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#surgical hernia repair
chc9 · 2 years
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Laparoscopic Hernia surgery in Chennai | Chennai Hernia Clinic
Chennai Hernia Clinic is known for Laparoscopic Hernia surgery in Chennai, proficient in dealing with all types of hernias, and focuses on quality care in the field of hernia surgery and it is minimally invasive surgical procedure.
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prashantsharma12 · 3 months
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shubhragoyal · 10 months
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Explore the future of fertility with breakthroughs in endoscopy and laparoscopy. Dr. Shubhra Goyal offers insights on advancing reproductive health.
Do Visit: https://www.drshubhragoyal.com/welcome/blogs/the-future-of-fertility:-exploring-breakthroughs-in-endoscopy-and-laparoscopy
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health5690 · 10 months
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somuikblog · 1 year
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Gallbladder Stone |Dhanwantaree clinic | Best Surgical care in Bhubaneswar|
Stones in gallbladder can cause life threatening conditions treat it immediately with best surgical care Dhanwantaree in Odisha.
Gall bladder is a small, pear shaped organ on the right side of our abdomen, under our liver its work is to store and release bile, bile is a liquid which is help with digestion and carries cholesterol and other wastes which our body create. These are the main reason for gallstone.
Some time it’s treated with medicine but in maximum cases it’s need surgery.
If you suffer with gallstone and need surgical treatment don’t ignore it get remove it with best surgeon in Odisha Dr. Ashok Acharya.  For better inquiry Visit the website https://www.dhanwantaree.com/ and talk to the medical staff 9776655073, 7381194400.
https://www.dhanwantaree.com/
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katrafiy · 2 months
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Really not so sure how I feel about the idea of redefining transfem to include people with PCOS if for no other reason than it muddies the water of what the term transfem is generally understood to mean and also totally crowds the kind of people that term was originally coined for out of their own identity.
I'm an """amab""" intersex transfem. I was surgically altered as an infant, I was assigned male at birth and while the records are inaccessible i have good reason to believe I was born with PMDS that was dishonestly characterized as a "congenital inguinal hernia repair" (the scars are way too big and in completely the wrong location for that to actually be true).
Anyways, this is not a matter of inclusion/exclusion. Its a matter of people with PCOS generally outnumbering "amab transfems" by over 10 to 1.
By redefining the term like this, you are turning "amab transfems" into an extreme minority within the identity their label was coined to describe. It's a total appropriation of an identity label by a group that massively outnumbers the original people that label has been used to describe.
And it absolutely is appropriation in the truest sense of the word, wherein a group takes over a label or practice such that the original people that term was for can no longer meaningfully be understood by that term.
Intersex transfems obviously do exist, I am one after all, but I find it endlessly frustrating how often the term "intersex transfem" isn't being used to refer to transfems like me, but instead to refer to people who are blatantly attempting to appropriate an identity label.
I also find it endlessly frustrating the way people seem to invoke the spectre of intersex transfems as a cudgel against other trans women in discussions about transmisogyny. Trans women/fems are my sisters and my community, the people trying to weaponize me against them are not.
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cannabiscomrade · 1 year
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It's Gastroparesis Awareness Month
Hi! I have gastroparesis and I'm an insufferable know-it-all so let's talk about it!
Gastroparesis, or a paralyzed stomach, is a condition that causes delayed gastric emptying.
This can cause a range of symptoms and complications:
nausea
vomiting
early satiety/fullness
upper gastric pain
heartburn
malabsorption
dehydration
malnutrition
Gastroparesis can be treated by a gastroenterologist, but often needs to be managed by a motility specialist due to a lot of misconceptions about the condition. Providers, especially in the emergency department, will commonly misdiagnose gastroparesis as cannabis-hyperemesis syndome, cyclic vomiting syndrome, gastritis, food poisoning, etc.
There are several commonly known causes of gastroparesis like vagus nerve damage from diabetes, injury to the stomach, and stomach surgery like hernia repair or bariatric surgery. There are also idiopathic cases with no known cause. Other causes of gastroparesis are:
Connective tissue disorders like HSD and EDS (commonly hEDS and cEDS)
Post-viral (like COVID, viral gastritis, mononucleosis/Epstein-Barr)
Restrictive eating disorders
Autoimmune diseases like Systemic sclerosis (scleroderma), Lupus, Hashimoto's
Central nervous system disorders
Gastroparesis also has common comorbidities with conditions like:
POTS and other forms of dysautonomia (POTS, EDS, and gastroparesis are a common triad of diagnoses)
MCAS
SMAS (which can also present with similar symptoms to GP)
Intestinal dysmotility and esophageal dysmotility disorders (known as global dysmotility)
PCOS with insulin resistance
Endometriosis
SIBO/SIFO
Chronic intestinal pseudo-obstruction
Migraines
Certain medications like Ozempic and other drugs in that class act on the digestive system to delay gastric emptying, which has caused people to be diagnosed with gastroparesis. Some people report that their cases have not gone away since stopping the medication, others report feeling better after stopping. Other drugs like opiates and narcotics can cause delayed gastric and intestinal motility as well, but these are commonly known side effects of those painkiller classes.
Gastroparesis is classed based on severity and graded based on how you respond to treatment.
Severity of delay ranges from mild to very severe, and this is based on your actual stomach retention calculated at 4 hours into a gastric emptying study.
The grading scale ranges from one to three, one being mild and three being gastric failure.
There is no consistent single treatment that is proven to work for gastroparesis, and there is no cure. Treatments can consist of:
Diet changes (3 Step Gastroparesis Diet, liquid diet, oral sole source nutrition)
Prokinetic (motility stimulating) drugs
Anti-nausea medications
Proton-pump inhibitors
Gastric stimulator/gastric pacemaker
Pyloric botox and dilation
G-POEM/pyloroplasty
Post-pyloric tube feeding
Gastric venting/draining
Parenteral nutrition
IV fluids
Other surgical interventions like gastrectomy or rarely, transplant
Gastroparesis is a terrible disease and I hope that if any of these symptoms resonate with you that you can get checked out. I was misdiagnosed for a long time before getting a proper gastroparesis diagnosis, and all it took was a gastric emptying study. This is ESPECIALLY true if you're having post-COVID gastrointestinal problems that are not improving. I almost died from starvation ketoacidosis because of how serious my GP got in a short period of time post-COVID (I had GP before COVID), and now I'm tube reliant for all my nutrition and hydration.
Stay safe friends!
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justagalwhowrites · 1 year
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Lavender - Ch. 20
Life in the QZ gets worse and you're called outside the walls again. A continuation of Lavender Ch. 1-19 found on Tumblr here.
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Pairing: Joel Miller x Female Reader (broken up), Tommy Miller x Reader
Warnings: Mild smut, talk of extreme police action, description of injuries. No use of Y/N. Minors, DNI 18+ only
Length: 6.5k
Saturday, June 11, 2011 - One Year Later 
“I can only keep them off your back so long,” Elias was all but stalking you into an operating room as you made sure your hair was tucked below your scrub cap. “At some point…” 
“I’m not asking for you to keep them off my back,” you said, pausing at the door to go scrub in. “Don’t need to lie, don’t need make up an excuse. Tell them I think they’re fascists and that I’m not going to prop up their dystopian police state.” 
He sighed, pinching the bridge of his nose, looking exhausted. 
“They’re going to do it with or without you there,” he said. “This isn’t the hill you want to die on…” 
“I think it’s exactly the hill to fucking die on, actually,” you snapped. 
“And if they decide to execute you, too?” He demanded. “What then?” 
“Sounds like you’ll need to find someone to fill in for me on Saturdays,” you shrugged. He glared at you. “Can I go do this hernia repair now or are you going to keep trying to get me to be a tool in the continued downfall of humanity?” 
“Sometimes we can’t solve everything ourselves,” he said. “Sometimes we have to go along with awful things because we can do more good if we survive it.” 
You sighed. 
“They don’t know shit about medicine, right?” You said. He nodded once. “Great. Tell them you really just can’t spare me because I’m the only one who can do some stupid common surgical procedure so you need me here when I’m on duty. Because it’s just raining appendicitis here in the QZ. I imagine that will satisfy them and they can figure out how to check the pulse of someone they’ve hanged themselves without dragging me into it…” 
“Might work,” he sighed. 
“None of us should be a part of this,” you said. “Not just me. None of us should. It goes against our oath and even if it didn’t, it’s cruel and wrong.” 
“I agree,” he said. “But imagine how many people would die if they executed the entire clinic for insubordination. Oaths are complicated things. Sometimes, we have to look beyond just ourselves and consider what’s best for the whole.” 
“What’s best for the whole is FEDRA not executing people who have broken curfew one too many times because suddenly they’re dissidents,” you replied and then you sighed. “I do need to actually operate, I’ve got another hernia repair after this one… I’m sorry you’re stuck dealing with this shit. If you can keep me out of it while letting me keep my head, I’d appreciate it.” 
“Just… try not to call any of the guards fascist to their face, alright?” He said. “I’d rather you not end up shot in the street.” 
“I’ll do my best.” 
You went in to scrub and ground your teeth. Things had been steadily going down hill with FEDRA for the last six months. 
Patrols had increased drastically. They instituted a curfew about 10 months back that people didn’t take seriously at first - especially not the speakeasy crowd. Being home by midnight seemed outrageous. 
Then the executions started. 
They waited a few months before they started killing people. Gave people citations. Warned them that they’d be seen as conspirators with the Fireflies, the militarized resistance to FEDRA. From what you’d heard on your regular visits to the radio - you were still hoping against hope to find Cassie one day, though you were far less certain of her survival than you’d ever been of Joel and Tommy’s - that the fireflies were gaining strength across all the other QZs. People were angry that things weren’t getting better. You didn’t blame them. 
The first sign you had that you, specifically, needed to worry about getting roped in was when Andrew showed up to your apartment one evening, looking distraught. 
“Hey,” you frowned, pulling him inside. You led him to your couch and he sat down, almost in a daze. “What’s going on?” 
“Guards just came by, they took Jess, said they needed her, they’re doing something outside the walls, I don’t know what they need her for out there, it doesn’t make sense,” his voice cracked. “I don’t know what they need her for, what if something happens? She’s never been out there, she’s from Boston, she came right here, what if…” 
You pulled him into a hug, his arms going around your waist, his head buried in your stomach and he let out a choking sob. 
“It’s OK,” you ran your fingers through his hair. “It’ll be OK, they’ll look out for her. She’s going to be OK.” 
He spent the night that night, you sandwiched between him and Tommy (“This is weird, right?” Tommy said. “I mean, I’m fine with it, I just want to know that I’m not crazy.” “It’s weird,” you and Andrew said together.) Jess came back the next day, shaken but otherwise OK. It was the first of numerous trips for her outside the walls of the QZ. They were trying to use her to justify increased militarized presence through psychology, how that would help keep raiders under control. They were trying to prove their own worth. It was only a matter of time before they started roping in medical staff and teachers, too. 
Meanwhile, the Fireflies were getting more outspoken, more vocal and more violent. The tighter FEDRA seemed to squeeze, the more people wanted to back the Fireflies. It was so incredibly stupid on FEDRA’s part it took all you had to not walk off both your jobs. The only thing that kept you going was the fact that it was the best way you could help people. There were no schools or clinics that weren’t run by FEDRA. If you wanted to teach, if you wanted to heal, there were no other options. 
And you could use your connections to keep Tommy, Joel and Tess safe. 
They were still making their smuggling runs. You tried talking Tommy out of it every time he was about to leave for another one, all but begging him to stay with you instead of going out again.
“What, and leave Tess and Joel without all my skills to back them up?” He kissed your forehead. “C’mon. I’m basically the only reason they’re still alive, Sweetheart. Can’t let them go it alone.” 
So you kept them stocked in trauma supplies, stealing things from work with even greater regularity. Tommy kept showing up at your door battered and bruised. You’d taken to keeping a suture kit at your house, regularly needing to stitch his wounds closed. 
“I really fucking hate this,” you said one night, stitching a knife wound to his shoulder closed as you sat behind him on your bed. 
“Sweetheart,” he sighed. 
“No, I mean it,” you said. “I really hate it. I really hate seeing you hurt, I really hate patching you up, I really hate that you feel like you have to do this. I really fucking hate it, Tommy, and I wish you’d stop going out there.” 
You tied off the suture and got the kit cleaned up, stashing what was unused and still sterile back in your abused at home supply kit. 
“Hey,” he took your hand and pulled you between his legs, looking up at you. “I’m not goin’ out there for nothing…” 
“You’re going out there for ration cards,” you snapped. “Which is damn near nothing.” 
“Goin’ out there for shit we can’t get here,” he said, untying your robe and unwrapping you slowly, like you were a gift. He pressed his lips to your bare stomach, kissing up your body to your breastbone. “Some of it is important shit. And I have to try to keep Joel and Tess safe. I’m not tryin’ to get hurt, I’m really not tryin’ to hurt you. I’m doing it because it’s important and it’s the only damn way I got to do something important in this fuckin’ place.” 
“You’re important to me,” you said quietly, running your fingers through his hair. “Be important that way.”
“And you’re important to me,” he kissed your chest again. “But would you listen if I asked you to stop working at the clinic?” 
“I’m not risking my life at the clinic.” 
“You’ve got your brain to offer,” he half smiled up at you. “I’m a soldier. All I’ve got’s my body, so I’m usin’ it.” He tugged you closer. “Hopin’ you’ll let me.” 
You sighed, straddling him, kissing him, your arms draped carefully over his shoulders so as to not disturb his fresh sutures. 
“Really don’t encourage a lot of physical activity so soon after a medical procedure,” you said as he slid your robe to the floor and trailed his lips down your throat. “Should probably make you wait…” 
“Swear to God I’ll lose my mind if you don’t let me inside you,” he growled and you laughed. He took the opportunity to pick you up and lay you down with a surprised shriek. 
“And you really shouldn’t be doing that,” you said between kisses. “You’re going to rip your stitches out!” 
“Worth it.” 
He quickly pulled off his pants and thrust into you, making you gasp and moan. “Fuck, Sweetheart, Goddamn,” he groaned. “How do you always feel this fuckin’ good?” 
You ground your hips into him and he pressed his lips to the hollow of your throat with a delicious moan, starting to work himself in and out of you. He knew just how you liked to be fucked now, knew all the places inside you to find, how to work your clit, touch your skin, suck your nipples into his mouth. He pulled you tight and close to him as his pace increased and your orgasm built and you fell apart together, gasping for breath as he lay on top of you. You lifted your head just enough to see his sutures before collapsing back down into bed. 
“You got fucking lucky, Miller,” you panted. “Because I’d never fuck you again if you made me redo those stitches.” 
“I’d seduce you eventually,” he said, kissing your shoulder and sliding out of you. You rolled your eyes. “Only took me 10 years the first time…” 
Your relationship with Tommy had been one of the few, surprising bright spots in the last year. It was oddly easy, being with him. There wasn’t much about him that wasn’t easy. He was sweet, he was fun. It was what you’d imagined a relationship to be like in college before you’d started dating Joel. With Joel, it had been heady and intense from the beginning. You’d been head over heels for him from the start. There was no other option, it was all in or nothing and nothing didn’t feel like it was on the table. 
Tommy was the opposite. But that was, in part, because you couldn’t seem to actually fall for him. Even when you tried. Even when you focused on it. 
It didn’t seem to matter what he did. He took you dancing at the Speakeasy. He brought you bottles of wine from outside the QZ. He got you a small TV/VCR combo from the underground market and a copy of You’ve Got Mail on VHS. You were almost giddy with it while trying to tell him it was way too much. 
“Nah, I had to,” he smiled. “Found the tape when we were outside, knew how much you loved that movie. Then I just had to make sure you could actually watch the damn thing.” 
Tommy was probably a damn near perfect boyfriend. He just… wasn’t Joel. 
It didn’t matter that you hadn’t seen him - not even in passing - since the conversation near the clinic. Tommy always came to your place. You always dealt with him or Tess when it came to resupplying their medical stash. He had done a thorough job of making sure you never saw each other. 
And it didn’t make a damn difference. 
There was a second every morning Tommy spent the night where you thought you were waking up next to his brother. It was one moment - a sweet, if brief, moment - where everything felt right. It was one of your favorite moments of the day, the second there your mind tricked yourself that you were still with the person you loved most. And then came the letdown followed by the shame of it. 
“What the fuck is my problem?” You asked Andrew one afternoon as you worked in your lab. “Why can’t I get the fuck over him? Tommy… he’s basically perfect, why can’t I just love him? Why do I have to want the person who doesn’t want me back? And at what point do I fucking tell Tommy ‘hey, I know you’ve basically done nothing but be the best boyfriend a girl could ask for for the past almost year but I’m still in love with your brother who, as it happens, is kind of a dick.’”
“The heart wants what the heart wants, I guess,” Andrew shrugged. “I can’t imagine loving anyone but Jess. You could drop Halle Berry in front of me, make her love all the same shit I do and I’d still want Jess. Just how it works sometimes.” 
“This is such a fucking mess,” you groaned. 
“He said he understood what he was getting into,” he shrugged again. “So, if I were you, I’d keep it to myself until he drops the L-word on you. Then you’ll have to come clean. But, until then, I think you’re in the clear.” 
“Why am I this stupid?” You asked. “Seriously. I’m not this stupid with anything else, how was I this fucking stupid?” 
“Eh, you’re pretty stupid with at least some other things,” he said. You glared at him. “You are an absolute shit partner to have in bridge. You cannot strategize for shit, you are really stupid at bridge.”  
“Thank you,” you said sarcastically. “That makes me feel so much better.” 
“Always happy to be of service.” 
It had been a few months that you’d known, for a fact, that you couldn’t fall in love with Tommy. It didn’t matter how hard you tried, how much you wanted to, it wasn’t going to happen. You still weren’t sure what to do about it. 
You thought about it more when he wasn’t around. So you were thankful, that Saturday, to have surgeries to attend to. Tommy, Joel and Tess were outside the QZ yet again. Not only were you always worried the whole time they were gone, your brain went into overdrive trying to figure out what to do about the Tommy situation. Surgery was a pleasant distraction. 
It was late when you finally finished everything on the docket that day. The sun had set and you felt like you were ready to fall asleep standing up. 
“Want to come over later?” Andrew asked as you leaned against the front desk. “Feel like you might need the distraction.” 
“Yeah…” you sighed, looking out at the empty waiting room. “Probably a good idea…” 
The bell on the front door rang and you instinctively looked. Tess ran in, eyes wide, blood dripping from her shoulder. 
“Fuck,” you swore. You were running before you even really knew you were running, grabbing one of the clinic’s go bags. 
“Andrew,” you said as you went for the door. “Keep an OR ready for me, do NOT shut down until I get back, understand? See if you can get someone else to stay, please…” 
“I’ve got it,” he said. “Go!”
Tess led the way to the hole in the fence. 
“What happened?” You asked, the two of you walking as quickly as you could without drawing the attention of anyone patrolling. 
“We got pinned down, about a mile outside the QZ,” she said. “We took everyone out eventually but Tommy and Joel…” 
“Tess,” your voice cracked. 
“They were alive when I left,” she said. 
“Fuck!” 
You slipped out of the fence, past the search lights and the debris field, and you ran. 
You’d never been an athlete. You liked hiking and swimming and walking and were in fine shape but you’d never been a runner. That didn’t seem to matter then. 
You raced toward where Tess pointed you, her falling back. You started watching for the bodies that would be around wherever they’d stashed themselves, the telltale signs of the showdown Tess mentioned. 
When you spotted it, you practically tore into the small storefront, yanking a flashlight out of your pocket. It didn’t take you long to find Joel and Tommy. 
“Hey Sweetheart,” Tommy smiled a little at you. He was breathing heavily, his gun lying across his lap. Tess ran in behind you. 
“Hey, you idiot,” you smiled a little back. Joel was silent on the ground. “I need to evaluate you both and figure this out, try to stay conscious for me, OK?” 
“Anything for you,” he said, wincing a little. 
You took off your backpack and put your flashlight in your teeth, looking Joel over first. He was unconscious but he had a pulse and was breathing. Good signs, even though his breath was shallow. There was a penetrating chest wound and a compound fracture just above his left knee. 
“Jesus Christ, what the fuck did you guys get up to?” You asked, pulling out your stethoscope. “Do you know how fucking hard it is to break your femur?” 
“Had to jump off a roof,” Tommy winced. “Think I just sprained an ankle, Joel landed wrong…” 
“Wrong is a fucking understatement,” you muttered, checking his heart rate and his breathing. “Think he’s stable for the moment…” 
You moved to Tommy. 
“Why do I feel like we’re gonna be in a fight after this?” He asked. 
“Because we are,” you said. “Show me what’s wrong.” 
“Got shot,” he angled his leg with a groan so you could see the wound. It was to the thigh but had missed the major arteries, so not terrible. “Sprained the ankle…” 
“Tess,” you said. “I’m going to need…” 
There was a sudden gasping sound from behind you and you spun. Joel was still unconscious but he was struggling to breathe. 
“Doc!” Tess ran to him. 
“Move!” You ordered, rushing over and thrusting the stethoscope into your ears. You pressed it to his chest and listened. “Fucking hell…” 
You yanked your bag to your side and started ripping through it. 
“What?” Tess sounded panicked. “What is it?” 
“He had a fucking pneumothorax that I missed and it just changed to a tension pneumothorax,” you said, thrusting the flashlight to Tess. She took it, shining the light down at the bag. You found a scalpel and some tubing. 
“What’s that?” She asked. “What does that mean?” 
“It means there’s air in his chest that’s trapped and making it so his lung can’t inflate and I need to get it out or he’s going to fucking die,” you snapped, ripping his shirt open, sending buttons flying and pointing to a spot on his rib cage. You cut off a short length of tube. “Light here.” 
She obeyed and you made the cut, thrusting the tubing in to hold the incision open so the air could escape. He took a deep, shuddering breath and you relaxed. 
“Thank fuck for that,” you sighed, really looking at his face for the first time. 
You had to fight the urge to touch him. He was still so fucking beautiful it made your heart ache. Seeing him again was like getting hit by the train. All this time, you’d thought you’d just been holding steady, that you just kept loving him the same way you always had. 
You hadn’t. It had become a dull roar. It hung on the edges of everything but you could forget about it sometimes, when he wasn’t there to remind you. But the second you saw him, it was all consuming. You felt it in your skin, your chest, your marrow. Loving him was built into you like any other vital thing, there was no excising it. You could quiet it, avoid it but it would never cease to exist. Not for you. 
“Tess,” you said after a second. “Hold pressure on the lower chest wound, leave the one I just made the fuck alone.” 
You went to Tommy and started looking at his gunshot wound. 
“How are you feeling?” You asked. “Lightheaded?” 
“Nothin’ I can’t handle, Sweetheart,” he smiled a little. “Just having a hard time walking is all…” 
“Yeah, that’s going to be the sticking point here,” you glanced to Tess.
“What?” She asked. 
“You and I are going to have to do some heavy lifting,” you said. 
“I can do that,” she nodded. “I can do that.” 
You grabbed some gauze and a brace from your bag, wrapping Tommy’s gunshot wound and giving him some ankle support before you looked him in the eye. 
“Alright Miller,” you said. “Time to boot and rally, you were in the army, you can do this. You’re going to go with Tess to the fence and head for the clinic. Andrew is waiting for you guys.” 
“What about you?” He asked. 
“I’m going to wake up Joel and I’m taking him to the main gate,” you said, getting to your feet and offering Tommy your hand. 
“That’s a fucking death sentence, you can’t go to the main gate!” Tess gaped up at you. 
“We can’t get him through the fence,” you said. “There’s no way in hell, not with a compound fracture, an open chest wound and a pneumo. Main gate might be a death sentence for you but I can get us in. It’ll be tricky but I can get us in.” 
“That’s too big a risk,” Tommy said, taking your hand. You pulled him to his feet and slung his arm over your shoulder. “You can’t…” 
“I can’t just leave him out here,” you looked up at him, meeting his gaze. “I need to get him to the clinic before shit gets worse and that’s the only way…”
He cupped your face, looking in your eyes and you knew he saw it. What you felt. Why you couldn’t leave Joel behind. Not now, not ever. 
“It’s gonna get you killed, Sweetheart,” he said softly. 
“Don’t have a choice,” you smiled sadly. He pressed his lips to your forehead. 
“Tess?” You said, still looking at Tommy. She came alongside you and you held up his arm. She stepped into place. “Straight to the clinic, OK?” 
“You sure you’ve got Joel from here?” She asked. 
“Yeah,” you said. “Get yourselves out of here, we’ll be right behind. The clinic. Andrew’s staying there, he’ll help you.” 
She nodded and they left you there with Joel on the ground. 
You ran to his side, checking his breathing. Still solid. 
“Well at least there’s that,” you muttered to yourself. You quickly bandaged the wound at his chest. Looking closer, you were pretty sure it was a stab wound and not a bullet hole. You tried to keep it so it wouldn’t be jostled and have him start bleeding out. You moved onto the leg. 
You were going to need to at least partially set it, there’s no way you could carry him and he couldn’t put any weight on it the way it was now. It was just going to hurt like a bitch. Which is part of why you’d sent Tess and Tommy along. This part was not going to be pretty and there was a good chance he was going to scream loud enough to attract every clicker and raider in a five mile radius. 
“OK Miller,” you grabbed the length of tubing you hadn’t used to open his chest and put it between his teeth, making him bite down on it. “You can do this, you can get through this you stubborn asshole, you’re going to be fine, hear me? I will never forgive you if you’re not fine so you’re going to be fucking fine…” 
You grabbed the stuff to make a splint from your bag and set it up around his injured leg before you put one knee on his hip, hoping to help hold him still. 
“Here we go,” you took a deep breath. “One, two, three…” 
You winced as you started pushing his bone back into alignment. He gasped and flung his hand out, catching you in the side. 
“It’s me!” You said quickly, pushing the bone back into place. He groaned, the sound choking and gasping. “Bite down on the tube, I’m setting your leg enough that you can put weight on it, I know it hurts, I’m almost done just stick with me…” 
The bone disappeared below the skin and you stopped pushing. Joel went slack, panting for breath. You grabbed gauze and quickly bound the point where the break had come through the skin before setting the splint. 
“You still with me over there, Miller?” You asked, not able bring yourself to look over at him, afraid of what you might see. 
“Still here,” he was panting for breath. 
“Good,” you said, sitting back on your heels for a moment, out of breath yourself. You looked over at him. 
He was watching you, a soft look on his face. Your heart swelled with it.
“Hey Kid,” he said quietly. 
“Hey,” you half smiled at him. 
“Tess and Tommy?” He asked. 
“Headed for the QZ,” you said. “Sent them on ahead because they’re taking a different route in than us.” 
“What route are we taking?” He frowned. 
“Main gate,” you said, starting to pack up your supplies. 
“No,” he shook his head. “No, we can’t…” 
“You can’t without me,” you cut him off. “But I can. And you can’t get under the fence right now, Joel, not with your leg like that coupled with the fact that you’ve got a penetrating chest wound and I had to give you an incision to relieve a tension pneumothorax.” 
“Then you’re leavin’ me out here,” he started trying to prop himself up on his elbows and you went to help him. “Not riskin’ you bringing me in through the main gate…” 
“Shut the fuck up, Miller,” you said, helping him sit up all the way. He glared at you. 
“Always knew there was a risk of not comin’ back, Kid,” he said. His eyes kept ranging over your face. 
“You don’t get to just die on me out here,” you snapped. “We’re not doing that, got it? I didn’t come all the way out here to save your ass just to have you die on me so we’re going to the main fucking gate.” 
You stood up and put on the pack before offering him your hand. He glared at you. 
“I swear to God Joel if you don’t I will go to the main gate myself and make them come get you in a patrol truck,” you snapped. “Guessing this is a smuggling hide out for you, I will bring them here, I don’t give a shit.” 
“You’re the most stubborn damn woman I’ve ever met,” he muttered, taking your hand.
“Put as much weight as you can on the good leg,” you ordered. He glared at you. “What, you’re saying dumb shit like I should just leave you out here to die so I have to state the obvious. Ready?” He nodded once. “Alright, one, two, three.” 
You pulled and he hissed in pain as you helped him up. He almost collapsed and you caught him with your shoulder tucked into his armpit. 
“See?” You said as he panted for breath. “We’ve got this.” 
It didn’t take long for you and Joel to fall into a rhythm that kept his pain from getting worse as you walked. It was slow going but you made steady progress. 
“Why’d you do this?” He managed after you’d walked half a mile. 
“What do you mean?” You frowned. 
“Come out here,” he said. His breaths came in short, gasping pants. “Save me. Why?” 
You were quiet for a moment.
“You know why,” you said eventually. 
He ground his teeth. 
“We’re not good for each other,” he said. 
“I know.” 
“Told you I didn’t want to see you.” 
“Trust me, I remember.” 
“You’re with Tommy.” 
“I know.” 
He growled. The searchlights of the QZ perimeter were getting close. 
“When we get up there, let me do the talking,” you said. “Keep your mouth fucking shut. I’m going to get us through this in one piece but you have to do what I say for a change, got it?” 
He just grunted in affirmation. 
The guards spotted you quickly. It wasn’t like you were trying to hide. 
“Hands up!” Their guns were drawn. You raised the hand you could. “I fucking said hands up!” 
“Can’t put them all up, I have an injured man with me,” you called back. “I’m a doctor at the clinic, I got word of an injured person outside the fence, I’m bringing him in for treatment…” 
The voice shifted. 
“Doc? That you?” 
You squinted against the searchlight as the guard came closer. You smiled a little. 
“Hi Tim,” you said. You’d known there was a good chance one of your former students would be at the gate. It was just luck that it was one who remembered you fondly. He lowered his gun. 
“What are you doing out here?” He asked, coming over and taking Joel’s other side. Joel just gaped at you. 
“Helping the injured,” you jerked your head in Joel’s direction. “That whole hippocratic oath thing, I couldn’t just ignore it once I knew about it. I was hoping you could let us in here.” 
“Doc, you left the QZ…” he said quietly. 
“I know,” you said. “And I don’t want to compromise you or your job in any way. But I had to do my job, too. If you need to write me up or take me into custody you can, but I need to get this man to the clinic first…” 
He looked Joel over. 
“You’ll make sure he does intake?” He asked.
“Of course,” you replied. He pulled out a scanner and took a sample from each of you. The screen glowed green. His jaw twitched. 
“Alright,” he said. “But we have to move quick and you never saw me, OK?” 
“Thank you,” you said, moving as quickly as Joel would allow. Your heart was in your throat until you were through the gate. 
“Get to the clinic by curfew,” Tim said. “You’ve only got 20 minutes.” 
*** 
Joel wasn’t sure what hurt more, his leg, his chest or seeing you. 
He’d managed to avoid you for a year. A whole year of not seeing your face, the longest he’d gone since he’d come to the QZ. He hated every goddamn second of it. 
It was the right thing to do, though, trying to let you go. He kept fucking failing you and he’d keep fucking failing you the more he was around you. And being around you hurt. 
He wasn’t sure it would be better or worse if you were his. Everything he’d lost was all tied up in you. The life he’d been inches away from having wound around your limbs and lips and hair. He didn’t think he could just be next to you and know that. But fuck, not seeing you… 
One of the hardest things he’d ever had to do was say goodbye to you that day on the street. But he couldn’t keep drowning you in his misery. As much as he’d hated Tommy for touching you, for picking you, he couldn’t hate him for pointing out the obvious. He’d been cruel to you. As much as he was angry, hurting, wanting to hate you, you didn’t deserve that. You deserved better than what he could give you. You were too much for him to take and he couldn’t seem to stop hurting you. It had to end. 
But he was relieved that he could gauge how you were doing by Tommy’s mood. He didn’t like much else about the fact that you were with him but when Tommy came home from seeing you in a good mood, he knew you were happy. If he were a little off, he knew you probably had a bad day at work. If he were irritable it meant you were upset about something. He didn’t dare ask what but he knew it was something. 
It was strange, knowing you existed in the world but not knowing much of anything about it. He clung to what he did know. Wished he didn’t want to know. Didn’t want to see you. Wished he didn’t want to look at you. 
But now you were close - so fucking close - and it hurt. Andrew helped you get him onto an exam table and he could barely hear what you were saying, giving him some kind of pill and making him breathe in some shit that made his head swim as you made him lie down. 
“Don’t want you workin’ on me,” he managed. You frowned. 
“Well I’m the only option you have, Miller, so suck it up,” you said, not looking up from your work at his side. 
“Don’t want to want to look at you,” he muttered. 
“Then don’t look at me,” you said, stitching up his side. 
“Can’t help it,” he mumbled. “Too fuckin’ pretty…” 
“Sounds like a personal problem, Miller,” you said. “Stop talking so much, you’re making it hard to sew.” 
“Sorry,” he said. “Just missed you.” 
You looked at him for a moment. 
“Missed you too.” 
You went back to sewing. He just watched you work, soaking up what he could of you. He didn’t know when he’d see you again. He wanted to hold onto this. 
He fell asleep watching you heal him. 
***
By the time you finished with Joel, you were exhausted. You were going to have to just sleep in an exam room, it was past curfew and you wouldn’t want to be far, anyway. But, for that moment, you just wanted to slump against the wall in the hall, not able to make yourself move any further. 
You slid to the floor, leaning your head back against the wall and taking a deep breath. Your legs and arms ached. You were pretty sure your abs would, too, in the morning after you hauled Joel all that way. 
Tess came out of an exam room and looked surprised to find you on the floor before siting next to you. 
“How is he?” She asked. 
“He’ll be fine,” you sighed. “Won’t be able to make any runs for at least two months while his femur heals, though.” 
She nodded slowly. 
“Can I ask you something?” She asked after a moment. 
“As long as it’s nothing philosophical,” you replied. “Brain is fried. Ask me how to do surgery, that I can do with my eyes closed.”
“What are you doing with them?” She asked, watching you. You frowned. “You’ve got Tommy wrapped around your finger. You’ll put your life on the line to save Joel. What are you doing with them?” 
“Nothing that I really have a say in,” you looked at her, too tired to try to dodge the question. “If I could stop… feeling the way I do, I would. I hate it, I hate what it’s done to me, what it’s done to him, what it’s doing to Tommy and I just… I don’t want it anymore. I don’t want to feel like this anymore. I want it to be over. 
“I keep thinking that loving people, that’s the reason we’re here. That’s what we’re supposed to do with life, we’re supposed to love people as much as we can for as long as we can but that doesn’t work anymore, does it? Maybe it did before all this happened. Maybe it didn’t and I was just too naive to know it but that’s what it felt like we were supposed to do. But I can’t keep loving him and I can’t just let this keep going with Tommy and I just….” Your voice cracked. You were too tired to try to fight off tears. 
Tess tugged you over so your head was on her shoulder. You blinked in surprise. 
“I was married before,” she said. “I told you that. I didn’t tell you that I had to shoot him, in the outbreak.” 
“Jesus…” you breathed. 
“Even knowing how it was going to end, I’m glad I had it while I did,” she said. “But I’m still too afraid to ever love someone like that again. Love like that wrecks you, utterly destroys you. It’s why I make the choices I make now. And yeah, it’s safer but my God is life sweeter when you have it.
“Joel’s broken like that, too,” she said. “Part of why we get along. I’m not sure he’ll ever get his shit together. It’s too big a risk for him. But I think you still can figure it out. It hasn’t broken you yet. You still wear ribbons in your hair. You’re not broken yet.” 
You stared at the wall for a moment. 
“I need to talk to Tommy,” you said eventually. 
“I’m really sorry, Doc,” she said quietly. 
“Me too.” 
You made yourself stop crying before you knocked on Tommy’s door and opened it quietly, half hoping he would be asleep when you went inside. 
No such luck. 
“Hey, Sweetheart,” he half smiled at you. 
“Hey,” you half smiled back. “How are you feeling?” 
“Been better,” he shrugged. “Been worse.” 
You nodded. 
“The nurse - Kristen, I think? - said Joel was fine,” he said. You nodded again. 
He just looked at you for a moment, like he was memorizing you. 
“I never had a shot, did I?” He asked. 
You smiled tightly. 
“I told you I wasn’t sure I could ever love anyone else,” you said softly. 
“You did,” he nodded. “Just hoped I’d convince you.” 
“You and me both.” 
He smiled at that and held out his hand for you. You took it, letting him tug you to him. 
“You’ve been the most fun I’ve had since the end of the world,” he said. “Glad we got to figure it out.” 
“Me too,” you sniffed, trying not to cry. 
He smiled and kissed your forehead. 
“Go sleep,” he said. “You look like you’re about to fall over.” 
“Yeah, I think I am,” you laughed. “Your brother is fucking heavy, I’m never hauling him anywhere again…” 
He laughed at that, too. You looked at him. 
“I really tried,” you said quietly. “But…” 
“I know,” he said. “Now get out of here before I do something stupid.” 
You nodded and went for the door. 
“Hey,” he said. 
You stopped and turned back to him. 
“Here’s looking at you, Kid.” 
You smiled, shook your head a little, and left him behind. 
A/N: Hi guys! I hope you enjoyed this chapter as things ramp up as we build into the core story of TLOU. Tommy will still be around for a bit but boyfriend Tommy is over. So sorry for all the Tommy Stans! This was always the plan, though. He was here to help Joel figure his shit out and give Doc a way out of her single-mindedness when it comes to Joel.
I do have a tag list, please let me know if you'd like to be added, just comment below! If you've asked and haven't made it on, please ask again. I'm trying to get everyone added but I think people may have slipped through the cracks because I have no organizational system for this.
Thank you so much for reading and commenting and letting me know how the story makes you feel! It's a joy to write for you all, thank you for hanging out with my characters :)
Taglist: @paleidiot @ayamenimthiriel @ginger-swag-rapunzel @drewharrisonwriter @flugazi @pedropascalsbbg @taoyuji @starstruckmusiciansartghost @splendsay @bigboiseason123 @jpbplvr @ashleyandring @mrsyixingunicorn10 @sloanexx @ninaminaromina @lady-bellyn
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obstinatecondolement · 11 months
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My GP thinks I probably have a hiatal hernia which may or may not need to be repaired surgically depending on how I respond to treatment and lifestyle changes. Honestly? Kind of not upset, because if this is a fixable issue and not just the Well, Your Tummy Is Just Like That :) runaround I have gotten since I was twelve fucking years old then that would be great.
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chc9 · 2 years
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Best hernia surgeon in Chennai | Hernia surgery hospital in Chennai | Chennai Hernia Clinic
Chennai Hernia Clinic provide hernia surgery by Dr.B Premkumar , famous laparoscopic hernia surgeon in Chennai. Choose the best affordable hernia treatment in Chennai by our experienced doctor. Book your consultation today.
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dandeliiontea · 4 months
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Something they don’t tell you about pregnancy is that sometimes your abs separate so much they leave a big gap between them and years down the line you’ll have a hernia that you then have to have surgically repaired.
Love being a mom.
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shubhragoyal · 10 months
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The Future of Fertility: Exploring Breakthroughs in Endoscopy and Laparoscopy
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In medical science, the future of fertility and reproductive health is experiencing a revolutionary transformation through the remarkable advancements in Endoscopy and Laparoscopy. These innovative medical procedures have become instrumental in diagnosing and treating various reproductive health issues, offering hope to countless individuals and couples worldwide. In this article, we delve deep into the world of Endoscopy and Laparoscopy, uncovering their benefits and trends and why choosing Dr. Shubhra Goyal can indeed be a game-changer in your journey toward optimal reproductive health.
Laparoscopy and Endoscopy - what are they?
Due to their accuracy and efficacy, minimally invasive medical treatments like Endoscopy and Laparoscopy have become extremely popular in recent years. These procedures use specialized tools fitted with small cameras and lights that enable doctors to view and access inside organs without the need for open surgery.
Benefits of Endoscopic Examinations!
The following are some benefits: -
Minimal Scarring - Endoscopy and Laparoscopy require just small incisions, unlike traditional surgical techniques that demand extensive incisions. Due to the minimum scarring produced, patients recover more quickly and enjoy additional aesthetic benefits.
Less Pain and Discomfort - Patients who undergo endoscopic procedures often report less pain and discomfort following the operation. This is because these techniques are less intrusive than standard operations and result in less tissue damage.
Shorter Hospital Stays - Compared to conventional equivalents, endoscopic operations often require shorter hospital stays. Patients may resume their regular daily routines and activities more quickly as a result, which also lowers healthcare expenditures.
High accuracy - Using cutting-edge technology in endoscopic exams gives surgeons a degree of accuracy never before possible. They can traverse and treat delicate and difficult-to-reach locations with outstanding accuracy thanks to their precision, which ultimately improves patient surgery results.
Moving ahead, let's discuss,
Top Upcoming Trends in Endoscopy and Laparoscopy
The areas of Endoscopy and Laparoscopy are examples of the ongoing change taking place in the world of medical science. The following are some of the most notable new developments that are influencing how these processes may develop in the future:
Innovations in Endoscopic Imaging Technology - The endoscopic imaging technology industry is expanding quickly. This includes the creation of 3D imaging systems and high-definition cameras. These developments considerably increase diagnosis accuracy by providing surgeons with an incredibly thorough and accurate picture of inside organs.
Read More: https://www.drshubhragoyal.com/welcome/blogs/the-future-of-fertility:-exploring-breakthroughs-in-endoscopy-and-laparoscopy
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jamiebluewind · 4 months
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I'm in a bit of a pickle.
The friend I'm visiting had a cat that walked into her yard and adopted her a couple months ago. She had kittens soon after. The solid black kitten is going to a friend back in Virginia, but... then we have her brother
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His name is Eclipse, my roommate/best friend and I adore him, and he has a birth defect.
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You can see it's a pretty bad umbilical hernia. He seems to be otherwise healthy, the area is soft, he has no fever, and his appetite is good, but the hernia is big enough that it PROBABLY won't close on its own without surgery.
My best friend and I didn't come down planning on taking a kitten for ourselves. There's a thousand reasons not to. I mean, we both have a cat of our own, our current apartment will only allow two animals (meaning he would have to stay with her mom a few months), our lease goes for a few more months before we can move, and we are on a tight budget, but the little guy has taken up with us and he has such a big personality that we don't want to leave him behind.
The other factor is that this area has a surplus of kittens and not a lot of programs. We came down to visit, but also to pick up the little girl to take her to a good home. We didn't know about his health issue or just how charming he was. Nobody here wanted a kitten with a lump and a big surgical bill from the word go, so his only prospects are currently us, our friend keeping him outdoors (in a neighborhood with a feral cat colony), and... that's it.
We're worried how our cats will react (they are best friends), what his needs will be (we're looking for someone to check him before we transport him back to VA but we have no experience with hernia repair), and if we can convince my roommate's mom to keep him until we move in a few months.
It's 2 am and I'm wide awake thinking of everything that could go wrong, but I want to at least TRY to give him a good life. So I guess I'm just screaming into the void to get all my thoughts out, but also hoping somebody out there knows what to expect and is willing to give me some pointers. I'm scared of what the vet will say. I'm scared of complications and everything that could go wrong. I'm disabled and made of anxiety and cognitive distortions. Am I even up for whatever is coming my way?
I hope so.
I really hope so.
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drpriya · 6 months
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Laparoscopic surgery, also known as minimally invasive surgery, is a modern surgical technique where small incisions are made in the abdomen, through which specialized instruments and a camera are inserted. Surgeons use the camera to visualize the internal organs on a monitor and perform the surgery with precision.
This approach typically results in less pain, shorter recovery times, and smaller scars compared to traditional open surgery. It's commonly used for procedures such as gallbladder removal, hernia repair, and appendectomy.
The procedure for laparoscopic surgery typically involves the following steps:
Anesthesia: The patient is given general anesthesia to ensure they are unconscious and feel no pain during the surgery.
Creation of small incisions: Several small incisions, usually around 0.5 to 1.5 centimeters in length, are made in the abdomen.
Insertion of trocars: Trocars, which are narrow tubes with valves, are inserted through the incisions. These serve as ports for the insertion of surgical instruments and a camera.
Insufflation: Carbon dioxide gas is pumped into the abdomen through one of the trocars to create space and lift the abdominal wall away from the organs, providing better visibility and working space for the surgeon.
Insertion of laparoscope: A laparoscope, a thin tube with a camera and light source, is inserted through one of the trocars. This allows the surgeon to view the internal organs on a monitor in real-time.
Surgical procedure: Specialized instruments, such as graspers, scissors, and cautery devices, are inserted through the remaining trocars. The surgeon performs the necessary surgical steps guided by the images from the laparoscope.
Closure: After the surgery is completed, the instruments and laparoscope are removed, and the carbon dioxide gas is released from the abdomen. The small incisions are closed with sutures or surgical tape.
Recovery: The patient is monitored in the recovery room until they wake up from anesthesia and are stable to be discharged or transferred to a hospital room for further observation.
Throughout the procedure, the surgical team works together to ensure the safety and success of the surgery.
Get the best treatments for various diseases and full body health checkup at the best hospitals in India.
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porterdavis · 1 year
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Aged out
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I was talking to my respirologist the other day, trying to get a surgical consult for repairing a large abdominal hernia I've had for decades. I thought I'd ask them to throw in the bariatric staples to help get rid of the extra covid pounds.
He cleared his throat a little, squirmed a bit, and finally said 'Mr Davis, you've reached the stage of your life where they won't consider such surgery'.
Translation -- you're too old and they won't spend the money on you.
Having considered it for a few days, I guess I agree with them. Just put me out on a park bench with my hearing horn and a spit cup.
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catwingsathena · 10 months
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14. If you could see one of your fics adapted into a visual medium, such as comic or film, which fan fic would you pick?
17. What’s something you’ve learned about while doing research for a fic?
22. Do you know how your fic will end before you start writing?
Thanks for the ask!
14. Thistle, you already know the answer to this one. A World of His Own would make an excellent comic. Jailbreak Squad all the way.
17. There’s a LOT I could go with, but I’m gonna have to say the two people in history know to have performed an appendectomy (surgery to remove the appendix) on themselves.
Evan O’Neill Kane, American physician and surgeon active from the 1880’s to the 1930’s, specialized in emergency trauma surgery for railroad workers, and was known for several innovations in this field, including weaving bandages from asbestos (which allowed them to be quickly sterilized with fire in the days before pre-sterilized bandages were available), multiple-needle subcutaneous (under the skin) infusions to replace IV infusion after hemorrhages, and a type of headlamp for nighttime operations. He was an advocate of local anesthesia instead of general anesthesia (which at the time was primarily ether) for some major surgeries, particularly in cases where the patient had a medical condition that made the use of ether unsafe. To experience an appendectomy from a patient’s perspective, he performed the procedure on himself under local anesthesia. He had previously amputated one of his own fingers, and would go on to repair his own inguinal hernia. He was also known for tattooing a small letter K in Morse code next to the closed surgical incision on his patients, and for tattooing mothers and new babies with small matching marks in inconspicuous places to prevent mix-ups. This man was deeply unhinged and I respect the hell out of him.
To talk about someone equally worthy of deep respect and admiration but far more reasonable, Leonid Ivanovich Rogozov was a Soviet physician stationed in Antarctica when he came down with appendicitis. As the only doctor within a thousand miles, after conservative treatments failed and his condition continued to worsen, he decided to operate on himself, which he did with the aid of novocaine, a meteorologist and a driver as assistants, and a mirror which he abandoned midway through the procedure due to the difficulty of adjusting to the reversed movement, relying on touch instead. The operation was completed in about two hours, and Rogozov was back to normal duties in two weeks.
People are fucking awesome.
22. Usually. I’m definitely more likely to finish the story if I do. Of course, more often I know exactly how the story is going to end but not how I’m going to get there, which presents its own problems… and there’s always the possibility that the story will throw me a hard left turn halfway through. It’s all part of the fun!
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