#and her parents were smokers so she knows secondhand smoke well

[thelightofthingshopedfor]

cw medical nonsense, also this is long and I would put it behind a cut except mobile

update on confusing health stuff: I got the chest x-rays and additional blood tests on Tuesday, and yesterday after some annoying back-and-forth with my doctor's office I learned that the two slightly high values on the one blood test aren't high enough to be concerning and everything else came back normal, so in conclusion, guess I just have weird fingernails that don't actually mean anything!

and like...obviously, that's good. obviously I don't want a serious health problem in general and I especially don't want one now, and I was able to get the x-rays and blood tests in a way that didn't even cost me a co-pay, so all I ended up losing was the time, irritation, and inconvenience it took to make and go to the x-ray/bloodwork appointment. but I've been annoyed with the doctor and the whole office from the beginning, and the more I think about it, the more pissed I am. she was the one who noticed the fingernail clubbing and then jumped right to lung cancer, and when I said I didn't smoke (which was already on my chart) or spend much time around secondhand smoke, she helpfully reminded me that non-smokers can get lung cancer...instead of, I don't know, asking about other risk factors, or backing off to "well, you say you haven't noticed your fingernails changing and also you have zero symptoms of lung problems, so it's probably nothing or at least definitely not that, but clubbed fingernails can be a symptom of a lot of different potential issues, so let's check it out soon just to be safe". no, instead she continued to be mildly alarmed but still alarmed enough that I was kind of worried despite also thinking it was ridiculous and felt like I'd better get the tests done yesterday, and then that turned into a whole thing because first I had to ask the office two or three times to fax over the orders before they did it right, and then when I tried to make an appointment at the place where I was having it done, we realized we didn't know if it needed to be a fasting blood test or not, so they left a message that my doctor's office never returned, and then I had to call back again multiple times before I could talk to a medical assistant who was like "huh probably not, I guess I'll ask the doctor and get back to you" which took at least a few more hours.

oh and when I emailed them the basic workup from last weekend (which my doctor DID ASK ME TO DO) and said "please call or text me at [number] so I know you got this," did anyone actually do that? LOL NO THEY DID NOT, I had to ask about it specifically, and then there was endless confusion between the basic panel I got at the health fair last weekend and the very specific ones my doctor ordered, so even when they got back to me with the results, there was YET MORE "oh huh I don't know what that means, well here are some facts I almost definitely just Googled, oh you want to know what the doctor actually thinks about this thing that she asked you to send and should have already expressed an opinion about, well let me talk to the doctor again and call you back". and by the end of it I was just like...okay, so...the doctor who noticed the clubbed fingernails and was worried enough that I spent several days also being a little worried because I figured it couldn't be lung cancer but my very basic Google research combined with my Google research on the two slightly high values in my first blood test indicated it could well be something else serious...is now basically going "welp results are all fine so I guess you just have weird fingernails! lol nvm"? really? she was being irresponsibly alarmist about a very specific (and, in the context of me having NO RISK FACTORS, very unlikely) possible problem enough to scare me, and now it's a big shrug that you couldn't even care about enough to be really thorough with whatever you put in my chart for the medical assistant to tell me? THANKS. THANKS BUNCHES. GOOD THING I APPROACHED IT MORE CAUTIOUSLY THAN YOU DID OR I WOULD'VE SPENT THE LAST SEVERAL DAYS BEING EVEN MORE FREAKED OUT THAN I WAS.

oh but you know what the best part is, I figured lung cancer was ridiculous because, again, NO CIGARETTE SMOKE and also NO SYMPTOMS, but I looked it up anyway and yes, not only do I have no symptoms, I also have none of the risk factors for nonsmokers (bad air pollution, exposure to radon or asbestos, family history). so I did some more research on clubbed fingernails in general, and from photos and diagrams I wasn't convinced they even were clubbed but on the other hand maybe they were just beginning to show signs so maybe it was still a concern? and, well, lung cancer definitely still seemed ridiculous but apparently it can indicate a wide variety of possible problems, mostly with the heart or lungs. but here is the thing though, even Wikipedia said that clubbed fingernails are not an indicator of any one specific thing, they're just a potential indicator of a wide variety of possible issues, so you cannot look at that and go "gasp! clubbed fingernails = specific health problem such as lung cancer!" in the same way that like...mild fatigue could be a symptom of a billion different health issues at varying levels of seriousness or it could just mean you need to go to bed earlier. but, BUT, according to Snopes, just a few months ago a story went viral about this girl who posted a photo of her weird-looking fingernails on Facebook and discovered she had lung cancer, and I'm convinced that's why my doctor went "!!!LUNG CANCER!!!" instead of FIRST LOOKING AT THE ACTUAL CONTEXT. which is especially ridiculous because the more typical situation is, you know, patient finds something online, freaks out, tells doctor, and doctor has to tell them "yeah it's probably nothing, viral stories aren't a great source of medical info, but we can do some tests to be sure" instead of LITERALLY THE OTHER WAY AROUND. and maybe it's unfair of me but I can't help thinking, okay, this whole office is an explicitly Christian practice, which means the people who work there probably watch Fox News, which also means they're more likely to take alarmist stuff at face value.

in some ways it's probably just as well; I've been vaguely meaning to find a new GP for ages, I just kept going to this place because I started when my parents took me there as a teenager and even as I started getting mildly uncomfortable with going there and stopped seeing my therapist there, I did still like my specific doctor and it was easier to keep seeing her than to find somebody new. but she doesn't work there anymore, and now I've got this new-to-me doctor who pissed me off, so...good incentive to find somebody else.

[royalrastafariannaynays]

Four Years

Hey! This is a short (sorta) fic for @notedchampagne!!! merry christmas i love you bro!!!!!!!! davekat high school au, rated T! contains abuse mentions and fluff and romance!!!!!!!!! 

In freshman year, you ‘meet’ Dave Strider.

He’s the kid who sits in the back of your classes. Every single one.

You came to this school and left all of your friends behind in your other town. Terezi, Sollux and Kanaya saw you off at your parents’ house. Sure you still talk to them online, but it’s not the same, is it? And there aren’t any other pinoy, or even ‘asian’ kids in any of your classes. Somehow that makes it even more lonely.

Anyways, this guy. He sits in the back of every single one of your classes. Somehow the scheduling worked out in the way that you have the exact same schedule. It’s something you notice right off the bat. Since every teacher tells him to take off his weird sunglasses, and he brings them up a note from where he sits in the back of the room.

He passes you every time he walks up to the front, with your seat in the front row. Dave is quiet, a little weird, and laughs at inappropriate times. Shoes ratty and falling apart even though he wears the same ones every single day. There are three layers of duct tape on them, shiny and gray. You think maybe they were red shoes at one point.

As it is, for that entire semester you try not to think about him.

You make a friend who’s an upperclassman, a guy who smokes out by the dumpster every day, and takes pity on you and offers you some of his weed. His name is Gamzee. You refuse the drugs, but find yourself spending time with his group.

The second semester of freshman year at Shit Ass High School, it happens again.

You have the same schedule as Dave Strider.

The last class of the day, you’re practically reciting the teachers’ “take off your sunglasses indoors, Mister Strider” when Dave… doesn’t have his note. He says he’ll retrieve it, and looks mildly panicked. Patting down every surface of his body and double-checking his bag.

The teacher tells him to take off his glasses until he can find the note, and Dave’s search increases in urgency. Eventually he goes up to the teacher’s desk, and tries explaining something you can’t even hear from the front row.

The only time you’ve seen him without those shades, he had his head down on his desk for the entire day, and covered his eyes in the hallways. A piece of broken tinted glass fell out of the bottom of his shoe as he absently picked at it. Surely he didn’t smash themself. You remember him coming back to class with different shades after that.

“I had every class with him last semester, ma’am,” you speak up, and the teacher stares you down. You resist gulping. “And all this semester, too. He’s got the doctor’s note, just lost it.”

Dave looks stricken with relief, and a little annoyed at you for defending. But he gives you a thumbs up when the teacher dismisses him back to his seat.

You pick up your things, and move to the back.

Dave stares at you until you give him a flash of irritated glare.

Flash forward to the end of the school year.

Dave Strider is standing at the bus stop, looking confused and troubled, about a month before finals.

You sigh, and walk over to help him figure out his shit.

----------

Sophomore year.

Besides your father pooling enough money to help you travel to visit your friends, it was an uneventful summer. Well, Gamzee got sent to juvie. That happened. It was entirely unsurprising.

When you walk into your homeroom, you’re not surprised to see Dave there. He’s sitting next to a girl with huge curly black hair, and huge round glasses. She’s excitedly showing him her tan lines, and he’s… grinning. Dave Strider can smile? Huh.

You dismiss it, and head to the other side of the room. You sit in the middle, instead of the back. Anything is better than a fresh new wave of kids making comments about the asian guy sitting in the front because he gets good grades, or something, whatever. Your hair is a little longer this year instead of the buzzy kind of thing you started off with last year. That should help? Maybe?

By the time you’ve gotten through the rest of your day, switching to and from classes and receiving syllabi and papers to get signed by your parents (Parent. Just one of ‘em now.), you find yourself missing Dave’s presence. You never talked to him, but.

He was there. Like a comrade.

Dave Strider always had just one, shitty pencil. And a multi-colored pen. His graphing calculator had a label ripped off the back, old and clearly secondhand. Maybe stolen, who knows. He cleared his throat conspicuously sometimes. It sounded familiar, like that throat clearing Gamzee did.

Right now, you can’t remember if Dave smoked last year. You don’t remember him smelling like it at least.

At the end of the day, Dave walks a little late into your math class. You find yourself a little relieved. Cool, he’s here. You’re not sure why you’re relieved.

When he sets down his books, and stands up to deliver his note to the teacher like always, you see a tiny round burn mark on his arm. He favors one of his ankles, and. Huh. If he’s a smoker, he’s a fuckin’ clumsy one.

----------

A week after that one class plus home room, you decide that it’s time to try to make friends. Maybe. Kanaya thought it would be a good idea, at least. So you stand up, and walk over to Jade and Dave, where they sit comparing notes for what looks like biology? They’re in pre-AP bio together? You recognize the book.

“I figure after a year of classes with you,” you say first, getting their attention. You sit in a chair clumsily next to them. Dave looks a little nervous around you. Weird. Maybe it’s the different context. “I should introduce myself.”

“Uh, hey?” Dave says, fiddling with the corner of his math book.

Jade smiles at you genuinely, looking between you and Dave for a minute and letting the silence stretch. Eventually, though, she holds out her hand to you.

“Hi, I’m Jade!” She says. And you understand how she could make anyone smile. You’re about to reach out and take her hand as well, even if you don’t have her talent for smiling, when Dave speaks up.

“I don’t remember you, dude,” he blurts, and you freeze.

Oh.

You feel a sick wave slide right through you and bubble in your throat. Recoiling, you pull your hand back to yourself and stand stiffly from the chair. It’s quiet for a long moment, as Jade sits there in shock, still looking at you.

It takes a lot not to cry.

Snubbed, you nod at her. And you walk away.

You were just… tired of not having friends here. But it’s okay.

You don’t need them.

Behind you, Jade scolds Dave. You tune it out completely, and go back to your math homework.

That day, you go back to sitting in the front of the class. Fisting your hands in your hair to focus.

----------

About a month later, Dave approaches you in a hallway.

You plan to turn on a heel and walk away, but he pursues you right up to your locker.

“Hey, I’m sorry about what I… did,” he says. You stay quiet. Maybe he’ll go away. “That wasn’t cool,” he continues. “I’m kinda messed up.”

You finish putting your things in your locker, and think. He apologized. He acknowledged what he did. You have no friends, but that’s no reason to take pity on this asshat with so little personality that he has to take it out on everyone else.

So, you walk away, leaving him dejected in the hallway.

The next day, however, you find yourself dropping your things on the desk next to him in homeroom. Jade claps her hands, but you level Dave with a long, piercing glare.

“You have one more shot, shitlick,” you tell him.

Despite your insult, he looks relieved.

“I’ll take it,” he replies. And Jade starts up a word game for the three of you to play.

You’re nice.

Way too fucking nice.

----------

After that, there are a few study sessions in the library where you get to know each other a little better. The next semester, you even have the same lunch. Dave and Jade wave you over to the table with them, and you eat with them and their other two annoying friends.

It’s… nice.

They all seem to warm to you quickly despite your incorrigible nature and spiky personality.

Toward the end of the year, though, something happens with Dave.

One morning, you walk out to the front of the building to meet them, and you see John helping hold Dave up by the shoulder. He looks frantic, and Dave seems to be waving him away. When John’s dad climbs out of his old station wagon, he takes Dave’s other arm.

There’s… you hope that’s not blood. That’s gotta just be his shirt, right? Half of his face is covered by a deep purple bruising.

John helps Dave into his father’s car, and then the tires are peeling away down the street. John looks on until his dad disappears from sight. When everyone is walking like normal, you trot out to ask John what’s going on. He just shakes his head.

Dave is out of school for two weeks after that.

John gets his homework for him, but doesn’t say anything. Rose and Jade don’t seem to know anything, either, even if Rose claims that she has all the answers. Jade lays hesitant hands on your shoulders, and tells you not to worry. Even if she’s worried herself, and her voice shakes when she tells you that Dave has missed a lot of school before, when they were in junior high.  

You’re still worried.

When Dave comes back in the third week, he has a broken arm. The black eye is kind of yellow and rapidly fading back under his shades, now. There are bandages on one of his arms, and…

He’s wearing a new pair of shoes?

Dave looks at you with a shaken, but desperate expression you’ve never seen before. “Don’t worry about me, man,” he says. “I’m fine.”

He glances at things in his periphery all day, and misses several questions directed at him by the teacher.

By the end of the year, though, he’s back to normal. Or as normal as he was before, at least. And he isn’t taking the bus anymore. He arrives and leaves with John every day.

----------

No contact with those friends over the summer, even if you do get to visit your friends again. Sollux got a job making amateur security tests, and used a lot of the money to fund your trip.

When you grab your schedule, though, you find out that you and Dave have all of the same classes again. Whoa, what are the odds? It probably won’t happen two years in a row.

Sitting next to him is second nature, and Dave jokes with you, sits near you. He’s in better spirits than you’ve ever seen, and doesn’t even flinch when you reach out to grab worksheets next to him. You always figured it had something to do with his eyes, but… now you’re not so sure.

There’s a late autumn afternoon, where the light hits Dave’s cheek just right.

Maybe your chest flutters.

Maybe just a little.

Dave gives you his new phone number, and you give him yours, and you start to text often. Like friends do. Dave has a lot to say, apparently.

The study sessions move to either of your houses, instead of the school library. Usually Dave’s, just because of Kankri. And it’s not really Dave’s house, it’s John’s. You guess. There are pictures of Dave on the walls, though. And there’s a mug with his name on it in the cabinet. And he looks like he feels at home.

When he shows you his bedroom, he looks so excited to show you where he lives. He talks about how there was never quite enough room for all of his things in his old room. John walks by and makes a snarky comment about how thrilled Dave is to show Karkat his mess, arms full of his trombone case.

On the mantle, there’s a tiny picture of Dave. A polaroid. And it’s half-burned. He’s a really little kid, but you can tell it’s dave. It’s the only one of him as a kid in the whole house, but it has its own shiny wooden frame.

Nearing Christmas, you find yourself blushing when Dave gets close to you. And you find yourself wishing Dave would get closer. Dave listens to your rants with laughter in his eyes, and he does a lazy amount of your group projects, and he only does enough of the homework to pass his classes acceptably. And he’s awful at math. But he’s your friend.

-----------

The next summer, Dave brings you along to a party at Ampora’s house. Even though he’s more of an introvert than you are, he insists on you coming with.

The both of you find the punch, and take a cup to the roof and get tipsy. There’s a rager in the pool, and Eridan is inviting someone to smash his father’s prized ming vase in a way that’ll make it look like a B&E. The sun is setting, and someone found a really good playlist to put on the huge speaker system downstairs.

“I love the weekend,” Dave says. And you frown at him.

“Today’s a Wednesday, Dave.”

He snorts into his drink.

“Nah, the music guy. The singer,” he corrects. “This is his song. Star guy or something.”

You down the rest of your drink.

The fruit juice almost covers the taste of alcohol. It still makes you gag.

“Yeah alcohol is nasty,” Dave confirms, and tosses his drink over the edge. Someone shouts as the sticky sugary stuff lands on them, and a group of people start up some raucous laughter.

“Why are we here, Dave?” you ask him, and Dave leans back on his elbows. You do the same, watching what you can see of the pink fade of sunset in the distance.  

“Did I ever tell you why I’m living at John’s?” he asks.

Oh. You drop onto your back, staring at the emerging moon in the night sky.

“No,” you tell him.

“I’m there because John’s dad adopted me after my ‘Bro’ tried to beat me to death,” he says.

And that information is shocking. You remember that morning, with the car and the blood. So it really was serious. How did he make it to the school, then? He didn’t take the bus. He must have walked. That would have been… quite a feat. Excruciating.

“Why the fuck did he do that?” you ask, scowling at the sky.

“A… abusing… me,” Dave starts, and it sounds like physical difficulty for him to get it out. “It was a regular thing for him.”

You choose not to acknowledge it. You don’t know what to do, what to say. Even thinking about the past and Dave’s shoes, and his fear… it’s too much for you right now. So you just blurt the first thing that comes to mind.

“If it was regular, what made this time special?” you ask. Dave laughs. At your frankness, at the wording? Something.

“I went home that day,” he says, and… he’s quiet for a long time. The song changes twice downstairs. Eventually you look at him, and he looks really conflicted. Before you can ask what’s up, though, he opens his mouth again.

“I came out to him, that day,” Dave says. “I told him I liked guys.”

He… oh.

Dave?

A rush of joy and hope fills your heart. You thought, with Jade, and with John being his best friend. And his reactions to you, or lack thereof. Before you know it, something is falling out of your mouth and onto a puddle between you on the roof.

“When I came out, my dad made me get blood tests to make sure I didn’t have aids,” you announce. Dave’s eyes get a little wide for a second, you can see through his shades. Like he wasn’t expecting that possibility. “But eventually he decided that treating me like his son was the ‘christian’ thing to do.”

Dave actually laughs.

It’s not a bitter laugh, or a knowing laugh, like you usually get. It’s bewildered, and like he legitimately thinks it’s funny. Eventually, though, you say “Yeah, it’s fuckin’ rough,” and Dave nods himself into silence.

“So John’s dad is okay? He knows?” you ask. And Dave…

Looks so happy in that moment. He smiles at the sky, just like you. The bleariness from the cheap beer downstairs and the fizz from the punch. “He’s a pretty great dad,” he murmurs.

There’s a hush.

The party booms below.

Night falls.

Dave leans over, in that dark and humid night. He presses a kiss to your cheek.

When he pulls away, there are stars in his bloodshot eyes.

You’re frozen, heart pounding and hands clamped down hard on the roof tiles. Dave grins at you, head still tilted, eyes still so close.

And you scramble from beneath him and… run.

Dave is waving at you with a smile as you swing through an upstairs window.

----------

Dave doesn’t text you for the whole entire rest of that summer.

And when the new school year starts, you have none of the same classes.

You don’t talk much to anyone, getting wrapped up in senior year havoc and spending half of your lunches wrapped up in AP studies with Jade, who’s aiming for valedictorian. Dave does the same as you, you guess, and you don’t see him for the first month or so.

And then you run into him in a hallway.

There’s a magnetism, a compulsion.

You turn around, staring at him, almost crashing into a group of freshmen, and dash away down a corner hallway. You hear voices following you, Rose shouting after Dave and a couple of people annoyed at being crashed into.

As the bell rings, the autumn air biting a little chill into your nose, Dave corners you under the bleachers.

“Stop following me!” you snap at him. But there’s no real feeling behind it. Dave is grinning, hands in his pockets. These southerners have no tolerance for cold weather.

“Wanna be my boyfriend?” Dave asks.

And it’s cool and there’s maybe five crows squawking in the closest tree.

And you just. It’s too good to be true.

Way too good.

“Excuse me?!” you ask, shouting even if he’s only ten feet away.

Months of silence? And then?

Dave sees that you’re not running. His smile grows.

He drops his books, and lifts his hands, and cups them around his mouth.

“I said, DO YOU WANNA BE MY BOYFRIEND,” he hollers through his hands.

And for some reason, you don’t bother answering out loud yet.

Something compels you to stomp over, and grab Dave’s face in your hands.

“Of course not, loser,” you grumble.

Dave is giggling by the time you slot your lips into his, heart pounding and nervous as hell. Clumsy, and together.

[kansascityhappenings]

Smoking during pregnancy doubles risk of sudden death for baby, study says

Smoking even one cigarette a day during pregnancy can double the chance of sudden unexpected death for your baby, according to a new study analyzing over 20 million births, including over 19,000 unexpected infant deaths.

The study, published Monday in the journal Pediatrics, analyzed data on smoking during pregnancy from the US Centers for Disease Control and Prevention’s birth/infant death data set between 2007 and 2011 and found that the risk of death rises by .07 for each additional cigarette smoked, up to 20 a day, a typical pack of cigarettes.

By the time you smoke a pack a day, the study found, your baby’s risk of unexpected sudden death has nearly tripled compared with infants of nonsmokers.

“One of the most compelling and most important points that I would take away from the study is that even smoking one or two cigarettes still had an effect on sudden infant death,” said pulmonologist Dr. Cedric “Jamie” Rutland, a national spokesman for the American Lung Association.

While ending a smoking habit should be the goal, the study did find that cutting back on the number of cigarettes was somewhat beneficial. Women who reduced their smoking by the third trimester saw a 12% decrease in sudden death risk; quitting entirely by the third trimester created a 23% reduction in risk.

“Every cigarette counts,” said lead study author Tatiana Anderson, a neuroscientist at the Seattle Children’s Research Institute. “And doctors should be having these conversations with their patients and saying, ‘Look, you should quit. That’s your best odds for decreasing sudden infant death. But if you can’t, every cigarette that you can reduce does help.’ ”

SIDS and SUID

Sudden infant death syndrome, known as SIDS, was a frightening, unexplained phenomenon for parents for decades until research discovered a connection between a baby’s sleeping position and the sudden deaths. If babies between 1 month and 1 year of age were put to sleep on their stomachs, the risk of dying of SIDS doubled, according to the American Academy of Pediatrics.

The introduction of the “back to sleep” campaign in 1994 educated parents about the dangers, and the rate of deaths dropped by about 50% when parents began putting babies to sleep on their backs. That was soon followed by recommendations to remove bumpers, blankets, toys and other potentially suffocating clutter from the crib.

By 2010, the rates of SIDS in the United States had fallen to about 2,000 a year, compared with nearly 4,700 in 1993, the American Academy of Pediatrics says.

But while the numbers of babies dying of SIDS decreased, two other types of sudden infant death — ill-defined causes and accidental suffocation — have risen over the past two decades, Anderson said, bringing totaldeaths to approximately 3,700 a year.

Today, researchers combine the three types of death and call it SUID, short for sudden unexpected infant death.

The link to smoking

Research has shown a direct link between mother’s smoking and SUID. According to the American College of Obstetricians and Gynecologists, 23% to 34% cases of SIDS and 5% to 7% of preterm-related infant deaths can be attributed to prenatal smoking.

The costs to children born to smokers are also high. Research has shown a connection between smoking during pregnancy and a higher risk of asthma, infantile colic and childhood obesity. Even secondhand smoke is dangerous to the developing fetus, increasing the risk of low birth weight by as much as 20%.

Just how smoking contributes to SUID is being heavily researched, but a prevailing theory is that it increases levels of serotonin, a neurotransmitter that plays a key role in behavioral arousal and activity. In susceptible infants, it’s possible that serotonin affects the ability of the brain stem to regulate the respiratory system during sleep.

“And maybe that leads to the infant stopping to breathe at night,” said Rutland, who is also an assistant clinical professor of internal medicine at the University of California’s UCRiverside School of Medicine.

Rates of smoking in pregnancy still high

Despite a significant drop in smoking rates in the United States, Anderson says, self-reported statistics show that about 338,000 women smoke during pregnancy each year.

“These numbers are probably on the conservative side,” Anderson said. “Women know they shouldn’t be smoking during pregnancy, and there is a certain population that either denies that they smoke or underestimates the number of cigarettes they smoke.”

Despite the knowledge that smoking can harm their baby, Anderson said, statistics show that 55% of those 338,000 pregnant women are unwilling or unable to stop.

“They do not reduce or quit smoking,” she said. “They just continue smoking at the same rate throughout their pregnancy.”

Yet if no women smoked during pregnancy, the study’s computational models estimate, 800 infant deaths each year could be avoided, Anderson said.

Smoking before pregnancy

The new research, the first to be done in conjunction with Microsoft data scientists as part of the company’s A.I. for Humanitarian Action Initiative, was also the first to look at the impact of smoking before pregnancy.

It wasn’t good news for women who smoke and suddenly find out that they are pregnant.

“If you smoke in the three months before pregnancy and quit by the end of the first trimester, you have more than a 50% greater risk of SUID compared to nonsmokers,” Anderson said.

That risk is still lower than if you smoked throughout pregnancy, she explained, but the overall risk is greater than for those who smoked only before pregnancy or never smoked at all.

“That’s the other take-home message,” Anderson said: “Women who are planning on getting pregnant and are smokers should quit well before they even try to get pregnant, because smoking in the first three months before you get pregnant can have a detrimental effect.”

For Rutland, the pulmonologist, that makes sense.

“What it tells you is that when you smoke a cigarette, the physiologic consequences don’t stop just because you quit for several weeks,” he said. “It just shows you how powerful something like smoking is and the lasting effects it can have on your body.”

Reducing risk

Many women who want to stop smoking for the baby’s health find it’s harder than they thought it would be, said Laurie Adams, founder and executive director of Baby & Me Tobacco Free Program, a smoking cessation program.

“What we find nowadays is that there are fewer women who are casual or social smokers,” Adams said. “The level of nicotine in most cigarettes really has hooked them. And so most of the women that we serve that are daily smokers, smoking anywhere from a half to a pack of cigarettes a day. They’re definitely hooked.”

Women who want to use FDA-approved smoking cessation products should be aware that most are safe during pregnancy, Rutland said.

“The only one that we say is not safe during pregnancy is Chantix, and that’s just because it hasn’t been studied, ” Rutland said. “Wellbutrin [bupropion] and the nicotine replacement strategies such as the nicotine-replacement gum and patch are safe.”

For women who want to use non-medical approaches, evidence-based counseling and support techniques are available through the CDC’s Office on Smoking and Health. There are smoking quit-line services in all 50 states that can be accessed via a toll-free national portal provided by the National Cancer Institute at 1-800-QUIT NOW.

A counseling-based program, like Baby and Me, will often focus on a positive approach, offering information and support to prepare a woman for what she will experience during nicotine withdrawal, Adams said.

“We’ll help her set up a quit plan,” she said. “We’ll give her things to do instead of smoking when the urge hits, such as deep breathing, drinking water to flush out toxins and reaching out to a support system. We’ll teach her how to reduce stress and avoid triggers.”

The important thing for women in this situation is to reach out and get help, Adams stressed.

“They can break free from this nicotine addiction,” Adams said. “Not only can they have a healthy baby born on time, they can continue their recovery and not go back to smoking so that the risk of SUID is dramatically reduced.”

from FOX 4 Kansas City WDAF-TV | News, Weather, Sports https://fox4kc.com/2019/03/11/smoking-during-pregnancy-doubles-risk-of-sudden-death-for-baby-study-says/

from Kansas City Happenings https://kansascityhappenings.wordpress.com/2019/03/11/smoking-during-pregnancy-doubles-risk-of-sudden-death-for-baby-study-says/

[rachelhartley-blog1]

Rhetorical Analysis (final draft)

Rachel Hartley Professor Marissa Michael 18 September 2017   Rhetorical Analysis of Anti-Smoking Advertisement Did you know that more than twenty-four million children in the United States have been exposed to secondhand smoke? Secondhand smoke is responsible for between one hundred fifty thousand and three hundred thousand lower respiratory tract infections and four hundred thirty sudden infant death syndrome deaths annually.(Health Affects) Anti-smoking advertisements often pop up throughout society, showing the harmful effects of tobacco through startling advertisements. The Child Health Foundation advertises a picture of a young child with the secondhand smoke forming a halo around her head. Beside her appear the words, “Children of parents who smoke, get to heaven earlier.” Through the utilization of rhetorical devices the image is able promote the awareness of secondhand smoke and its danger toward young children. The image was created to evoke a response from its audience, which consist of both smokers and non-smokers. For the non-smoking audience, the image will hopefully increase their distaste of smoking and remind them of the negative health effects at risk. The audience it would appeal most to is the people who oppose cigarettes and smoking. This may lead them to believe that anti-smoking ads will reach smokers and convince them to quit for the sake of young adolescents. To the other side of the audience, smokers, the image will serve as a reminder of the harm they are doing not only to their bodies, but to others around them. However, they will

Hartley   2

likely be indifferent to the image. Why? This is because they already know it is bad for their health, but continue to smoke because they are heavily dependent on the nicotine. They may even find this ad to be a personal attack on them, their views, and their habits. Smoking is often seen as a bad thing in society. The first rhetorical device used in this image is logos. A common major criticism is that smoking is bad for your health. In modern-day society, this is general knowledge. Almost everyone, when asked, would agree. This is especially true in today's society. Smoking is generally seen as damaging to your health and negative actions taken by some role models. The child in the advertisement is looking up, this is symbolic of her watching the actions of those around her. However in past decades, smoking was acceptable and even encouraged throughout society. The assumption in this advertisement is that smoking is equivalent to condemning a young child's life, simply stealing time with each inhale of secondhand smoke taken in. This is shown by the smoke from the cigarettes forming a halo around the young girl’s head. From the general knowledge of the harm cigarettes do and the image of the halo, we can infer that the claim the Child Health Foundation is making is that smoking is consider homicide. This claim is enhanced by the words on the image “Children of parents who smoke, get to heaven earlier,” which should encourage people that smoke to put out their cigarettes. This is implying that if smokers continue to pollute the lungs of today's youth, it is the same as if they took their life away from them. The second rhetorical device, ethos, also has an effect on the ad’s message. The creator, Child Health Foundation, is a prominent association in society and is known internationally for their charity work and donations, attention received on social media networks,

Hartley   3 and people who join the charity to do volunteer work. However, the audience is able to conclude several things about the organization and credibility through this image. The audience can infer that the foundation is trying to encourage a healthy lifestyle in the audience for not only themselves, but for their children. However, with depth and darkness an image such as this one creates, it also represents the organization thinking only negatively of smokers as people, not just the presence of the habit in their lives. Those who oppose cigarette use will connect most strongly with this image because they and the organization are worried about the safety and wellbeing of the children. They will find the advertisement more believable and more important than because they agree with the message. With the foundation being widely publicized, it is easier to know how credible the source is. Doctors, researchers, scientists, and a board full of well respected people fully support this campaign. The perspective towards smoking is supportive of modern day societal views toward smoking. Many find it is incredibly harmful to an individual’s health and can result in death. The ad tends to look down on smokers because it is considered, it loses some credibility. This is because the image seems like it is scolding smokers rather than making friendly suggestions. The words on the side contribute to the image, and therefore significantly help the emphasis of the message. The words were effective because of the callous and dark tone they embrace. Without any words, the image would not be as moving. Finally, the last rhetorical device, pathos, also comes into play. The dark and black background  image creates a dark and depressing situation by implying that the decision to smoke or not can affect the quality of someone's life. The young girl is staring upward into society with an innocent expression on her face, making the image and thought of death more personal to the viewer. The smoke that is forming the halo appeals to the emotions in several 

Hartley   4 ways. It immediately grabs the audience’s attention, since she is so youthful and she is only just now starting her life. Smoking is not only dangerous, but one of the top causes of death in America. The smoke halo is also suggestive of her purity. It is saying that if someone smokes, she is exposed to these chemicals. Her lungs are no longer pure, they are contaminated during development. This causes the viewer to be taken aback because they often have someone, a daughter, friend, or family member that is going to be exposed to these toxins. The audience feels a sense of responsibility, if not need to make a change for the better. They want the person they care about to live a long and healthy life. This image of the young girl with the cigarette smoke halo enclosing around her head employs the use of ethos, logos, and pathos through its coloring and inspiring message. Though not every individual will make a change in their life, the simple message that smoking is hazardous to one’s health still proves its point. Smoking is very frequent and has become necessary for some people throughout the world, but so are the anti-smoking advertisements. This advertisement was created in attempt to inform its audience and to convince them to make society a safer and cleaner place for generations to come. We only have one life, it should not be cut short because of another person's choice. It makes homicide look strikingly similar to the advertisement's purpose.

Hartley   5 Citations “Health Effects of Secondhand Smoke.” American Lung Association, www.lung.org/stop smoking/smoking-facts/health-effects-of-secondhand-smoke.html. Accessed 20 Sept. 2017. “Saving the greatest number of children's lives at the lowest possible cost.” Child Health Foundation

[mysurveys]

Random Qs

Survey #38 on the Countdown to 2018!

This one's from back in May from before my hiatus. I took a long break after posting two others from May months ago. There were a lot of changes to my health and other parts of my life so the pause was necessary. I'll be posting one more from the same month before getting to some from last week.

Did you have a New Year’s kiss?

No, but I don't really celebrate the new year.

Are there any words that you cannot pronounce, or that you pronounce incorrectly?

No, I just have throwbacks from my early youth concerning words I confuse and conflate such as "itch" and "scratch".

After a long day at work or doing something physical what tends to hurt more, your back or your feet?

It varies. If I did a lot of lifting then it would probably be my back, but if I just did a lot of walking then it would most likely be my feet.

Do you have a smartphone and if so, what’s your favorite app?

I prefer not to carry a phone, but there are apps on my computer. I just don’t have a fave right now.

If you had to choose between being a nurse or an English teacher, which would you choose and why?

The latter since I'm much more qualified for it.

Do you have a specific gas station you usually go to, or do you stop wherever?

I don't drive, but my mother has a preference and it has the best Subway in our area. It’s not somewhere I shop otherwise.

How much older than you was the oldest person you've dated or had a relationship with?

Five or so years, I think.

Is anything stressing you out at the moment?

I have some minor stress from my grandmother's situation right now. She might lose her only eye and that could mean different living arrangements for my parents and I since we would probably need to move in with her.

My mother's been avoidant when it comes to talking about the situation, but it's something I have to get her to do.

What's your opinion on dating someone who already has children from a previous relationship?

I don't want to take care of kids so I wouldn't date someone who has their own. It’s definitely a deal-breaker for me.

Have you ever actually found a mascara that makes a huge difference for your lashes?

I don't use mascara. My eyelashes are fine without it.

Would you rather have one or two great facial features that stand out or just an overall pretty face but no special features?

I don't feel I need any special distinguishing marks on my face. However, I do have facial moles right now. One of them stands out slightly on my forehead and the other is underneath my left eye.

Do you check your horoscope daily and if so, did you relate to your horoscope at all today?

I don't check it and I haven't since I became a Christian which was many years ago, but just using your star sign is pretty pointless anyway. I did learn that much about astrology way back in the day.

When you need to remember something, how do you usually go about doing so?

It depends on what I need to remember, but I’ll never use Post-It notes for things like that. I don’t like sticking those on things.

How would you describe someone that's your type?

I don't have a type as if I'm a child; I certainly prefer certain qualities in the men I date, but I don't generalize them into types.

The traits I always like in a man are dominance, intelligence, a broad sense of humor, someone who loves cats, one who doesn’t have or want children and men who share most of the same moral and political beliefs as I do.

Have you recently accomplished anything that you're proud of yourself for?

Some of the dietary changes I've made are marked improvements.

Are you still friends with any of your exes, and do you still communicate with any of them at all?

I only speak to Symon G. and Sasuke M. who're two of my besties. Most of them separated with me on good terms, though. There’s only one who was truly a jackass back when I knew him.

Do you live on your own or with your parents or a roommate, and do you think you’d like to live alone?

I can't live alone so I opted to stay with my 'rents although I'm wanting more personal space these days.

How often would you say you use Microsoft Word?

I no longer use that. I’m on a Chromebook now.

How often do you typically change your bra?

As needed, which is how I handle most things.

What's the last online purchase you made?

I think I last purchased more DD on Goatlings.

Do you usually have bad symptoms around that time of the month?

That's irrelevant to me now as I don't have a uterus.

Is there anyone you have to see on a daily or weekly basis that you really dislike?

I'm in control of my own life now that I'm an adult so I wouldn’t easily tolerate someone like that. However, I’m not in school anymore and I can’t work a paid job because of my learning disabilities.

The one “job” I do is entirely at my own discretion as well. I’m in charge and I only work with people I actually like.

The only awful person I ever had to see frequently was my paternal grandmother because my parents made the mistake of trying to live with her years ago. It didn’t go well at all. 

I learned a great deal from that experience; I don't force myself to tolerate anyone just because I'm related to them anymore.

Is your hair thick or thin, and would you say it’s easy to manage?

It's thinner now because of certain medications I'm on as well as my problems with hypothyroidism, and my bangs are the only unruly part.

Have you ever had to deal with any type of long-distance relationship whether romantic or just a friendship?

I have several good friends who live out-of-state or in other countries. I've also had romantic relationships over the internet just because it's so much easier to find guys with the qualities I'm looking for that way.

I tend to find male besties online who eventually have romantic feelings for me that I usually reciprocate.

Are you procrastinating doing anything right now?

Not really. I'm using this as a time-waster, but I'm also trying to chill before eventually confronting my mother on the issues we have with changing our living arrangements if my grandmother loses her eye.

It could be a negative experience. I just don't care to dwell on it all morning before she's even up.

Do you have a place you go to a lot that you may be considered a regular at?

There are a few restaurants Mom and I frequent where we request servers we know by name. We'll often ask for Juanita at Casa Ole or Ivy at Red Lobster for instance.

Have you smoked a cigarette today?

I don’t smoke and I'd never take up a deadly bad habit like that. Don’t tell me that the smoker is the only victim either. I know people who have cancer because of secondhand smoke.

What does your last received text message say?

Do you like to read during your leisure time?

If I do read then I only read paper books or fanfiction online. The paper books are most often educational although I occasionally pick up fiction these days. I’ll pick up book versions of certain shows I love.

Did you have a tree house when you were a child?

I had a two-story playhouse that my father built. The top was mine and he used the bottom for storage, but it wasn't built into a tree because that was my preference.

I never wanted to install a building right into a tree, and I just used what I had kind of like a clubhouse for when the neighborhood kids came over.

Do you still live with your parents?

It's either that or assisted living due to my learning disabilities. There's too much abuse in those situations. My family wouldn’t abandon me.

Have you ever dated outside of your race?

Yes, technically. I just don’t believe there’s anything but the human race. Our differences are actually ethnic, cultural, national, etc.

Do you have your own laptop or desktop?

I currently have this Chromebook, but I also have another laptop.

What's the last horror movie you watched?

It might've been The Bye Bye Man.

What was the last thing you ate?

I last ate an orange.

What's something that makes you grumpy?

Being hungry and hot at the same time usually makes me agitated.

What're you wearing?

I'm just wearing a nightgown.

Have you ever witnessed a drug deal?

Yes since Port Arthur and Beaumont are basically ghettos depending on where you go although a lot of people are just oblivious to it.

Are you better at science, math or art?

I have dyscalculia so I'm better at certain forms of art.

Do you have any songs in your head at the moment?

I don't.

Did you ever call any teachers by their first name?

I never did that, but I was a very respectful and obedient child.

Were you born in a hospital or somewhere else?

I was born in a hospital.

Do you often have doors held open for you?

Yes, men are often polite around this area and sometimes women are the same way toward me. It’s usually older men, though.

Do you know anyone who volunteers a lot?

Yes.

Have you ever been cheated on?

I have been as a kid, but if it ever happened otherwise I never knew.

Which would you choose between chocolate chip cookies and oat and raisin cookies?

I'd rather not have either right now and I don’t often eat cookies.

What did you have for dinner tonight, or last night if you haven’t had dinner yet?

I had some shrimp fried rice from Sun Wok last night. I rarely go there these days.

Are your parents smokers or have they ever been?

I don't think my mother has ever even tried a cigarette, but my father has smoked before. He once had a terrible habit of picking it back up whenever he was really stressed out.

That hasn't happened since his mother and brother died, though. They gave him so much trouble, but that’s really no excuse.

Do you drink alcohol?

I don't drink alcohol at all and I’m not stupid enough to try it as my mental issues prove that I could be very susceptible to substance abuse. Drinking within reason might not be a problem, but getting drunk is just dumb.

[rachelhartley-blog1]

Rhetorical Analysis (first draft)

Rachel Hartley Professor Marissa Michael 18 September 2017   Rhetorical Analysis of Anti-Smoking Advertisement Did you know that more than twenty-four million children in the United States have been exposed to secondhand smoke? Secondhand smoke is responsible for between one hundred fifty thousand and three hundred thousand lower respiratory tract infections and four hundred thirty sudden infant death syndrome deaths annually. Anti-smoking advertisements often pop up throughout society, showing the harmful effects of tobacco through startling advertisements. The Child Health Foundation advertises a picture of a young child with the secondhand smoke forming a halo around her head. Beside her appear the words, “Children of parents who smoke, get to heaven earlier.” Through the utilization of rhetorical appeals, the image is able promote the awareness of secondhand smoke and its danger toward young children. The image was created to evoke a response from its audience, which consist of both smokers and non-smokers. For the non-smoking audience, the image will hopefully increase their distaste of smoking and remind them of the negative health effects at risk. The audience it would appeal most to is the people who oppose cigarettes and smoking. This may lead them to believe that anti-smoking ads will reach smokers and convince them to quit for the sake of young adolescents. To the other side of the audience, smokers, the image will serve as a reminder of the harm they are doing not only to their bodies, but to others around them. However, they will likely be indifferent to the image. Why? This is because they already know it is bad for their

Hartley   2 health, but continue to smoke because they are heavily dependent on the nicotine. They may even find this ad to be a personal attack on them, their views, and their habits. Smoking is often seen as a bad thing in society.  The first rhetorical appeal used in this image is logos. A common major criticism is that smoking is bad for your health. In modern-day society, this is general knowledge. Almost everyone, when asked, would agree. This is especially true in today's society. Smoking is generally seen as damaging to your health and negative actions taken by some role models. The child in the advertisement is looking up, this is symbolic of her watching the actions of those around her. However in past decades, smoking was acceptable and even encouraged throughout society. The assumption in this advertisement is that smoking is equivalent to condemning a young child's life, simply stealing time with each inhale of secondhand smoke taken in. This is shown by the smoke from the cigarettes forming a halo around the young girl’s head. From the general knowledge of the harm cigarettes do and the image of the halo, we can infer that the claim the Child Health Foundation is making is that smoking is consider homicide. This claim is enhanced by the words on the image “Children of parents who smoke, get to heaven earlier,” which should encourage people that smoke to put out their cigarettes. This is implying that if smokers continue to pollute the lungs of today's youth, it is the same as if they took their life away from them. The second rhetorical appeal, ethos, also has an effect on the ad’s message. The creator, Child Health Foundation, is a prominent association in society and is known internationally for their charity work and donations, attention received on social media networks, and people who join the charity to do volunteer work. However, the audience is able to conclude

Hartley   3 several things about the organization and credibility through this image. The audience can infer that the foundation is trying to encourage a healthy lifestyle in the audience for not only themselves, but for their children. However, with depth and darkness an image such as this one creates, it also represents the organization thinking only negatively of smokers as people, not just the presence of the habit in their lives. Those who oppose cigarette use will connect most strongly with this image because they and the organization are worried abou the safety and wellbeing of the children.They will find the advertisemtn more believable and more important than because they agree with the message. With the foundation being widely publicised, it is easier to know how credible the source is. Doctors, researchers, scientists, and a board full of well respected people fully support this campaign. The perspective towards smoking is supportive of modern day societal views toward smoking. Many find it is incredibly harmful to an individual’s health and can result in death. The ad tends to look down on smokers because it is considered, it loses some credibility. This is because the image seems like it is scolding smokers rather than making friendly suggestions. The words on the side contribute to the image, and therefore significantly help the emphasis of the message. The words were effective because of the callous and dark tone they embrace. Without any words, the image would not be as moving. Finally, the last rhetorical appeal, pathos, also comes into play. The dark and black background  image creates a dark and depressing situation by implying that the decision to smoke or not can affect the quality of someone's life. The young girl is staring upward into society with an innocent expression on her face, making the image and thought of death more personal to the viewer. The smoke that is forming the halo appeals to the emotions in several ways. It immediately grabs the audience’s attention, since she is so youthful and she is only just

Hartley   4 now starting her life. Smoking is not only dangerous, but one of the top causes of death in America. The smoke halo is also suggestive of her purity. It is saying that if someone smokes, she is exposed to these chemicals. Her lungs are no longer pure, they are contaminated during development. This causes the viewer to be taken aback because they often have someone, a daughter, friend, or family memeber that is going to be exposed to these toxins. The audience feels a sense of responsibility, if not need to make a change for the better. They want the person they care about to live a long and healthy life. This image of the young girl with the cigarette smoke halo enclosing around her head employs the use of ethos, logos, and pathos through its coloring and inspiring message. Though not every individual will make a change in their life, the simple message that smoking is hazardous to one’s health still proves its point. Smoking is very frequent and has become necessary for some people throughout the world, but so are the anti-smoking advertisements. This advertisement was created in attempt to inform its audience and to convince them to make society a safer and cleaner place for generations to come. We only have one life, it should not be cut short because of another person's choice. It makes homicide look strikingly similar to the advertisement's purpose.

Citations “Health Effects of Secondhand Smoke.” American Lung Association, www.lung.org/stop smoking/smoking-facts/health-effects-of-secondhand-smoke.html. Accessed 20 Sept. 2017. “Saving the greatest number of children's lives at the lowest possible cost.” Child Health Foundation, childhealthfoundation.org/. Accessed 20 Sept. 2017.