votingrightsforall

[votingrightsforall]

I had a patient come in the other day because she wanted her IUD replaced. It was at the end of it's life and she loved having her IUD, this was her second one. My MA let me know that the patient was very anxious about getting the IUD replaced, she'd had painful experiences in the past with her other replacements and was dreading this visit for that reason.

I spoke with the patient and she was literally shaking with anxiety. I asked her to describe her prior experiences as well as what she liked about her IUD and what she didn't like. She said that she wished she didn't have to get it replaced so often, so I recommended we place a Mirena instead of just inserting a new Kyleena IUD. She was nervous about this because she didn't want an IUD that was big. I explained that the Mirena and Kyleena are essentially the same size but the Mirena lasts 3 years longer and would likely bridge her to menopause given her age whereas with the Kyleena she'd probably need another replacement to get there. She was okay with trying the Mirena.

I then talked to her about pain control during the procedure as this was what she was most worried about. I asked about her prior experiences and then laid out what I wanted to do to try and improve her experience during this procedure. I told her I planned to give her prescription strength ibuprofen, a heating pad, and a very dense anesthetic block in her cervix to hopefully make it a better experience. If she had had someone to drive her home I would've also given her an ativan because we have studies that show patients who report higher rates of anxiety surrounding a procedure also report higher rates of pain associated with it.

She was down for this plan. I gave her a very dense block, she only felt three small injections and then nothing else. She was shocked when I told her that her old IUD was out and the new one was in. She didn't believe me when I told her it was over.

I don't tell this story because I wanna brag about how amazing of a doctor I am because I'm not. I tell this story because this is the way IUD insertions SHOULD go and I want people to know that IUD insertions do not need to be traumatic. And I want other providers who may insert IUDs to know that a paracervical block should be your standard when it comes to IUD insertions.

When people find out I'm an OBGYN, complete strangers, acquaintances, etc. , the two things they like to tell me immediately are their horrible birth trauma story and their terrible IUD insertion story and I'm trying to at least make the latter one a little less common.

If you place IUDs and aren't doing a cervical block, you need to start. This should be the standard but over 90% of OBGYNs in the US aren't doing them and it's unacceptable. We are traumatizing people and it's entirely avoidable. We are scaring people away from one of the most effective and long lasting forms of birth control in a time when people are losing their ability to end unwanted pregnancies all for no justifiable reason.

"It takes too long:" No it doesn't, that visit took me 20 minutes with a highly anxious patient from start to finish.

"It's not worth it for such a short/small procedure." It's worth it for the patient.

"It's too expensive." You can do a paracervical block with just normal saline. You don't even need lidocaine if you use a generous amount of volume. And if you place Nexplanons I know you stock lidocaine in your office, stop being fucking cheap at the expense of women's pain.

"Patient's don't need it, they'll get over it." I'm telling you they do need it and they aren't getting over it as evidenced by literally everyone wanting to tell me about their terrible IUD insertion experience as soon as they find out I'm an OBGYN.

We should do better. The cervix has nerve endings, stop acting like it doesn't.

Make cervical blocks your standard of care, there's no excuse not to.

[votingrightsforall]

hate when i say “i can’t do [thing] because of my autism” and hear (usually lower support needs) autistics say “well i’m forced to do [thing] so i have to” in response.

there will be autistics who never can do [thing] no matter how forced, no matter how punished, no matter how anything.

i can’t force myself to do [thing] i can’t do. not ever.

many autistics like me.

especially hate hearing autistics say “well if i didn’t do [thing] i would get abused” as if we autistics also didn’t get abused, except we still couldn’t do [thing].

you are dismissing higher support needs autistic who are or have been abused.

* [thing] here can be literally anything, doing chores, eye contact, speaking, socialising, get good grades in school etc.

[votingrightsforall]

many autistic people need people use simpler words when talking to them

many autistic people need tasks broken into tiny steps to understand how do something

many autistic people need positive feedback in way that other think condescending

many autistic people childish and have childish interests

many autistic people have to always be supervised never alone because of risk of hurt self or get in dangerous situations

many autistic people have violent messy big meltdown, even in public

many autistic people struggle with speech always will maybe rest of life (non verbal, semi verbal, demi verbal etc.)

AND most of these autistic people higher support needs + level 2 & 3 autism, don’t forget or ignore us. can’t say “that not true just stereotypes” when it just symptom and sign of higher support needs higher level autism.

you want to raise awareness for lower support needs level 1 autism and yes good ok!!!! but not this way where throw HrSN level 2+3 autistic under bus.

- winnie

[votingrightsforall]

Do you get it now? Without due process, everyone is at risk. How are you going to prove your citizenship otherwise?

[votingrightsforall]

Every person, every life led on this earth, is unique, and from some angle, beautiful in its complexity. A thousand thousand thousand stories, all told at once, a cacophony of narratives intertwining and competing and coinciding and diverging, all at once, everywhere you go on this warm, wet rock, hurtling through space.

Every person's personality and actions are dictated by the sum of their lived experiences and their memories of those experiences. Free will dictates that we have choice and agency over our lives, that no matter what we always have the ability to choose, even if the choices aren't always great. But from a zoomed out macroscopic lens, that doesn't really hold. Life is complex, sure, but it's a finite complexity. With enough information, with enough time, the seemingly infinite choices would break down into a linear path.

But not everyone sees it that way. In fact, most people don't. In fact, many are bothered by the notion. One of my best friends, one of the most important people in my life, is. But I do not understand that, it does not bother me, it's not even something I feel any particular way about. Perhaps not everyone sees my angle? Or is my angle wrong?

I feel a disconnect, from most people. People are the sum of their experiences, but my memory has so many holes, so much haze, so much fog. I most certainly cannot be the sum of my memories if I can't even access most of them. Then am I a person at all? Who am I, if not everything I've experienced is available to me? I feel adrift, as if lost in a pitch dark sea in my own mind.

I often do not concern myself with a defined identity, but honestly, truthfully, I wish I knew. I try and ask others about me, their perspective. If I aggregate enough reflections of myself off of others, then perhaps I could finally see myself, yes? After all, if people are a system of inputs, outputs, and statistics, then with enough data I could find myself, right?

I struggle so often to feel passionate, to feel driven, about anything. Being fully honest, I do not know what I TRULY want, because my desires are so muted. I envy others, especially one VTuber I follow, for their natures that are so driven, so fueled by energy and passion. I see them speak of how truly they know what they want, and how that drives them to find their way. Then I look at myself, I see myself floundering, failing to move forward, failing to grow. False start after failure after false start after stalling out.

I just wish I had more conviction, I wish I felt more certainty. I wish I knew myself and had a self. Life is beautiful, it is wonderful, and I do appreciate that I am allowed to be here too amongst everyone else. I just wish it wasn't so hard to know what to do next, and I wish it wasn't so hard to just do it.

[votingrightsforall]

what abled ppl think is a massive problem for disabled folks: 13 year old on the internet faking something

what is actually a massive problem for disabled folks: "well you don't LOOK disabled, are you sure you're not faking? I'm not giving you accommodations until you PROVE you're not faking. Please give me, a stranger, your medical info and explain your condition to me in detail so I know you're not faking and only then will I respect or take you seriously"

[votingrightsforall]

Above image is a pride flag with every color band represented by a NASA image. White is Earth clouds, pink is aurora, blue is the Sun in a specific wavelength, brown is Jupiter clouds, black is the Hubble deep field, red is the top of sprites, orange is a Mars crater, yellow is the surface of Io, green is a lake with algae, blue is Neptune, and purple is the Crab Nebula in a specific wavelength.

[votingrightsforall]

happy autism awareness day to all the girls who had “ friends” growing up who were actually bullying them . to the girls who always sat alone in the grass and wondered why nobody wanted to talk . to the girls who spoke to animals like they were listening . to the girls who created a little world in their room . to the girls who always felt ashamed for how deeply they love things and how passionately they enjoyed media . to the girls who covered their ears when they were overwhelmed by everything . to the girls who carrying a special thing around to feel safe . to the girls who never understood what they did wrong to feel so lonely . to the girls who were diagnosed later in life because they weren’t little boys who liked trains. you are so special and beautiful and you’re not worse for it, you love deeply and that is so wonderful please never try to push that down . I LOVE YOU !!!!!

[votingrightsforall]

hello. i'm silly and in love with you

[votingrightsforall]

I spent a good chunk of my weekend scrambling to finish this comic. I hope you like it. I was really trying to push myself with the colours.

[votingrightsforall]

god some of you are just so weird about having content on this site

"justify"?! babes it's a bullshit internet scrapbook not a fucking phd thesis

[votingrightsforall]

Bata Shoe Museum: T. E. Lawrence's gay sandals

Me: If anything will do numbers on Tumblr

[votingrightsforall]

[votingrightsforall]

One of my recent posts pissed of the MAGA cult and they're crawling out from under the refrigerator to spout all the classic conspiracy jams in the comments. But, I wanted to address one specific challenge tacked to the end of this guy's particularly tedious rant...

First of all, *your.

And you want 5 things the Democratic Party did to improve your day-to-day prosperity? Here's just a handful of the countless things FOX News will never tell you because they like Republicans to stay scared, uninformed, and angry. (Hint: It's how they make money off of you.):

Medicare and Medicaid (Medical debt is the No. 1 reason for personal bankruptcy in the U.S. and these programs help you avoid that.)

Social Security (We all pay in so we all can live a little better in retirement, but the guy you voted for is likely going to make it go away. Oopsies!)

40-hour work week (That's right, Democrats gave you "the weekend.")

Overtime pay (Bet you've enjoyed that a time or two.)

Federal Farm Loan Act (Among other things this act does, it helps farmers get affordable food to your table… or it did before the guy you voted for started dismantling all that, but whatevs!)

Family and Medical Leave Act (Yes, Democrats gave you paid sick leave.)

Pell grants and student loan program (I'm assuming you don't care about this because it's about getting a better education.)

Affordable Care Act [This helps everyone get health insurance by creating a competitive marketplace (capitalism for good!), expands Medicaid eligibility (socialism for good!), and makes sure your employer can't fuck you over if you get sick (government regulation for good!) Oh, also, if you enjoy the Affordable Care Act, but hate Obamacare, boy, do I have some shocking news for you… They're the same thing.]

And thanks to Warren, Ohio's Tribune Chronicle — specifically, Ron Urchek's Letter to the Editor of that paper — that compiled these and other reasons to thank a Democrat. Because journalism also matters.

In fact, it's so important it's the only profession mentioned in the U.S. Constitution because a free press is supposed to keep the powerful in check. But, you'd just call that fake news, I guess.

[votingrightsforall]

HEY

People are fighting. Don’t forget that people are fighting.

[votingrightsforall]

[votingrightsforall]