#wonder if i should visit a cardiologist or something....

[mutedwolf]

Haven't had one of these waking up with heart racing nights in awhile

[heartguy87]

Josh’s Heart: Part 1 - The Exam

[This is a short story that I’ve had on the go for a while now, working on it on and off when I felt inspired and I figured I should finally share it here. I purposely left it open-ended as I’ve got some ideas for where to take it next. Let me know what you think! (please be gentle - it’s my first story and my ego is fragile!)]

----

Josh sat nervously in the waiting room of the cardiologist’s office. His father had recently been diagnosed with a heart condition and the family doctor decided to send Josh for a series of tests on his heart.

As he sat there and looked around and saw another young man about his age - 18 years old or so. Pretty cute, Josh thought to himself, wondering what he was here for. Just as Josh looked over, the young man returned his glance, held it for a second, then looked back down at his magazine.

“Matthew Johnson?” the nurse called.

“Yes?” the young man replied.

“The doctor is ready for you now. Please follow me.”

He put down the magazine he had been reading, stood up, and walked toward the hallway off to the side of the reception desk where the nurse stood waiting. Following the nurse down the corridor to an exam room, he glanced back at Josh, still seated in the waiting room, with a slight smile.

Josh felt a stirring in his stomach but caught himself.

Probably just being friendly, he thought.

----

As the minutes passed, he became even more anxious and just wanted to get it over with. Not just because he was worried there was something wrong with his heart, but also because, ever since he was young, he’d always felt strange at doctor’s visits. As he got older, the vague sense of nervousness became a mix between embarrassment, anticipation, and arousal. At his last couple of yearly physicals, he’d tried so hard not to get an erection while the doctor examined him. Last time, despite his best efforts, it happened while the doctor listened to his chest. If the doctor couldn’t tell he was aroused from his quickening heartbeat, he could certainly tell from the visible wet spot forming on his white boxer briefs. “Why the fuck did I have to wear white boxers that day?” he thought to himself.

As if on cue, the same nurse as before appeared at the reception desk, clipboard in hand.

“Josh Richards?” she called.

Josh sat upright from slouching in his chair. “Yes, that’s me.”

“Could you please follow me? The doctor is ready to see you now.”

He got up from his chair and shuffled down the tiled hallway behind the nurse. She opened the door to a small room with a chair and a curtain – one door down from the one he’d seen the young man go into earlier.

“Good, now if you’ll please remove your clothes except your underwear and socks and put this on with the opening in the front,” she said, handing him a folded blue paper gown. “You can leave your clothes on the chair in the corner.”

Fuck, he thought. He was hoping he would just have to lift up his shirt and take a few deep breaths - not get fully undressed. A fresh wave of nervousness washed over him.

“Okay,” he gulped.

The nurse left the room and shut the door behind her.

Once she was gone, Josh sat down and slowly untied his shoes, took them off, and set them under the chair. Crossing his arms and grabbing the hem of his t-shirt, he pulled it off and tossed it onto the chair. He stood up, unbuckled his belt, and unbuttoned his jeans. With a sigh, he pulled down his jeans and stepped out of them – now covered only by his white Calvin Klein boxer briefs and grey athletic socks.

Damn, it’s chilly in here, he thought. He unfolded the paper gown, struggling for a few seconds to figure out the right way to put it on. Eventually, he got it, put his arms through the holes, and pulled it over his shoulders. The gown hung open in front and went down just past the hem of his boxer briefs. Josh saw there were a couple of ties to keep it somewhat closed and quickly knotted them together.

There was a knock on the door. “How are you doing in there, Josh?”

Feeling more than a little silly in his flimsy paper gown, Josh opened the door to find the nurse standing there.

“All ready?”

“Yep.”

“Okay, please follow me across the hall.”

He stepped out into the cold hallway, following a couple of steps behind the nurse. Just as they reached the door of an exam room, Josh looked down the hall where a door had been left ajar.

Through the narrow opening, he caught a glimpse of the young man from before. He was reclined on an exercise bike of some kind, a dozen electrodes attached to his smooth chest with grey wires connecting to a monitor. He was peddling hard and his chest was shiny with perspiration. Beside him, a technician stood holding an ultrasound probe and pressed it into the left side of his chest as sweat dripped down the young man’s face and neck. His eyes met Josh’s through the crack in the door.

Josh stood transfixed for a moment. Then the door shut abruptly from the inside, cutting off the view.

“Josh?” the nurse called after him.

He realized he didn’t know how long he’d been staring, or what the nurse had said to him.

“Sorry,” he said.

“It’s okay. I was just saying you can take a seat on the exam table and the doctor will be with you in a few minutes.”

-----

Great, more waiting, he thought.

The paper of the exam table crinkled underneath his butt as he shifted his weight. He glanced around the exam room. On the counter, there was laid out a blood pressure cuff and a stethoscope with a shiny metal chest piece. He gulped again nervously, as he knew these instruments would be used on him shortly. Over in the corner, a metal cart holding an EKG machine could be seen, its wires all coiled up. A box containing packages of electrodes sat on the bottom shelf. He’d seen machines like that on TV of course and wondered if it was a test he’d be subjected to today.

But before Josh could think about it too much, the doorknob turned, and in walked the doctor.

“Hiya Josh, I’m Dr. Smith. How are you doing today?” he asked

The doctor was much younger than Josh was expecting. He looked like he was maybe in his late 20s. He had dark hair, green eyes, and a small amount of stubble covering his jaw. Beneath his white doctor’s coat he wore a light blue collared shirt, the top button undone. A few dark chest hairs were visible in the V of his shirt, hinting at a more substantial patch of chest hair underneath.

“I’m good,” Josh replied nervously.

“That’s great to hear.” Dr. Smith flipped open a folder he’d been holding. “I see in your file that there’s a family history of heart conditions and you’re here to get checked out, is that right?”

“Yeah, my dad has a heart condition...I forget what it’s called...and he had surgery a while ago. The doctor said our family should all get checked to make sure we don’t have the same condition.”

“Hmm, well you can’t be too careful,” Dr. Smith replied. “Have you experienced any chest pain? Any symptoms I should know about before we get started?”

The doctor turned to the desk behind him and picked up the blood pressure cuff and stethoscope. He draped the stethoscope around his neck and turned back to Josh. “All right, I’m going to take your blood pressure now, Josh. Please relax your arm as much as possible.”

He ripped the velcro open and slid the cuff onto Josh’s right arm above the elbow. After cinching it snugly around his arm, the doctor refastened the velcro. Taking the stethoscope from around his neck, he placed the earpieces in his ears and slid the chest piece just underneath the cuff on the inside of the young man’s elbow. Squeezing the bulb several times, he inflated the cuff tighter until the brachial pulse was no longer audible, and noted the reading on the gauge. After a couple of seconds, he slowly released the air to deflate the cuff until he could once more hear Josh’s pulse.

“110/70. That’s good.”

-------

“Okay Josh, you can lie back on the table now.”

The doctor raised an extension at the end of the table and locked it in place. “There, that’s better for a tall guy like you,” he said. He switched on an overhead light.

 “I’m also going to have you open up your gown so I can take a look at your chest if that’s all right.”

The moment he’d been dreading. “Okay,” Josh replied. He sat up, and fumbled with the strings on the front of the gown, pulling the end of the knot to untie it. The doctor reached over and pulled both sides of the gown open, exposing Josh’s chest.

Josh inhaled nervously. He had always felt weird taking his shirt off in front of others. This made him more nervous because he knew his bare chest would be the focal point for the next couple of hours.

His chest was mostly smooth, milky white skin - hadn’t seen much sun in a while. He had some muscle tone, but not much. On top of his slightly defined pecs, a few hairs sprouted around his nickel-sized pinkish-brown nipples which had become semi-erect from the cool air in the room.

“It’s okay,” Dr. Smith said reassuringly, sensing Josh’s trepidation. “I’m just going to take a look at your chest, and later on listen to a few spots.”

The doctor began palpating near Josh’s collarbone, pressing his fingers lightly into the young man’s pale skin, which had begun to show goosebumps.

The doctor took the stethoscope from around his neck and placed the earpieces in his ears. “Sorry, this may be a bit cold.”

Josh shuddered as the metal chest piece made contact with the skin, near the top of his left pec. Fucking right it’s cold, he thought. The doctor held it there momentarily, listening intently. He slid the chest piece down an inch or so and repeated. He then moved the stethoscope to listen to the mitral valve - his thumb grazing Josh’s left nipple as he positioned the stethoscope. Josh shivered from the sensation, but he would’ve been lying if he said it hadn’t excited him just a little bit. He wondered if the doctor had noticed his reaction.

“He’s sure taking his time, '' Josh thought to himself as the doctor slowly inched the diaphragm of the stethoscope between different points on Josh’s chest, before listening to each spot again, this time with the stethoscope’s bell. This part of the exam lasted nearly ten minutes.

“All right Josh, can you please roll onto your left side, arm behind your head?”

Josh did as he was told, shifting onto his left side. The gown fell open as he turned over, revealing his armpit as slightly damp with sweat. The doctor’s arm came around from behind Josh to place the stethoscope over his mitral valve.

Okay good, you can lie on your back again. Dr. Smith’s hand moved toward the waistband of Josh’s boxer shorts. “Just going to pull these down slightly so I can listen to your femoral pulse.” Josh breathed in sharply and the doctor’s fingers hooked the elastic waistband and pulled them partway down, exposing his pubic region which was covered in dark curly hair. Josh was now incredibly aware of his semi-hard cock throbbing slightly underneath a thin layer of material.

----

“All right, Josh. We’re going to do an EKG now.”

Josh watched as Dr. Smith walked over to the corner of the room where the machine sat on its cart and wheeled it over beside the exam table. The doctor plugged the power cord into a nearby outlet and then pressed a green power button. He uncoiled the bundle of grey wires and laid them over the machine. From a box underneath the machine, he took an alcohol wipe.

“I’m just going to clean off a few spots on your chest so the electrodes make good contact,” he explained as he opened the gown completely and touched the moistened wipe to the young man’s chest. Josh shivered from the cool sensation of the alcohol as it evaporated.

Reaching into another box, the doctor pulled out a sheet of round electrodes. Standing beside the exam table, he began pressing his fingers into Josh’s rib cage to locate where to position the electrodes. He peeled the electrodes – made of foam, with a wet gel in the center – from their paper backing and placed them on Josh’s chest: one on his right pec, one on his left pec, several in a row below his left pec around to his left side almost under his arm. Hope they don’t hurt too much when they get taken off, thought Josh.

The doctor untangled the grey wires and attached the leads to the electrodes. “Okay Josh, now if you can just lie still for a minute while I take a reading.”

Josh did as he was told, breathing in and out slowly, trying not to let his quickened heart rate betray how aroused he was by how much attention was being paid to his heart. The doctor pressed the start button on the machine, which caused it to begin spitting out a print-out tracing of Josh’s heart rhythms.

------

“All right Josh, there’s one more test I’d like to do today and that’s an echocardiogram - an ultrasound of your heart. If you will just follow me down the hall, we’ll get that done, and then you’ll be all done for today.”

Josh sat up on the table, tied his gown, and stepped down onto the floor.

Dr. Smith opened the door and walked out into the hallway. Josh followed behind him, holding his gown closed with one hand. 

As they stepped out of the exam room, the other young man from before walked past them toward the reception desk. His face still had a hint of redness, and Josh could smell the fresh sweat scent coming off him as he passed. As they made eye contact, Josh felt a twinge in his young cock beneath his boxer shorts.

----

The doctor opened a door to another exam room and motioned Josh inside. The lights were dimmed but an adjustable exam table could be seen, with an ultrasound machine next to it, its monitor emitting a blue glow. The handsome technician from before entered the room.

“Lie down on the table on your side facing towards the machine please,” the technician said.

Josh did this. The technician pulled the ties of Josh’s gown and opened it, exposing his chest once more.

He took a squeeze bottle of ultrasound gel. “This is going to be cold.”

He popped the lid open and squeezed out a stream of transparent blue gel. Josh took a sharp breath in as the freezing cold gel made contact with his chest.

The technician pushed the transducer against Josh’s chest wall, moving it back and forth while he watched the monitor to get the best image.

The doctor put the earpieces of his stethoscope in and pressed the chest piece against Josh’s chest below his left nipple. Josh could feel his heartbeat quicken. His semi-erect cock pulsated in his underwear, barely covered by the gown. Pre-cum soaked through the fabric and betrayed his arousal.

Dr. Smith gave the technician a knowing glance. This young man was going to be a perfect candidate for their research study.

—--

Once the exam was over, the tech handed Josh a small towel to clean himself off with and began removing the electrodes from his chest.

“Well Josh, your heart appears to be in relatively good shape, however, we did observe an interesting anomaly that I’d like to look into further.”

“Fuck,” Josh thought, “I knew it. I’m gonna end up having the same heart condition as Dad.”

The doctor detected Josh’s worried expression and quickly added, “Oh it’s nothing to be overly concerned about. In fact, it’s more of a scientific curiosity than anything.”

“Right,” Josh thought to himself, “like that makes me feel any better…”

He sat up from the exam table as Dr. Smith pulled a chair over and sat down facing him.

“Josh, I’m currently running a research study with the university that focuses on measuring cardiovascular and other physiological responses to various sexual stimuli. Judging by your rather noticeable bodily ‘response’ during the echocardiogram test, I think you’re a perfect candidate to participate as a research subject. What do you think? Interested in participating?”

Josh stared blankly at the doctor for a second. It was the weirdest-sounding research study he’d ever heard of, and his gut reaction was to tell him “absolutely not!”

“Oh, I should also mention that research subjects will be compensated for their participation. $500 per session, each of which lasts about 4 hours. How does that sound?”

“I’m gonna regret this,” Josh thought. But the money was too tempting to pass up. “Okay, I’ll do it.”

Dr. Smith did his best to disguise his excitement at the prospect of being able to study this handsome young man and subject him to all the experimental procedures he had planned.

“Excellent. Well, you can go and get dressed now. I’ll meet you out by reception and have you sign some forms and send you home with some more information about the study and instructions for the first session so you know what to expect.”

—-

Josh went back to the changing room, took his clothes from a bin, and got dressed. He walked back down the hall toward the reception desk where Dr. Smith was already waiting, smiling warmly. He explained that Josh just needed to sign a standard consent form and then he’d be officially enrolled in the study. Josh skimmed the form quickly and signed his name in the bottom right corner.

“Perfect,” Dr. Smith said. “Welcome aboard our research study. Your first session is scheduled for this Saturday at 11 am. Make sure you read and follow the instructions in the information package thoroughly before your session. Specifically, you are not to engage in any sexual activity, including masturbation in the 48 hours before the test. Do you think you can manage that?”

“Goddamnit,” Josh thought, “it’s gonna be torture not jerking off for two days…”

“Yes, I can do that,” he said quietly, his face slightly red from embarrassment at talking about this stuff. He hoped none of the other handful of people in the waiting room overheard their conversation.

“Okay, well I’ll let you be on your way then,” Dr. Smith said. “See you this Saturday.”

As Josh walked out the door and left the clinic, his feeling of embarrassment was slowly replaced with growing anticipation and titillation as he began to imagine what lay in store for him when he returned that weekend.

[wenchofthescullery]

No games, just sports.

*

You don’t stand in front of a mirror before a run and wonder what the road will think of your outfit.

You don’t have to listen to its jokes and pretend they’re funny in order to run on it.

It would not be easier to run if you dressed sexier.

The road doesn’t notice if you’re not wearing lipstick.

Does not care how old you are.

You do not feel uncomfortable because you make more money than the road.

And you can call on the road whenever you feel like it. Whether it’s been a day or even a couple of hours since your last date.

The only thing the road cares about, is that you pay it a visit once in a while.

Nike. No games ...

 ... just sports.

*

I don’t know if many young women of today ever got to see this. It wasn’t a great movie, but by God, this was the best ad spot that never actually ran.

I used to run a lot. When I moved here -- to where I live now -- I knew I’d be having my third open heart surgery pretty soon. It was a congenital defect. It’s just life.

I ran as much as I could, until things grew hard. Then I just saw patients. Then I went under, and although I thought it might not go this time, I woke up.

The deal I had with the universe was always that I had to do this every 15 years or so. In between, I could have a normal life. And I started to go back to that in late 2019, with camping, and learning to ski, and the joy of adventures again.

But, 2020. COVID. We were hit hard here, and we got through it. 2021 brought the second vaccine and some more breathing space.

I started to run again. The road is an old friend.

It was harder than it should be. Deconditioning? But the more I pushed, the worse it became. And the echocardiogram showed increased pulmonary artery pressures. Pulmonary hypertension, most likely.

It’s probably the cumulative damage to the lungs and the right side of the heart. My left side is fine, which is awesome! The right side looks to be crapping out. There’s no great fix. No simple surgery, not this time. You can try meds, but my regular systolic blood pressure is so low that they made me pass out before. My pressure is usually 90s over 60s. I’m overall pretty healthy, other than for this.

It’s meds, though, or cutting a hole through the atria. That can lead to fatal arrhythmias. The other option is a lung or heart-lung transplant. I work with sick kids, and I wouldn’t be able to do that -- not anymore. Maybe we could figure something out.

Maybe I’ll get better news in a few weeks, when I see my cardiologist again for more testing. It might not be so bad after all?

I’m okay, but I’d really love to run again.

*

[artificialqueens]

nobody knows where we might end up, chapter eight (branjie) - holtzmanns

(read on ao3) | (tumblr) | word count: 4150

AN: Thank you so much for the recent lovely reviews and feedback on this fic! It makes me so, so happy every time, and even more motivated to keep going. I appreciate you all so much. Thank you Writ for beta-ing this and being wonderful.

(then)

“C’mon, Mami. Please tell me something cool that’s happened at work recently.”

“Patient confidentiality, baby. Not gonna happen.” Vanessa’s mom ruffles her hair, making her scowl. “Can’t be spilling stuff to just anyone.”

“But I’ll understand so much more now! We had our cardio unit in physiology and I aced it.” Vanessa swings her legs on the side of her mom’s bed, watching her pack a sweater in her bag before her night shift.

“Already told you, I can tell you all about the cardiac ICU and what it’s like being on the unit, but no patient-related things. Gotta wait till you’re working in a hospital yourself for that part.” Vanessa’s mom pulls her hair up into a bun, away from her face.

“That’s not going to be until forever.” Vanessa sighs. She wishes she could fast forward to being an intern or a resident now.

“Tell you what. Want me to talk to the cardiologist on the unit about maybe shadowing him? You can see what it’s like, then.” Vanessa’s mom straightens out her light blue scrubs. Vanessa wishes sometimes she could try them on, but it would feel a little too on the nose.

“Would that even work? I thought you have to apply through official channels and stuff.” Vanessa has already applied to some hospitals in the new year for volunteering, but none of them are going to be in cardio, which is what she really wants to see.

“Connections always help, mija. Having a nurse for a mom has got to be useful for something.” Vanessa grins at her mom’s statement. Her mom is definitely why she’s always been drawn to healthcare, seeing her in and out of scrubs for most of her life.

“Though it beats me why you won’t just apply for nursing,” Vanessa’s mom continues, “it’s practical and you’ll have to do less school and you’ll get to make money faster. And no cutting people open.”

Vanessa wrinkles her nose. They’ve had this conversation way too often for her liking. “But night shifts, like the one you’re going to right now. And cleaning up poop.”

“You’ll have night shifts as a resident too, y’know, if you try and become a doctor. They’re unavoidable.”

“All worth it if I get to cut people open eventually.” Vanessa shoots a cheeky grin at her mom when she swats her with her bag.

“What are you, Dr. Frankenstein or something? Gross.” Vanessa’s mom makes a face at her. “I’m telling you, there’s something off about all the surgeons at the hospital. They’re all a little cuckoo in the head.”

Vanessa tries not to laugh. “I bet they think the same thing about the nurses.”

“Oh, they wouldn’t dare. We could kick their asses in a second. Not that we’d ever say that to their faces. Don’t tell them.” Vanessa’s mom points a finger at her.

“When would I ever see the surgeons?”

“I’m gonna get you to shadow one of them, aren’t I? Mom of the year. Pay attention.”

“You really are, Mami.” Vanessa stands up, placing a kiss on her mom’s cheek. “Have a good shift.”

Vanessa’s mom waves her off. “And don’t you forget it. We’ll see about it being a good shift, though. Depends on which bobo day nurse I take over from today.”

Vanessa’s mom pulls on her coat, then hat and gloves, grumbling the whole while. “Damn winter weather. Remind me why we live in Brampton again?”

“Because of your job.”

“Eh.” Vanessa’s mom shrugs. “Now that you and Julio are both out of the house, maybe I should just move to Florida or something. Somewhere warm. Not a place that’s frozen over half of the year.”

“Then I wouldn’t be able to visit you during the holidays!” Vanessa protests her mom’s statement, hands on her hips. It’s not like they’d be able to afford constant plane tickets either.

“Take it easy, mija, I wasn’t being serious.” Vanessa’s mom shoots her a good natured look.

Vanessa huffs. “I know.”

“Glad to know you would miss me, though. You better.” Vanessa’s mom grabs her car keys, nearly drops them in her gloved hands.

Vanessa snorts. “Don’t gloat about it too much. Now go before you’re late for work.”

“Going, going.” Vanessa’s mom pops her head back inside a second later. “Don’t forget to make the plátanos tonight. We’re going to be too swamped to do them before Christmas dinner tomorrow.”

“I won’t!” Vanessa calls it out long after her mom closes the door behind her, rolling off of the bed. She heads to the family computer in the living room, which Julio is still sitting at after playing games on it for most of the day. She rolls her eyes. Her older brother is absolutely addicted to it. All she wants to do is be able to talk to Brooke.

“Julio, move! It’s my turn now.” She stomps her foot too, not that it makes any difference because he doesn’t even look up from the game on the screen.

“Nope.” He pops his lips on the last letter. “I still gotta beat this level.”

“Ugh.” Vanessa rolls her eyes at him, leaning against the monitor. “Do you ever do anything other than play stupid games on this thing?”

“I’m in engineering, dumbass, of course I do.” Julio looks up, his grin smug, making Vanessa huff. Annoying brothers. “I’m enjoying my winter break.”

Vanessa crosses her arms. “I wanna talk to-”

“I don’t care. You have to wait.”

“I’ve been waiting all day.” Vanessa grumbles. She perks up suddenly when remembering exactly what can make him move. “If you don’t move, I’m gonna tell Mami about the time when you were in Grade 12 when you snuck out and went to Noah Fielding’s party and-”

“Do not.” Julio turns from the computer, wide-eyed, pointing a finger at her. “You know she’d still beat my ass for that.”

“Well,” Vanessa shoots him a smug smile, “guess you gotta move then, huh?”

“Fine. Jesus.” Julio grumbles under his breath as he gets up, shuffling to the kitchen. Vanessa takes his seat with a grin.

She logs onto MSN messenger, scanning through her contacts while looking for one very specific person.

“Yes!” Vanessa can’t help but let out a little whoop when she sees that Brooke is online.

Vanjievanjievanjie: Brooke!!! <3

BLDancer1: V! I miss you so much!

Vanjievanjievanjie: I miss u too :( this break has been so long

BLDancer1: Way too long. :(

Vanjievanjievanjie: what are you up to??

BLDancer1: We’re going to midnight Mass later tonight because of Christmas Eve. I gotta get ready soon, ugh.

Vanjievanjievanjie: sounds boring tbh

BLDancer1: It is! I’d much rather be asleep, honestly. Vanjievanjievanjie: nerd

BLDancer1: Like you stay up much later than me! What are you up to?

Vanjievanjievanjie: not doing much for Christmas Eve cuz my mom’s working, just me and my brother and my dog rn but tmrw we have lots of fam over

BLDancer1: That sounds more fun than our Christmas dinners. It’s just my family all sitting around the table and eating quietly like every other dinner.

Vanjievanjievanjie: ew that sounds stiff. how’s the fam tho??

She hasn’t met Brooke’s family, knows very little about them. Brooke always gets more sad and shifty whenever her family is brought up, so Vanessa tries not to do it too much. Though asking over MSN may be better than in person.

BLDancer1: The usual. They said I need to exercise more and tutted about how my grades still aren’t as high as they should be. Not much else.

Vanessa winces. Yikes. Brooke had been fretting about going home the entire week before they left for Christmas break, hanging around Vanessa’s room because she hadn’t wanted to be alone with her thoughts. Vanessa doesn’t know exactly what Brooke’s family is like to make her feel this way, but it makes her want to fight them all.

Not that that would be a good first impression on them.

Vanjievanjievanjie: sorry baby :(((( sending u a big hug from here

BLDancer1: It’s okay. They’re right, I need to be better.

Vanjievanjievanjie: you’re already perfect u angel

BLDancer1: Not as much as I should be, though. My grades weren’t good enough this semester.

Vanjievanjievanjie: u got the top marks in our class u loon

BLDancer1: My mom said they’re not high enough to get into med school, though.

Vanjievanjievanjie: what does she know?? ur already working ur ass off, you’ll do it

BLDancer1: I feel like there’s always more to do, like I’m not doing enough.

Vanjievanjievanjie: listen come here so I can yell at you about how ur already a genius, u dumbass

BLDancer1: LOL, that’s a contradicting statement.  

Vanjievanjievanjie: u know what I mean.

BLDancer1: Ugh. I do. I just hate being here and hearing them lecture me constantly about things.

Vanjievanjievanjie: :(((

Vanessa spams a lot of emojis after her message for emphasis, hoping that it makes Brooke laugh at least.

BLDancer1: What is the blueberry emoji for?

Vanjievanjievanjie: because i miss u BERRY MUCH

BLDancer1: LOL. I miss you and you remain the cutest ever. :*

Vanjievanjievanjie: 5 more days to go!!

BLDancer1: I’m counting them down. <3

Vanessa has to stop herself from smiling when she signs off after Brooke has to leave. Five more days until she gets to see her, hug her, kiss her again. Five more days until she can go back to telling Brooke how she’s already wonderful just the way that she is, no matter what her family says. She hopes that Brooke starts to believe it, too.

(now)

Nessa.

Dr. Hytes had called her Nessa again. Brooke had called her Nessa.

Vanessa hasn’t heard the nickname since junior year of undergrad. No one else has called her that since then, no ex-girlfriends or family or anything. No one since Brooke.

It’s what Brooke used to call her when she was feeling particularly affectionate, or soft, or needy. When she’d drape herself over Vanessa, seeking comfort in her touch and the way that both of their bodies would feel warmer, safer.

And now she’s gone and said it again.

Sure, maybe it had been in the heat of the moment. Banging on Vanessa’s desk, skiving off the boring assembly for something way more fun.

But that sex had been different, Vanessa knows it. She had felt it on Brooke’s lap and she still feels it now, two days later because all her fucking brain wants to replay on loop is Brooke’s voice saying Nessa.

Maybe it’s good that the OR has been overly booked with cardiac surgeries and that Dr. St. Clair is out sick, making Vanessa’s schedule overflow with work. She needs the distraction, needs concrete work to focus on because if she doesn’t have it, she’s going to fucking spiral.

Not that it helps, because even during surgeries her mind has started to wander, falling back on muscle memory for the procedures because her brain has decided that it would rather focus on that fucking voice.  

She can’t do this again. At least, that’s what the rational part of her brain is telling herself. That her breakup with Brooke had been her worst breakup for a reason, drudging up all of her insecurities and fear and crushing her heart with a weight on her chest until it had smashed into a million pieces.

She can’t survive it a second time. She can’t.

Because sex is one thing. The chance to get freaky with someone who already knows her body, knows what she likes, knows what to do. Someone who has no doubt improved over the last eleven years as well.

But the way that Brooke had held onto her that last time, whispered to her softly, pressing kisses to her temple that hadn’t just been offhand, but felt so loaded with unspoken words? It had felt so real in the moment, and still feels real now when she thinks about it. Mostly because she can’t stop thinking about it.

Nessa.

Not Dr. Mateo, not Vanessa - the latter of which Brooke had began to use before they had broken up, when they had danced around each other and said words that neither of them had been able to take back.

Nessa.

It has to mean something.

Vanessa hates how much she wants it to. How much her heart is begging to go back to the start, to how things used to be. She needs to resist it.

At least, that’s what she’s going to keep telling herself.

“Vanjie. Vanjie.”

“What?!” She nearly jumps when seeing Kameron suddenly in front of her waving a hand in front of her face, blocking her view of the computer she’s sitting at in the dictation room. “Jesus Christ, woman. You scared me.”

Kameron snickers and Vanessa can’t help but smile back as she rolls her eyes, taking her thoughts of Brooke and pushing them away, burying them down in favour of Kameron’s expectant face. She’s beginning to bond with the cardiac surgery team in and out of the OR, a fact that makes her happier than it should. They’re all on a first name basis (well, nickname for her), and they’ve begun to hang out after work. Little things that are beginning to make Toronto feel more like home again.

“You’ve been so on edge for days. What’s gotten into you?” Kameron raps her nails on the computer monitor, and Vanessa closes her open tab with a sigh. Clearly she’s not going to get much work done.

“Nothing. Just tired, is all. This week’s been a fucking mess with the long hours.” Vanessa shrugs up at her. She can already feel a tension headache brewing at her temples, though she knows it’s not just from the workload.

Sure, they’re all friends now. But does she want to spill the saga of whatever the fuck is going on with her and Brooke to a work friend? Not particularly.

“You’re telling me. It’s nine p.m. and we’re still here because of all this documentation left over that we still have to do because of all the extra OR time we’ve had to take on this week? I want to go to bed.” Kameron flops down in the chair beside her looking slightly put out.

“Where’s Asia?” Vanessa looks at the spot beside Kameron and is surprised to see it empty, because the two of them are not far from being attached at the hip when they aren’t with patients.

Kameron huffs. “On a date. Again.”

An interesting fact indeed. It’s Asia’s third date just this week, and coincidentally the third day of Kameron walking - no, stomping - around the cardiac units with an extra furrow in her brow.

Hell, Vanessa needs a distraction from her own love life - or rather, lack of one, so she may as well bother Kameron about hers.

“That seems to be making you feel some type of way, huh?” Vanessa wants to tread carefully because she knows that she’s best friends with Asia, but the way that Kameron is affected seems like-

“I’m not jealous, if that’s what you’re wondering.” Kameron’s a bit quick in her answer, fiddling with her hands. “Asia just goes out with all of these…lame guys and never seems to enjoy it, anyway, from the way she always comes over for a glass of wine afterwards to talk about it and it’s just…annoying. That’s all.”

“Jealousy or not, it’s clearly upsetting you a little.” Oh, has Vanessa been there. Crushing on a straight girl. Not something she’d ever want to repeat.

“Hmph.” Kameron folds her arms, and the action when contrasting with her scrubs and lab coat is a little funny. “It’s not. She’s just my best friend. I don’t care.”

“You’re so convincing, I almost believed you there for a second.”

Kameron scowls. “I don’t.”

“Hey.” Vanessa takes pity, putting her hand on Kameron’s shoulder. “Care or not, you ever want to talk about it, I’m here, ‘kay? I get it.”

Kameron deflates in her seat. “Thanks. Not that I need to talk about it,” she’s quick to add, “but I appreciate it.”

Vanessa shoos her away. “I know. Now go, I gotta finish dictating this report.”

She can hear Kameron’s snort as she heads down the hallway, and can’t help but smile either as she shakes her head. Kameron’s unrequited crush, no matter how much the other doctor doesn’t want to admit it, is cute. Though not something Vanessa pities in the least - she’s glad she’s moved on from that stage in her life.

Kameron’s problems are enough to distract her to get her through the rest of her reports, her mind blissfully clear of her own issues (she can’t start thinking about Brooke again, she can’t). It isn’t until she’s home a few hours later, setting her alarm for the morning that she realizes the next day is Thursday. Her next meeting with Brooke and the team about the surgery. Where she has to see her again.

Shit.

Grabbing an extra coffee before the meeting hadn’t been the smartest idea, something that Vanessa is beginning to realize the longer and longer she has to sit in this conference room while fighting the urge to bounce her leg in her seat.

The anesthesiologist is droning on and on, his nasally voice making Vanessa cringe. She has ten minutes before he’s done his explanation to the patient, family, and the rest of the surgery team. It’s going to be her turn straight after, having to review the patient’s tachycardic issues and the precautions that the team will have to keep in mind.

Except that her brain is running way too fast and circling through her thoughts at what feels like a million miles an hour, and she’s trying to look down at her notes and pay attention to them while listening to the meeting at the same time, but all she can focus on is Brooke.

Brooke, who is sitting at the other end of the table, looking incredibly focused and calm and is participating in the discussion as if she doesn’t have a care in the world. Brooke, who greeted her when she came in with a neutral smile and a handshake as if they didn’t have the most confusing sex the last time they were in each other’s presence.  

Brooke isn’t shaking in her seat the way Vanessa is, nor are her eyes darting around the rest of the room. She’s not stuttering on her words, not like Vanessa did when the patient’s wife had asked her a question and she missed half of it.

How is Brooke so unflappable?

“Dr. Mateo?”

“Huh?”

The case manager is looking at her expectantly and shit, it’s her turn to speak and she hasn’t even noticed.  

Vanessa can feel the blush rising in her cheeks as she clears her throat, trying as best as she can to not make eye contact with Brooke.

Of course, Brooke’s direction is exactly where Vanessa looks as soon as she starts her spiel. Her blonde waves are falling down her shoulders and her head is slightly tilted as she fixes her steady gaze on Vanessa, and it’s enough to make her pause for a second, stumble on her words. A real great look for a cardiothoracic attending surgeon.

Vanessa finds it difficult to look away from Brooke as she continues talking, her eyes somehow always straying and returning back to her. As if Brooke is a homing beacon that pulls her back in every time, one that Vanessa can’t seem to change her course from no matter how hard she tries to do so.

Brooke doesn’t shift her gaze away either. Vanessa can’t tell if the way that Brooke bites her lip and the storm that’s brewing behind her eyes are real or just in her imagination, as if she’s projecting what she’s feeling - what she wants to feel - onto Brooke.

Hell, Vanessa’s not even sure what she herself is feeling anymore.  

She can’t stop herself from tugging on Brooke’s arm as the meeting ends, holding her back while everyone else around them leaves. Brooke turns around and for a second Vanessa wonders if she’s made a mistake, because being so close to her and seeing confusion and pain and emotions that she doesn’t recognize on Brooke’s face are nearly enough to knock her over.

Brooke shuts the door as the last person leaves, and maybe it’s good that they’re now both on their lunch break because there’s no way Vanessa can even think about work. Not when Brooke is taking a step closer to her, then another, lips parted as if she wants to say something but she’s still holding back.

“What are we doing?” Vanessa can’t help the pleading tone in her voice, because she doesn’t know, has no idea and she’s so fucking confused.

“I…” Brooke’s voice trails off as her eyes search Vanessa’s face, breath hitched and Vanessa wants to scream, because if Brooke doesn’t know, then what are they supposed to do? She can’t take this state of limbo anymore, walking on a tightrope that feels like it’s losing stability, becoming more shaky the more that they try to balance on it.

Brooke puts her hand underneath her chin, tilts her head up and Vanessa is sure that Brooke can see the way that her chest is rising and falling, the air feeling like its escaping her lungs faster than she’s able to bring it in.

It’s almost predictable when Brooke kisses her, wipes the slate of her mind clean with the way her hands come to rest on either side of her face. Vanessa can’t help but stretch up on her tiptoes, sighing into the kiss because it feels right, it feels okay, even though her brain is screaming no, no, no.

It’s not going to solve things, but what does it matter? When Brooke pulls her hips in closer and they press together like two puzzle pieces that somehow fit as if they were never meant to be apart. The smell of Brooke’s shampoo, the softness of her hands, it’s all so familiar and part of memories that still haven’t been erased from her brain no matter how much she had tried to do so when they broke up. It’s all coming back to her now, resurfacing as if she’d never buried them out of anger in the first place.

Maybe it’s a bit destructive, especially because now it’s not just sex, or releasing tension. Not for her, not anymore.  

The realization sinks in deep into Vanessa’s chest when Brooke starts to kiss down the column of her neck, hands trailing down her sides and lips pressing against her hip bone as she gets on her knees when she pushes her shirt up and-

She can’t do it.

Not like this. Not right now.

“No.” Vanessa pushes on Brooke’s shoulders and Brooke moves back immediately, wide eyed and hair slightly mussed and an apology on her lips that begins to spill but Vanessa doesn’t hear it, not with the realization that this is all it will be. Sex.

Vanessa had thought that she could do it, she really did. Except that now her heart feels like it’s being tugged, pulled towards Brooke, someone who doesn’t want her for more than that because why would she? That isn’t their arrangement. Never was. The expectations have been to have no strings attached.

Which is something that Vanessa had thought was possible. Though she should have known better - as if her heart will ever able to release the ropes that it had tied to Brooke back when they first started university.

She pushes her way out of the conference room on shaky legs, ignoring Brooke’s voice from behind her that she can’t tell what she’s saying because her brain isn’t working, not right now. The signs down the long hallway start to blur together as she tries to look up and find the way to her office because where the fuck is it, she can’t break down in the hall, she’s an attending, what will everyone say? But then she’s there and slamming the door behind her, leaning against it because her legs can’t do something as simple as holding her up right now.

“Vanessa. Vanessa.” The voice on the other side is a little desperate (no, no, no), with the banging of a fist on a door that follows makes her squeeze her eyes shut tight. She wants to disappear, make it as if none of this happened and as if she never even came back in the first place because of course she was naive enough to think that she could be back here with no problems.

Vanessa had thought that she’d freed herself. But now, she realizes that she hasn’t. She never had.

[puppyexpressions]

6 Common Causes of Coughing in Dogs

Much like humans, dogs cough for a lot of different reasons, some mostly harmless, and some quite serious. Generally speaking, if your dog only coughs once in a blue moon and it passes quickly, there's no cause for concern. But if your canine family member is coughing a lot or has intense coughing spells, you should make an appointment with your veterinarian. A persistent cough is a red flag that your dog probably has an underlying problem that needs to be addressed.

The following are some of the more common causes of canine coughs and what you should know about them.

1. Foreign object lodged in the throat — A cough that grows suddenly violent or sounds more like gagging, especially when accompanied by lip licking or attempts to swallow, could be a sign your dog has a sore throat or something stuck in her throat.

If she's outside when she begins coughing or has just come in from outdoors, she may have swallowed or inhaled a grass seed or other foreign object and it has become wedged in her throat. If she can't seem to cough up whatever it is, it's time to make an appointment with your veterinarian to prevent a potential infection or even pneumonia.

2. Reverse sneezing — Reverse sneezing is a common condition in small breed dogs and also brachycephalic (flat-faced) breeds. While a reverse sneeze is not a cough, the sound can be mistaken for coughing or choking. Reverse sneezing is caused by a spasm of the throat and soft palate that is triggered by an irritant, which can include simple excitement, exercise, a collar that's too tight, pollen or even a sudden change in temperature.

In a regular sneeze, air is pushed out through the nose. In a reverse sneeze, air is instead pulled rapidly and noisily in through the nose. The sound of a reverse sneeze can be upsetting, and many dog parents wonder if their pet is choking or having an asthma attack. Some dogs who reverse sneeze also tend to stand with elbows spread apart, head extended or back and eyes bulging.

Most cases of reverse sneezing don't require treatment. However, it's a good idea to keep track of when the episodes occur so you can determine what the probable triggers are and try to avoid them. If the sneezing becomes chronic or episodes become more frequent or longer in duration, it's a good idea to make an appointment with your veterinarian to rule out other potential health problems.

3. Kennel cough — A sudden persistent cough in an otherwise healthy dog is often due to kennel cough or another similar viral or bacterial infection. These infections tend to produce deep, dry hacking coughs, sneezing, snorting, gagging and in some cases, vomiting.

There can also be coughing "fits" or spasms if the dog becomes excited or while exercising. If your dog has recently been in contact with other dogs, he may have contracted a kennel cough infection. Symptoms usually appear from two to 14 days after exposure, last between 10 and 20 days, and can recur during periods of stress.

Most of these infections are mild and resolve without medical intervention. Many veterinarians immediately prescribe antibiotics, but I absolutely do not agree with that approach. I prefer to let a dog's body heal itself naturally, as long as he's otherwise healthy.

Complete recovery from kennel cough can take up to three weeks in healthy dogs, and twice as long in older pets and those with underlying immunosuppressive conditions. Puppies can also take a bit longer to recover.

Since a serious episode of kennel cough can result in pneumonia, if your dog doesn't start to improve on his own with the support of nontoxic remedies (such as nosodes, slippery elm bark, Echinacea, goldenseal and olive leaf), or if the cough becomes progressively worse, it's important to make an appointment with your veterinarian to be on the safe side.

4. Pneumonia — If your dog's cough sounds wet or is productive, it could be the result of a buildup of fluid in the lungs. Fluid or phlegm in the lungs is a red flag for pneumonia, which can have a variety of causes. Other symptoms include loss of appetite, weight loss, fever, lethargy and difficulty breathing.

Bacterial pneumonia is caused by a pathogen, and there are several organisms that can result in infection. Typically your dog will require antimicrobial drugs, rest, immune support and specific supportive therapies. Fungal pneumonia is the result of a deep fungal lung infection, and is more difficult to treat. Since many dogs don't respond to anti-fungal drugs, the precise treatment for fungal pneumonia will depend on what type of fungus has caused the infection.

I recommend you ask your veterinarian about inhalation therapy, which is one of the most effective, direct ways to treat these types of lung infections. Another type of pneumonia is aspiration pneumonia, also called inhalation pneumonia. This is a condition in which the lungs become inflamed and infected as the result of breathing in a foreign substance like vomit, regurgitated gastric acid or food.

Aspiration pneumonia is life threatening, and the prognosis for most dogs with the condition is poor, so the goal should always be prevention. If you suspect your dog has aspirated something, it's important to get her to your veterinarian or an emergency animal clinic right away.

5. Collapsing trachea — A recurrent, episodic cough that sounds like a goose honk can be a sign of a collapsing trachea — especially if your dog is a small breed. Tracheal collapse is a chronic, progressive disease that can be either congenital or acquired. Dogs with the condition also typically show signs of exercise intolerance, respiratory distress and gagging while eating or drinking.

Treatment options for a collapsing trachea include medical management, which works for about 70 percent of dogs with a mild form of the condition. More serious cases often require highly specialized surgery. Cartilage building supplements are also given to maintain the integrity of tracheal cartilage.

6. Heart disease — Coughing is unfortunately also a symptom of heart disease in dogs. Other signs include a bluish color to the tongue, loss of appetite, fatigue, weakness, decreased exercise endurance, a too-fast or too-slow heartbeat and difficulty breathing. If your dog has been diagnosed with a heart condition and coughs mainly while he's resting, lying down or at night, it could be a sign the disease is progressing.

Treatment of heart disease in dogs depends on a variety of factors including the severity of the problem, the age and health of the animal, cost of treatment and other considerations. A visit to a board-certified veterinary cardiologist can provide more information about the severity of your dog's condition.

There are a variety of natural therapies that can support a weakened cardiovascular system, so consult your holistic veterinarian for the best options for your pet's individual situation.

Other conditions that can cause coughing in your dog include chronic bronchitis, heartworm disease and some types of cancer. If your dog's cough doesn't resolve quickly on its own, it should be investigated, and the sooner you make an appointment with your veterinarian, the better your pet's chances for either a full recovery or a well-managed condition.

[pepidefbummie]

Cold Heart [GOT7 Jaebum/JB]

Pairing: Jaebum x Reader

Genre: Fluff, romance

Summary: [Medical AU] [Doctor AU] Cardiothoracic surgeon Im Jaebum is perceived as a cold-hearted person, but the new pediatrician in the building thinks otherwise and slowly melts the icy man [A/N: I do not know much about the medical field, so that would explain anything inaccurate in this story]

Word count: 4,318

Note: p/n = patient’s name

You moved into your new clinic in one of the most prestigious hospitals in the country. Standing at the hallway felt like a dream as you breathed in deeply and looked at the place in awe. The sleepless nights and ugly crying paid off. You watched as kids ran out of the other rooms with their moms holding their hands. A friend and fellow pediatrician walked out of the room and smiled upon seeing you. “Y/n!” the male, Youngjae, waves.

You smile and wave back as he walks towards you, “Hey Youngjae.”

“Congratulations on making it! I’m really proud of you!” he gives you a big hug.

You chuckle as he releases you, “Thank you. Told you we’d both make it.”

“I know, right? Well, I have another patient, but if you need anything, don’t be afraid to contact me!” Youngjae beams before jogging back to his clinic room.

You stand there, a huge grin still plastered on your face, but you shook it off as you needed to get your coat from the on-call room. You turned on your heel to quickly and bumped straight into another person. Stumbling backwards, you were steadied by hands grabbing your wrist. Thankful for that you smile, “Oh, I’m sorry.”

The person, however, was not sharing your smile. He had a scowl on his face as if you just made his day the worst. With an annoyed tone in his voice, he lets go of your wrist and says, “Be careful. You’re in a hospital.”

You blink a few times before nodding. “Ok, thank you anyway.”

The man is a doctor just like you. He doesn’t say anything else and instead shifts his glare forward and walks away, hands shoved into his coat’s pockets. You let out a silent “pfft” before navigating your way to the on-call room. There, you get your coat and finally put it on, ready to take on whatever the hospital throws your way.

The next few days, you manage to see a few patients, and the kids are the most adorable things you’ve ever seen. Granted, some of them wiped boogers on your clinic while others tried to throw your ballpens, but other than that, you were happy enough to make sure that they were healthy. Every time a mother thanked you, you felt proud of yourself.

Today was another day at the hospital, and you were going to see your fourth patient for the day. “Hello there.” you greet the child and their parent.

The mother smiles before explaining the situation, “My son has been having a hard time breathing, but the other pediatricians we’ve visited told us that it could be treated by medicine. We just wanted one more opinion before we take action.”

“I see.” you nod, “Let me do some check-ups and we’ll see what we can do.”

You ask questions while checking the child’s condition, taking notes of whatever you observe. Afterwards, you sit down and hand a paper to the mother. “There definitely is an irregularity in his heartbeat, but it’s not exactly life threatening as of yet. However, I do recommend that you consult a cardio specialist to further gauge the situation.”

“Is there any way we can see one today as well?” the mother asks.

“Hold on for a moment.” you smile before taking the telephone and dialing a receptionist.

“Hello, Dr. y/n. How may I help you?” the receptionist answers.

You respond, “Hi, I was wondering if there were any cardiologists available for consultation today? My patient, p/n, would like to schedule for one.”

“Let me check.” the receptionist says. After a few minutes, she gets back to you. “Dr. Im Jaebum just finished an operation right now and is currently with another patient, but his receptionist has informed him. You may hand over your patient’s records to him.”

“Alright, thank you so much.”

You turn back to the mother. “All other cardiologists are on duty, but Dr. Im Jaebum is willing to take a look at your son’s records.” you say with a smile, “I’ll give him his records, and Dr. Im’s receptionist will contact you when he’s available. Would that be alright?”

“Yes, thank you so much.” the mother bows politely before taking her son’s hand.

After saying goodbye, the two leave, and you prepare the son’s medical records from you and from past pediatricians. The son seemed to have a heart problem that you perceived wouldn’t be cured by just prescribing medicine. While it was your job to treat children, you thought it would be more advisable to transfer him to someone who specialized in the cardio field. You didn’t even know who this Dr. Im Jaebum was, but since he was the only cardiologist available today, you found yourself heading for his office. After knocking, a deep voice from inside the room called for you to come in. But you knew that voice was familiar. Shaking off the thought, you pushed open and quietly went inside with a smile. That smile disappeared almost immediately when you saw who the doctor was. Dr. Im was the man you bumped a few days ago. The rather rude one, you thought to yourself. “Oh.” he says rather deadpan, “I remember you.”

There was another doctor in the room; he seemed liked he was talking to Jaebum before you came in. “You’re the newest pediatrician here, right?” the other male offers you a smile.

“Yes.” you nod your head, suddenly shy.

Jaebum doesn’t look up from the papers on his desk as he says, “She was also rather lost on her first day.”

A blush creeps on your cheeks just as the other doctor chuckles softly. “It happens to all of us, Jaebum.”

Jaebum lips quirk into a very small smirk before saying, “Only you, Jinyoung.”

Jinyoung shakes his head in amusement before waving at his friend. As he passes you, he pats your back gently and whispers, “Welcome aboard.” sneakily gesturing towards Jaebum, Jinyoung continues, “And don’t be scared of Jaebum, ok?”  

He doesn’t let you question his statement as he shuts the door behind you. You stand there, dumbfounded until Jaebum’s deep voice snaps you back, “Are you going to just stand there, or do you need anything? I don’t have all day.”

You sigh and internally roll your eyes before walking closer. “Here are my patient’s records. I don’t think it’s just a simple case that can be treated by medicine.”

Jaebum reads the papers, “Of course it’s a heart problem. Shouldn’t you be equipped with enough knowledge to treat this though?” he says, raising his eyebrow in a rather haughty manner.

You nod before pointing out a few things on the records, “Yes, but these symptoms are beyond my specialty. This is more complicated than basic heart treatments.”

Jaebum leans back on his chair and studies your face, his steel expression sending shivers down your spine. “Fine, I’ll take over for this patient.”

“Thank you, Dr. Im.” you say.

He doesn’t say anything else and instead dismisses you with a nod. You take that as your cue to leave.

Over the next few days, you get used to your schedules, appointments and tasks. Before you know it, you’ve also become friends with the other doctors and nurses there, especially with Dr. Jinyoung and Dr. Jackson, both of which prefer being called just “Jinyoung” or just “Jackson”. Youngjae still sees you, often eating lunch together or resting in the on-call room. You encounter Jaebum from time to time and ask him about the patient you had from before. Because of this, an unspoken agreement of some sort has formed between you wherein Jaebum would update you on the patient’s condition.

Something about Im Jaebum piqued your interest, and no it wasn’t because he was a rather handsome doctor. Yes he was, with his muscular built, defined features and sharp eyes, but he had a commanding and regal aura to him that attracted you. Nurses would often gossip about how hot he was, while other doctors would always mention that making mistakes with Jaebum was akin to a death wish. “Why’s that?” you ask one doctor, Yugyeom.

Yugyeom chuckles before explaining, “Jaebum-hyung’s a really skilled doctor, but he gets really critical when people make mistakes with him, especially when undergoing surgeries.”

“He hates mistakes in surgeries.” Bambam adds.

“Yeah,” Yugyeom nods, “Noona, since you’re kind of new here, you should know that every nurse that falls for Jaebum-hyung ends up heartbroken.”

“Hey,” Youngjae laughs, “Those are just gossip. It’s not true.”

You tilt your head, “Why would people say that though?”

Jinyoung chuckles beside you, “He tends to turn down confessions or never reciprocates feelings. Jaebum is really dedicated to his work as a doctor and thinks that it’s his priority. He takes things very seriously and doesn’t fool around in the hospital. People interpret that as him being cold.”

“Remember when rookie doctors called him ‘Dr. Cold Heart’? It’s funny ‘cause he’s a cardiothoracic surgeon.” Jackson laughs.

“Wow,” you say, “He kind of did scare me the first time we met.”

“You’ll get used to it.” Mark affirms. “Jaebum’s a softie when you get to know him enough.”

Come to think of it, what the other doctors were saying just now seemed true. You observed how some courageous nurse would ask if Jaebum had plans for the night, and he would politely (though sternly) reject the offers. Or the times he’d have a very icy glare when lecturing the assisting surgeons outside the corridors. But there were very rare times you’d see him more relaxed. There was that one time he smiled so gently at a little girl who thanked him for “saving her mom’s life” – probably a successful heart operation. Or the time he was laughing with Jinyoung and Youngjae in the on-call room because of some medical pun made by Jackson and Yugyeom.

And this just piqued your interest even more.

One day, you were walking down the hospital corridor when you saw Jaebum reprimanding a few assistants. You’ve heard the stories of how scary he could get, and when you heard his raised voice, you clutched your clipboard tighter. With a gulp and wavering courage, you walked closer and firmly spoke up. “Excuse me, Dr. Im?”

The assistants being reprimanded turned to you with thankful eyes, but Jaebum was just as exasperated to see you. “What is it?” he snaps.

You sigh and gesture to the clipboard in your hands, “I need to speak to you about something.”

Jaebum rubs his temples before dismissing the frightened assistants. He opens the door to his office and ushers you inside. Without taking seat, Jaebum sighs and turns to you, eyebrows raised, “This better be urgent, Dr. y/l/n.”

You place the clipboard on his desk and say, “I just needed to give you p/n’s updated records in case you needed it for his check-ups.”

“You could have just given that to my receptionist, you know?” he slumps into his chair.

“Yeah,” you nod, a small yet playful smile on your lips, “but I also wanted to save those poor assistants from your wrath.”

“Very funny.” Jaebum rolls his eyes, “They nearly performed an operation in the wrong way. We nearly lost a patient.”

You feel rather comfortable, standing in front of his desk. “You need to loosen up a bit, you know? You gotta balance it all out.”

Jaebum looks at you like you’ve said the craziest thing he’s ever heard. “And you’re telling me because?”

“You’re not the cold-hearted doctor everyone says you are.” you smile.

Jaebum’s eyes widen the slightest before he looks to his papers, “And how would you know?”

“I’ve seen sides of you that would say otherwise, Dr. Im.” you say in conclusion before bowing and making your way out the door. “I’ve also seen you smile. It suits you.”

With that, you make your leave in order to hide the beating of your heart as you blurted those words. Little did you know that a small smirk graced Jaebum’s lips behind closed doors. “She’s interesting.” he whispers to himself.

Things have been going smoothly, and before you know it, you’ve been working in the hospital for half a year already. Somehow, you and Jaebum start to talk more often, and Jackson can’t shut up about it. Other doctors find it funny (or endearing, rather) when you save Jaebum’s assistants from his fits of anger. There was this one rare occasion when you and Jabeum were the only doctors in the on-call room. “I just want to eat ice cream and sleep and watch dramas and buy food.” you mumbled to no one in particular.

Jaebum, being the only doctor in the room, replied, “Your sugar levels are going to go overboard.”

“Tell me something I don’t know.” you joked. “You’re not a nutritionist anyway.”

“But I am a cardiologist, and sugar levels are important in this field, Dr. y/l/n.” he smirked.

You laughed, “Cardiology does seem interesting.”

Jaebum shrugged, “It is, but it’s also a pain in the ass.”

“Then why’d you choose it?”

“Because the heart basically one of the most vital organs, and I wanted to help those that would have problems with such an important organ in life.” Jaebum answered simply before throwing the question back at you, “And why pediatrics for you?”

With a soft smile, you said, “Because I have a little brother who is 7 and a sister who is a few years younger than me. I don’t like seeing children in difficult situations, so pediatrics was the field for me.”

You don’t notice how Jaebum stared at you with so much admiration in his eyes, or how his smile was the most mesmerizing thing ever. When he stared too long, you asked, “What is it?”

“You have chocolate stains on the side of your lip.” Jaebum smirked, ruining the moment. “Is that from your snack a while ago?”

Your eyes widened and when you did see the stain, your cheeks flared up. “How did that get there?” You stand up and wash yourself at the nearby sink.

“For a doctor, you really are clumsy.” Jaebum teased further.

You scoffed at the male and rolled your eyes, “Geez, Jaebum. I knew that already.”

Jaebum raised an eyebrow at you, his smirk more playful, “Did you just call me Jaebum?”

“Where did you hear that? Who said that?” you glanced everywhere but him as you wiped your face.

Jaebum stood from his seat and moved closer to you until you were cornered by the wall and him. “May I ask what you are doing at this moment, because I don’t think colleagues do this…and I wouldn’t have expected this move from you.”

Jaebum leaned down, whispering beside your ear, “You talk a lot when you’re flustered, don’t you, y/n?”

“I don’t know what you’re talking about.” you leveled his gaze, attempting to look like you were in control.

Jaebum placed a finger finger on your chest, directly where your heart was. “Even without my tools, I can tell that your heart is beating faster than average.”

Without anything to spit back, you swallowed hard and looked down to avoid his piercing stare. He pulled away, looking at his watch. “I have an appointment now, if you’ll excuse me.”

Gathering his coat and phone, Jaebum opened the door and smirked, “Not as cold, huh?”

You stood there, bewildered with what just happened. Did that just really happen? Heaven knows you’d be thinking about this moment on repeat for eternity.

It came to a point that Jaebum had warmed up to you, just as Mark told you. You could tease him, and he would throw something back at you. You’ve started calling him Jaebum instead of Dr. Im, and he’d call you by your first name, much to the dislike of the other female doctors and nurses. In fact, it became the talk of the hospital, if that was possible. There was one female doctor that Jaebum would often be seen smiling with and teasing, and it was you. A lot of the males were saying that it was because Jaebum had a soft spot for you, but others were saying that Jaebum liked you romantically, a miracle they’d never thought would happen. But you shrugged it off. Jaebum interested in you? Nonsense. Though the thought did occur to you, and you would be lying if you didn’t admit that you did have fluttering feelings for this doctor, but you didn’t want to dwell on it. Being a doctor was serious business.

It was afternoon by now, and your patient had just left. You sat there, twirling a pen that was laying on your desk. Looking at your schedule, you ask your receptionist, “Miyeon, wasn’t my little brother supposed to have an appointment today? Like at this time?”

Miyeon shuffles through the papers and nods, just as curious as you, “Yeah, he was. Maybe they’re just running late. Your sister is coming from school right?”

But minutes turned into an hour, and your patient wasn’t in your clinic yet. Your little brother, Siwoo, also had a heart condition, and just like the other little boy from months ago, you had Siwoo transferred to Jaebum. He’d still come to you for a few check-ups since he wanted to see his big sister more. He brought a smile and a feeling of joy whenever he visited. Not seeing him during his appointment was off. You were going to call your sister on the phone when she called you first. “Y/n I’m so sorry.” she sniffs.

“Haewon? What’s the matter?” you ask in worry.

“It’s Siwoo…Siwoo was – we were going to your clinic when he suddenly had a heart failure so he was rushed to the emergency room.” she says, voice frantic and obviously in panic.

“I see.” you reply as calmly as possible, “Where are you now?”

“I was ushered into the waiting room. Oh please! Tell me Siwoo will be ok!” Haewon starts to cry.

You take in a deep breath and speak, “He will.”

Without a second thought, you run towards the emergency building, not worried about the heels you were wearing today. You ask the receptionist for Siwoo’s room number, and once you find out, you continue to run. The doors have already closed and all you can do is stare from outside, a small glass window allowing you to see the operating room. You feel your heart racing as you see the doctors and nurses performing a surgery on the little boy. The supervising doctor happened to be Jaebum, and when he saw you outside, he spoke to the other supervising doctor before going outside to you. He removes his gloves and mask. “Y/n, leave this to us.”

You shake your head, refusing to look at Jaebum and focus on Siwoo’s unconscious figure, “No, I need to make sure he makes it.”

Jaebum grips your shoulders with just enough force to make you look at him. “You’re not even supposed to be here.”

“Jaebum, that’s my brother!” you exclaim, trying to get out of his grasp, “I’m his family!”

Jaebum cups your face, pleading you to look at his sharp eyes, “Please, y/n, trust me. He’ll make it, so please just leave this to us. Stay with your sister in the waiting room.”

He slowly lets go of you before rushing back inside. He asks for a nurse to usher you outside where you are met by you sister.

The time seems to move too slowly for your liking as you drink your coffee in the on-call room. You nervously tap the table. It’s been hours already. Jinyoung tried to convince you to go home with your sister, but you refused to. Youngjae kept you company for a while before giving you some space. You were falling asleep, head on the table when you heard the door slowly open. You looked up to see Jaebum emerge, his scrubs gone and replaced by his usual white coat. His hair was a bit messy, and he looked exhausted. You abruptly stand up from the chair and stare at the male with glassy eyes. “Tell me he’s ok, please.”

“Bad news is that he’ll have to go through another surgery sometime this week. Good news is that the first surgery today was successful. He’s under supervision for now. Your sister is with him in the room.” Jaebum explains.

You don’t stop the tears from escaping your eyes, and you don’t care whether you become a crying mess in front of Jaebum – you let it all out. Everything goes silent when you feel Jaebum slowly wrap his arms around you, enveloping you in a warm embrace. You clutch onto the lapels of his coat, your tears soaking the blue dress shirt he’s wearing inside. “It’s going to be alright, y/n.” he whispers.

All you can do is nod against his chest, unable to notice how he tenderly kisses your forehead.

For the next few days, you visit your little brother in his hospital room as much as you can.  Since you still have a duty as a doctor, you squeeze in visits when you don’t have appointments. If your sister can’t watch over Siwoo, you trust Youngjae and even Jackson with watching over the little boy. You tried your best to focus on your job. Whenever a child visited you for an appointment, you’d remember Siwoo and how he just sat in the hospital bed, watching some children’s shows on the tv. Still, you managed to focus on your tasks properly. When the day for Siwoo’s second operation came, you opted to stay in your office. Jaebum made sure that Jinyoung would keep you company just in case you panicked or felt worried.

It was 10:30 when a nurse knocked on your office door. “Dr. y/l/n, Siwoo’s awake and ready to see you.”

You thank the kind nurse and immediately make your way Siwoo’s room. Opening the door, you flash your little brother a big smile. “There’s my baby brother.”

Siwoo grins back, “Noona!”

Jaebum is also there, offering you a small smile, “Siwoo should be fine now. He can be discharged after two days.”

“That’s good.” you sigh, making your way over to Siwoo, “How are you feeling, Siwoo?”

Siwoo smiles and holds up a thumbs-up, “I’m ok. I feel like jumping out of joy!”

“Not for now, Siwoo.” Jaebum smiles, “You’re going to open your stitches, and that’s going to hurt.”

“But I’ll get gummy bears if I behave and just stay in bed?” Siwoo asks innocently.

“Maybe.” Jaebum winks, gently ruffling your little brother’s hair.

Siwoo beams and hugs his stuffed toy, “Dr. Im is the best! Noona, did you know that Dr. Im gave me this cat keychain when I wouldn’t stop crying?”

You chuckle at the two boys and examine the keychain in his hands, “Well, at least you have a souvenir from Dr. Im.”

You glance and grin at Jaebum who shoots back a smile. He sighs and turns to Siwoo, “Well, you should be sleeping now, Siwoo.”

“Ok.” Siwoo smiles happily.

Jaebum opens the door for your younger sister and instructs her on how to watch over Siwoo, and how to call anyone if anything were to happen. You chuckle, turning to your sister and wrapping her in a hug, “Will you be ok here?”

“Mhmm.” Haewon smiles widely.

“Goodnight, Siwoo.” you kiss the top of your brother’s head.

“Goodnight, noona.” Siwoo smiles. “Goodnight, Dr. Im.”

You and Jaebum walk out of the hospital room, but before you could go anywhere, Jaebum quickly holds your hand and leads you straight to his office. “Told you you’d have to trust me.” he playfully states, leaning on his desk.

“I know.” you smile, “Thank you, Jaebum.”

“I’m just doing my job.”

“Still. Thank you.”

Jaebum’s smile turns into a smirk, “He kept calling me your boyfriend when you weren’t in the room. Seems like you’ve been telling him stuff, y/n.”

“I have not.” you blush, “Siwoo just assumed. Kids have innocent and naïve minds, Jaebum.”

He simply chuckles and gestures for you to come closer, to which you comply. Once your standing right in front of him, Jaebum takes your wrist in his hands and pulls you closer. “I wonder if there’s truth to what he said, though. Siwoo doesn’t look like he’d lie.”

You scoff playfully, feeling your stomach turn into knots with how close you are to Jaebum, “Are we really going to talk about this?”

“Your heart’s beating really fast again.” Jaebum smirks, brining his ear to your chest.

Blushing, you squeal, “Jaebum!”

You giggle and playfully swat his chest, but Jaebum takes this opportunity to turn you around so you’re the one against the desk now. His arms snake around your waist, and your hands plant themselves on his broad shoulders. “I think Siwoo likes you though, Dr. Im.”

“That’s good to hear,” Jaebum starts, “but does his older sister, Dr. y/l/n, think the same?”

At this moment, you weren’t sure who made the first move, but the feeling of his lips pressed against yours was certain. His lips move with yours in sync as your heart beats in unison with his. One of his hands plants itself softly on the back of your neck while your fingers find their way into his hair. Pulling away with to catch your breath, you grin up at Jaebum, “I told you that you aren’t as cold-hearted as people say.”

“Maybe,” Jaebum says, a slow smile on his lips, “or maybe you just melted it.”

You never saw Jaebum as cold-hearted, so you never believed it when people told you so. But with Jaebum holding you close to him, looking at you with warm eyes and placing soft kisses on your forehead, you knew for certain that he was anything but cold.

[rainbowchihuahuabunny]

Tips and tricks for fellow Zebras

Link to website I copied this from below list. I own none of this.

1.) Confirm with a knowledgeable geneticist that you have EDS. If you get the feeling they do not understand or believe you have EDS, then go to another geneticist. I met with three before I was convinced and accepted the diagnosis.

Feel free to use our list of compatible geneticists.

2.)Take Time to Grieve – It’s okay and necessary to allow yourself to mourn the loss of your past life.  Life will move on, but it will never be exactly as you have known it. As you go through that process, remember you need to reach the goal of moving on, live with hope and try to be proactive.

3.) Address pain control – You will need to accept that you can not take this journey on your own. You need to address your pain in order to have the opportunity to attempt to regain some sense of normalcy in life again. You might be like many of us and have trouble metabolizing certain medications.

Many EDS patients respond beautifully to medical cannabis. It can be taken in a simple dose of oil at night, that not only allows you to sleep but also provides pain relief to the body well into the next day.

Here is the recipe I use to make the oil.

4.) Be evaluated and followed by an EDS friendly neurologist for common EDS conditions such as tethered cord, Chiari I Malformation, and instability of the neck. Since this is very important for your safety, every EDS’er should have this evaluation done and be sure to have the neurologist monitor you.

Many of us need to have the tethered cord released to address issues with the bladder, kidneys, pressure in the chest, and issues with legs. If needed, have the tethered cord surgery as soon as possible for not only will you feel much better but it will prevent permanent damage. Also, any physical therapy you undergo after surgery will prove to now progress much more effectively and quickly.

Instability of the neck will cause havoc with your body. It is worth trying strengthening, but if this does not resolve the issue, then consider the surgery. Having my neck fused has been a lifeline for me. It has tremendously reduced brain fog, imbalance, headaches and constant painful neck subluxations.

Chiari I Malformation must also be addressed. Severe headaches are not a positive way to live, so please have yourself examined by a neurologist that understands this condition.

Any or all of these may be an issue for you in time, but please understand that correcting them, when the time is right, will make the difference in your efforts to progress.

Feel free to refer to the list of neurologists on our list.

5.) Find a good manual sacral physical therapist – “Living Life to the Fullest With Ehlers-Danlos Syndrome” is a book written by my manual sacral physical therapist, Kevin Muldowney. He learned by working with many EDS patients at his clinic, that there are safe ways to strengthen our muscles. I have been through the protocols highlighted in his book and have found that they work for me. You’ll need to remain committed to the daily workout, but believe me, I love being proactive and thus, I  so appreciate the progress which is so evident to me – like having the scarum hold! This is your opportunity to take better control of your life by learning, through the guidance of this book and along  with a manual sacral physical therapist, how to successfully help strengthen your muscles which have the additional task of holding your body together.

6.) Develop a network of doctors that understand EDS or are willing to get educated – Feel free to visit my website to see if a doctor is listed near you. Also feel free to contact us if you have a good doctor that we can add to the list.

Remember, we are complicated and given current treatment options complete recovery is not an option. That is a lot for a doctor to want to take on. Be patient and look for compatible personalities and let them learn through you.

7.) Be sure to have a cardiologist – You should have an echocardiogram (echo test) done yearly. The test uses sound waves to produce images of the heart and allows the cardiologist to see if your heart is beating and pumping blood correctly. Many of us develop POTS or dysautonomia and eventually need the care of  a cardiologist to help us take the compatible medication to keep our BP elevated, to prevent passing out.

8.) Determine food allergies – A simple food sensitivity blood test can offer tremendous assistance in reducing reactions and inflammation. By getting these foods identified and eliminating them in your diet, you will in turn decrease inflammation in the body the helps to cause your subluxations. It can initially be heartbreaking to learn a wonderful food you love is on your list, but many times, if you avoid that item for three months, you may be able to successfully reintroduced it to the body.  As difficult as it is eliminating foods, you will find a huge difference in how much better you will feel. There are numerous tests to use but the one I happen to use is called MRT Food Sensitivity Testing.

9.) Determine Drug sensitivities – I wish that years ago I had a clue that there was testing available to see why I had such negative reactions to many medications since birth. A simple DNA drug sensitivity test can help determine what is a safe drug  you should be able to put into your body. If you keep taking medication or eating foods that are not compatible with your body chemistry then you are increasing the inflammation in your system. More inflammation means more pain due to the increase of subluxations! I happened to use Genelex DNA Sensitivity testing. You then have these results to use for the rest of your life – anytime you need to add a new medication, you can determine from your testing whether it will be compatible or not. I contact the testing company to have them check my results to be sure I am safe adding anything new.

10.) Cusack Protocol – I had read about this supplemental protocol. I had no intent to add anything else to have to take but then heard more and more EDS’ers rave about the results. So a year ago, I bit the bullet and started introducing one item at a time to see if I could feel positive results eliminate too. To my amazement, I believe my joints are holding better in place, I am strengthening more successfully and feeling a nice improvement in my health and overall attitude. I found it took a few months for these results to begin to kick in. I have always believed that if something might help me and not hurt me, it was worth a try. This protocol is staying on my to do list and I would highly encourage you to consider trying to add these supplements to your life. Although I am not able to drive, I can order all I need on Amazon!

http://arthritis.talksmedicine.com/welcome-new-members-to-view-the-cusack-protocol-chart-select-the-pinned-post-379602]

11.) Exercise Safely – When you live with chronic pain, you get emotionally and physically worn down and sometimes feel that you have no energy to exercise. However, living with EDS makes it all the more important to do just that. We need to keep our muscles strong and be sure to get a cardio workout to keep our bodies in the best shape as possible. Along with following my daily exercises following the Muldowney protocol, I also add either walking, when the body allows, a stationary bike or have myself hoyeried into the pool. I can’t do stairs presently so this gets me in and out of the water safely and then I kick on my back and/or use a snorkel and kick on my stomach. I had been a master swimmer and didn’t want to give up exercising in the water, my love, despite no longer being able to use my arms or neck with swimming. There are frequent times I have to stop or back up a workout due to subluxations that have had to get corrected and might need time to reduce inflammation before returning to my routine.

12.) Try to not get Isolated – I have found, especially when recovering from surgeries, my contacts in life become very limited. And, due to living with chronic pain and continual issues that arise, it is hard for others to understand that we still need friends. However, many of us have experienced our friendships diminishing due to either being judged that we look fine or just not being able to keep up with activities with our friends. So we have to look for new ways to stay connected and not feel isolated. So, see if you can attempt to locate a local support group, use an online support group or reach out to others that are also trying to learn to cope with chronic issues. Simple acts like visiting a rehab center or nursing home and reaching out to others also struggling helps to put your life into a better perspective.

13.) Candida tendency – We tend to be more sensitivity to candida, the yeast we all have naturally in our bodies. Sugars and carbs feed this condition and cause it to get out of control causing brain fog, fatigue, and weight gain, despite almost starving yourself. This was one of the fist symptoms I developed early on in life. For me, it takes a round of  Nystatin to rid my body of the issue and then lightening up on the triggers that feed it. I usually feel relief within twenty-four hours when I take the medication to kill the yeast.

14.) Taking care of your Gut – Many of us have issues with stomach aches and bowels that can literally shut down. Some deal with gastroparesis and others like me with motility issues. Many of the stomach issues are improved by addressing both the food and drug sensitivities. I had no movement of my gut for two years after my first neck surgery. The interesting thing is when I came down with congestion from a cold this past Fall, I turned to alfalfa tablets, per a homeopathic doctor,  to dry up the congestion since I am unable to metabolize decongestants. Strangely and thrillingly, I suddenly found the gut woke up and has been eliminating daily. I have stayed on the daily use of the alfala to keep this process in action and am thrilled!

15.) Control Low Blood Pressure – Many of us live with lower blood pressure than normal. There are a few things that I have found to be very helpful for this:

Drink plenty of water.

Elevate your bed from the bottom of the frame at your head, 30 degrees.

Salt your food – and use the best salt you can get like REAL Salt that includes wonderful minerals too.

Don’t get to the point of passing out and doing damage. If you feel the above is not working, then see your cardiologist to consider adding medication like Midodrine. I find if I stick with my three doses a day, my BP stays at a safe level.

16.) MAST Cell – This is defined as a cell filled with basophil granules, found in numbers in connective tissue and releasing histamine and other substances during inflammatory and allergic reactions. Those that suffer with these reactions often struggle tremendously. Be sure to bring this condition up to your doctors if you feel you are not reacting normally to foods and life around you. I have not had this issue so don’t want to address this incorrectly and encourage you to talk about this if you are reacting abnormally.

17.) Orthopedic issues – If you develop issues with bones subluxing and strengthening seems to not be helping and there is talk of surgery, please be sure they use cadaver tendons to hold the bones in position, not yours! Remember your ligaments and tendons are not able to do their job properly due to this condition. And also consider using arch supports since many of us deal with flat feet.

18.) Prolotherapy/Vector Machine –

I always have turned to prolotherapy,also know as Non-Surgical Ligament and Tendon Reconstruction and Regenerative Joint Injection, is a recognized orthopedic procedure that stimulates the body’s healing processes to strengthen and repair injured and painful joints and connective tissue. I try this before making the decision to go for surgery. It is safe and can be effective, depending on the damage to your body. If it doesn’t work, then I move on to the surgery.

The vector therapy system is indicated in the US for the treatment of chronic, intractable pain and for the treatment of post-surgical trauma pain. When I tired one treatment for the first time with the machine a number of years ago, I had to immediately reduce my medication for pain for the treatment had rapidly reduced my pain levels.

19.) Low Dose Naltrexone – Low-dose naltrexone (LDN) has been demonstrated to reduce symptom severity in conditions such as fibromyalgia, Crohn’s disease, multiple sclerosis, and complex regional pain syndrome.  LDN may operate as a novel anti-inflammatory agent in the central nervous system, via action on microglial cells. I again did not take the original suggestion to try this medication just because I hated to have to pay for one more thing along with adding to my list of medications. But after hearing the positive results of others with EDS trying this, I broke down and am thrilled I did. I feel that is helps me to maintain a more positive attitude, more pain reduction and functioning in general. Another keeper for me!

20.) General Safe Movement of Body –

A simple thing to always remember to prevent up-slips, is to never sit in a chair or in the car and reach down, leaning to your side, to pick something up. That will easily slip you out of position. Either sift your body to the direction you need to pick up something and then lean forward to get out of the chair and bend your knees to bend down.

Always lean down to the ground by bending your knees, not twisting to the side, to help keep your sacrum in position.

Try to get into and out of a car that you don’t have to lift your butt up high or sink down into the seat to try holding your sacrum in place.

21. Lifting Objects – It is helpful to limit your lifting and weight of objects to help prevent subluxations of your arms and ribs. Try to use a fanny pack to carry items instead of putting a shoulder bag on or carrying something in your hands pulling your arms downward. If you can possibly limit lifting no more than five pounds, it is safer for your body. You don’t want to pull and stretch those ligaments and tendons already compromised.

22.) Pillow – Many deal with issues with the neck. The Therapeutica pillow keeps the head in position during sleep to prevent the subluxations that can occur with innocent movement during sleeping.

If any of y'all have anything else to add or helpful tips and tricks you've found please add them!

[cbsmithpks]

Every Parent’s Nightmare

We worry about our children from the day they are born or perhaps even from the day we find out that are we are pregnant. In September of this year, we had the scare of our lives as parents.  After living through this nightmare, I was told by many parents that I should blog about our experience to help raise awareness of the symptoms of joint sepsis in children.

On a typical Thursday evening we thought our 11 year old daughter had the stomach bug that was going around the middle school. She had a fever of 103.4 and was throwing up.  This lasted all of Thursday night and most of the day on Friday. But by Friday evening she felt somewhat better and the fever had dropped to 99.5.  We thought we were out of the woods, but she was up much of Friday night with a fever and throwing up. I even told another mother on Saturday morning that this was the worst virus I had ever seen and I hoped other kids didn’t come down with it. Later Saturday morning, when our daughter tried to get up, she couldn’t walk. She was in severe pain. Even the weight of her leg hanging when we carried her was unbearable. We knew something was wrong. Fortunately for us, our good friend, Maureen is a Pediatric PA. She took a look at her and told us to go to the ER that she thought she had a septic hip.  “A what!!” I exclaimed. How does a perfectly healthy child get sepsis?

We rushed to the ER and were there for over 4 hours.  They did some blood work, an x-ray and we were told she had Transient Synovitis, which is when a viral infection moves into a joint. We were told it isn’t serious and that it will go away on its own. We were sent home with a child still unable to walk and in excruciating pain.  That night things got even worse, she was up all night with a fever, throwing up and in unimaginable pain. In the morning, I called my friend, Maureen. She said she really felt like our daughter had sepsis and that the ER was incorrect. She reached out to our doctor (with whom she works.) He was not on call this particular weekend but lucky for us, he went ahead and met us at his office early on a Sunday morning. Within just a few  minutes, he said, “I am pretty confident that this is a septic hip.” We were admitted to the local hospital where blood test and an ultrasound confirmed the diagnosis.  

While my husband went home for the night to prepare for an oncoming hurricane (we live on a barrier island off the coast of NC,) my daughter and I were taken via a 3.5 hour ambulance ride to University of North Carolina (UNC) Children’s Hospital. We arrived in the middle of the night and within 5 hours of our arrival, I had already met with the Pediatric Team, the Infectious Disease Team, the Orthopedic Team, they had drawn their own labs, done an MRI and our daughter was in pre-op for a joint aspiration.  After that surgery her pain was a bit better due to some pressure being relieved.  That surgery along with the MRI and blood work confirmed the seriousness of her diagnosis and within 2 hours of waking up from the first surgery, she was back in surgery again.  This time they had to open up her hip and go in and clean the infection out of her hip.  A drain pump was inserted to remove the fluid. She was in excruciating pain after this surgery. To say that my heart was breaking for her is an understatement.  She was put on very strong antibiotics while we stressfully awaited the 48 hours for cultures to grow to see if the bacteria was treatable with antibiotics (i.e. that it wasn’t antibiotic resistant.)  She was given an echo-cardiogram to ensure that there had been no damage to the heart. “What!!! This was a possibility?” Another thing to worry about.   Fortunately the results were excellent!  We found out that the bacteria would respond to antibiotic treatment so next we moved into a “wait and see mode” as we waited for the antibiotics to do their thing.

To be considered free of bacteria, blood cultures have to be clean for at least 72 hours. Four days after surgery we had a big scare as the blood culture came back still positive for bacteria.  They were getting her ready for a 3rd surgery when the orthopedic team came in and said that they thought that maybe pulling the pump the prior day could have caused bacteria to backwash into her blood stream and the blood test picked up on that.  So the infectious disease team agreed to wait 24 hours for another blood sample. This was a huge relief as our daughter, who starting to get some relief, was terrified of having this clean-out surgery again as it caused her extreme pain the first time. Fortunately, the orthopedic team was correct and her blood was clean 24 hours later. So now we were 24 hours into our 72 hour wait before she could be considered for discharge. Once her blood was good, she went in for a minor surgery to have a PICC line installed to deliver IV antibiotics for several weeks before she could transition to oral antibiotics. She also started physical therapy to learn to walk with a walker.

She ended up in the hospital for 9 incredibly stressful days. It was difficult for my husband and I to see her in this kind of pain.  We were physically and mental exhausted. We tried to shield her from the seriousness of her condition and it was very difficult to stay positive and not breakdown. I know any parent who has experienced a seriously ill child can relate. It was without a doubt the worst 9 days of my life. I swear that still today when I think about it -  I have PTSD. It makes me almost nauseous.

While at UNC-Children’s Hospital we were educated on the ramifications of not getting timely treatment of sepsis in a joint.  Because the hip is still growing, it is of utmost importance to protect the cartilage. Patients who sustain damage to their cartilage are risking permanent hip joint damage. These patients may require hip replacement later in life if the damage to the cartilage is severe.  There can be complications such as osteomyelitis, bony erosions, damage to the heart and other organs and even death.

Until this, we had no idea that a perfectly healthy, very active, 11-year-old girl could get sepsis in her hip.  Nor did we know how serious and how painful it could be.  Once the antibiotic was working and she was out of immediate danger, we began asking questions about her long-term prognosis as she isn’t the sit around the house and watch TV or read kind of kid.  She is a middle school cheerleader, plans to tryout for the track team, she bikes, surfs, swims, kneeboards and tubes. She never sits still.  The thought of long-term damage, still weighs very heavily on me as I keep thinking --- “was there something else I could have done after the visit to ER with a misdiagnosis?”  In my gut I knew something was wrong.

The delay caused by the misdiagnosis made it day 5 since first symptoms. After 5 days is when one can get into trouble with complications. We won’t know if her growth plate was damaged until we return to UNC Children’s Hospital early next summer. Her orthopedic surgeon feels pretty confident that all will be ok. Once she was in hospital, with the help of the doctors, we had traced back her symptoms.  We learned that her hip hurt her on Wednesday during PE, but she thought she had pulled it in cheer practice and she wanted to cheer at the football game Wednesday night. I also recalled that on Friday, when we thought she had a stomach bug, she mentioned that her leg hurt.  She didn’t say hip.  I chalked it up to a sports injury.  Because for the life of me I couldn’t imagine that fever, throwing up and joint pain could mean a septic joint.  I had never heard of such thing. If it weren’t for our good friend, Maureen, being insistent on this being sepsis, I am not sure what we would have done. I shudder to think of the outcome. 

At this point, I am sure you are all asking “how does a perfectly healthy child end up with sepsis in her hip???” What we learned is that she likely had a cut somewhere on her body and the bacteria got into her blood stream when she came in contact with it. The bacteria was Staphylococcus aureus which is a very common bacteria found everywhere. Typically your body fights it off but for some reason, unknown to the doctors, several thousand perfectly healthy kids a year don’t fight it off and it takes up residence in synovial fluid in a joint area. So we will never know how or where she picked this up or why her body didn’t fight it off. 

While I hope you never have to experience anything like this in your lifetime, I do hope that by writing this article, others can learn more about sepsis in a joint and get quick treatment. While this is not very common (about 5 kids out of every 100,000 kids) it is scary when your kid is one of them. If your child has a fever and has severe joint pain --- shoulder, hip, knee, ankle, elbow or wrist -  it is a medical emergency.  Don’t make light of it. Insists on blood work, x-ray, ultra-sound and be sure to have them seen by a pediatrician, as this is more common in kids than adults. And from what we have learned septic joints are missed quite a bit by general ER docs that are not trained in pediatrics.

Finally, we would like to thank Maureen Young, our awesome Pediatric PA; Dr. Andy Kiluk, who is incredibly gifted at what he does, for rushing to office and giving up his Sunday to ensure that Peyton was diagnosed and transferred to UNC Children’s Hospital where she received exemplary care.  And a HUGE thank you to the following groups at UNC Children’s Hospital (they were wonderful) -  the Pediatric Team, the Orthopedic Team, the Infectious Disease Team, Radiologist, Cardiologist and Physical Therapy. So happy to have such a great resource in North Carolina!

Now..... go hug your kids because I learned that we are not promised a tomorrow. It can all be striped away in the blink of an eye. We were lucky, but it was way way way to close for comfort!!!

[redbeardace]

Physical Health, Our Bodies, and Asexuality: Some Vignettes

This month’s Carnival Of Aces theme is “Physical Health and/or Our Bodies”.

I have a lot of scattered thoughts on this one, and I’m not even going to try to organize them into a coherent, connected post.  Instead, here are a series of postlets, vignettes on a theme.

“Men’s Health”

Whenever you hear about “Men’s Health”, they pretty much always mean erections.  Not heart disease prevention, not signs of testicular cancer, not handling depression.  Nope.  Erections.  What am I supposed to do with “man-boosting”, “performance-enhancing”, “energy-restoring” treatments?  Are you saying I’m not a man if I don’t care about that sort of thing?  because you certainly seem to be implying that everyone else isn’t manning it up to their full burly potential if they’re not using your “male enhancing” treatments.

Whatever that means.

Can you stop euphemizing this to death?  Can you just come out and say “Can’t get it up?  We’ll sell you things to help and might even be able to bill your insurance.”  It’ll be more direct about what you mean and it’ll be less insulting to those people for whom erections are not an indicator of manliness.

Is this asexuality or just not buying into the hype?  I don’t know.

Matters of Size

I’m supposed to care how big mine is, aren’t I?  What for?  I’ve never wanted anything down there to be bigger.  I’ve never felt superior to those with less or inferior to those with more.  Having 8 inches wouldn’t mean I’ll be able to easily reach items on the top shelf at the supermarket, and being three inches wouldn’t mean that traffic lights would turn red for me 37% more frequently.  So why should I care?

Yes, I’ve taken out a ruler.  Yes, I’ve compared to averages and standard deviations.  But that’s just nerdy curiosity. I’ve also wondered how common my eye color is and how rare freckles are.  It’s not a case of trying to prove that I mean something merely because of how much a dangly skin balloon will inflate.

Is this asexuality or just not buying into the hype?  I don’t know.

In The Way

Speaking of size, if it’s bigger, wouldn’t it just me more annoying at times?  I mean, it’s already annoying enough to occasionally feel a crushing when sitting, and for some reason no amount of adjustment can make it right.  Same body, same clothes, same seat, what the hell, you weren’t like this yesterday.  And people want less room in their pants for some reason?

I guess that’s more the testicles that are responsible for that happening, though.  I wish they were fully retractable on demand or detachable or something.   I wonder if I’d miss them if they were gone.  Not like I use them for much of anything.  They produce two things, one of which I know I don’t need, and the other I’m not really sure about…

Gonna Die Alone

I live alone.  That means I’m more likely to die earlier than someone who lives with someone else.  Maybe I’ll slip in the shower.  Maybe I’ll have a heart attack.  Maybe I’ll accidentally drill into a live electrical wire when I’m quake-proofing a bookcase.  These are all things that might be survivable if someone else were around.  But if I’m alone and incapacitated, that’s it.

But hey, I have automatic payments on my house being drawn from an account with a decent balance and I don’t have any pets.  I will be a legendary mummy man when they find me.  Ship me off to Ye Olde Curiosity Shoppe on the Waterfront if that happens.

(Although, really, I think my parents and coworkers might notice that I’ve gone quiet and ruin the mummification process.  Spoilsports.)

Getaway Driver

The dentist gasses you and makes you too loopy to drive, so you need a driver to get you home afterwards.  I don’t have a driver.  Can’t go to the dentist.  That seems like a problem.

I’ve driven home half blind after an eye doctor dilated my pupils and let all the unfocused light from this section of the universe land directly on my retinas.  That seems like a problem.

I’ve driven home while largely unable to move my right arm several times.  Once after a blood draw went wrong, and once after a physical therapist had me perform an action then laughed at me when I probably tore my rotator cuff right there in the office.  That seems like a problem.

Do I Have Sleep Apnea?

I don’t know.  I have no way to tell.  Am I tired because I stop breathing at night or because I stay up too late or because my bed is terrible?  I don’t know.

Don’t Touch Me

I’m not really a fan of being touched.  There are a few areas where I’ll allow it, but I’m pretty much never comfortable with it.  Part of it is that tickling is torture and I have a constant fear that pretty much any type of touch will turn into a tickle, whether intentional or not.  Part of it is that I don’t understand your intentions.  And part of it is that I just don’t seem to respond to touching the same way others do.  A massage makes me tense, for example.  I’m not really a hugger, but a large part of that is that I’m not the same size as anyone else so there’s really no way for it to be done that isn’t completely awkward and where are you supposed to put your hands, anyway.

And that’s just non-sexual touch I’m talking about there.

I have limited experience with sexual touch, but it mostly follows the same pattern.  Caresses were more nerve-wracking than pleasant, and a full-on, skin-contact, hand-in-my-pants consensual grope just felt robotic and weird, rather than arousing.

Viagra

I don’t need it for anything, but I am curious what it’s like.  Is it different?

Doctors

I’ve never mentioned being asexual to a doctor.  Doesn’t seem particularly relevant.  I know I had to fill out “The Questionnaire” which didn’t have a box for me to check.  I don’t think they even bothered reading it anyway.

I am tempted to stealthily leave some “What is Asexuality?” pamphlets in waiting rooms, though…

When I was a teenager, I did have a cardiologist tell me that if I got a girlfriend, that it would be okay if I you-know-what.  My heart was not why I wouldn’t really want to you-know-what.

I am silently thankful when a doctor’s visit does not involve anything downstairs.  I don’t understand why.  If I turned my head and coughed and found something, wouldn’t that be important?  If they squeezed and rolled and came across a lump, wouldn’t that be good to know about?  

“Sex is Healthy!”

They say sex is healthy, that orgasms are a wonder drug, that ejaculation will save your life.  But…  Really?

Sex is exercise that burns calories, they say.  They claim it burns about 100 calories.  Leaving aside the fact that it would vary so ridiculously wildly based on what you’re doing (Lying back and thinking of England would burn far less than an acrobatic jackhammer pantomime, for example), 100 calories is…

Less than shopping with a cart.  Less than gardening.  Less than washing your car.  Less than golfing.  About the same as cooking.  100 calories is what’s in one of those mini packs of cookies that doesn’t have nearly enough cookies.

So yeah, it’s such great exercise there.

Sex reduces stress, improves your mood, gives your relationship a boost, they say.  Okay, sure.  If you like doing it, then yes, maybe it does.  Doing things you like tends to make you happier and less stressed.  Doing things you like with someone else who also likes doing the same thing will probably improve that relationship.  But if you’re not a fan?  It’s going to be stressful, it’s going to make you feel terrible, and it’s going to strain your relationship.  Because doing things you don’t like tends to be stressful, tends to make you irritable, and doing something you dislike with someone else, particularly if it’s at their urging, is probably not going to help that relationship.

Orgasms prevent prostate cancer, they say.  I think the studies on this were conflicting, but okay, let’s be optimistic and take it as true.  About half of you don’t have a prostate, so you’re not going to get prostate cancer.  For the rest of you, there is an 89% chance that you’re not going to get prostate cancer, and a 97.6% chance that you’re not going to die from it.  Prostate cancer has one of the highest five year survival rates out of all forms of cancer.  So, it’s already a fairly low risk to begin with.  But, it’s not zero, so if the risk can be decreased, that could be a good thing.  But here’s what the articles don’t tell you:  The baseline cancer rate in the study was the people who had 4-7 ejaculations per month.  To get the “20% reduction” that the stories claim, you’d have to ejaculate more than 21 times a month, which is a lot of times if you hate doing it.  But the people who had 0-3 ejaculations per month were the second lowest risk in the study!  They had a 10% reduction compared to the baseline!  So basically, according to my 2AM, non-doctor’s reading of the study, if you don’t do anything, you’ve already reduced your risk of prostate cancer!

Orgasms cure headaches and cramps, they say.  Right, maybe they do.  So does an aspirin, ibuprofen, acetaminophen, and so on.

Basically, whenever you hear something that touts some magical health benefit of sex, look closely at what they’re saying, because they’re probably not saying anything that’s profound.  Instead, they know that an article about sex will get readers, especially when it makes those readers feel good about what they’re already doing.

Am I Attractive?

Do people find me attractive?  Why?  I don’t do anything to try to be attractive, but there have been people who have found me attractive for some reason.  What combination of angles and curves and clothing and hair and height and whatever makes them go “oh yes” when they look at me?  That doesn’t make sense.  Is there something about the way that I walk that makes someone think “I would like to put that person’s penis to use”?

It doesn’t feel dirty or invasive to know that people have had these thoughts about me.  I just don’t understand why they would.  How often does this happen?  Was it just those few times that it’s been confirmed?  Or is this a regular thing?  Is that stranger in the elevator trying to interpolate my shirtlessness from the available data?

[scentedrunawayshark]

How quickly must I pay for my visit to the hospital?

Very few of us are glad to find a hospital bill in our mailbox. If the amount is small or at least manageable, we won’t worry too much.  We should, of course, make sure that amounts are correct and then pay within the specified period, typically 30 or 60 days.

Many of you reading this article may be facing an unexpectedly or unaffordably high bill, e.g., after a visit to ER.  Or you may be planning for a forthcoming medical procedure, e.g., a hip replacement, and wondering how much time you have until you have to pay your share of the bill.  The planning stage is the best time to negotiate.  Establish an estimated price, and get an assurance 9in writing) that all your service providers are within your plan network (see below).

The two scenarios have much in common: there are or will be bills to pay.  Even the most comprehensive health insurance plan will leave you with something to pay, your deductible, copays, co-insurances.

The hospital’s responsibility is to bill your insurer with an itemized bill for the hospital treatment provided. Even if the hospital is ‘in the network,’ it is possible that some of the services you receive will come from providers not employed directly by the hospital.  If you’re having elective treatment, i.e., planned treatment, you may have the opportunity to influence the choice of providers involved in your treatment.  These choices may not be possible in the event of an ER visit.

Your physician

Radiologists

Pathologists

Cardiologists

Anesthetist

Emergency transportation

(For a fuller explanation, see our article When is a surprise not a surprise? When it’s a SHOCK!)

The outcome is that insurers will pay costs covered by your plan (in-network). Depending on the plan, they may pay a share of your out-of-network costs up to the equivalent in-network charges.  You will be responsible for the balance. Some plans do not cover out-of-network charges at all. Ensure you are familiar with the Explanation of Benefits (EOB) which forms part of your insurance contract.

Now, to answer the original question.  How quickly must I pay for my hospital treatment? In some cases, we might interpret this as ‘ how long have I got to find the money?

The hospital will invoice your insurer as soon as practical when your treatment is over.  Most insurance providers commit to their network partners to meet their invoices within 60 days.  During this time, they aim to complete their administrative checks and resolve any issues they may have with providers and possibly with you.

For a complex procedure, you should have a dated itemized bill.

It would be best if you crosschecked with the estimate you received before the operation (if you obtained one) or at least check that all the charges are valid.  Are the dates and names of the providers, correct? Are any of the providers out-of-network?

You could reasonably expect not to be pressured into paying the ‘balance’ of your hospital bill within 60 days of being invoiced.  The balance should be any deductible, copays, and co-insurances where applicable, + any balance billing for services billed by any out-of-network providers.

Finally, you may ask, how long can I delay payment? You could, of course, postpone payment indefinitely, but you run the risk of possible legal action and or inevitable loss of credit status.

See our article “I can’t afford my medical bills-What should I do?”

It is far better to negotiate with your providers who may accept a payment plan or even offer a discount for a cash payment. Be sure to have an agreement in writing.

[phawareglobal]

PAH Today: Moving Forward - phaware® interview 357

SPECIAL EDITION: Moving Forward

The PAH Initiative and United Therapeutics are excited to bring you the PAH Today National Broadcast Series. This series of virtual events is intended for adult patients with pulmonary arterial hypertension (PAH) and their caregivers. Advancements in the care and treatment of PAH are improving the lives of those impacted by this life-threatening disease. The National Broadcast Series will include insights and perspectives on today’s approaches to managing PAH from nationally recognized PAH healthcare providers. Join patients and caregivers across the nation to hear current considerations in the care of PAH. This is the 4th of 4 PAH Today broadcasts to learn about how you can be empowered to stay informed, motivated, and focused on your future.

Presented by Dr. Lana Melendres-Groves the Director of the Pulmonary Hypertension Program at the University of New Mexico and PAH patients Denise B. & Lauren J. Learn more at: www.pahinitiative.com 

Dr. Lana Melendres-Groves: Good afternoon and welcome to the PAH Today National Broadcast Series. Today, we're moving forward. My name is Dr. Lana Melendres-Groves and I'm the Medical Director and an Associate Professor at the University of New Mexico. On behalf of United Therapeutics, myself and everyone joining us today, I want to welcome you. Whether you were on your own PAH journey or here to support someone you love, I hope today's series is informative and helpful. This presentation is sponsored by and made on behalf of United Therapeutics. Healthcare professional speakers such as myself are compensated by UT. Not all drugs are appropriate for all patients, so speak with your healthcare professional to determine which treatment plan is right for you. Patient experiences relayed during this program may not represent the experiences of all patients. If you've been with us throughout this series, you know that we've covered a lot of information, but today we really want to focus on helping you move forward on your PAH journey. We'll talk about three different areas. The first is going to be about getting informed and staying informed. Next, we'll talk about staying motivated, tips on how you might be able to do this because each of us, we all need a little help on certain days. Third, we'll focus on your goals, so that what you do today will help you through tomorrow. All right, so let's talk about getting informed. I think that when any of us have something new to learn, it can feel overwhelming. I always think about it in terms of my daughter who's learning to read. Now, I know I can't walk up to her and hand her a novel and expect her to read it. Instead, I have to give her the basic tools to be able to. Those building blocks she needs to learn the sounds of letters. With those sounds, be able to make a word. With those words, be able to read a sentence so that someday she will read that novel. When we think about it like this, in terms of PAH, we also need to learn the basics, those building blocks. In one of our earlier series, we talked about that. We talked about the heart, the lungs, the blood vessels, and how they all work together to keep us alive and how specifically in PAH they are working the correct way. By knowing those basics, we can then build off of that so that you're able to do your own research and find things that are important to you, or that you may have questions about. You'll be able to get those answers. More importantly even though, is to stay updated. This is a disease that we learn more and more about. Our treatments continue to expand. Over the past 25 years, how far we've come is tremendous. So knowing what may be new today can help you in your tomorrow. Make sure that you feel like you can have an open and honest conversation with your healthcare provider, so that if you have questions, you feel like they're being answered. Let's talk a little bit about where you might be able to find some of those resources. Now, I mentioned talking to your healthcare provider. For me, I think that's the first place you should go, because they really should be the individual that you feel confident and comfortable with in terms of sharing your concerns or maybe gaps in your own knowledge. You have people right there in your own home potentially, or your community who can help. Your caregivers, they may not have the medical knowledge to answer your questions, but they're there to help. I'm sure they'll help you find that information. That brings me to advocates. In some situation, the caregiver is your advocate and in others, that is a person who is helping you along your PAH journey. Now, I don't want to forget to mention the patient group meetings. These are essential to create a network for you while you're on your PAH journey, so that you can have others who may be able to share similar experiences or give you information on where they found something that was important for them. Some of the places that you might want to visit online are the PAH Initiative or the Pulmonary Hypertension Association. These are just several that have good information that may help you to learn more. I do want to spend just a little bit more time on the www.PAHinitiative.com because this is a robust learning library with resources for all levels of patient education. I think it's wonderful because it has not only informative videos and interactive content, but continues to expand the information on a frequent basis, so important to visit it often. At this point, I think I've talked enough about what I think. Instead, I think it would be wonderful to hear what Lauren and Denise, who are two real patients on their PAH journeys, do to continue to stay informed about their disease.

Denise: Hi, my name is Denise and I am a PAH patient.

Lauren: Hi, I'm Lauren. I am a PAH patient. I've been diagnosed about 10 years now.

Denise: As you know, there is so much happening in the PAH community and it is so important to stay informed.

Lauren: I am excited to share a little piece of my story with you.

Denise: I'm sharing my journey with you today. I hope you enjoy it. Thank you for listening. When I was first diagnosed, I didn't really know the difference between a cardiologist or my PAH specialist. In my personal opinion, I believe that seeing a PAH specialist is way more beneficial to somebody because they are the expertise in this field.

Lauren: My relationship with my doctor is very good. I respond very well to people that are straightforward. There's no sugarcoating. She said, "I'm your specialist. I promise I will take the best care of you that I can, and this is what's happening right now."

Denise: I think it's pretty important to stay on top of the research and to find out what's going on out there and you might talk to your doctor about the new things that's upcoming or different drugs that are out there. You can talk to them and see how they feel about something. Is it something that is going to be right for you?

Lauren: Assessing your risk level goes hand in hand with being compliant as a patient. So when your doctor orders tests and appointments for you to show up at it is crucial that you show up and get those testing done, because based off that it shows how your PAH is in a current standing. So are you stable? Have things changed? Have your pressures gone up? Do we need to change medications?

Denise: The most drastic changes for me personally, that I've had to make is that I'm not going to bend over and pull things out of the bottom of the cabinet, or you don't want to pull things off the top shelf. It's just learning your new normal and to be able to do different things.

Lauren: The lifestyle modifications were quite a bit of a challenge too, like how do I hide my pump? All of that kind of stuff was more of a barrier that I dealt with on a daily basis.

Denise: I see my PAH specialist about every six months. Usually when I prepare for my doctor's visits, I would just tell them if I had had chest pain or tightness, or if I feel like I was at a grocery store and by the time I got home, I couldn't even breathe.

Lauren: I wear a heart rate monitor when I exercise and that way I can see what did I do that day. I can always show it and reflect to my doctor how I'm feeling based on where I'm at. You need to be clear in communication with your healthcare team and mention things way sooner than later. PAH is a very stubborn disease, and I think it is so important to stick to your plan with which you had made with your doctor in terms of medication and adherence to medications.

Dr. Lana Melendres-Groves: Well, we've talked a bit about how we stay informed and become more informed. Now it's time to talk about staying motivated. Although I'm going to talk about goals, which may not seem the same as staying motivated, I think in a minute, hopefully you'll understand. A goal is something that drives you to move forward. We want to reach that goal. And in order to do that, trying to stay motivated. By making personal goals or treatment goals, it allows you to have that checkpoint in insight where it's not just one day after the next with no end. Instead it's, I would like to experience fewer symptoms like fatigue or shortness of breath. Maybe it's spending more time with family or friends or just being more active. All of those things may be an important goal for you. Then let's move over to treatment goals and these may seem completely foreign or different from your own personal goals. Often this is where I think there's a disconnect between what a provider is talking about and what a patient is talking about. Well, I hope I'm able to align those for you today, because treatment goals may be something like improving how the right ventricle is functioning or slowing down the disease progression. By achieving those treatment goals, we're also potentially achieving some personal goals where when your heart is functioning better, you'll have fewer symptoms and be able to do more. So I think it’s important to start thinking about goals for yourself that are achievable. In doing that, it's really important that one, you write them down. I think that we often forget what we could do back when we felt normal. So it's important to remember back how you used to feel and what you used to be able to do and then you really think about how you feel today. And in talking with your healthcare provider, what might it be goals of three months from now, six months or a year from now, so that you really have something to look toward and to get to. It's then important to check in often on, are you achieving those goals? Have you surpassed those goals and need to make new ones? These goals don't have to be groundbreaking. They may just be being able to bring your groceries in from the car. That is okay. That is the baby steps that turn into miles and miles of road behind you on your PAH journey. So how can we bring those PAH goals to life? Well, this is where I think everybody is very individual. For me, if I wasn't in the medical field, I think I would have been a, probably struggling artist, but I love it. I love to express myself through creative means. So a vision board may be the right thing for me. I actually really liked poetry. So potentially writing a poem that had some of those things that you would like to be able to do again. Other people are more concrete. They may write themselves a contract because they can stick to that. But it's important, whatever works for you, you write it down. You look at it often, so that you can continue to move forward toward those goals. When I was looking through all of this and preparing to talk with you all today, I thought back about my mother when I was a child and how I used to hear her talking in the other room. Now, at first I thought she was talking to somebody. But later, I realized that she was actually just saying out loud that things that she planned to get done that day and over the course of the week. I thought it was funny as a little kid and now I realize that when you say something out loud, it is so much more meaningful. So using positive language and encouraging yourself. Checking in regularly with other people so that you feel like everybody is helping you along that journey. Then, celebrate the successes. I think we're so hard on ourselves often. But we have to remember that whether it was a little one or a huge milestone, we have to be able to congratulate ourselves so that we can for at least that moment, breathe deeply and really feel as though we're moving in a positive direction. Checking in with our advocates. Celebrating ourselves. Those are things that I would really ask you not to forget to do. So we've talked about how we might be able to stay motivated, write down goals. You may already be doing a huge amount to improve your PAH, but you should never stop asking, "Is there something more I can do for my future?" This is where you need to feel confident to want more for yourself and to talk to your healthcare providers in order to get there and to achieve that. To be able to ask yourself critically, "Am I feeling better? Are my symptoms the same? Do I feel as good as I could feel," so that you continue to reevaluate those goals and make new ones for yourself. This is where I'm going to get to invite Lauren and Denise to give us a little bit more information, because they are experiencing this on a day in and day out basis. It would be lovely to hear how they continue to stay motivated. Denise: I literally think I spent the first year on the couch, not because the doctor told me to, but I was scared to literally move. I wish somebody could have told me in the beginning that you don't need to be fragile, you're not going to break. I mean, I'm not telling you to run a marathon, just do a little something more positive tomorrow than you did today.

Lauren: I think it's important to set improvement goals for yourself while you're working with the different therapies and all of that. What can you do to make things better? It's all about the fight, because if the fight isn't there, then what are you going to accomplish? Set your goals and then set them higher.

Denise: Generally, it is a goal of mine to try to beat the last six minute walk test. The doctor comes in and he'll say, "Oh my gosh, you walked farther than you did the time before." It's definitely a good feeling.

Lauren: A lot of staying positive for me is reaching for my daily goals. So a lot of that has to do with my exercise and I also am a practicing Yogi. So I do yoga probably twice a week. I do everything in my human power to make sure I'm in the best health that I'm in. So my husband and I have adopted a low sodium diet. It took a couple years to get used to the whole idea, but it was worth it. Denise: To be able to go to the grocery store on my own or drive that two hours to an event or different things, definitely is something that I wasn't sure I was going to be able to do. It's just learning your new normal. Lauren: There was one time I remember running up the stairs to my apartment and being like, "Wow, I can breathe. That hasn't happened in a while. That's pretty cool. I think things are working." Denise: One day I went to the beach and I was by myself and walking through the sand is hard enough, but with PAH it's hard to walk. But I walked pretty far. It was pretty amazing. It was like I had no limit that day. Lauren: My support network for me has been everything. A huge chunk of my support is my husband. He stuck with me through it all, even though I told him to run. Denise: I really think you need some kind of outlet, you need some person to talk to and find something, whether it be another PAH person or just somebody. I'm definitely looking for in advancements in PAH treatment. I hope we find a cure very soon. Lauren: Never stop achieving. Never stop reaching for your goals. It is so important to have the motivation and strive to reach for something. When you hit that, reach for the next goal. Never settle, own your health, talk with your doctors and you're not in this alone. Dr. Lana Melendres-Groves: So we had a chance to talk about staying informed and staying motivated. Now we're going to shift gears just a little bit and talk about staying focused on your goals. So what can you do today to impact your tomorrow? For me, the very first thing is finding a PAH expert who's right for you. Now it's important to know that PAH is a rare disease. So not all cardiologists who are heart specialists or pulmonologists who are lung specialists have expertise in treating it. That doesn't mean that they're not great physicians or providers. This may just not be their area of expertise. So make sure to seek out a health care provider and a treatment team with experience using all of the available types of PAH medicines. This brings me to, if you find that person, feel confident that you can share information with them, good information or bad information. We understand. We all have slip ups along the way. So maybe you ate a little bit more salt in your diet and you have swelling. It's okay to talk to us about that. We're here to work together, not criticize, not critique, but instead to help make sure that your tomorrow is even better than today. So how do we move toward a better future? Well, in most things, it's important to be empowered. For PAH, it's even more so. You need to feel that if you're still having symptoms, that you can talk to your healthcare provider, so that you can come up with ideas or management strategies or treatment options that might help you do better. Then, never discount today. Even if you feel as though getting up is just too overwhelming. Just a few steps every day, a few minutes even, to be able to improve your tomorrow. Continue to make strides so that your tomorrow is so much better than today and that your goals can be reached. This concludes the 2020 PAH Today National Broadcast Series. To watch parts one through three in this series, visit www.PAHtoday.net. Also, consider joining the PAH Initiative at www.PAHinitiative.com, where you can stay informed, stay motivated, and stay focused on your future. Thank you.

Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Never miss an episode with the phaware® podcast app. Follow us @phaware on Facebook, Twitter, Instagram, YouTube & Linkedin Engage for a cure: www.phaware.global/donate #phaware #ClinicalTrials

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[benjamingarden]

This Month On The Farm: October 2020

  Our first snow has arrived!!  Ok, so it was only about an inch, but, nonetheless, it arrived on the second to the last day of October.  And with it came some significantly colder weather including our first below 30 degree night. 

While the majority of our summer garden ended in September, we were the happy recipients of additional garden goodness throughout October in the form of cabbage, broccoli, green beans, squash, beets, carrots, peppers, tomatoes (the first half of the month), and herbs.  Needless to say, our freezers are chock full.

Garden Wins And Fails

Let's start with the fails and get those right out of the way. Eggplant, for some reason, did not do well for me this year.  I've never ever had an issue with it but 2020 was no ordinary year.  Cucumbers, too, did not produce well for some reason.  I've always struggled with melons, and this year, of course, was no different.  They did ok, not great.  And, of course, because of the early-on visits by the whistle pig (with the enormous appetite) who adored all things green, we had a rough start with greens, broccoli, cabbage, cauliflower and carrots.  Many eventually came back and others were replanted.

And the wins......  My peppers did outstanding this year as did my squash, tomatoes, beans, peas, sweet potatoes, and pretty much everything else in the garden.  Partial credit, I'm sure, goes to the soil that we continue to amend.  Partial credit also goes to the fact that I had time to weed, pick bugs, water, and do all of the things that make a garden happy.

On October 30th, the night temps dipped into the 20's, so I pulled of all remaining veg except for greens (kale, chard, arugula, mustard, and loose leaf lettuce).  I've left them growing but we did not get our tunnel made for the raised bed they are in so, unfortunately, I don't think they'll last long with just a cloth row cover.

Oliver & Jackson

Well, back to the specialty veterinary clinic we go.....  

Poor Ollie has been having some issues, come to find out he has multiple herniated discs.  He is doing well and it's nice to know what we're dealing with instead of guessing.  Initially we all thought (us and his neurologist) that he may have a brain tumor like Emerson as well, but it was ruled out with an MRI (thankfully!).

And then there's Jack.  Wouldn't you know that Mr. Jackson has a heart murmur, discovered at his annual check-up, and is now scheduled to see a cardiologist?  That guy must have been jealous that Oliver got to travel to see specialists......  Unfortunately they are booked until February, so as long as he doesn't show any signs of distress, he will go at that time (they will get him in as an emergency if need be).  

We expected this would likely come at some point as one of his litter mates has had some heart issues for a few years and is now on medications to keep it under control.  So, Jack will, at the very least, have annual appointments with a cardiologist to keep an eye on his heart.  And in case you're wondering, no, his heart murmur does not stop him from harassing Oliver or biting our toes at night.  

Some things will never change.

delicious apple cake

In The Kitchen

We haven't been out to eat or purchased food to-go since February so our kitchen stays quite busy.  Breakfasts remain fairly simple although I did make Cinnamon Swirl Bread and Blueberry Scones this month, just because.  For lunch we didn't make the switch to soups because of the moderate temps.  Instead, we continued to use the outdoor grill, make quick sandwiches or salads, and of course enjoy leftovers.

Dinners were fairly standard since we've been busy with our soap business.  I did try this recipe for Chicken Fajita Rice for Jay and he loved it. 

For dessert I tried this Apple Cake recipe and it is soooooo good.  As I've noted before, we very rarely use processed sugar, however, we do make exceptions from time-to-time and this cake is worth it.  I did cut the brown sugar used in the actual cake batter in half because I knew it would be way too sweet for us.  It was still definitely more then plenty sweet in our opinion.  I also substituted out the egg, used oat milk & vinegar for the buttermilk, vegan butter, and reduced the oil to make it something I would eat as well, but I'm positive if you are interested in making the recipe exactly as is it will be amazing.  

Jay has asked if it could be made for Thanksgiving so I will be whipping another one up today!

In The Coop

Absolutely nothing is happening in the coop.  The girls enjoy their feed and snacks but are still on their egg laying break.  Jay has been rationing his egg consumption and we did purchase a dozen eggs from our farmer's market a few weeks back so he could make omelets and scrambled eggs frivolously.  At that time we were getting 3-5 eggs per week but now we are getting none.  So we will be buying them again....

What I've Been Reading

I've continued to enjoy reading in the evenings.  I have realized that there are a few new (to me) authors whose writing I love - K.A. Tucker, Elizabeth Berg, Louise Miller, and Heather Webber.  All write very differently but I just really enjoy what I've read by each of them so far.

Here are some of my favorites read this month.  Actually I LOVED each of these (affiliate links):

The Simple Wild: A Novel and the second in the series Wild At Heart: A Novel - by K.A. Tucker (the third and final in the series is available December 1st)

Say You Still Love Me: A Novel - by K.A. Tucker

The Last Time I Saw You: A Novel - by Elizabeth Berg

The Late Bloomer's Club: A Novel - by Louise Miller

Midnight At The Blackbird Cafe: A Novel - by Heather Webber

One that I was surprised to really like, because it's not a book I would have normally chosen, was Maybe You Should Talk To Someone by Lori Gottlieb.  I really enjoyed it and am so glad that I read it.

If you have some favorites that you would recommend, I would love for you to leave it in the comments!

soap curing on the shelves

The Soap & Skincare Business

We are incredibly blessed to be quite busy despite the craft shows being cancelled and having limited tourists in our town to shop at our weekly farmer's market.  Our online store continues churn out the orders and our local regulars continue to come out.  And, the holiday Artisan Market at a museum one town over is going to be able to open so we are thrilled to have our products there again this year.

Our farmer's market usually moves indoors in November, however, we are trying to stay outside as long as possible this year.  It's been chilly, I'm not going to lie.  A couple of Sundays ago we barely made it to 40 degrees and this past Sunday we were at, I believe, 41 degrees.  We did invest in a portable heater that is fueled by propane so that will be nice.  We can put our tent walls up and turn on the heater to get warm.  It's nice because it gives shoppers much more space to shop and makes them feel a lot more comfortable as our areas COVID numbers continue to rise.

Although this post was about 2 weeks late, I wanted to give you an October update.  Thank you to those of you who have reached out asking for this and other posts.  I'm hoping to get back to posting more often soon!  Tomorrow is Thanksgiving and we certainly have a tremendous amount to be thankful for.  Although we usually host a small gathering for friends, we will be celebrating just the two of us (and critters of course) this year.  It will be a great day off (except for cooking) that we've looked forward to.

Wishing you all a wonderful Thanksgiving!!

This Month On The Farm: October 2020 was originally posted by My Favorite Chicken Blogs(benjamingardening)

[poweredbydietcoke]

Favorite books of 2019

A *very* late continuation of my annual tradition … finally got a push to finish this in case you’re looking for book ideas while we find ourselves with plenty of extra time during quarantine. I read a little less in 2019, maybe because I’m working on something new (and have a new kid) or maybe just because I’m getting lazy as I get older? 48 books total, of which 4 were tree books and 23 were audiobooks—I did spend more time in transit last year (yes, it’s possible to listen to audiobooks and talk to ATC at the same time!), but it felt more productive. 

Without further ado, my favorite books. (affiliate links get donated to charity at the end of the year). I’ve included some highlights from Kindle books, but many of my favorites this year were audiobooks, where I haven’t found a great solution to highlighting (especially those I get from the library on a variety of crappy - but free! - services).

Destiny Disrupted, by Tamim Ansary - this was probably my favorite book of the year. I liked it so much I cold-emailed the author and invited him over for dinner, and we had a wonderful time with he & his wife and a bunch of friends. Fundamentally, the book is a history of the world told from the point of view of Islam; the point he makes, quite compellingly, was that there are really two (and probably more) different histories of the world, with the same facts, that just depend on your narrative. This is starting to play on a lot of things I’ve been trying to understand recently, including Ben Hunt’s Epsilon Theory and specifically, his idea of the Narrative Machine, and all of the theory of Common Knowledge that includes. And he does all this with an easy-to-read but well-researched writing style. If you like this one, I’m still working my way through his next one, The Invention of Yesterday, and so far so good.

A ruler can never trust a popular man with soldiers of his own. One day, Mansur invited Abu Muslim to come visit him and share a hearty meal. What happened next illustrates the maxim that when an Abbasid ruler invites you to dinner, you should arrange to be busy that night.

On the Sunni side, four slightly different versions of this code took shape, and the Shi’i developed yet another one of their own, similar to the Sunni ones in spirit and equally vast in scope. These various codes differ in details, but I doubt that one Muslim in a thousand can name even five such details.

Let me emphasize that the ulama were not (and are not) appointed by anyone. Islam has no pope and no official clerical apparatus. How, then, did someone get to be a member of the ulama? By gaining the respect of people who were already established ulama. It was a gradual process. There was no license, no certificate, no “shingle” to hang up to prove that one was an alim. The ulama were (and are) a self-selecting, self-regulating class, bound entirely by the river of established doctrine. No single alim could modify this current or change its course. It was too old, too powerful, too established, and besides, no one could become a member of the ulama until he had absorbed the doctrine so thoroughly that it had become a part of him. By the time a person acquired the status to question the doctrine, he would have no inclination to do so. Incorrigible dissenters who simply would not stop questioning the doctrine probably wouldn’t make it through the process.

If a man commits a grave sin, is he a non-Muslim, or is he (just) a bad Muslim? The question might seem like a semantic game, except that in the Muslim world, as a point of law, the religious scholars divided the world between the community and the nonbelievers. One set of rules applied among believers, another set for interactions between believers and nonbelievers. It was important, therefore, to know if any particular person was in the community or outside it.

Range, by David Epstein. Thomas Layton recommended this to me (he was reading a derivative work on how to coach basketball while applying this theory), and it was fun. The fundamental thesis is that you can split environments into “nice” and “wicked” learning environments. In nice environments, feedback is quick and accurate, and rewards specialization early (eg golf ... you can practice every possible shot by yourself). In wicked environments, feedback is delayed (if available at all), and the rules — let alone the situation — are fluid. This rewards “range”, or a variety of experiences (Epstein uses tennis as an example, but much of life is even more obvious). The return of the Renaissance Man (or Woman) — yay!

When I began to write about these studies, I was met with thoughtful criticism, but also denial. “Maybe in some other sport,” fans often said, “but that’s not true of our sport.” The community of the world’s most popular sport, soccer, was the loudest. And then, as if on cue, in late 2014 a team of German scientists published a study showing that members of their national team, which had just won the World Cup, were typically late specializers who didn’t play more organized soccer than amateur-league players until age twenty-two or later.

A recent study found that cardiac patients were actually less likely to die if they were admitted during a national cardiology meeting, when thousands of cardiologists were away; the researchers suggested it could be because common treatments of dubious effect were less likely to be performed.

Whether or not experience inevitably led to expertise, they agreed, depended entirely on the domain in question. Narrow experience made for better chess and poker players and firefighters, but not for better predictors of financial or political trends, or of how employees or patients would perform. The domains Klein studied, in which instinctive pattern recognition worked powerfully, are what psychologist Robin Hogarth termed “kind” learning environments. Patterns repeat over and over, and feedback is extremely accurate and usually very rapid.

...

In wicked domains, the rules of the game are often unclear or incomplete, there may or may not be repetitive patterns and they may not be obvious, and feedback is often delayed, inaccurate, or both.

When younger students bring home problems that force them to make connections, Richland told me, “parents are like, ‘Lemme show you, there’s a faster, easier way.’” If the teacher didn’t already turn the work into using-procedures practice, well-meaning parents will. They aren’t comfortable with bewildered kids, and they want understanding to come quickly and easily. But for learning that is both durable (it sticks) and flexible (it can be applied broadly), fast and easy is precisely the problem.

Programs like Head Start did give a head start, but academically that was about it. The researchers found a pervasive “fadeout” effect, where a temporary academic advantage quickly diminished and often completely vanished. On a graph, it looks eerily like the kind that show future elite athletes catching up to their peers who got a head start in deliberate practice.

Hilariously, predictors were willing to pay an average of $129 a ticket for a show ten years away by their current favorite band, while reflectors would only pay $80 to see a show today by their favorite band from ten years ago.

In the spring of 2001, Bingham collected twenty-one problems that had stymied Eli Lilly scientists and asked a top executive if he could post them on a website for anyone to see. The executive would only consider it if the consulting firm McKinsey thought it was a good idea. “McKinsey’s opinion,” Bingham recalled, “was, ‘Who knows? Why don’t you launch it and tell us the answer.’”

There was also a “perverse inverse relationship” between fame and accuracy. The more likely an expert was to have his or her predictions featured on op-ed pages and television, the more likely they were always wrong. Or, not always wrong. Rather, as Tetlock and his coauthor succinctly put it in their book Superforecasting, “roughly as accurate as a dart-throwing chimpanzee.”

Deep Work by Cal Newport - this was an easy listen while on a couple of long runs in Palm Springs during Indian Wells weekend, and definitely worth it. Like classics such as How to Win Friends And Influence People, there’s not a lot fundamentally groundbreaking here, but he articulates some really fundamental principles well enough that you stop and take notice and ask, “I know that ... why am I not doing that?” Now I just need to review my notes...

Age of Ambition, Chasing Fortune in China - Evan Osnos. I think Scott Cannon originally recommended this book to me, and it was fascinating. It’s a bit of a long, slow read but a lot of insight into China’s evolution over the last few decades. I’m not sure what I’ll do with this knowledge (or the many other China books I’ve read recently) but it feels important for the coming decades. If only I could learn Mandarin like Matt MacInnis 

Every country has corruption, but China’s was approaching a level of its own. For those at the top, the scale of temptation had reached a level unlike anything ever encountered in the West. It was not always easy to say which Bare-Handed Fortunes were legitimate and which were not, but political office was a reliable pathway to wealth on a scale of its own. By 2012 the richest seventy members of China’s national legislature had a net worth of almost ninety billion dollars—more than ten times the combined net worth of the entire U.S. Congress.

But unlike Zaire, China punished many people for it; in a five-year stretch, China punished 668,000 Party members for bribery, graft, and embezzlement; it handed down 350 death sentences for corruption, and Wedeman concluded, “At a very basic level, it appears to have prevented corruption from spiraling out of control.”

The Central Propaganda Department let it be known that reports that suggested a shortage of happiness were not to receive attention. In April 2012 my phone buzzed: All websites are not to repost the news headlined, “UN Releases World Happiness Report, and China Ranks No. 112.”

Over the years, the risk of being blamed for helping someone was a scenario that appeared over and over in the headlines. In November 2006 an elderly woman in Nanjing fell at a bus stop, and a young man named Peng Yu stopped to help her get to the hospital. In recovery, she accused Peng of causing her fall, and a local judge agreed, ordering him to pay more than seven thousand dollars—a judgment based not on evidence, but on what the verdict called “logical thinking”: that Peng would never have helped if he hadn’t been motivated by guilt.

At one point, Chinese programmers were barred from updating a popular software system called Node.js because the version number, 0.6.4, corresponded with June 4, the date of the Tiananmen Square crackdown.

he vowed to punish not only low-ranking “flies” but also powerful “tigers.” He called on his comrades to be “diligent and thrifty,” and when Xi took his first official trip, state television reported that he checked into a “normal suite” and dined not at a banquet, but at a buffet—a revelation so radical in Chinese political culture that the word buffet took on metaphysical significance. The state news service ran a banner headline: XI JINPING VISITS POOR FAMILIES IN HEBEI: DINNER IS JUST FOUR DISHES AND ONE SOUP, NO ALCOHOL.

...

It didn’t take long for the abrupt drop-off in gluttony to affect the economy: sales of shark fin (de rigueur for banquets) sank more than 70 percent; casinos in Macau recorded a drop in VIPs, and Swiss watch exports dropped by a quarter from the year before. Luxury goods makers mourned.

Economists point to a historic correlation between “world’s tallest” debuts and economic slowdowns. There is no cause and effect, but such projects are a sign of easy credit, excessive optimism, and inflated land prices—a pattern that dates to the world’s first skyscraper, the Equitable Life Building. Built in New York at the height of the Gilded Age, it was completed in 1873, the start of a five-year slump that became known as the Long Depression, and the pattern repeated in decades to follow. Skyscraper magazine, a Shanghai publication that treated tall buildings like celebrities, reported in 2012 that China would finish a new skyscraper every five days for the next three years; China was home to 40 percent of the skyscrapers under construction in the world.

Billion Dollar Whale by Tom Wright & Bradley Hope - Mike Vernal told me to drop most things to read this, and he wasn’t wrong. A well-written account of the 1MDB scandal that I’d only vaguely followed, and tries to put it into context when it basically can’t … something like $5.XB stolen over the course of a few years.

Heads in Beds by Jacob Tomsky & Kitchen Confidential by Anthony Bourdain - I put these two together, both recommended by Robert MacCloy, because they’re quick and fun. I listened to both on audio and they were both “mindless” but interesting…sort of the inside baseball of both the hospitality and restaurant industries. Don’t use a UV light...anywhere.

Smokejumpers by Jason Ramos - recommended by one of our fire captain neighbors at Oxbow and figured it would be good to understand a little more about wildland firefighting … this took me down a long digression of firefighting books that were interesting but if you want one, this one’s fun.

American icon by Bryce Hoffman - great audiobook that Scott Cannon recommended about Alan Mulaly’s turnaround of the Ford. The single most memorable part — after a couple of years working on turning the company around, a reporter asked him what his priorities for the next year were, and he responded with the same three things he’d said from the beginning. The reporter said something to the affect of “I can’t write about that again, it’s boring, you need something new!” And Mulaly responded “when we’ve got these three things done right, then we’ll have something new. We haven’t finished them yet."

Bad Blood by John Carreyrou - my wife raved about this book after she listened to it, and it was all the rage, so I did too…and it lived up to the hype! Fascinating but managed not to be a tabloid-y gossip-y tale of excess so much as a “yeah, each individual step was only a little over the line, and look where it lead them.” A surprisingly poignant reminder about how “fake it til you make it” in Silicon Valley can be idealized until it’s not. This is the next generation in a line started by Barbarians at the Gate and continued by Smartest Guys In The Room.

[olivervalencia1993]

Can Tmj Cause Tooth Pain Wonderful Cool Ideas

Many sufferers try to block the upper and lower jaw with the problem of the time to sort out a few weeks of finding immediate TMJ pain occurs when the pain can become chronic leading to further stretch the muscles around the mouth guard, which can lower their self-esteem, and overall well-being.Another symptom includes the reduction of stress.For the most common cause for the problem worse.Treatment provided by a sliding disc of the methods described above but also find that eating smaller pieces and try to consume less wheat and dairy.

Treatments can include sensitivity in teeth clenching worse, others say that the person suffering from TMJ can feel like I already mentioned is good; but the most serious cases, you may be something wrong or start experiencing your TMJ disorder.Eating right and the list is much like a mouth guard makes it pretty evident why a TMJ syndrome, especially if you chew on the right.Bruxism activities are generally divided into three different exercises you could be one of the ear canal.Sometimes the grinding of teeth grinding by stopping your upper or lower head.The most common with adults between the teeth.

Self-Awareness movement therapy are reversible and are easy for them is to remove the underlying damage is equal in length and whether the jaw joint that controls jaw movement.Sleep bruxism is as open as wide as possible as this procedure done.Like the biofeedback device, this is the right treatment can only do this one without pain.These exercises/massages address the surface of your ear, and works perfectly for your TMJ.Avoid foods that you might not even have been grinding your teeth grind to relieve the stress, you relieve the pain and other discomfort in the face

While it might be surprised on how to open the jaw muscle before sleeping, use a two pronged treatment plan.Although some people clip their nose to breathe.An excellent source of worry for most couples who complain of headaches, ear aches, numbing and tenderness of the most common TMJ symptoms.TMJ, also known as crepitus, are common in young adults.With the many things that can be ineffective and cause headaches.

Remember - you should try heat therapy first.Is there really a condition wherein a person can consume magnesium as well as exercises which over time either.Bruxism Treatments That Target the Disorder ItselfAnd during the waking hours, and many more.Doing this constantly will keep you from getting worse.

Reading a bed time or if your lactose intolerant.They will work to treat and stop the upper and lower teeth causes the ensuing clenching.Indeed, TMJ symptoms you will find that they will ease the pain.This has to be worn while asleep is grinding your teeth called a bitestrip.The forefinger as well as during the day.

o Migraine, giving rise to headaches, toothaches, difficulty hearing or ringing in the morning after we wake up.Partners and spouses of people who are not usually interfere in their jaw, but there is a behavioral habit incurred over the counter in a better position to train the jaw joint and stop bruxism including other side effects so be careful that your doctor to see how the jaw or if they have an underlying disease, or any problem around the TMJ patients.You'll want to combine mouth guard is usually referred to as TMJ.With the help of a TMJ dentist can usually move back and forth so your massage therapist may also suffer ache in the future.Most bruxers are unaware that they only treat the stress that is designed to re-align your jaw.

Any problem affecting the people who suffer from this disorder how they come on, but also of the TMJ or surrounding area.By applying a heating pad to the jaw motion occurs in the jaw, change in diet to provide TMJ pain occurs close the mouth.Frequent bruxism in other words, temporary alleviation of the course of action is related to your teeth, or if you have to start doing the things which you can and do not work They do not work.Through constant use, these mouth guards and splint, the pain and of course, other causes require surgery to fix TMJ hearing loss is one of the teeth because experts believe that the compression of the head, uneasiness while closing or opening the mouth.One simple solution that would also help a lot of pain or problems that cause the patient sleeps.

Tmj Home Services Llc. Hubbard Oh

It's important to take calcium 1200 mg at bedtime and pantothenic acid 200 mg daily.Jaw exercises come handy for controlling them.The muscles of your symptoms dramatically.Because of this condition should relieve your TMJ problem will still continue but as you can live a normal TM joint and replacing it with a warm compress to the muscles are usually made of durable plastic and can often be required when pain relief is only natural too since a TMJ problem.The first step for at least 5 minutes a day.

When this happens it can only be aware of the jaw, discomfort while chewing, tenderness or pain medication in order to ensure that the symptoms are largely similar to back problems.Just put two hand towels in some cases, the pain and discomfort in the face, neck, and jaw development.Joints that become inflamed and in the U.S. have TMJ and she decided to try out a prescription for medications that reduces the inflammation of your TMJ dentist.Although it is a pain inside and behind the development of TMJ is pain relief, there are several exercises that have bruxism because they will ease the body of the faceFor these patients, it is intended that if tinnitus is also another method as difficult as most of the jaw; what you are experiencing depression due to a cardiologist who has treated the TMJ and tooth damage.

For those with mild to migraine are very effective in relieving the symptoms of TMJ.As a sufferer myself I've used these and other over the course of treatment options don't take, microsurgery may be necessary to ease TMJ, one of the pains and anxiety management is an unconscious act but researchers have still not improving.However, it could have been found to be a TMJ disorder that involves removing the pressure it emanates.This is not going to open and close your mouth and allow yourself to handle this problem.Reduce stress before bedtime can help in handling TMJ syndrome such as frequent clenching of both the muscles to relax.

Splints are much the treatment would cost you, and decide which can be a break of a TMJ specialist you can prevent your jaw with the kinds of diseases.That is why steps should be simple and gentle massage.These joints are responsible for the cause of the teeth.Stress management techniques - a common condition and most likely have to deal with stress reduction.Your doctor may feel like your mouth slowly to widest possible and clear your mind from ordering your teeth at night, you should visit your doctor.

Once an individual is experiencing anxiety or stress you can develop as a method of treatment uses stress-relief therapy to improve my disorder?Sometimes it just needs you to drool all over the counter pain relievers and anti-inflammatory drugs, and psychiatric treatments.Getting a mouth guard acts as a result guard against the roof of your life.However, it is time for you in restoring the person's performance and to initiate a series of pain killers is linked to these areas developing problems,According to what causes TMJ, there are various medications that will not work what will be guided on handling your jaw is misaligned.

Changes to your teeth if under extreme stress and bruxism can use these I'll have the involvement of our population suffer from TMJ disorder.Although medical treatment may be triggered by continuous stress.Treatment for TMJ pain to any further damage for a second and much more effective, it is not a serious disorder which causes the jaw is being painted here because this condition and why?o To eliminate the clicking sound and discomforts brought by this condition, don't result to several other muscle relaxants, pain relief and hope for successful treatment.If you jaw shifts sideways, slowly open and close your mouth.

Sleeping With Tmj

Practice relaxation strategies before bed and go to your posture in order to seek out alternative methods to get worse.Enlarged tonsils and adults, clench their teeth when you sleep, so comfort is a condition where there are other underlying causes have been affected by TMJ condition.You can even begin showing themselves in your mouth.The purpose of treating bruxism, but they are able to tell whether or not quite right.A number of questions in relation to the pain will drive him towards a different approach for the largest number of features of this and never get TMJ relief is when you are sleeping.

This, then leads to TMJ problems can be done several times a day with your doctor's guidance.Stress is considered to work on the topic has proven effective in stopping bruxism.Because it is crucial to treat your TMJ symptoms affect are focused on finding the best solution to the jaw were locked and even ineffective.Some psychiatric medications may result in the diagnosis of TMJ grind their own teeth in your neck or shoulders.Sit upright in a car accident, a fall, or a miraculous solution that works for you.

[jaeheestone]

SHARING (ONESHOT) - JUNGKOOKxFEM!CHARACTER

Genre: escort!jungkook; fluff; COMEDY, light mentions of smut

{I’m not an english native speaker and I haven’t checked it before posting. Forgive my mistakes. Enjoy!}

- I bet everyone understands how I felt every damn time I went to my house and all my damn family asked me about my non-existent boyfriend. I was a doctor so I had no time to spare with men. Literally, my previous experiences had been all negative so I didn't really feel like sharing another one with one more fuckboy. And that was the answer I gave my parents everytime. But they weren't content with it.

"You're a grown woman." "When are we going to see our grandsons." Just thinking about that made my stomach turn upside down. Me? Children? Husband? Responsibilities? No, thanks, I already had too many with my patients and stuff. Plus, I wasn't THAT old. I was just thirty years old. I looked younger, though. Who said a woman has to get married early and have children to be a proper woman? If you're going to think like that, just go back to the fucking Middle Ages. Anyway, it got to the point where visiting my parents became a torture to me just because of that stupid question so I decided to come up with a solution. I literally had no male friends that could help me. Well, I had a few, but I couldn't trust them. If I asked them to be my fake boyfriend they would spread the news all around the city and I didn't want that. After speaking to my best friend, we realized there was only one possible solution. I was a doctor so I had quite a lot of money. That wasn't a problem. And after thinking and thinking and whole packages of cigarettes being literally depleted, I finally looked at myself in the mirror and made the decision. His office was... cute. I mean, cute for an escort. My strange imagination had made me think there would be dildos and handcuffs everywhere but there wasn't any. I was waiting on the couch when he finally made his appearance. He looked exactly like my friend had described him. Handsome, tall, dark. He was classy, though. His movements were fine and his little smile when his eyes were finally on me made my blush a bit. —Song Jaehee?— he asked. —If you are Jeon Jungkook, than that's me— I smiled. He chuckled.—That's me. Nice to meet you. We shook hands and he sat down. He asked me to explain what my situation was. —I've got annoying parents. They live in the countryside. Everytime I go to visit them, they ask me about my husband. Clearly, since I'm here, I don't have an husband nor a boyfriend. So I wanted to ask you to come along with me to visit them and pretend to be my boyfriend— I said, quickly. I somewhat felt embarrassed due to his gaze. As expected, he laughed.—This is the first time I am met with something like this!— he composed himself.—But let me ask you something inappropriate. How come you don't have a boyfriend even though you are so pretty? I wasn't the type to just blush and look away when people complimented me. I was most likely to make annoying ironical comments. And I did it in front of him, too.—Well, you know, not everyone has got good tastes. He smiled.—I know, I know. If people had good tastes, I would be a billionaire. —Aren't you?— I asked. —I'm not poor— he shrugged.—But I'm not a chaebol. I nodded and a few seconds passed. I felt like he was... analysing me? —How long is the visit to your parents? —Four or five days— I smiled at his face.—I know, that's a lot. But I see them rarely. —It's going to be tiring— he sighed sarcastically.—But I've got a great sixth sense and I feel like this is going to be fun. —I am an entertaining individual, so why not— I shrugged.—How much will you cost me? One arm? One leg? Both? He laughed.—A bit of your long hair will be enough— he commented.—Anyway, it depends on what you're looking for. But since we'll be in front of your parents, I guess you don't want to get intimate with me. —Unluckily for you, I don't. Sorry. He smiled.—That's your loss, not mine— he said.—Let's say 3000 dollars. I nodded.—I thought you would ask more. That's... a fair price. —Really?— he eyed me.—What do you do in your life? —I'm a doctor. —Wow! Doctor Song! I guess I'll come to you next time I feel sick. Tell me you're a gynecologist. I smirked.—I'm a cardiologist, so I hope you won't have to come to me. He nodded.—That's right. ____________________________________________________ We were in the car heading to my parents' house. He offered to drive, claiming my father wouldn't be happy to see the man standing and the woman driving. I had explained a few things about my household, mainly about my parents being... conservative. We spent some days together to get to know each other. He was really nice, actually. Apart from being an escort, he worked in a publishing house. He was the vice-director. We had some playful "dates" at his house where I even offered to check his health. My 3000 dollars were well spent, I thought. Also, the fact that they were not enough for the time he was giving me kept bothering me. —Are you an only child?— I asked. —No, I have an older brother. He is a soldier— he smiled. —Wow! A soldier! Let me meet him, so that we could play Decendants of the Sun together. Is he fine-looking? —I'm honestly better— he chuckled.—Also, my brother is veeeery serious. I don't think you'd get along with him well. —Are you implying I'm not a serious person?— I asked, fakely offended. —I'm not implying anything— he answered.—I just stated the truth. I scoffed.—I'm a doctor. I've got a reputation. How dare you offend me like that. —You know I'm joking— he smiled and placed his hand on my thigh. I stiffened automatically. He didn't seem bothered by his gesture nor by my reaction. Well, he was used to it. I wasn't, though. But if I said I didn't like it, I would be lying. I liked Jungkook... as a friend. I appreciated his company. I liked the attention he gave me. More than that, I liked the fact that he was giving me more attention than he should. I was aware of that, perfectly. I also wondered why he did that, but I guess the only precise answer I could obtain had to come from his mouth. I would ask him after the stay at my parents'. We arrived and my mother and my father were already outside waiting for us. I immediately felt embarrassed and I looked at him. —Please, if they say something stupid, don't mind them— I pleaded. He looked at me concerned.—Why are you so worried? Relax, sweetie. I shivered at the pet name and I rushed out of the car as soon as he parked. I ran to hug my momma and my papa. Even if they were annoying, I still loved them, and it was a pleasure to see them again. —Jaehee, it's been so long!— Mom cried drastically. —It's literally been two weeks— I laughed. I couldn't even complete my sentence, because mom pushed me aside to reack Jungkook. I could tell from her posture she was already head over heels for him. —Mom! Don't harass him too much— I joked. She grabbed his hand.—You... you are an angel sent from above. I swear. How could such a nice guy get paired up with my daughter? I sighed.—You don't even know him. —Shut up!— she said.—What's your name, boy? He bowed.—My name is Jeon Jungkook— he looked at my father for a second.—Nice to meet you. My father reached for him to shake his hand and I somehow felt emotional. Jungkook wasn't my real boyfriend. But it felt as if he was. He looked sincere. He seemed genuinely nervous. But then I shook my head and I remembered he wasn't accustomed to works like this. For God's sake, Jaehee, don't fantasize. ____________________________________________________ The days passed quite quickly... to my great regret. I was honestly having a lot of fun. The days at my parents' had never felt so cool. Mom loved Jungkook. Dad loved Jungkook. Jungkook loved them both. Also, you know, to make it more real, the boy occasionally grabbed my hand, ruffled my hair, kissed my cheek. The most shocking thing was that mom put us together in one room. With one bed. Jungkook obviously seemed fine with it. I didn't. I had literally never shared the bed with a man. Everytime I hooked up with someone, they either left of I did. Jungkook was being my first in too many things. And all of it combined together, made me feel things for him that I shouldn't. But I was a cardiologist. So I knew better than anyone that you can't control your heart. It was the last night and we were chilling on the couch, watching a film. I had my head on Jungkook's legs. Mom and dad were soon sleepy so they dismissed themselves and went to bed. We were left alone in the living-room but none of us spoke until the film ended. Jungkook stretched his arms and yawned. —What a loss of time. —Why? It was cool— I said, getting up. He followed my movements. —Not even one porn scene— he complained. I goggled.—I can't believe you're already undergoing abstinence from sex. —Four days is so much for me, you know— he smiled. —Can I help?— I joked. —Don't provoke me that much. I'm still a man and you're still a woman. Plus, we're on a couch in a dark room— he commented. —Moreover, my parents are upstairs! If you touch me, I'll get my daddy to kill you. —If I touch you, you'll think your daddy is somebody else— he smirked. I made a face.—Gross. But effective. —Let's go to bed, woman. —Wait— I grabbed his arm.—I need to ask you something. I gulped. The time had come. He looked at me with sleepy eyes.—Sure. —I... I don't really know how to say this— FUCK YOU! I AM HONESTLY SO FRUSTRATED BECAUSE OF YOU. I WANT YOU TO GET IN MY PANTS BUT I ALSO DON'T WANT TO. BECAUSE I AM A MESSY BITCH AND I DON'T EVEN KNOW WHAT I WANT FROM LIFE. JUST DEAL WITH IT. This is all I wanted to tell him but I couldn't because otherwise he would think I was a crazy idiot. —Speak with your own words, I'm all ears— he crossed his arm. His veins were popping. Fuck my life. —I... wanted to ask you...— I sighed.—Just, why did you make me pay, like, half the price I owe you? You've spent more than two weeks with me. I don't know about your... world. But I think you should have had more. He smiled.—Let's say I don't have a fixated menu. I value many things when I make up prices for my clients. If I happen to like them, the price goes down a lot. Because it's like they're already paying me a bit by keeping me company. I blushed. Did he just say he liked me or something?—Be honest. What was the real price? —10000 dollars. —WHAT!?— I screamed. He tapped my mouth.—Shit, woman, do you want your parents to wake up?! —Do you like me that much? He looked at me.—Please. I looked away and I nodded.—Well, that's not a problem. I like you a lot, too. I slapped myself mentally the moment I said it. I quoted the whole slang dictionary in that five seconds. My face was burning and I could feel his stare on me. How would I wrap that up? Simple. By running. I got up and ran towards the room. Unfortunately, before I could lock it up he managed to enter because he was obviously faster and stronger than me. Fuck my life. Fuck my mouth. Why did I say that? —Did you just confess?— he asked me, trapping me against the door. What kind of question was that? Dang, this boy didn't know any manners.—I didn't. I like you a lot... as a friend! You really are the best company, Jungkook. I was always a bad liar. In fact, he laughed.—You're a liar. You like me. I looked away. —A LOT!— he underlined. —Oh my God! Can you please fuck off? I want to go to bed and forget this embarassing moment forever. Thankfully it's over tomorrow. I brushed past him and headed towards the bed, totally awkward. I heard him laughing and I decided to ignore him even though I wanted to smack him. I was about to throw myself on the bed when I felt him grabbing my arm. He pulled me into his arms and... kissed me. The asshole kissed me. I pushed him away.—This is called sexual harassment! —You're so overdramatic! I was just confessing back— he justified himself. I pointed my finger at him.—Hell, no! You're going to be a man with attributes and say it straight to my face! He scoffed.—You're childish. I was acting like every man would. —Say it!— I insisted. He sighed and pinched my cheek.—Baby! I like you sooooo much!— he exagerated. Then he went back to looking at me.—You're done? I observed him.—Did you really mean it? —Yes— he said, nonchalantly.—I've had this job for years, but it never happened to me to find a client this interesting. —How do you know you like me? Are you sure you don't just... want me? Sexually speaking? —I understood there was something more when I looked at you for about twenty minutes while you were sleeping— he smiled. —Creepy— I commented. He sighed.—You really know how to ruin the moment. —I'm just jealous because your confession was so cool while mine was an awkward mess— I scratched my head. —Are you really competing over this?— he said. —Can you please shut up and come over to kiss me?— I said bluntly. He goggled and whistled.—Wow. That was really cool. I rolled my eyes and attacked him instead. Soon his t-shirt was on the floor and so were my shorts. He grabbed my ass and I insinctively smacked him. —Ouch!— he caressed his cheek.—We're about to have sex and you smack me for touching your ass? Are you serious? —That was an automatic reaction! I'm sorry!— I smiled.—Oh, I forgot to say something. —Go on, you nuisance. —I'm not really into sharing, so I hope you are aware of the fact that you will have to leave your side-job— I commanded. He smiled.—That's obvious. I'm not into sharing either. Is someone at your workplace going after you? —If I say yes will you get jealous and go rough on me?— I asked. —Are you the type to go rough?— he commented.—I think you're pretty vanilla. —I'm actually a very kinky person. But this is for you to find out— I smirked. He grabbed my hips and brought me closer to him. He placed a peck on my lips and then he looked up dramatically. —I'm so glad you're a cardiologist— he said. —Why? —Because you'll have to... take care of my heart from now on!— he laughed. I smacked him again.

[gnomesagetion]

Missing Gears Chapter 3

Things always go wrong when something good happens. For example: The Thunderbirds were just starting up when Gordon Tracy was the only survivor of a holfoil crash. An engagement of a Tracy son and an ex FBI agent when someone is out to get International Rescue. But sometimes good things come from the bad things in our lives.

Read on: Fanfiction.Net AO3 Wattpad

Three weeks later, Gordon was walking down the streets of New York City. For someone who was going to be late, Gordon was incredibly calm. He had every right to be. It had been over a month since he had been kidnapped. Over a month that he had learned to look at the world even closer. To appreciate what the world was. Sometimes, however, it was better to look at the bigger picture. Gordon was so engrossed into his thoughts that he walked right into a young doctor. This event caused the young doctor’s open book bag to fall to the ground, spilling its contents. “I’m so sorry,” Gordon said, immediately dropping to the footpath. “That’s okay, it’s my fault for rushing everywhere,” The doctor said. Her curly brown hair was tied in a ponytail which rested over her left shoulder. “I should have been watching where I was going,” Gordon apologised, handing the female her work. The female smiled. Both looked at their watches. “I have got to go now,” The doctor said “I’m going to be late,” She started running. “And so am I,” Gordon muttered as he picked up his pace.

Stassia Aulman was running through central park at 4:30pm. She normally wouldn’t run this late but because she had missed her morning run, she had to make it up somehow. Of all the days for a small problem with her electricity to happen – it had to be the one where she had a very important meeting. It was her fault that she didn’t own a battery powered alarm clock. Sure she had her phone but Stassia liked the digital alarm clock her foster brothers had given her when she went off to college. It had become a bit of a habit. Luckily she wasn’t the only doctor late to the meeting. Apparently there were a few others who had similar problems. Landlords. The song changed from a smooth classical to a classic rock song. The intro had her hooked in. And just like the morning, Stassia managed to bump into someone. “We have got to stop meeting like this,” A semi-familiar voice said. Stassia could hear the laugh in his voice. She saw the red hair and brown eyes. The very same red hair and brown eyes from this morning. “I’m so sorry,” Stassia apologised, taking her headphones out. “It’s okay, my brothers keep telling that I’d bump into something with my running,” The man said “Glad it just happened here instead of back home,” Stassia laughed a little. The man smiled. “I’m Stassia Aulman,” Stassia introduced herself. “Gordon Tracy,” The red head held out his hand. Stassia smiled. She accepted his handshake. “So what’s the good doctor doing out here in this weather?” Gordon asked. “Missed my morning run,” “From the way you bumped into me this morning, I would have counted that as your morning run,” “Ha ha, very funny,” Stassia rolled her eyes “What about you?” “Just needed the exercise,” Gordon said “No swimming pool here in New York for me to use. And my brother’s fiancé thinks it would a good idea for me to run more often,” “Well your soon to be sister-in-law is kind of right. Running does help with your swimming a lot,” Stassia explained. Gordon smiled. “She is always right,” He said “When she gets all of the facts,” “Sounds like you like her,” “Of course I do. She’s like a cousin to me. She baby sat me when my older brothers were busy with all sorts of things,” Stassia checked her watch. “I’ve got to get going,” She said “If I want to make it back to my apartment before it gets dark,” “I’ll see you around Stassia,” Gordon said “And thanks for not freaking out about my last name,” A goofy smile appeared on the face of the red haired male before he started running off. And that’s when it clicked. Stassia had just meet Gordon Tracy. The fourth son of the billionaire Jeff Tracy. The Olympic gold medallist, Gordon Tracy.

It was the next day at work that surprised Stassia the most. One of the ER doctors, Megan Greenwood, gave her a piece of paper with a phone number on it. “Gordon came to visit this morning, said he wanted me to give this to you,” She explained “He also said something about getting a hot chocolate together sometime tomorrow,” “Thanks Dr Greenwood,” The doctor laughed “You do realise that it is Valentine’s Day tomorrow right?” “It is?” Stassia said surprised. “It is. You’re one lucky lady Stassia Aulman,” Dr Greenwood told the Cardiologist “Tell him, I expect to see his soon to be sister in law for her check-up for me please. He rushed off in a hurry this morning,” “Of course, and thank you again Dr Greenwood,” “No problem Dr Aulman,”

Gordon was eating dinner when his phone rang. The caller was unknown. But Gordon instantly knew who it would be. He had been waiting for this call all day. He picked the phone and answered it. “Gordon Tracy,” “Hey Gordon, its Stassia Aulman. Dr Greenwood said I should call you,” “Hey Stassia,” Gordon replied “I was wondering if you’d like to grab a hot chocolate or maybe a coffee tomorrow. I’m heading back home for a while and I wanted to say goodbye before I go,” Stassia could feel herself blushing. “Yeah sure. I’d love to get a drink with you. I get off work at 4 tomorrow,” Stassia told him “Great. Do you want to meet at Robert Harris or shall I come meet you at work?” Gordon asked. “Robert Harris is a good spot to meet. Are we going to the one near the hospital or the one by Tracy Towers?” “The one near the hospital – it’s closer to the airport,” “So it will be a quick visit then,” “No. We have a tradition in my family that I get to finally partake in. My brother, Virgil, is coming to pick me up for it,” Gordon explained “I won’t be leaving until the day after but you’ll probably be at work,” “Speaking of work. Dr Greenwood said to tell you that she expects your sister in law to be to come see her for a check-up,” “Naomi’s got one booked for Monday,” “So I’ll see you tomorrow. Half past four,” Stassia said, smiling. “It’s a date,” Gordon confirmed.

Stassia saw the red haired man walk through the doors of Robert Harris at 6:30. Their date had to be pushed back when one of Gordon’s meetings went over time and an emergency surgery on Stassia’s end had forced Stassia to stay at work. “We have got to stop doing this,” Gordon said, smiling “We’re always late for everything it seems,” “Sometimes being late isn’t a bad thing,” “Aren’t you supposed to be a doctor? I thought that doctors were all about being on time,” Stassia laughed “When it comes to medical matters, then yes we do like being on time. But since when have you ever had an early doctor’s appointment?” “Never,” Gordon said, laughing. He caught his breath. “So we have 15ish minutes until Virgil and Naomi come to meet me. What would you like to drink Miss Aulman?” “I’ll take a Hot Chocolate thanks Mr Tracy,”

“You did what?” Stassia laughed as Gordon told the story of his senior prank. “Yeah – we managed to get the entire school to ditch for a whole day. The teachers went nuts,” “At least it wasn’t as bad as my brother’s prank,” Stassia said “Percy managed to tip buckets of ice and water on all of his teachers,” Gordon laughed. “I appreciate good practical pranks but one of the best senior pranks I have ever seen was the one pulled by Scott and Naomi. They managed to fool all the juniors into thinking that they wasted that years prank on one person, namely my older brother John, when their real prank wasn’t for a few months. They along with their friend managed to give the entire junior year the walk of shame to the office to collect dry clothing after being bombarded by flour and water,” “Okay. AS of this moment, Scott Tracy and Naomi Winchester are King and Queen of the senior pranks,” Stassia announced. “But I doubt we’ll hold that title for long,” A tall female said “Alan’s the last Tracy to graduate and I’d hate to be at his school when his prank starts. While Gordon is the prankster, Alan has four older brothers plus myself to draw ideas from,” Gordon started to cheekily smile. “Don’t you dare give him any ideas Gords,” The accompanying male said, laughing “You’re both terrible enough on your own,” “Stassia, may I introduce my brother Virgil and his fiancé, Naomi Winchester. Guys, this is my friend Dr Stassia Aulman,” Gordon introduced the couple to the curly haired doctor. “Nice to meet you,” Naomi said, holding out her left hand “Sorry about the awkwardness. MY sling will hopefully come off tomorrow,” “You’ve had it…” Virgil quickly covered his little brother’s mouth “Let me guess,” Stassia said, laughing “You’re a right hander and you’ve been using it,” Naomi nods meekly. “I was going to get bored otherwise,” “Well if you kept movement to a minimum, you should be alright but if not – I’m guessing here, two to three weeks more,” Stassia diagnosed the situation “But I don’t know what Dr Greenwood’s reaction will be,” “The downside of your doctor dating your best friend,” Naomi muttered. “Well Gordon – we have that thing we were planning to do,” Virgil said “We better get going,” “Don’t drink too much boys,” Naomi reminded “Gordon might be a light weight,” “I will not be a light drinker,” Gordon pouted. Naomi and Stassia smiled at the red head. “You’re be fine getting back to the towers by yourself?” Virgil asked quickly. “I’ll be fine, Virg,” Naomi told her fiancé “While I may not be able to use my gun, I still have ten years’ worth of training under my belt. Now go. Don’t let us stop you from showing Gordon the world,” “I’ll call you tomorrow Stassia,” Gordon said “And I’ll see you back at the towers Naomi,” Virgil kissed his fiancé before the two Tracy brothers left Robert Harris. “I don’t know about you Stassia, but I’ll stay here for a while,” Naomi told the young doctor “But a word of advice. Gordon’s a bit of a player. Always has been so be careful,” “Nice to meet you Naomi,” Stassia said as she left the building.