#acute abdominal pain

[direwombat]

generally speaking, syb is fairly smart and perceptive. her problem is that her stubbornness, her compulsive need to sacrifice herself, and her superiority complex as a soldier (ie, her thinking that no one can do The Job™ as good as she can) are working against her every damn step of the way

[cardinalvalentino]

should i risk the devastation coffee wrecks on my body to see if it makes me focus on writing my essay?

[dratefahmed1]

Acute Appendicitis 19 Questions and Answers #acuteappendicitis #appendicitis #symptoms #shorts #mcqs

#shorts #mcqs #appendicitis “Acute Appendicitis: Questions and Answers” #acuteappendicitis #appendicitis #symptoms #causes #treatment “Everything You Need to Know About Acute Appendicitis” #acuteappendicitis #appendicitis #symptoms #causes #treatment #prevention “Acute Appendicitis: Frequently Asked Questions” #acuteappendicitis #appendicitis #faqs #symptoms #causes #treatment “Can You Really Die…

[drpedi07]

Acute Abdomen

Abdominal pain is one of the most common presentations in the pediatric emergency department. The most important concern is to decide if the condition requires surgical intervention or can be managed medically.

[halsteadlover]

𝐌𝐢𝐧𝐞

*Gif and pics not mine credits to the owner*

• Pairing: Connor Rhodes x Fem!Reader.

• Requested: yes by anon.

• Summary: Connor shows his possessive and jealous side and you love every bit of it.

• Warnings: jealousy, few curse words and I don’t know what else, please let me know if I missed any lol.

• Word count: 1930.

• A/N: I’m not sure about this one but here it is anyway since I was too lazy to write it all over again 😭 I hope you’ll like it, looking forward for your opinion. Comment, like and reblog, it’d would mean the world 💕 I love you all xx

Connor's first case since coming back to Med’s was fairly simple.

He thought that day would go uneventful. He thought.

An elementary school girl was taken to the ER after her teacher called 911 because of an intense abdominal pain and after an ultrasound it turned out to be a case of acute appendicitis.

“She’ll need surgery, where are the parents? We need their consent,” Connor had asked Natalie while they examined the little patient who was still writhing in pain. She was given a small dose of morphine to calm some of her excruciating pain.

At that same moment Maggie entered the room and Connor glanced at her as he tried to calm the little girl, whose name turned out to be Daisy. “Her teacher is here and asked about a doctor.”

“I'll talk to her,” Connor said and Natalie nodded.

Connor and Maggie exited the patient's room and his gaze fell on a figure near the nurses' station who was filling out some forms.

He tried to keep an expression as serious and impassive as possible even though internally a flock of butterflies had just exploded in his stomach.

There was no need to even take a double take, he would’ve recognized that figure even in a crowd of thousands of people. After all, how could he not recognize his own girlfriend?

You were a teacher and taught science in an elementary school but what were the chances that you would’ve been the little girl’s teacher?

You and Connor had been together for about few months them so none of his colleagues knew you existed yet. He had to act like he didn’t know you, like he didn’t want to breathtakingly kiss you right then and there.

He couldn't help but let his eyes wander over your body suppressing the innate desire to approach you and grab your ass like he always did.

He approached the nurses' station, hands shoved in his uniform pocket. “Ma’am.”

Your heart skipped a beat when you heard not a voice but his voice. You immediately tried to suppress the smile that threatened to appear on your face as well as the urge to giggle since he knew how much it annoyed you when he’d call you ‘ma’am’.

“It’s ‘miss’, actually.”

You said when you turned to him, pen still in your fingers as you gave him a polite smile and chuckling to yourself when you saw Connor press his lips together in an attempt not to burst out laughing.

“Nice to meet you miss, I’m doctor Rhodes. I’m treating Daisy.”

Your eyes quickly scanned his body, trying to maintain composure and not blush like a fourteen year old when thoughts about you and him in his bed that morning crept into your mind.

“How is she, doctor?” You asked, failing miserably at not giving him a little mischievou smile.

“Unfortunately I cannot discuss my patient's health status with people outside of her family. I wanted to ask you if you have by any chance notified her parents? We need to talk to them,” he replied in a professional tone although the way his eyes shone as they spoke to you and the way he couldn't help but check you out gave him away.

Maggie and April, who were there at the time and witnessing your conversation, couldn't help but exchange a knowing look.

They had both thought the exact same thing.

There was no way you and Connor didn't know each other.

It was so obvious and even funny how you both tried to maintain a professional and unemotional facade. But the way he looked at you, the way his eyes had never left yours, the way his body was totally turned towards you and in which he seemed to be imperceptibly drawn continuously towards yours had revealed there was no way in hell that he didn't know you.

But it was also how your head was tilted slightly as you spoke to him, how you kept touching your hair, how you batted your eyelashes and the shadow of a smile that never left your lips that had given definitive confirmation that you two knew each other very well.

And not talking about the fact you two were blatantly flirting.

“I came here in a hurry so I didn't have time to call them, but I'll do it right away,” you had said and Connor had nodded, trying to keep himself from following you with his eyes as you walked away to make the call but failing miserably.

“Connor oh my god! What was that?!” April screamed/whispered, approaching Connor with Maggie, a look of pure surprise and amazement on both their faces. “You know her?!”.

Connor shrugged nonchalantly. “N-no of course not.”

“Oh come on we saw the way you looked at each other, you clearly know her and there is definitely something going on!” Maggie retorted.

“She's just a good looking woman, that's all,” Connor remarked even if ‘good looking’ didn’t even come close to how gorgeous you were.

All his attention though had shifted from Maggie and April for a moment, his eyes falling on the two doctors that were talking as they looked through some patients' medical records.

He saw the direction of their gaze, hearing the comments about the object – or rather the person – that had attracted their attention.

“Man if she was a stripper I would’ve spent my whole salary on her, did you see that ass?”. One of them had confessed to one of them while he was pretending to fill out the medical records even though he was watching you like a hawk while you were talking on the phone.

“I would’ve never skipped a class if I had a teacher as hot as her,” the other continued laughing.

“You think she has someone?”.

“Oh I hope not, but if it is he is a damn lucky bastard.”

Connor clenched his hands into two fists, almost having a brain aneurysm.

A wave of jealousy washed over him, every cell of his body exploding with anger at hearing the words directed towards you who unawarely continued to talk on the phone.

His jaw clenched as he struggled to stay calm, but God how much he wanted to beat the shit out of those two sons of bitches. He hated the way they looked at you, the way they made those disgusting comments about your body.

He hated it so much because that was the way he looked at you.

He was the only one who could make those comments about you, the only one who could have those sinful thoughts about you, the only one who could touch and admire you.

Your ass, your legs, your smile, your laugh, that twinkle in your eyes when you looked at him, that body, all of this were his.

It was as if his mind had gone into blackout, as if all his reasoning, judgment and common sense had just flown away because now all he could do was imagine the bastards' heads banging against the wall over and over again.

Drastic? Perhaps. Excessive? Probably. But Connor didn't give a fuck.

And it was in fact at that precise moment that he did something he’d never have thought of doing for anyone.

“Daisy's parents are…-” you announced as you ended the call and walked back to the nurses' station but stopped on your tracks when Connor came towards you, and a confused expression appeared on your face.

Your eyes widened and you almost had a heart attack when he grabbed your face and crushed his lips on yours.

He didn't give a shit.

Neither that you both were keeping your relationship a secret anymore, nor that you were in the middle of the ER, nor that everyone at that moment had stopped to witness that scene.

He wasn’t thinking clearly and in that moment it was that part of him with which he had never come face to face before that controlled him, that primitive and caveman part he was hating so much.

Even though that gesture had taken you completely by surprise, your body reacted before your mind could even understand what was happening, so you kissed him back, feeling your breath stopping in your lungs. Your hands slid up his chest and fisted his uniform as he wrapped his arms around your hips, sliding his hands down to your ass.

He didn't care he’d receive an endless scolding for what he was doing, he didn't care about the voices that commented the scene, he didn't care that everyone saw his hands squeezing your ass.

He didn't care because he wanted them to see, he wanted everyone to know you belonged to him, that he was the only one who could kiss you, fuck you, squeeze that stripper ass, that loved you.

You broke away from the kiss before the situation could escalate, your heart pounding and your legs shaking like jelly. “Babe oh my god…-”.

“You’re mine, you know that right?” He whispered. “Only mine.” His hands moved up from your ass back to your face and his thumbs caressed your cheekbones before placing a small kiss on his lips. “And I love you.”

Woah hold on.

Did he fucking say ‘I love you’? In an ER?

Wait. Connor loves me?

You looked at him in shock but you didn't have time to process and figure out what the hell was going on because he grabbed your hand and led you back towards the nurses' station, where Maggie and April's jaws were now on the floor.

“Meet my girlfriend, Y/n,” he announced, wrapping his arm around your waist and pulling you close as you were about to faint. Your heart was beating so fast you feared you’d need a defibrillator to revive you sooner or later.

You were so shocked you couldn’t elaborate a word, fuck you couldn’t even think about one.

Connor's eyes focused on the two doctors that had been talking about you until recently but who at that moment were looking around embarrassed.

“You wanted to know if she was taken? Yes, she is. I’m the lucky bastard who gets to have her and now let me hear one more thing about my girlfriend, I fucking dare you.”

You looked with confusion at your boyfriend, then at the doctors he was glaring at, and then back at him. You had no idea what he was talking about and you were so dazed and confused that your mind didn't know what to process first.

From the way Connor’s hand was gripping your hip, the way he held you so close to him, and the way he glared at the two doctors, you imagined it was somehow about you. And although the embarrassment of being the center of attention made you want to be swallowed by the floor, you couldn't help but feel… Flattered.

Was this the right word?

You didn’t know.

You couldn't even describe it, but that jealous, protective side of him lit a fire inside you that burned every single fucking cell of your body.

You knew Connor always had this protective instinct towards you but knowing he had ‘marked his territory’ so blatantly, just to stop whatever they were saying, made you giggle to yourself like a teenage girl.

It was so damn hot and sexy, more than you would’ve ever expected.

And instead of thinking about how out of place or inappropriate that gesture was, the only thing you could think about as you looked at Connor was how good he was going to get it that night.

General tag list: @hngbrooks, @alexxavicry, @halstead-severide-fan, @mrspeacem1nusone, @allivzs, @omniaimy, @cursedashes, @kmc1989, @klovesreading, @firetruckstuckley

Connor Rhodes tag list: @rsquared31, @novabckly, @wnbweasley, @thebejeweledwatercat

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[literaryvein-reblogs]

Do you have any good words for pain? (Hurt for example) Like being in pain or exclamations of pain (ouch for example)

Pain—unpleasant bodily sensation; mental/emotional distress or suffering

Ache - a usually dull persistent pain

Affliction - a cause of persistent pain or distress

Agony - intense pain of mind or body; anguish, torture

Anguish - extreme pain, distress, or anxiety

Bruise - an injury involving rupture of small blood vessels and discoloration without a break in the overlying skin; an injury especially to the feelings

Burn - to produce or undergo an uncomfortable or painful sensation like that of being injured by fire

Chafe - to make sore by or as if by rubbing

Clonus - a rapid succession of alternating contractions and partial relaxations of a muscle occurring in some nervous diseases

Colic - an attack of acute abdominal pain localized in a hollow organ and often caused by spasm, obstruction, or twisting

Cramp - a painful involuntary spasmodic contraction of a muscle

Deleterious - harmful often in a subtle or unexpected way

Discomfort - mental or physical uneasiness; annoyance

Distress - pain or suffering affecting the body, a bodily part, or the mind; trouble

Fester - to generate pus; putrefy, rot;; to cause increasing poisoning, irritation, or bitterness

Gripe - a pinching spasmodic intestinal pain—usually used in plural

Inflamed - to cause inflammation (i.e., injury that is marked by capillary dilatation, leukocytic infiltration, redness, heat, and pain) in (bodily tissue)

Lancinate - pierce, stab, lacerate

Malaise - a vague sense of mental or moral ill-being

Misery - a circumstance, thing, or place that causes suffering or discomfort

Noxious - physically harmful or destructive to living beings

Pernicious - highly injurious or destructive; deadly; (archaic): wicked

Prickle - a prickling or tingling sensation

Sore - a source of pain, distress or vexation; affliction

Spasm - an involuntary and abnormal muscular contraction; a sudden violent and temporary effort, emotion, or sensation

Sting - a wound or pain caused by or as if by stinging (sharp or piercing)

Suffer - to endure death, pain, or distress

Throb - to pulsate or pound with abnormal force or rapidity

Travail - a physical or mental exertion or piece of work; task, effort; agony, torment

Twinge - a sudden sharp stab of pain

Woe - a condition of deep suffering from misfortune, affliction, or grief

Exclamations of Pain

ouch, boo, ow, aw, woe, shucks, ay, rats, yuk, sheesh, alack, tush, pooh, yuck, wirra (Irish), phooey, alas, tsk, pshaw, bah, humph, tut, pish, ho hum, faugh, fie

Hope this helps with your writing. Do tag me, or send me a link. I'd love to read your work!

More: Word Lists

[roachrotting]

It's EJ time.

Eyeless Jack was never one of my ultimate favorites...so I turned him into something that could be. >:D

More headcanons under the cut, if you want to see what speculative changes I'm making to his backstory: (Graphic Horror Ahead)

Jackson Nichols, born in 1987, is currently enrolled at Pacific Northwest Medical School in the 3rd year of his program in human endocrine medicine. He was a fairly average college kid, if not a bit nerdy and antisocial.

On a cold February night in 2012, Jackson had received a good grade for an exam he was very stressed about. To celebrate, Jackson's close friends brought him to his very first party, with the intent to get drunk and have a good time.

Late in the night, Jackson meets a beautiful woman. She was a little gothic, and seemed like a bit of a wallflower, but he felt a deep connection with her. He doesn't quite catch her name before he felt a slight pinch in his side. In fact, he doesn't catch the rest of the night at all.

He wakes up on a stranger's bathroom floor, naked and pouring with sweat. He's cuffed to the bathtub faucet. The lights are off, there are no windows. There's a padlock and chain keeping the door shut. He can't breathe, there's something stuffing his mouth, a kitchen towel soaked in blood. And the blood - it's everywhere. Some of it looks new, but most looks old. Way too old. It's not his. He blacks out.

He wakes up again, in another room, this time restrained by his hands and ankles on what feels like a washer and dryer, pushed together to form a sort of makeshift table. It was so dark. He couldn't see anything. He hears voices, and realized he was no longer gagged. Screaming for help proved useless very quickly.

After a few wasted moments of screaming and thrashing, he starts to hear low chants, in some sort of ancient language. He hears the word "graeae" whispered among the omens in hushed tones by the leading voice, and before he can ponder on its meaning, he feels a sharp stabbing pain.

One after another, he can only scream as he feels each one of his abdominal organs being carved out of his body. First, his kidneys, then his liver, then his intestines and stomach, then his heart and lungs, taken in quick succession by sloppy human hands with seemingly no medical expertise. As his body twitches with the last shots of electricity from his blood-starved brain, he feels his eyes being ripped from his skull, and a warm, wet-feeling lump being shoved into the gaps they left behind.

Almost like the shell of his body is being puppeteered by something he can't understand, Jackson suddenly flings the hollow shell of his body off of the table, breaking his chains with ease. He busts through the chained door keeping him in, paying no mind to the imbeciles who had just mutilated him beyond recognition. He doesn't need them anymore. He doesn't need anything, anymore.

More General HCs:

'The Body Snatcher' is the moniker given to him by news outlets and true crime media. Nobody calls him Eyeless Jack here except his roommates in the mansion, sorry. :[

His M.O. is to target people wandering alone, primarily in alleyways or somewhere else in seclusion. He'll subdue them, harvest an organ from them with perfect precision, and then leave them to bleed out. If he chooses to take something like a kidney, you have a small chance of survival. If he chooses to take your heart...bad luck.

His conscious is submissive to the demon that has since attached itself to his brain. His emotions are dulled down to almost nothing, and he rarely makes his own decisions. Despite this, he is perfectly lucid to all of the terror and pain he internally feels while stuck in this situation, and he is acutely aware of his possession.

He's still a fantastic doctor. Jack's previous passion in medicine, with the addition of his new demonic instincts, leads him to be a fantastic surgeon and first aid nurse. At least, if you're his friend, and not one of his victims.

His lack of eyes, somehow, does not seem to impact his sight. I wonder what's in there...

[lesbianfeminists]

From heart disease to IUDs: How doctors dismiss women’s pain

Several studies support the claim that gender bias in medicine routinely leads to a denial of pain relief for female patients for a range of health conditions

One woman was told she was being “dramatic” when she pleaded for a brain scan after suffering months of headaches and pounding in her ears. It turned out she had a brain tumor. Another was ignored as she cried out in pain during a 33-hour labor. She was supposed to be getting pain medication through her epidural, but it had fallen out. Dozens of women complained of torturous pain as their vaginal walls were punctured during an egg retrieval process. They were told their pain was normal, but, in actuality, they were getting saline instead of anesthesia. These are just some of the stories of women who say their pain and suffering has been dismissed or misdiagnosed by doctors. Although these are anecdotal reports, a number of studies support the claim that women in pain often are not taken as seriously as men.

This year, the Journal of the American Heart Association reported that women who visited emergency departments with chest pain waited 29 percent longer than men to be evaluated for possible heart attacks. An analysis of 981 emergency room visits showed that women with acute abdominal pain were up to 25 percent less likely than their male counterparts to be treated with powerful opioid painkillers. Another study showed that middle-aged women with chest pain and other symptoms of heart disease were twice as likely to be diagnosed with a mental illness compared with men who had the same symptoms. “I was told I knew too much, that I was working too hard, that I was stressed out, that I was anxious,” said Ilene Ruhoy, a 53-year-old neurologist from Seattle, who had head pain and pounding in her ears. Despite having a medical degree, Ruhoy said she struggled to get doctors to order a brain scan. By the time she got it in 2015, a tennis ball-sized tumor was pushing her brain to one side. She needed surgery, but first, she rushed home, hugged her 11-year-old daughter and wrote her a letter to tell her goodbye.

Ruhoy did not die on the operating table, but her tumor had grown so large it could not be entirely removed. Now, she has several smaller tumors that require radiation treatment. She said many of her female patients have had experiences similar to hers. “They’re not validated with regards to their concerns; they’re gaslit; they’re not understood,” she said. “They feel like no one is listening to them.”

Doubts about women’s pain can affect treatment for a wide range of health issues, including heart problems, stroke, reproductive health, chronic illnesses, adolescent pain and physical pain, among other things, studies show. Research also suggests that women are more sensitive to pain than men and are more likely to express it, so their pain is often seen as an overreaction rather than a reality, said Roger Fillingim, director of the Pain Research and Intervention Center of Excellence at the University of Florida. Fillingim, who co-wrote a review article on sex differences in pain, said there are many possible explanations, including hormones, genetics and even social factors such as gender roles. Regardless, he said, “you treat the pain that the patient has, not the pain that you think the patient should have.”

Women say reproductive health complaints are commonly ignored

Women often cite pain bias around areas of reproductive health, including endometriosis, labor pain and insertion of an intrauterine device, or IUD. When Molly Hill made an appointment at a Connecticut clinic in 2017 to get an IUD, she said she was warned it would be uncomfortable, but she was not prepared for “horrific” pain. Hill, now 27 and living in San Francisco, recalled that during the procedure, she began crying in pain and shouted at the doctor to stop. “We’re almost done,” she said the doctor told her and continued the procedure. “It was full-body, electrifying, knife-stabbing pain,” she said. After it was done, she said she lay sobbing on the table in physical and emotional pain. “It felt violating, too, to have that pain that deep in your core where you feel the most vulnerable.”

Studies consistently show that women who have not experienced vaginal birth have much higher pain during IUD insertion compared with women who have given birth. A Swedish study found that among 224 women who had not given birth, 89 percent reported moderate or severe pain. One in six of the women said the pain was severe. Although numbing agents and local anesthetics are available, they are rarely used.

In some cases, women have sued physicians for ignoring their pain. Dozens of women sued Yale University claiming that during an egg harvesting procedure at its infertility clinic, they were supposed to be receiving the powerful painkiller fentanyl. But some women were getting only diluted pain medication or none at all, according to lawsuits filed in the state Superior Court in Connecticut. Later, the clinic discovered a nurse had been stealing vials of fentanyl and replacing the painkiller with saline solution. The nurse pleaded guilty last year and was sentenced for tampering with the drugs. One of the plaintiffs, Laura Czar, wrote about her experience for Elle magazine, describing it as “a horrible, gut-wrenching pain,” and told a doctor at the time, “I can feel everything you’re doing.” Despite her protests, the doctor continued. Yale said in a statement that it “deeply regrets” the women’s distress and has “reviewed its procedures and made changes to further oversight of pain control and controlled substances.”

Racial disparities in pain management

For Sharee Turpin, the pain of sickle-cell disease sometimes feels like tiny knives slicing her open. Sickle cell disease is an inherited blood disorder that can cause suffering so severe, its attacks are called “pain crises.” But when Turpin, who is Black, experiences a pain crisis, the 34-year-old does not rush to the ER in Rochester, N.Y. Instead, she combs her hair, mists some perfume and slips on her “Sunday best” in hopes that the doctors and nurses won’t peg her as a drug seeker, she said. Sometimes, Turpin gets a care team that understands her pain. Other times, she is treated as a bother. “I’ve even been told ‘shut up’ by a nurse because I was screaming too loud while I was in pain,” she said.

Abundant research shows racial bias in pain treatment. A 2016 study found half of white medical students and residents held at least one false belief about biological differences between Blacks and Whites, and were more likely to underestimate Black patients’ pain. “The management of pain is one of the largest disparities that we see between Black people and White people in the American health-care system,” said Tina Sacks, an associate professor at the University of California at Berkeley and author of “Invisible Visits: Black Middle-Class Women in the American Healthcare System.”

Labeling women “hysterical” or blaming psychological causes

Research shows men in chronic pain tend to be regarded as “stoic” while women are more likely to be considered “emotional” and “hysterical” and accused of “fabricating the pain.” Carol Klay, a 68-year-old from Tampa, had endured years of chronic pain from arthritis, degenerative disk disease and spinal stenosis. During a hospital stay last year, her doctor noted in her medical record that she was crying “hysterically.” Klay said she was crying because she was unable to sit, stand or walk without agony, and the doctor had removed morphine from her cocktail of pain medications. She wonders whether the doctor “would have called me hysterical if I was a man,” she said. Tampa General Hospital said it could not discuss specific patients, but stated: “Patient treatment plans, including medication orders to reduce pain, are prescribed by multi-disciplinary clinical teams.” Research shows women’s physical pain is also often attributed to psychological causes.

Jan Maderios, a 72-year-old Air Force veteran from Chipley, Fla., said the trauma of having pain dismissed by doctors has stayed with her for years. She saw about a dozen doctors in the early 1970s for pelvic pain. When clinicians could not identify the cause of her pain, she was referred to a psychiatrist.

“You start to doubt yourself after so many medical experts tell you there’s nothing wrong with you,” she said. After a hysterectomy in 1976, Maderios learned that fibroid tumors in her uterus had been the source of her pain. She said learning her pain was real — and physical — “made all the difference in the world.”

Why women’s pain complaints often aren’t taken seriously

During a 33-hour labor with her first child in 2011, Anushay Hossain, 42, of D.C., opted for epidural pain relief but said she still felt it all — every contraction, every cramp and every dismissal of her pain by her medical team. The doctor reassured her that she was getting the maximum dosage of pain medication.

In fact, she wasn’t getting any at all. She said her epidural had slipped out. By the time the error was caught, she was shaking uncontrollably and in need of an emergency Caesarean section, she said. “There’s a pain gap, but there’s also a credibility gap,” said Hossain, author of “The Pain Gap: How Sexism and Racism in Healthcare Kill Women.” “Women are not believed about their bodies —period.”

This pain gap may stem, in part, from the fact that women have historically been excluded from medical research. It wasn’t until 2016 that the National Institutes of Health (NIH) required sex to be considered as a biological variable in most studies it funded. “We’re making progress,” said David Thomas, special adviser to the director of NIH’s Office of Research on Women’s Health. “But we do have a long way to go because there’s this whole institutional approach to doing research — pain and beyond — where it tends to be male-focused.”

Nearly 95 percent of U.S. medical school students said instruction on sex and gender differences in medicine should be included in curriculums, according to a 2015 survey. But only 43 percent said their curriculum had helped them understand those differences and only 34.5 percent said they felt prepared to manage them in a health-care setting.

“It is changing, but it’s changing very slowly,” said Janice Werbinski, immediate past president of the American Medical Women’s Association and chair of the mentorship committee of the association’s Sex and Gender Health Collaborative.

How women can advocate for better pain care

It took decades to solve the mystery of Maureen Woods’s chronic pain. Woods, 64, of Myersville, Md., started having joint pain in her teens and, over the years, told dozens of doctors her pain was “debilitating,” she said. Some told her it was all in her head. In 2017, she was diagnosed with hypermobile Ehlers-Danlos syndrome, a connective tissue disorder often causing loose joints, dislocations and chronic pain. She said women who are not being heard should keep advocating for themselves. “You have to go with your gut — something is wrong and I need to find a doctor who can figure it out,” she said. Marjorie Jenkins, dean of the University of South Carolina School of Medicine Greenville, urged women against feeling pressured to accept an “everything is normal” non-diagnosis. “If your provider does not appear to be listening to you or believing what you’re saying, then you need a new provider,” Jenkins said. “You are the client, you are the customer and you are the owner of your health.”

Women can also take a family member, friend or other support person who can corroborate their stories, said Alyson McGregor, an emergency medicine professor at the University of South Carolina School of Medicine Greenville and author of the book “Sex Matters: How Male-Centric Medicine Endangers Women’s Health and What We Can Do About It.” Particularly in emergency departments, she said, there can be an inherent bias. “There’s this assumption that women are emotional and they’re anxious and that that’s the main issue,” she said.

[macgyvermedical]

Getting to Monday Morning: How Not to Go to the Emergency Department if You Don't Super Freaking Have To

Listen, I've re-written this intro a dozen times. I've talked about staffing in US hospitals (bad), I've touched on how the system backs up when staffing is bad (no staff on floors means ED stays full means new patients wait for hours or days to get a bed), I've even considered sharing my own experiences as a bedside nurse.

But the bottom line of all of it is that if your life or at least one limb doesn't absolutely depend on it, stay the heck out of the emergency department. And this post is here to help give you some tips for staying home until you can be seen by your primary care doctor or an urgent care.

Everything in this post (except an albuterol inhaler) is something you can find at a pharmacy without a prescription in the USA.

Officially, the following information is for educational use only.

What Conditions Are Life or Limb?

Lack of breathing or pulse

Blue or grey skin due to respiratory problems after taking prescribed rescue medications

An obvious hole in the chest wall

A sudden change in mental status that doesn't resolve within a few mins, especially if you don't know why

A head injury with worsening confusion or profuse vomiting

Abdominal pain that gets better when you press on the abdomen, or gets worse when you release pressure suddenly

Severe abdominal pain and not passing any gas

A musculoskeletal injury (fracture, sprain, etc...) with numbness, tingling, severe weakness, or very pale skin below the site of injury

Spurting bleeding that you can't stop, or numbness, severe weakness, or very pale skin below the site of injury once the bleeding is stopped, or if the bleeding required a tourniquet to stop

Red streaks spreading from a wound

Seizure that has lasted longer than 5 minutes without stopping, or which stops and starts without the person coming back to baseline in between

Chest pain without a known cause or with symptoms like nausea, weakness, sweating, or confusion

Any of the above, you want to call 911 or go to the hospital and explain exactly why you are there to the first person with a hospital badge you come across.

BUT

If it's pain or nausea or not-absolute-emergency respiratory problems from a known source or wounds or fever or skin infections, maybe consider some alternatives first.

PAIN:

OTC Meds: if you can take both acetaminophen (paracetamol/Tylenol) and an NSAID like ibuprofen, consider staggering them. For example, take 650mg acetaminophen at 0000, then 400mg ibuprofen at 0200, then acetaminophen at 0400, then ibuprofen at 0600, etc... This helps make sure one or the other medication is at it's peak effectiveness at all times (one study found pain control similar to 5mg oxycodone from a similar regimen). If it's night time consider OTC doxalamine (unisom) or diphenhydramine (benadryl) if you know they make you sleepy.

Acetaminophen works significantly better as a suppository. Sorry to tell you.

If it's muscle pain (back, neck, shoulder, menstrual cramps, broken bone more than a few days old) or arthritis pain, heat helps relax muscles and decrease stiffness. Try to get it as hot as you can without burning and wrap in something light like a pillow case. A hot water bottle or wheat pillow is great for this.

If it's an acute injury like a sprain or break that happened today, cold works better at decreasing pain, if not for helping the injury to heal. But pain is what we're dealing with here. You want several ice packs wrapped in a pillowcase or hand towel and wrapped all around the injury.

If the pain is an injury that is in a spot where you can elevate it (like a limb), elevate above the heart- this will significantly decrease throbbing.

Splinting an injury or recent surgery site decreases movement in that area, which decreases pain. If the injury is on a limb you can wrap a pillow around it and tape it in place. If it's abdominal (like a surgical incision) or in the chest area (like a cracked rib) you can hold a folded blanket against the site when you cough or move.

Abdominal pain can sometimes be partially relieved by bending the legs or laying on one side or the other.

For young children, sugar is an excellent distraction and is used in medical environments to relieve pain from short procedures.

NAUSEA/VOMITING/DIARRHEA/CONSTIPATION:

Nausea/Vomiting:

Any antihistamine that produces drowsiness will work on nausea. These include diphenhydramine, doxalamine, and dimehydrinate.

If unable to take by mouth, any of the above can be crushed, mixed with a small amount of softened coca butter or coconut oil, and frozen in the tip of a finger of a glove to make a suppository.

Once you stop vomiting, you can also take bismuth subsalicylate on top of an antihistamine.

Smelling mint or unscented isopropyl alcohol

Starting with an hour of trying to drink nothing at all, then 1oz of a clear liquid (water, electrolyte drink, peppermint tea, etc..) every half hour for an hour, then 1oz every 15 mins for an hour and slowly build up from there.

Sipping regular coca cola (I hate to mention a brand name, but coca cola has phosphoric acid in it (most off brands don't or have less), which is the same active ingredient as a lot of anti-nausea medications, and is a lot cheaper (and tastier) for the amount. It only works for about 20 minutes by slowing down your stomach's squishing your food around, but that's long enough to be able to drink other clear liquids in between).

Sipping soda water reduces stomach acidity and helps you burp, which often helps you feel better.

Cool wash cloths on the forehead or neck.

If someone has severe nausea that is causing worsening dehydration but no diarrhea, a slow tap water enema can be absorbed by the colon (up to 2 liters per day), which can often relieve some of the dehydration and help get someone to business hours.

Diarrhea:

Loperamide- for diarrhea not caused by antibiotics, loperamide is your friend. Read and follow the instructions. You need to take twice as much on the first poop as the rest of them. You do not need to "clear out" an infection. The infection itself is in the wall of the intestine, all you're doing by pooping a lot is spreading it around.

You can take bismuth subsalicylate with loperamide

One of the most dangerous parts of diarrhea is dehydration. A good electrolyte drink can be made by mixing 1/4 tsp table salt and 1/8 tsp potassium chloride salt replacer with a favorite drink mix and 8oz of water. Drink water too, but alternate with electrolyte drinks.

BRAT (banana, rice, applesauce, and toast), if eaten exclusively, will help reduce frequency.

Constipation:

A whole head of iceberg lettuce or a couple grapefruit or like half a thing of prunes all work. But you have to drink a lot of water with them or they'll just make it worse.

Docusate sodium. If that doesn't work add senna. If that doesn't work add milk of mag. If that doesn't work add mag citrate. If that doesn't work try a soap sud enema. I would wait 12 hours in between each, but to each their own.

Basically any stimulation of the rectum can help things move along.

FEVER:

First, don't try to get rid of a fever unless it is over 103F or the person is really, really uncomfortable.

OTC meds like acetaminophen, ibuprofen, aspirin, and naproxen all reduce fevers. If you need to you can stagger them (see instructions under "PAIN")

Cool wash cloths on the forehead or neck make things a little more comfortable

Loose-fitting, light clothing

Don't try to force a fever down with cold water or ice packs. If it is 105F or above and acetaminophen or an NSAID hasn't worked, that's something to go to a hospital about.

Prevent most of the problems with fevers by keeping the person very well hydrated (see Diarrhea above for instructions on hydration)

Calories are super important because the body is using a ton of them to keep the temp up. If the person isn't eating, 8oz whole chocolate milk with about a third of a flintstones vitamin (on the side) has essentially the same nutritional profile as an Ensure. And it tastes better. And it's way cheaper.

A brief seizure in a kid with a fever that happens once is fairly common and something to call a doctor about, a long seizure (more than 5 mins) is something to go to the hospital about.

RESPIRATORY PROBLEMS

If you have an albuterol inhaler but no spacer, you can make a kinda crappy one from a plastic bottle. Make a hole in the side just slightly larger than your inhaler mouthpiece. Stick the mouthpiece in, put your mouth on the mouth of the bottle, puff the inhaler, and breathe the medication in through the mouth.

Coffee and chocolate have caffeine and theobromine in them, both of which are bronchodilators

Breathing steam from a shower or a pot of boiling water can help loosen mucous in the lungs

Good hydration can help loosen mucous

Having the person lay at about a 45 degree angle gives the best range for the lungs to open fully

Sitting in "tripod position," a sitting position with the torso leaning forward and both arms pushing on knees

"Pursed lip breathing" you will probably have to look up a video on this, but it essentially creates some additional positive pressure in the airways that helps hold them open.

CUTS/OPEN WOUNDS/SKIN INFECTIONS:

Cuts/Open Wounds:

Stop the bleeding with pressure. This is literally just pushing on the cut, which pinches shut tiny blood vessels and allows them to clot off. If someone needs a tourniquet they need to go to the ED.

Clean the cut really well with plain water (if you would be comfortable drinking it, it's safe to wash wounds with). You want to get all visible particles of dirt or foreign material out

If water from the tap isn't enough pressure to do this, take a disposable water bottle and punch a small hole in the lid. Squeeze the bottle to put a pressurized stream of water into the cut to clean it.

If the wound isn't more than a half inch deep, you can close it yourself without stitches. Thin strips of very sticky cloth tape, dots of super glue, or even tying the wound together with the person's hair (if on the scalp) is great. If you have commercial closures those are great too. You just want to leave some open space to let the wound drain.

If the wound is deeper than that, pack it by taking clean gauze (kerlix is perfect for this) or in a pinch clean strips of long-fiber cloth, wetting them with water, and packing them in the wound. Put something on top of this to hold everything in place. Every 12-24 hours pull it all out and put clean stuff in. Note: any wound caused by an animal needs to be packed and seen by someone at the health department, usually within 48 hours for rabies prevention.

If it's really pulling at things in the wound, use some water to wet the fabric and loosen it up a bit. But you want some stuff to come out with the

Really shallow scrapes you can clean in a similar way but then just cover in petroleum jelly.

There is virtually no use for isopropyl alcohol, hydrogen peroxide, or triple antibiotic ointment. The former two may do more harm to healthy cells than to bacterial cells, the latter the antibiotics only last a few minutes and a lot of people are allergic to them. Just use water to clean and petroleum jelly if you have to cover something.

Skin or Wound Infections:

If you have a scrape or cut and a red, hot, painful area begins to creep outward around it, know you need to do something.

Start by drawing a line around the outside edge of the red area. This will help you track if it is getting bigger or smaller.

If it's bigger a few hours later, you need to do something quickly

Get a pot of water and 3 wash cloths

Boil the wash cloths in the water

Let the water cool to the point where it's really hot but won't burn the patient

Pull one of them out, wring the water out of it (it should be pretty uncomfortable to do this), and press it against the infected area. It will hurt.

When that wash cloth cools even a little, pull the next one out and do the same thing. Over time it will get less and less uncomfortable as the skin heats up to the temp of the wash cloths.

Rotate your wash cloths like this for 20-30 mins. If there is an abscess, it may burst during this process. That is a good thing. If there is a big opening, pack it (as described above), otherwise put a clean dressing over it and just let it drain.

Repeat this several times per day

If the site is getting bigger despite this, especially if this is happening quickly or there are streaks coming from the wound, go to the ED.

[loving-n0t-heyting]

Went to ER recently over sudden intense bout of abdominal pain (symptoms were concerning but tests were all negative, prolly just bad digestion or a stomach bug or smth) and as with other recentish er visit i found the doctor so much more pleasant to work with that my pcp's usually are. I think part of that is that when dealing with a pcp, ive usually looked into whatever problems ive been having and how to address them (or at least know i could and should have done so), and so the interaction mostly consists in trying to convince them to prescribe the treatment i want. Theres no real value theyre adding expertise-wise as long as ive done my work. Whereas at the er, usually the problem is too urgent or too acutely painful to allow me to do enough research in time, or diagnostics are gated behind the use of diagnostic tools i would not be in a position to acquire or operate or interpret otherwise. So the expertise (and equipment) are doing real fucking work, its not just me running a CHA based skill check against some one with a medical degree

Also this trip i got a hefty dose of morphine injected straight into my vein. Which was a nice enough high on its own but even better with the knowledge its at taxpayer expense. Freeloading opioid-shooting neet lyfe 5eva w00t

[gallifreyinstituteforlearning]

Hello! What happens biologically (anatomically) when a gallifreyan (time lord?) Is partially shot by a dalek?

(For clarity: what happened internally/biologically to the doctor when he was shot by a dalek in The Stolen Earth?)

What happens anatomically when a Gallifreyan/Time Lord is partially shot by a Dalek?

Ah, emergency medicine! My speciality! Thank you!

All Dalek shots will differ in their nature - different weapons, different ways to get shot, different places to get shot - so that has to be on a case-by-case basis, but we can definitely take a look at the specific example mentioned.

It's a little unclear exactly where the path of the shot was, so for this it's assumed it coasts along the ribs and ends just under the sternum on a straight, constant angle.

💥 Entry Point and Initial Damage

The Dalek energy blast first made contact with the Doctor’s torso, glancing from the mid-low left costal region (around the 7th to 8th rib ... ish). Upon contact, the energy blast:

Burnt through the skin and subcutaneous tissues, cauterising the wound instantly and preventing external bleeding. This likely caused immediate necrosis and damage to nerve endings.

Fractured and maybe partially vaporised the ribs at the point of impact, creating a concussive shockwave that propagated through the thoracic cavity, which might have caused the ribs to fracture inwards and potentially puncture a lung.

🔥 Internal Penetration and Pathway

The blast then traversed along the chest, following a path just below the sternum (breastbone). The energy blast then:

Damaged the intercostal muscles and nerves, causing immediate breathing difficulties and partial paralysis of the chest wall muscles. Gallifreyans have a lot of biological getouts, but this would've restricted the Doctor's ability to breathe when his lung probably couldn't expand/contract properly.

May have slightly penetrated the lower lobe of the left lung, causing pulmonary contusions (bruising) and possible alveolar rupture or a pneumothorax (if the ribs didn't do it already), leading to compromised gas exchange and hypoxia.

❤️ Heart(s) and Circulatory System

The close proximity to the sternum means the blast was darn close to the Doctor’s hearts, possibly causing:

Acute pericardial effusion (fluid buildup around the hearts) due to the shockwave and thermal effects, leading to very fast cardiac tamponade (compression of the heart due to fluid build-up).

Potential contusion to the left heart, specifically the left ventricle, causing a decrease in cardiac output, leading to the disruption of electrical conductivity. That translates to irregular heartbeats at best. This could have been the reason why he collapsed and stayed down, because his blood pressure would've immediately gone through the floor.

🌡️ Shockwave and Secondary Effects

The energy blast created a shockwave that propelled merrily through the Doctor’s body, exacerbating internal damage through kinetic transfer, and resulting in:

Probable spinal shock, temporarily disrupting neural signals to the legs and resulting in partial loss of function and control of the lower limbs.

Maybe damage to the diaphragm, causing yet more breathing problems and possibly spasms when we weren't looking.

Microtears in blood vessels, leading to internal bleeding.

Extended damage to the abdominal organs: The shockwave may extend into the abdominal cavity, causing bruising or mild trauma to other internal organs.

⚡ Pain and Neural Response

Dalek weapons are notorious for inflicting maximum pain:

The energy discharge damages nerve endings, causing excruciating pain radiating from the point of impact.

The intense pain triggers a massive release of stress hormones (like adrenaline), which can cause symptoms such as sweating, increased hearts rate, and further difficulty breathing.

⚠️ Shock Response

Gallifreyans bodies are quite hardy, but Daleks have been shooting them for a while, now. The Doctor’s body would've attempted to compensate for the injury, but the extent of damage overwhelmed these mechanisms.

The Doctor likely went into a state of physical shock very, very quickly.

🏫 So ...

The combination of direct damage from the Dalek blast, secondary shockwave effects, and the resultant pain and physiological responses culminate in a pretty instant death, even though it was a 'nick'. All this of course is theoretical.

Related:

Anatomy of a Dalek: Detailed description of the parts of a Dalek and what they do.

Gallifreyan CPR: Guide for reviving a Gallifreyan in cardiac arrest.

Gallifreyan Assessment Scoring System (GASS): Guide for assessing vital signs.

ABCDE Assessment: Guide for quickly assessing and treating a sick Gallifreyan.

Hope that helped! 😃

Any purple text is educated guesswork or theoretical. More content ... →📫Got a question? | 📚Complete list of Q+A and factoids →😆Jokes |🩻Biology |🗨️Language |🕰️Throwbacks |🤓Facts →🫀Gallifreyan Anatomy and Physiology Guide (pending) →⚕️Gallifreyan Emergency Medicine Guides →📝Source list (WIP) →📜Masterpost If you're finding your happy place in this part of the internet, feel free to buy a coffee to help keep our exhausted human conscious. She works full-time in medicine and is so very tired😴

[gaycrouton]

Who ended up in the hospital more: Mulder or Scully?

The following calculations come from the hard work of @xfilesobsession​, my idol 

Note: this is solely a list of their on-screen hospital appearances where they were admitted as patients (in gowns), not all the times they were injured and/or briefly taken care of.

Beyond the Sea (1x13) 

Patient: Fox Mulder 

Reason: He was shot during a rescue mission. 

Current Total Mulder: 1 Scully: 0

Darkness Falls (1x20) 

Patient: Fox Mulder and Dana Scully 

Reason: They took a nice trip to the forest and were almost devoured by insects. 

*semantically speaking, this is a quarantine facility 

Current Total Mulder: 2 Scully: 1

One Breath (2x08)

Patient: Dana Scully

Reason: She was ding dong ditched at the hospital by the people who had abducted her for months. The hospital was apparently so shocked, they forgot to give her a blanket :/

Current Total Mulder: 2 Scully: 2

Colony (2x16) and End Game (2x17)

Patient: Fox Mulder

Reason: He was exposed to the Alien Bounty Hunter’s blood.

*counts as one since Colony begins in medias res with events from End Game.

Current Total Mulder: 3 Scully: 2

Død Kalm (2x19)

Patient: Fox Mulder and Dana Scully

Reason: They were on a ship where “contaminated water caused rapid oxidative damage and dramatically increased sodium chloride in the body,” (Scully, 1995).

Current Total Mulder: 4 Scully: 3

Apocrypha (3x16)

Patient: Fox Mulder

Reason: Mulder’s car is run off the road.

Current Total Mulder: 5 Scully: 3

Wetwired (3x23)

Patient: Dana Scully

Reason: Scully becomes victim to the control of a device that incites paranoid delusions.

Current Total Mulder: 5 Scully: 4

Memento Mori (4x14)

Patient: Dana Scully

Reason: She’s diagnosed with terminal brain cancer.

Current Total Mulder: 5 Scully: 5

Redux II (5x02)

Patient: Dana Scully

Reason: Her terminal cancer flares up, but she is cured. Hopefully alien implants are part of her health insurance plan.

Current Total Mulder: 5 Scully: 6

The Red and The Black (5x13)

Patient: Dana Scully

Reason: She sustained burns and smoke inhalation.

Current Total Mulder: 5 Scully: 7

Folie à Deux (5x19)

Patient: Fox Mulder

Reason: Mulder began seeing things others couldn’t (according to Scully, he was succumbing to folie à deux — shared psychosis), and Skinner had him committed.

Current Total Mulder: 6 Scully: 7

Fight the Future (1998)

Patient: Fox Mulder

Reason: He is shot by the people who abduct Scully.

Current Total Mulder: 7 Scully: 7

Triangle (6x03)

Patient: Fox Mulder

Reason: While searching for the Queen Anne, he wrecked his ship.

Current Total Mulder: 8 Scully: 7

Tithonus (6x10)

Patient: Dana Scully

Reason: Scully was accidentally shot by a fellow agent during a case.

Current Total Mulder: 8 Scully: 8

Biogenesis (6x22) and The Sixth Extinction (7x01)

Patient: Fox Mulder

Reason: He’s hospitalized for being in critical condition due to his abnormal brain activity.

*counts as one since he was never relocated/discharged in between episodes.

Current Total Mulder: 9 Scully: 8

The Sixth Extinction (7x01) and The Sixth Extinction II: Amor Fati (7x02)

Patient: Fox Mulder

Reason: Abnormal Brain Activity (cont.)

*counts as a new one since he was relocated by Skinner and remains there in between these two episodes

Current Total Mulder: 10 Scully: 8

Signs and Wonders (7x09)

Patient: Fox Mulder

Reason: Attacked by snakes

Current Total Mulder: 11 Scully: 8

Brand X (7x18)

Patient: Fox Mulder

Reason: Beetle eggs began hatching in his lungs.

Current Total Mulder: 12 Scully: 8

Requiem (7x22)

Patient: Dana Scully

Reason: Scully faints at the office after realizing Mulder was in danger. It is later revealed she’s pregnant.

Current Total Mulder: 12 Scully: 9

Without (8x02)

Patient: Dana Scully

Reason: She’s in a physical altercation with the Alien Bounty Hunter which leaves her with several injuries.

Current Total Mulder: 12 Scully: 10

Via Negativa (8x07)

Patient: Dana Scully

Reason: She checked herself into the hospital after feeling acute abdominal pain.

Current Total Mulder: 12 Scully: 11

DeadAlive (8x14) and Three Words (8x15)

Patient: Fox Mulder

Reason: “Brought back from the dead.”

*counts as one since it is the same hospital stay between episodes

Current Total Mulder: 13 Scully: 11

Empedocles (8x17)

Patient: Dana Scully

Reason: She had some abdominal pain that turned out to be a partial abruption.

Current Total Mulder: 13 Scully: 12

Babylon (10x05)

Patient: Fox Mulder

Reason: He woke up in the hospital after apparently embarrassing himself while under the influence of placebos he believed were magic mushrooms.

Current Total Mulder: 14 Scully: 12

My Struggle III (11x01)

Patient: Dana Scully

Reason(s): She suffered from a seizure in the office; then another while driving and she crashed.

*this counts as two because she left the hospital and was brought back a second time.

Current Total Mulder: 14 Scully: 14

So how many times did we see Mulder and Scully admitted to the hospital?

Overall Total 🏥 Mulder: 14 Scully: 14

It’s a tie! 🥳

I stated earlier that this is not every time they were injured and not every time they went to the hospital. Instead, it is every time we saw them while they were admitted to the hospital as a patient.

As with everything, this can be calculated in different ways.

There were instances where we saw them go to the hospital for something temporary (Blood, Gesthemane) and there are episodes where they definitely went to hospital, but we didn’t see them (Zero Sum, Never Again).

This also doesn’t take into account variables like length of hospital stay or injury v. illness. It’s impossible to know the full circumstances in some cases and overall to estimate who spent the most *time* in the hospital.

All to say, this was just for fun and I acknowledge it is not comprehensive based on different criteria (so don’t come for me), but I do believe it is every time we see them on screen admitted in hospital gowns.

[sisterspooky1013]

Gaslight, Chapter 7/48

(On previous posts I listed the chapter count as 58. I was trippin, it’s 48)

Rated X | Read it here on AO3

Dana taps her pen rapidly against the desktop, re-reading the chart for the umpteenth time.

Male, age 32, presenting with acute abdominal pain. Blood and urine tests came back normal, as well as x-ray and ultrasound. She puts in an order for a CT scan and an endoscopy, making a note for herself to follow it with a barium swallow if those tests aren’t conclusive.

“Who died?”

Dana looks up to see Dr. Thomas entering their shared office and smiles wearily.

“I guess that isn’t a great joke for a hospital setting, is it?” the younger woman adds, taking a seat behind her desk and cracking open a can of soda.

Her copper-skinned face and wide, bright smile had been a welcome second impression after Dana’s initial entry into St. Agnes, and the two became fast friends. Thick-waisted and ample-breasted, Dr. Thomas insisted that Dana call her by her first name, Tiffany, and simply smiled sadly and told her it didn’t matter when Dana asked if they had met during her previous tenure there.

“Sorry if I’m being moody,” Dana says with a sigh, leaning back in her seat. “I didn’t sleep well last night and it’s my husband’s birthday today—I’m just feeling a bit overwhelmed.”

Tiffany arches a curious eyebrow as she logs into her computer.

“Does he have unrealistic birthday expectations or something?” she posits. “One of those people that expects to be treated like royalty?”

Dana shakes her head.

“It has nothing to do with him. I think I’m just putting a lot of pressure on myself.”

What she doesn’t tell Tiffany is that as she and Cal have become more physically intimate over the course of the last week—mostly just kissing, and one instance of wine inspired dry humping on the living room couch—her dreams have intensified to the point that they wake her several times at night.

Sometimes they, she and the man, are in the kitchen with the green countertops. She’s washing dishes and he wraps his arms around her waist, or they are dancing in the middle of the room, sometimes kissing as they move across the floor. She can see his face, his hooded green eyes and full mouth, his impish smile. He’s tall, close in height to Cal, and sometimes he is walking her slowly backwards, grabbing at her ass and pulling her close so she can feel him, stiff against her belly. There is always music, though she can’t quite hear it; she senses that it’s there. In some dreams he’s looking up at her from between her thighs, in others his cock is hovering inches from her face. But it’s the ones where she’s riding him, feeling him not just physically but emotionally, that affect her the most. Those are the dreams that pull her from a dead sleep flushed and humming, that send Cal down the hallway to check on her after another nightmare. They are the reason she can’t quite bring herself to return to the master bedroom, for fear that she will call out the other man’s name in her sleep. But then, at least, she’d know what his name is.

“Men are easy,” Tiffany says, giving her a meaningful look. “Give him a steak dinner and a hummer and you’re good to go til next year.”

Dana barks a surprised laugh, but her belly twists. She has the passing thought that maybe being fully intimate with Cal will relieve her of these sordid memories, these haunting dreams. But at the same time, they feel like all she has left of something that was clearly very important to her at one time.

“We’re getting dinner at Mercato,” she supplies. “Have you been there?”

“Yeah, Rick’s taken me there a few times. It’s nice,” Tiffany answers. “Do you have a sitter for the kids?”

“They’ll be at the neighbors’ while we’re out to dinner, but it’s a school night so we can’t stay out too late.”

“Sounds like fun,” Tiffany quips, then stands and drapes her stethoscope over her neck. “I have rounds. See you tomorrow?”

“Yep.”

Tiffany gets as far as the threshold of the door, then stops and looks back at her with a serious expression. Dana lifts her eyebrows in question and waits.

“Don’t forget to cup the balls,” Tiffany says, holding her hand palm up with the fingers curled as though cradling a pair of testicles.

Dana’s groan at her tasteless joke is cut short by the clip of the door closing.

-

“You look great,” Cal says uncomfortably, and Dana smiles demurely.

“Thanks,” she replies, pulling in a breath and looking around the restaurant.

It’s small, only a dozen tables or so, and the ambiance is decidedly romantic: low lighting, flickering candles, smooth jazz music lilting from cleverly hidden speakers. She tugs on the neckline of her dress, which is a low scoop that reveals the tops of her pushed-up breasts. She’d felt good when she put it on, admiring her silhouette in the bathroom mirror, but now that Cal’s eyes keep falling down to her chest as they try, awkwardly, to make conversation, she feels exposed and vulnerable. They’ve only gotten as far as water glasses on the table beside their menus, and already she can’t wait for this meal to be over.

“How was work today?” he attempts, and she remembers Tiffany’s advice regarding his gift.

“It was okay,” she says blandly, and again they fall into tense silence. Cal’s shoulder jumps and his head quirks to the side, and she knows she’s making him uncomfortable with her own discomfort. “Um, I didn’t really know what to get you for your birthday—” she starts, but Cal stops her.

“You don’t need to get me anything, Dana,” he insists, and she nods once.

“I didn’t, actually,” she admits, and he smiles shyly. “But I had this idea that maybe we could sort of—recreate something. An event that was important but that I can’t remember. Kind of a do-over.”

His smile blooms into a delighted grin, and she feels a warm flush in her belly.

“Really? Like what?”

Dana shrugs. “I don’t know, you tell me. This is something I can’t help you with, unfortunately.”

Cal sits back in his seat, pondering with a playful glint in his eye. The waiter approaches their table and asks about a drink order, and Cal turns to Dana.

“Let’s get out of here,” he says, and she flashes her eyes over to the waiter in embarrassment.

“Right now?” she asks in a low voice.

“I apologize,” Cal directs to the apron-clad man waiting beside the table expectantly. “There’s somewhere else we need to be.”

He tosses a twenty dollar bill on the table top and stands up, extending his hand to Dana. She takes it and follows him out of the restaurant, choosing to trust him enough not to ask where they’re going.

_

When Cal pulls the front door of O’Blarney’s open, smoke seeps out and curls into the evening air. She walks in and is greeted by all the trappings of a dive bar: pool tables, dart boards, worn down pinball machines, and the saturated stink of cigarettes and hops. The floor is covered in patchy green carpet and the man behind the bar looks like he’s ready to pose for a mugshot.

Cal directs her to a table and then goes to the bar to get them drinks, returning with a beer for him and a cocktail for her. She takes an experimental sip and smiles with pleasant surprise.

“Gin and tonic?” she asks, and he bobs his head.

“That’s what you used to drink when we met,” he says, scooting his chair closer to hers.

She looks around at the clientele. The bar is relatively busy for a Monday evening, and most of the patrons have the comfortable posture of regulars. A swarthy man in a camo jacket leers at her, and Cal slings his arm over the back of her chair posessively.

“So, what are we recreating?” she asks, taking another sip.

“This is where we met,” he tells her fondly, and her eyebrows lift in surprise.

“Here?”

Cal nods, clearly enjoying her reaction.

“Tell me,” she encourages him, touching his knee lightly for emphasis. He covers her hand with his and holds it there, and she feels a little flutter of excitement.

“I used to come here all the time,” he begins. “Me and my buddy Ryan would come almost every night after work to play pool or just talk. I started seeing you come in every once in a while with another regular, this woman Erin, do you remember her?”

“Erin?” Dana repeats. “I don’t think so.”

“Anyway, you were here with Erin one night and I decided to make my move.” Dana smiles at him and he shakes his head dismissively. “I totally struck out. I think I asked you if you were new to the area or some cliche bullshit, and you pretty much brushed me off. But I saw you again a couple weeks later so I tried just introducing myself, and you were polite but clearly not interested.”

“Ouch,” Dana says with a sympathetic pout.

“I know, it was rough. But there was just something about you. I don’t know, it just felt like I needed to know you, so I decided to go big—”

“Oh, no,” Dana groans, but she’s smiling around her anguished expression and Cal laughs.

“I know, I had no idea who I was dealing with. And Ryan was a horrible influence. He got me all hyped up on this “Say Anything” style gesture that would show you that I was worth giving a chance. And of course I got totally hammered first, for courage.”

“Oh, Cal,” Dana says, pressing one hand to her cheek. “You did something ridiculous, didn’t you?”

“I got up on that stage,” he says, pointing to a small elevated platform in the corner of the room, “even though it was not karaoke night, and I, uh—I sang you a song.”

“You didn’t.”

“Oh, I did. Very off key. But the bartender was kind enough to play the song so I had some accompaniment.”

“What was the song?” she asks hesitantly.

Cal clears his throat, closes his eyes, and sings, “Hands, touching hands. Reaching out. Touching me, touching youuuuu.”

“You’re joking,” Dana says flatly, and he opens his eyes and looks at her.

“Sweet Caroline, bah bah bah. Good times never seemed so good,” he croons creakily.

A genuine grin stretches across her face, and Cal elbows her in encouragement.

“So good, so good, so good,” she completes softly.

“I’ve been inclined,” he says in a whisper as he leans in, “to believe they never would.”

She accepts his kiss, returning it with a few soft smooches befitting a public setting. He pulls away, eyeing her with nothing short of adoration, and she finds herself feeling quite happy.

“And I went for that?” she questions cheekily.

“Absolutely not,” he answers, and she laughs. “By the time I stumbled off the stage you were gone. But I guess it did make some kind of impression, because about a week later Ryan and I were sitting over there shooting the shit,” he says with a thumb hitched toward a table near the wall, “and the waitress brought a drink over courtesy of a mystery woman at the bar.”

Dana makes a face, impressed with her own forwardness.

“And the rest is history?” she asks, and Cal bobs his head side to side.

“Somewhat. We stayed up all night talking, and you actually overslept and missed an interview,” he explains.

“What for?” she asks.

“The FBI, of all things. You said you weren’t totally sold on it being the right path for you, and when you woke up and realized you’d missed it, you decided it was fate.”

“Fate?” she repeats incredulously. Cal shrugs.

“Your words, not mine.”

“Hm,” she says, pondering.

She does remember the call from the FBI and setting up an interview. Her father was incensed that she was even considering it.

“Tell me about when you met my dad,” she asks, her voice suddenly tight.

“Oof,” Cal says with a grimace, and Dana mirrors it. “It was a little bit rough. He asked me about my family and where I’m from, which didn’t set us off on a great foot.”

“You lost your parents young,” she says, and he realizes she doesn’t remember the details.

“I never even met my dad,” he tells her, and her hand slides sympathetically back over his knee. “My mom was a junkie, and she OD’d when I was thirteen. I was in and out of foster care until I turned eighteen and joined the army.”

“I’m sure Dad liked that, though?” she says hopefully.

“Yes, once I was able to get that far and tell him about some of my accomplishments, he came around a little. But then I got you pregnant, and we weren’t married, and that knocked me down quite a few pegs.”

“Would it be wrong to say that I’m glad I don’t remember having to tell him that?” she asks with a pained smile.

“I only wish I were so lucky,” he replies, and they sit there for a moment, sharing smiles and affectionate glances. Cal blinks and shakes his head a little as though suddenly dazed.

“What?”

“I just got the most intense sensation of deja vu,” he says. “It happens to me a lot, actually.”

“Perhaps we’re living in an alternate universe,” she suggests, and he eyes her skeptically before he checks his watch.

“It’s almost eight, we better go get those rugrats to bed,” he says, and they stand, settling the bill before they walk out of the bar arm in arm.

-

After washing her face and pulling on an oversized sleep shirt, Dana turns down the guest bed and slides under the covers.

She thinks about her date with Cal, about her appointment with Michelle tomorrow, about Abby attending summer camp in a couple weeks when school gets out. She thinks about how grounded she’s beginning to feel, though the edges may always be fuzzy, and contentment washes through her body as she relaxes into the bed.

From down the hall, she hears a persistent murmur, like someone is talking. There is no TV in the master bedroom, and it almost sounds like maybe Cal is on the phone. She rises from the bed and creeps quietly down the hall, straining her ears. As she nears the bedroom door she recognizes that the sound is music, and she knocks gently.

“Yeah,” Cal says quietly. “You can come in.”

She pushes the door open and spots him sitting in an armchair near the window. He’s still wearing his slacks and dress shirt, his loosened tie hanging limply around his neck. He’s slumped down in the chair, his long legs extended before him and his elbows propped on the armrests, fingers steepled under his chin. His eyes are slightly swollen, his mouth set. He looks miserable.

Sweet Caroline, good times never seemed so good. I’ve been inclined to believe they never would.

She follows the sound to a small boombox on the dresser, then looks back to Cal.

“Are you okay?” she asks gently, still standing in the doorway.

He nods, then sniffs, and his jaw jerks to the side.

Dana enters the room, pushing the door closed behind her, and approaches him. He watches her with an anguished expression as she kneels down on the floor beside the chair, resting one hand on his knee.

“What’s wrong?” she asks, surprised that he’s not feeling the same buoyant optimism after their date.

Cal shakes his head solemnly, then reaches out and pushes her hair behind her ear.

“I don’t want to put my shit on you, Dana. Don’t worry about it,” he says, then attempts a smile.

“You’re not putting anything on me,” she says. “Please, tell me what happened.”

His watery smile widens, and her heart aches.

“Nothing happened, mija. We had a great night. It was a great birthday. It’s just hard sometimes, you know?”

She nods. She does know.

“I’m sorry,” she says, and he closes his eyes and grimaces.

“Please stop saying that,” he whispers.

She has the impulse to apologize again, so she sucks her bottom lip between her teeth. She thinks about the man from her dreams, how he feels so close in her mind and yet she can’t reach him. She thinks that maybe that’s how it is for Cal: she’s right here, but she’s also eight years away.

She shuffles forward on her knees, navigating around one of his legs until she’s positioned between them, her hands resting on the tops of his thighs. Cal opens his eyes and watches her, his jaw twitching. Dana swallows, tamping down the butterflies erupting in her belly as she slides her hands up to his hips. He tenses, but doesn’t move. His breathing is shallow, coming out in urgent little puffs. She hooks her fingers under the waist of his slacks and meets his eye.

“Let’s go to bed,” she says huskily, and he shifts a little in his seat.

“Are you sure?” he asks, but she can already see him responding in her periphery. She knows how much he wants her, and she wants to want him too. She wants to feel the way she feels in her dreams: seen, adored, worshiped.

She nods.

He rises slowly from the chair and she stands, wrapping her arms around his waist as he cradles her face in his hands. And she does feel adored by him, she has since the day she came home. She just wasn’t ready to accept it.

And when I hurt, hurting runs off my shoulders. How can I hurt when holding you?

He walks her backwards toward the bed, lays her down gently, touches her like she is the most precious thing on earth. He worships her, he loves her, he makes her come.

And all the while she is thinking. Thinking of him—he. His hands on her hips and his mouth on her ear, and the way his body fits into hers like a missing piece of a puzzle.

She sleeps in the master bedroom, Cal wrapped around her like a vine. Awash in dopamine and oxytocin, she prays that she won’t always long for her dreams.

-

She flexes her hips forward and back, her slick lips sliding over his shaft as he kisses her sweetly. She wants him, and she feels ready—so ready. She feels the press of his head against her opening and she arches her back, angling herself just right, and he begins to slide into her. There is a stretch, a sting, and she gasps a little even as she’s still taking him deeper, wanting more of him. They stay still for moments, panting against each other’s mouths, until he sits up and takes her face in his hands. His kisses grow urgent, needy, and she rises up halfway, falling back down with a little whimper. He moans, his hips jumping off the bed, trying to get more of her. She’s never felt so wanted in her entire life.

“Fuck, Scully. I love you,” he groans, and she feels herself rising, gathering, melting into him. Becoming one.

Tagging @today-in-fic

[queen-of-boops]

"Doctor Lucas"

Alright friends, it's time to talk about my biggest LITG pet peeve. It happens all the time, I'm reading a Lucas villa fic or scrolling through Tumblr and I see it: "doctor Lucas". My brain immediately checks out, alarm bells blaring.

I want to be clear here, I'm not policing headcannons or what you can or can't do in fic, especially AUs, the entire point of AUs is to mix things up like careers or backgrounds, etc.

What I am saying, is that canonically, Lucas is a physiotherapist.

For some reason, of all the physios we have (Summer and Jack), Lucas is the only one that's often referred to as a doctor. Maybe it's because he works in a hospital, or maybe somewhere along the line fanon warped him into something else. But as an acute care PT, nothing will make me click out of a post/canon compliant fic/etc faster than "doctor Lucas" or having him do something wildly out of scope.

For one thing, the US is the only country that requires a doctorate for physical therapy. That being said, I can count on one hand the number of times someone even knows I have a doctorate, and I have never been called Doctor outside of the academic setting.

So what does a hospital physio do?

Preserve mobility: let's be real, sick people don't want to move, but lying in bed all day makes you lose strength and range of motion fast

Transfers: how do you get to a chair now that you suddenly don't have left leg anymore? How can I make moving less painful for you following major abdominal surgery? How do you move when you have new precautions and can't bend your hip past 90 degrees?

Gait: Do you need a walker now? A cane? Do you have weight bearing restrictions and need to figure out how to walk with them? Is your gait pattern unsafe?

Stairs: Are there stairs at your house? How can I make them safer for you and the person who's going to be helping you? What techniques can I teach you to help decrease pain and increase safety?

Balance: 99% of people in the hospital are at an increased risk for falls, how can I decrease that? What can I do to improve your balance?

Discharge recs: Where is the patient going after the hospital? Are they safe to go home or do they need rehab? Do they need any equipment to be safe at home? 90% of the time, the rehab department is the one making those calls.

Communicate mobility needs to staff and family: Most of the time, I'm the first one getting someone up. Do they need 2 people to sit on the edge of the bed? Does their right knee buckle when they walk? This is important information that the people taking care of the patient needs to know for everyone's safety.

We see patients post stroke, waiting on transplants, post surgery, after getting the transplant, chronically ill, etc. Patients on vents, with lines and tubes and drains all over the place, even with open surgical sites... they're all appropriate for therapy.

What physiotherapists definitely don't do:

Perform surgery or scrub up or observe or do anything even near the OR.

Give or adjust medications. I'm expected to know what medications do and look out for associated symptoms, but the most I can do is message the doctor and tell them what I'm observing.

Work with a crashing patient. It happens, you're in the middle of a session and a patient codes. Call the code and start performing CPR. But as soon as anyone else arrives, the therapist is the least qualified and least important person in the room. And if a therapist hears a code called, they're getting the hell out of the way to make space for the appropriate team to arrive.

Call time of death. Yes, patients die. Unfortunately, that's just how it goes. And yes, sometimes you come in to work only to learn that the patient you were working with yesterday passed away. But most of the time, if a patient is that close to dying, they're not appropriate for therapy. They're not dying in the therapist's arms or anything like that.

Use physical therapy as a stepping stone to become a doctor. There's not a ton of overlap tbh. I'm sure it has happened, but it's not like a PT degree is a degree that gets you into med school.

Listen, I LOVE my job. I get peed on, puked on, pooped on, etc. There are rude patients and emotional days and difficult conversations that need to be had, but at the end of the day I'm proud of being able to help people in need. You don't get into physical therapy if you don't love it. The pay isn't all that great and sometimes it's a very thankless job. Burn out rates are high, especially in the hospital setting. But those who stick it out are those who can't imagine doing anything else.

You have no idea how happy I was to see a character with my job who actually responds well to questions about it, so you can imagine how frustrating it is to constantly see my profession being overlooked or misinterpreted in the fandom.

Please, next time you go to respond to a post saying that you'd rather be stranded on a deserted island with Lucas because he's a doctor, or write a villa fic where Lucas talks about scrubbing in for surgery, keep this post in mind.

[covid-safer-hotties]

Spatial immune landscapes of SARS-CoV-2 gastrointestinal infection: macrophages contribute to local tissue inflammation and gastrointestinal symptoms - Published July 16, 2024

Background: In some patients, persistent gastrointestinal symptoms like abdominal pain, nausea, and diarrhea occur as part of long COVID-19 syndrome following acute respiratory symptoms caused by SARS-CoV-2. However, the characteristics of immune cells in the gastrointestinal tract of COVID-19 patients and their association with these symptoms remain unclear.

Methodology: Data were collected from 95 COVID-19 patients. Among this cohort, 11 patients who exhibited gastrointestinal symptoms and underwent gastroscopy were selected. Using imaging mass cytometry, the gastrointestinal tissues of these patients were thoroughly analyzed to identify immune cell subgroups and investigate their spatial distribution.

Results: Significant acute inflammatory responses were found in the gastrointestinal tissues, particularly in the duodenum, of COVID-19 patients. These alterations included an increase in the levels of CD68+ macrophages and CD3+CD4+ T-cells, which was more pronounced in tissues with nucleocapsid protein (NP). The amount of CD68+ macrophages positively correlates with the number of CD3+CD4+ T-cells (R = 0.783, p < 0.001), additionally, spatial neighborhood analysis uncovered decreased interactions between CD68+ macrophages and multiple immune cells were noted in NP-positive tissues. Furthermore, weighted gene coexpression network analysis was employed to extract gene signatures related to clinical features and immune responses from the RNA-seq data derived from gastrointestinal tissues from COVID-19 patients, and we validated that the MEgreen module shown positive correlation with clinical parameter (i.e., Total bilirubin, ALT, AST) and macrophages (R = 0.84, p = 0.001), but negatively correlated with CD4+ T cells (R = −0.62, p = 0.004). By contrast, the MEblue module was inversely associated with macrophages and positively related with CD4+ T cells. Gene function enrichment analyses revealed that the MEgreen module is closely associated with biological processes such as immune response activation, signal transduction, and chemotaxis regulation, indicating its role in the gastrointestinal inflammatory response.

Conclusion: The findings of this study highlight the role of specific immune cell groups in the gastrointestinal inflammatory response in COVID-19 patients. Gene coexpression network analysis further emphasized the importance of the gene modules in gastrointestinal immune responses, providing potential molecular targets for the treatment of COVID-19-related gastrointestinal symptoms.

[zebrapotsie]

It’s EDS awareness month once again and the reality is awareness is not enough.

For those that don’t know EDS is a connective disorder that causes a wide array of symptoms from joint dislocations to chronic nausea and so much more. There are 13 identified subtypes, all but one having an identified gene and some being ultra rare.

EDS has been overlooked, mistreated and misunderstood for far too long.

Patients seeking care and understanding are often met with disbelief from the very people who are supposed to be helping us. We as patients with EDS are denied our own experience by our healthcare providers, the very people who are supposed to help us.

Women’s pain is all too often dismissed and ignored. A study found that women who are in the emergency room with acute abdominal pain wait on average 65 minutes before receiving analgesic (painkiller), while their male counterparts receive analgesic wait on average 49 minutes.

I look back at my childhood and all the signs were there, they were just simply dismissed and ignored by the people who were supposed to be helping me. look back at my childhood and all the signs are there.

Women are disproportionately affected by EDS. My story however is not unique, both anecdotal evidence and peer reviewed research supports this.

Women are more likely to be dismissed and overlooked when it comes to chronic pain and other health issues.

This is a cultural issue that we must continue to fight for ourselves and those to come, as demonstrated above both my peer reviewed research and personal narrative. These issues are ever present in our society and women’s pain is taken less seriously whether it comes to emergency care or by a primary care physician.

But there is so much hope for the future. All of us zebras who are fighting for more awareness. Hopefully in the future it won’t take us on average 20 years to be diagnosed. 🦓