#but anyways isnt he a doctor why is he so beefy

[biblicallyaccurateangeloncrack]

PLEASE IM SHITTING TABLES YOURE TELLING ME THIS GUYS NAME IS ACTUALLY RATIO I AM CRYING

[superspookywombat]

falling {j.h} chapter nine

Warnings: mentions of sexy stuff kinda (rated PG13 at the most)

Taglist:  @Sleepy-whore @geekysimmerthings @mauvette268 @treestarrrrrrrr @kaleigh404 @krazykatkay456 @meganlikesfandoms @darknacademia @hi-my-name-is-riley @vdtwsupernatural @selmeuuh @raindancer2004 @wondersandtempests @royale-trash-slytherin @im-hella-bright @bootylimpics @livfg @It-is-rebel-owl-ma-dudes @peacemusicinch @coffeeslut16 @bvbwestfall @Actuallyedythecullen @stan-joonies @Peacebuglove @Millie-753 @Frozenhuntress67 @i-tried21 @seaevans @femflorals @arseofrivia @trashysara @vulgarfuckinvirgo @sleepysnapesnake @hey-bulldogs @mental-breaker-74 @pansexual-and-eating-pancakes @duty-isnt-always-honour @jelly-fishy-babie @carnagefuck @clubpengiunn @wondersandtempests @100-percent-loving @fandomsandmore394 @pomiotszatana @cherrybuck @alohorcruxes @harryskillerqueen @left-in-the-woods @galaxypox @what-if-im-the-bad-guy @daughterofanarchy997 @camillapad @babieboth @thequeerishere555 @your-average-wallflower @anxiety-station @xo-sophiemae-xo @rachthestressedbandobsessed @amordesiempre01 @avalon68 @imaginebeinlovedbyme @vampiregirl1797 @scuzmunkie @maelleoute @popwhitlockanddrop

A/N: (i think i got the taglist fixed now oops) emmett is the biggest spongebob stan and you can’t change my mind. he makes SB references constantly and rosalie hates it.

“So... you and Edward..” You trail off as you and Bella sit in front of the tv. She doesn’t bother to turn to look at you while she responds.

“What about us?” She asks. You sign and take the remote, turning down the volume on the reruns of Psych.

“Well, have you two.. You know..” You trail off again, not really wanting to say the words and have the mental image of that in your head. Bella freezes for a moment before snapping out of it.

“No, we haven’t done it.” She mumbles. You make a face and turn to look at her. 

“Why not? You two have been together for, like, an eternity.” You say. She makes a noise, sounding like a mix of a scoff and a chuckle.

“He wants to wait until marriage.” She sighs. You raise your eyebrows and put down the red nail polish you were using.

“Really? Are you sure the guy’s human?” You tease. She gives you a look. “What! I’m just saying! He’s hot, I don’t know how you keep your hands off of him. And, I mean, you’re hot too, just look at who you’re related to.” You wink. 

“You act like I’m completely oblivious to his appearance.” She says. You raise an eyebrow at her response.

“I’m just saying, if I had a boyfriend like that, it would take all I have to not jump his bones at any possible second.” You shrug. “But you have to respect his wishes, and it may suck to you, but it’s important to him. And anyways, it’s not like that means no making out or anything. You can run the bases without going all the way home, you know?”

“Wish I didn’t.” She says. You nudge her shoulder with yours. “So, enough about my love life..”

“Or, we can return our focus back onto Shawn and Gus.” You say, clearing your throat. Bella notices your change in attitude and quietly gasps.

“You kissed him!” She accuses. Heat flushes to your cheeks and ears.

“He kissed me.” You clarify. She lets out a breathy chuckle and brushes her hand through her hair.

“And?” 

“It was awesome.” You say. “Who knows, I might win this virginity race.” 

“It is not a race!” Bella laughs, hitting your shoulder. You scoff, hitting her back and then scooching far away from her on the couch.

“Yeah, because I’d win.” You tease. She rolls her eyes and returns her focus back to the show.

------------------------

You’re laying on your bed, flipping through travel brochures your mom sent you when Bella walks into the room, shutting the door behind her.

“Good evening, sister.” You say in a fake proper accent. She sighs and falls down onto her bed backwards. You raise an eyebrow. “Rough day?” 

“Can I tell you something and you swear not to tell anyone else?” She asks, staring at the ceiling. You close the brochure and sit up, hugging a pillow to your chest. 

“Always.” You say. She stands back up and comes over to your bed, sitting down and pulling one of your pillows to her chest, mimicking you.

“Um, Edward sort of.. Proposed.” She barely gets the words out before you slap a hand to your mouth to cut off an impending gasp. Your eyes widen as she goes more into detail about the event.

“You- I- when I said you needed to respect him waiting ‘till marriage I didn’t mean get hitched !” You say, scrambling to find the right words.

“Shhhh! Charlie’s home, don’t be so loud.” She scolds in a harsh whisper. You can’t stop the laugh that bubbles up from your throat, and a moment later, you fall over in hysterical laughter. 

“You.. You.. Charlie!” You laugh. Bella watches you as you howl in laughter.

“I’m glad you find this funny.” She says coldly. You calm down for a moment, that is until you remember she has to tell Renee too. “Okay, fine. See if I ever tell you anything again.”

“Oh, lighten up.” You say, catching your breath. “Just be sure Charlie isn’t armed when you tell him.”

“Yeah, no crap.” She sighs. After you calm down a moment or two later, you return your gaze to Bella, only to see her looking solemnly at the wall.

“Hey.. show me the ring.” You say softly, putting a comforting hand on her shoulder. She keeps her eyes on the wall.

“Edward has it.” She says. You glance at the alarm clock on the nightstand.

“It’s only nine, maybe he’s still awake.” You suggest. “It sounds like Charlie’s passed out, we could sneak out the window.”

“Who are you and what have you done with y/n?” Bella says. “Okay. Get some shoes on, I’ll call Edward.”

“Yes ma'am.” You salute her. She tiptoes down the stairs as you slip a sweatshirt on over your pj shirt and some fuzzy socks on. After Bella returns with the ‘go ahead’ from Edward, you tuck your Ninja Turtle pj pants into some soft boots. She cracks open the window and you follow her as you climb down the trellis. As soon as your feet hit the grass, you grab Bella’s hand and you both run down the street. You spot Edward’s vehicle and you climb in after Bella. 

You sit in the back, used to third-wheeling this way after being driven to school over the last few months. “So, congrats to the happy couple.” 

“You told her.” Edward states. He doesn’t seem mad, infact, his voice almost has no emotion in it at all. Bella nods and he grabs her hand, holding it on the center console as he drives.

-------------------------------

When you step foot into the Cullen’s house, the first thing you notice is two new people sitting on the couch, the woman flipping through a magazine and the guy watching something on tv. They both look as effortlessly flawless as the rest of the family, of course. The blonde lifts her head up, then stands and walks out of the room. Doctor Cullen and his wife sit at the dining table as she draws in a notebook and he reads. Alice and Jasper aren’t anywhere to be seen. Bella stands to the side as Edward holds her close to him while you slip off your boots. You stand in the entryway until Bella suggests you go sit down in the living room while she gets the ring. You walk into the spacious room and sit down gingerly on the couches, finally seeing what’s playing on the large tv- Spongebob.

“Sick pants, dude!” The beefy, unfamiliar guy says. You pull at the soft fabric, stretching Mikey’s face out.

“Thank you. They’re really comfortable.” You say, smiling at him. He leans forward, out of his seat, and holds out his hand. You shake it, ignoring the goosebumps that form from the chilliness of his skin.

“I’m Emmett,” He says. “I’m the coolest Cullen.”

“Y/n-” You respond. “The coolest Swan.” Emmett laughs, a big contagious booming laugh, and lays back into the couch. You relax a bit, instantly comforted by his cool demeanor. 

“You can change the channel if you want, I’ve seen this episode like, 80 million times.” Emmett offers. 

“Oh! I’m good, thanks. I like Spongebob.” You answer quickly. He nods and glues his eyes back to the tv. It’s about five minutes until Bella enters the room again, a tiny box in her hand. She sits down next to you, Edward leans against the arm rest, barely letting Bella a foot from his arm’s reach. 

“So it was Edward’s m-” She starts. Emmett shushes her, leaving Edward to brotherly scold him.

“Just- hold on. You can wait until commercials.” You say, raising a finger to her to shush. She glances at Emmett, then you, then Edward. 

“My God, it’s like they’ve combined their personalities.” Bella sighs, running her hand through her hair. 

“Let’s hope for y/n’s sake they didn’t.” Edward says, humoring her. Emmett doesn’t even look away from the screen as he picks up a throw pillow and chucks it at Edward, knocking him off balance as a flurry of down feathers rain down on you and the surrounding area.

“Sorry, Esme!” Emmett yells out, shrinking down into the couch shyly.

[thegloober]

Going to the gynecologist isn’t just about Pap smears

Some days, work frustrates me. Yes, we all have our frustrations. Maybe the traffic is slow, and you get to work late. Maybe you spill your coffee on your work clothes as you walk into your office. Maybe someone calls in sick, and you are short of help at work. But my frustration has to do with not being able to properly care for my patients. This frustration lies in the misconception that women should only go see their gynecologist if they need a Pap smear.

Why is there the belief that gynecologists only perform Pap smears? What about the plethora of other women’s health issues that gynecologists manage at every age of a woman’s life? And so I just want to shout: “It’s not just about the Pap smear!”

On a cold November day, I walked into my office and greeted my new patient sitting with her back to me. As she turned, I realized she was my patient from years ago.

“Where have you been?” I asked her with a smile. “You disappeared on me,” I teased. Although she had put on some weight, she looked well at 60. As I sat down, I noticed her face was tense, and she was fidgeting in the chair.

“I heard I only need a Pap every few years … something like that anyway. And my internist said she would do my Pap whenever it was due. It seemed easier that way.”

“So what brings you in to see me today?”

“I had spotting a while ago, sometime last year. And then I had some more bleeding recently. I finally decided maybe it was time to see you again.”

As I probed her with questions, I finally was able to get the whole story and fill in her health history. She now had diabetes and high blood pressure, and over the years, the weight just gradually came on. As she talked, alarm bells were going off in my mind  —  uterine cancer. Her story fit the signs and symptoms, but I would need to do more tests to confirm my suspicions.

After her exam, I explained my concerns and the tests that would tell us what was causing the bleeding. “I was afraid you were going to tell me something like that. I should have come sooner, but I thought if I didn’t need a Pap, I didn’t need to see my gynecologist.”

So within a month, I was sending her to a gynecologist oncologist for cancer treatment. If only she had come in earlier, maybe she would have been diagnosed earlier, even perhaps at a precancerous stage rather than stage 3. Somewhere along the line, the medical community failed her by letting her believe she didn’t need to see a gynecologist anymore. The patient may not have known the importance of telling her internist about the spotting or forgot to mention it. Her internist, busy managing her many health issues. may not have asked about any gynecological issues.

As the cold days now filled with snow, I could see an older woman struggling to get her walker out of her car from my office window. A few minutes later, I overheard her talking to my medical assistant and realized that I knew her from before. She had been a patient in our practice for many years  —  seeing my senior partners when she was young and years later switching her care to me. Watching her walk, I knew her health had declined since I had seen her. She always struggled with her weight, but despite that, was active and involved in her community. Today, she looked defeated, huffing and puffing with the effort it took her to walk down the hall.

“I had a Pap smear three years ago with my primary care. I felt like he pinched something on my skin and ever since then I have bleeding once in a while when I wipe. I didn’t want to go back to him, and it hurt too much. Since I was told I didn’t need Pap smears anymore, I never came back here.”

When I asked her more about how she was doing, every sentence started with a sigh. She went on to describe her medical issues, the struggles getting her medications paid for by Medicare, how she moved into a senior living apartment and hated it. “No one wants to do anything!” She looked tired and worn out from life. Her usual animated and energized demeanor was extinguished. How sad it was for me to see her like this.

In the exam room, it took no time for me to figure out where this spotting was coming from. She had a marble size mass extruding from her vulva near the clitoris. This beefy red, angry looking mass easily bled when I touched it. “I can see what is causing the bleeding, and it isn’t because of your last exam. You have something growing here that I need to biopsy.” She didn’t want me to do the biopsy that day. “I have too many things to do today.” I couldn’t convince her otherwise.

A month later, she finally came back for the biopsy. I scheduled a follow-up appointment in a week since I was certain the growth was cancerous. When I received the biopsy results, my first thought was: “This could have been caught so much earlier if she had yearly GYN exams.” But here she was, with multiple health issues, difficulty getting around, and now vulvar cancer with a disfiguring, painful surgery ahead of her.

The warm spring air came and seeing Peggy’s name on my schedule brought a smile to my face.

Every time she comes for her appointment, she is giddy with excitement to see me and my medical assistant. “Hi girls!” she greets us with a giggle. “I just love seeing you two!” like we are having a girls night out. A year ago she came to me complaining of bladder infections nearly every month. Her previous doctor would get a urine sample and prescribe antibiotics, but the infection would always come back. She was in her 70s and had not been getting regular GYN exams.

Once undressed, it took me no time to figure out the issue. She had a large cystocele (due to lack of support, the bladder protrudes into the vagina) that kinked off her urethra. “Do you feel like you fully empty your bladder when you urinate?” I asked her. “Oh, I don’t know, but there is always pressure. I thought it was because of the infection.” I decided to catheterize her bladder and found she was retaining a large amount of urine. A perfect reservoir for bacteria to grow and thrive!

After managing her cystocele, she could fully empty her bladder and never had a bladder infection again. But without a pelvic exam, there was no way to diagnose her issue.

All women benefit from yearly GYN exams.

For younger patients, we can address topics such as family planning, birth control options, STI prevention, vaccinations, pre-conceptual counseling and genetic counseling. We can screen and manage menstrual issues, pelvic pain, fibroids, ovarian cysts, vulvitis, vaginitis, and sexual issues. As our patients age, we help them transition through menopause and the various symptoms and concerns they may have. We assess pelvic floor weakness, vaginal atrophy, sexual wellness, vulvar disease, risks for breast cancer, osteoporosis, heart disease, and thyroid disease. This is just a small list of women’s health issues that we address.

Additionally, because a woman can be in a new sexual relationship at any age, STI screening —  including HPV   — may need to be individualized. So despite the new US Preventive Services Task Force recommendations for pap smears, American College of Obstetrics and Gynecology cautions that “the new guidelines emphasize the importance of the patient-provider shared decision-making process” and “more importantly, there needs to be a continued effort to ensure all women are adequately screened.”

Woman need to be encouraged to see their gynecologist, not discouraged.

Andrea Eisenberg is a obstetrician-gynecologist who blogs at Secret Life of an OB/GYN. This article originally appeared in Doximity’s Op-Med.

Image credit: Shutterstock.com 

Source: https://bloghyped.com/going-to-the-gynecologist-isnt-just-about-pap-smears/