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marshmallow-phd · 4 years

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Healing Touch

Part of The Untamed - EXO Wolf Universe

Genre: Wolf!AU

Pairing: Yixing x Reader

Summary: Medical school abroad was the last line on your to-do list before starting the rest of your life. Everything was going according to plan. Everything, that is, until tragedy strikes your campus. In the wake of a professor’s untimely death, you’re partnered with the cute boy with a breathtaking smile in the newly combined labs. You find yourself unable to resist the dimples and shy glances, but his life is here with no plans of leaving. Will you continue on as planned or will you accept the hand that Fate had dealt you?

Part: 1 I 2 I 3 I 4 I 5 I 6 I 7 I 8 I 9 I 10 I Final

Yixing sat at the kitchen table as the others finished up their breakfast. Minseok took the now empty plate that had belonged to Ji Yeon and rinsed it off in the sink, scrubbing away at the bits that had caked onto the white porcelain. Yixing continued to stare at the newspaper article. He’d read it so many times in the last fifteen minutes that surely he had it memorized by now. Worry pounded in his ears and not simply because of the rise in wolf-related deaths in the area. It had been his professor that was killed this time.

The same splitting headache that had been plaguing him for weeks now came back in full force. Dropping the paper, Yixing rubbed his eyes with his thumb and index finger. It didn’t do any good.

“You okay?”

Yixing looked up at Baekhyun, who stood on the other side of the table. He smiled. “Of course. Given the circumstances. I’m just hoping I can catch up in this new class.”

“It sucks that it had to be one of your pre-med classes,” Baekhyun said, shaking his head.

“It’s terrible that it had to happen at all.”

“You know what I meant. We’re already worried enough about these attacks, but now you’re connected to one of the deaths. We’ll have to be extra careful.”

“I’m always careful.”

“Yixing isn’t the one we have to worry about.” Junmyeon said pointedly. Baekhyun feigned a wounded look. Snickers echoed around the room, except from Minseok’s mate, Ji Yeon. Her eyebrows were pinched tight with concern. And she had every right to be. Perhaps she should even be more worried than she already was.

The headache still throbbed behind Yixing’s eyes. Relief didn’t seem to be coming soon. He stood up from the table, excusing himself quietly as he left the kitchen for his bedroom to be alone.

“Yixing?”

He stopped a few steps up.

Ji Yeon stood just inside the short hallway, arms folded in front of her with the fingers tucked underneath. Yixing thought of her as a strong person, someone who stood as a good foundation for Minseok. He didn’t know her that well yet, but he already say her as the strong type, the sturdy kind.

“Yes?”

“You guys will catch this omega, right?” She glanced off to side, probably to check that Minseok hadn’t overheard her question. The eldest wolf was more than aware, Yixing was sure of it. The connection between a mate and their wolf was strong, indescribably so from the stories he’d heard. If he was honest, he was a bit jealous that Minseok was the first to be mated. The hope he had, however, was that she would not be the last. Once a pack started finding their other halves, it was a domino effect. His time would come, sooner or later.

Yixing mustered up a smile that he hoped came off as reassuring. “There’s nine of us and one of him. Eventually, we’ll find him.” Accepting that answer for the time being, Ji Yeon nodded and walked back into the kitchen. As soon as she was out of sight, Yixing dropped the smile and swallowed thickly. He headed up the rest of the way to bedroom and shut the door.

Tense energy tingled through his feet as he sat on the edge of his bed. They were aching to move, to pace in hopes to work out the nerves, but he didn’t want to concern his brothers who would certainly hear it from the floor below. A run was out as well. As soon as any of the others got a whiff of someone shifting to wander through the woods, they jumped in to join. Only Minseok had the talent to get away clean.

Honestly, that was the least of his worries if he were to go running.

He wasn’t a killer. He wanted to help people. That was why he was studying medicine, why he wanted to be a doctor. But lately… These headaches were never ending, plaguing him over the last several weeks. And then there were the blackouts. Moments of time where he couldn’t remember what had happened. No one saw him during those times. Though he didn’t have to ask when he saw the pack after an episode. He was usually questioned where he had been himself. And he never had an answer. Not a truthful one.

No. This couldn’t have been him. There was another explanation for what was happening, both with the killings and with himself. It would just take time to figure it out.

Your fingers clenched tightly to the textbook against your chest. All morning you had been spending time at the library, reviewing last week’s vocabulary in an effort to distract yourself. Unfortunately, in a place like this with a wild animal running around killing people, escaping the whispers and rumors was not an option. It seemed that everyone was discussing the latest tragedy. And it made sense with how close it hit to the university.

“I hear her body was found in pieces.”

“I’m surprised they even found a body with all the animals that live in the woods.”

“Some of the hunters are talking about going out to kill the animal before it kills someone else.”

“No way. Did you see the pictures someone took of the paw prints in the dirt? That thing has to be huge. Like a bear.”

“There’s no way its as big as a bear.”

“I didn’t even know there were wolves in the forest.”

“What? Did you think it was all bunnies and squirrels?”

Unable to take it anymore, you’d slammed the textbook shut (gaining annoyed glares from those around you as if they weren’t the cause of your inability to utilize the library in the way it was meant to be used) and headed out. It was mystifying to you, the way others would talk about what was happening, like it was sports game or a thriller on TV.

Professor Xui was strict and stern, but she was also admired by the students. The “tough love” type. Though you personally had never been in any of her classes, you did know who she was, and you’d cried when you’d heard the news. Naturally, the university was on top of how to move forward. You’d groaned audibly when you’d read the email that the classes would be combining. Your human physiology class was already close to capacity. They had moved your session into one of the larger science rooms where freshman chemistry classes typically took place. Goodbye uncomfortable wooden desks, hello overly tall lab tables and bar stools with no back support.

You were one of the first to arrive at the lab, giving you the pick of the lot. One of the front tables was free so you settled there. You continued to clutch to the textbook that should have been opened to the page written on the white board in front of you. It was hard to let go. This thick, overpriced book wasn’t going to protect you from anything. And besides, you had no reason to be afraid. You didn’t go into the woods. You weren’t the kind to hike or camp or go near the trees for any reason. The flannel shirt you wore was simply because it was comfortable. You were absolutely fine.

Rolling your eyes at yourself and the silliness that was the track of your mind, you let go of the book and flipped to page thirty-four. Other students filed in as the seconds ticked closer to the allotted time. Professor Jiang, a short, salt and pepper-haired man with wired-framed glasses and a dad-level sense of humor, walked into the room with his old school briefcase, corners wearing thin and the metal on the push latches showing the brass base until the silver coating. The duet of the latches still made you jump even after fully expecting it.

“Good morning, everyone.” Professor Jiang adjusted his glasses. A nervous twitch he completed at the beginning of every class. All it took was five minutes into his lecture and he developed the steel nerves of an alligator wrestler. Pulling a pencil out from your bag, you barely paid attention to the rest of Jiang’s announcement. “I know it's difficult to process, but we’ll all get through this together. For the new students, I will be available for anyone who needs help adjusting to the new teaching style. And I- Oh. Hello.”

You looked up to see what the interruption was.

A late comer had entered the classroom, the door slowly closing behind him. Slim yet athletic, the newest student wasn’t overbearing or imposing, but he still captivated your attention, holding on to it as if his life depended on it. And he was staring right back at you with an intensity that matched your own. Mouth hanging open by the slightest of centimeters, he didn’t move or pay any attention to the professor or the other students staring at him. The muscles in his hand strongly gripped the strap of his backpack that hung off one shoulder. He was going to misalign his back if he kept doing that.

Professor Jiang cleared his throat pointedly, ending the staring contest. “New student?”

The new student blinked rapidly as he turned to the teacher. “Yes. Sorry. I got lost with the new room assignment.”

“One of Xui’s students?”

He nodded.

“That’s alright. We all need an adjustment period. Please, take a seat.”

You stiffened as Professor Jiang held his hand out in the direction of the empty seat right next to you. And that’s exactly where the new student sat. You forced yourself to keep your eyes straight ahead, concentrating a little too hard as Professor Jiang started his lecture of the circulatory system. But his words were drowned out by the shuffling beside you as the new student took out his textbook and other necessities for notes. You leaned forward, holding your neck up by your palm as you mentally repeated the highlights of the pulmonary circuit in order to be productive. The scratch of the pen against your notebook seemed louder today. Your heart seemed to be working in overtime as well. Was everything louder today? Or were you being overly sensitive to noise due to the current circumstances?

“Alright. Please, take a few minutes to go over the review questions located at the end of the section,” Professor Jiang said. It was almost a relief for his short lecture to be over. “Feel free to check with your partner at the table. To make things easier for all of us, the seats you chose today with be permanent for the rest of the semester and who you are seated with will be your constant collaborator.”

Oh, joy.

You were not the best at getting to know new people. It wasn’t your fault, you didn’t think. The other person always wanted to start off with the weather or their job or some other subject that you found difficult to bounce off of to continue the conversation. It was like your mind wasn’t built for small talk. Somehow, you’d missed the installation of pre-programmed responses that everyone else carried around. You had a tendency to go a little too deep a little too quickly. Those were the conversations you wanted to have. Those were the kind that you found easy responses for. But people tended to find your passion about Rosalind Franklin and her forgotten contribution to science a little much.

“Hi.”

The cool voice that broke through your scrambled thoughts made you jump. You hit your knee against the lab table. Careful to hide it from view, you rubbed the sore spot to make the throbbing go away. Your new lab partner must have heard it given the shy smile that pushed up left corner of his mouth, revealing a deep dimple in his cheek. As much as you wished it wasn’t, your heart beating rapidly against your ribs.

For several seconds, you said nothing. No greeting back, no “I’m trying to focus on my work”, not anything. You were silent, staring back at him like he was walking around with a windmill on his head.

“I’m Yixing,” he continued in an effort to get you to speak.

Right. Conversations were two-way streets. “(y/n).”

His smile spread even wider. “It’s nice to meet you, (y/n).”

Words had apparently abandoned you today. All you could do was nod. He didn’t take it offensively. A small chuckle pushed passed the silence.

“Do you want to do the questions together?” he asked. “Or maybe when we’re both finished, we could compare what we got?” he suggested when you still didn’t answer.

“Compare,” you finally spat out. “I think it would be better if we compared. Afterwards, that is.” Not that you were usually the most articulate person, but this was becoming painful.

Yixing nodded. “Okay.” And with that he turned to his book, numbered the lines down on his paper and read over the questions. Taking a deep breath, you turned to your own station to do the same. Big mistake.

His natural scent hit you like a gust of wind on a previously calm day. You weren’t expecting the soft pine smell that he radiated. It wasn’t an overly musty, too-much-cologne type smell. It was subtle; the reason you didn’t catch on to it until this moment. Glancing over at you, Yixing frowned.

“You smell nice.” Oh, gosh, someone kidnap you now. Get you out of here in a fashion that would give reason as to why you didn’t come back. Did those words actually just leave your lips? Turning away from him, you reprimanded yourself for the slip up. Yixing laughed softly, making you turn to face him again.

“Thank you,” he said sweetly. “I appreciate the compliment. Especially since this building has a tendency to smell bad between the chemicals and dissections. I’m always worried that I’ll leave with some of it on me.”

You smiled at his joke. And that was where your thought train stopped. Instinct told you that an additional response was appropriate, but none came to you. You tried to rifle through the possibilities. Before you could find one, though, Yixing had turned his back down to his work.

With the awkward exchange over, you were able to make it through the five questions, writing down the answers with confidence.

“Do you want to compare?” Yixing asked as soon as you wrote the last word.

“Sure.” You slid your paper closer to the middle and shifted your body so you were partially facing him. One by one, you went over what each of you had gotten. Physiology of the human body was a strong suit of yours, more so than of your other science classes. That little bit of pride you had was perking up. It was ready to show off its penchant for knowledge. Unfortunately, this was not going to be one of those times for showing off. For the most part, you were evenly matched. Your answers were close, nearly identical in some parts.

“Professor Jiang might think we cheated,” Yixing teased.

“Well, he did say to collaborate with each other.” Good response. Appropriate response. You nearly patted yourself on the shoulder with that one. You even gave it the kind of tone that said you were merely teasing back.

“Yes, that’s true.”

“That concludes today’s class,” Professor Jiang announced. “As you leave, please stack your answer papers on the corner of the desk up here.” He patted the black top for emphasis. “Have a good day, everyone.”

Standing up, the sounds of stool legs scraping against the scuffed tile echoed through the large room behind you. Once your textbook was zipped up safely in your bag, you reached for the paper. Yixing swiped it up first.

“I’ll take it up there for you.”

“Oh, no, that’s okay. You don’t have to.”

“I want to.”

You might not have been the only one blurting out thoughts before you stop them. A slight pink hue bloomed on Yixing’s cheeks. You were left there speechless as he hurried to the front, dropped off the papers, and left the classroom.

Dazed was an understatement. You didn’t know what to make of what had just happened. So, you ignored it. It was probably nothing anyway. Checking your watch, you calculated the amount of time you had until your afternoon sessions. There was a long break in between. The smart decision would be to hang out somewhere on campus to ensure that you actually went to your afternoon classes. But you needed quiet. Somewhere with no whispers about the woods or comments about the college’s new schedules. The only place you were guaranteed to find that was in your apartment. The building was a couple blocks away, a short walk no more than five minutes. You would have plenty of time to head there and back.

The front door was unlocked when you arrived. A bad habit from your roommate. She didn’t see the need to lock it if she was home and awake. You, on the other hand, clicked it tight and double checked it before stepping in deeper to the apartment.

Ran was sitting at the table, eating noodles and scrolling through a site on her laptop while her phone played a soft melody led by a pipa. It was a dreamy song, soft and comforting, like what your parents used to play for you after a nightmare.

Sighing to yourself, you sat down across from Ran and let your bag fall off your shoulder and to the floor. You hadn’t taken your computer with you, so the loud clump wasn’t one to panic over.

“How was class this morning with the new students?” Ran asked over the music.

The two of you weren’t extremely close. Friends, but not blood sisters. Ran had been your roommate freshman year and when you started talking about moving off campus, you’d offered her the other room to cut down on cost. She’d taken it rather than risk getting a new roommate that she didn’t like. You were similar some ways and vastly different in others. It balanced out, though, and you got along to the point where neither of you kicked up a fuss about cleaning the rooms or washing the dishes. You simply cleaned up after yourself. It was a co-habitation of convenience.

You shrugged. “It was fine. We’re all partnered up now, which is a little awkward, but I’ll survive, I guess.”

“Are they cute, at least?” Ran said with a smirk.

Yes. “I don’t know. I wasn’t paying that much attention.”

“You’re a terrible liar.” Reaching over to the stack of envelopes, Ran plucked the one off the top and handed it to you. “I picked up the mail this morning. Thought you might want to see what came for you.”

Your stomach whirled like it was in a tumble dryer. The envelope had a familiar red emblem of a brick clocktower stamped in the top left corner. With a shaky hand, you took the envelope and ripped open the top. The nicely folded letter slipped out easily. Your eyes scanned the black letters. When they finally sunk in, you slumped back in your chair with a sigh.

“Oh, no.” Ran frowned. “They didn’t reject you, did they?”

You shook your head. “No, not out right. They want to see how well I do this semester before giving a final decision.”

“Well, that’s not too bad. It’s not a no.”

“It’s not a guaranteed yes either.”

Closing her laptop, Ran crossed her arms. Her lips were pursed, eyes down on the table. “You could just stay here. I mean, they have a pretty good medical program and you said that this was where your parents had met-”

“I don’t want to stay here,” you stated firmly. “There’s no reason to.”

“Your aunt is close by.”

“She wants me to do what I want. If that means going to medical school far away, then so be it. I’ll stay in touch with her. Visit when I can.”

“Well, I hope you get in.” Ran stood up and stretched. “On a brighter note, Hae In and I are going out tonight if you want to join us.”

You shook your head. “I’m good. Thanks for the invite, though. I appreciate it.” Whenever Ran and Hae In went out, things tended to get a little crazy. You were sure they had fun and they always came home safe. You just didn’t think that it would your kind of scene. She left a few minutes later and you were finally granted that peace and quite you had been searching for. Well, the quiet, at least.

Peace was nowhere to be found. Stress was rearing its ugly head as you stared at the letter. Ran was right, it was wasn’t a flat rejection. They were, at minimum, interested in giving you a chance. As one of the most prestigious medical universities in the country, you were eager to walk their halls.

The fact that it was far away from any reminders of your life was the bigger incentive. Releasing all the air your lungs were holding on to, you folded the letter back up and tucked it away in the front pocket of your bag. All you had to do was make it through this semester with no hiccups and you would be fine.

Shouldn’t be too hard. There was no reason for any of your plans to be derailed or for you to change your mind.

As long as you survived the next few months, that is.

#exo #exo wolf au #exo wolf!au #yixing x reader #zhang yixing #lay #exo werewolf!au #exo werewolf au #exo supernatural au #exo series #exo fanfic #exo fanfiction #exo college au #exo college!au #The Untamed Universe #Healing Touch

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whump-town · 3 years

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Lie to Me

Chapter Two

Warnings:

Chapter One

It’s not as bad as it looks.

Derek Morgan stands in place, his right hand coated in a drying layer of the foaming pink blood Hotch had choked up. He’s staring ahead, eyes growing an unfocused haze as his body and mind struggle to keep pace with all that’s just happened. No nurse has stepped in to remove him, medical staff simply navigate around him. It’s violating, it feels like he’s being given a front-row seat to a trauma no one’s supposed to witness. Unmoving, he’s unable to look away. Tears start to cloud his vision but someone has to stay. Someone has to see.

The catheter that they use to suction his mouth is clear. The tubing long and spirally, the room’s occupants able to see the sea foam blood leaving Hotch’s lungs. He’s sat up on the stretcher, shirt cut-off in a long simple swipe. Left to be packed into a bag, the once white fabric speckled in pink. There’s a cloth against the upper section of his chest, catching drool and blood that the doctors miss with the tube hunting the corners of his mouth. Hotch heaves, producing nothing from his empty stomach than acid and thin, soft pink spit. He twists away from the catheter, sucking in wet wheezing breathes. Sounds like he’s breathing through a straw, waterlogged and thick.

A nurse directs Derek closer to the bed with a hand on his bicep, her kind words of encouragement going over his head as he pulls his shell-shocked body closer to Hotch’s. That whispered, useless comment bursting through the space between them. It’s not as bad as it looks. Derek finds that incredibly hard to believe, no matter how neatly they wipe Hotch’s mouth and rid the space of blood-tinged rags.

He’d sat in the ambulance for ten minutes listening to Hotch choke on blood. Heard the EMTs warning the hospital about a pulmonary aspiration, watched them debate intubating Hotch while he was still conscious enough to writhe on the stretcher. Trying to pull his body away from the steady hands placing an IV, to sit up and get away from them. Derek could do nothing, had been forced to

It’s not as bad as it looks. He’s assured, taking the thin, uncushioned chair at Hotch’s side. Close enough now to see the pink of Hotch’s dried blood on the side of his cheek. To hear the wheezing breathes he’s taking, quick and shallow. His eyes dart underneath his eyelids, fingers jerking as he struggles to find comfort trapped between awareness and the bliss of unconsciousness.

One week after his diagnosis he had a panic attack. Not the sort he could hide, as he’d hidden many, but suddenly just the full force of his life hitting him centerfold and buckling his knees from underneath him. Jessica had Jack in the kitchen, the two of them laughing as she made fun of his inability to cook. Jack eagerly agreeing, lacing light accommodations in their mix to make him the butt of their joke. Thoughtful and grounding. He listened to his son try and recount at least one meal he hadn’t ruined by burning it. He’s gotten way better at cooking but for a few months, they survived off of chicken nuggets, macaroni and cheese (that he could never get the shells to soften entirely), and frozen vegetables. Off of the kindness (and off fear) of Dave and Penelope bringing pre-cooked meals over. Things he could keep in the freezer and just stick in the over.

He’d tilted his head back against the wall, laced his fingers through the strands of the carpet, and held on. Tried to breathe in through his nose and out through his mouth. Listened to Jack sticking up for him, “it wasn’t that bad” Jack pouts. And he’d managed a shallow smile, still choking on punched breathes leaving his parted lips. He’s Haley’s son, through and through. The only people who have ever stuck up for him -- even in the face of his awful cooking. Jessica found him on the floor twenty minutes later. Old tears drying on his face and new ones still dripping down from his eyelashes. He told her the truth when she asked what was wrong, took his burden, and brought her down with him. He held her as she cried into his shoulder and then he cried when she asked him to stay, not to leave her. She’s so tired of losing her family and he cracks a smile, thinks an awful little stabbing joke about how he’s the reason she’s lost her family. Haley. Her mother to a heart attack three months after Haley died. Now him, his own body betraying him.

It’s not that bad, he promises but all he can think about is his father. Lung cancer at fifty-three and dead by fifty-four. He’s only fifty but he’s still repeating the story.

We’ll do it together, she assures him but he’s already made sure that’s not an option.

“He’s so cold,” JJ whispers. She’s the only person who can stand to get close enough, who can penetrate the heavy sickness in the room to take his hand. To hold his stiff, cold fingers between her own. She looks over her shoulder, expecting someone to say something but finds them all in the distance. Unable to fully enter the room. Pressed to the walls. Eyes counting the tiles on the floor and making up the ceiling. JJ frowns sadly at them, not surprised but disheartened. She warms his hand between her own, trying to rub warmth back into the cold digits.

Jessica comes into the room, a storm of movement and noise that throws the silent contemplation of the room off. She looks around herself, frowning at the collection of them before rolling her eyes. She knows of the team intimately. For years she’s been listening to Aaron come home and talk about them and she’s grown to know them by means of her own exchanges as Jack gets older. They’re Aaron’s family and Jack’s other aunts and uncles, naturally she’s interested in them. That isn’t to say she isn’t annoyed with them. For the willing ignorance in Aaron’s rapid health decline. In the ways that they chose to appease Aaron rather than help him, can’t they see how much it is to make him happy with their ignorance rather than annoyed with their care?

“Derek,” she’s moving things around the room. They’ll be here for a while. His oxygen saturation is too low and his breathing is causing some mild concern that he might develop aspiration pneumonia. With his temperature still low he might be safe but even then they’re things are not magically better. “Will you please get his heated blanket out of that--” she points to the bag and nods when he goes to the right one. “Thank you.”

She takes control of the room, of the movements they make. Who stays when and who goes where.

He’s sleeping, probably will be for a while.

Around the third week of chemo, he started to understand the doctor’s warnings about fatigue. That, yeah, he might feel okay now and maybe he will continue to feel good for several more weeks but it’s going to catch up, and when it does he needs to be ready to ask for help. His current workload is by no means healthy and hardly sustainable for a healthy person, he’s going to have to make adjustments.

He’d started to feel the fatigue but not creeping in as he’d thought. One Wednesday morning he woke up feeling like he’d gone out drinking the night before. The sort of night Emily’s in charge of, where he wakes up in weird clothes with a haircut Emily gave him in the bathroom. It’s Wednesday, though, and his hair is intact. An awful headache and no amount of sleep were able to bring him to life.

His hours at the office got smaller, falling asleep at the desk and on the couch. He leaned to the explanation that he was just getting older. One sly comment about the grey creeping into his hairline spread unevenly and no longer contained to his temples, and he knew they were using the same safe answer. Making the journey from his office for coffee became a mental battle. He needed twenty minutes to prepare himself. Standing too quickly makes him nauseous. The chemo seemed to make every moment of the day, every complex thought, and all foods cause his stomach to twist threateningly.

Saline dripping above his head, oxygen hissing around his ears, and the warmth of overlapped conversations around him. He feels vacantly removed, left out of a loop that he can’t even tell what’s happening. Prying his eyelids open his hard, resolve weak and body too heavy. Weighed down, rocks tied to his hands. He can feel himself being pulled down through the stretcher. He can’t make his mouth work properly, lips parted in a hoarse groan. “W’as wrong?”

Jessica hears him, sees him waking up. His fingers twitching on the bed and his head lifting up off the pillows, searching for something without opening his eyes. Jessica decides to let someone else handle it, looks over the top of her book, and makes it clear.

Dave moves first, pen sliding into the pages of his book as he sits it down. He squeezes Aaron’s hand, smiling at the groan that leaves his mouth. “Shh, now,” Dave encourages. “It’s alright. It’s nothing, go back to sleep. You’re okay.” His response is another groan, slivers of brown iris’ finding him. “Back to sleep, Aaron.”

Hotch turns his head, “don’.” He pulls his hand back, agitated. He rubs the back of his hand against his nose, “not tired.”

Dave rolls his eyes, Jessica scoffs.

“Aaron,” Jessica, mercifully, leans forward to take the situation into her own hands. “Sleep.”

He groans eyes weighed down, body betraying his rebellion. “Bossy,” he rasps and Jessica just hums. She stands, smirking, and pulls his blanket back up to his neck. He does fall back to sleep, lulled under by the fingers Jessica passes across his hairline. Comforted by how tightly Dave holds his hand.

The medical staff advises and predicts a stay of about a week. They need to closely monitor his breathing for a little longer, prevent another episode from occurring. He spikes a fever and that gets him a few more days, his combative behavior doesn’t help. He’s resistant to the idea that anyone helps him and as his fever spikes it’s hard to comply to his request.

Here Garcia and Reid step back. They’re not… as prepared.

Emily doesn’t even ask when she walks into the bathroom where he’s trying to shower, talking to him about Stephanie from the third floor who was totally hitting on her. He’s shaking by the time the shower’s done, exhausted from lifting his hands up and down and from standing so long. Emily keeps talking, towel drying his hair roughly until he grumbles and then they laugh at the oddness of the situation. His hair is untamable and she gets a kick out of standing the ends up, spiking his hair into a mohawk.

Derek falls into step with him when the nurses come in to remind him of the three daily walks he’s supposed to take up and down the hall. He’s a person to lean into when Hotch starts coughing, an arm around his hips so that he doesn’t fall over. And when they wrap a fall risk bracelet around his hand Derek winces and Dave supplies “yellow isn’t your color”. Some days Derek is met with intense distance and other days they walk close, Derek’s arm already around his back, and talk about nothing, anything.

Dave brings dinner, not that Hotch is eager to eat it, but also popsicles of whatever flavor he could possibly want. He’s partial to Outshine, especially the strawberry ones, and it might not be food but it feels nearly right again to see him eating at least something. It’s a sensitive barrier, a hard line to play with knowing when Hotch just needs a little encouragement and when he just really can’t.

JJ brings movies. Her speed is action movies and Hotch is more into anything but that. So they take turns picking and usually pull punches so that the movie is something they’ll both like but when he’s feeling particularly ill, she’ll pick something awful. Give him an excuse to fall asleep during the movie and she enjoys as much, if not more than he does. An excuse to invade his personal space, cut the lights off, and lay beside him on the bed. She’ll paperwork up there, so relaxed she can zone in and out of what she’s supposed to be doing. He’ll look over her shoulder, reading case reports until he falls asleep or until she shuts the file and tosses it to the side.

These habits, these formations, do not stop when he leaves the hospital. Early. He leaves the hospital, too. Reid comes to visit on Thursday when the others are simply too busy doing other things. Resolve weakened and still shaken, Reid doesn’t last even phase one of Hotch’s plan to bust himself out of the hospital.

Derek is already at Hotch’s house, fighting Jack in the kitchen as they search through the fridge that Garcia’s just packed full of food. She feels ill-equipped to deal with everything, despite having known the longest. She feels guilty. She should have said something long before he got this bad, to the other’s so that they’d know, or to Hotch so at least he could ask her for help.

“Daddy!” Jack jumps up from the floor, running straight to his father before anyone can advise against it but Hotch withstands the collision, beaming down at his son. “I missed you.” Jack wraps his arms around Hotch’s hips, face pressed into his stomach. “Do you wanna help me put my puzzle together?”

They’re livid that he left but they don’t take it out on Reid. Emily won’t speak to either of them but she’s just too mad to hold a conversation. Derek helps him back to his room, Jack hot on their heels. It actually makes Hotch feel worse, being home and still unable to do things the way he wants. They get out of his hair a little more, there isn’t the same guilt associated with his home as the hospital.

It gives him a lot of time to think.

And he finds himself thinking about his father.

No one but Jessica knows the full story of his childhood but they’ve seen him shirtless too many times, know him too well not to have pieced at least most of it together. It’s not his best-kept secret.

He had been the kid that sat in the back of the class. Who never raised his hand, eagerly dancing in his chair, jumping at the chance to prove himself by means of validation from his teachers praising his correct answers. If they were reading aloud, rest assured he’d never have his name spoken by another classmate -- no one ever called his name and giggled in glee at his shocked and annoyed face like they did with one another. He couldn’t be certain they even knew it.

Logged with secrets of his short life, managing only the barest glimpses of life behind his dark eyes, he’d lurched and crawled his way to graduation. No more than a lifeless corpse dragging its reanimated form up and down the halls in its familiar pattern. Showing no signs of spontaneity, neither pain nor joy. Grey and slow.

It hadn’t mattered the silent prayers Hotch sent by way of hushed whispers just under his breath, Haley’s head tucked just under his chin, and the soft wisps of her hair moving with each puff of his breath. No matter how Hotch worked at integrating Jack quickly into as many social situations as possible, he had raised his son to be just a little bit too much like him. There are glimpses of Haley in the things that Jack does. Befriending Paul was leaps out of Hotch’s introverted ways and, more surprisingly, Jack’s.

Jessica’s sage words of frequently repeated wisdom disagree -- “he’s exactly like you, Aaron. The messy hair, that look he makes when he’s doing his homework… that’s all you”.

The little cowlick at the back of Jack’s blonde hair hardly speaks of anything more than Hotch forgetting to run a comb through it in the morning. Perhaps some validity points in favor of his paternity, after all it’s nearly the same cowlick he has. Neither one has tameable hair once it gets longer than an inch. Which does not leave a lot of stylistic options.

“Do you like the dinosaurs with the -- with the spiney -- What are they called?” As carefully as Derek had instructed him to be, Jack sits up by his father’s head. He’d crawled into the bed without invitation, he gets by with a lot these days, and Hotch can’t find it within himself to put those boundaries up between them right now. Jack curls up on his side, head on his father’s chest and a Triceratops staring at Hotch.

It had taken a year for cancer to kill his father and he knows that they’re right, he’s not the same as his father. His father smoked, heavily. Drank frequently and always too much. Didn’t have any friends -- and he finds himself snagged on this difference. Even as Derek throws his son up in the air, hauling Jack over his shoulder and making him shriek with laughter. As Penelope tries new recipe after new recipe of his favorite foods in the hopes that he manages to eat at least one. Not angry, not once, when he picks at the food the others shovel into their mouths. Singing her praises. Emily dragging him around on walks, slowly her pace to accommodate him. She never asks if he needs to stop, just does.

He has friends but sometimes he forgets.

“Daddy,” Jack pulls him back into the conversation. “Can we go to the museum? Uncle Spencer said there are dinosaurs everywhere.”

Hotch nods, “I can ask Uncle Spencer to take you.”

Jack shakes his head, sitting up, “I want you to take me.” He would have never demanded a thing from his father. Never once considered asking for something. Sean was allowed these luxuries, begging to be taken to a game or to the park. Jack pouts, leaning forward and tucking himself up against his father. “We can go Saturday? I’ll take a shower the night before, I promise.”

He’s been hospitalized for four days and Saturday is only two days away, it’s not enough time to recuperate. Not enough time to feel like himself but he can do it. He’ll invite Reid, it’ll provide a great distraction for them both, and that way there’s someone else to focus on. It’s just the museum.

“Okay,” he caves. “On Saturday.”

He’s got a family, people who can trust and who need him just as much as he needs them. He’s going to be okay.

#tw cancer #lie to me #criminal minds #criminal minds fanfiction #aaron hotchner #derek morgan #emily prentiss #david rossi #jennifer jareau #spencer reid #penelope garcia #jessica brooks

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theundercovermarvelfan · 4 years

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Whumptober 2020 - Day 13

Whumtober Challenge @whumptober2020

Day 13 Breathe in, Breath Out Delayed Drowning | Chemical Pneumonia | Oxygen Mask

“Is everyone out, did everyone make it out?” Steve demanded as he ran up to the jet, desperately taking stock of his team.

Tony, Thor, Bruce, Natasha…

“Clint!” Natasha gasped as they all seemed to come to realization of who was missing at the same time.

Steve spun around, feeling the blood drain from his face as he looked at the warehouse, smoke pouring out of every visible window and door.

“Clint? Clint, can you hear me?” Steve tried over the comms., even though he knew in the pit of his stomach it wouldn’t do any good. There was a long moment of silence over the line, followed by a burst of static.

And then Steve was running.

He barely paused as he slammed his shoulder into the nearest door, bursting into the warehouse. He paused, squinting through the smoke. The air clung hot and heavy to his skin, indicating how difficult it would be to breathe if it weren’t for the Super Soldier Serum.

“Clint?” Steve called as he looked around frantically, but he couldn’t see more than a few feet in front of him because of smoke that was only getting thicker by the moment.

He heard him before he saw him. In the end all he had to do was follow the sound of the hacking cough before he finally came across Clint, slumped over on the floor as he had tried to get underneath the smoke that was now pressing almost to the floor. He had ripped off the bottom of his pant leg and was holding it over his nose and mouth, in an attempt to filter some of the air he was breathing, but it was painfully clear the damage had already been done. As Steve dropped to a knee next to him, Clint looked up at him, blinking through bloodshot eyes as he desperately wheezed in one labored breath after another.

“It’s okay, it’s okay, I got you,” Steve assured him as he leaned down and ducked under one of Clint’s arms and leveraged him up to his feet.

Clint thankfully had enough awareness to keep the piece of fabric pressed to his nose and mouth as he stumbled along next to Steve. Steve moved them as quickly as he could back toward the exit, finally bursting back out into the fresh air. They made it a good twenty feet from the burning warehouse before Clint’s legs finally gave out, sending them both toppling to the ground.

“Clint! Clint, are you okay?”

Steve looked up to see Natasha running over to them, dropping to her knees next to Clint. He was hunched over with one hand braced on the ground while the other was still pressing the cloth to his face as he coughed and wheezed, every breath sounding horribly painful.

Suddenly, the load roar of an explosion tore through the air around them. On instinct, Steve threw his arms up and used his body to cover the two more vulnerable teammates, blocking the heat and debris. Once the wave passed, Steve looked over his shoulder to see that half the warehouse had collapsed. More than that… it was the portion where Clint had been stranded just a few minutes ago.

Damnit, that was lucky.

“The fire must have hit something explosive,” Steve panted as he stared at the wreckage, knowing full well he was pointing out the obvious.

“Steve, we need to get Clint back to the jet,” Natasha said urgently. “Now!”

Steve turned back quickly, surprised by the panic that laced Natasha’s voice. He looked down at Clint, who was still coughing but didn’t seem any worse off than he had been just a minute ago. Then Steve saw it. Clint had dropped his hand away from his mouth, letting the piece of fabric fall to the ground. It was hard to tell, since the fabric was black, the stains could have just been saliva. But when Steve saw Clint’s hand, it was painfully clear what those stains really were.

Blood. Clint was coughing up blood.

“Here, I got him,” Steve said, moving forward.

It said something that Clint didn’t even have it in him to protest as Steve scooped him up in his arms. Instead, Clint seemed to spasm in on himself as he continued to choke and wheeze desperately for oxygen.

Steve and Natasha ran back to the Quinjet, finding the rest of the team waiting anxiously for them.

“Is he alright?” Thor asked.

“Tony, get the jet powered up, we need a hospital,” Steve ordered, letting the statement answer the question.

“On it,” Tony said as he ran up the ramp into the jet.

“What’s the situation?” Bruce asked worriedly as they approached.

“He hasn’t stopped coughing and there’s blood coming up,” Natasha said briskly as they made their way up the ramp, Bruce and Thor falling into step behind them.

“Okay, put him down over there, but keep him sitting up,” Bruce ordered as he hurried over to the medical supplies.

Natasha stepped in front of Steve and quickly pushed one of the medical cots over so that it was up against the wall of the jet. Then Steve set Clint down, carefully situating him so that his back was to the wall, though he still remained hunched over and coughing into his hands. For a long moment, Steve could only stare helplessly as it felt like they were watching him slowly suffocate right in front of them.

“Here, hold this to his face,” Bruce said, shoving an oxygen mask into Steve’s hands. “Don’t put the strap over his head, just hold it, you’ll need to move it when he coughs so the blood doesn’t pool in it.”

Steve folded his leg underneath him as he shifted more fully onto the cot. “Easy, Clint,” Steve said, trying to draw Clint’s attention to him. Clint’s gaze drifted vaguely in his direction. “This is going to help,” He said as he held up the mask while Bruce set the oxygen tank that it was hooked up to to run wide open.

Steve slipped one hand behind Clint’s head to help brace him as he used the other to hold the mask up over Clint’s nose and mouth, an action that Clint was aware enough not to fight as he dropped his shaking, blood stained hands into his lap. Natasha sat on Clint’s other side to keep him from tipping over. Holding the mask was easier said than done since Clint seemed to be coughing more than he was breathing, but Steve quickly found a rhythm.

“Will he be alright?” Thor asked, shifted uneasily from foot to food nearby.

“It’s hard to say,” Bruce admitted as he went back to rummaging through medical supplies. “The blood could just be from a relatively minor lesion in his trachea caused by the coughing. Or… it could be coming from his lungs. Which would be really bad. Especially since we’re a decent ways out from a real hospital out here.”

There was a heavy silence following the statement, broken only by the sound of the Quinjet rumbling to life.

“Clint, I’m going to hook you up to an IV, hopefully I’m just being overly cautious though,” Bruce narrated as he set up the equipment.

Bruce took Clint’s hand and had to scrub with three different alcohol wipes before it was clean enough to place the IV. Clint watched with what seemed like a detached interest. But the coughing was finally starting to slow down a bit and Steve felt like he was holding the mask up to Clint’s face for longer than he initially was.

“Clint, can you try talking at all?” Bruce asked as he took out a stethoscope.

Clint wheezed in a couple labored breaths before he managed to rasp out, “Hurts.”

“I know,” Bruce said sympathetically as he listened to Clint’s chest. “I need you to stay upright and conscious for me though. If the blood is in your lungs, we don’t want it pooling there.”

“Can you tell if it is in his lungs?” Natasha questioned as they watched Bruce listen carefully to his stethoscope.

“I can’t say for sure,” Bruce said grimly as he straightened up. “There’s definitely some fluid, but he also very likely has chemical pneumonia due to all the chemicals in that warehouse he likely inhaled while they burned up. In any case, I don’t have the equipment to really be able to deal with it here. All we can really do is keep him going until we can get him to the hospital.”

“We can do that,” Steve said with what he hoped sounded like more conviction than he felt.

It was perhaps the longest plane ride any of them had endured. Even as Clint’s coughing became less severe, his breathing remained terribly shallow as he fought to pull in each breath. His coughs also went from painfully dry to thick and wet, which was perhaps even more concerning.

It took almost two hours for them to reach a hospital that had a landing pad where they could land. Tony had alerted the medical team, who were ready to rush onto the jet the moment the jet lowered. Bruce stuck with the team as they loaded Clint onto a gurney and took him into the hospital, rattling off his decompensating vitals. And if they were being honest, Bruce was there to help but also to look after Clint, since the Avengers couldn’t necessarily trust random hospitals to be free of anyone who held a grudge against them.

Once again, Clint had gotten lucky. The smoke inhalation had caused a pulmonary embolism that had been severe enough to need removal, but the doctors were able to perform the procedure without any complications. After that, they were able to stabilize him enough that the next day the Avengers were able to transport him home in order to be under the care of their own trusted medical staff.

Another crisis averted and just another day in the life of the Avengers.

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camden-bridges · 5 years

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The nightmare is always the same. Benjamin is there. He’s three, but I’m not. I’m who I am now… 6’2 and twenty-four years old. He’s frozen – never aging; never growing up. He’s watching me with big eyes and says, “It hurts.” I know what happens next but I still ask, “What hurts?”

“My chest.” His voice sounds smaller before he coughs and there’s a red trickle from the edge of his mouth. I try to yell for my mom to come help him, but she must not hear me because we’re still alone as Ben coughs more… and more… until we’re both covered in splatters of his blood.

The young man recants the dream to his therapist as she hums in interest, watching him intently behind a pair of thick-rimmed glasses. “And how do you feel when you wake up?”

“I feel sad.” He confesses. “I feel guilty.”

Camden “Tripp” Bridges III was three years old when his twin brother died. The doctors said it was a rare clotting disease that took his life before they could treat it. His ultimate cause of death was a pulmonary embolism – a clot so large that it stopped his breathing, and eventually his heart. There were no warning signs; nothing anyone could do. That didn’t stop Tripp from asking the same question: “Why him? Why not me?”

Countless tests proved that the twins did not share the same disease. It was lucky, but also a little bittersweet. What would Ben be like if he was here? Would he be sinewy like Tripp, maybe a little more muscular, or husky? Would he be artistic? Athletic? A genius? The ghost of him was always there, yet offered no answers or comfort. It was a black cloud that followed Tripp like a curse.

Moira Bridges couldn’t have any more children, despite years of trying to expand and strengthen their family with more. When Conrad – Tripp’s best friend – essentially became an orphan at the age of fourteen, the Bridges were happy to bring him in. Despite their trauma, they remained optimistic and hardworking people. Their upper east side multi-million dollar row house offered more than enough accommodation for their new addition. For the first time in a long time, they felt hope again.

Tripp now navigates his life in a lazy haze, doing whatever interests him at the time. For now, he focuses on streaming video games and periodically producing music. His parents pay for the boy’s to live in LA and try to live out their dreams.

The unfortunate truth is that Tripp is caught in a vicious cycle. The guilt depresses him, which keeps him from living to his fullest potential. Not living to his fullest potential adds to his guilt, because Ben doesn’t have the chances that he does. Instead of expressing it healthily, he puts on his goofy act and insists that weekly therapy is all he needs - but underneath it all the dark cloud of his twin’s death still lingers.

#{ tripp intro }

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kk095 · 6 years

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Amanda's amniotic fluid embolism

Warning: this story features blood and other potentially sensitive subjects. Besides that, I hope everyone likes the story!

******

Amniotic fluid emboli (AFE) are a rare, but often fatal complication associated with childbirth. AFE's occur when amniotic fluid from the mother’s reproductive system enters her bloodstream, causing complications with pulmonary circulation, disseminated intravascular coagulation (DIC), and bleeding/hemorrhage. The risk factors for AFE’s are very debatable, but the 2 that we know of are: advanced maternal age (35 or older) and a maternal weight of 220lbs or more. However, our patient Amanda didn’t fit into either of these categories. Amanda was a 28 year old white woman with straight brown hair, chocolate brown eyes, was 5'4, average build, and had a “girl next door” sort of look.

As with most cases of AFE, the onset was totally unexpected; Amanda’s case was no exception. Amanda was carrying twin boys and the pregnancy was uneventful until 2 days before her due date. Amanda complained of severe abdominal pain as well as difficulty breathing. Her fiancée Greg decided to call 911 due to Amanda's symptoms. Greg was a 29 year old white guy who was tall, thin, had blue eyes, longish brown hair, and fair skin. Greg and Amanda were together for 3 years, but decided to hold off on getting married for a little while due to Amanda becoming unexpectedly pregnant with twins.

After Greg's 911 call, EMS arrived approximately 5 minutes later. The paramedics set up 2 large bore IVs, got Amanda on an oxygen mask, removed her clothes, and got her hooked up to a portable heart monitor. On scene, it was noted that Amanda's pulse ox was 94, her BP was 150/100, and her heart rate was 108. Her stats were a bit off, but not to the point of raising a red flag. After these findings, a fetal heart monitor was placed on Amanda’s belly, revealing a fetal heart rate of 154 in one child and a heart rate of 158 in the second child. Although those numbers are within normal limits for fetal heart rates, they’re very close to the upper limits. Shortly following these findings, Amanda was brought out of the house and into an ambulance, while Greg was instructed by paramedics to drive to the hospital.

On the way to the hospital, Amanda’s pulse oxygenation didn’t improve. Her blood pressure started to decrease and she developed a dry cough while continuing to struggle with dyspnea. A few minutes into the trip, Amanda started to bleed vaginally. The bleeding was relatively minor, but it didn’t appear to go away despite paramedics’ efforts.

When Amanda arrived at the emergency department, she was gasping for air, crying, complaining of being cold, and increased vaginal bleeding. Amanda shivered and cried while the trauma team tried to figure out what exactly was wrong with her and her unborn children. Amanda was very scared at the time; she said things like “am I gonna die?” “are my babies ok?!” And “if you can’t save me, save my babies.” The trauma team tried to reassure her, but they still didn’t know what was wrong with her.

The attending physician in the ER ordered a battery of blood tests, along with an echocardiogram and an abdominal ultrasound. The echocardiogram didn’t reveal anything abnormal, but the abdominal ultrasound showed bleeding from an unknown location.

After a few minutes of unsuccessful attempts at replenishing Amanda's blood loss, she started coughing up sputum with a reddish pink color in it. Amanda also started to look rather pale and sickly at that point. Her blood pressure was decreasing and her o2 saturation was continuously going downhill. Because of that, it was decided Amanda would be taken up to the operating room for a c-section and emergency laparotomy to locate the source of the bleeding. Amanda seemed very frightened by the idea of surgery. “surgery?! Is there something else you can do?” she shouted out to us while continuing to gasp for air.

Once in the operating room, Amanda was sedated and intubated. The first order of business was to perform a cesarean section and deliver the 2 boys. Betadine was squirted onto Amanda’s large, protruding belly shortly before a pfannenstiel incision was made. Once her lower abdomen/pelvic cavity were exposed, the uterus was incised. The first child was quickly removed as its cries temporarily relieved the mounting tension in the operating room.

The uterus had to be opened a bit more in order to deliver the 2nd child, and prophylactic antibiotics were also administered to limit the chance of post-operative infection. 2 and a half minutes later, the 2nd child was brought into the world. Thankfully, both children were healthy and in stable condition; the same couldn't be said about Amanda.

After the c-section site was closed with double layer suturing, the exploratory laparotomy began. The surgical site was was sterilized so a midline laparotomy could be performed. A midline laparotomy is a clean cut in the center of Amanda’s abdomen starting below the xiphoid process/diaphragm, curved to the right around the belly button, and continues to the bottom of the pelvis. It’s a large cut that’ll leave a nasty scar, but it’s the most efficient method in regards to overall technique and access to structures in the abdominal and pelvic cavity. Midline laparotomies are also the quickest incision to make, which was important in Amanda’s case.

Amanda’s blood pressure and o2 saturation continued to decrease incrementally throughout the procedure while also continuing to bleed vaginally. Multiple units of blood and FFP were already used, but didn’t appear to correct Amanda’s hemorrhaging. After poking around in Amanda’s abdomen for 25 minutes, the source was still unknown. Eventually, Amanda's hemodynamic instability exacerbated and converted to V-Fib. The surgery was paused to perform resuscitation efforts.

An OR nurse pumped Amanda’s chest as hard as she could while she was switched over to an ambu bag. The defibrillator pads were charged and placed onto her chest while a round of epinephrine was injected into her IV. After several seconds, shock #1 was delivered. Amanda’s feet jumped into the air and slammed back down seconds later, showing off a few thick, prominent wrinkles in her soft, size 6 soles.

The monitors showed v-fib once again so CPR was resumed as the defibrillator pads were recharged. Amanda’s breasts bounced around from the force of each individual compression. Her arms jerked around on the table slightly as the OR nurse continued deep, rapid chest compressions.

After that cycle of CPR and ambu bagging, shock #2 was delivered. Amanda’s body quickly flopped on the table, making a wet squishing sound since she was essentially laying in a pool of her own blood. The monitors displayed coarse V-Fib so another cycle of CPR and ambu bagging was performed before the next shock.

Shock #3 was also unsuccessful. Amanda’s body jolted sharply on the table. The heart monitors displayed pulseless electrical activity (PEA), a deterioration from the previous rhythm. A round of epinephrine was injected as frantic resuscitation efforts continued on the cute, new mother of 2.

Unsuccessful resuscitation efforts went on for another 3 minutes. Another round of epinephrine was pushed, causing Amanda to convert back to V-Fib. The defibrillator pads were charged yet again, forcing everyone to back off of the table in anticipation of the next shock.

Amanda’s back arched before crashing back onto the table a second or two later. The monitors displayed no change whatsoever so the same cycle of CPR and ambu bagging went on as the defib pads were recharged.

Amanda’s lifeless body twitched violently on the table as another unsuccessful shock sent a dose of electricity through her limp body. This shock sent Amanda back into PEA.

Deep, violent chest compressions were resumed. Amanda’s abdomen bounced outward from the compressions while her head bobbed. The situation appeared to be grim, but the OR team continued their valiant efforts on the young mother.

After 4 more minutes of uneventful efforts and epinephrine injections, Amanda converted to V-Fib once again. Just like before, everyone backed off as the next shock was delivered. Amanda’s toes scrunched, showing off large wrinkles in her soft soles. Amanda’s nail polish on her toes was red, almost matching the small amounts of blood on the heels of her feet.

The OR team continued ACLS efforts since the monitors continued displaying V-Fib, or a variation of it. Amanda was shocked unsuccessfully 4 more times, and coded for another 7 minutes. Unfortunately, the surgical team couldn’t shock Amanda out of V-Fib and called time of death at 9:26pm after a 23 minute battle to save her life.

All equipment was removed from Amanda’s body, except for the detached ET tube in an ET tube holder and detached EKG electrodes on her chest. Because of DIC, there was blood in Amanda's ET tube, IV sites, and leaking from each nostril.

The laparotomy was then closed up and the bloody mess of an operating room was cleaned up. Once that was done, Amanda’s body was covered up, only leaving her cute, wrinkly soles exposed. A toe tag was placed on the big toe of her left foot with a vague cause of death listed since nobody knew what happened to Amanda at the time.

After the surgery, Greg was told the news by the doctors. He didn’t exactly know how to feel; on 1 hand, he’s happy both of his kids were alive and well, but on the other hand, he was upset his fiancée died in surgery. Since the cause of death was relatively unknown, Amanda’s family gave the pathologist permission to perform an autopsy.

Amanda’s autopsy revealed that she died from an amniotic fluid embolism. The amniotic fluid ended up in her venous system, went to her heart, and was pumped into her pulmonary arteries, explaining why she had trouble breathing. The body doesn’t know exactly how to fight an AFE, so it attempted to clot the blood in her body, but she quickly ran out of her natural clotting factors, explaining the vaginal bleeding, which turned out to be DIC.

Even though Amanda’s cause of death was discovered, it’s still a tough loss considering she was a young woman who’s leaving a fiancée and 2 children who won’t know their mother.

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br83bs56-blog · 6 years

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By Jill U. Adams January 2, 2017 (The Washington Post) Why does it take so long to recover from pneumonia?

I was diagnosed with pneumonia in October. The doctor told me to rest, really rest. She told me to expect to feel better after a couple of days of antibiotics, but that I still must rest. She told me I would have good days, but they would be followed by bad days. After a week of antibiotics, the bacteria causing my illness — presumably Streptococcus pneumonia — should have been dead. Also called pneumococcus, this pathogen is the most common perpetrator of community-acquired pneumonia, which is pneumonia that people get outside hospitals and nursing homes. The antibiotic I received, a common first-line treatment, covers pneumococcus as well as other bacterial invaders. Yet my doctor told me to expect weeks to months of recovery. Friends with recent pneumonia experience confirmed this rather depressing outlook. Pneumonia can vary in severity so not everyone will need months to recover. The scientific literature concurs with the anecdotal evidence I collected. One study followed 576 adult patients with community-acquired pneumonia. Thirty days after diagnosis, 65 percent of them reported fatigue, nearly half of whom said their fatigue was moderate to severe; 53 percent reported cough and 36 percent reported shortness of breath. Ninety days after diagnosis, 51 percent reported fatigue, 32 percent cough, and 28 percent shortness of breath. Another study surveyed 500 pneumonia patients age 50 and older and found that tiredness, weakness and shortness of breath lasted more than three weeks, on average. In addition to the burden of illness on patients, researchers noted burden on family members-turned-caregivers and on the health-care system, including multiple visits to doctor’s offices if not the emergency room or the hospital, says study co-author John Powers, an internist and infectious-disease specialist at George Washington University. Pneumonia is a serious and potentially fatal disease. In Powers’s study, about 40 percent of people with community-acquired pneumonia ended up in the hospital. Pneumonia and flu together are on the top 10 list of causes of death, according to the Centers for Disease Control and Prevention. A 2011 study of health-care records estimated that 866,000 cases of pneumonia occurred in the United States in 2004; in patients age 65 or older, pneumonia caused 242,000 hospitalizations and 16,000 deaths. I went back to the doctor after two weeks because of intensely uncomfortable shortness of breath. She prescribed oral steroids in addition to a rescue inhaler to calm my overactive airways, which helped. By Day 30, I felt reasonably well most of the time, but I still needed daily naps.

Why does it take so long to recover from pneumonia? One reason is that the detritus from an infection of the lung is hard to clear. Antibiotics kill the bacteria, but all the weaponry your body produced to fight the bacteria — mucus, essentially, or sputum, as it’s called once you cough it up — is left behind. Your clearance mechanisms have to take all that stuff out,” says Steven Simpson, acting director of the division of pulmonary disease and critical care medicine at the University of Kansas. Your airways are lined with hair-like cilia that consolidate microbes and mucus and help move it toward the exit. “It literally takes a lot of energy to keep yourself going with all that stuff in your lungs,” Simpson says. Cough is a primary way to clear the gunk. That’s why doctors advise pneumonia patients not to take cough suppressants. You want to get that stuff out. It’s harder to explain the lingering of symptoms such as fatigue and weakness. “We really don’t understand the biology of this,” says Norman Edelman, senior scientific adviser for the American Lung Association, who practices medicine at the State University of New York at Stony Brook. “Most people think that illness is related to the organism. That’s only one part of the story,” Powers says. “Some symptoms, such as cough and chest pain, clear up relatively quickly. Fatigue, however, takes much longer. That’s because your immune system is still revved up.” The infection sets off a cascade of events that ramps up inflammatory and immune response, Powers says. “You have the bug, and you have the host response to the bug.” A revved-up immune response requires a lot energy. “Your body goes into a mode where it’s diverting energy to the immune system,” Powers says. Simpson says the energy drain burns calories and proteins. When illness dampens appetite, that can exacerbate fatigue and weakness. He advises: “Eat good protein and take plenty of calories.” And don’t forget to rest — really rest. “There’s no reason to confine yourself to your bed, but don’t push it,” Edelman says. “Don’t make yourself exhausted.” What about shortness of breath? This was the most bothersome of my lingering symptoms. Air would suddenly feel thick in my lungs, and my upper back would start to ache — the stress of labored breathing, my doctor said. “Pneumonia can trigger a syndrome that is asthma like,” says Powers, who has experienced it. “It’s not asthma. It’s a hyper-responsiveness of the airways.” Triggers such as exercise or cold air can lead to that very tight feeling in the chest and labored breathing. I felt as if I had a good idea of the scope of this illness — both from my doctor and from a handful of friends with experience. My case was not severe by any measure — I was never considered for hospitalization — and I don’t have preexisting conditions affecting my lung function, such as asthma or chronic obstructive pulmonary disease. I can work from home and steal naps during the day. Yet I was still unprepared to deal with the worst bad days and sought medical care three times in that first 30 days. This, too, is not unusual, Edelman says. “As physicians, our main job is to reassure patients.” Vaccines reduce risk: To reduce the risk of pneumonia, two vaccines are recommended for people age 65 and older: Prevnar 13 first, followed by Pneumovax a year later. That series sets you up for life, although you should continue to get annual flu shots. The Centers for Disease Control and Prevention also recommends vaccinating babies and children younger than 2, and people age 2 to 64 who have high-risk conditions such as a compromised immune system. (Recommended vaccines for children include Prevnar 13 in a series of booster shots in the first two years of life.)

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sinrau · 4 years

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Ravi Sharma, an emergency medical technician serving Brooklyn and Queens, before he fell ill.Credit…via Bina Yamin

Doctors have reported a flurry of cases in Covid-19 patients — including a healthy 27-year-old emergency medical technician in Queens. After a month in the hospital, he is learning to walk again.

By Roni Caryn Rabin

Ravi Sharma was doubled over on his bed when his father found him. He’d had a bad cough for a week and had self-quarantined in his bedroom. As an emergency medical technician, he knew he was probably infected with the coronavirus.

Now, Mr. Sharma, 27, could not move the right side of his body, and could only grunt in his father’s direction. His sister, Bina Yamin, on the phone from her home in Fort Wayne, Ind., could hear the sounds.

“Call 911,” she told her father. “I think Ravi’s having a stroke.” She was right.

Over the next few hours, doctors at a Queens hospital worked frantically to break up a blood clot blocking an artery to Mr. Sharma’s brain. But the doctors were puzzled.

Mr. Sharma was far too young for a stroke. He worked out every day and didn’t have diabetes, high blood pressure or the kinds of medical conditions that can set the stage for strokes in young adults, which are rare.

Neurologists in New York City, Detroit, New Jersey and other parts of the country have reported a flurry of such cases. Many are now convinced that unexplained strokes represent yet another insidious manifestation of Covid-19, the illness caused by the new coronavirus.

The cases add to evidence that the coronavirus attacks not just the lungs, but also the kidneys, brain, heart and liver. In rare cases, it seems to trigger a life-threatening inflammatory syndrome in children.

“We’re seeing a startling number of young people who had a minor cough, or no recollection of viral symptoms at all, and they’re self-isolating at home like they’re supposed to — and they have a sudden stroke,” said Dr. Adam Dmytriw, a University of Toronto radiologist who is a co-author of a paper describing patients who suffered strokes related to Covid-19. The paper has not yet been peer reviewed.

Though many of those patients had diabetes and hypertension, none had heart risks known to increase the odds of a stroke. Many were under age 65. For some, stroke was the first symptom of coronavirus infection, and they postponed going to the emergency room, fearing exposure.

Of 10 patients described in Dr. Dmytriw’s paper, two died because the coronavirus attacked their lungs, and two men — a 46-year-old and a 55-year-old — were killed by strokes.

Jamaica Hospital Medical Center in Queens, where Mr. Sharma was treated.Credit…Sarah Blesener for The New York Times

Doctors at Mount Sinai Health System in New York have also seen an unusual number of young stroke patients, saying they treated five such patients with Covid-19 during a recent two-week period. The medical center typically sees only one stroke patient under the age of 50 every three weeks, Dr. Johanna Fifi, a neurologist, and her colleagues noted in a letter in The New England Journal of Medicine.

Four of the five patients were relatively healthy; two patients in their 30s had no known risk factors for stroke. “We came to the conclusion it had to be related to Covid-19,” Dr. Fifi said in an interview.

Though strokes seem to affect a very small number of Covid-19 patients, they appear to be related to a broader phenomenon that has emerged in critically ill patients: excessive blood clotting.

Patients with severe Covid-19 may develop clots in the legs and lungs that can be life-threatening, doctors said. Their blood can be so thick and viscous that it blocks intravenous lines and catheters. Tiny clots in other organs, like the kidneys and liver, have been found in autopsies of coronavirus patients.

Dr. Michael Yaffe, an intensive care physician at Beth Israel Deaconess Medical Center in Boston, called clotting a “hallmark” of the disease, although “not in everyone.”

German scientists reported last week that autopsies of 12 Covid-19 patients turned up a type of blood clot called deep vein thrombosis in seven of them. The cause of death in four patients was another type of blood clot in the lungs, called a pulmonary embolism.

Clotting is a risk in all critically ill patients if they are immobile for long periods. But patients with the coronavirus have elevated levels of clotting proteins in the blood, and the condition seems to be less responsive to blood-thinning drugs, said Dr. Adam Cuker, an associate professor of medicine at the University of Pennsylvania.

Some evidence suggests that the coronavirus may directly infect the endothelial cells that line the inside of blood vessels, causing injury and swelling that draws proteins that promote clotting, Dr. Cuker said.

People who have been exposed to the coronavirus, or are managing the infection at home, should call their doctors if they notice chest pain and shortness of breath, which may signal a blood clot in the lung, or leg pain, swelling, redness and discoloration that may indicate a clot.

Healthy, Until He Wasn’t

Bina Yamin, at her home in Fort Wayne, Ind., recognized over the phone that Mr. Sharma’s symptoms were those of a stroke.

Until he arrived at Jamaica Hospital on April 1, Mr. Sharma had never been tested for infection with the coronavirus. But he knew he was at risk. He had spent weeks making back-to-back ambulance runs, ferrying sick, elderly patients from nursing homes to hospitals in Brooklyn and Queens in February and March.

By mid-March, Mr. Sharma had developed a dry cough. He went to an urgent care clinic, where he was told that it was out of tests, but that he should stay home because he was probably infected.

At the hospital, emergency room doctors took aggressive steps to restore the blood supply to the left side of his brain. They also diagnosed acute respiratory distress syndrome, finding that Mr. Sharma’s infected lungs were filling with fluid and his blood oxygen levels were low. A test revealed infection with the coronavirus, and he was placed on a ventilator.

The doctors were kind but honest with the family, Ms. Yamin said: “They told us that it was 50-50. They didn’t know if he would live or die.”

Over the next few days, while Mr. Sharma remained sedated, Ms. Yamin spoke frequently with the doctors and nurses at the hospital, taking meticulous notes that she shared with relatives and with The New York Times.

Mr. Sharma’s body was flooded with blood thinners to prevent additional clots from forming. His fever spiked as high as 104 degrees Fahrenheit some days, raising his heart rate and further incapacitating his lungs.

Then, on April 8, Mr. Sharma started having seizures. He was sedated more deeply and put on additional medications. Doctors cranked up the ventilator.

By mid-April he had been intubated for two weeks, a period considered a critical make-or-break point for Covid-19 patients, and Ms. Yamin was concerned. No one knew the toll of the stroke itself, or whether Mr. Sharma would be able to walk or talk when he woke up.

The left side of the brain controls movement on the right side of the body, as well as speech and language, reading and writing, organizational ability, reasoning and analysis.

“I began to lose faith,” Ms. Yamin recalled in an interview.

Then, on April 15, there was some movement on the left side of Ravi’s body, the side not affected by the stroke. His fever ebbed. The staff lowered the ventilator setting, and he tolerated it.

“Looks like he’s slowly beating this,” Ms. Yamin wrote in a note to the family. “We just need to be patient.”

By April 18, Ravi was breathing more on his own. His fever had disappeared, and his blood pressure and heart rate had stabilized. The next day, he woke up, was taken off the ventilator and started breathing on his own.

He still could not speak and didn’t know what had happened to him, but a nurse held up his phone so the family could see him on FaceTime. “We couldn’t stop crying,” Ms. Yamin said. “We just said: ‘Oh my gosh, Ravi, we love you. These are happy tears.’”

Mr. Sharma whispered into the phone for the first time the next day, his throat still sore and hoarse from the ventilator tube.

Progress continued in baby steps. He ate some applesauce one day, a whole container the next. He started walking using a walker for support.

After a few weeks of inpatient physical therapy at Nassau University Medical Center, he graduated from a walker to a cane. He walked up stairs, sat in a chair and practiced getting up from the bed on his own..

A full recovery from a stroke can take months or even years, and Mr. Sharma is also recovering from the lingering effects of Covid-19, which has left him fatigued, and 50 pounds lighter than before his illness, he said in a video interview with The Times.

But he has made great strides in a short time, and those closest to him say he is still the old Ravi: a social butterfly.

Mr. Sharma boasted that he is everyone’s “favorite patient” at the rehab facility and that he is recovering quickly because staff members have been sneaking him chocolate milk and sweets.

“I got the doctors to order me ice cream as part of my diet,” he said.

He wants to go home, see his family in person, continue to build strength and start building a future with his girlfriend, Leana Soman. They both cried when they were able to video chat for the first time.

“He couldn’t speak, his throat was so bad, so I was lip reading,” Ms. Soman recalled. “He said, ‘I love you,’ and I said, ‘I got that — I love you too.’”

Too many people are still cavalier about the coronavirus, Mr. Sharma said, and young people think they are immune. The disease “was like being hit by a bus,” Mr. Sharma said.

“I’m 27, and if this could happen to me, it could happen to anyone,” he said. “This is real and it’s scary. I want people to go out there and be cautious.”

The Coronavirus Outbreak

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savvyherb · 5 years

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A Young Man Nearly Lost His Life to Vaping

Gregory Rodriguez thought he had the flu when he went to the emergency room on Sept. 18, feeling feverish, nauseated and short of breath.

He woke up four days later in a different hospital, with a tube down his throat connecting him to a ventilator, and two more tubes in his neck and groin, running his blood through a device that pumped in oxygen and took out carbon dioxide. The machines were doing the job of his lungs, which had stopped working.

“I was basically on the verge of death,” he said.

Mr. Rodriguez, 22, a college student, is one of the nearly 1,300 people in the United States who have become seriously ill because of vaping. Like him, about 70 percent are young men. And also like him, many vaped THC, the psychoactive ingredient in marijuana.

Vaping is odorless and easy to hide, and Mr. Rodriguez slipped into doing it constantly, inhaling enormous amounts of THC and craving more. He decided to talk about it in the hope that his story might be a warning to other people under the false impression that vaping is safe.

“I want people to stay as far away as they can from vapes, especially THC vapes,” he said.

Lung illnesses linked to vaping were first recognized during the summer. The exact cause is still unknown. Toxic chemicals released from vaping fluids, or from the battery-powered vaping devices themselves, are among the suspects.

So far, 29 deaths have been reported. The youngest to die was a 17-year-old boy from the Bronx.

Image

Gregory Rodriguez has been home since Sept. 30. “When I climb stairs, it feels like climbing a mountain,” he said. “When I run a couple of steps, it feels like I ran a marathon.”CreditHilary Swift for The New York Times

The lung damage looks like a chemical burn, the kind of injury caused by industrial accidents or the mustard gas used as a weapon in World War I, according to researchers at the Mayo Clinic.

So far, no vaping product is in the clear.

Mr. Rodriguez said he started smoking marijuana toward the end of high school. He has struggled with anxiety and depression, and marijuana, he said, “gave me some relief.”

But the smell gave him away, and his parents would not allow it in the two-bedroom apartment he shares with them and his older brother in Jamaica, Queens.

After about two years, friends suggested that he try vaping THC. He ordered a few vaping devices from Amazon, and found local THC dealers.

“When you’re in college, you always know somebody who knows a guy,” he said.

He would text a dealer and they would meet, usually in the dealer’s car. A cartridge holding a gram of THC oil cost $40, which Mr. Rodriguez would pay in cash, money he had earned from a part-time maintenance job at Kennedy Airport.

Vaping THC was “like a miracle,” he said. The high came on faster and felt more intense than when he smoked marijuana. Best of all, he said, “It was discreet.” There was no odor, so he could vape in his room, at school, on the street, just about anywhere, and no one would know. The device was small enough to hide in his hand. He also thought vapor would be safer for his lungs than marijuana smoke, even though it sometimes made him cough violently.

Vaping made it easy to take in more and more THC. When he smoked marijuana, a joint or blunt or pipe lasted only so long. But with a THC cartridge, he could vape for hours, with no need to roll a new joint or reload a pipe.

Eventually, Mr. Rodriguez was vaping much of the time. “I was never without it,” he said. His favorites included flavors like Fruity Pebbles and Sour Patch Kids. The few times he ran out, he could think about nothing but getting more, and sometimes, one of his legs would start shaking. A cartridge that would last most people four or five days, he would finish in a day or two.

“It was a habit, an addiction,” he said.

It is possible to become addicted to marijuana or dependent on it, according to the National Institute on Drug Abuse.

A computer-science student, he explored the dark web to find THC vendors with lower prices than he paid on the street, and turned money from his bank account into Bitcoin, to make purchases that would be encrypted and untraceable. On the electronic order forms, he requested the best and strongest THC available.

Boxes of cartridges, 25 for $400, started arriving in the mail early last summer. The return address was a house on a residential street in Ventura, Calif.

The products had a variety of labels, including Dank Vapes, the same name reported by many other people who got sick. It is not actually a brand, but a label that sellers can put on any product. Some of the other cartridges may have been counterfeit versions of brands that are legal in some states. No one knows what is in the knockoff products or who makes them, health officials say.

In August, distraught over the death of a dog his family had for 13 years, Mr. Rodriguez began vaping even more heavily.

In September, he started feeling ill, with headaches and severe nausea, vomiting and diarrhea. He waited several days, hoping to recover, but did not. He felt too sick to vape.

On Monday, Sept. 16, he went to the emergency room at Long Island Jewish Forest Hills Hospital, part of Northwell Health. Doctors said he probably had a stomach virus and sent him home.

Two days later, he felt worse, and had become alarmingly short of breath. His father, on the way to work, dropped him off at the emergency room at about 5 a.m. Embarrassed about vaping, and worried that it was illegal, Mr. Rodriguez did not tell anyone.

“I was hesitant to believe the vapes could be the cause of this,” he said.

The oxygen level in his blood was way below normal. He was given oxygen. Doctors suspected a lung infection, though they were puzzled because he was young and healthy and had not traveled overseas recently.

His mother, who works nights, arrived at the hospital a few hours later. She insisted that he tell the doctors about his vaping.

His condition deteriorated. By afternoon, he was on a ventilator. He still did not improve. By the next morning, his blood oxygen had sunk to levels low enough to cause organ failure, or even stop his heart.

“A 22-year-old gentleman, and he was, essentially, dying in front of me,” said Dr. Syed H. Iqbal, a specialist in pulmonary and critical care medicine at Long Island Jewish Forest Hills Hospital.

It fell to Dr. Iqbal to tell Mr. Rodriguez’s family how dangerously ill he was.

“It was terrible,” Mr. Rodriguez’s mother, Martha, said. “I will never forget the doctor’s face. I prayed, ‘Please, God, don’t let him go.’” She told the doctors to do anything needed to save her son.

Dr. Iqbal recommended a desperate measure called ECMO, a machine that would pump oxygen directly into Mr. Rodriguez’s blood and take carbon dioxide out — breathing for him while, if he was lucky, his lungs recovered. The hospital in Forest Hills did not have it, but the main campus of Long Island Jewish Medical Center did, and sent out an emergency team with the machine in an ambulance. As soon as Mr. Rodriguez was connected to it, his blood oxygen shot up to normal levels, Dr. Iqbal said.

Mr. Rodriguez was transferred to the main campus of Long Island Jewish Medical Center and was on the machine for four and a half days.

“Gregory was in danger of dying,” said Dr. Mangala Narasimhan, a lung specialist there and Northwell Health’s regional director of critical care.

“I think he was our 19th case,” she said. “It’s hitting us pretty hard, and that’s just the ones who are severe enough for us to know about.”

Mr. Rodriguez had extensive damage to the air sacs in his lungs, and widespread inflammation.

Dr. Narasimhan’s team treated him with steroids to quell the inflammation, and other medicines to open his airways. They also performed procedures to wash the secretions out of his lungs.

“The stuff coming out of his lungs looked like flan or custard, it was so thick,” Dr. Narasimhan said. “It was a lot of inflammatory cells. We had to do multiple rounds of washing his lungs out every day. After a few days, his lungs started to heal, and started working again.”

She said doctors do not understand why Mr. Rodriguez, like many other patients, had vomiting and diarrhea before the lung symptoms set in, but she said it may be a systemic response to a toxic substance or irritant that moves into the bloodstream after vaping and spreads around the body.

Mr. Rodriguez spent 12 days in the hospital. He has health insurance, and the family has not seen a bill yet, but they imagine the cost of his care will be astronomical.

He returned home on Sept. 30.

“When I climb stairs, it feels like climbing a mountain,” he said. “When I run a couple of steps, it feels like I ran a marathon. The doctor said that what will help is I’m still young and I can get back into shape. Every day I get physically much better. It becomes easier to walk. I practice my breathing exercises.”

He went back to classes at Queensborough Community College a week and a half after leaving the hospital.

But psychologically, he is having a tough time, feeling anxious and depressed, and unable to sleep. His mother has taken a leave from her job to stay with him while he recovers, and his distress worries her.

“I feel like I am, in a way, going through withdrawal,” Mr. Rodriguez said. “I am going to therapy for substance abuse, and getting the help I need.”

He thinks marijuana products should be legal and regulated, so that people can be sure they are safe.

While he was unconscious and attached to the machines, his mother took a cellphone photo of him, so that she could show it to him later.

“The doctors and my parents told me the severity of my case,” Mr. Rodriguez said. “As you can imagine, I was a little bit shaken up. I had no idea what I was putting into my lungs.”

The post A Young Man Nearly Lost His Life to Vaping appeared first on Savvy Herb Mobile Cannabis Platform.

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toldnews-blog · 5 years

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New Post has been published on https://toldnews.com/world/india-election-2019-the-killer-air-no-ones-talking-about/

India election 2019: The killer air no one's talking about

Image copyright Getty Images

Pollution killed at least 1.2 million Indians in 2017, but as the country votes in a general election, is fixing the bad air any party or politician’s priority? The BBC’s Geeta Pandey reports from Kanpur which topped a global list of most polluted cities in the world last year.

Just before the elections were called in March, Prime Minister Narendra Modi visited Kanpur to address a rally for his Bharatiya Janata Party. In April, the state chief minister, Yogi Adityanath, leader of the opposition Congress party Rahul Gandhi and two former state chief ministers – Akhilesh Yadav and Ms Mayawati – addressed their own rallies in the city.

Not one of them mentioned pollution – a topic that dominates news and conversations every winter when a thick grey blanket of smog descends on large parts of northern India, rendering the mere act of breathing hazardous.

Indian cities routinely dominate global pollution rankings so it came as no surprise when last May the World Health Organization named Kanpur as the most polluted city in the world.

The rankings were based on 2016 data from the Central Pollution Control Board on the presence in the air of PM2.5 – particles so tiny that they can enter deep into the lungs and make people susceptible to respiratory and cardiovascular diseases.

The safe limit, according to WHO is 25 micrograms per cubic metre although Indian officials put it at 60 – Kanpur’s was 173.

Image caption Air pollution is seriously impacting the health of Kanpur residents

Prof Sachchida Nand Tripathi, environmental engineer at the government-run Indian Institute of Technology (IIT) in Kanpur, says it’s really “hair-splitting” who takes the top place as the city is not the only one on the list.

“In the top 50, there were 20 plus cities from the Gangetic plains, including Varanasi, Lucknow and Allahabad. Data after data shows pollution is a major problem, the air is very poor.”

The major contributing factors to air pollution, he says, are roadside and construction dust, industrial and vehicular emissions, and smoke from burning of crop residue, garbage and solid fuel like wood and coal.

“Together, they are turning the air in our cities toxic, laden with deadly PM2.5 and the larger PM10 particles,” he adds.

India votes 2019

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Media captionIndia’s elections: Why you should care

And these are seriously impacting the health of the citizens, says Dr Anand Kumar, head of the pulmonary department at GSVM Medical College, Kanpur’s biggest hospital.

“In 2015, we saw 40,000 patients a year. Last year that number rose to 60,000. All the cases coming here can be co-related to pollution in some way.”

The “commonest complaint” he hears is of breathlessness. The other symptoms are “sore throat, tracheal infection, heaviness in the chest and unexplained cough that does not respond to regular treatment”. And the most at risk are those who work outdoors such as traffic constables, drivers, cleaners, roadside vendors and the poor living by the roadside.

Image copyright Getty Images

Image caption Industrial pollution is a major contributor to foul air in Kanpur

In his office, he looks at the X-ray of Seva Ram Parihar, a 50-year-old auto-rickshaw driver, who’s asthmatic and has been under treatment for “eight-nine years for breathlessness”. His condition has worsened in the past month.

“He’s been diagnosed with chronic persistent bronchial asthma. It’s an occupational disease, he’s exposed to diesel fumes and other pollutants in the course of his work,” Dr Kumar explains.

I ask him what he can do to help Mr Parihar? Not much, he says: “We can only give him the best care, prevent further exacerbation. He has no other options.”

Dr Kumar takes me on a guided tour of the outpatient department, where his team of 19 doctors sees 200 to 250 patients daily, and the respiratory ward where seriously ill patients are curled up on beds, many connected to oxygen pipes.

The room is bleak, its walls disfigured with peeling paint, tubelights shine harsh light on the beds, and noisy fans provide some respite from the sweltering heat.

Image caption Dr Anand Kumar says the “commonest complaint” he hears is of breathlessness

It’s crowded in here – all the beds are taken, there are extra patients on stretchers and on mattresses thrown on the floor.

Almost all the patients here are poor, unable to afford expensive private medical care and the air is heavy with their pain and despair. Most of the patients here are dependent on oxygen to continue breathing.

Like Nasreen Begum, who has been in and out of the hospital since 2015. “She was discharged just last month, and now she’s back again,” says Dr Kumar.

Along with the number of patients, he says the “severity” of the symptoms too has grown in the past four to five years and children are most susceptible to falling ill.

“Even very small children are nowadays being diagnosed with bronchial asthma. And earlier we’d see children recover in five to seven days, now it’s two weeks.”

The incidence of lung cancer too is growing – earlier it was found only in those above 55 years, now people in their 40s are getting it, he says, adding that the situation is worsening quite rapidly.

Kanpur’s chief pollution officer Ghanshyam (who uses only one name) admits that air pollution remains high and a cause of worry.

But, he says, ever since Kanpur topped the WHO list, a lot of measures have been taken to tackle pollution.

“We are trying to stop farmers from burning crop residue, sanitation workers are being asked to stop burning garbage, guidelines to control dust are being implemented, and vehicular emission is being checked.”

He says a committee has been set up under the district magistrate with representatives from 17 government departments. They meet regularly to discuss problems and monitor progress. “It’s not a problem we can solve alone,” Ghanshyam says.

Image caption Nasreen Begum has been in and out of the hospital since 2015

His colleague, assistant environmental engineer Dr Anil Mathur, says what they need the most is “better diagnosis” – to understand the source of air pollution.

The city has only one centre to monitor PM2.5 and a case has been made to set up five more such centres at different locations to generate better data.

The request is yet to be granted, but better data is something that Prof Tripathi could help with in the near future.

The Indian Institute of Technology has installed lots of low-cost monitors in Kanpur, Delhi and elsewhere in India. They also have programmes to monitor aerosols, real-time dust reading and radiation levels and by the end of 2019, he says, “we should have some answers”.

For instance, they would be able to tell how much pollution is being contributed by local sources and how much is coming from outside the city and how much is generated by biomass fuel or traffic. Then new policies can be formulated or existing ones tweaked accordingly, Prof Tripathi explains.

Image caption At the lone pollution monitoring system in the city, operator Rajesh Gupta checks the machine that measures PM2.5

In January, the government launched the National Clean Air Programme which aims to have breathable air in 100 cities in five years. Prof Tripathi, who is advising the government on the programme, says earlier the mindset was that environmental issues can impede sustainable development, but slowly that notion is changing and there is the realisation that the two can – and must – co-exist.

“There’s realisation that bad air is impacting human health so the government is forced to make it their agenda. But everyone – the federal government, the states and the cities – will have to work together and consistently to make a real difference.”

Read more from Geeta Pandey

When I visit the lone pollution monitoring system in a crowded market in the city centre, the machine shows a reading of PM2.5 of 67. Operator Rajesh Gupta says a day earlier it was 78.

In the winters, he says, the air quality is “very bad”, sometimes “critical – with PM2.5 averaging 400 to 500, on occasion even hitting 600”.

Image caption A huge breach in the sewage pipeline means untreated effluents are flowing into the river

It’s not just the air. Pollution has also blighted a stretch of Ganges, India’s holiest river, in Kanpur, says environmental activist Rakesh Jaiswal.

The city of four million plus people is an industrial hub. It is home to more than 400 tanneries and generates large amounts of sewage and industrial effluent and a lot of that goes untreated into the river.

“The city produces 430mld (million litres per day) waste water. Only 250mld is treated before being released into the river,” he says.

The run-up to the start of the Hindu festival of Kumbh Mela in January saw some relief.

Millions of Hindu pilgrims bathe in the river in the city of Prayagraj (formerly Allahabad) during the festival, 200km downstream from Kanpur.

The authorities ordered tanneries shut; effluent from the city drains was sent to treatment plants; and more water was released into the river from upstream.

Image caption Prof Sachchida Nand Tripathi says the air is very poor in a number of Indian cities

The festival ended in early March and the river water is polluted again.

Mr Jaiswal takes me to Dapka Ghat to show a huge breach in the pipeline that carries sewage from Sisamau, Kanpur’s dirtiest drain, to a treatment plant in Wajidpur.

Untreated effluents from the drain used to flow directly into the Ganges before the festival. The pipeline breach means it’s flowing again into the river untreated.

In the past 30 years, 310bn rupees ($4.4bn; £3.4bn) have been spent on cleaning the Ganges, but as we stand there watching the murky greyish liquid gushing into it, the river looks more like a stinking stream.

At one of the poll rallies in Kanpur, I ask several of the attendees if they think pollution should be an election issue?

Durga Prasad, a day-wage labourer, says he worries about the impact of pollution.

“It affects everyone, rich, poor, man, woman and child. But no-one has made it an issue,” he says, “and let me tell you, no one will.”

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drkkpandey-blog · 6 years

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Best pulmonologist in Delhi NCR

This article contains all the necessary information to make the readers aware of who is a pulmonologist and what does he do and how an expert pulmonologist can make life simple and disease free.millions of people worldwide are victims of Pulmonology, which is a very dangerous disease. Due to the lack of knowledge of the disease in India, thousands of people die each and every year, but most of them do not even realize it. In fact, the symptoms of this disease are so common that people don't even notice. But due to delayed treatment and negligence, this disease proves deadly.

How do pulmonology problems happen?

In the world full of pollution where the level of the pollutants in the air is increasing day by day and as per the WHO reports the air quality index (AQI) is dropping in the developing countries. As per the experts, the quality of air is demeaning day by day especially in the metropolitan cities, especially in Delhi NCR.

Pollution is the 5th most common reason for killing and unwellness of the human being in Delhi where everybody inhales pollutants can cause severe and dangerous changes to the most vital and important structure of the body that is Respiratory System.

As we are living in a world where technology is progressing at a very fast pace and every tech always comes with at the cost of environment and human lives. So in the world where getting a natural and fresh air is a bit task in the age of revolution, everybody should be conscious.

How they can be treated?

These issues can be resolved with the help of an expert pulmonologist. A pulmonologist is a specialist who is an expert in the area of the lungs and respiratory system. As everybody is being direct exposure to the smoke smog and the different form of harmful chemicals which can cause irreparable damage to the body, one should always seek professional advice with an expert.

Pollution can cause simple symptoms like coughing to complicated choking, breathlessness which can be an alarming situation where might have to rush to a doctor, so it is advisable for a regular follow-up with the experts.

These professionals basically experts who will take every possible measure to secure their patients from falling into a pothole of diseases by performing the various diagnostic as well the liver function and various allergy tests.

The problems which sound very normal like not getting enough sleep can affect the health of the individual and in long term effects, it can cause some serious issues like heart problems, confusion, Dilemma if left untreated. This kind of issues needs to be addressed to your doctor is necessary, which can be diagnosed by your doctor with the help of sleep studies and other diagnostic tests and can be treated accordingly.

There are numerous disease and its treatment like when somebody has a habit of smoking they might get into trouble in a long go, in that case, they need professional advice and as well the proper guidance.

Nowadays respiration has become such a common problem even the newborns are being diagnosed with breathing difficulties which need immediate care for the further health of the baby.

Interstitial lung disease can cause scarring of the lung tissues, In this disease, the tissue becomes so thick, which makes it difficult for the person to breathe and in the consequences, blood does not get sufficient oxygen which can create some tension.COPD, emphysema, is a chronic problem which sometimes life-threatening conditions require immediate treatment which can be done only by an experienced medical professional who knows the seriousness of the disease like Dr.k.k.pandey, who is a ray of hope for the patients who have lost every hope.

Nobody should be ignorant of their symptoms when they appear. If these symptoms make you more anxious than the person is advised to get in touch with the doctor immediately because if treated properly, the symptoms can be cure with the main disease. Differentiation between asthma and lung fibrosis can be easily done through investigations like Pulmonary Function Test (PFT), Lung C.T. to detect the internal damage of the lung if there and accurately can be scanned.

Any issues can be diagnosed with the help of advanced tech on an early stage with the help of bronchoscopy and other tests. Some problems can also spread from the lungs to the other part of the body which can also be treated under the supervision of the experts.

Web :- http://www.drkkpandey.com/

#best pulmonologist in noida #bronchoscopy specialist in delhi #snoring specialist in delhi #best lungs specialist in delhi #DR KK Pandey

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nevamwitti · 5 years

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AHA News: Where There’s Wildfire Smoke, There May Be Heart Problems

MONDAY, July 22, 2019 (American Heart Association News) — When the Tubbs Fire swept through their neighborhood in Santa Rosa, California, in October 2017, there was little time for Richard Grundy and Jamei Haswell to think about how all the smoke they were inhaling was impacting their health.

Trees already were burning when they pulled out of their driveway. Flames were consuming neighboring houses, ultimately destroying theirs as well. The couple took refuge in a hotel miles away from the fire, but burning ash rained down all around them.

“It was like being on another planet,” said Haswell, who was 70 at the time. “We were probably walking around in some nasty stuff.”

About a month later, Haswell’s body swelled up with fluid. Doctors diagnosed her with heart failure, a condition she’d clearly had for some time. But Haswell wonders whether the wildfire smoke exposure worsened the problem.

According to Dr. Janki Shah, a cardiologist at UCLA Medical Center in Los Angeles, wildfire smoke is potentially hazardous and can exacerbate heart and lung conditions.

During last year’s Woolsey Fire that swept through the Malibu hills, authorities asked Shah and her family to evacuate their Calabasas home. The neighborhood escaped destruction, but Shah and her family lived out of suitcases for days. Work was just as chaotic.

“The week after the fire was one of the busiest that I’ve had in the hospital with so many heart illnesses related to the fire,” Shah said.

Dr. Zachary Wettstein, who now practices emergency medicine at the University of Washington School of Medicine, worked at the San Francisco VA Medical Center during the 2015 wildfire season, and he noticed an uptick in the number of patients seeking treatment for heart failure and chronic lung disease.

He investigated the matter with researchers from the California Department of Health and the Environmental Protection Agency. Their study, published last year in the Journal of the American Heart Association, looked at over 1 million emergency room visits across much of California during 2015. They found a link between wildfire smoke exposure and an increased risk of heart attacks, strokes, worsening heart failure and pulmonary emboli.

“Those associations were stronger when people were exposed to more intense smoke,” Wettstein said. The risk was highest among people over 65.

Other studies also have discovered links between exposure to wildfire smoke and other forms of air pollution with respiratory diseases, such as asthma and chronic obstructive pulmonary disease, and even death.

Wildfire smoke is particularly dangerous because it contains not only harmful gases like carbon monoxide but also fine particulate matter, components small enough to travel into the lungs and the bloodstream. This can result in inflammation, blood clots and heart attacks.

“Wildfire smoke is associated with multiple effects on the body,” Shah said, noting her normally mild case of asthma was exacerbated by the smoke from the Woolsey Fire. “It can cause an increase in stress hormone levels, which can increase blood pressure; it can affect the metabolism of glucose, lipids and insulin … . Exposure prevention is key.”

The EPA’s monitoring website, AirNow.gov, contains information about air quality, including levels of particulate matter. When conditions are poor, people – especially those with heart conditions – should reduce or eliminate outdoor physical activity. If leaving the house is unavoidable, the EPA suggests people wear N95 or P100 respirator masks, which are designed to filter small particles.

Given the evidence of a warming world with hotter, dryer summers and bigger, more intensely burning wildfires, Wettstein said more research is needed about the long-term and cumulative effects of exposure to wildfire smoke.

“That’s a huge area to study, because more people in the country and around the world will be exposed to more wildfire smoke over longer periods of time,” he said.

Grundy and Haswell briefly toyed with the idea of leaving Santa Rosa after the fire destroyed their home. But the way the community rallied around them convinced them to remain, and they quickly found a new home with magnificent mountain views.

Since then, there have been several other big fires in the area, including the one that destroyed Paradise in 2018. During that one, Haswell said, the smoke was so thick that it obscured their view almost entirely. “I had some flashbacks.”

The post AHA News: Where There’s Wildfire Smoke, There May Be Heart Problems appeared first on Be Healthy News.

AHA News: Where There’s Wildfire Smoke, There May Be Heart Problems posted first on https://www.behealthynews.com

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lulew1988 · 7 years

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An interview with Sheryl from A Chronic Voice!

I am so chuffed that I got to do this! I have been a follower of Sheryl @Achronicvoice for a long time now and am really excited she agreed to let me interview her! Something I haven't done before!.

So here it is the full interview:

Interview with A Chronic Voice

LUCY

Hello, Sheryl.

Thanks so much for agreeing to do this!

Right then...

Maybe we could start with a bit of a bio about you. So could you tell me about you and your conditions?

(SHERYL)

Hello, My pleasure, and sure!

It started when I had a mini stroke at 14, caused by blood clots from the antiphospholipid syndrome. I developed multiple DVTs and a pulmonary embolism (clot in the lung) at 17 which was nearly fatal. It mutated into Lupus (SLE) when I was about 20, and then I developed Sjögren's Syndrome, epilepsy, PSVT (a heart rhythm disorder), a mitral valve prolapse which I had to repair via heart surgery in the U.S., clinical depression and anxiety, and more things here and there that required surgery.

(LUCY)

Oh my gosh that sounds awful!

Do you have to take many medications for those conditions? And how do your conditions affect your day to day life now?

(SHERYL)

Yep. My current cocktail comprises of:

1. Warfarin (blood thinner) for antiphospholipid syndrome

2. Prednisone (steroids) - Lupus, Sjögren's

3. Cyclosporin - Lupus, Sjögren's

4. Sodium Valproate (Epilim) - epilepsy, depression/anxiety

5. Hydroxychloroquine - Lupus

6. Vortioxetine - Depression/anxiety

7. Escitalopram - Mood stabilizer

8. Calcitriol - Osteoporosis

9. Calcium carbonate - Osteoporosis

10. Maltofer (liquid iron) - Lupus

11. Verapamil - (as and when needed for PSVT heart palpitations)

12. Omeprazole - Because I'm on certain meds

13. Assorted other pills such as painkillers as and when necessary

It affects every day to day aspect of my life - from cooking, exercise, working, social interactions and more. Basically, if you're in chronic pain or are easily fatigued or brain fogged, you can see how that will affect every aspect of your life.

(LUCY)

Wow, that's a huge list of medications. Have you ever tried any natural remedies? Or homeopathic / diet changes? If so has it made a difference at all?

(SHERYL)

The problem with antiphospholipid syndrome is that it makes trying alternative treatments or diet changes tricky. I have to constantly worry about blood thinning and clotting, and many super foods mess this ratio up. Even eating one too many salads as compared to normal can be tricky. And stuff like massages - I still go for them because I love it, but I only good when my blood thickness is not too low or high, and I don't do anything too strong.

I am trying out essential oils and a cheap TENS machine I bought. Not sure if the machine does much. The oils do help relax me a bit.

I also recently tried flotation therapy. Bit early to say if it does anything...but it definitely helps quite a bit with stress relief...which is a big trigger for flares.

I've also attempted Ayurveda. While I couldn't follow the food and supplement regime, I did make some changes to foods I should avoid or eat more of. It also took into account of suitable exercises for your body type and an oil massage which should be removed from chickpea flour. Sounds weird maybe, but quite normal in Asia. I actually think this form of support helped, but you do need to put in a bit of effort. I haven't gone back to check in a while, so I'm not sure how my pulse has changed (we have 2 types of pulses - one from birth and one imbalanced if any).

Oh, I also tried yoga. It helps some people a lot...they tell me a bit of movement every day helps control their flares. But for me, it was actually triggering them (even the yin classes!) so I stopped.

(LUCY)

You will have to keep us updated on the flotation therapy! That sounds really intriguing! I'm a big believer in tens machines as well. I'm doing a review soon on some tens pens.

So as I've mentioned I've been a follower of a chronic voice for a while now. It was the blog that inspired me to start the thyroid damsel. What was your inspiration to start your blog?

(SHERYL)

I will...there's a review on flotation on my blog, and part 2 when I've done it a few more times!

As for the TENS machine...can't wait to hear what you have to say about it! I'm not sure it helps me or if I'm not using it right. I just used it actually...it's 4:30 am here and having painsomnia ;) didn't help though ;)

And wow...I never knew that I'm happy that my blog inspired someone out there! :)

I mainly just wanted to get back to my first passion i.e. writing, and chronic illness is something close to my heart, literally ;) I also wanted to raise more awareness...every little bit counts!

(LUCY)

Yes, your blog was one of the first I saw. So, with all the health issues you have. Is there anything that your illness has really prevented you from doing? Or are there any positives that have come from your illness?

(SHERYL)

It's prevented me from just about everything I had originally wanted to do as a young person. I would love to be a travel literature writer, the sort that lives in a far out place for a couple years, to immerse myself in their culture, and write about it. I think different cultures are very important to preserve and learn from, perhaps even more so than healthcare, but that's a whole new topic! ;) This is obviously impossible with chronic illnesses with the frequent doctor appointments, increased risks and costs.

Apart from that, I can't really invest my energy into my career either. I have to take it easy and need more sick leave than the maximum allowed in a company. I have freelanced for the past 10 years or so, and it's a good thing I enjoy that sort of lifestyle. But the field of work I'm in (advertising and web development) is highly stressful no matter where I work from, so I'm looking for alternatives as well.

The positive side to my illness, which I could never have imagined, is that I'm forced to examine myself as a person more closely and to try and understand my self-worth. I also saw a psychologist for a while due to everything that has happened, something I would probably never have done if I were well. My illness taught and is teaching me about acceptance and life in itself.

(LUCY)

My last question would be then. What would your advice be to other sufferers with chronic illnesses? What would you like to have known when you were first diagnosed that you didn't know, that you do now? Is there anything you would do differently?

(SHERYL)

I wish that I had taken my medicines more regularly. My parents are highly religious and believed that I could be healed if I had enough faith...so I constantly asked, does having enough faith meant I had to completely stop taking my medicines? Taking a little bit showed a lack of faith, right? My mom didn't exactly encourage me to stop my medications, but she didn't stop me from not doing so either. I was 14. Perhaps the pulmonary embolism and multiple DVTs I suffered at 17, which changed my entire life, could have been prevented. But who knows, right? At the end of the day, who knows what's right and wrong, and who knows what will be. We all just want the best for ourselves and our loved ones.

One piece of advice I have is to always seek for a 2nd, 3rd, 4th, 100th opinion if that's possible if you don't agree with what your doctor has planned for you, or even because you don't like him/her or feel uncomfortable. Chronic illnesses are for life, like it or not, and it's best to find someone you can work with. A partner who will help you navigate life, and not dictate it. After numerous bad surgeries as well, it's best to find surgeons who actually like their work, and who cares. These are all consequences you can avoid, by working with the right people.

As for what I would have liked to have known when I was first diagnosed...I'm not sure really. The knowledge I have now is all based on trial and error and we all experience symptoms differently. Read up as much as you can, but also be wary of your sources. Not everything that is written online is true and can be detrimental to your health. Listen to your inner voice, usually, he/she knows best.

If you would like to follow A Chronic Voice you can below.

Facebook

Twitter

Blog

You can also follow A Chronic Voice on Medium and Bloglovin!

(adsbygoogle = window.adsbygoogle || []).push({}); (adsbygoogle = window.adsbygoogle || []).push({});

#sle #chronicblogs #lupus #spoonie #chronicillness #pulminaryembilism #dvt #achronicvoice

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johnbutlersbuzz · 7 years

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New Post has been published on http://www.johnbutlersbuzz.com/go-directly-to-the-emergency-room/

"GO DIRECTLY TO THE EMERGENCY ROOM"

A different view than watching a sunrise from the sailboat as I returned from Cuba a few days ago. And more threatening than being close to the gators in the Everglades just hours before arriving at the ER.

The doctor’s voice came through the phone firmly. “Do not drive yourself. Have someone drive you directly to the emergency room.”

Before my cell phone rang, I had been going thru musty boxes of old photos, notes my wife had written before she died, college notes, writings, etc. Each box was being reduced to a handful of things I thought would be nice to keep for the proverbial day of sitting in the rocking chair in my old age reflecting back on life someday. Since I flew back to Dallas for Easter, I thought I would take a few hours to clear out some of the “memory boxes” taking up storage space.

I stayed over an extra day and had some extra time. Had a routine CT scan the day before related to slightly bulging disk that gives me a little discomfort periodically. No big deal.

My cell phone rings with a NO CALLER ID on the screen. Probably a telemarketer I think putting the phone back down. The NO CALLER ID is either a junk call or a very important call. I decide to answer. It’s the doctor. “I have good news and I have bad news.” I immediately assume he is setting me for a joke since I know him.

“Okay, good news first,” I say playing along.

“The good news is the spot we were watching is not a problem. The bad news is you need to go to the hospital … to the emergency room … immediately. You have a blood clot … a pulmonary embolism. Do not drive yourself. Have someone drive you directly to the emergency room.”

“You realize of course,” I said still with my sense of humor radar out and not comprehending what he was telling me, “I don’t have time for this.”

“John, you’ve heard of a widow-maker … well, ah, you have a serious situation … and you are lucky to be here. You could die on the way to the hospital. Again, do not drive yourself and do not delay,” he stated authoritatively to drive the point into my thick scull.

“I get it … I hear you. I will leave now.”

His words bounced around inside my head. An out-of-the-blue bit of shocking news.

A surrealist moment walking downstairs where my son had just entered. He drove me to the Presbyterian Emergency Room. I was still processing the phone call. My son was also.

Hospitals are not my idea of a place to hang-out especially if you are sick. The Emergency Room was filled with cold and flu sufferers. People coughing, spitting into cups and an occasional moaning. I felt for all of them, but the whole place struck me as a Russian Roulette germ exchange.

So, boring details aside, I went through questioning, a series of tests, scans and, of course, several blood draws. I’m convinced it’s a scheme by the head nurse to take enough blood to weaken each patient into submission. Just a hunch.

When the ER doc appeared, the verdict: Blood clot or clots had passed through the right side of my heart, then into my right lung, lodging there. “You are lucky to be alive,” he said.

The next day, after more tests, scans, and, of course, more blood drawn I got the best of the bad news. My heart was NOT damaged. A little stressed, but no long term damage. What damage it caused was in the right lung and it would heal as the clot dissolves with a new med. Had the clot been slightly larger it would have stopped at my heart. I could have dropped dead on the spot. The fatality rate is as high as 80% with this type of condition depending on factors such as the size of the asteroid, or rather, the clot.

This one apparently came from my leg. It can happen to anyone. Take note if you are going on long flights or long car rides. The sitting/driving part for long periods in ARGO this year put me in the high risk category.

I didn’t want to write till I was sure I was in the clear. I had been in intense pain, but was trying to power thru it. My daughter gave me a stern lecture about not doing that again when she came to help me. She is a good caring daughter and I pay attention to her advice.

I am out of the hospital and laying low. Good news: There is no long term damage to my heart. So, instead of a game over scenario for me, it’s back to where I left off. Flying back to Florida to continue my American discovery journey project as I mental process my near miss with the staircase to Heaven. Grateful I can continue the project of talking with folks across America and filming stories for the documentary.

So the take away from this for me, AND FOR YOU: 1. Stay hydrated by drinking extra water (as a double benefit the extra water will motivate you to get up sooner) 2. Stop at least once an hour and walk around if you are driving or flying long distances. 3. In between stops, rock your feet back and forth and wiggle your toes. . These simple things help will move the blood around to help you avoid a blood clot. Not doing so puts us at risk for blood clots for a few weeks following driving/flying long periods.

I found that out first hand. Even though I have no history of any clotting or heart problems and I work out regularly … it happened to me.

Fortunately I get to hang around a bit longer to continue my project Discovering America One Story At A Time and my blog: JohnButlersBuzz.com.

“Life is a near death experience.” – George Carlin

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audrainorthopaedics-blog · 8 years

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Kyphosis of the Spine

Kyphosis is a spinal disorder in which an excessive outward bend of the spine leads to an irregular rounding of the upper back. The problem is oftentimes called "roundback" or, in the case of a severe curve, as "hunchback." Kyphosis may occur at any age, but is most significantly found during adolescence. That is why Kathleen Weaver of Audrain Orthopaedics is enthusiastic about making sure that parents of Central Missouri teenagers with orthopaedic problems find out about this important info.

In most cases, kyphosis causes few problems and doesn't require treatment. Occasionally, a patient may need to put on a back brace or do exercises in order to improve his or her posture and strengthen the spine. In severe instances, however, kyphosis can be painful, trigger significant vertebral disfigurement, and result in respiration issues. Patients with severe kyphosis might need surgery to help to lower the excessive spinal curve and improve their symptoms.

Anatomy

Your spinal column is comprised of three segments. When viewed from the side, these segments form 3 natural curves.

The "c-shaped" curves of the neck (cervical spine) and lower back (lumbar spine) are known as lordosis. The "reverse c-shaped" curve of the chest (thoracic spine) is known as kyphosis.

This natural curvature of the spine is very important for stability and helps us to stand upright. If any of the curves gets too large or too little, it becomes difficult to stand up straight and the posture will look unnatural.

Other areas of your spine include:

Vertebrae. The spine is made up of twenty-four small rectangular-shaped bones, called vertebrae, which are built on top of one another. These bones make the natural curves of your back and connect to create a canal that protects the spinal cord.

Intervertebral disks. Between the vertebrae are flexible intervertebral disks. These disks are flat and round and approximately a half-inch thick. Intervertebral disks cushion the vertebrae and act as shock absorbers when you walk or run.

Description

Although the thoracic spine should have a natural kyphosis between 20 to 45 degrees, postural or structural irregularities can result in a curve that's outside this normal range. While the medical term for a curve that is greater than normal (over fifty degrees) is actually "hyperkyphosis," the term "kyphosis" is commonly used by physicians to refer to the clinical condition of excessive curvature in the thoracic spine which leads to a rounded upper back.

Kyphosis can affect patients of every age group. The condition, nevertheless, is common during adolescence, a time period of rapid bone development.

Kyphosis can vary in severity. In general, the greater the curve, the more severe the condition. Less severe curves may cause mild back pain or no symptoms at all. More severe curves may cause significant spinal deformity and create a visible hump on the patient's back.

Types of Kyphosis

There are lots of kinds of kyphosis. The three that most frequently affect children and teenagers are:

Postural kyphosis

Scheuermann's kyphosis

Congenital kyphosis

Postural Kyphosis

Postural kyphosis, the most common kind of kyphosis, usually becomes evident during adolescence. It is observed clinically as poor posture or slouching, but is not related to extreme structural abnormalities of the spine.

The curve caused by postural kyphosis is usually round and smooth and can frequently be corrected by the patient when he or she is asked to "stand up straight."

Postural kyphosis is a bit more common in girls than boys. It is seldom painful and, because the curve does not progress, it does not normally lead to problems in adult life.

Scheuermann's Kyphosis

Scheuermann's kyphosis is named after the Danish radiologist who first described the condition.

Just like postural kyphosis, Scheuermann's kyphosis commonly becomes apparent during the teen years. Nevertheless, Scheuermann's kyphosis may result in a far more severe deformity than postural kyphosis, especially in thin people.

Scheuermann's kyphosis is brought on by a structural abnormality in the spine. In someone with Scheuermann's kyphosis, an x-ray from the side will reveal that, instead of the normal rectangular shape, multiple consecutive vertebrae have a more triangular shape. This irregular shape causes the vertebrae to wedge together toward the front of the spinal column, reducing the normal disk space and making an exaggerated forward curvature in the upper back.

The curve brought on by Scheuermann's kyphosis is typically sharp and angular. It's also stiff and rigid; unlike a patient with postural kyphosis, someone with Scheuermann's kyphosis is not able to correct the curve by standing up straight.

Scheuermann's kyphosis generally affects the thoracic spine, but occasionally develops in the lumbar (lower) spine. The condition is definitely more typical in boys than girls and stops progressing whenever growing is complete.

Scheuermann's kyphosis can sometimes be painful. If pain is present, it's commonly felt at the highest part or "apex" of the curve. Pain might also be felt in the lower part of the back. This results whenever the spine attempts to make up for the rounded upper back by increasing the natural inward curve of the lower back. Activity can make the pain worse, as can long periods of standing or sitting.

Congenital Kyphosis

Congenital kyphosis is present at birth. It occurs when the spinal column failed to develop normally when the newborn child was in utero. The bones may not form as they ought to or several vertebrae might be fused together. Congenital kyphosis usually gets worse as a child ages.

Patients with congenital kyphosis often require surgical treatment at a very young age to stop progression of the curve. Oftentimes, these patients will have added birth defects that impact other areas of the body such as the heart and kidneys.

Symptoms

The signs and symptoms of kyphosis vary, based on the cause and severity of the curve. These may include:

Rounded shoulders

An obvious hump on the spine

Light back pain

Fatigue

Spine stiffness

Tight hamstrings (the muscles at the rear of the thigh)

Rarely, over time, progressive curves may lead to:

Weakness, numbness, or tingling in the legs

Loss of sensation

Difficulty breathing or other respiration troubles

Doctor Examination

Mild kyphosis in Mexico, Missouri often goes unseen until a scoliosis screening in school and this prompts a visit to a doctor. If changes to the patient's back are evident, however, it's usually rather unpleasant for the parents and the child. Concern regarding the cosmetic appearance of the child's back is oftentimes what brings the family to find medical assistance.

Physical Examination

Your doctor will start by taking a medical history and inquiring about your little one's general health and symptoms. He or she will then examine your child's back, pushing on the spine to find out if there are any areas of tenderness.

In more serious cases of kyphosis, the rounding of the upper back or a hump could be clearly visible. In milder cases, however, the condition may be harder to diagnose.

During the exam, the doctor will ask your child to bend forward with both feet together, knees straight, and arms hanging free. This test, which is called the "Adam's forward bend test," allows your physician to better see the slope of the spine and detect any spinal deformity.

Your doctor might also ask your son or daughter to lay down to determine if this straightens the curve, a sign that the curve is flexible and might be representative of postural kyphosis.

Tests

X-rays. These studies provide pictures of dense structures, such as bone. Your doctor might order x-rays from different angles to determine if there are changes in the vertebrae or any other bony abnormalities.

X-rays will also help appraise the degree of the kyphotic curve. A curve that's in excess of fifty degrees is regarded as unusual.

Pulmonary function tests. If the curve is severe, your doctor might order pulmonary function tests. These tests will help in determining if your little one's breathing is reduced as a result of reduced chest space.

Other tests. In patients with congenital kyphosis, progressive curves may bring about symptoms of spinal cord compression, such as pain, tingling, numbness, or weakness in the lower body. If your child is suffering from any of these symptoms, your physician may order neurologic tests or a magnetic resonance imaging (MRI) scan.

Treatment

The goal of treatment is to stop advancement of the curve and prevent deformity. Your physician will give consideration to a few things when identifying treatment for kyphosis, including:

Your little one's age and overall wellness

The total number of remaining growing years

The kind of kyphosis

The seriousness of the curve

Nonsurgical Treatment

Nonsurgical treatment is suggested for patients with postural kyphosis. It is also suggested for patients with Scheuermann's kyphosis who have curves of under 75 degrees.

Nonsurgical treatment may include:

Observation. Your doctor can recommend merely monitoring the curve to make sure it doesn't get worse. Your child might be requested to go back for periodical visits and x-rays until they are completely grown.

Unless the curve gets worse or becomes painful, no other treatment may be needed.

Physical therapy. Certain exercises can help relieve back pain and improve posture by strengthening muscles in the abdomen and back. Certain exercises can also help stretch tight hamstrings and strengthen parts of the body that may be impacted by misalignment of the spinal column.

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, including aspirin, ibuprofen, and naproxen, can help ease back pain.

Bracing. Bracing might be recommended for patients with Scheuermann's kyphosis who are still growing. The particular kind of brace and the number of hours a day it ought to be worn will be based upon the seriousness of the curve. Your physician will adjust the brace regularly as the curve improves. Typically, the brace is worn until the child reaches skeletal maturity and growing is complete.

Surgical Treatment

Surgery is commonly suited to patients with congenital kyphosis.

Surgery can also be advisable for:

Patients with Scheuermann's kyphosis who have curves beyond seventy five degrees

Patients with severe back pain that doesn't improve with nonsurgical treatment

Spinal fusion is the surgery most commonly utilized to treat kyphosis.

The goals of spinal fusion are to:

Reduce the degree of the curve

Lessen any further progression

Maintain the improvement over time

Alleviate significant back pain, if it's present

Surgical Procedure

Spinal fusion is basically a "welding" process. The basic idea is to fuse together the affected vertebrae so that they heal into a single, solid bone. Fusing the vertebrae will decrease the degree of the curve and, since it eliminates motion between the impacted vertebrae, may also help reduce back pain.

During the procedure, the vertebrae that comprise the curve are first realigned to reduce the rounding of the spine. Small pieces of bone, referred to as bone graft, are then placed into the spaces between the vertebrae to be fused. Over time, the bones grow together, comparable to the way a broken bone heals.

Before the bone graft is placed, your physician will typically use metal screws, plates, and rods to increase the rate of fusion and further stabilize the spine.

Just how much of the spine is fused depends upon the size of your child's curve. Only the curved vertebrae are merged together. The other bones in the spine can still move and assist with bending, straightening, and rotation.

Long-Term Outcomes

If kyphosis is identified early, most patients can be treated properly without surgery and proceed to lead active, healthy lives. If not dealt with, however, curve progression could potentially result in trouble during adulthood. For those with kyphosis, regular check-ups are required to track the condition and check advancement of the curve. If you’d like to find out more, get in touch with Audrain Orthopaedics, serving the men and women of Mexico, Moberly, Fulton, and Centralia, MO with kyphosis and other orthopedic problems.

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