almost everything about him or his life, including stellas death. he only knows that he longs for someone, and that someone is in hawaii. determined to find her, he steals a small wooden rowboat, planning to sail off back to hawaii to find her. 

with absolutely no plan or preparations, simon takes off in the dead of the night. his mental health worsens the longer he is alone at sea, considering hes slowly starving to death. 

(this next part is planned to dsism, down to the very second, but ill try not to be too wrapped up in their every move)

in the middle of the third night, simon hears the sound of the water stirring. lifting his head, he sees stella standing over the water, looking no different than the night of the ball. she reaches out her hand, and as he grabs it, he is suddenly in his suit. the feelings of hunger and worry wash from his body. he doesnt feel tired anymore, just at ease. they dance on the water, and slowly up into the clouds, where they reside happy in heaven together

the end :3

and just to clear a few things up:

-the story is set in the 1960s

(in the original ref sheet drawings it says 1940s but my dumbass forgot hawaii wasnt a state until 1959)

-i have 2 versions of my hpii story. the first one (this one) is less realistic and has a few unnecessary changes because i just decided i wanted to

the second one is my hpii movie concept ideas. the movie concept is pretty similar with 2 exceptions. 

1: its more realistic (stellas last name isnt octangula, the court system is more true to life ect ect)

2: it sticks to the album better 

-last thing to know is im dyslexic so pretty please ignore the grammar mistakes. because of the built in spell check, spelling isnt usually a problem, but i do sometimes overcompensate with my punctuation, so theres probably a few out of place commas out there.

[rainbowgod666]

Sonic.exe: (drunk as shit) an' uh- you... y... uuuhhh... honestly? Your girl isss... rreeEALLYy cool actshtually... (demoman noises) aa- at leasth you donth av to let a one offf phrase thefine yu...

SCP-166 Epon: (showing off her eìre goddess side) y- yuyeaahhh... thscanks for teaching her about... th-uuuhh thE SECOND AMENDMENT (she- did she fucking down half a pint of hard liquor like th- IS THAT IN THE "APOCALYPSE KNIGHT" CODE?) WOOOOOOOOOO! thiss... thissum gus shite i tellyahwat...- anyway ye t- think its hardd? Boi lemme tell ye, im suppos' ta be the Foundation's WAIFU! And thossshshshsheee...ff... fUCKs go after... (sighs) the fuckin' furrybait shy girll

Sonic.exe: prEaCh girl, thats... thatsh whut ye learned from whenyou uh... l-lived in a c...hurch

Epon: y-yuh cause like... me father's alto cLef yknow??? He focken döömped me thaer! Me name meansh fucken MEESTÆK in HEBREw! Like???

Sonic.exe: at leASt yer creatorshnot a fuken EDGELORD! HAAAAA

(They both drown the cringe in alcohol)

Herobrine: the top sniper of the Creepypasta Unit and the Second Knight of the Apocalypse everyone. (Disappointment intensifies)

________________________________

Tumblr furry: hang on, i get to stay AWAKE and it still counts as anesthesia?

Aubergine Man: its some SCP shit but its actually harmless (turns on red lightsaber) anyway, you said you wanted to transition?

Tumblr furry: yes pls i need the gender euphoria

Aubergine Man: Based.

Aubergine Man: also you get a free blåhaj after gender-affirming surgery and you get three months of hormones free of charge, but then you need a renewal service and depending on the fandom the price can change-

Gaster (from the storage room): afton PLEASE dont advertise during sURGERY

Orochimaru, all the way from the office: yeah! Its annoying!

Aubergine Man William Afton: ah whatever, anyway time for some personalized genital moddding :D

_________________________________

Eric: so... uuhhh

Kyle: no, i wont tell anybody WHAT you used as the generator for dickinbaus

Butters: you promise?

Kyle: considering that i just saw 30 SCPs taped toghether to generate infinite energy from a taco-bell induced diharrea attack from cartman, yeah

Eric: good.

Eric: so... (looms at butter) you wanna do a nuclear warcrime? I want to staple a nuclear reactor to the dickinbaus

Butters: yeah! Nuclear energy!!!

Kyle: what the fuck is wrong with you two

________________________________________

Pomni: what is this... white space?

Ink: welcome to the anti-void

Uncle grandpa: its basically an infinite canvas at the bottom of the undertale multiverse.

Dr.bright: its also a physical version of the Noosphere

Pomni:... a- (spontaneous combustion)

I fucking told y'all

(All the charachters that ever canonically knew or had access to a "white space" like the undertale anti-void/uncle grandpa "intermission space" proceed to nod, agree, and talk about how such a simple concept is THIS complex apparently)

______________________________________

MONIST-1 RA: when i discovered that "Deimos" is also the name of a Madcom Charahcter i... genuinely liked this rock even more

Metat Aun: some people compare me to a scene of an extremely ancient cradle film... "2001 space odissey"... whatever tf that means

P.O.L.L.V.X.: a pilot canonically "pacified" me by having yaoi seggs with me

(Everyone embarassed)

Lancer!Alex (callsign ALPHA): (face bursts from pavement like he got shot from a basement or shit) and i would do it agaaain~

(All NHPs are now currently screaming in abject fear at the UwU NHP-Fucker pilot)

_____________________________________

Collector: why are we in ukraine?

Sonic.exe: i wanna teach you how to use a sniper rifle by killing some REALLY bad russian generals

Collector:... considering my lore, i would like you to define "bad"

Sonic.exe: the one we're "hunting" rn? He kills 10% of his squad every time they lose. And they lose A LOT.

Collector:...

Sonic.exe: were using Alex's "special ammo". This one is .65 BMG, Telekill/Depleted Uranium anti-tank DARPA. And theyre encased in fucking NuclearCraft Extreme Alloy. Because the powder used is so reactive it makes caesium and water look like a fart in a kids cartoon.

Collector:... (realizes that theyre basically launching nukes out of a customized-af barrett) what the fuck is Alex ON when he does these things???

Sonic.exe: the autistic spectrum

Collector: oh yeah right

_______________________________________

(48??u or something idk)

Xian Xiaoli: i need a melee weapon but all i have is the pieces to make a shotgun the size of a Barbarossa!

RA, from a busted radio: then do it?

Xian: how???

RA: let me use my Funny OP-plz-nerf Paracasualty Powers

Xian Xiaoli: (MONIST-1 RA enlightened noises)

Xian Xiaoli: (shudders) whOOH! That actually felt kinda good... thanks!

RA: any day girl!

___________________________________

Shinji: just so you know, i figured that you didnt wanna do this to "save humanity"

Kaworu: how did you know?

Shinji: Kaworu, we have been lovely breeding each other for 6 hours straight. Its 2 AM and were naked under the covers while we cant feel our S H L O N G S anymore, this is TOO gay to be a "world-saving effort", and honestly?

Shinji, fully embracing kaworu: i wouldnt have any other way ❤️

(They then kept being lovebirds throughout the entire night. Rei was the only one who knew about this but shes based enough that when Asuka asked her she roundhouse kicked her into the wall) (because rei is THUG LIFE BAYBEEEE)

_________________________________

SCP-096: wait, WHAT

Umbral: yeah, my name is like this because he thought "Number 96" sounded dumb. And one day he goes "actually when I watched the anime i never figured out your name" SO NOW HERE WE ARE!

096: at least its a good name...?

Umbral: THATS THE ONLY UPSIDE-

____________________________________

Betê Noire betty: please tell me you're joking.

Bright: yep. Were now Alex's OCs because our creatore were associate with Predators

Betty: what

Bright: yeah hes like that

Betty: ALEX IS "LIKE THAT"? HE PHYSICALLY WANTS PEDERASTY TO REMAIN A THING OF THE GREEKS AND NOT A CRIME. Which would be good... IF HE DIDNT WANNA ANTIMEMETICS HUB IT OUT OF THE HUMAN PSYCHE

Bright: yep. He has good intentions, but sonetimes the way he goes about them are... excessively violent.

Betty: and he excuses his mistakes with autism?

Bright: only when its ACTUALLY the autism

____________________________________

Hank: no you dont get it- Rye is the girlfriend, and Chelsea is the emoticona support pillow

Chelsea: exactly

Rye: (whispers to chelsea) wait so we take turns?

Chelsea: (whispers back) yeah girl, i got the assets but you got the wholesome

Rye: (whispering) aww tysm

____________________________________

Hunter: honestly nice UNO win there, anyways why are we in your room and what did you mean by "taking your rewar-"

Willow: (stretches Vine like whip)

Hunter: (blushing HARD) oh shit-

(30 mins later, in the living room)

The collector: (staring right at Luz and Amity with the eyes of somebody that is 👌 this close to SNAPPING.) this is what i hear every fucking time i just wanna play pokemon in PEACE, and you two decide to give more material to the "next generation" part of our fandom.

_______________________________________

Monika: ok no seriously Alex, your mom is right- YOU CANT BUY MORE YUGIOH DUDE STAHP

Need content for unboxing. ( ◕_◕)

Monika: (mental breakdown) why are you like this

___________________________________

Bright: i still feel you did something REALLY stupid

Clef: RE-LAAAAAX. Alex is a literal eigenweapon but he has a moral compass, hes gonna go there and do the job

Shaw: clef. You basically unleashed the only thing that can kill 682 (and then ressurrect it for "natural order" bullshit) on a small CI platoon that managed to get SCP-882.

Shaw: you sent a nuclear bomb eater to recover a nuclear bomb from nuclear thieves

Clef: (realizes that he is gonna be the reason the Veil is gonna be used as a hanging rope for the CI) fuck.

___________________________________________

Epon: why does my "knight" form... excite you so much

Sìgurros: girl, look me in the eyes and TELL me that "fiery war goddes of bare-handed murder with toned abs and large bazonkas" isnt peak waifu

Epon: (teary-eyed from the compliment) t...thank youuuu 🥺

Sìgurrós: exactly :3

____________________________________

Benjamin kirby Tennyson: i feel like i am forgetting something important

Rex salazar: well you know how the reference goes

Daniel Fenton: if you forgot then it wasnt important!

Ben: u guys are right :3 its probably nothing

(Meanwhile, a few trilion lightyears from earth...)

Alex (Gear5): Ğømü ģòmų ñô...

Divinity: WAIT PLEASE NO-

Alex (Gear5): MÜŁŤÏVĘŘŚÉ ĞÂŤĻĪŃĞ!

Divinity: (cant speak on account of getting fisted from across every fandom ever at once)

_______________________________

Belos: what.

Luz: yeah so... Alex is about to kill us all

Alex (Gear5) Alex-ULTIMATE FORM : GOMU GOMU NO-

Collector: and its all your fault

Amity: and YOU wanted to join forces with him

Odalia: yeah i know dear daughter, i mean- you get a girlfriend that is a human with less manners than a wild animal? Eh i can survive that. The literal emperor of the boiling isles being not only ugly, misoginistic and bigoted, but also a massive idiot? Oh titan NOPE

Hunter: yeah... considering what he did until now, if i knew he was THIS stupid i would have defected the instant i saw someone else even remotely smart

Alex-ULTIMATE FORM:

DIGAMMA METEOR!

Eda: congratulations, youre a failure

Belos:what-

(And then everyone died in a gigantic HBM mod themed explosion because yes.) (AND there was epic music behind it because here in italy we use sick beats as condiment for explosions)

_____________________________________

Herobrine: between Entity303 using all our internet connection for yaoi, and SCP-4335 basically being kirby but with even less braincells?

Herobrine: better than the screming italians and their constant overkillage anyway

Bill: the what

____________________________________

Scunt player: what... ARE you?

Alex, omnitrix transformation 250 "team fortress" version SCOUT ultimate form cyberpsychosis scout: im... your upgrade?

Scunt player: that explains the green

Cyberpsychosis scout: those are a ben 10 reference

The entire fucking server: (peeks to see whats happening) what.

__________________________________

Jax: you know, i get that i need to be nicer to others...

Jax: but INFINITE OVER-THE-TOP ULTRAVIOLENT TORTURING IS NOT WHAT I EXPECTED

Talloran: BOO! GROW A PAIR!

Jax: (crying in existential pain)

Lmao get rekt

Pomni:... why do i feel satisfied looking at this

________________________________

Pomni: i want to kill.

Caine: what

Pomni: (looks right at caine) you will be the last one to see this place die.

Caine: what???

Ragatha: (blushing) woah uh-

Pomni: (points to ragatha) you shall reign over the aftermath of my fury.

Ragatha:... thats actually kinda hot ngl

Caine: WHAT THE-

_________________________________

049: im sorry what

1048: ok look we get it sounds weird but-

2295: we want to build an EVA unit!

049: WHY ARE YOU ASKING ME-

_________________________________________

(Downtime action "Go Diving", gain result 6)

ALPHA: what the fu-

SCP-035: so uhm... if you ever need to know, SCP stuff is compatible with this setting but uuuuhhh... NOT the other way around!

ALPHA: i have questions and that wasnt one of them

_________________________________________

Chara: why does the fnaf movie have a scene where a child does MY "eyes bleeding void" thing?

G. Freddy: in that film im the 「stand」 of a little girl and matpat is there to do the "just a theory" line. Dont ask wtf were the producers smoking

____________________________________

Sonic.exe after hearing about the "pissing on the moon" incident: yeah sure, like eggman actually DID that...

(A few hours later)

Sonic.exe: (traumatized)

Sonic: we told you.

Shadow: seriously, he was drunk, what did you expect.

Sonic.exe: (broken innocence noises)

Tails: is he gonna have that thousand-yard stare for long? I need somebody to debug a program...

__________________________________

Baby: i excuse the glorified dress-up but i draw the line at tHIS

Afton: (doing the California Girls meme as a mass of wires in the Vanny costume... all while the "proportions" are "exaggerated") this is how its fucken done :>

Gregory: really. THIS is the villain of the series?

Baby: the film removed all the nuance dear

Gregory: sick claw tho

Baby: ty

____________________________________

Cyana: (looks around)

Cyana:

Cyana:.

Cyana:..

Cyana:...

Cyana: where the fuck am i.

___________________________________

Susie: kris where the fuck are we

Kris: this is the chernobyl reactor in 1989, we are here because Towa from DBXV wants to stop Boris The Slav Superstar to crawl out of Reactor 4

Susie: oh yeah, side gig at the dragonball time patrol, i remember

Kris: you need some Omega-3 girl

Susie: where the fuck do i find all that fish tho?

Kris: do i LOOK like i would know?

__________________________________

Herobrine: ma dici che qualcuno ci fa caso che noi due (come tutti) sappiamo l'italiano

Sans: seeeeeeeeh come se qualcuno ci facesse caso

Herobrine: la "libreria" a snowdin si chiama "librerbia".

Sans: ...senti un pò blockman-

____________________________________

Alex: im 70% sure this is normal

Cross: Alex, Xgaster is getting springlocked

Alex: yeah thats what i said

Xgaster: (suffering for his fandom crimes in an excessively graphic way)

_______________________________________

Astolfo: being in the testosterone squad is actually really based

(postal dude does a terrorism)

Astolfo: i mean, the only reason im here is that all my testosterone went in my Monster Can and im also pretty sure its also a health problem for future me but hey i get to be the sniper because i have the lowest T of all the squad

Astolfo: (another Gmod explosion in the background) which is probably ANOTHER health hazard. but Duke smokes literal kilos of cigars a day, Postal dude heals using crack, and im pretty sure Slayer is like, 1% Biologically Human so im... probably fine!

Astolfo: we get full health benefits (not just dental) and we kill people as the most masculine team ever, so we're not getting bored anytime soon

(another fucking explosion but this time its CLOSER???) (boi wut dhehel boi)

______________________________________________

Cimmerian: i have no idea WHY am i able to kill Alex by telling him hes wrong.

Cimmerian: and at this point? im not fucking asking.

________________________________________________

Frisk: wait, how did we end up like this?

Betty: see, the thing is, Alex rewrote like three AUs toghether and taped them to eachother, and it WORKED. years later we do wacky adventures and right now were fighting plantera

Asriel, currently escaping from the funny omega flowey joke: FUCK FUCK FUCK FUCK FUCK FUCK FUCK FUCK FU-

Frisk: yeah its the last part thats confusing

Chara (flying on a- thats a fucking jetpack): Dimensional Breach. we are going deep into Asriel's Terraria file to grab a zenith and unfuck things up back there

Frisk: ok... still doesnt explain asriel's starter weapon being a funny prism tho

__________________________________________

Massive wave of mindustry drones all ominously chanting the "hamburger cheeseburger big mac whopper" song:

Alex: so yeah, im gonna out-drone robotnik

Sonic:...

Sonic:... compared to eggman, robotnik is fucking insane

Sonic.exe: and extremely pathetic

Sonic: exactly my (technically our) point, but still; Alex. WHAT THE FUCK

Alex: IM GETTING THIS FUCKING SECTOR

IM GETTING THIS FUCKING SECTOR

Sonic.exe: oh no hes doing that thing where hes both in and out of this reality

Sonic: fuck

____________________________________________________

Ink: so uhm... should we do something about that?

(SCP-3125 stuck in the threads holding the papers that make the Undertale Multiverse while other SCP gods try to pull him out)

Error: NAAAAAH

__________________________________________________

Uncle sam: (turns out to be an immortal sarkic man that genuinely wants to help)

[REDACTED]: let him cook.

_______________________________________

Vriska: 4r3 y0u 3v3r g0nn4 w47ch 0ur 53r135?

Tf do i know

Vriska: FU-

_____________________________

Shaggy: like zoinks scoob

Shaggy: we fell in the backrooms

Scooby: ruh roh

________________________________________________

Rick:... tumblr is-

Emptier than you expect?

Rick: yeah.

[sunshine-and-pink-skies]

Y'ALL I'm having sinus surgery!

My whole life I've had allergies and sinus issues. I stay sick with sinus amd ear infection ls the entire time from October to April. The last couple years have been so bad. I finally got a primary care doctor last year and FINALLY got an Ear Nose and Throat Doctor. It only.took 20minutes for the doctor to be like "Oh its a hot mess." 🤣

Well I spent 3 weeks at my Sister House and on my way back home yesterday, Tuesday, a call that my Insurance denied preauthorization to fix my deviated Septum. Which is only one of a few things he's doing. Called them. Paperwork missing. I stopped driving to call the doctors. TEN times. And no answer.

So the first thing I did this morning was go to the ENTs office. I didn't even eat breakfast first. That's how serious it was. The nurse was working from home. And I was like "It has to be fixed TODAY. It's holiday tomorrow! Nothing will be open and my surgery is the next day." So got another nurse to call. They get told all the paperwork is there. And and approval is pending based on review. Marked urgent because TOMORROW IS A HOLIDAY.

So I called the Insurance this afternoon and get told they'll review it and have an answer before end of day.

And an hour later I get the email it's been approved.

I'm so happy. I was really worried it wouldn't get straightened out.

I wanted to go to an ENT 20 years ago as a teen. But a friend of a friend of my Mom's died during sinus surgery bc they didn't know he was allergic to the anesthesia. And my Mom noped out.amd REFUSED. it's been a long time coming.

But anyway I'm SO EXCITED. Like I'm so excited it's weird. 🤣

---------

tldr: I'm having sinus surgery. There was a minor hiccup but it got straightened out. And I'm so excited it's weird.

Send good thoughts and any surgery recovery tips you have my way.

[scholarlypidgeot]

Prompt: “You’re a disaster.” “Thank you!”

"Oh, no, you don't get to just stumble onto my operating table and not tell me how it happened. You know my rules."

Even as Doc said that, he moved about the little office. Pat stepped out of the way whenever he rushed past, but he didn't even seem to notice her. When he swept back over to the table, it was with a knife in hand. With little ceremony, he took the back of Ash's shirt and cut it cleanly down the back before pulling it off. Ash barely flinched, although she watched as he dropped the fabric to the ground.

"I liked that shirt."

He dipped a curved needle into a clear solution. "You should have thought of that before you got it torn to shreds anyway. There wasn't any hope to save that anyway."

"Well, it wasn't exactly my intention when I put it on." Ash's face twisted visibly in pain as she pulled her feet up onto the table, catching the boot heel on the edge of it as she did so that the shoes fell on the floor before she crossed her legs in front of her.

"Nothing you say can convince me you didn't go looking for trouble. Not if you turn up like this."

"It wasn't the usual kind of trouble!" Ash protested as she watched him thread the needle. "I wasn't hunting."

"The last time you 'weren't hunting' and you turned up like this—"

"I didn't go looking for him, either." She sighed. "I probably wouldn't've even come back if I did."

Pat wanted to ask a question, but this was the wrong time to interrupt, so she just watched and listened. For his part, Doc just raised a thick eyebrow as he pulled on a pair of leather gloves, the thick and durable kind that based on their condition were kept impeccably clean between surgeries. Ash sighed again, this time with a barely hidden tremor to her voice.

"I had an informant turn on me is all."

"Strong informant."

"C'mon, Doc, I wouldn't lie to you about that."

Doc stepped behind her. His face was stern, but otherwise unreadable. Ash winced again a little as he placed a hand on her shoulder to brace.

"No anesthesia?"

He barely paused.

"First, you know most of the doses I have on hand would probably kill you. Second, I know that you wouldn't take it even if I offered it to you."

"You know me so well."

"We do this dance too often for me not to."

Ash barely flinched as the needle pierced the edge of the gash in her back, and didn't move after except to close her eyes. Doc's hand rested professionally on the back of the woman he loved, the one he'd inevitably break up with by the end of this procedure. Pat hadn't been here to witness it before, but she'd seen the consequences too often in the brief time she'd worked with Ash. For now, though, they were doctor and patient, and seemed far too used to those roles.

While Doc worked, Pat could now see the full extent of the scars that laced Ash's torso. A few were long and had once been deep. But there were others, hundreds of small scratches and punctures that were silver against white skin. Her body was a map of every fight she'd endured, the scars the stars in the sky of her history. Her new injuries included the deep gashes on her back that Doc seemed to prioritize, and what must have been a bite on the inside of her elbow that was hidden under a bloodied bandanna. There were other, smaller bites from where the Seelie addict must've tried desperately to get another hold after losing the first one. There were other, less severe scratches along her sides and on her opposite wrist.

Doc interrupted the silence by saying, "You should stop paying your informants in blood."

"It's better than some of the alternatives." Ash's voice was a little strangled, but far clearer than Pat's would've been in her circumstances.

"Giving them money like a normal officer wouldn't land you on my table this often."

"Are you sure you wouldn't miss this?"

"Or using blackmail."

"You're encouraging worse behavior?"

"You use it anyway."

"Not that you can prove."

"You're a disaster."

Ash sucked air between her teeth, and then said, in a voice far too bright for someone in that much pain, "Thank you!"

Doc grunted as he tied off the knot.

------

Word Goal: 450

Final Word Count: 753

Yet another prompt from the depths of the inbox! This was originally going to be a Pat and Vlad prompt but it fit the Disaster Couple too well. Thank you for reading!

@that-catholic-shinobi @redheadedbrunette @irishironclad

If you'd like to be added to or removed from the tag list, please let me know!

[killed-by-choice]

Laura Hope Smith, 22 (USA 2007)

Laura Hope Smith had a hard start in life, but this didn’t make her any less loved by her adoptive family. She was born in Honduras and spent the first three years of her life in an orphanage before being adopted and then rejected by an American family. She finally arrived on Eileen and Tom Smith's doorstep at age 4½, with a black eye and dirty clothes. The Smith parents loved and cherished their daughter, and as an attorney who represented Smith's family in the medical malpractice lawsuit said, her death "ripped a piece of her parents' heart out."

In 2007, 22-year-old Laura Hope Smith was 13 weeks pregnant. Her mother says that she was very opposed to abortion, which may mean that Laura was forced or coerced to have the abortion. Eileen recounts the horrifying phone call: “It was 7pm, we had just finished dinner and settled down to watch the evening news. My husband's cell phone rang with Laura's name on the ID. We always loved hearing from her. Laura was so full of life, your spirits were lifted just by talking to her. Except this time it wasn't her voice. There was guttural screaming and sobbing on the other end by a voice I did not immediately recognize. I heard the words "Laura", "Hospital" and the worst one, "Not Breathing," and then "abortion". My brain tilted, my heart sank, and life as I knew it ceased.”

Laura had died during a legal abortion at the deceptively named Women's Health Center. The abortionist was Rapin Osathanondh, who failed to monitor Laura after her abortion. An assistant with no medical training, dubbed a "hand holder" by her boss, was assisting with general anesthesia and there was no emergency resuscitation equipment. Additionally, nobody in the facility knew CPR and they did not call 911 after attempts to revive Laura failed. She died on the operating table.

"My daughter was 22, healthy, and alive when she walked into that clinic," Eileen Smith later told news sources. "She didn't even have a cold. There is no reason for her to be dead."

Two days after Laura’s death, Eileen gave a full interview to the local newspaper, which was scheduled to be published on the day of Laura’s funeral. The article did not appear when it was scheduled, leading Smith to suspect that someone was trying to cover up her daughter’s death.

An investigation was started to find out what happened to Laura. Osathanondh falsified CPR certification cards, bought new equipment and changed the configuration of his Hyannis office to make it appear that a defibrillator and oxygen were easily accessible. This did not fool the Medical Board.

He was sentenced to a 2 1/2-year jail term with six months to serve. However, the plea agreement allowed him out on parole after three months when Osathanondh pleaded guilty to involuntary manslaughter and admitted he was reckless and negligent. In addition to the jail time, Osathanondh's sentence included nine months of home confinement (during which he must be electronically monitored and cannot leave his house except in emergencies or pre-approved medical appointments.) He was also banned from practicing medicine, teaching anything having to do with medical science or contacting the Smith family. The sentence also banned him from commenting on the case on any social media, with Facebook specifically mentioned.

Laura’s parents won $2 million from the lawsuit, but none of the money could bring back their daughter. It was devastating that after everything Laura had survived, her family would lose her to something advertised as “healthcare”— especially something that Laura herself was so against.

What was especially heart-rending was the first time Laura’s mother met her daughter’s killer: “I met with the doctor who aborted my grandchild, and who saw my daughter take her last breath. He would only meet me in a public place, without my husband. We talked for an hour and a half. Based on that meeting I believe I know what happened to Laura. He denies doing anything that caused her death. When we were done talking about Laura, I prayed, and asked God if there was anything He would have me say to the doctor. This is what I said next.... "The blood of my daughter is on your hands; the blood of my grandchild is on your hands; the blood of every life you have ever taken is on your hands," and I went on from there. He was silent with his head hung low.

“Parents search for clues in daughter’s unexplained death”, Cape Cod Times, Oct. 21, 2007

[drnehalalla]

Is the removal of a retained IUD a complex procedure?

The removal of a retained Intrauterine Device (IUD) is typically a straightforward and routine procedure. However, the complexity can vary based on several factors:

1- Location of the IUD:

If the IUD is easily visible and located within the cervix, the removal is usually simple. However, if it has migrated or embedded in the uterine wall, extraction may be more challenging.

2- Time Since Insertion:

The longer the IUD has been in place, the more likely it is to become embedded. This can make removal more complex, as the device may become surrounded by tissue over time.

3- Experience of the Healthcare Provider:

A skilled and experienced healthcare provider, such as a gynecologist, is better equipped to handle challenging cases. They can employ various techniques to safely retrieve the IUD.

4- Patient Comfort:

The procedure is generally well-tolerated, and healthcare providers may use local anesthesia or recommend pain relief measures to enhance patient comfort during removal.

In most cases, the removal of a retained IUD is a quick office-based procedure. The healthcare provider may use forceps or special instruments to grasp the IUD strings and gently guide it out. If the strings are not visible, imaging studies such as ultrasound may be used to locate the device.

It's crucial for individuals experiencing difficulty with IUD removal to seek prompt medical attention. Delayed removal can lead to complications, such as infection or perforation. Healthcare providers are experienced in managing such situations and will take necessary steps to ensure a safe and effective removal process.

Experience comprehensive women's health care with Dr. Neha Lalla, your trusted Uterine Polyp removal in Dubai . Book your appointment today for expert guidance and personalized care.

[rigberts]

I'm starting to realize I have a terrible reputation with all my medical specialists bc this morning I went to the same dentist I've been to since I was seven and everyone there has either known me since that age or treats me based on my file with them, which is labeled with my childhood nickname and contains a summary of all the panic attacks I've had due to overstimulation/adverse anesthesia reactions over the years, so I get babied, to a ridiculous degree. Like, constantly patting my shoulder to reassure me, an absurd amount of praise, and crouching down so I'm taller than them while sitting in the chair. It's like a combination of being a pediatric cancer patient or an elderly Chihuahua at the vet, I assume. It's very sweet and a little bit mortifying and I doubt it will change anytime soon bc I had (surprise) another adverse reaction to the novocaine while getting a filling that interacted badly with some lung issues im dealing with and ended up having a super gross sounding coughing fit/pseudo-asthma attack that was bad enough they needed an inhaler and oxygen to stop it. So yeah I got babied by the entire office, including the receptionists that looked younger than me delivering me handfuls of cough drops. I give off Victorian Boy Dying of Consumption vibes in terms of both drama and general aura of patheticness, especially back when I didn't realize my constant coughing was like an actual medical thing I was justified in seeing a doctor for, and I would just sorta complain "ugh my mouth always tastes like blood" and my family would just give me these looks that were a lovely combination of horrified concern and also "I'm so fucking sick of your bullshit".

[mcatmemoranda]

Patient is a [ ] yo male/female presenting to the clinic for a preoperative evaluation.

Procedure [ ]

Scheduled date of procedure [ ]

Surgeon performing procedure requesting consultation for preop is [ ] and can be contacted at [ ]

This patient is/is not medically optimized for the planned surgery, see below for details.

EKG collected in office, interpreted personally and under the direct supervision of attending physician as follows- sinus rate and rhythm, no evidence of ischemia or ST abnormalities, no blocks, normal QTc interval.

The following labs are to be completed prior to surgery, and will be evaluated upon completion. Procedure is to be performed as scheduled barring any extraordinary laboratory derangements of concern.

Current medication list has been thoroughly reviewed and should not interfere with surgery as written.

Patient has no prior history of adverse reactions to anesthesia, problems with airway management, difficult IV access, prolonged emergence, or postoperative nausea/vomiting.

Airway Mallampati score: This patient is a Grade based on the criteria listed below

-Grade I Tonsillar pillars, soft palate, entire uvula

-Grade II Tonsillar pillars, soft palate, part of uvula

-Grade III Soft palate, base of uvula

-Grade IV Hard palate only, no uvula visualized

Patient is a low/medium/high risk for this low/medium/high risk surgical procedure.

Will send documentation of this preoperative visit to surgeon [ ].

**** ADDITIONAL INFORMATION****

Patient Risk for Elective Surgical Procedure as Determined with the Criteria Below:

1- Very Low Risk

No known medical problems

2- Low Risk

Hypertension

Hyperlipidemia

Asthma

Other chronic, stable medical condition without significant functional impairment

3- Intermediate Risk

Age 70 or older

Non-insulin dependent diabetes

History of treated, stable CAD

Morbid obesity (BMI > 30)

Anemia (hemoglobin < 10)

Mild renal insufficiency

4- High Risk

-Chronic CHF

-Insulin-dependent diabetes mellitus

-Renal insufficiency: creatinine > 2

-Moderate COPD: FEV1 50% to 70%

-Obstructive sleep apnea

-History of stroke or TIA

-Known diagnosis of dementia

-Chronic pain syndrome

5- Very High Risk

-Unstable or severe cardiac disease

-Severe COPD: FEV1 < 50% predicted

-Use of home oxygen

-Pulmonary hypertension

-Severe liver disease

-Severe frailty; physical incapacitation

Surgical Risk Score Determined as Below:

1- Very Low Risk

Procedures that usually require only minimal or moderate sedation and have few physiologic effects

-Eye surgery

-GI endoscopy (without stents)

-Dental procedures

2- Low Risk

Procedures associated with minimal physiologic effect

-Hernia repair

-ENT procedures without planned flap or neck dissection

-Diagnostic cardiac catheterization

-Interventional radiology

-GI endoscopy with stent placement

-Cystoscopy

3- Intermediate Risk

Procedures associated with moderate changes in hemodynamics, risk of blood loss

-Intracranial and spine surgery

-Gynecologic and urologic surgery

-Intra-abdominal surgery without bowel resection

-Intra-thoracic surgery without lung resection

-Cardiac catheterization procedures including electrophysiology studies, ablations, AICD, pacemaker

4- High Risk

Procedures with possible significant effect on hemodynamics, blood loss

-Colorectal surgery with bowel resection

-Kidney transplant

-Major joint replacement (shoulder, knee, and hip)

-Open radical prostatectomy, cystectomy

-Major oncologic general surgery or gynecologic surgery

-Major oncologic head and neck surgery

5- Very High Risk

Procedures with major impact on hemodynamics, fluid shifts, possible major blood loss:

-Aortic surgery

-Cardiac surgery

-Intra-thoracic procedures with lung resection

-Major transplant surgery (heart, lung, liver)

High risk surgery: yes/no

Hx of ischemic heart disease: y/n

Hx of CHF: y/n

Hx of CVA/TIA: y/n

Pre-op tx with insulin: y/n

DM/how are blood sugars?

Pre-op Cr >2mg: y/n

OTHER EVALUATIONS BASED OFF PATIENT HISTORY SEE BELOW:

1. CARDIAC EVALUATION

A. Ischemic Cardiac Risk- Describe any history of cardiovascular disease and list the cardiologist/electrophysiologist. For CAD, report the results of the most recent stress test or cardiac cath, type of procedures or type of stents, date of MI, and recommendations for perioperative management. Include antiplatelet management. Continue baby aspirin for patients with cardiac stents - unless having neurosurgery, then coordinate with surgeon.

B. Ventricular function - include most recent echocardiogram evaluation ideally performed within the past 2 years

C. Valvular heart disease- include most recent echocardiogram, type of prosthetic valve

D. Arrhythmias - include any implanted devices and recent interrogation report, contact electrophysiology about device management during the surgery and include recommendations provided. For A-Fib, include CHA2DS2-VASc score

E. Beta blockade - All patients on chronic beta blockers should have these medications continue throughout the perioperative period unless there is a specifically documented contraindication.

F. Hypertension - Other than for cataract surgery, ACEI inhibitors and ARBs should be held for 24hours prior to surgery and diuretics should be held the morning of surgery

G. Vascular disease - include antiplatelet management and dates of strokes

2. PULMONARY EVALUATION

A. COPD/Asthma - include any recent exacerbations, intubations, chronic O2 use, amount of rescue inhaler use

B. OSA risk - STOPBANG score - address severity of sleep apnea and CPAP use

3. HEMATOLOGIC EVALUATION

A. Bleeding Risk - assess the bleeding risk and history for every patient

B. VTE Prophylaxis/Thrombotic risk - estimate risk and provide recommendations

C. Anticoagulation management - include pre-op and post-op medication instructions

D. Anemia - pre-op treatment plan

D. Oncology - history and treatments

4. ENDOCRINE EVALUATION

A. Diabetes mellitus - include type, medication use, recent A1c, pre-op and post-op management instructions

B. Adrenal insufficiency risk - assess for prolonged steroid use in the last year

5. RENAL EVALUATION

A. CKD - include stage, baseline labs

B. ESRD - include dialysis schedule, type, access, dry weight, location of dialysis. Generally, surgery should not be scheduled on a dialysis day.

C. Electrolyte abnormalities

6. GI EVALUATION

A. Liver disease - including MELD score and Child-Pugh classification

7. OTHER relevant comorbidities or anesthesia considerations

[substance abuse, chronic pain, delirium risk, PONV (post-operative nausea and vomiting) risk, psych disorders, neurologic disorders, infectious disease, etc.]