#Pulmonary Fibrosis Fibrosis Mouth

[aligndentalcare]

Different types of bad breath

Halitosis, or bad breath, is a common dental condition that is comparable to periodontal disease and tooth decay. Due to the offensive odour coming from their mouths, people with this illness detest opening their mouths and speaking freely. Their everyday lives are impacted by this issue since no one wants to stand close to them or converse with them because of the offensive smell.

The bacteria in our mouths break down food particles that become lodged there. The bad breath is caused by certain chemicals that are released by this bacteria.

These bacteria are not the only causes of bad breath; other medical conditions can also contribute to it. Nonetheless, a dental examination is the first thing you should do if you have terrible breath. The following are some of the primary causes of foul breath:

Inadequate dental care

A few pharmaceuticals and remedies

Dry mouth from smoking

Other medical conditions

These explanations explain why there are various causes of foul breath. They're

Breath diabetes

The human body of a diabetic patient produces less insulin. His or her body must therefore burn more fat. This type of fat burning produces a substance known as a "ketone." The foul smell coming from the mouth is also caused by the ketone.

Diabetes-related foul breath can also be caused by chronic renal failure. It emits an ammoniacal or fishy scent. Also referred to as a uremic fetor, the odour is produced by the decomposition of urea, which is present in high concentrations in saliva, into ammonia.

Liver odour

Liver failure is the cause of liver breath, which leaves the mouth smelling putrid and pleasant.

Drug breath

Certain treatments and pharmaceuticals cause your mouth to dry up by absorbing saliva. Asthma, obesity, and Parkinson's disease medications have a great tendency to cause bad drug breath.

Stomach odour

When there is an obstruction or disturbance in our digestive tract, some stomach acids are created. The category of stomach breath includes unpleasant breath, which is caused by these acids.

Period Breath

Gum disease strikes women more frequently when they are menstruating. They will not be secreting as much saliva during this time. As a result, they frequently experience tongue dryness and foul breath.

Breath of the lung

Lung breath is caused by lung infections. Here are a few of the most common lung infections: pneumonia, TB, pulmonary abscess, emphysema, and bronchitis. It's the main sign that you have lung cancer. Bad breath can also be a symptom of other conditions like asthma and cystic fibrosis.

Breath of tonsils

The tonsils are two little pads of glandular tissue that are situated at the throat's border. Tonsil stones form when food particles become lodged between them, hardening the tissue. One such cause of unpleasant breath in the mouth is tonsil stones.

Breath metabolism

One of the causes of poor breath is also eating foods that are deficient in minerals and carbs. There won't be enough nutrients in fast food, which makes it harder to burn fat. Bad breath is caused by the production of ketone in order to burn more fat.

To know more information, visit: https://www.aligndentalcare.lk/different-types-of-bad-breath/

[medicalmart-blog]

What is suction machine an where it is used?

A suction machine, also known as a suction pump or aspirator, is a medical device used to remove mucus, blood, secretions, or other fluids and debris from a patient's airways, respiratory tract, or surgical site. Suction machines create a vacuum to draw fluids and materials into a collection container, facilitating a clear and unobstructed airway for the patient or maintaining a clean surgical field. They are commonly used in healthcare settings, particularly in the following contexts:

Respiratory Care:

Respiratory Distress: Suction machines are used to clear airways in patients who have difficulty coughing up or clearing mucus or secretions due to conditions like pneumonia, chronic obstructive pulmonary disease (COPD), or cystic fibrosis. Mechanical Ventilation: Patients on mechanical ventilators may require suctioning to remove secretions from their endotracheal tube or tracheostomy tube to ensure proper airflow. Surgical Procedures:

Operating Rooms: Suction machines are used during surgeries to remove blood, bodily fluids, and other substances from the surgical field, providing a clear view for the surgeon and maintaining a sterile environment.

Dental Procedures: Dentists use smaller suction devices to remove saliva and debris from a patient's mouth during dental procedures.

Emergency Rooms and Ambulances: Suction machines are essential for clearing the airways of patients who are experiencing choking, drowning, or other life-threatening situations where immediate removal of fluids or obstructions is necessary.

Home Care: Some individuals with chronic medical conditions that require frequent airway clearance may have portable suction machines at home for self-care or for use by caregivers.

Neonatal Intensive Care Units (NICUs):

Suction is often required for premature infants or newborns with respiratory distress to clear their airways and assist with breathing. Long-Term Care Facilities:

Nursing homes and rehabilitation centers may use suction machines to assist residents with compromised respiratory function.

In some cases, suction machines can also be used in aerosol therapy to deliver medications directly to the respiratory tract.

Suction machines come in various sizes and configurations, including portable and wall-mounted units, to accommodate different healthcare settings and patient needs. They typically consist of a vacuum pump, a collection container, tubing, and various suction catheters or tips designed for different applications. Healthcare professionals receive training on the proper use and maintenance of suction machines to ensure safe and effective patient care.

[bandit-wares]

Letter #1 to my father

You know, your death fucked me up. I was only 16, a junior in high school. You developed pulmonary fibrosis, I guess decades of construction work took a toll on your lungs. Since you distrusted the medical system so much (honestly who can blame you?), it only took a few months for you to deteriorate. The pneumonia didn't help, and neither did that waiting list for better lungs. In only a third of a year, it destroyed you, took you away. I still remember how my oldest brother held your hand and cried like a child, it still shakes me after nearly 7 years. I can't forget that sound, nor can I forget the sound of your oxygen machine. I can't stand the silence anymore because of it. Some part of me still believes that as long as there's noise in the background, everything is okay. If the AC isn't on, if there's no fan or heater on, if there's no music or talking around me, no noise, I don't feel safe. I'm in danger, and so is everyone else.

But then, I still felt scared during those months, even with the sound of the machine helping you breathe. After all, you did talk several times in front of your youngest 3 children how you wanted to put a gun in your mouth and end the suffering. You made me so afraid to sleep at night without even realizing. I was terrified I'd be woken up by a gunshot, or wake up to pure silence, and go to find you lying there motionless. I was sick at the thought of having to make that call to the police, to my mother, to be the one to tell my brothers and sister, my nephews, the world, that my father was dead by either the illness or his own hand. I was so scared of being the one responsible for telling everyone, of having to put that grief on them. You scared me.

You still scare me. I look out the window some days and hope I see you in your truck, waiting on your phone to pick us up for the weekend or for a camping trip by our uncle's creek. I look and I hurt because you aren't there. You've long since been reduced to ashes and spread between the seven of your most loved children.

I hope my sister finds the home videos you made when we were all still kids. I don't want to forget what you looked like, what you sounded like. I want to see you when you were happy. When all of us were happy. I hardly see any of us genuinely happy anymore. Even my precious nephews, and they're so fucking young.

I miss you so much, Dad.

I hate that I loved you so much, because the backlash gnaws at my heart like a starved dog.

But I love you.

[enterenews]

Moon Dan-yeol, the upsetting situation of 'star instructor who earned 4 billion won'…

Dan-yeol Moon, who had been hiding for a while, announced his current situation with unfortunate news.

MBN's 'Special World', which aired on the 12th, shed light on the original star instructor's door insulation.

Dan-Yeol Moon, who was the 'first-generation original star instructor' for his new English class, said, "I asked him to find out at a rest area on the highway and sign it, and suddenly it went well, and the number of students reached 1,300. Soon it was in billions of debt.

In Yangyang, Gangwon-do, door insulation started the day by opening the window. Seo Woo-ro lives in and out of Yangyang, but spends most of his time in Yangyang. Dan-yeol Mun began each morning by greeting his father's urn. He explained, "Her mother bought a family graveyard, so now I'm temporarily cremating it so I can move it there and enshrine it there."

Dan-yeol Moon opened his mouth, "I coughed up blood for three months. I couldn't sleep. I walked three steps and gasped. But it was too long and severe to be called a cold." Surprisingly, in January of last year, he was diagnosed with pulmonary fibrosis, a hardening of lung tissue. Pulmonary fibrosis has been an incurable disease with no specific treatment to date.

Moon Dan-yeol said, "Some say that people die in two months. This is not really public. When the doctor said, 'It's confirmed,' I walked out and thought, 'Has the deadline expired?'" he smiled. . Pulmonary fibrosis, which he said would slowly eat up his breath and lead to death in an instant. As there is no cure, it is important to slow the progression of the disease.

The sweet happiness of success was short-lived, but with the foreign exchange crisis, he began to owe billions of won. Moon Dan-yeol recalled, "In that vicious cycle, I appeared on the air." He said, "At that time, there were rumors that Dan-Yeol Moon had bought a building in Gangnam.

A video production business that started 7 years ago. I had a meeting with the staff in Seoul, so I wore the VR device. There was a reason why I came out of the English pulpit for the last time in 2017. Moon Dan-yeol said, “The debt I have paid off over the past 20 years is about 3 billion won.” The job he started because he liked English became a means of paying off his debts, and colon cancer came to him after running so tirelessly.

He says he wears an oxygen concentrator and sleeps even while lying in bed. He sang a song and climbed the mountain without even checking his neck, but he exhaled more and more breathlessly. He shook his head, saying, "I'm always in good shape, but if I overdo it a bit, I get a little cough. Then I drank some dust on the way home." Symptoms that arise the moment you lose your guard.

Moon Dan-yeol went to the hospital, but was very nervous, but fortunately heard good news. The doctor said, "From 100 to 100, Dan-yeol Moon is 97.8%, almost normal. Pulmonary fibrosis has not progressed well," making Moon Dan-yeol happy. Moon Dan-yeol liked it, saying, “I think my family will like it. The doctor diagnosed, "The lung picture is good and it looks like the early stages of pulmonary fibrosis, but you have to take good care of it because the life expectancy is only 3 to 5 years."

[biologyeye]

What Is Ventilator - How its Work

A ventilator is a medical machine that is used to assist or control breathing in individuals who have difficulty breathing on their own. It can be used in a variety of settings including hospitals, long-term care facilities, and at home. There are many different types of ventilators, but they all work by delivering air or oxygen to the lungs through a tube or mask that is placed over the nose or mouth.

There are different ways ventilators can work, such as:

A mechanical ventilator uses a machine to move air into and out of the lungs.

A positive pressure ventilator, the most common type, blows air into the lungs, which expands them and pushes air out.

A negative pressure ventilator creates a vacuum around the patient's chest, which pulls air into the lungs.

Ventilators are used to treat a variety of conditions such as acute respiratory failure, chronic respiratory failure, severe pneumonia, and severe asthma. They are also used for people who are critically ill with COVID-19 and other lung infections. The use of ventilator should be under the supervision of trained medical staff, as it requires knowledge of how to adjust the settings, monitor patients' response, and troubleshoot problems.

Working Principle of A Ventilator

The working principle of a ventilator is to deliver air or oxygen to the lungs in order to help the patient breathe. The most common type of ventilator used in hospitals is a positive pressure ventilator. The basic working principle of a positive pressure ventilator is to push air into the lungs, which expands the lungs and pushes air out.

The ventilator consists of a few basic components, including a flow generator, a breathing circuit, and a patient interface. The flow generator is the main control center of the ventilator, and it is responsible for producing the flow of air or oxygen to the patient.

The breathing circuit is a tube that connects the flow generator to the patient interface. It is responsible for delivering the flow of air or oxygen to the patient.

The patient interface is the device that connects the breathing circuit to the patient. This can include a face mask, nasal prongs, or a tube that is inserted into the patient's trachea.

When the patient inhales, the ventilator pushes air or oxygen into the lungs through the patient interface. This causes the lungs to expand, which in turn pushes air out of the lungs. As the patient exhales, the ventilator stops delivering air or oxygen, and the lungs start to contract, expelling the used air. This cycle of inspiration and expiration is controlled by the ventilator and is adjustable based on patient's needs and condition.

It is important to note that the working of ventilator depends on the type and model of the ventilator, some ventilator also use advanced mechanism such as pressure support, volume support, and volume control ventilation. And the settings should be adjusted by trained medical professionals according to the needs and condition of the patient.

Uses of the Ventilator Machine

Ventilator machines are used in a variety of medical settings to help individuals who are unable to breathe on their own. Some common uses of ventilator machines include:

Acute respiratory failure: Ventilators are used to help individuals who are experiencing acute respiratory failure, which is a sudden and severe impairment of the ability to breathe. This can occur as a result of conditions such as pneumonia, asthma, or trauma.

Chronic respiratory failure: Ventilators are also used to help individuals who are experiencing chronic respiratory failure, which is a long-term impairment of the ability to breathe. This can occur as a result of conditions such as chronic obstructive pulmonary disease (COPD) or cystic fibrosis.

Critical illness and trauma: Ventilators are used to assist breathing in critically ill or injured patients who are unable to breathe on their own. They can be used for patients with injuries or illnesses that affect the lungs or the ability to breathe, such as severe head injury, burns, or spinal cord injury.

Neurological conditions: Some neurological conditions, such as Amyotrophic lateral sclerosis (ALS) can cause muscle weakness and eventually affects the muscles used for breathing. Ventilator can provide support to the patient in such cases.

Anesthesia: Ventilators are used to provide breathing support during anesthesia and surgery. They help to ensure that the patient receives enough oxygen and maintains proper ventilation.

COVID-19 and other lung infections: Ventilators are used to help people with severe COVID-19 and other lung infections, who are critically ill and unable to breathe on their own.

It is important to note that the use of ventilator machines is typically only required for patients with serious breathing problems, and the decision to use a ventilator is made by a physician based on the patient's individual needs and condition.

Applications of  Ventilator

In addition to the medical uses of ventilator machines I mentioned in the previous answer, there are also other applications of ventilators that go beyond the healthcare industry. Some examples of non-medical applications of ventilators include:

Industrial uses: Ventilators are used in industrial settings to help control the quality of air in enclosed spaces. This can include ventilation for factories, mines, and other industrial buildings to improve air quality and prevent the buildup of dangerous gases.

Automotive industry: Ventilators are used in the automotive industry to help control the temperature and air quality in vehicles. These can include air conditioning systems, air filters and air vents used in cars and trucks.

Construction: Ventilators are used in construction industry to help circulate fresh air and control the temperature in buildings under construction. This can help to improve the working conditions for workers on the site, as well as help to prevent the buildup of dangerous gases.

Disaster management: Ventilators can be used in emergency or disaster situations where individuals may be trapped in enclosed spaces, such as buildings or underground tunnels, to help provide fresh air and prevent the buildup of toxic gases.

HVAC systems: Ventilators are used in heating, ventilation, and air conditioning systems in buildings to provide fresh air and remove indoor air pollutants.

It's important to note that these are just a few examples of the many different applications of ventilators. The specific use and design of ventilator depend on the application it is being used for and the requirements of the specific setting.

[healthyquestion]

What are the most common causes of illness?

Illness is a state of poor health or disease. There are many different causes of illness, but some are more common than others. Here are the five most common causes of illness:

Infections — Infections are caused by germs such as bacteria, viruses, fungi, and parasites. These germs can enter the body through the mouth, nose, eyes, cuts, or sexually transmitted infections. Some common infections include the common cold, flu, pneumonia, and sexually transmitted infections (STIs).

Lifestyle factors — Many illnesses are caused or exacerbated by unhealthy lifestyle choices. These can include a poor diet, lack of exercise, smoking, alcohol consumption, and drug abuse. These lifestyle factors can increase the risk of developing conditions such as heart disease, diabetes, and cancer.

Environmental factors — The environment can also play a role in causing illness. Pollution, toxic substances, and radiation can all contribute to health problems. For example, exposure to air pollution can increase the risk of respiratory illnesses, such as asthma and chronic obstructive pulmonary disease (COPD).

Genetic factors — Some illnesses are caused by inherited genetic mutations. These can be passed down from one generation to the next and can increase the risk of developing certain conditions, such as cystic fibrosis, sickle cell anemia, and Huntington’s disease.

Aging — As we age, our bodies become more susceptible to illness and disease. This is due to a variety of factors, including changes in the immune system, the natural wear and tear on the body’s systems and the accumulation of environmental and lifestyle-related damage.

In conclusion, the most common causes of illness are infections, lifestyle factors, environmental factors, genetic factors, and aging. By understanding these causes, we can take steps to prevent illness and maintain good health.

[fitconnmed]

Compressor nebulizer introduction

A compressor atomizer is a device that uses compressed air to atomize a liquid. It is usually used in the medical industry. The function of the medical nebulizer is to atomize liquid medicine and deliver it to the respiratory tract for patients to use for inhalation treatment. The respiratory system is an open system. After the liquid medicine is atomized into particles, the medicine mist can be directly absorbed by the patient's mouth, throat, trachea, bronchus, pulmonary, etc. after the patient inhales the medicine mist, and then absorbed through the mucous membranes to form achieve the purpose of treatment. Compressor atomizer consists of tank, air compressor and nozzle. An air compressor provides energy to atomize the liquid and a nozzle directs the spray.

Use of compression nebulizers

A compressed nebulizer is a medical device that helps deliver medication to the lungs in the form of a fine mist. It is commonly used to treat respiratory conditions such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis. Medications are usually prescribed by a doctor and delivered through a face mask or mouthpiece.

[darrenflott]

A Look at the Main Types of Respiratory Therapy

Respiratory therapists (RTs) are healthcare professionals specializing in assisting patients with chronic lung conditions affecting their breathing and airways. These conditions include asthma, pneumonia, acute bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD).

Respiratory therapists are usually found in hospitals working alongside doctors and nurses and can practice in different areas of hospitals such as maternity wards, emergency rooms, and intensive care units. Their services are not limited to any gender or age group. They are also very conversant with advanced technological equipment like mechanical ventilators and oxygen concentrators. The subject of respiratory therapy is a broad one with many areas. Therefore, RTs can't have the expertise for all types; however, they can specialize in one or more areas.

One of the most common types is emergency respiratory therapy which usually happens in the hospital. Respiratory therapists working on emergency and urgent care cases can help patients by providing ventilation, especially mechanical ventilation, to aid patients who need assistance breathing. They help determine the right solution to relieve patients of blockages to their airways and closely observe patients for respiratory symptoms.

In addition, RTs can perform intubation on patients when needed. Intubation refers to a process whereby RTs insert a flexible airway tube into their patient's nose or mouth to pump and suck out air to and from the lung. They can also abet doctors during complex surgeries and can commence life support for patients when needed.

One of the most critical requirements of working as an emergency respiratory therapist is thinking very fast and responding swiftly to situations.

Pediatric respiratory therapy is another area of this healthcare profession. As the name implies, it happens in neonatal units and pediatric wards where newborns, especially the premature ones, are closely observed to detect possible breathing problems. Pediatric RTs can also treat newborns with pulmonary conditions.

Although most of their work relates to newborns, pediatric RTs also assist toddlers and older children. For newborns, every medical procedure relating to respiratory therapy happens strictly in the hospital. Still, pediatric RTs are sometimes required to provide outpatient care for non-life-threatening cases for older children.

Adult respiratory therapy is also a common area of specialization. This type of therapy happens in the hospital, outpatient, or at home. It helps adults who suffer chronic respiratory conditions like cystic fibrosis, emphysema, chronic obstructive pulmonary disease, sleep apnea, or asthma.

Adult respiratory therapy also includes programs to help people quit smoking and pulmonary rehabilitation. Pulmonary rehab is a supervised exercise and education routine developed by RTs to help patients with long-term lung diseases. This program offers adult RTs to help patients improve their lung's breathing capacity after surgery. They may do it outside of the hospital.

An adult respiratory therapist can also work in sleep laboratories to help diagnose and treat adults suffering from sleep apnea.

Geriatric respiratory therapy is the last major type of respiratory therapy and has to do with aging people. As human beings age, so does every part of their body, and the lungs are not an exception. According to the Center for Disease Control and Prevention (CDC), one in seven middle-aged and older individuals suffers long-term lung disorders like respiratory tract infections, Phenomena, and COPD.

Therefore, older people must get geriatric respiratory therapy, which can happen anywhere from hospitals to outpatient facilities or homes. It is crucial for RTs to consider their patient's pre-existing medical conditions before commencing treatment.

[definitecure]

Fibrosis Treatment Pulmonary Fibrosis Fibrosis Mouth Fibrosis Surgery Definite Cure

Fibroids are abnormal growths in the uterus that can result in several issues including infertility. Without the right uterine fibroid treatment, fibroids are accompanied by heavy periods and excruciating abdominal pain. Symptoms If you notice the following uterine fibroid symptoms, it is a good idea to visit your doctor immediately: READ MORE...DefiniteCure: Surgical Care Par Excellence Definite Cure

[let-love-run-red]

I was re-reading your Garcello hcs(sorry I’m addicted to your writing!) and you said you had more hcs?? I’m here for it all bestie!

Babe you don't have to apologize for enjoying my writing! It's actually a big compliment when someone likes my writing. Here's some more headcanons I have for Garcello 😊😊

***

- Garcello had pulmonary fibrosis, which is a fancy way of saying scarred lungs. He had a lung transplant and is doing much better now! He did have to stop smoking though.

- To help him stop smoking he uses nicotine patches and started eating suckers because he missed having something in his mouth.

- Which means he always has a pocket full of suckers, whether they're tootsie pops or dum dum suckers. His favorite flavor is blue raspberry.

- Garcello loves having his hair touched and played with and brushed and braided, anything really. He just loves being fussed over and spoiled.

- Going along with that, Garcello is a cuddle slut. He loves to be cuddled in any way shape or form, he just needs to be touching someone at all times.

- He isn't the best at asking for affection from people, but once he's comfortable with them he loves to give casual hugs, and if he's in a romantic relationship with them he has no problem asking for snuggles when he needs them.

- He'll often just lay on the couch with his significant other with his head on their chest and snuggle them while they play with his hair. It's basically heaven to him.

- He also loves to snowboard, because he grew up snowboarding and skiing with his mother (she lived near the Dolomites in Italy so she used to go all the time).

- He actually taught snowboarding before he started having breathing problems, and decided to go back after he had the lung transplant, and teaches a few of the beginner classes.

[aloysiavirgata]

In The Gale

Title: In The Gale

Author: Aloysia Virgata

Rating: PG

Category: MSR

Author's Notes: For @perplexistan, who asked and helped me make it better. This is shortly after settling into the Unremarkable House. I tried making sense of their legal status, but it’s simply impossible and I gave up.

Our heroes quote from Melville, Shakespeare, Sagan, Baudrillard, and (Emily) Dickens.

***

Because I know that time is always time And place is always and only place And what is actual is actual only for one time And only for one place I rejoice that things are as they are and I renounce the blessed face And renounce the voice Because I cannot hope to turn again Consequently I rejoice, having to construct something Upon which to rejoice

And pray to God to have mercy upon us And pray that I may forget These matters that with myself I too much discuss Too much explain Because I do not hope to turn again Let these words answer For what is done, not to be done again May the judgement not be too heavy upon us

Because these wings are no longer wings to fly But merely vans to beat the air The air which is now thoroughly small and dry Smaller and dryer than the will Teach us to care and not to care Teach us to sit still.

T.S. Eliot, Ash Wednesday

***

She recites The Raven to herself on the drive in, lists all the state capitals in alphabetical order, and goes through the periodic table. Her body fizzes like a shaken soda, tiny anxious bubbles rising through her blood. They’ve done so much for this, called in so many favors. Mulder put his book on hold for a month, quizzing her with dog-eared notecards. 

“Immediate treatment of myocardial infarction,” he’d call, and she’d say “MONA TASS.”

She feels a pang for the simplicity of the other life, the hiding one, where she just had to ring up cigarettes and herbal Viagra at gas stations.

***

She’s the new girl at the cafeteria table, awkward and alone. Mulder had prepared her a lunch like it’s the first day of school, and she stares at it, wishing for an appetite.

From the corner of her eye she sees two colleagues - an MRI tech and an obstetrician, she thinks - talking softly and glancing over. Scully thinks she hears “FBI,” and she looks up and smiles, uncertain.

They blink at her, look away.

***

Ybarra comes around the corner, gliding in his cassock like a disapproving ghost. “Dr. Scully,” he says, in his pinched voice.

She smiles thinly. “Father Ybarra.”

“Nurse Mossing was looking for the chart for Mrs. Sullivan. Imagine my surprise when I found it in Room 314 instead of Room 413. That’s a potential HIPAA violation, Dr. Scully. That’s a federal law.”

Scully curls her hand so that her nails dig into her skin. “I’m so sorry,” she says. “Father Ybarra, please forg-”

He holds up his palm. “It won’t happen again,” he says, and glides onward.

Scully closes her eyes and leans against the wall. She breathes through her nose until the ringing in her ears stops.

***

She wants to collapse into his arms and cry when she gets home, but that would be giving in. It would be letting them down.

“How’d it go?” he asks. He’s wearing basketball shorts and a Knicks shirt, a five o’clock shadow.

She smiles brightly. “It was good. Learning curve, but good. I think Father Ybarra might be a tough nut to crack, is all.”

Mulder rubs his cowlicked hair. “Put your feet up, Scully, since you won’t wear sensible shoes.”

She does, and accepts the glass of wine he holds out. “Thanks. I’ll sleep well tonight, anyway. There are miles of hallways.”

He sits next to her on the couch. “I wrote a few pages,” he says. “I deleted a bunch, but I think there was a multi-paragraph net gain.”

“I’m glad you’re able to stop focusing on my stuff now,” she says. “Both back in the saddle.”

“Go team.”

She clinks her glass against his. She drinks her wine too fast.

***

Ybarra had come in during her rounds that morning and startled her into knocking a metal bedpan onto the floor. Scully thinks the reverberations of that sound will follow her to the grave.

She’s now in the chapel, tucked into a back pew. She’s been staring at the small altar, at the stained glass windows flanking the crucifix. The Blessed Virgin smiles beatifically down at her, a wretched sinner.

Scully laces her fingers on the back of the pew in front of her and bows her head against them. “Please,” she whispers. “Please.”

***

Mulder wakes her with tea and eggs. “You haven’t been eating,” he says, brow furrowed. 

She rubs her eyes, yawning. “What?”

He sits next to her on the bed, sets the plate and mug on her night table. “You just push your food around your plate, you hardly talk when you get home. What’s going on, Scully?”

She sits up, looking at his worried face. He’s sun-browned and tousled, beautiful, with a mouth that still makes her weak in the knees. “Nothing. It’s just a lot to jump back into.”

“I’m sure it is. And I still want to help you with it.” He pulls the flash cards from his pocket, touches her wrist with his other hand. “Let’s see - causes of upper zone pulmonary fibrosis?”

She looks at the ceiling, back at him. “I don’t need help.”

Mulder blinks, stung. 

“I’m sorry, I didn’t mean to be rude. You just don’t need to hover over me. You have your own things to work on. Work on your book, patch up your henhouse. ” Her voice sounds snappish to her own ears.

His changeable eyes, now mossy green, darken. He chews his bottom lip, nodding slowly. “I thought you were one of my ‘things.’ Sorry to bother you.” He rises, walks downstairs.

“Mulder,” she whispers.

The tea goes down fine. Scully tries to eat the eggs but feels bile rise in her throat. She flushes them down the toilet instead of leaving them behind, because that is love.

***

She arrives at the nurses’ station on the second floor with three dozen donuts and two cardboard boxes of coffee. She deposits them on the desk. “Good morning, Annabel,” she says.

“Anneliese,” the woman says.

Scully nods, walks away.

*** 

He slides his hand up her pajama top, tracing circles on her ribs, sliding his fingers around to her breasts. He kisses the back of her neck. “Scully,” he whispers, his breath warm and ticklish in her ear.

She wants to pretend to wake up, to turn towards him and lose herself in his body. She wants to tell him everything, to be held and loved and petted and reassured. She wants him to remind her that she once stared down Congress, that some backwater priest and his prickly staff should be a joke to her. She wants them to laugh together at these silly, petty people.

But she can’t, she can’t disappoint him. He’s been so proud of her.

Scully stays still, breathes evenly until his hands move away and she’s alone again.

***

Her car rattles over the driveway, through shimmering waves of heat that rise from the crisping grass. It is the kind of late July afternoon where the sun is a hazy white ball in the west, and clouds of gnats are a permanent feature of the landscape. 

Scully parks, avoiding a puddle in which a peacock is standing. Mulder has recently become enamored of yard fowl. She narrows her eyes at it while opening the car door. 

“Good boy, Kevin,” she calls to it, wary.

Scully picks her way over the gravel in her thin heels. The peacock mews an alarm as she approaches, but doesn’t charge. She lets herself inside, shuts the heat and sun and wildlife outside. The house smells of coffee and microwave popcorn.

She walks into Mulder’s office and finds him hunched at his desk, typing. “Hey,” she says, and drops a kiss on his head. There’s a sketch of Baphomet taped to his monitor, her worn flash cards atop a tome about Raëlism.

He turns in his chair. He puts his arms around her hips. “Hey.” 

“Kevin behaved himself,” she offers.

“You two will be friends yet, you’ll see.”

She peers at the computer. “You get a lot done today?”

Mulder shrugs. “Eh, a bit. Waiting on a few emails, and I had to run that tubing to drain the sump down into the woods. Ate up most of the afternoon.”

Scully shakes her head in admiration. “I don’t know how you manage all the multitasking.”

“Well, the book helps me avoid the house, and the house helps me avoid the book. It’s a perfect system. That Ybarra guy still riding your ass?”

She chews her lip. “No,” she lies. “I think we’re okay now.”

“Good,” he says. “I’d hate to have to beat up a priest.”

***

Scully gazes at herself in the empty locker room. She looks thin and tired, and her hair is frizzing up, even pulled back like this. All her makeup has sweated off except for smudged crescents of mascara. Her bra is the color of a Band-Aid, her underwear white and sensible. Between the two is the hard white rose of her gunshot scar, like a second navel, an artifact of a second birth. It is numb when she touches it, indifferent. There are no stretch marks from William, a tale missing from the anthology of her skin. She unhooks her bra, lets it slide down to the damp floor. Scully turns to observe her body in profile. The scar is gone this way, the tattoo hidden as well, and she smooths her hands along her ribs. Her breasts seem out of place to her when they are unbound, frivolous somehow. Vestigial. 

She looks away.

***

The hospital is labyrinthine, having been constructed of various additions when funds allowed. There are dead ends, pointless staircases, and a mysterious storage closet filled with old televisions. She makes little maps on notepaper. 

“So where did you work before this?” an orthopedic surgeon asks her.

A diner in Wyoming. 

“I was out West for a while,” she says.

***

A week in, and Mulder has made a cake to celebrate. A bouquet of Kevin’s shed tail feathers ornaments the table.

An offering, Mulder calls it, tickling her chin with one.

A week down, she thinks, and blows out the candle. She wonders when she’ll stop counting the time.

***

Shy, he gives her a chapter to read. It’s good, and she tells him so. It’s very good. She hears his voice in her head when she reads it, his passion. She loves the esoterica tucked into his gyri and sulci.

“Your prose was never this clear in your reports,” she remarks. 

“Hey if you can’t blind them with brilliance, baffle them with bullshit.”

Scully laughs. “You want to read a few medical reports?”

He looks at her, suddenly serious. “Yeah,” he says. “I would. It would be nice to hear about your day for once.”

She wonders if love is the weapon that lets them wound so casually.

***

“You’re late,” Ybarra says softly. 

She doesn’t explain that she’d somehow ended up at the TV closet again, that the room numbering system in this hospital had been designed by nihilists, that the nursing student had Dermabonded her glove to a patient’s forehead.

She lowers her eyes like she did at Catholic school. She promises to do better.

***

“What’s going on?” Mulder asks her for what feels like the hundredth time. “Talk to me, Scully.”

She presses her hands to her face for a moment, drops them to her sides. “Nothing,” she says again, frustrating them both. “I’m tired. It’s a hard schedule.”

He places a throw pillow on his lap and pats it. “Come here,” he says. “Please.”

She acquiesces, curling on her side with her back to him. He runs his fingers through her hair, traces the Fibonacci spirals of her ear. She wants to relax, to melt into his touch. She indulges in a Mulderesque conspiracy theory that the hospital microdoses the water with tetanus toxin to keep everyone rigid and tense.

Scully gazes at the windows, at the hard white light of summer streaming in. The curtains are blue with an arabesque pattern, and they looked very chic in the store. She wonders now if they seem desperate in this odd little house. She thinks of Meg March, dressed up in borrowed finery at the Moffats’ ball.

***

Scully clomps up the steps to the porch and kicks her rain boots off next to the umbrella stand. It contains four umbrellas and a gnarled hickory limb that Mulder claims is going to be polished into a fine walking stick one of these days. She goes into the house and is dismayed to find it stale and stifling and dark. Dust motes waft in Brownian motion through shafts of sunlight, undirected by fans or air conditioning. 

“Mulder,” she calls, and there is silence.

She twists her hair into a bun as she pads upstairs, old wood satiny under her bare feet. She pushes open the bedroom door, and the air is hot and still. 

“Mulder?” She needs his help with her zipper, but there is no reply.

She wrestles herself out of her silk sheath, sticky and irritating, and lets it puddle on the floor. Her bra follows. She feels guilty, as Mulder has turned out to be a surprisingly diligent housekeeper. His office is filled with perilous stacks of home improvement books and arcane journals about lake monsters, the walls papered with clippings and blurry photographs, but he seems able to quarantine his own entropy.

She is trying to do the same.

Scully pulls on soft cotton pajama shorts, a gray tank top imbued with the compressive powers of Lycra. She uses lotion to rub away the mascara beneath her eyes. She goes downstairs and out the back door, shielding her eyes against the piercing sunlight. A mosquito whines at her ear and she pinches it out of the air.

“Still got those reflexes, kid,” Mulder says from somewhere off to her left. 

She turns and sees him crouched next to the hulking green block of the transformer. “All the lights are off, and the house feels like a rainforest. I take it you’ve had an eventful day?”

He sighs. “Not really. Well, not the event I was hoping for, which is the power coming back on. There was a pretty heavy thunderstorm around one and that’s when the electricity blew.”

She sits on the bottom step, knees drawn up. She likes to watch him working, a side of him they’re both still learning about. There was never much call for home maintenance at Hegal Place, or living out of cash-only motels. “You call the power company?”

He huffs. “Yeah, they told me they had no reported outages and the power should be fine. I explained that I was trying to report an outage and that it definitely was not fine and she promised someone would be here between tomorrow and eventually.”

Scully smiles. “And that’s why you’re out here toying with death?”

“Not much else to do, really. Can’t write with the power out.” Mulder sits back on his heels and shrugs. “You, uh, have a good day?”

She hadn’t. “Yep. Starting to feel like part of the team.”

“Good. You need to get your career standards as high as your standards for men,” he says, getting to his feet.

“Oh, well, that’s an obviously unattainable bar.”

“Obviously.” He sits next to her on the step. “You wear that to work? You know I think bras are a tool of the patriarchy and you shouldn’t bother, but I’m just surprised Our Lady of Perpetual Shame takes such a liberal view.”

She laughs a little. “I figured as long as I tossed a lab coat over it, I’d look like a real doctor. It worked when I was a kid.”

“Hey, that’s what I did with my badge half the time. Listen, Scully. The house is pretty tropical. You want to bunk up in a hotel until they get the power sorted out?”

Scully thinks about the convenience it would afford. Maids and room service and maybe a pool, depending. But she is tired of hotels, even nice ones. She is tired of polite signs that remind her that the pillows and towels and hairdryers aren’t hers, the tiny toiletries an indicator of her temporary status. She is tired of living out of suitcases and dressers that made her clothes smell strange, tired of running from her own life.  She wants to be home.

“Nah,” she says. “We’ll manage.”

Mulder looks surprised, but doesn’t question it. “I’ll call Lowe’s about getting a generator delivered tomorrow. We ought to have one anyway out here.”

She’d always had a vague idea that Mulder had money - it was the only explanation for his complete disinterest in it. But when they’d come back, when they’d talked to his lawyers, she'd been staggered. The Vineyard house alone explained his casual international jaunts. They can have things now, endless things, and there is something frantic in her that wants to spend the money. Bingeing chocolate bunnies after Lent.

Mulder peels his shirt off, wadding it into a limp ball. He tosses it so that it hooks over the doorknob. “Still got it,” he says. He preens.

“Does the NBA realize the tremendous talent they’re missing out on?” she asks. “Do they even know that, at this very moment, a six foot tall middle aged white man is out here flinging his clothing a distance of several feet?”

He snuggles up to her, wrapping his sweaty arms around her shoulders. 

“Ugh,” she says, and pushes at him. “Mulder, you’re disgusting and it’s a thousand degrees out here.”  

“Hoping that cold, cold heart of yours might cool me off.” She sniffs disdainfully, and he releases her. “Scully, how do you feel about bees?”

“We have a history, bees and I,” she observes, tapping the back of her neck.

Mulder curls his hand over the scar, kneads the muscles there. “Well, these wouldn’t be fancy bees.”

“Hmmm,” she says. “I’m not inherently opposed. Why do you want bees, Mulder?”

He shrugs. “I’m getting older, and I’ve got to consider funeral plans. The last one didn’t really go as expected, so I thought maybe I’d mellify myself this time.”

She nods. “Makes sense. I mean, of course, there’s no actual proof that mellification actually occurred, but that’s never stopped you.”

“I also like honey,” he adds. “And bees are good for the planet.”

“Honey often contains botulism spores,” she remarks. “Botulinum toxin is the most lethal toxin known, and it’s estimated that as little as 40 grams of it would be enough to kill everyone on earth.” She doesn’t say you shouldn’t give it to babies, that she sweetened her smoothies with dates and maple syrup so that -

“Well, nobody better piss off my bee army and me,” he says darkly. 

“Everybody eventually pisses you off. Mulder, is that old tent in the shed still? We could sleep in that tonight.”

He shakes his head. “Heavy mildew and dry rot, so I threw it out. We could sleep out here if you want, though. We’ve got that big air mattress.”

“Let’s do that,” she says. “We can put it on the porch. Tell you what - you get stuff together, and I’ll even make dinner.” Scully doesn’t like cooking, but she wants to create order, to complete a finite task. She can be domesticated again, like a lost house cat finally returned to a hearth.

“We having eggs or peanut butter?” he asks, smirky.

“I’d hate to spoil the surprise,” she snips, and goes back into their sauna of a house. 

In the kitchen, she stands in front of the open fridge, letting the delicious leftover cold soak into her skin. She’ll deal with the spoiled food later. Eggs had, actually, been her plan but it’s just too hot. The stove doesn’t work, and she doesn’t have the fortitude to turn the grill on. She finds some leftover shrimp pasta that Mulder has made, some vegetables, and assembles it all into a passable salad.

There, she thinks, pleased. I’d pay twelve bucks for that somewhere. She uses her foot to scratch a mosquito bite on her calf.

Her skin is clammy, hair stringy and damp from sweat. Maybe they should just go to a hotel after all. Perhaps she should stop ascribing symbolism to every damn thing and enjoy herself once in a while. But she thinks of packing, of driving, of unpacking and somehow it’s all too much and her eyes start to fill and her sinuses sting.

Scully pinches her wrist until it passes, feeling weak and hating the weakness in herself. It’s the heat, it’s the exhaustion, it’s the heavy mental load. She considers going outside for a dip in the pond, but suspects the water will be unpleasantly warm. Instead, she drags herself back upstairs for a cold shower.

She sits on the edge of the bed, weary, and stares at a framed picture of a sea turtle on the far wall. If she lets her eyes drift out of focus, it looks like it’s swimming. She tips her head back for a better angle, watches it float across her vision. It slips away then, into the black of the deep waters.

***

She startles awake when he touches her shoulder, gasps.

“Jesus,” Mulder says, and sits next to her. “Bad dream?”

Scully sits up, dazed. “What? No, was I asleep?”

“You’ve been out cold for over an hour, but I wanted to make sure you got some food. Water at least, it’s too hot up here.”

She blinks, confused. “I don’t remember,” she says. Peering to her right reveals night outside.

Mulder holds a hand out and she grasps it, letting him pull her to her feet. She wavers and he steadies her, arm about her shoulders. 

“I just need some water,” she says, defensive.

He guides her down the stairs and out the front door onto the porch. The air outside is substantially cooler, a light breeze kissing her face. She settles into a chair, stares deep into the felty dark. She still can’t remember falling asleep. 

Mulder hands her a water bottle from the little table and she rolls it between her palms, the plastic crinkling. “Hey, I thought you were setting up the air mattress out here,” she says.

“No air flow behind the wall,” he replies. “Drink that up like a good girl and I’ll show you what we’ve got.”

Scully obeys and feels better. The water tastes stale, but it’s cool and wet. “Maybe you should have my job,” she says, looking up. “Caring for live people is so much work.”

“Everybody eventually pisses me off,” he reminds her. “Come on, Doc.”

She follows him down the steps and around the side of the house. Their property is vast and feral, pocked with mole burrows and rabbit nests. The floodlights are out with the power, and the house is nearly swallowed up by the vast night. Scully glances up at the Milky Way, at the waxing moon, and marvels again at the sky they have out here. We are star stuff, she thinks.

“Moonstruck?” Mulder asks.

“The fault, dear Brutus, is not in our stars.”

“As long as you can tell a hawk from a handsaw,” he says, and tugs her along.

She follows him to the back of the house and then stops, smiling. Mulder has hammered some old two-by-fours into a frame, draped the structure in white bedsheets. Inside, the air mattress is piled with sofa pillows. Outside, camping lanterns, candles, and two strands of solar lights make it into a kind of fairy circle.

“Mulder,” she says, delighted. “This is ridiculous.”

“Indian Guide saves the day,” he says.

“Your architecture badge is definitely more impressive than your fire badge,” she says, walking over to the little tent. He’s brought her salad inside, and there is a cooler packed with ice and water bottles. Cans of bug spray sit at the flap. She crawls inside, suddenly ravenous. 

Mulder joins her on the mattress, which bounces in response. “Remember my water bed?”

She laughs, piling food on a plate for each of them. “What a swinging bachelor you were.”

She remembers the water bed fondly, the leather couch and the fish and the postage-stamp bathroom in his apartment. It shouldn’t hurt still, but it does. She knew herself there, her place on the map. She eats her salad, wistful for Chinese food and beer at that battered coffee table.

“Scully,” he says.

“What?”

“Scully.”

“Just middle-aged nostalgia, I suppose,” she murmurs.

He reaches out to take her hand. “You’re scarcely middle aged.”

She smiles, squeezes his fingers. “If you go by life experience, we’re both about two hundred years old.”

“Like those Galapagos tortoises. But you need to tell me what’s going on at work. You won’t disappoint me.”

It can be very disagreeable to live with a profiler.

Scully drops his hand. She bites at the fleshy part of her thumb. This is real, she thinks. This place. It is not down in any map; true places never are. She can only deflect for so long, and her armor is rusting away. “I’m afraid,” she whispers, then chances a look at his face.

His eyes are soft, searching. “Why?”

She shakes her head. “I don’t know, I don’t…” Her sinuses sting again and she presses her palms hard into her eyes. “Please.”

Mulder’s hand on her back, in endless, gentle figure eights. He pulls the elastic from her hair and lets it tumble down to her shoulders. He shifts so that her back is to him, his long legs on either side of her body.

“Mulder, what -”

“Shhhh,” he says, and gathers the hair at the crown of her head. “It’s not a real sleepover if you don’t get your hair French braided.”

Scully blinks. “Since when do you know how to braid hair?”

“Little sister, absent parents. Now stop moving and talk.”

She keeps her head very steady, thinking of her own sister’s deft fingers when their mother was too busy for anything but ponytails. Mulder tugs at another little section of hair. Scully thinks she might be okay if she isn’t looking at him, if she can’t read herself in his eyes.

Moth shadows dance across the white sheet wall, drawn to the flickering candles outside. It fascinates her that they never figure out that fire burns.  “I don’t know how to do this,” she says, and her voice is thick.

“To talk, or to be still?” he says in his Oxford psychologist voice.

She isn’t sure of what she means either. “Yes,” she says, with a hiccupy laugh. “Both.”

“Me too,” he says, slipping his thumb through the strands behind her ear. “I don’t know how to do this.”

She swallows hard. “I just...I’ve always had something to consume me. I had the FBI, we traveled all the time, and then we were running and I thought it was hard but it was so easy to just survive. There were no decisions. I didn’t care about, I don’t know...plates.”

He pauses in his work. “Plates?”

Scully chews at a hangnail, frustrated. “Just things, the things you buy for a house. Long term things. I did with William and then…” she trails off, her chest tight. “I feel like I’m playing a game sometimes, like improv theater. Fox and Dana Build A Home.”

“Fox and Dana?” he repeats. “Surely not.”

“Well, we’re hardly Mulder and Scully anymore, are we?” Her stomach clenches and that’s it, she sees. That’s the fear.

He finishes the braid and fastens the elastic at the end of it. “Of course we are,” he says. “We are who we are.”

She turns to him then, the whispering anxiety back with a roar. “And who is that, Mulder? I was plain old Dana Scully until I met you. And we had this life, this strange and wonderful and terrible life where I was Scully because I was your partner and now that’s over. It’s all nothing.” She’s crying openly now, quietly, and it feels cleansing.

“You’re still my partner,” he says, and his eyes are shining too.

She wipes her nose with a paper napkin. “Am I? At what? I go to work and see patients but I forgot there’s no closure with the living. People get sick and get better and get sick again. It doesn’t end. And this house, the power is always going to go out and the chickens will always be hungry and -“  she stops, feeling hysterical.

“You don’t have to work,” he says softly. “The settlement from the FBI, my inheritance…”

She shakes her head. “You know I have to work.” 

He sighs, rubs her knee. “I know you do. But it doesn’t have to be this. It doesn’t have to drain you.”

He’s right, of course he’s right, but he’s also so terribly wrong that she wonders if he knows her at all. She has to be a doctor for her father, for William. For him. She has to see something through. Scully smooths her hand over the back of her head, feeling the even ridges of the braid. Mulder is so competent with everything he does, so easy with himself. He’ll get his damned bees and become some kind of honey magnate in no time.

“People at the hospital, they ask me what I did before. And I don’t know how to answer. How can I possibly answer that question? I just say I was with the government, but that isn’t really the answer, is it?”

Mulder shrugs. He’s never felt the need to explain himself to people. “It’s true.”

Scully stretches out on her stomach across the mattress, chin on the pillows, watching the moths again. They tumble like acrobats, untethered in the thick air. “There’s this number called Graham’s number, used in Ramsey Theory, which is, well, nevermind. It doesn’t matter. Anyway, it was in the Guinness Book for being the largest specific number used in a proof at the time. And Mulder, this number is so big that writing out all the digits would exceed the bounds of the known universe.”

“Nobody likes a math nerd, Scully.”

She rolls onto her back to glare at him. “Yes they do, they give them Nobel prizes. Anyway. A whole new notation system, Knuth Notation, had to be developed to express these massive numbers. Graham’s Number, Tree(3), et cetera. And I feel like that at times. That there’s this endless amount of vital, inexpressible information inside of me that is so essential but that I have no way to share.”

She blinks a few times, spent by this unburdening.

Mulder stretches out next to her, propped on his side. “You can express it to me,” he says, massaging her temple with his thumb.

Scully closes her eyes. “I feel like a ghost sometimes. How do you do it, Mulder? How do you just keep moving forward without getting lost?”

He sighs. “I don’t know how to tell you this, but you have a tendency to compile people into perfect specimens, then measure yourself against that imaginary standard. It’s the precession of simulacra.”

She looks at him, indignant, then realizes he could be right. “Well,” she says. “It’s possible. But Mulder, is that such a bad thing, to want to hold myself to the highest goals?”

He tugs her onto her side so that she’s facing him, nearly nose to nose. Her lips feel tingly. “Yes,” he says, stroking her hair. “When the goal isn’t attainable. And when it puts everyone else on pedestals where we’re ill equipped to balance. And when it puts you in a constant state of frustration and anxiety. No one is perfect. Not even you.”

“I don’t want to be perfect,” she lies. “And I don’t need you to be either.” That part is true, at least.

He laughs in reply. “Apropos of being Galapagos tortoises, Charles Darwin once said ‘I am very poorly today, and very stupid and hate everybody and everything.’”

“He rode the tortoises,” Scully says, calming. “I can’t defend his methodology.”

“See? You’re better than Charles Darwin.” He kisses her forehead.

“Well,” she says. “Well.”

“Scully, look. You’re not alone here, feeling at sea. I went to the feed store and some guy picked a fight, shoved me pretty hard with his shoulder. And this reflexive part of my brain wanted to grab my badge, stick it in his face, and put him against the wall for assaulting a federal agent. But I ignored it and bought the chicken feed and just headed out. And I felt like, is this who I am now? Some pushover with yard birds and home improvement books?”

“You made a little fast and loose with your authority sometimes,” she says, thinking of Roche. She curves her palm against his cheek, thumbs the fine ridge of his zygomatic bone.

He bumps her nose with his. “You broke into a secret morgue.”

“You made me.” She sniffles, laughs a little. “The good old days.”

“These can be the good days too,” he says. “They can, if we work at it.” He traces her mouth with his finger.

“Okay,” she says. Hope stirs in her, a thing with feathers. “Partners?”

“Partners.”

He kisses her, in their small tent, in their ring of light.

[majetypraveena]

Navigating Spirometry and Its Clinical Applications

Spirometry, encompassing fundamental lung function assessments measuring both exhaled and inhaled air, involves the examination of three interconnected parameters: volume, time, and flow. This method stands as an objective, non-invasive, and remarkably sensitive approach, capable of detecting early deviations in lung function and offering reproducible results. The advent of portable spirometers has extended its reach to almost any setting and, with proper training, made it accessible for a broad range of individuals. The primary objectives for conducting spirometry encompass identifying the presence or absence of lung disorders, quantifying degrees of lung impairment, monitoring the impact of occupational or environmental exposures, and evaluating the effectiveness of medications.

What are the Indications for Pulmonary diseases?

Spirometry is a versatile tool used for detecting and diagnosing a range of pulmonary diseases, including:

Asthma

Chronic obstructive respiratory disease (COPD)

Cystic fibrosis

Pulmonary fibrosis

Patients with these conditions often require regular follow-up tests to monitor their lung function and disease progression. Spirometry is instrumental in assessing the effectiveness of prescribed medications and tracking any changes over time.

Furthermore, spirometry serves as a means to establish an individual's baseline lung function, offering a reference point for future comparisons and the identification of any alterations that may occur over time. This baseline measurement is especially valuable for individuals exposed to occupational hazards that increase the risk of lung disease, such as dust or toxic particles in the air.

Spirometry can also aid in investigating specific respiratory symptoms like persistent cough and dyspnoea (shortness of breath). It is a recommended diagnostic test for heavy smokers aged over 35 due to their elevated risk of pulmonary diseases.

When is Spirometry Contradicted?

If an individual has any of the following that has occurred recently, then it may be better to wait until the patient has fully recovered before carrying out spirometry.

Haemoptysis of unknown origin

Pneumothorax

Acute disorders affecting test performance, such as nausea or vomiting.

Thoracic, abdominal, or cerebral aneurysms

Recent eye surgery

Unstable cardiovascular status, recent myocardial infarction, or pulmonary embolism

Recent thoracic or abdominal surgical procedures

What is Spirometry Device?

Spirometry relies on a device known as a PFT spirometer. This medical apparatus comprises a mouthpiece and a connected tube, which is linked to a machine designed to measure the flow of air. This tool is essential for conducting spirometry tests, as it accurately records the volume, time, and flow of inhaled and exhaled air to evaluate lung function.

How is Spirometer used?

Several techniques can be employed when conducting spirometry, allowing flexibility based on the patient's comfort and cooperation:

Tidal Breathing Technique:

The patient begins with normal, tidal breaths through the mouthpiece.

A deep breath is taken while still using the mouthpiece.

This deep inhalation is followed by a rapid, full exhalation.

Immediate Exhalation Technique:

The patient starts by taking a deep breath.

They then quickly place their mouth securely around the mouthpiece.

A complete exhalation is performed promptly.

Quick Inhale and Exhale Technique:

The patient is instructed to fully empty their lungs first.

Following exhalation, they are asked to take a quick, full inhalation.

This inhalation is succeeded by a thorough exhalation.

What is a normal reading on a spirometer?

In adults, age, height, sex, and race are the main determinants of the reference values for spirometry measurement.

Spirometry measures two main components:

Forced Vital Capacity (FVC): It's the maximum amount of air exhaled after a deep breath.

Forced Expiratory Volume in One Second (FEV1): The volume of air exhaled in one second.

Results are compared to typical values for your demographic, with a normal reading being 80% or higher. Spirometry helps diagnose lung conditions like obstructive and restrictive diseases.

Spirometry results can also aid in diagnosing lung conditions, including:

Obstructive Lung Disease: Conditions that make it challenging to exhale all the air from your lungs due to lung or airway damage. Common examples include asthma, bronchiectasis, COPD, and cystic fibrosis.

Restrictive Lung Disease: These conditions prevent your lungs from fully expanding. Common causes include amyotrophic lateral sclerosis (ALS), interstitial lung disease, muscular dystrophy, sarcoidosis, and scoliosis.

Spirometry is a vital tool in the diagnosis and management of respiratory diseases. Its non-invasive nature, sensitivity to early changes, and reproducibility make it a cornerstone of modern respiratory healthcare. By navigating spirometry and understanding its clinical applications, healthcare providers can better support patients in their journey to optimal lung health.

[indestinatus]

it was this post’s fault.

This may be triggering (about COVID-19). Please, stay safe.

“Ziva…?”

“Hmmm”

“You awake?”

“No,” she snuggled up closer to him, her arm over the one he had put around her waist hugging him tighter.

“You think… you think I have a higher chance of getting this virus because of the plague?”

Ziva turned to him, opening her drowsy eyes, “…what plague?”

“The… the bubonic plague. I almost died of pneumonia right before you arrived.”

Tony’s eyes were worried, searching hers as if the certainty he was looking for was hidden right in front of him.

“No, Tony,” she whispered softly, a hand caressing his cheek, “of course not. That happened long ago.”

Tony nodded but his face was still grave. He clenched his jaw and inhaled deeply, accepting her poor attempt of comforting him at the late hours of the night.

“You’re probably right, it’s just-” he huffed a tired laugh, “it’s just so much information about this disease, I don’t know if I can get it and- and pass it to you and Tali-”

He clenched his jaw tight, but the tears escaped despite that.

“Pass it to you and Tali, and if I live through that and you-”

“Shhh, don’t think about it,” Ziva wiped his tears gently, kissing his temple, “this will never happen. Don’t do this to yourself.”

Tony fixed his eyes on hers and nodded again.

“Promise me,” his voice was hoarse but steady, “promise me you’ll get her safe. Promise me you’ll do whatever you have to to keep her safe. To keep you both safe.”

Ziva nodded, eyes alert but giving him a calmness he knew was the only thing keeping him sane, “I promise. Though there’s no need for that. We’ll be okay, dear,” he relaxed his face where her hand was holding his cheek, “after all we’ve been through, we’ll be okay.”

Tony kissed her hair and got back to their position in bed.

“Thank you,” he kissed her bare shoulder.

“Your welcome, dumbass.”

°°°

“IMA! IMAAA!”

“WHAT? WHAT, TALI? WHAT’S WRONG?” 

Ziva woke up in a second, jumping from the bed and heading to the living room with her weapon raised, still in pajamas.

Tali was crying, sitting on the kitchen floor.

Ziva was there in an instant, bending herself towards the ground behind the counter until she was rocking her little girl on her lap.

“Shhhh, it’s okay. You’re okay,” Tali held her pajama shirt and tears wet Ziva’s skin, “tell me what’s wrong, mon coeur. A bad dream?”

“No-no,” Tali sobbed and her voice was quiet, “daddy. Daddy has it, doesn’t he? I don’t wanna him to die.”

“No, sweetie, of course not, he-”

A series of coughs.

A series of hard coughs coming from nearby.

Ziva stood up. She couldn’t feel herself doing that, every cell on her body had turned cold. Her heart was in her throat, eyes darting everywhere, searching for him. Shivers ran up and down her arms, Tali was pulling her shirt down and had started crying again.

The world stopped.

She could feel her own heart breaking.

Tony turned around. 

He was at the balcony, the one that led to their backyard, a hand over his already mask-covered mouth, coughing and gasping for air in the in-betweens.

A closed glass door separated them.

“No, no, no,” Ziva started muttering to herself, knees wobbling as she ran towards the door, “you can’t be serious. This isn’t happening.”

Tony’s eyes turned alarmed and he raised a hand towards her, begging her to stay away.

They were red eyes. As if he had been crying all morning. 

“No, no,” Ziva didn’t feel the hot tears streaming down her cheeks, “Tony, come back here. Come back here this instant.”

Tony started to cry as well, eyes darting from her to the little girl hiding behind Ziva’s body, sad eyes wide. He couldn’t stop coughing.

“You can’t do this to me,” Ziva yelled at him, knees giving in as she slipped to the floor, “you can’t go. I can’t live- I can’t live without you. I can’t-”

Tony clenched his jaw and made an effort to stop coughing, chest going up and down. He kneeled in front of her, on the other side of the glass. A shaky hand pressed his mask and blew a weak kiss towards her, followed by one directed to Tali, his eyes red with tears.

Ziva’s voice died in her throat. She couldn’t move. The world blocked out all the sound, she couldn’t hear a thing except his coughing restarting. Tears continued to stream down her face and Tali kept asking her what was going on. 

Tony took out something from his pocket and held in her direction.

A phone. His phone.

“911, what’s your emergency?”

Ziva was paralyzed. Everything was darkness.

“Hello, 911, what’s your emergency?”

Tony laid down on the ground, gasping for air.

“Hello, is anyone there? 911, what’s your emergency?”

Tali continued to cry.

°°°

There wasn’t a dry eye at the navy yard that day.

The television was on, but Ziva wasn’t listening to it.

“The world is at mourning. Every day there is horrible news, one after the other, and most of us can’t stand hearing about COVID-19 any longer. We ask for hope, and peace and kindness. We send good wishes and stay at home, praying to ourselves this won’t happen to us or our family. Praying for good news.”

“Today, we lost someone special to the United States. Someone very special, as most may know him as former Very Special Agent Anthony DiNozzo, from the Naval Crime Investigative Service. He was tested positive for COVID-19 and remained at the Washington Hospital Center throughout his intensive care. Reliable sources confirmed he had survived the bubonic plague almost twenty years prior, but that has left pulmonary fibrosis and his immune defense compromised.”

“He was a hero for many and loved very dearly by all his colleagues. As they say, he was made of laughter and only wished the good in this world.”

“His legacy will continue by his wife, former Special Agent Ziva DiNozzo, and his six years old daughter, Tali DiNozzo.”

“Please stay at home. The whole team from CNN wishes the family peace and the best of wishes. Tonight, there won’t be joy, but tomorrow, there’ll still be hope. Stay safe.”

Tony’s photo stared at her from the screen, his smile wide as if he were still sitting at the desk in front of her. Ziva felt a coldness she had never felt before, even if Abby hugged her tightly, sobbing on her shoulder. 

In fact, the whole office was silent, and only faraway sniffs could be heard.

“Here, McGee, don’t miss it. One-two-three- AAAAAH,” he jumped in front of Ziva, scaring her from behind. His features were so young, so naive and careless at the video from years back.

Young Ziva started punching his shoulder, making Tony cower down laughing loudly, “did you get it? Did you get it on camera?”

McGee’s face appeared, smiling wide as he pulled the camera to film the three of them, Ziva showing her tongue to her partner, “of course I did.”

“Great,” Tony’s laughter echoed, coming from the screen, “great, I’ll do this again in fifty years and we can make a comparison to see if older Ziva’s reflexes are better. Once Mossad, forever Mossad. Well, we’ll see about that. Thank you, Probie.”

The television froze and his smiling face turned black and white.

Ziva couldn’t stop crying.

Everything was cold.

Everything was darkness.

[oxylusofficial]

The Impact of Coronavirus on Lungs

Why are the lungs important?

 Every cell in your body needs oxygen to live. The air we breathe contains oxygen and other gases. Once in the lungs, oxygen is moved into the bloodstream and carried through your body, and carbon dioxide, waste gas from the metabolism, leaves the blood and enters the lungs from where it is expelled through the windpipe and nose.

 Hence, the function of the lung is of utmost importance and a reduced lung function implies a reduction of the ability of the lungs to exchange gases.

 To quote Tim Winton “It’s funny, but you never really think much about breathing. Until it’s all you ever think about.”

 At times even breathing can be a luxury, especially during these challenging times!

 The origin of all maladies

 In late 2019, a new coronavirus began circulating in humans. This virus, called SARS-CoV-2, causes the illness known as COVID-19.

 The coronavirus that causes COVID-19 is still very novel to us, and a lot of research is under progress as to what this virus does to a person's body — including how it affects the lungs.

Coronavirus, The Culprit

 We do know that COVID-19 is a respiratory illness, and that infected people can easily spread as they cough, sneeze, clear their throat, or even breathe or speak near someone else — even without having any outward symptom of carrying the virus.

That is the reason why we should all be maintaining social distance, maintain hand hygiene and wear masks while outside our homes.

The Gateway

This virus can spread easily from person to person. It mainly does this through respiratory droplets that are produced when someone with the virus talks, coughs or sneezes near you and the droplets land on you.

 You may acquire SARS-CoV2 if you touch your mouth, nose, or eyes after touching a surface or object that has the virus on it.

 The Battle Begins.

 Having entered your body either through your eyes, nose or mouth, the virus travels to your chest. The real combat starts there. Your lungs become the battleground, sustaining injuries in the process.

The extent of damage varies from person to person. While some may experience only mild damage to the airways, others might suffer damages more severe, even life-threatening.

The Combat Continues

Once in the chest, the virus begins to attackthe airways, causing inflammation. As inflammation increases, you might feel tightness in the chest or even breathing could cause pain.

Also, this can cause chest tightness or deep pain while breathing. A dry cough with a barking sound and feels like asthma develops.

Your Lungs turn into a warzone

The battle turns into a war when the lung tissue becomes infected. It becomes swollen and filled with fluid containing dead cells. A condition clinically referred to as pneumonia.

Pneumonia can be mild, moderate, or severe. Depending on how difficult it becomes to breathe and how impaired the gas exchange at your lungs become, the situation could even become life-threatening.

This fluid build-up can affect your oxygen levels, which could eventually hamper the functioning of all other vital organs like the heart, brain and kidneys.

It is especially important to keep a close watch on the oxygen saturation levels as you might require hospitalization if the oxygen level dips. As it meansthe transfer of oxygen into the bloodstream is reduced. You will need supplemental oxygen and close monitoring in a hospital setting.

In profoundly serious cases, one may need to be placed on ventilator support in the ICU.

Does COVID-19 have long-term effects on the lungs?

This new virus has only been around for about a few months now. Research is on to know potential long-term effects it can have on a person's lungsor any organ system in the long run, be it your heart, brain, and vascular systems.

There are reports that one unique thing that people with this covid-19 infection might experience is pulmonary fibrosis resulting in scarring in 20% to 30% of the patients who require ventilation. Inthe case of regular ARDS (Acute respiratory distress syndrome), the lung disease, your lungs would have recovered by six months.

So, it might just be too soon to tell but there could be a possibility that this disease can cause more injury to the lung and more residual fibrosis than other forms of ARDS.

Get Vaccinated.

Vaccination will significantly protect you from this disease and hospitalisation. The full protective effect develops two to three weeks after the second dose. Continue taking all precautions even after vaccination.

Prevention is in your hands.

It is in your hands indeed! Hygiene! Practising hand hygiene, following social distancing norms and keeping your body immunity high with the right kind of food, supplements and nutraceuticals like Chovsafe for Lungs is like waving a white flag and making peace.

Isn’t it wiser to prevent such a ravaging war rather than suffering its physical and mental aftermath?

Visit Us: Nutrition for Lungs ,Vitamin for lung infection ,Vitamins and minerals for lungs ,Smoking vitamin E ,Vitamins That Help With Breathing, Antioxidants for Lungs 

[stacyqcee967]

20 Myths About microorganism: Busted

The Greatest Guide To How Dangerous Is The Coronavirus?

Hidden health conditions, such as heart or lung disease, can increase your threat of establishing unsafe symptoms if you become infected with coronavirus illness 2019 (COVID-19). Coronavirus illness 2019 (COVID-19) signs can vary extensively. Some individuals have no symptoms at all, while others end up being so sick that they eventually need mechanical help to breathe.

This resembles what is seen with other respiratory health problems, such as influenza. While each of follow this link these serious illness increases the danger of extreme COVID-19 signs, individuals who have several of these underlying illness are at even greater danger. Individuals of any age, even children, can catch COVID-19.

Everything about Doctors Chase Treatment For Kids Threatened

The threat of developing unsafe symptoms increases with age, with those who are age 85 and older at the greatest risk of major symptoms. In the U.S., about 80% of deaths from the disease have been in people age 65 and older. Dangers are even greater for older people when they have underlying health conditions Take all your medications as prescribed.

Assisted living home locals are at high risk because they often have numerous underlying health issues, integrated with advanced age. And bacteria can spread out extremely easily between individuals who live in close proximity to each other. If you live in a nursing home, follow the standards to prevent infection. Inquire about defense steps for residents and visitor restrictions.

Rumored Buzz on Everyone Should Know About The Coronavirus

COVID-19 targets the lungs, so you're most likely to develop serious signs if you have preexisting lung problems. Your risk of major symptoms is greater if you have these conditions: Chronic obstructive lung disease (COPD) Lung cancer Some lung conditions might increase your threat of serious illness from COVID-19, consisting of: Cystic fibrosis Lung fibrosis Moderate to serious asthma While some medications for these conditions can damage your immune system, it is necessary to stay on your maintenance medications to keep signs as managed as possible.

It might likewise help to avoid the things that make your asthma even worse. These asthma triggers can differ from person to person. Examples include pollen, dust termites, tobacco smoke and cold air. Strong emotions and tension can activate asthma attacks in some individuals. Others are troubled by strong smells, so make certain the disinfectant you're utilizing isn't an asthma trigger for you.

The Coronavirus Disease Advice For The Public Diaries

People with numerous chronic conditions are most likely to experience harmful signs if https://naturallygreenla.com/what-is-the-best-disinfectant-spray-for-covid-19/ contaminated with COVID-19. These include type 2 diabetes, serious obesity and major heart diseases. Hypertension and type 1 diabetes may increase your threat of severe COVID-19 symptoms. Obesity and diabetes both decrease the performance of a person's immune system.

The danger of infections, including COVID-19, can be lowered by keeping blood sugar level levels controlled and continuing your diabetes medications and insulin. Your danger of severe disease is greater if you have heart problem such as cardiomyopathy, pulmonary high blood pressure, congenital heart disease, cardiac arrest or coronary artery disease. Continue to take your medications precisely as prescribed.

How Covid-19 Frequently Asked Questions can Save You Time, Stress, and Money.

Keep your hypertension managed and take your medications as directed. People who currently have cancer are at greater danger of developing more extreme illness from COVID-19. This risk can vary, depending upon the type of cancer and the type of treatment you're receiving. Sickle cell anemia is another condition that increases the risk of extreme COVID-19 signs.

It also causes agonizing obstructions in little blood vessels. Another inherited blood condition, called thalassemia, may also make you more likely to have serious COVID-19 symptoms. In thalassemia, the body does not produce enough hemoglobin and this impacts how well the red cell can carry oxygen. A healthy immune system fights the bacteria that cause illness.

Excitement About Certain Medical Conditions And Risk For Covid-19

Conditions that affect your body immune system and increase your risk of severe disease from COVID-19 include: Organ transplants Cancer treatments Your danger of severe signs from COVID-19 might be increased if you have conditions such as: Bone marrow transplant HIV/AIDS Long-term usage of prednisone or comparable drugs that compromise your body immune system If you have a weakened immune system, you may require to take additional preventative measures to avoid the virus that causes COVID-19.

You may desire to have your medications sent by mail to you, so you don't need to go to the drug store. If you have persistent kidney illness, you're at greater danger of becoming seriously ill with COVID-19. You might have a higher risk of being ill with severe COVID-19 symptoms if you have chronic liver disease.

inactivate bacteria id="content-section-6">The Ultimate Guide To Common Questions About The Covid-19

Let your physician know if you feel ill. You may have a weakened immune system if you have chronic kidney disease and are having dialysis. If you have persistent liver disease, your threat of being seriously ill with COVID-19 may be greater since you may have a weakened body immune system.

The U.S. Food and Drug Administration (FDA) has given emergency situation use permission for 2 COVID-19 vaccines, the Pfizer/BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine. A vaccine might prevent you from getting COVID-19 or prevent you from ending up being seriously ill from COVID-19 if you get the COVID-19 virus. You can take additional steps to minimize your danger of infection.

The Ultimate Guide To Why Is Covid-19 Dangerous To Heart Patients?

Centers for Illness Control and Avoidance (CDC) suggest following these precautions for preventing COVID-19: Avoid large events and mass events. Prevent close contact (within 6 feet, or about 2 meters) with others. Prevent anybody who is ill. Stay at home when possible and keep range between yourself and others if COVID-19 is spreading out in your neighborhood, especially if you have a greater danger of serious health problem.

Cover your face with a fabric face mask in public spaces, such as the supermarket, where it's tough to prevent close contact with others, particularly if you're in an area with ongoing neighborhood spread. Cover your mouth and nose with your elbow or a tissue when you cough or sneeze.

[doctorfiction]

Hey Doc, how realistic is a “mild” punctured lung? Like, an ice pick in the top of the lung. Will that kill you after an hour or so?

First, my apologies; Doctor Fiction has spent the last few weeks wrapping up some developmental copyediting coursework and revising the prologue and epilogue of my latest novel. I have a backlog of excellent questions that I will work through as quickly as possible.

An injury of this type is called a Traumatic Pneumothorax.

Pneumothorax has many fiction applications and is a great device to incapacitate, or if the plot warrants, terminate a character. The medical sequelae (outcome) can be mild and develop over hours to days or catastrophic and occur in less than a minute or anything in-between.  

As usual, we begin with a little anatomy and physiology, progress to pathology, and finish with a few fiction applications.

The Good, the Bad, and the Ugly:

Anatomy and Physiology: (The Good)

Lungs: Paired organs used to exchange carbon dioxide, the bodies waste gas, carbon dioxide, for oxygen (oxygen makes up approximately 21% of what passes for “fresh air” in our current environment.)

Thoracic Cavity: The lungs are contained within the Thoracic or Chest cavity. This cavity is lined with a slippery membrane called the pleura.

Pleura: This membrane lines the thoracic cavity. It secretes a serous fluid that keeps the lung in direct contact with the inner wall of the chest cavity but allows it to slide freely while breathing.

Pleural Space: This is a potential space between the lung surface and the cavity wall. Any injury or disease process that converts this potential space into an actual space is called a Pneumothorax.

Pericardial Sac: This is a double-walled sac containing the heart. It is located in roughly the center of the chest cavity and contains a pericardial membrane that functions like the pleural membrane for the heart.

Trachea and Bronchi: This is the “breathing tube.” Think of it as an inverted “Y” with one bronchus branching off the trachea to each lung and the trachea or root of the Y accessing the outside air via the mouth and nose.

Alveoli: There are over six hundred million of these tiny air sacs in the lung. Each one communicates with the circulatory system via its own venule and arteriole which are connected by a capillary bed wrapped around the alveoli.

The venules carry oxygen-depleted blood and carbon dioxide to the Capillary Bed where the inspired oxygen is extracted and the carbon dioxide discarded. The arterioles then carry the oxygen-rich blood back to the heart where it is distributed to the body and the whole process repeats itself.

 Pneumothorax: (The Bad)

A pneumothorax is the creation of air space between the chest wall and the lungs for ANY reason. Pneumothoraxes (sounds like a character from Dr. Seuss) can be categorized two ways:

By their etiology, that is their cause, which can be spontaneous or traumatic.

Spontaneous Pneumothorax

·      Medical condition: asthma, lung cancer, or chronic pulmonary disease

·      Genetics: Cystic Fibrosis, Marfan’s Syndrome, or Ehlers-Danlos Syndrome

·      Physical Attributes: Thin males between the ages of 15-34 have a five-fold risk

·      Lifestyle:  Smokers have a twenty-two-fold risk increase over non-smokers

 Traumatic Pneumothorax

·      Penetrating Chest Wound: gunshot, stabbing, foreign bodies (open to outside)

·      Blunt Trauma: fractured rib (closed to outside)

·      Barotrauma: sudden pressure change: SCUBA and blast injuries (closed)

The second and more germane classification is by their presentation as Simple or Tension. In the most basic terms, a Simple pneumothorax is the creation of a space between lung and chest wall which is uncomfortable, may require intervention, but does not expand and is not life-threatening.

 This qualifies as, The Bad, but it does not qualify as …

Tension Pneumothorax: (The Ugly)

Each time you take a breath, a small amount of air moves into the space between the lungs and the chest wall and cannot escape. This results in several forms of badness:

·      The air trapped between the lung and the chest wall does not pass through the alveoli, and as such, cannot replace the carbon dioxide waste with needed oxygen.

·      With each breath, the space grows larger and pushes against the lung (tension pneumothorax), compressing the alveoli and further decreasing function.

·      This ever-expanding bag of air pushes against the pericardial sac and compresses the heart, decreasing cardiac output. This is rapidly fatal without immediate intervention. The “Adam’s Apple” or trachea shifts or “points” to the side where the pneumothorax is. (this information will be helpful later)

If the stab wound has pierced a blood vessel, potential space may be filling with blood as well, creating a hemopneumothorax an all too common occurrence here in the emergency department knife and gun club.

The Cure

 In an Emergency Room:

In a Closed Pneumothorax insert a chest tube with a one-way valve so that each inhalation will force air out, decrease the size of the air pocket, and alleviate the symptoms.

 Treating Open Pneumothorax is a rapid-succession two-step procedure:

·      Close the sucking chest wound to stop the influx of air through the chest wall

 ·      Insert a chest tube as above to decrease the size of the pneumothorax.

 In the case of hemopneumothorax; if the bleed has stopped, the chest tube will clear the blood. If not, surgery is required to “tie-off” the bleeder.

And now … Fiction:

           So, your character is in the field, far removed from a hospital. This is well and good if you want him to die. If not …

          Suppose your character has suffered a closed tension pneumothorax:

 ·      Blast Injury: the character has punctured a lung due to over-pressure. They may have other injuries as well.

 ·      Blunt Trauma: fall from a height, hit by a car, smacked by a bear, etc.

 ·      SCUBA: saw a monster on the bottom, came up to quickly and dropped a lung due to pressure change

 Improvised Chest Tube:

 Supplies: a pocket knife, ink pen, plastic glove, duct tape, and left-over alcohol from last night’s festivities.

 Technique: have your rescuer pick a spot halfway between the armpit and the nipple on the affected side (remember the tracheal shift) and count down four or five ribs.

 Clean the area with the alcohol. Clean the pocket knife with the alcohol. Remove the cartridge from the ink pen and use the barrel without the clicker. Cut a finger off the glove with your knife and cut a hole in the tip of the glove finger. Slip the glove finger over the non-pointy end of the ink pen barrel and secure with a small strip of duct tape.

Your rescuer will need to make a small puncture over the rib and push the pointy end of the ink pen barrel over the top of the rib so that it enters the chest cavity. There will be a slight “whoosh” of air as the pneumothorax decompresses; the vein, artery, and nerve of the rib run along the bottom and MUCH badness will occur if they are injured. The area around the pin is sealed and secured with wide strips of duct tape.

If the injury is an open tension pneumothorax:

·      Knife Wound

 ·      Puncture wound of any type: tree branch, punji stick, fence picket, etc.

 ·      Gunshot Wound

 If the hole is small, your rescuer could insert the makeshift chest tube as above through the opening. Alternatively, the hole could be covered with duct tape to create a closed pneumothorax and the chest tube inserted in the as above.

If there are no supplies for a chest tube, a flap valve can be created by taking a piece of plastic wrap or thin ground cloth sufficient to cover the wound and securing it on three sides with duct tape. The open side functions as a flap valve, letting the air escape but not reenter the pneumothorax.

This may get your character to a hospital.

This is a long post, but now that you know the anatomy, physiology, and pathophysiology you can use it in your writing.

Click the link below for the rules for questions

https://doctorfiction.tumblr.com/post/181400956523/the-doctor-is-in