#clinical development specialist

[clinfinite]

Bio-Specimen and Bio-Repository Solutions: Advancing Healthcare Research In the realm of healthcare and biomedical research, the collection, storage, and management of biological specimens are paramount. These specimens, often referred to as bio-specimens, include various biological materials such as tissues, blood, urine, and genetic samples. Bio-specimens hold the key to unraveling the mysteries of diseases, understanding genetic predispositions, and advancing medical treatments. To facilitate these endeavors, bio-repository solutions have emerged as vital components of the healthcare ecosystem. What are Bio-Specimen and Bio-Repository Solutions? Bio-specimen solutions encompass the entire process of collecting, preserving, and cataloging biological materials from humans, animals, or even plants. These materials serve as the foundation for research, diagnostics, and therapeutic development. Bio-repository solutions, on the other hand, are the infrastructure and systems designed to store, track, and distribute these bio-specimens efficiently. They form a bridge between researchers and the valuable resources required for their work. The Importance of Bio-Specimens and Bio-Repositories Medical Research Advancements: Bio-specimens are invaluable for understanding the underlying mechanisms of diseases and discovering potential treatments. Researchers can analyze these specimens to identify biomarkers, study genetic mutations, and explore the effects of various factors on human health. Bio-repository solutions ensure that these specimens remain readily available for future research endeavors.

[nupalcdc]

Pediatric speech therapy is vital for children with speech and language challenges. It addresses issues like articulation, fluency, language comprehension, and social communication skills. Discover how it fosters communication development.

Read more at https://tinyurl.com/nhfvjudk

[roedhamilton38]

Brian Houchins Recognized in Employee Spotlight for Outstanding Leadership at Athletico

Q: Brian, can you tell us about your current role at Athletico? Brian: Certainly! I'm the Work Comp Regional Director for Illinois and Missouri. I've been in this role since August 2017. Before that, I managed clinical staff as the Work Comp Manager for Missouri Territory and was a Facility Manager in the Arnold, Missouri clinic. Q: What inspired you to start a career in Physical Therapy? Brian: I was attracted to a profession where I could make a real difference in people’s lives. Physical therapy perfectly fits that desire, enabling me to help patients optimize their function and inspire them to achieve their best. Q: Why did you choose Athletico as your workplace? Brian: I've been with Athletico for 17 years, starting when it was PRORehab. Brian Houchins, Work Comp Regional Director, Physical Therapy Leadership, Employee Spotlight, Missouri Illinois Health Care, Clinical Team Management, Careers in Health Care, Work Comp Specialist, Patient Care Excellence, Health Industry Leadership, Employee Achievements, Corporate Wellness Programs, Rehabilitation Services, Missouri Health Care Professionals, Illinois Physical Therapy, Success Stories in Health Care, Professional Development in Health Care, Employee Recognition Programs to superior customer service, quality patient care, and a patient-first philosophy resonated with me. Q: What do you enjoy most about managing a clinical team? Brian: Guiding the Work Comp Specialist team is a true pleasure. They are a group of extremely driven individuals, committed to delivering exceptional outcomes. Whether they’re in the clinic with patients or advising employers onsite, their pride in their work is evident. It's inspiring to work daily with such a committed team. Brian Houchins, Work Comp Regional Director, Physical Therapy Leadership, Employee Spotlight, Missouri Illinois Health Care, Clinical Team Management, Careers in Health Care, Work Comp Specialist, Patient Care Excellence, Health Industry Leadership, Employee Achievements, Corporate Wellness Programs, Rehabilitation Services, Missouri Health Care Professionals, Illinois Physical Therapy, Success Stories in Health Care, Professional Development in Health Care, Employee Recognition Programs : Can you share your greatest accomplishment in your current position? Brian: One of the most rewarding aspects has been creating a significant difference on companies and witnessing the growth of employer and work comp services. It’s fulfilling to see the advancements and progress in this area. Brian Houchins, Work Comp Regional Director, Physical Therapy Leadership, Employee Spotlight, Missouri Illinois Health Care, Clinical Team Management, Careers in Health Care, Work Comp Specialist, Patient Care Excellence, Health Industry Leadership, Employee Achievements, Corporate Wellness Programs, Rehabilitation Services, Missouri Health Care Professionals, Illinois Physical Therapy, Success Stories in Health Care, Professional Development in Health Care, Employee Recognition Programs : What do you like to do when you're not working? Brian: My time away from work is spent cherishing moments with my family and friends.

[woundcareunited]

Best Wound Care specialist in united states | WoundCare United

Collaborating with Wound Care United allows physicians to enhance their wound care capabilities,Wound Clinic Management, Wound Care Program Development provide optimal treatment to patients, and achieve improved healthcare outcomes. Whether you are looking to start a new outpatient Wound Treatment Program or transition management of your existing program, we can help you design a cost-effective, evidence-based, and quality-driven Wound Treatment Program!

[bestfemaledoctorinbhubaneswar]

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[noirandchocolate]

RICE Alzheimer's Research Institute

Terry died on 12 March 2015, having given his PCA a run for its money.  Open about his diagnosis, he has helped to unlock the secrecy and stigma that often surrounds dementia.  His legion of fans is undoubtedly grateful that despite the inevitable progression of the PCA he was able to fight his ‘embuggerance’ and continue to produce a number of both well-received and well-reviewed books.  Terry was also a great example to me in emphasizing how important it is that, in caring for people with any type of dementia, we always look for what people with a condition like PCA can still do, rather than what they can’t: by maximizing what is possible, a person can still live well with dementia for a significant time.

–Professor Roy Jones, Director of RICE (taken from “Terry Pratchett: His World”)

I wanted to post something for the Glorious 25th about the Research Institute for the Care of Older People (RICE) in Bath, where Sir Terry Pratchett received treatment for Post-Cortical Atrophy, the type of Alzheimer’s disease that eventually took his life. From the organization’s website:

RICE established one of the first memory clinic services in the UK in 1987 – a service which has since been widely replicated and is now considered standard and best practice by the NHS. In fact, RICE now runs the NHS Memory Clinic in Bath and North East Somerset on behalf of the local clinical commissioning group and local authority through a sub-contract with HCRG Care Group. To date, we’ve assessed, diagnosed, treated and advised 12,000 people with memory problems and their families in our memory clinic. 

Most of RICE’s clinical services and research activities take place in our own purpose built, specialist centre located on the Royal United Hospital site. The building of the RICE Centre was possible as a result of generous donations from major donors, trusts and foundations, and members of the public. RICE moved into the ground and first floor of the centre in 2008. Following the success of the DementiaPlus Appeal and further generous donations from major donors, trusts and foundations and members of the public, RICE converted the attic floor in 2019 to create more office space. This has given us access to much needed additional rooms and offices which will enable us to grow and run more services and activities. We’ve worked hard to ensure that the areas of the centre visited by our patients meets their needs and we regularly receive feedback on how much our patients enjoy their visit to our centre.

RICE not only provides clinical services to patients, but also conducts research into aging and dementia, including performing clinical trials for new drug treatments for memory-related diseases and developing other “techniques for diagnosing, managing, treating and understanding dementia and memory changes in older adults.”

Lady Lyn Pratchett is the patron of the organization, and the website includes a page about how people can donate funds or volunteer at the clinic and participate in fundraising events.

SO, if you’d like to help fund Alzheimer’s research on this Glorious 25th of May–or at any time–in honor of the Man in the Hat, take a look!

[star-anise]

are we talking about broke therapists yet?

I've been out of things for a couple of years now, which is why I'm willing to talk about it, and maybe the pandemic has helped things a little, but holy shit the counselling and psychotherapy field is not equipped to help its practitioners in the gig economy.

Of all my interests and talents, I pursued a degree in psychology because being a therapist is supposed to be a safe, stable, well-paid job. Every therapist I met who was registered before 2008 worked and lived under that assumption. And oh boy are all the fee structures--registration, supervision, continuing education, conferences--set up for that scenario.

After getting my Master's, I struggled like hell to get a job. It was especially bad because to get my license, I needed a supervisor to take me on. To take me on, most supervisors wanted me to already have a caseload and client base. To get a caseload and client base, I needed a job.

Friends: Every single job I heard back on wanted me to have my license before I could even land an interview.

Professors and career advisors and professional development specialists all advised me very earnestly to just keep cold-calling people on the supervision list, and it began to feel a lot like my parents' friends telling me to hit the bricks and hand out resumes. That's what worked for them, right?

I finally got a supervisor who agreed to take me on, and I'd be able to use her clinic for advertising and workspace, and we were doing the paperwork to send in with my registration, when she called me up and said, "Is this job going to be your only source of income? If you're trying to depend on getting clients and building your practice for your basic needs, this is not going to work out. This has to be something you're doing on top of a basic salary. Okay, so you're not working anywhere else right now? I'm sorry, I can't move forward with this."

Even once I landed a supervisor and a job building my own private practice, I struggled. I have ADHD and am not great at self-promotion, so trying to do all my own advertising, scheduling, bookkeeping, billing, and records management (on top of counselling) was an enormous strain. One my bosses, supervisors, and other senior professionals watched with a slightly critical eye, but consoled me about because in their early days, their clinics had had business managers, receptionists, filing clerks, and accountants, and getting used to doing everything online yourself was a bit of a learning curve, wasn't it?

I counted my pennies very carefully, because I had to pay my supervisor roughly $180 for their services every 6 hours of in-person counselling I did. This meant that to break even I had to charge my clients an average of about $30 (plus room rental and service fees) an hour--and my clients, being people with complex trauma, were frequently poor, disabled, unemployed, and had no health benefits, so even $10 or $20 a session was a lot for them.

Maybe it would have been easier if I could have taken some of those nice comfortable organization positions where they find clients and funding for you and you work 40 hours a week and get benefits and a pension, but I had to be disabled into the bargain, so working 40 hours a week just isn't possible for me. I start passing out from stress and exhaustion. Older colleagues gave me serious-faced advice about approaching my employer and asking them for some flexibility and accommodation in my schedule, and I tried to explain across the gap between us that employers simply did not hire me if I made the slightest noise about the workload. They weren't going to invest in me as a person; they were hiring 40 units of work a week, and if I wouldn't do it there were a dozen applicants after me who would.

At one point I broke down enough to email my licensing body because the Annual General Meeting/Professional Development Conference was coming up, and I wanted to attend, but I could not produce $500 to do it with. Was there some kind of way I could attend anyway? I felt ashamed to have to ask, and then absolutely mortified when the response came from the organization president, who needed to personally sign off on me being too poor to attend the single most important event in my profession's calendar year.

I honestly felt so ashamed all the time at how I was apparently failing to be a successful therapist, failing to be rich and successful, and every time I mentioned it around mentors and bosses, I could feel myself shrinking from a person to a problem to be solved. My closest therapist-friends and I have reflected on how much more difficult, poorly-paid and underworked, our various career starts have been than we were ever warned about. About the classmates and coworkers who couldn't get disability exceptions when they fell behind in their registration requirements, or burned out and left the field, or dropped their registrations and took up as life coaches, or moved their whole family somewhere exceptionally remote or rural because it was the only good job available, or worked for some godforsaken app skirting the bounds of malpractice like BetterHelp.

I like those conversations, because I feel less like an absolute fuck-up in them. There's less "Hey Lis, you were so talented in grad school, I really admired you, what are you doing now?" "Oh, I, uh... am professionally disabled, so I get government benefits, and I... sell embroidery patterns on Etsy now."

My own therapist kept asking if and when I felt like going back to being a counsellor, and I finally told him: I don't, actually. I don't want to go back and do it like I was doing it before. It was a profession I loved to the depths of my soul, and it profoundly did not love me back. I can't even imagine what would have to change, in me or it, to make it have a space in it that could fit me.

All of which I was way too scared to admit to at the time, because the more I let people know I was struggling, the more they hinted that maybe I just wasn't in a place in my life where this was a job I could do, and I needed to take a little break and wait to come back until money and disability just weren't issues for me anymore.

Eventually my cups of doubt and exhaustion did overflow, and I quit. I'm here now, living a much different life. And at the very least, all my years of helping people in bad life situations set me up perfectly for my own. I already knew what form to fill out for financial assistance, which student clinics to access for mental health support, and which government agency would, if pressed, cough out pharmacy coverage for the genuinely destitute. It gave me that much.

I hope this is just me being in extraordinary circumstances, sitting at the intersections of a few different shitty life situations that most people skip right past. Because it's on one level comforting, but another deeply infuriating, if I'm not, and I've just missed it or we've just all been too afraid to admit it to each other.

[swampgallows]

Now we know how COVID attacks your heart

Even patients with mild COVID symptoms could face a higher risk of developing heart disease and stroke

By Sanjay Mishra Nov 07, 2023 04:08 PM 5 min. read

Scientists have noticed that COVID-19 can trigger serious cardiovascular problems, especially among older people who have a buildup of fatty material in their blood vessels. But now a new study has revealed why and shown that SARS-CoV-2, the virus that causes COVID-19, directly infects the arteries of the heart.

The study also found that the virus can survive and grow inside the cells that form plaque—the buildup of fat-filled cells that narrow and stiffen the arteries leading to atherosclerosis. If the plaque breaks, it can block blood flow and cause a heart attack or a stroke. The SARS-CoV-2 infection makes the situation worse by inflaming the plaque and increasing the chance that it breaks free.

This can explain long-term cardiovascular effects seen in some, if not all, COVID-19 patients.

SARS-CoV-2 virus has already been found to infect many organs outside the respiratory system. But until now it hadn't been shown to attack the arteries.

"No one was really looking if there was a direct effect of the virus on the arterial wall," says Chiara Giannarelli, a cardiologist at NYU Langone Health, in New York, who led the study. Giannarelli noted that her team detected viral RNA—the genetic material in the virus—in the coronary arteries. “You would not expect to see [this] several months after recovering from COVID.”

Mounting evidence now shows that SARS-CoV-2 is not only a respiratory virus, but it can also affect the heart and many other organ systems, says Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis. Al-Aly's research has shown that the risk of developing heart and cardiovascular diseases, including heart failure, stroke, irregular heart rhythms, cardiac arrest, and blood clots increases two to five times within a year of COVID-19, even when the person wasn't hospitalized.

"This important study links, for the first time, directly the SARS-CoV-2 virus with atherosclerotic plaque inflammation," says Charalambos Antoniades, chair of cardiovascular medicine at the University of Oxford, United Kingdom.

Virus triggers the inflammation in plaque

A recent study of more than 800,000 people led by Fabio Angeli, a cardiologist at University of Insubria in Varese, Italy, has shown that COVID-19 patients develop high blood pressure twice as often as others. More worrying is that the risk of cardiac diseases can also rise for patients who suffered only mild COVID symptoms.

"I saw a patient who now has a defibrillator, and she didn't even have a severe [COVID] illness," says Bernard Gersh, a cardiologist at Mayo Clinic, Rochester, Minnesota.

Wondering whether the cardiovascular damage during COVID was due to the virus directly attacking the blood vessels, the NYU team analyzed autopsied tissue from the coronary arteries and plaque of older people who had died from COVID-19. They found the virus was present in the arteries regardless of whether the fatty plaques were big or small.

"The original finding in this study is that the virus was convincingly found in the plaque in the coronary artery," says Juan Carlos Kaski, a cardiovascular specialist at St George's, University of London, who was not involved in the study.

The NYU team found that in the arteries, the virus predominantly colonized the white blood cells called macrophages. Macrophages are immune cells that are mobilized to fight off an infection, but these same cells also absorb excess fats—including cholesterol from blood. When microphages load too much fat, they change into foam cells, which can increase plaque formation.

To confirm that the virus was indeed infecting and growing in the cells of the blood vessels, scientists obtained arterial and plaque cells—including macrophages and foam cells—from healthy volunteers. Then they grew these cells in the lab in petri dishes and infected them with SARS-CoV-2.

Giannarelli found that although virus infected macrophages at a higher rate than other arterial cells, it did not replicate in them to form new infectious particles. But when the macrophages had become loaded with cholesterol and transformed into foam cells, the virus could grow, replicate, and survive longer.

"We found that the virus tended to persist longer in foam cells," says Giannarelli. That suggests that foam cells might act as a reservoir of SARS-CoV-2. Since more fatty buildup would mean a greater number of foam cells, plaque can increase the persistence of the virus or the severity of COVID-19.

Scientists found that when macrophages and foam cells were infected with SARS-CoV-2 they released a surge of small proteins known as cytokines, which signal the immune system to mount a response against a bacterial or viral infection. In arteries, however, cytokines boost inflammation and formation of even more plaque.

"We saw that there was a degree of inflammation [caused] by the virus that could aggravate atherosclerosis and cardiovascular events," says Giannarelli.

These findings also confirm previous reports that measuring inflammation in the blood vessel wall can diagnose the extent of long-term cardiovascular complications after COVID-19, says Antoniades.

"What this study has found is that plaque rupture can be accelerated and magnified by the presence of the virus," says Kaski.

Understanding heart diseases after COVID

While this new research clearly shows that SARS-CoV-2 can infect, grow, and persist in the macrophages of plaques and arterial cells, more studies are needed to fully understand the many ways COVID-19 can alter cardiac health.

"The NYU study identifies one potential mechanism, especially the viral reservoir, to explain the possible effects" says Gersh. "But It's not going to be the only mechanism."

This study only analyzed 27 samples from eight elderly deceased patients, all of whom already had coronary artery disease and were infected with the original strains of virus. So, the results of this study do not necessarily apply to younger people without coronary artery disease; or to new variants of the virus, which cause somewhat milder disease, says Angeli.

"We do not know if this will happen in people who have been vaccinated," says Kaski. "There are lots of unknowns."

It is also not clear whether and to what extent the high inflammatory reaction observed in the arteries of patients within six months after the infection, as shown in the new study, will last long-enough to trigger new plaque formation. "New studies are needed to show the time-course of the resolution of vascular inflammation after the infection," says Antoniades.

COVID patients should watch for any new incidence of shortness of breath with exertion, chest discomfort, usually with exertion, palpitations, loss of consciousness; and talk to their physician about possible heart disease.

[sysmedsaresexist]

I do not mean to sound stupid, but I read your post "dissociation is not solely trauma-based", and I was wondering if you knew of any sources or books about it? I think I don't fully understand what dissociation is. For exemple, no matter how I look at it, I don't understand how meditation could be considered like anything close to dissociation, simply because it's also used as a grounding technique.

I'm combining two asks here, because I'm going to cover both in one go :) you don't sound stupid.

You've got to start with the understanding that dissociation is a continuum from normal (aka nonpathological) to "abnormal" (I hate that word, but aka pathological). I finally dropped the wild existence of Dr Jamie Marich, clinical trauma specialist and a pro endo, CDD system, who wrote Dissociation Made Simple. Let me quote because the book is actually good.

Yes, dissociation is so hard to understand that she wrote an entire book about the concept.

"The English word dissociation comes from the Latin root dissociātiō, meaning “to sever” or “to separate.” At this point when lecturing, I usually ask my students: What are we severing or separating from when we dissociate? You may take a moment, before reading on, to ask this question of yourself. Try not to think on it too rationally. Listen to your gut-level response...

For the purposes of this opening chapter, let’s focus on the form of separation that every human being can likely relate to —severing or separating from the present moment—especially when the present moment becomes unpleasant, overwhelming, or otherwise painful."

Dissociation is a disconnect from something-- this can be memories, thoughts, emotions, or, in worst cases, reality. The present moment.

Not all meditation is dissociative, but most is. For example, emptiness meditation is about disconnecting from everything in the moment. You are literally fine-tuning your dissociative techniques. This is also true when you're using grounding meditation to disconnect from overwhelming emotions or thoughts to get back into the moment.

There are a variety of tasks that we either develop naturally or learn as a way to achieve some degree of separation (e.g., enough to stay somewhat present but still get some relief, or going further into totally cutting oneself off from in-the-moment presence). Dissociation of this nature is not all or nothing—it generally happens in degrees and can depend upon how much distress you feel in any given context. We can do this by daydreaming, drifting off, zoning out, zoning inward, disengaging eye contact with people, losing focus (especially when driving), or getting a little floaty in many other life circumstances. Some people frame this “floatiness” as similar to hypnotic trance and others feel it is quite distinct. We may even take deliberate steps to enhance the experience of separation. How often have you escaped into a book or a movie, into your phone or computer, or into some activity, because it makes the harshness of dealing with the present moment and the emotions it can elicit somewhat more bearable?

Let me be very clear, if you said yes to this question, this answer does not mean that there is anything wrong with you! All of these can be quite ordinary forms of dissociation that every human being is capable of experiencing.

A really, really good way to understand this concept is actually through maladaptive daydreaming (MADD), a highly addictive form of dissociation.

Indeed for many of us, substances or other behaviors that cause major surges of dopamine (e.g., spending, computer games, sexually acting out) can become the accelerant of dissociation...

Whenever we become accustomed to dissociating, especially as children growing up in complex trauma, our brain becomes bonded or some would even say addicted to that state of escape. Once chemical or other reinforcing behaviors are introduced to us, they can accelerate that already familiar experience and we become further bonded to that behavior.

Daydreaming itself is dissociative. Point blank. It is both the most normal kind of dissociation, and yet the most common maladaptive dissociation.

Daydreaming and journeying into my head’s imaginative scenarios is another series of behaviors that can have both adaptive and maladaptive qualities. As a kid, they kept me safe. As an adult, they are the source of so much of my creative power—yet if I engage them too long, too hard, or too much, I run the risk of getting lost and not being able to attend to what helping professionals might call my activities of daily living (e.g., eating properly, sleeping, taking good care of myself, getting to work, attending to loved ones appropriately and with good boundaries).

Let's cut away from the book really quickly to look at Eli Somer, the guy who came up with MADD.

Maladaptive daydreaming is a dissociative disorder: Supporting evidence and theory.

The only real thing I want to quote is:

Although trauma may be one causal factor, we indicate several other etiological pathways to the development of MD. We discuss associations with related concepts and suggest directions for future research.

And

MD is strongly related to dissociation and seems to rely on an innate tendency for absorptive and imaginative fantasy. Through its rewarding properties, this form of immersive daydreaming becomes abnormal. MD may thus be viewed as a disordered form of dissociative absorption.

While Somer talks about how it can be a behavioral addiction in that paper, I find this is a more succinct description.

Maladaptive Daydreaming: Epidemiological Data on a Newly Identified Syndrome

Maladaptive Daydreaming (MD) is a proposed mental disorder characterized by excessive, compulsive immersion in vivid and complex fantastical daydreamed plots, generating intense emotional involvement, often accompanied by stereotypical movements. This addictive absorption in daydreaming becomes maladaptive as it consumes many hours a day, generates shame or guilt, hinders achievement of short- and long-term goals or tasks, and overall causes clinically significant distress and/or interferes with functioning in social or occupational realms. Maladaptive Daydreamers (MDers) report a strong urge to daydream whenever they can and annoyance whenever they cannot, and, repeated unsuccessful efforts to control, cut back, or stop daydreaming, like other behavioral addictions.

And that's the best way to look at DID and other maladaptive, pathological forms of dissociation. It's a behavioral addiction, an escape that we not only crave, but can no longer live without. Just like you can get addicted to working out and gambling, you can become addicted to severing ties with reality through pleasurable (and in some cases, necessary) forms of escape.

I don't know if this is going to make sense, but I've found looking at dissociation like an upside-down iceberg helps me.

At the top, the widest part, is everyone on the planet, and the basic, general concept of dissociation. Severing from the present moment, be it through your phone, book, daydreaming, meditation, zoning out.

As you go down, and it gets narrower, it becomes more important to put names to specific types and forms of dissociation, and fewer people struggle with these forms. In the middle is a confusing mix of seemingly normal and pathological dissociation. You have mediumship, authors with living characters, OCD (yup), ADHD (shocking, I know), MADD, DPDR, (C)PTSD, people on the edge of forming behavioral addictions.

At the bottom, the smallest point, only pathological dissociation, with a much smaller population experiencing it. DID, OSDD, severe and chronic DPDR, DA.

For people that struggle with dissociation... they fell down a hole and travelled all the way to the bottom of the iceberg. What was once a general, normal, human experience became a very specific problem. Over the years, as they travelled deeper, they used and developed a complex mix of various normal dissociative reactions until it eventually became a named, pathological experience.

I sincerely hope that this helps explain and answers both questions ):

Here's another really interesting paper (from none other than, DUNDUNDUN, Colin Ross).

Maladaptive Daydreaming, Dissociation, and the Dissociative Disorders

[theivorybilledwoodpecker]

I was exactly halfway into my second pregnancy, and up until that point, we were so ecstatic to be expecting again — a baby we’d been praying for. We kept talking about and imagining the joy it would be to bring our new baby home to meet our 2-year-old daughter. But at my 20-week ultrasound, a day that is supposed to be full of excitement and awe, we received devastating news. Our baby, a second daughter, had many severe and insurmountable skeletal and organ issues. Fetal specialists told us that it was extremely unlikely she could survive because all her major organ systems had significant development issues. We were blindsided and heartbroken, and yet somehow clear-minded. We chose to do what we believed was best for our unborn daughter as well as for our family; because that is what you do as parents. And we saw the choice we ultimately made as an act of love for her. We respect and honor that other parents have chosen — and will continue to choose — the only other option our doctor suggested to us — to let the pregnancy take its natural course and provide specialist or palliative care as needed. And that is the point. Individuals and their families — no matter where they happen to live — must be able to make the best choice for them. They need to be free to choose their own act of love. I believe now more than ever that anyone’s reason for seeking an abortion is valid. Who are we to say it isn’t? What we didn’t know when we made our decision was that in addition to being so difficult emotionally, it would be made so much worse by the abortion bans recently enacted in Idaho. Because of these cruel laws, my Idaho doctors could not provide me with an abortion — something they could easily have done before Roe v. Wade was overturned — in my own community supported by family and friends. We had to spend the following days cold-calling countless clinics in nearby states where abortion is still legal, but found out that because of all the other new abortion bans in states across the country, many clinics had closed, most had no open appointments for several weeks, and still others considered my pregnancy, at 20 weeks, too far along for me to receive care. The thought of waiting out this pregnancy, possibly for weeks, or however long, while trying to get through the day working as a chiropractor and still being active and present for our toddler was more than I could handle. All I could think about was whether the daughter I was carrying was already suffering; my anxiety and sadness were overwhelming. We both felt hopeless and heartbroken until we reached a Seattle clinic with a last-minute cancellation. Although relieved, there was so much we had to do to get there in the haze of our grief. There were flights to make, hotels to book, a car to rent and medical care our health insurance would not cover because we were going out of state to access and receive it. One of the most tragic — and degrading — parts of our situation was knowing that people in my home state of Idaho believe this is acceptable, denying me bodily autonomy. We will always be grateful to the clinic and team in Seattle for offering us professional, compassionate care. I am a person of faith and for months after my abortion, I kept telling Brandon there had to be something positive that would come out of this experience. Several months later, I learned that the Center for Reproductive Rights was putting together a challenge to Idaho’s abortion laws, and I knew immediately that moving forward as a plaintiff in the case was something I had to do. I’m proud to be one of the many women and doctors challenging and broadening these laws. Physicians in Idaho must have greater discretion over when abortion exceptions are warranted, and the decision should be the patient’s in consultation with their doctors.

[clinfinite]

Bio-Specimen and Bio-Repository Solutions

Bio-Specimen and Bio-Repository Solutions: Advancing Healthcare Research

In the realm of healthcare and biomedical research, the collection, storage, and management of biological specimens are paramount. These specimens, often referred to as bio-specimens, include various biological materials such as tissues, blood, urine, and genetic samples. Bio-specimens hold the key to unraveling the mysteries of diseases, understanding genetic predispositions, and advancing medical treatments. To facilitate these endeavors, bio-repository solutions have emerged as vital components of the healthcare ecosystem.

What are Bio-Specimen and Bio-Repository Solutions?

Bio-specimen solutions encompass the entire process of collecting, preserving, and cataloging biological materials from humans, animals, or even plants. These materials serve as the foundation for research, diagnostics, and therapeutic development. Bio-repository solutions, on the other hand, are the infrastructure and systems designed to store, track, and distribute these bio-specimens efficiently. They form a bridge between researchers and the valuable resources required for their work.

The Importance of Bio-Specimens and Bio-Repositories

Medical Research Advancements: Bio-specimens are invaluable for understanding the underlying mechanisms of diseases and discovering potential treatments. Researchers can analyze these specimens to identify biomarkers, study genetic mutations, and explore the effects of various factors on human health. Bio-repository solutions ensure that these specimens remain readily available for future research endeavors.

Personalized Medicine: In the era of personalized medicine, bio-specimens play a pivotal role. By studying an individual's genetic profile or specific biomarkers, healthcare providers can tailor treatments and therapies to maximize effectiveness while minimizing side effects. Bio-repositories help maintain a diverse collection of specimens, facilitating these advancements in healthcare.

Quality Control and Assurance: Proper storage and handling of bio-specimens are essential to maintain their integrity and reliability. Bio-repository solutions incorporate state-of-the-art technology and strict protocols to ensure the quality of stored specimens. This, in turn, enhances the reproducibility of research findings.

Longitudinal Studies: Some research projects require the analysis of bio-specimens collected over extended periods. Bio-repositories enable the storage of specimens for many years, making it possible to conduct longitudinal studies that track changes in health and disease progression.

Challenges in Bio-Specimen and Bio-Repository Management

While bio-specimen and bio-repository solutions offer immense benefits, they also come with unique challenges:

Ethical and Legal Considerations: The collection and use of bio-specimens often involve complex ethical and legal considerations, including informed consent and privacy protections. Managing these aspects requires careful attention to regulations and guidelines.

Data Management: Bio-repositories not only store physical specimens but also associated data, such as patient information and experimental results. Ensuring the security and accessibility of this data is crucial.

Sustainability: Maintaining a bio-repository is resource-intensive, and long-term sustainability can be challenging. Funding, infrastructure, and skilled personnel are essential for its continued operation.

Standardization: To enable collaboration and data sharing among researchers, standardization of processes and data formats is essential. Harmonizing practices across bio-repositories can enhance the utility of collected specimens.

Future Directions in Bio-Specimen and Bio-Repository Solutions

As technology advances and research methodologies evolve, bio-specimen and bio-repository solutions will continue to evolve as well. Some key trends and future directions include:

Digitalization: Embracing digital technologies for cataloging and managing bio-specimens and associated data will enhance accessibility and collaboration among researchers.

Automation and Robotics: Automation in bio-repositories can improve efficiency, reduce human errors, and increase the capacity for specimen storage and retrieval.

Integration with Omics Technologies: Linking bio-specimens with omics technologies (e.g., genomics, proteomics) will enable more comprehensive and detailed analyses, opening new avenues for research and diagnostics.

Global Collaboration: Bio-repositories will increasingly collaborate on a global scale, allowing researchers to access a broader and more diverse range of specimens for their studies.

In conclusion, bio-specimen and bio-repository solutions are indispensable in advancing healthcare research and improving patient outcomes. As these solutions continue to evolve and address challenges, they will remain pivotal in unlocking the secrets of diseases, facilitating the development of personalized medicine, and driving innovations in the field of healthcare. Researchers, healthcare providers, and society as a whole stand to benefit from the continued advancement of bio-specimen and bio-repository solutions.

[nupalcdc]

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[roedhamilton38]

Athletico Highlights Brian Houchins for His Remarkable Leadership

Q: Brian, can you tell us about your current role at Athletico? Brian: Certainly! I'm the Work Comp Regional Director for Illinois and Missouri. I've been in this role since August 2017. Before that, I managed clinical staff as the Work Comp Manager for Missouri Territory and was a Facility Manager in the Arnold, Missouri clinic. Q: What inspired you to start a career in Physical Therapy? Brian: I was attracted to a profession where I could make a real difference in people’s lives. Physical therapy perfectly fits that desire, enabling me to help patients optimize their function and inspire them to achieve their best. Q: Why did you choose Athletico as your workplace? Brian: I've been with Athletico for 17 years, starting when it was PRORehab. Brian Houchins, Work Comp Regional Director, Physical Therapy Leadership, Employee Spotlight, Missouri Illinois Health Care, Clinical Team Management, Careers in Health Care, Work Comp Specialist, Patient Care Excellence, Health Industry Leadership, Employee Achievements, Corporate Wellness Programs, Rehabilitation Services, Missouri Health Care Professionals, Illinois Physical Therapy, Success Stories in Health Care, Professional Development in Health Care, Employee Recognition Programs to superior customer service, quality patient care, and a patient-first philosophy resonated with me. Q: What do you enjoy most about managing a clinical team? Brian: Guiding the Work Comp Specialist team is a true pleasure. They are a group of extremely driven individuals, committed to delivering exceptional outcomes. Whether they’re in the clinic with patients or advising employers onsite, their pride in their work is evident. It's inspiring to work daily with such a committed team. Brian Houchins, Work Comp Regional Director, Physical Therapy Leadership, Employee Spotlight, Missouri Illinois Health Care, Clinical Team Management, Careers in Health Care, Work Comp Specialist, Patient Care Excellence, Health Industry Leadership, Employee Achievements, Corporate Wellness Programs, Rehabilitation Services, Missouri Health Care Professionals, Illinois Physical Therapy, Success Stories in Health Care, Professional Development in Health Care, Employee Recognition Programs : Can you share your greatest accomplishment in your current position? Brian: One of the most rewarding aspects has been creating a significant difference on companies and witnessing the growth of employer and work comp services. It’s fulfilling to see the advancements and progress in this area. Brian Houchins, Work Comp Regional Director, Physical Therapy Leadership, Employee Spotlight, Missouri Illinois Health Care, Clinical Team Management, Careers in Health Care, Work Comp Specialist, Patient Care Excellence, Health Industry Leadership, Employee Achievements, Corporate Wellness Programs, Rehabilitation Services, Missouri Health Care Professionals, Illinois Physical Therapy, Success Stories in Health Care, Professional Development in Health Care, Employee Recognition Programs : What do you like to do when you're not working? Brian: My time away from work is spent cherishing moments with my family and friends.

[reasonsforhope]

When Swiss cardiologist Thomas F. Lüscher attended an international symposium in Turin, Italy, last summer, he encountered an unusual “attendee:” Suzanne, Chat GPT’s medical “assistant.” Suzanne’s developers were eager to demonstrate to the specialists how well their medical chatbot worked, and they asked the cardiologists to test her. 

An Italian cardiology professor told the chatbot about the case of a 27-year-old patient who was taken to his clinic in unstable condition. The patient had a massive fever and drastically increased inflammation markers. Without hesitation, Suzanne diagnosed adult-onset Still’s disease. “I almost fell off my chair because she was right,” Lüscher remembers. “This is a very rare autoinflammatory disease that even seasoned cardiologists don’t always consider.”

Lüscher — director of research, education and development and consultant cardiologist at the Royal Brompton & Harefield Hospital Trust and Imperial College London and director of the Center for Molecular Cardiology at the University of Zürich, Switzerland — is convinced that artificial intelligence is making cardiovascular medicine more accurate and effective. “AI is not only the future, but it is already here,” he says. “AI and machine learning are particularly accurate in image analysis, and imaging plays an outsize role in cardiology. AI is able to see what we don’t see. That’s impressive.” 

At the Royal Brompton Hospital in London, for instance, his team relies on AI to calculate the volume of heart chambers in MRIs, an indication of heart health. “If you calculate this manually, you need about half an hour,” Lüscher says. “AI does it in a second.” 

AI-Assisted Medicine

Few patients are aware of how significantly AI is already determining their health care. The Washington Post tracks the start of the boom of artificial intelligence in health care to 2018. That’s when the Food and Drug Administration approved the IDx-DR, the first independent AI-based diagnostic tool, which is used to screen for diabetic retinopathy. Today, according to the Post, the FDA has approved nearly 700 artificial intelligence and machine learning-enabled medical devices.

The Mayo Clinic in Rochester, Minnesota, is considered the worldwide leader in implementing AI for cardiovascular care, not least because it can train its algorithms with the (anonymized) data of more than seven million electrocardiograms (ECG). “Every time a patient undergoes an ECG, various algorithms that are based on AI show us on the screen which diagnoses to consider and which further tests are recommended,” says Francisco Lopez-Jimenez, director of the Mayo Clinic’s Cardiovascular Health Clinic. “The AI takes into account all the factors known about the patient, whether his potassium is high, etc. For example, we have an AI-based program that calculates the biological age of a person. If the person in front of me is [calculated to have a biological age] 10 years older than his birth age, I can probe further. Are there stressors that burden him?”

Examples where AI makes a sizable difference at the Mayo Clinic include screening ECGs to detect specific heart diseases, such as ventricular dysfunction or atrial fibrillation, earlier and more reliably than the human eye. These conditions are best treated early, but without AI, the symptoms are largely invisible in ECGs until later, when they have already progressed further...

Antioniades’ team at the University of Oxford’s Radcliffe Department of Medicine analyzed data from over 250,000 patients who underwent cardiac CT scans in eight British hospitals. “Eighty-two percent of the patients who presented with chest pain had CT scans that came back as completely normal and were sent home because doctors saw no indication for a heart disease,” Antioniades says. “Yet two-thirds of them had an increased risk to suffer a heart attack within the next 10 years.” In a world-first pilot, his team developed an AI tool that detects inflammatory changes in the fatty tissues surrounding the arteries. These changes are not visible to the human eye. But after training on thousands of CT scans, AI learned to detect them and predict the risk of heart attacks. “We had a phase where specialists read the scans and we compared their diagnosis with the AI’s,” Antioniades explains. “AI was always right.” These results led to doctors changing the treatment plans for hundreds of patients. “The key is that we can treat the inflammatory changes early and prevent heart attacks,” according to Antioniades. 

The British National Health Service (NHS) has approved the AI tool, and it is now used in five public hospitals. “We hope that it will soon be used everywhere because it can help prevent thousands of heart attacks every year,” Antioniades says. A startup at Oxford University offers a service that enables other clinics to send their CT scans in for analysis with Oxford’s AI tool.

Similarly, physician-scientists at the Smidt Heart Institute and the Division of Artificial Intelligence in Medicine at Cedars-Sinai Medical Center in Los Angeles use AI to analyze echograms. They created an algorithm that can effectively identify and distinguish between two life-threatening heart conditions that are easy to overlook: hypertrophic cardiomyopathy and cardiac amyloidosis. “These two heart conditions are challenging for even expert cardiologists to accurately identify, and so patients often go on for years to decades before receiving a correct diagnosis,” David Ouyang, cardiologist at the Smidt Heart Institute, said in a press release. “This is a machine-beats-man situation. AI makes the sonographer work faster and more efficiently, and it doesn’t change the patient experience. It’s a triple win.”

Current Issues with AI Medicine

However, using artificial intelligence in clinical settings has disadvantages, too. “Suzanne has no empathy,” Lüscher says about his experience with Chat GPT. “Her responses have to be verified by a doctor. She even says that after every diagnosis, and has to, for legal reasons.”

Also, an algorithm is only as accurate as the information with which it was trained. Lüscher and his team cured an AI tool of a massive deficit: Women’s risk for heart attacks wasn’t reliably evaluated because the AI had mainly been fed with data from male patients. “For women, heart attacks are more often fatal than for men,” Lüscher says. “Women also usually come to the clinic later. All these factors have implications.” Therefore, his team developed a more realistic AI prognosis that improves the treatment of female patients. “We adapted it with machine learning and it now works for women and men,” Lüscher explains. “You have to make sure the cohorts are large enough and have been evaluated independently so that the algorithms work for different groups of patients and in different countries.” His team made the improved algorithm available online so other hospitals can use it too...

[Lopez-Jimenez at the Mayo Clinic] tells his colleagues and patients that the reliability of AI tools currently lies at 75 to 93 percent, depending on the specific diagnosis. “Compare that with a mammogram that detects breast tumors with an accuracy of 85 percent,” Lopez-Jimenez says. “But because it’s AI, people expect 100 percent. That simply does not exist in medicine.”

And of course, another challenge is that few people have the resources and good fortune to become patients at the world’s most renowned clinics with state-of-the-art technology.

What Comes Next

“One of my main goals is to make this technology available to millions,” Lopez-Jimenez says. He mentions that Mayo is trying out high-tech stethoscopes to interpret heart signals with AI. “The idea is that a doctor in the Global South can use it to diagnose cardiac insufficiency,” Lopez-Jimenez explains. “It is already being tested in Nigeria, the country with the highest rate of genetic cardiac insufficiency in Africa. The results are impressively accurate.” 

The Mayo Clinic is also working with doctors in Brazil to diagnose Chagas disease with the help of AI reliably and early. “New technology is always more expensive at the beginning,” Lopez-Jimenez cautions, “but in a few years, AI will be everywhere and it will make diagnostics cheaper and more accurate.”

And the Children’s National Hospital in Washington developed a portable AI device that is currently being tested to screen children in Uganda for rheumatic heart disease, which kills about 400,000 people a year worldwide. The new tool reportedly has an accuracy of 90 percent. 

Both Lopez-Jimenez and Lüscher are confident that AI tools will continue to improve. “One advantage is that a computer can analyze images at 6 a.m. just as systematically as after midnight,” Lüscher points out. “A computer doesn’t get tired or have a bad day, whereas sometimes radiologists overlook significant symptoms. AI learns something and never forgets it.”

-via Reasons to Be Cheerful, March 1, 2024. Headers added by me.

--

Note:

Okay, so I'm definitely not saying that everything with AI medicine will go right, and there won't be any major issues. That's definitely not the case (the article talks about some of those issues). But regulation around medicines is generally pretty tight, and

And if it goes right, this could be HUGE for disabled people, chronically ill people, and people with any of the unfortunately many marginalizations that make doctors less likely to listen.

This could shave years off of the time it takes people to get the right diagnosis. It could get answers for so many people struggling with unknown diseases and chronic illness. If we compensate correctly, it could significantly reduce the role of bias in medicine. It could also make testing so much faster.

(There's a bunch of other articles about all of the ways that AI diagnoses are proving more sensitive and more accurate than doctors. This really is the sort of thing that AI is actually good at - data evaluation and science, not art and writing.)

This decade really is, for many different reasons, the beginning of the next revolution in medicine. Luckily, medicine is mostly pretty well-regulated - and of course that means very long testing phases. I think we'll begin to really see the fruits of this revolution in the next 10 to 15 years.

[bumblee-stumblee]

NHS England to stop prescribing puberty blockers

10 hours ago

By Josh Parry,

LGBT & Identity Producer

Children will no longer routinely be prescribed puberty blockers at gender identity clinics, NHS England has confirmed.

The decision comes after a review found there was "not enough evidence" they are safe or effective.

Puberty blockers, which pause the physical changes of puberty, will now only be available as part of research.

It comes weeks before an independent review into gender identity services in England is due to be published.

An interim report from the review, published in 2022 by Dr Hilary Cass, had earlier found there were "gaps in evidence" around the drugs and called for a transformation in the model of care for children with gender-related distress.

Dr Cass's review follows a sharp rise in referrals to the Gender Identity Development Service (Gids), run by the Tavistock and Portman NHS Foundation Trust, which saw an increase from 250 per year to over 5,000 in 2022.

Puberty supressing hormones - more commonly known as puberty blockers - work by suppressing the release of hormones that cause puberty and are often prescribed to children questioning their gender as a way of stopping physical changes such as breast development or facial hair.

Fewer than 100 young people in England are currently prescribed puberty blockers by the NHS. They will all able to continue their treatment.

NHS England held a public consultation on their usage and last year introduced an interim policy which stated they should only be given as part of research trials or in "exceptional circumstances".

The BBC understands that the new policy, confirmed on Tuesday, will not allow them to be prescribed "routinely" outside of a research trial, but that individual clinicians can still apply to have the drugs funded for patients on a case-by-case basis.

Gids is due to close at the end of March. Two new NHS services due in London and Liverpool are set to open at the beginning of April, followed by a number of regional specialist centres over the next two years.

Health Minister Maria Caulfield said: "We have always been clear that children's safety and wellbeing is paramount, so we welcome this landmark decision by the NHS.

"Ending the routine prescription of puberty blockers will help ensure that care is based on evidence, expert clinical opinion and is in the best interests of the child."

The consultation on the future of gender services received more than 4,000 responses, including 10% from trans adults and 5% from clinicians.

John Stewart, national director of specialised commissioning at NHS England, said: "Given that the debate is often very polarised, so too were the responses to the consultation.

"Many people said the policy didn't go far enough in terms of still allowing potential access [to puberty blockers] through research, and others saying clearly they disagreed fundamentally and that these should be routinely available to everyone who believes they need it."

The BBC understands NHS England aims to begin its study into the use of puberty blockers by December 2024, and is yet to decide who can take part

---

Oh hey, will you look at that.

[therhythmafterthesummer]

Heat (M) ~Changbin

Pairing: Werewolf!Changbin x Werewolf!F.Reader Themes: Supernatural/Fantasy AU | Smut | Fluff | Established Relationship Warnings: time jumps, graphic depictions of intercourse (smut warnings under the cut) Word Count: ~6k | AO3 Summary: With you, Changbin was able to explore areas of himself he’d never even imagined existed. With you, Changbin found himself feeling at home more than ever, which was why he wanted nothing more than to experience your heat with you, too. [This story is an instalment of my WereRoomies series, a sort of part 2 to Finding Comfort in Autumn].

Author’s Note: this piece had been sitting in my WIPs for way too long ! i missed Changbin and his girl… since i finally got some inspo to continue this one, i rode the wave and here we are ! a bit of a pwp but i just couldn’t hold back…

Due to all the abovementioned warnings, this story is intended for an adult audience only. Minors please do not interact.

Changbin’s WereRoomies Instalments: Finding Comfort in Autumn · Heat · The Love I Always Dreamt Of.

Smut Warnings: Fingering [M.Rec gasp], Oral [M.Rec], unprotected penetration [piv], snowballing, marking, breeding kink, werewolf cock, copious amount of fluids, knotting

Disclaimer: the story represented in this work does not represent Stray Kids in any way; anything described in this story and all actions performed by the characters are purely fictional, this was created just for good fun.

Changbin was worried.

He had been for a while, but he didn’t want to express it too much. Not because you would judge him, or disregard him in any way, but because he knew that vocalising it time and time again would probably make it worse. So he settled on being a good partner and giving you an ear to complain to on the matter when you needed it.

It had been over a year since you ran away from your pack, over a year since you moved in with him, a handful of months since you finally shared your affections, and the whole time, you’d not gone into heat. Not even once. Changbin had gone on his rut right before you two got together, he had left your shared home a few days prior to the fact to stay in one of the vacant flats at their den to not make you uncomfortable in any way. 

Going into his rut when he lived with an omega was dangerous, especially when that omega was you. By that point he had already developed feelings for you, so he made it a point to leave as soon as he saw the first signs of his rut approaching, meaning his rut-enhanced pheromones had no time to affect you and send you into heat. At the time that was for the best, all things considered, but now that you’d been together for a while it had become quite the topic.

It wasn’t that Changbin needed you to go into heat by any means. There was no real push for breeding in any way, but he worried about your health, about your well-being. Not going into heat could potentially mean there were underlying issues with your health and that was something he hoped you didn’t have to go through.

So, you had seeked medical advice with a specialist just for your kind–funny thing, how werewolves lived so intertwined in human spaces and they didn’t even notice. Not even the other doctors at the clinic knew one of their seemingly normal doctors was treating her own kind, along with humans. Changbin couldn’t go with you to the appointment, and it wasn’t because he hadn’t tried, but work had been hell that week and he had to work extra hours. ‘Don’t worry about it, Binnie, seriously. I’ll be just fine. Will call you as soon as I’m done. Besides, our dearest Pack Mum has offered her company, so I won't be alone’, you’d told him at the time, and it was just as he had left the server room that evening that you finally called him.

“Okay, good news and bad news… Which one do you wanna hear first?” You said it so unfazed, so level, Changbin truly wasn’t sure what to expect.

“Bad news first, pup. Always the bad news first”, Changbin felt his hands shake a bit as he fumbled with his ID card to leave the area.

“Okay”, you took a deep breath, trying to ease nerves of your own, Changbin supposed. “She said it’s probably due to stress. A combination of leaving my former pack, joining a new one, my general day-to-day stress at work…”

Changbin found the exit to the roof, stepping out to try and get more privacy and enjoy the fresh evening air. “That doesn’t sound… That bad?”

“Hm. The bad part is that there’s no way to medically trigger it”, Changbin heard your tired sigh on the other side of the line, just as he leaned on the railing to look at the tiny flashes of light moving through the roads below. “My heats have been so… Stunted for so long she said it’d take a while for my body to push a normal cycle again”.

You had explained to Changbin that for the past handful of years you hadn’t gone into heat on your own, they would mostly get triggered by your ex’s rut, and even then they wouldn’t always occur. With the new information from the specialist, Changbin figured your entire situation in your former pack had made it so your body was in a constant state of distress, meaning your cycle really had been thrown off for years.

“So it’s all about waiting?” Changbin pushed a pebble with his foot, hearing your hum of confirmation.

“Yes. Physically everything’s alright, and my birth control shouldn’t be affecting the cycle anyway, so it’s just a matter of patience”.

“Something you don’t have much of, unfortunately”, Changbin teased you a bit to try and ease the mood, chuckling at your mock offended ‘hey!’ on the other side of the line. “And the good news?”

“The good news is that the results of the tests came in! I mean, not like we didn’t know already, but now we know for sure. Your precious little omega is one hundred percent clean. So I hope you’re ready for us to fuck into next week, baby!” 

Changbin couldn’t help but let out an incredulous laugh, feeling his cheeks heat up a bit at your forwardness as if he hadn’t already fucked you countless of times–to his credit, you hadn’t done it raw this entire time, and just the mere thought had him vibrating with excitement. “And to the week after, too. Damn…”

When Changbin came back home at almost midnight, exhausted out of his mind after dealing with the goddamn priority one outage in the office, you had engulfed him in a tight hug, proceeding to smother his face in kisses, making him giggle.

‘Poor Binnie has been working all day long. Let me take care of you, baby, hm? Got a surprise for you’, and Changbin almost wept when you guided him to the bathroom, dimly lit by numerous candles that you had carefully placed on every available surface and an already prepared warm bath.

When Changbin lowered himself into the tub he quite literally let out a sigh of relief at the feeling of warm water easing his muscles, making you chuckle just as you went in as well, leaning on the other end of the tub, looking fondly at him. 

“Good, Binnie?” 

“So good. Feel like I might cry”, Changbin chuckled, closing his eyes and sinking further into the water.

There was movement, and the water around him sloshed slightly as you moved closer to him. By the time he opened his eyes you were already kneeling between his legs, smiling at him. You reached for him, setting your hands on his shoulders and softly kneading his flesh, eliciting a content hum from him with your tender touch. 

Sometimes, Changbin couldn’t even believe his luck. Starting a relationship with you had completely liberated this side of himself that he had tucked away deeply within his heart for years, the side of him that rejoiced in the way you took care of him.

He had been a bit worried at first, wondering if you, like he himself had done many times in the past with former partners, were simply trying to mould yourself to him, to his needs. ‘I really do enjoy taking care of you, Binnie. Making you feel good makes me feel good’, and when you looked at him like this, there were no doubts in his mind that you were telling him the truth.

“What time are you working tomorrow?” You asked him as you continued to knead his shoulders.

“Not working tomorrow. That was my condition for the out of hours thingy today. Wanted to rest. Plus you won’t be working tomorrow either, right?” Changbin was turning into putty in your hands, just letting himself enjoy your touch as he lazily reached for your hips, softly digging his thumbs on your skin.

“Mm, not working tomorrow either”, moving your hands from his shoulders, you cupped his cheeks, pulling him to you for a tender kiss. “Wanted to be fresh for our run in a couple of days”.

“Smart…” His hands sneaked to the small of your back, drawing circles there with his fingertips as he pressed a kiss to your lips. “You think the full moon might…”

You sighed, pulling away from his lips to look him in the eyes, just as you returned your hands to his shoulders. You clearly knew exactly what he was asking, on whether you thought the full moon would trigger your heat or not. “Dunno… It hasn’t the past handful of months… But one can hope, right?”

“Mm…”

“Why?” Leaning closer, you brushed your nose against his briefly, only to bring your lips to hover over his. “Wanna breed me that badly, Binnie?”

A shiver ran up and down Changbin’s spine. He couldn’t help it, it was an instinctual thing. Sliding his hands further down, he groped your buttcheeks, just as he pressed a brief kiss on your lips. “What if I do? What if I wanna stuff my precious omega full of my pups?”

“Would you?” You mumbled against his lips, and Changbin could practically feel you vibrating in his hold. “Pump me full of your pups? Maybe even… Mark me?”

Changbin had to use every ounce of willpower to not let his canines enlarge at the suggestion, suddenly feeling lightheaded, salivating, at the mere thought of claiming you, of marking you as his. “Want me to mark you, pup? Make you mine?”

“Hm…” You lightly brushed your nose against his, threading your fingers through Changbin’s hair and tugging his head back. “But only if you become mine, too”.

“Already am”, was all Changbin murmured before he connected his lips to yours in a heated kiss.

“Shh, Binnie… You’ll wake up the whole house…”

Changbin bit his lip to muffle himself. It was hard to stay quiet when you had two fingers up his ass and your fist around his cock, but he was certainly not about to complain.

“You’re leaking, baby”, you chuckled, keeping up those slow strokes on his length and the even slower thrust of your fingers. “So much…”

Changbin swallowed, just as the heat on his cheeks spread all over his chest, too. “All for you, pup…”

Last night’s run certainly affected you, just like it had affected Changbin. It didn’t particularly trigger your heat like he was expecting, but the way you jumped him as soon as you were inside your shared room almost knocked the breath out of his lungs. Not only did you fuck like bunnies–or should he say, like wolves…–last night, but you’d woken up in the same needy, horny mood this morning.

It was really early, but the second Changbin woke up and got the first whiff of your scent, he wasted no time in waking you up. As soon as you opened your eyes you took a hold of his length and guided him to your entrance, letting him stuff you full and fuck into you until you were trembling with your release, and when you recovered, you simply turned around and pushed on his shoulder for him to lay down.

Which got him right here, with his legs spread open for you, all lubed up and stretched open by your fingers.

The first time you told Changbin you wanted to finger him he was a bit apprehensive, mostly out of his own prejudice. After all, males–and especially alpha males–were taught that the act was something to look down on, but considering he was going through his own journey of self-discovery, he trusted you enough to be that vulnerable, and the second he finally gave you the go ahead and tried it, he realised two things:

One, that he wasn’t any less of a man–of an alpha–for taking a finger up the ass. He hadn’t felt any less of anything since he started to be more open with himself, so this discovery didn’t surprise him.

And two, and the most shocking of all, was that it felt so fucking good, which certainly helped cement discovery number one.

The feeling was almost indescribable, having his cock tugged and sucked and played with was amazing on its own, but the added stimulation just made him feel like his entire body was alight. Every time your fingers went in and out, tiny shots of pleasure ran up and down his spine, and every time you hit that sweet spot within him, he’d literally shiver and leak fluids like crazy.

As an alpha, Changbin already produced almost triple the amount of a regular human male, and double of a werewolf of any other designation, but whenever you stimulated him like this, the amount increased considerably, and the fact that you seemed to love it made it even more arousing than it already was.

“Puppy…” Changbin was panting, whining, writhing a bit, and he felt so, so close. It was the second time you got him this close, and he needed to come or he would seriously start crying under your touch.

“What is it, baby?” Your voice was deceivingly sweet, speaking to him just as you settled to massage his prostate, making him whine.

“Wanna… Wanna come…” Changbin held your gaze, getting lost in your lust-filled irises. Had you done this last night, with his senses enhanced by the full moon and looking at your glowing eyes, he would’ve blown right then and there, he was sure.

You squeezed the base of his length, and Changbin couldn’t help but throw his head back as you kept massaging him. “Already?”

Changbin let out a strained laugh, gripping the bed sheets tightly. “It’s been–Fuck… Over twenty minutes of this, pup… Wanna–”

He all but choked on his words as you resumed your movements, now with the addition of your warm, wet mouth around his tip. Bringing a fist to his mouth, Changbin bit down to stop the sounds that were desperately trying to come out of his mouth, carefully rolling his hips to meet the thrusts of your fingers, but not enough to shove his cock too much down your throat. 

Changbin loved to see you like this, he would admit. Settled between his legs, struggling to take his cock into your mouth. He was big, just like any other alpha would be, but that never stopped you from wrapping your lips around his length and making him whine and whimper for you.

You bobbed your head, sucking harshly on his tip, jerking the rest of his length that you couldn’t fit in your mouth just as your fingers kept massaging him, working him up closer to his release by the second, and Changbin felt his mind cloud, registering only your touch, the pressure building inside of him, and the feeling of his teeth sinking on his index finger.

Finally, that pressure inside of him bursted, all that tension left his body as he came with your lips still around him, pathetically whining and moaning as low as he could–he had embraced this part of himself, but Changbin didn’t particularly feel like having his entire family hear him have a mind-blowing orgasm, he was barely conscious enough to keep that in check. 

His legs were shaking, you kept sucking him and massaging him, and it was just too much. So he called for you, the most strained ‘puppy, enough…’ leaving his lips for you to finally pull your fingers out of his ass and your mouth off of him with a lewd pop. 

Crawling up his body, you settled on his lap, cupping his cheeks and pulling him to you for a heated kiss, and Changbin couldn’t help but moan as you shoved your tongue inside his mouth, spreading his cum over his tongue. He swallowed it all, just like he always did, holding you tightly, naked chest against naked chest, kissing you with fervour.

Changbin felt tingly all over, not only from finally blowing his load, but also just by having you close, by being completely engulfed in your scent. These days he just felt completely flooded by it, and he absolutely loved every second of it.

“Good boy…” You mumbled against his lips, petting his hair and making him huff out an incredulous chuckle. 

“Unbelievable…” With his arms securely around your waist, Changbin rolled, bringing you with him and pinning you to the mattress, smothering your face with kisses. “You’re seriously unbelievable”.

You chuckled, wrapping your limbs around him and pressing a kiss on his lips. “You love me either way”.

“I love you because of it”, Changbin gave you a brief kiss, pulling away from you entirely right after. “C’mon, let’s get ready for the day, I really want to clean my ass and I’m sure everyone will be awake soon…”

By the time Changbin and you had taken a quick shower and made your way downstairs, there were already some pack members in the kitchen. Chris, his girlfriend, and Jeongin were sitting at the table, while Hyunjin, Felix, and Jisung got busy preparing breakfast.

You offered Felix your help, while Changbin simply made his way to the table and sat down, engaging in conversation with the rest. This was honestly one of Changbin’s favourite moments of their monthly trips, just being able to sit together and chat, everyone still in their pyjamas, hairs tousled, and still sleepy. It made him feel completely at home, at ease, and he always felt grateful that this was his family now.

It wasn’t like his previous pack wasn’t family, it just wasn’t the same. Changbin loved his parents–his mother particularly was very important to him, he’d go visit her once every two weeks at least–but the pack Chris and Changbin built together had become such a safe space for him he truly couldn’t imagine himself living anywhere else, with anyone else. Even more so now that he had you in his life.

“…It sucks ‘cause I’ll have to take the night shift once we’re back in the city”, Jisung was whining about his job, just like he often did. He always claimed he loved it, but loving his job wouldn’t stop him from complaining either way. 

“Didn’t you say you loved night shifts, baby?” Chris’ girlfriend chuckled from where she was sitting on Chris’ lap, with one of his arms securely around her waist as he fed her pieces of freshly cut apples.

“I kinda do, but lately they’ve been getting weird… We’re getting a lot of weirdos in the emergency room and it’s annoying…”

“You do work at a hospital that tends mostly to supernatural creatures, what were you expecting exactly?” Hyunjin said as he continued to whisk eggs in a bowl. “Find a normal, human hospital if you don’t wanna deal with oddities, darling”.

“But then what’s the point?” Jisung sighed dramatically, handing Felix his freshly chopped veggies.

“Morning”, Minho mumbled as he walked through the door, with an arm draped over his best friend who was coming to one of their monthly trips for the first time–his kitten, as he’d often call her, both to her face and when she wasn’t there. ‘Ahh, my kitten’s coming tomorrow…’, ‘Ahh, my kitten’s not feeling well…’, ‘Ahh, was just talking to my kitten…’ Minho would always talk about her, and Changbin found it endearing and annoying in equal parts.

Endearing, because it was cute to see Minho being absolutely whipped, but annoying because he’d never act on it. They’d been friends since childhood, and it was more than clear that both of them had feelings for each other, but they were both oblivious to the other’s more than obvious crush. It was even more painful than watching Chris and his girlfriend interact when they were just roommates, considering they had even more history.

“Morn–” Jisung’s sentence cut short with a gasp as he looked at his two childhood friends. “You two fucked?”

Jisung asked in his version of a whisper, which was, essentially, audible to everyone in the room, including the humans–if the snort that Chris’ girlfriend let out was anything to go by. 

Minho facepalmed, groaning. “You sure are the epitome of discretion, Jisung…”

“I’m sorry! You caught me off guard, okay?!” Jisung’s ears were slightly red, but Minho’s… Friend? Chuckled regardless.

“How could you even tell?” She made her way to the table, sitting next to Chris and his girlfriend, who offered her a slice of apple, too.

“Scent”, you touched your nose, grinning at her, and her face flushed as she let out a barely audible ‘oh…’

“Alright, everyone”, Chris’ girlfriend interrupted the conversation, with her hand outstretched, palm up. “Pay up. I’ll collect the payout from the others later and distribute it”.

Minho’s jaw went slack, watching completely incredulous as some of his packmates deposited tenners on their Pack Mum’s hand. “You bet on us getting together?!”

“Just like you bet on us fucking last night”, Chris motioned to him and his girlfriend with a teasing smirk on his face. “We’re fucking even”.

Minho just scoffed, but he was smiling regardless, and as he started to uselessly banter with Chris, as the rest started to add their playful remarks and teasing jokes, Changbin couldn’t help but feel incredibly happy once again that this was the family he had chosen to have.

Going back to work after a couple of nights in the woods was always more refreshing than Changbin could ever expect. He loved being able to run freely in nature, especially when he did it with his pack, but coming back to his mundane office job always reminded him that he wasn’t just an animal, that he was very much part human, too, and it helped him connect with that side of him.

You had decided to take your annual leave right after the trip, since you had a bunch of errands to run and it’d be easier to do them if you didn’t have to deal with office shenanigans. So, Changbin had been coming to work on his own these past couple of days, which was fine, you two often had different schedules so it wasn’t particularly uncommon for that to happen, but still he enjoyed seeing your pretty face around the office every once in a while when he was able to leave his desk, which he couldn’t do now that you weren’t here.

The network was stable today, he’d checked all the switches early in the morning, everything was in order, so today was one of those rare days in which he was able to fulfil all his tasks in a few hours. There wasn’t much to do, just stay put in case something happened and his expertise was needed, so he settled to pretend to be busy by checking the pack’s group chat through the messaging app’s web browser.

> Seungminnie: guys > found a gnome trying to sneak into the den

> Mr Alpha: what u do with it > ???????

> Minho: why tf would a gnome try to go into the den?

> Mrs Mother: pls tell me you didnt kill it > or eat it

> Innie: dw mum > we just chased it away

> Hyunjinnie: they say it’s bad luck > if a gnome visits a werewolf den

> Jisung: literally who said that > no one said that > u just trynna spook us

> Hyunjinnie: @Jisung look it up sweetcheeks

Changbin just chuckled, puzzled at the entire exchange, and it was just as he was going to add to the conversation that he felt his mobile phone buzz in his pocket. He couldn’t stop the smile that settled on his face as he saw the ‘💕Gingerbread💕’ text on the screen.

“‘Sup, pup?”

There was silence for a moment, until finally, Changbin heard you swallow, thickly enough for him to hear it over the phone. “Binnie…”

Changbin went stiff, suddenly frozen in place. The way you said his nickname had the fine hairs on his nape standing on end, and the sound sent a shiver up and down his spine. “Babe–”

“Need you”, you whined, and at that exact moment Changbin understood what was happening, and he simultaneously felt as if a cold bucket of water had come down on him, and as if he was being lit on fire. “Please, Bin, it hurts so bad… Need you…”

Changbin stood up from his desk, gathering his belongings and hastily shoving them in his bag. “I’ll be there soon, pup. Don’t worry. Are you at home?”

“Mhm…” Your voice was a bit weak, but knowing you were safe at home was enough for him.

“I’m on my way”.

While the call disconnected Changbin was making his way out the door, shooting his boss a quick ‘there’s an emergency at home, I have to leave now’. His boss didn’t object, probably because Changbin had inadvertently used his alpha voice, if anyone so much as tried to stop him right now that he was trying to get to you he’d surely rip their head clean off, so it was for the best.

The drive to the den was a blur, all Changbin could think about was you and how you’d be managing, about how he wasn’t there to take care of you. As an alpha, knowing his omega was in heat and he wasn’t there for you at this exact moment brought a mix of distress and anger that was difficult to handle while driving, but he was able to make it home without much trouble, thankfully.

As soon as Changbin stepped through the door he was hit by your overwhelming scent, your delicious nutmeg and ginger scent that drove him absolutely insane, now heightened and somehow more concentrated, making him stumble slightly and brace himself on the hall’s wall.

He got his shoes off out of habit, an action completely mechanical as his hands started to tremble, and his mind started to cloud more and more with each intake of breath. Fertile, breed, claim… Were words that repeated in his mind in an endless loop as he stumbled towards the bedroom.

Sure enough, as soon as he opened the door, his mouth watered, his cock that had steadily been growing hard pumped to its fullest just as the sight. You, laying on your shared bed, wearing nothing but one of his t-shirts, surrounded by a mix of yours and his clothes, sweaty, panting, whining… And the second you registered his presence you squirmed, with the most delicious mewl leaving your lips.

“Changbin… Changbinnie, please, baby…”

The sound of your voice, so desperate for him, your scent flooding his senses completely, the sight of you in your pretty nest on your shared bed was enough to send Changbin into a frenzied state. He could feel his humanity quickly slipping between his fingers as his wolf instincts started to take over. Please, taste, mount…

His skin felt ten times hotter than it did before he stepped into his flat, so he removed his shirt, swiftly making his way to the bed, climbing on top of you to press kisses all over your face.

As soon as his lips were on you, you whined, so, so desperate, needy… Your hands reached for his chest, your touch seething as you felt him up. “Shh, pup… I’m here”, Changbin’s lips descended from your face to your neck, nibbling and licking right on your pulsepoint. The salty taste of your skin, coupled with the smell of your scent had his nerve-endings on fire, and his hands moved below your shirt–his shirt–to palm your hips as he pressed his nose to your neck and inhaled deeply.

“You smell so delicious, puppy… So, so good, fuck, wanna–” Changbin choked on his words as he felt your hand on his crotch, pressing firmly against his erection as you started to kiss and lick his cheeks.

“Need you”, your breathy tone had his head spinning, had his cock twitching in his underwear, just as fluid started to leak from his tip.

You fumbled with his belt, and Changbin grabbed a handful of your tit to knead and squeeze while licking the expanse of your neck. He didn’t know where to start, there were so many things roaming chaotically in his brain–licking your cunt clean, stuffing his fingers in you until you were crying for him, sucking on your tits, fucking you, mounting you… There were so many options, and his mind was so hazy and cloudy he just couldn’t choose one.

You, however, clearly knew exactly what you wanted right now, since your fingers expertly unbuttoned his now soaked trousers and shoved them and his underwear down just enough for his cock to spring free, holding him in your hand and pumping him, eliciting an almost desperate growl from his lips.

“Need my alpha’s cock, please…” Before Changbin could register the movement, you had locked your legs around him and pushed with your whole bodyweight, effectively rolling you both for him to lay on his back and for you to straddle his hips.

“Pup–” Changbin’s call for you died on his tongue, replaced with a groan as your lips finally connected to his. His tongue pushed its way into your mouth, making you whine as your hips started to roll, grinding yourself on his length.

You were literally dripping, your fluids mixing with his, covering his lower abdomen and your inner thighs with them. Enjoy, satisfy, submit… His hands found purchase on your buttcheeks, gripping you tightly and moving you harder against his cock as his hips bucked up trying to get as much friction as possible. 

There was that damn shirt, though… The fabric prevented him from feeling your heated skin against his and he was hating it, he wanted to feel your breasts against his chest, for you to feel the rumble resonating from deep within him as you pressed yourself to him, to feel your rumble against his chest…

“Need to feel you…” was all he mumbled against your lips as he tugged on the shirt, and you mewled, bringing your hands to his chest to push yourself up.

You tugged the shirt off of your body, shuffling down to tug Changbin’s trousers and underwear fully off of him, leaving you both completely bare. Once you climbed up his body again, hovering just above his length, you braced yourself on his abdomen. “Please, please, Changbinnie, can I–”

“Yes!” Changbin interrupted you, knowing exactly what you wanted from him, him wanting exactly the same thing. His hand reached for the base of his cock, angling it to rub the tip against your folds, and you shuddered with the touch.

Before he could even register it, you took a hold of his wrist and sank down on him just as you moved his hand away from his length and brought it to one of your breasts. As soon as your walls wrapped snugly around his cock a shared moan of relief escaped you both. His hand squeezed your breast almost on instinct, and Changbin felt heat spreading all over his face and neck just at the feel of you, warm, wet, tight, his…

Changbin had spent many ruts with people in the past, he had helped friends through their heats as well, but never had he had his rut triggered by someone’s heat, never had he felt this way, this needy and desperate. More than wanting to do anything to you, he vaguely realised he wanted you to do anything you wanted to him, he wanted to give you anything and everything you asked him for, and the thought of you voicing your needs and taking him however you pleased had him burning up from the inside out.

You leaned in to kiss him, your hips moving up and down his cock with ease, the mix of your slick and his aiding every single one of your movements. Moving a hand to one of your buttocks, Changbin squeezed tightly as the other tangled in your hair, tugging you off of his mouth for him to press kisses on your neck, right where your scent concentrated the most, thrusting up into you as hard as his hips would let him. “Such a good little omega, aren’t you? With your pretty little nest ready for your alpha to breed you, hm?”

You couldn’t help but moan, nodding frantically as much as you could with his hand still holding onto your hair. “Do you–Do you like it, Binnie?” The neediness in your voice had his cock twitching inside of you as he continued to drill into you, the sound of your wet skin meeting almost drowning your meek words, had you not whispered them against his neck as you sucked marks on his skin he could’ve easily missed them. “Prepared it… Just for you… For us…”

Warmth spread quickly within Changbin, his hips stuttering the slightest bit once your words registered in his hazy brain, but he recovered quickly, holding you tighter in his arms, his grip on your buttock probably leaving bruises already. “I love it. Love my perfect omega’s little nest”, you clenched hard around his cock, and he couldn’t help but groan at the feeling. “Fuck, pup… Want to do so many things to you… For you…”

“Later… Later, baby. Now, I–” A whine fell from your lips, and your thighs twitched as his cock continued to hit that sweet spot inside your walls. Bracing yourself on his chest you sat straighter, and Changbin’s hold on your hair relented as soon as you started moving. His hands frantically roamed your body, not knowing where to settle, your hips, your ass, your tits, your thighs… There were so many places for Changbin to hold onto he just couldn’t settle for one.

As you started to bounce up and down his length Changbin started to feel his knot expanding within your walls, a loud, desperate moan falling from your lips as you clearly started to feel it as well. “Fuck… So big, so, so big…” Your pace picked up, Changbin’s hips chasing your hips to enhance your pleasure and his as you continued to move. “Want you to stuff me full, Binnie… Want your pups, alpha, my alpha…” 

Omega, mate, tie… Changbin couldn’t help but moan, the thought of filling you up, breeding you, stuffing you full of his seed had him close, so close to the edge he started to lose a bit of his self control, and his hips pistoned up as hard as he could against you, just as his deepest desires flew past his lips before he could even stop himself.

“Mark me, puppy…” His eyes were fixed on yours, taking in the blissed out expression on your face, your beautiful features contorting in pleasure, whether it was for his words or his movements he didn’t know, nor could he think too clearly about it to care. “Please, mark me… Want everyone to know I’m yours and yours only. Mark me…”

With a whine, your canines enlarged upon his request–not much, you were an omega after all, but that didn’t stop you from dipping, and your mouth found the junction of his shoulder and his neck for your teeth to sink into his flesh, sending sparks of hot, unadulterated pleasure throughout his entire system.

The feeling of your teeth breaking his skin, along with your merciless hips bouncing on top of him was enough to send him over the edge, lodging his knot deep within your walls for him to shoot his seed into you with a long, drawn out growl just as your walls started to spasm around him, just as your whole body shook in his hold as you came undone with him.

Changbin felt lightheaded as his cum spurted almost endlessly from his tip, filling you up. You weakly licked his neck, right where you bit him, trying to soothe the wound. “My alpha, my Binnie, mine, all mine…” You whispered against his skin, bringing heat to his face, making him blush.

Turning his head slightly, Changbin’s lips found yours. One of his hands came to rest on the back of your head to deepen the kiss, and his tongue pushed lazily against yours, savouring you. “My sweet, precious omega, mine, all mine…” He mumbled against your lips, hearing your satisfied hum when he finally stopped coming, when he finally stuffed you full of everything he had.

Hiding in the crook of his neck again, you snuggled impossibly closer to him, letting out a content sigh as you both just laid there catching your breaths for a long while.

Changbin’s skin felt tingly, especially where you bit him–holy shit you marked him. As he regained clarity, he finally realised he begged you to mark him, and you did. You marked him and the mere feeling of it made him blow his load immediately, and his mind was racing.

Suddenly, you tensed, moving away from his neck to look him in the eyes. “Holy shit, Changbin…” Your fingers traced the mark on his neck, making a shiver run down his spine at the contact. 

“You marked me”, Changbin confirmed, feeling his heart swell in his chest as he said it, his voice was barely a whisper, and his palms moved from where they had been laying on your back to softly caress your shoulders. “How does it look?”

“Like… Like a mating bite…” You licked your lips, your eyes jumping back and forth from his face to the mark. “Didn’t even know omegas could mark others… Much less an alpha”.

“You’re no ordinary omega, pup”, one of Changbin’s hands pushed away the hair that was sticking to your forehead. “Just like I’m no ordinary alpha, thought we had established that already”, with a hand on the back of your neck, he pulled you down gently, to press a soft, tender kiss to the apple of your cheek.

“Do you–” You shuffled, or at least tried to, but the tug of Changbin’s knot in your core made you wince and whine as soon as you tried to move.

Changbin’s hands found your hips, keeping you firmly in place. “Don’t move, baby. This is quite possibly one of the worst positions we could’ve tied in”, Changbin chuckled softly, pressing kisses on your cheeks to try to soothe you.

“Sorry…” A sheepish smile made its way onto your face, a blush settling on your cheeks. “Couldn’t help it…”

“I know, pup”, stretching his neck a bit, Changbin’s lips found yours, placing a peck on your lips. Wrapping his arms around your waist he held you to his chest and inhaled deeply. “You smell so good, puppy… So good…”

“You do, too, baby…” You rubbed your forehead on Changbin’s shoulder, letting out a content sigh. “Did I… Did my heat trigger your rut?”

Changbin just hummed, softly caressing your hair and your back. “The second I stepped through the door and I got a whiff of your scent I lost my mind. My rut wasn’t due yet”.

You hummed, pressing soft kisses on his neck. “Guess you’ll have to call in sick…”

Changbin chuckled. Leave it to you to think about work even in a moment like this. “They’ll live. This is more important than that stupid office”.

Giggling softly, you smothered his face with kisses, bringing the widest smile to his lips just as you brushed Changbin’s nose with yours once you had finished your attack. “We’re gonna have so much fun, Binnie…”

Once his knot fully deflated, Changbin moved you off of his lap, and your eyes went wide as you looked at him, still hard and leaking. With a smirk on his face, he took a hold of your hips, a tiny squeak left your lips as he harshly turned you around and pulled your lower body up to rest your weight on your knees. 

“My turn now. Gonna make a mess out of you, pup…”

Yes, Changbin enjoyed being taken care of. He enjoyed letting you take control, but on odd occasions, and especially now, with his mind still hazy and completely drunk on your scent and your pheromones, he enjoyed taking control, too. He was determined to take care of you.

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Changbin’ WereRoomies Instalments: Finding Comfort in Autumn · Heat · The Love I Always Dreamt Of.