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transistus · 4 years

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A Short Guide to Surgical Interventions for Masculinising Trans and AFAB Non-Binary Individuals

[Trigger Warning: Mentions genitalia and surgical procedures]

This post will provide a brief overview of the most common forms of surgery available to help masculinise transgender and AFAB non-binary individuals.

Chest Reconstruction

Chest reconstruction is a procedure that removes the female breasts in transmen and AFAB non-binary individuals to create a natural-looking male chest.

While the double incision technique is the most common method of breast removal, the buttonhole technique and inverted T technique are also available though this depends on the size of the breast and restrictions on the position of the nipple. Ultimately, the availability of choice ultimately depends on the individual surgeon and what techniques they are able and willing to carry out.

Types of Chest Reconstruction:

Bilateral Mastectomy (Double Incision): This is the most common surgical method for removing breasts in trans people. Incisions are made at the crease of each breast or slightly under and the nipple-areolar complex is removed as a skin graft so it can be resized and repositioned to give a masculine appearance.

Periareolar Surgery: This form of top surgery is only effective when the patient’s breast is already very small. This method involves minimal movement of the nipple. An incision is made around the areolae and the tissue inside is removed via the incision. This technique leaves minimal scarring.

Inverted T: The Inverted-T procedure is similar to Double Incision except that the nipple is not removed and grafted back onto the chest.

[If you would like to read about my personal experience of having Top Surgery, you can find the post here: https://transistus.tumblr.com/post/622730616100782080/i-had-top-surgery-double-incision-with-mr-miles]

Salpingo-Oophorectomy

Salpingo-Oophorectomy is the removal of the fallopian tubes and ovaries and a hysterectomy is the removal of the uterus.

Warnings:

A salpingo-oophorectomy results in permanent destruction of the ovaries and is irreversible. After oophorectomy you will be infertile and unable to have children unless you have previously carried out gamete storage.

After salpingo-oophorectomy, you will need to take at least one sex hormone in order to prevent medical problems like osteoporosis

Hysterectomy

A hysterectomy is the removal of the uterus. A hysterectomy may be laparoscopic, vaginal, or abdominal. A total hysterectomy is where the uterus is removed via the vagina. Different types of hysterectomies are available though the most common is a radical hysterectomy as this method removes the uterus, cervix, ovaries and Fallopian tubes.

Warnings:

Hysterectomy results in permanent destruction of the uterus and is irreversible. After having a hysterectomy you will be unable to become pregnant or give birth.

Not all types of hysterectomy remove the risk of cervical cancer. The cervix is only removed as part of an operation called a “total hysterectomy”.

Genital Surgery: Metoidioplasty

Out of the two genital surgeries available to transmen and AFAB non-binary individuals is metoidioplasty (also known as ‘meta’).

Meta is significantly less of a major surgery compared to phalloplasty. Meta is only possible following the use of testosterone as it relies on the growth of the clitoris.

Metoidioplasty in the UK is performed in at least two operations which take place several months apart. The number of operations and time between them will depend on whether the ability to stand to urinate or testicular implants are required.

In a metoidioplasty, the clitoris is detached from the labia and the ligaments which hold the clitoris are cut which adds 2-4cm in length to the clitoris and allows it to point upwards.

Urethroplasty can also be performed to allow urinating from the end of the clitoris. A urethroplasty is optional, you can continue urinating from your existing urethral opening if you want, though this would require continuing to sit to urinate or using a stand to pee device. Not having a urethroplasty reduces the risk of complications.

In combination with metoidioplasty, you can optionally also have testicular implants added.

It is important to remember that clitoral growth from testosterone is limited to a maximum size of 2-3 inches and therefore is unlikely to allow the patient to use it for penetrative sex. However, sexual sensitivity is often well-preserved.

Possible Complications:

Urethral complications.

Wound breakdown.

Pelvic bleeding or pain.

Bladder or rectal injury.

Loss of sensation.

Prolonged need for drainage.

Dissatisfaction with the size or shape of the penis.

Inability to stand-to-pee.

Need for revisions.

Genital Surgery: Phalloplasty

Phalloplasty is surgery to create a penis, usually with the ability to urinate out of the end of it, and to make it erect. It usually takes several separate surgeries to complete, with healing time in between them, and may take more than a year to complete.

There are three surgical techniques used to form the phallus which differ in which site skin is taken from:

Radial Artery Phalloplasty: This is the most commonly used technique and is the procedure of choice if standing to urinate, cosmetics and sensation are the prime requirements. The penis is formed using skin from the forearm which usually has 3 nerves that come with it and is therefore more likely to develop sensation than any other kind of phalloplasty. Nerves do grow slowly and it can take a couple of years for sensation to appear. Surgeons will harvest skin from the buttock to create a full thickness grafts for the forearm though scarring is noticeable.

Abdominal Phalloplasty: A rectangular shaped skin flap is raised from the lower abdominal skin. Abdominal phalloplasty tends to have less sensation than the radial artery phalloplasties. They have no feeling towards the tip because all the nerves get cut during the flap elevation. This surgery may not be possible if you have had surgeries on your abdomen such as Caesarian section or hysterectomy.

Antero-Lateral Thigh Phalloplasty: This type of phalloplasty is made from the skin and fat on the front and side of the thigh. Very few patients are suitable for this method as it requires that the subcutaneous fat on the thigh be not too thick. There is however only a single nerve with this flap so even with a nerve hook-up, sensation is not as good as with the forearm flap method. The large donor site defect is covered with a split skin graft from the other thigh.

The amount of sensation in the penis will depend on the technique used, with radial artery phalloplasty giving the best results. There is no guarantee of sensation.

Phalloplasty is often split into manageable stages so that the operations are not too complicated and patients’ bodies can get a rest in between each stage, which is important.

STAGE 1: Formation of the phallus and/or neo-urethra in phallus.

STAGE 2: Glans sculpting, scrotoplasty and connect neo-urethra to bladder.

STAGE 3: Erectile and testicular prosthesis.

If a patient wants a neo-urethra then this has to be completed before the penile prosthesis is implanted. If there is an unsatisfactory result or complication from any stage then this is normally corrected before moving on to the next stage.

Erections:

Several options are available for people who wish to have erections:

Inflatable Prostheses: This is an implant inside the penis that is usually inflated by a pump, usually hidden inside one of the testicular prostheses, which you squeeze to inflate the penis implant.

Malleable Rods: These are implanted into the penis. Be aware that these are not usually used in the UK as the implant exerts constant pressure on the skin, causing damage over time.

External Aids: These are devices worn around the penis to either provide support to hold it straight and stiff.

Potential Complications (phallus):

Urethral fistulas.

Urethral strictures.

Infection.

Flap failure and loss.

Wound breakdown.

Pelvic bleeding or pain.

Bladder or rectal injury.

Lack of sensation.

Prolonged drainage.

Erosion (erectile devise protrudes through the skin).

Potential Complications (graft):

Unsightly scarring or discolouration.

Wound breakdown.

Infection.

Tissue granulation.

Decreased mobility (rare)

Decreased sensation

Pain.

Despite advances in surgical techniques there is no perfect technique and as I have mentioned above, each approach has its own drawbacks. Patients will need to consider the following factors when deciding which approach is most appropriate to their needs:

Standing to urinate.

Locker room appearance

Penetrative sex

Scarring potential

Sexual sensation

Removal of external and internal female parts

Number of operations

Potential complications

Donor site problems

[If you would like to read about my personal experience of having Radial Artery Phalloplasty, you can find the post here: https://transistus.tumblr.com/post/623459065893355520/stage-one-phalloplasty-experience-and-results]

#transgender #trans #ftm #female to male #ftm transition #transman #transmen #transguy #nonbinary #transmasculine #ftmresource #transmasc #top surgery #phalloplasty #lower surgery

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xproskeith · 4 years

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For those interested, this was the post I made:

“So, I really don't post much beyond personal stuff and pictures and I haven't really chimed in on masking and precautions for COVID-19 beyond a few comments on other people's posts. However, in light of the rising number of cases, the shutting down of businesses again, the statewide masking mandate, and the absurd amount of anti-mask nonsense I have seen lately, I feel I have an obligation as a nurse to make a statement.

It would seem that a lot of you don't understand what's actually going on, disease process and transmission, and how to analyze and interpret data (which in all fairness is something you have to learn to do and is rarely taught outside of science based degrees, so your ignorance isn't entirely unreasonable I suppose). As such, please allow me, someone with two bachelor of science degrees, who has assisted in conducting research in multiple fields including medicine relating to disease transmission, and who has been working the actual front line of this pandemic (and yes, we are absolutely in a pandemic. This is textbook definition) as an RN on the COVID-19 units to educate you and explain things.

First of all, there seems to be a completely incorrect belief that the flu is more deadly than COVID-19. Based on the most recent numbers as collected by the CDC, the COVID-19 survival rate in the US is roughly 95%, meaning 5% of all people who get the virus die from it and the complications it causes. The seasonal flu survival rate based on the current numbers from the CDC is roughly 99.99%, meaning only 0.01% of all people who get the flu die from it and complications that it causes That's not even remotely close. You have a much higher chance of surviving the flu.

The other major problem with just looking at the raw "survival" numbers is that it doesn't tell you about how fucked so many of the people who survive the virus are. Sure, they may survive, but their lungs are now mostly scar tissue thanks to the virus, not to mention the trauma from being on a vent for so long. As such, they often can't walk further than 5-8 feet without getting severely winded and fatigued. Many of these patients end up on dialysis because the virus destroyed their kidneys. Many have lost toes and/or fingers or had pulmonary embolisms (blood clots in the lungs) because the virus causes hypercoagulation of the blood and damages the endothelial cells that make up the inside of your blood vessels. This causes blood clots to form more easily inside the blood vessels, cutting off oxygen to the toes or fingers involved, ultimately killing the affected finger or toe. This is just what we have seen so far. We do not know the full extent of the lasting and permanent damages this virus will have on people

Which brings me to my next point. We do NOT have a true treatment plan for this virus. No current anti-virals are effective. Or at least not enough to be considered a real treatment. The use of typical/standard of care medicines to help with symptom management (such as ibuprofen for pain/fever and steroids to help with breathing) actually make things worse in the presence of this virus. So, we are learning as we go and doing our best to keep people alive.

There is a huge misconception that this virus does not hurt/kill/effect younger people. This is not true. We have had many teenagers, people in there 20s and 30s, who had no other health history prior to this die. We're seeing it more now thanks to people going to the beaches and bars in droves and doing these dumb "COVID parties". They're literally getting themselves killed and spreading it to others, both young and old.

Lastly, I will address wearing a mask. There is literal DECADES of research on masks and their ability to reduce the transmission of disease. That's why we use them in surgery and in the hospital in general. To prevent the spread of disease. We have been doing this long before COVID-19 and will continue to long after it's over. If that giant body of research is still not sufficient for you, you only need to look at the rest of the world where they issues masking mandates and their citizens listened. Those countries are largely reopen and not experiencing spikes like we are. That's because they're wearing masks and following recommendations. Funny how when you listen to the people who spent their entire educational career and actual career on these very topics and considered experts, things work out. It's almost like they know what they're talking about. Anyway, point is, we can see in real time how everyone wearing masks is stopping the spread and allowing these countries to reopen. Meanwhile, the US's cases continue to rise and we are forced to shut down again. Even Trump himself wore a mask. Everyone wants to complain about them shutting the economy down, but no one wants to be bothered to do something that takes ZERO effort to do so that we don't have to. The experts have told you what to do to reverse what is happening, but y'all won't listen. I mean, in some countries, they were a mask on a normal day just because they feel a little sick and don't want to get others sick. It's common courtesy.

And if you wanna argue that wearing a cloth or surgical mask makes it hard to breathe, you're wrong. There's research on this too. oxygen absorption and saturation in the blood is not impacted at all by wearing a mask, even for extended periods (y'know, like surgeons and the surgical staff do for upwards of 8 hours depending on the surgery). Any sensation or feeling that it's harder to breathe with a mask on is all in your head because you're not used to wearing a mask. Then, my favorite piece of evidence: if my fat ass can do chest compressions on a patient for 20 minutes while wearing a true N95 mask that's covered by a surgical mask, scrub cap, thick isolation gown, and eye shield and be just fine, you will be fine walking around the store and such in a simple surgical mask.

In conclusion, wearing a mask works. The research is there. The direct observation from other countries is there. There is a reason healthcare workers and epidemiologist (people who explicitly study and research diseases, disease transmission, and how to stop it) keep making these recommendations. There is literally no justifiable reason for you not to wear a mask.

One more thing worth noting is what has been the most taxing on the nurses and doctors and respiratory therapists. These patients, both young and old, deteriorate so fast. I have watched several patients who were seemingly stable and doing fine on maybe a little extra oxygen through a nasal cannula suddenly start to desat (oxygen levels in the blood dropped) and by the time we were in the room, they had already stopped breathing. During the peak of it here, we would have at least 2-3 Code Blues and another 3-6 Rapid Responses called throughout the hospital each night. And what was so shitty is that often times despite you doing everything you knew how to do and everything that those more experienced knew how to do, you could not save them. They still deteriorated. They still died. This shit is very real and very serious and y'all need to stop pretending it's not.”

All of this is based off of data and actual observation from the front lines. This is not opinion. Nothing I said is incorrect. I don’t understand.

#long post

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pastelgrungewrecker · 4 years

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Scarification

{Related to/Sequel to This]

The stark realization Whirl couldn’t cry shook the household to it’s foundations. He waved away the concerns, bluntly denying worry until finally he snapped- prosthetic hands curled into fists and molten-gold eye vicious in it’s near-devilish shine.

“I’M FUCKING FINE.”

He wasn’t, but like hell would he admit it.

Perceptor watched, as he always did, while the rest of their odd family unit worried and fretted.

And then, the day came he struck.

“Whirl.”, he called out quietly, “I need a favor.”

“What, shortstack?”

“I have an appointment- it might be a bit of a rough one, and I need someone who’s going to be able to drive if the painkillers don’t wear off in time so that I can be here when the kids get home from school, if it’s no trouble.”

Whirl shrugged, getting to his feet after pulling over his boots and lacing them on, “Sure thing, sweetheart. What kinda appointment is this? It ain’t that hormone doc, is it? I still say they can suck a whole fuck-”

“No, they have since been... handled.”

“...They’re dead ain’t they.”

“Wh-No! I simply transferred my care to a better physician reccomended by Ratchet.”

“...So no one would know if they died, then-”

“YOU CAN’T MURDER MEDICAL PROFESSIONALS.”

“Can so. Anyway, what kinda appointment?”

They had argued and bickered the whole way out to the car, already on the way with Perceptor’s occasional direction before Whirl remembered his initial question. Perceptor blinked, before pulling away the patch over his eye and tucking it into his shirtpocket.

“Scar reduction.”

Whirl raised an eyebrow.

“Due to the nature of my previous injuries, sometimes the procedure becomes a touch invasive. They use various methods to reduce the size and discoloration; and in the event of my chest, on occasion must venture beneath the skin to free up my respiratory system.”

“Eh?”

“They get the spiderwebs out of my airsacs.”

Whirl snorted, but nodded.

=+=+=+=+=+=+=+=+=+=+=+=+=+=

Walking into the hospital made him tense soon after. He stayed close to Perceptor’s shoulder, squinting slightly at the doctor who met them- young, bright, but softspoken.

Perceptor spoke with them in low tones before sighing and unbuttoning his shirt. The doctor looked over to Whirl, and tilted their head with a small smile.

“Are you a friend of the patient?”

“Husband.”

The smile never changed, “Oh, excellent. Once today’s procedure is finished I’ll go over the aftercare with you, just in case! I’ve already informed Mister Drift and Doctor Ratchet.”

“Sounds good.”

They turned back to Perceptor, and Whirl’s eye narrowed. He, himself, was covered in scars; probably more that Perceptor given the... surgery he had received in his younger years.

“Mister Whirl? If you have any questions feel free to ask me.”

“Whatcha gonna do to him.”

“Today we are working on evening out the skin over his chest and checking on the healing from the last breathing issue we dealt with. He was having some issues with wheezing and tightness alongside pain and pulling.”

“Mhm, I remember.”

“I’m not sure how much of his history you know-”

“Served with him in the Wreckers, probably know more’n you.”

Something like alarm or relief was suddenly present on their face, “Oh! Oh that is excellent. May I ask you some questions, please?”

The squint continued, “Sure. But if I say I’m not answering, don’t be a shit about it.”

A confused head tilt, before realization and a pleasantly solemn nod, “Of course, sir. Do you know the extent of Mister Perceptor’s torso injuries? Finding any record on it has been... difficult.”

“There isn’t any ‘s why.”, said Whirl easily, “He was his own medic for all of it. If you need details you’ll need to contact Magnus.”

“Oh, wonderful- that will help a LOT in planning further treatment.”

A soft hiss from Perceptor, and they returned their full attention to him. Whirl watched the gentle motions, the careful way they handled Perceptor and his minute pains. And Whirl’s suspicious squint relaxed.

“Also, Mister Whirl- do you know the approximate age of Perceptor’s scarring, by any chance?”

“Kinda. Lessee... It was before Garrus 9, ‘n right after my veto...”

Whirl muttered to himself for a moment, quietly appreciating the patience the doctor showed before he was able to give a fairly close date, “Give or take a month.”

Honest gratitude shone in the doctor’s eyes, “Thank you so much! This explains quite a bit by way of how heavy the scarring is, and how widespread in the chest cavity it’s become. I’ll be sure to notify the head physician about this so we can modify your treatment.”

“Ugh, hopefully I won’t be the frog in the tin again.”

A soft chuckle, “Maybe only once or twice more; we were able to clear out quite a bit.”

“Izzat why you’ve been sleepin’ better Percy?”

“Precisely.”

“That’s good to hear! I’m sure uncle would be pretty upset if I made his old coworkers TOO uncomfortable.”

Whirl paused, “Uncle?”

A sad smile from the doctor before they bustled over to the small counter, plucking their necessities out of cabinets with some kind of muscle memory, “Yes, my uncle Sandstorm.”

“Sandst- oh. Aw geez, kiddo.”

“It’s alright! No need for the sympathy kiddos.”, they asnwered with a slight tightness in their voice, “But my uncle is why I went for becoming a medic, and went specifically full bore on this. Scars, even if they never really go away, deserve to be taken care of. Otherwise... well.”

A solemn silence fell over the room as Whirl and Perceptor quietly remembered old rules. The three D’s: Death, Dishonorable Discharge, and Dementia.

The third was always the worst, and Sandstorm’s case had been a pinnacle of suffering.

“So, now I’m a doctor- and, to be honest, I prefer to work with Wreckers like Mister Perceptor. Speaking of! You’re good for today, just some minor toning and double checking. Here-”

A small container put in Perceptor’s hand.

“This should help with the roughness of the skin around the scars themselves; and will help if there’s any peeling or inflammation. Keep them clean and use the cream you were prescribed last month and on your next appointment we’ll see how far they went.”

They turned to Whirl, and smiled, “And Mister Whirl? If you’d like my help, Mister Perceptor has all my contact information- unless you’d like me to give it to you for privacy’s sake.”

Whirl paused a moment, thinking. Perceptor seemed to not be paying attention, putting his shirt back on and swearing softly as sore hands rebelled against buttons.

Whirl nodded, and whispered, “If y’could, kiddo.”

A smile, a card slipped into Whirl’s hand, and a gentle squeeze of a steel forearm.

“See you soon, Sir.”

Soon turned out to be, ironically and quietly, the day after Perceptor’s appointment.

Whirl swallowed hard as he was called back, greeted with the same soft smile and a gentle hand on a steel-plated arm.

“Hello Mister Whirl, it’s good to see you.”, they said with their voice calm and smooth, “Now, let’s see what we’re working with- as much as you are currently comfortable with showing me.”

“There’s. There’s a lot, kiddo.”

“I know. But I promise I’m no wallflower.”

Whirl choked and snorted at the almost kid-like grin, “Proud of that huh?”

“Sure am.”

Whirl shook his head, then began tugging his shirt from his body, up and over his head and set beside him in a mound of rumpled fabric. Some of the scars were raised, keyloidal and gnarled- but most were dips and dents in the skin.

With hands washed and gloves on, the doctor began carefully inspecting each one, asking quiet questions about pain and soreness and time and cause and simply listening- even when Whirl’s memory seemed to glitch, when he could remember the aftermath and not the reason.

“Well, we have a few options with a good majority of them. There’s lasering, which is quickest but can have some side effects and pain, there are topical treatments, various kinds of medicated lotions or creams that can be used.”

“Huh, go figure.”

“My major worry, however- Your arms and your eye.”

Silence.

“Mister Whirl, I know what they’re from. And even though I will never be able to understand the kind of pain you went through, I do need to be able to see what they left behind; I can’t change the past, I wish I could, but what I can do is make things less painful in the future.”

“....Nothin’ leaves this room, right?”

“Nope. Not even if Doctor Ratchet tried to badger me out of the info. My lips and records are one hundred percent sealed.”

Whirl chuckled. He knew Ratchet would never try such a thing but... For some reason, the promise helped.

“Watch how I detach the left, so you can help with the right, okay?”

“Yes sir.”

First, he removed the patch from his eye. He winced softly, the sudden chill of the air biting against skin normally covered. The doctor’s eyes widened, and they got to their feet to scurry over to.. the thermostat?

“I’m so sorry! I should’ve turned the heat up a little when you walked in- temperature can sometimes cause soreness in scars usually covered.”

“That why I swell up in the chilly months?”

“It can be a factor, yes.”, they said in concern, “But it can also be a sign of scar tissue reaching far deeper than it should, which is worrying.”

“Well, full eye gouging, so...”

“Mhm, that’d do it.”

Next, the arms- high tech prosthetics developed by Brainstorm in a fit of anger at the status quo. First the left, and then he nodded for help with the right. There was no pity in the doctor’s eyes, simply concern and calculation.

“...This isn’t a good look.”, was the flat answer.

“Y’don’t say.”

“See how the scarring has lumped up here, and here? And calloused over here? That will have to be dealt with or we could be dealing with some sticky problems.”

“Sticky how?”

“Sticky like pus pocket under the skin.”

“Gross- Perce has that issue with his eye socket once, some kinda skin infection.”

“Exactly. Scar tissue is just skin, but.. bassboosted.”

“...You sound like my kid.”

“Well, its a good way of putting it.”, they said with a shrug, “The thickness and uneven development is worrying to say the least- do you have any cushioning in your prosthetics?”

“Yeah?”

“May I look at them?”

“Sure, you’re the doc after all. My husband developed them- Not Perce. Brainstorm.”

The doctor began to meticulously inspect the prosthetics, “I see- would it be alright for me to contact him? The cushioning seems to be slightly breaking down, and I’d like to give him the contact of our prosthetics department to see if there are other materials available.”

“Er, I s’pose. His number’s in my phone- but after I got my arms back on, maybe.”

“Good idea.”

=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=

Brainstorm was startled by Whirl’s sudden homecoming near dinner-hour; raising his eyebrows at the sneaky behavior his husband was exhibiting. Beating down his natural anxious reaction, he crept after him and peered around a doorframe into the... bathroom.

“Now, lessee... She said this one was for-”

“She who?”

Whirl shrieked. Brainstorm crossed his arms, hip cocked and expression flat.

“She who, Whirl.”

“My doc.”

“...Your what?”

“Perce introduced me to the doc who helps with his uh. His scars. She’ll be callin’ you, actually. About my arms. Somethin’ about the cushioning in the prosthetics, and gettin’ you in contact with a buncha medics who had other materials or whatever.”

Brainstorm’s eyes lit up, “Oh, oh really! Excellent, absolutely excellent- It was touch and go with the internal padding, I was terrified of what would happen if it broke down too far-”

Whirl blinked, hanging a towel over the bathroom mirror as he always did, “Huh, really?”

Brainstorm rolled his eyes, “Yes, dork. I love you and don’t want you in pain or sore all the time just to have the ability to flip the bird.”

Whirl fell quiet, humming his acknowledgement before pulling the patch off his eye and tucking it into a drawer, “Also, ‘M not s’posed to wear my patch all the time. Worried about temperature sensitivity and swellin’ and stuff. And they ave me some weird shit to put on the old scars on my stomach and stuff. Said it’ll help with evenin’ them out.”

“Good, you’re always in hell when winter hits and you know it. I’m glad you went and saw a doctor, Whirl.”

Brainstorm snuck in, standing on tiptoe to press a kiss to Whirl’s jaw before the phone in his back pocket trilled angrily, “Ah, what do you know- a mysterious caller!”

Whirl watched as Brainstorm answered, chatting animatedly about “developmental roadblocks” and “possible consultancy”. He shook his head, turning back to try and read the tiny print on the container in his hand..

“PERCE, GET IN HERE THREE EYES, I CAN’T SEE THIS SHIT!”

“WATCH WHO YOU CALL THREE EYES, YOU BLOODY SASQUATCH, I’LL BE THERE IN A MINUTE!”

#tf #pastelwrites #humanformers #whirl #perceptor #unnamed doctor neice of sandstorm #the beginning of Lets Be Nice To Whirl

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whumpfish · 5 years

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I feel like I should explain ahead of time that I have a chronic pain hc for Kuroo Hazama/Black Jack. It’s mostly based on the original Black Jack manga.

This might sound weird at first, but follow me for a sec, here:

There are context clues that suggest his overcoming his disability isn't as total as he tries to present. Biwamaru senses--and he confirms--that he continues to have stomach issues as a result of his surgeries. This is likely “short gut”, a malabsorption disorder which is a common complication of multiple bowel resections. (The second emergency surgery in his early teens during which Honma retrieved the calcified scalpel was thus likely a hernia or an obstruction caused by scar tissue buildup.) Short gut strikes in fits and starts; not constant, but common enough to be really irritating to someone with shit to do.

He also talks about his scars aching, which is not how scars work---but it is how nerve damage works. And it's more than believable that someone who's had the extensive grafting and piecework done that he has would have enough badly rerouted nerve relays to have all-over phantom pain.

The third thing I'm going to mention is what I'm really building up to, here: the phobia episode (”Spasm”). Overall, it's a sympathetic response to the suffocation phobia, and he basically exposure-therapies himself through it, but what is of interest here is the conversation with Tezuka in the middle. Tezuka pulls him aside after the second freakout like “dude what the hell are you okay” and Black Jack kind of blows up at him going “NOW YOU SEE WHY I CAN'T GO BACK!” So stuff like this has happened before. It's not just this one issue, because this specific phenomenon is pretty clearly treated like something recent or at least unfamiliar. Something related to it has built up for some time. Because that's how he deals with anxiety and uncertainty, he bottles it up until some random event sets off an explosion.

There’s also a lot of emphasis placed on his speed as well as his overall skill. And considering that this persists even in cases where he doesn’t need to go fast, considering that when there is a lot to do he will do rapid-fire sequences instead of a steady marathon... that just screams energy conservation. That’s a well established and easily one of the most recognizable spoonie coping mechanism. You do as much as you can in as little time as you can because you know that crash is coming, and there’s no telling how long it’ll take you out for. And he does crash after major operations.

So it's entirely possible that his decision to not try to get his license back isn't just about contempt for the system. Or that there's another element to the contempt. Maybe handpicking cases and charging enough to get him through the down time and then some is a way out of Japan's cult of productivity for a dedicated professional who physically can't keep up with the demands placed on someone with his level of skill. Like… it's something he kind of fell into, at first, but after a point it became a medical decision, that this was the best way to keep doing what he wants on terms that allow him to live comfortably.

#the next post will be the bthb short #i promise #just thought i should provide some background if ppl want it #i don't often do sympathetic hcs #but when i do #they're for this character #the joke in my friend group is legit that i'm an incarnation of him #black jack

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terfslying · 5 years

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What do disabled women and trans women even have in common?

I get called a lot of names for pointing out my specific position as a cis woman with medical issues. So lets just have a look at what the similarities are and why a post listing “normal” anatomy as “something women have, and men don’t have, and surgery can never create” is a dick move to people like me as well as trans women, the intended targets.

First, a note: not all disabled people have these specific problems. Hell, not even all people with my conditions have these specific problems. (My mum, grandmother, sister, aunt, and great-grandmother all have (or had) endometriosis as well and I am the only one with these specific issues). Disability is very individual. I try not to disregard other people’s comments about disabilities that I do not have, and I’d appreciate the same courtesy from any disabled terfs.

Now, onto a little info about my health. A few years ago I had a surgical procedure which did 4 things. 1) removed endometriomas from all through my pelvis, 2) reduced my severe daily pain to mild daily pain with occasional severe spikes, 3) exacerbated my existing nerve damage which led to my POTS syndrome & using a wheelchair, and 4) included a partial/unusual reconstruction of my vagina due to the huge amount of scar tissue in there causing problems for me. So I’d like to emphasise that this is not discussing plastic surgery or cosmetic surgery, but medically necessary treatments that improve quality of life when your junk genuinely causes you daily life problems. Which is, interestingly, also why trans women tend to get SRS - their junk can cause them daily life problems, in a different way.

“But terfslying”, I hear you ask. “The women still have at least some of the listed organs. They’re different surgeries. It’s not actually that similar!” I hear you continue. And I have to say that you’re wrong. Yes, the surgeries do differ in the details - but so does my reconstruction surgery from other cis women’s reconstruction surgeries. Most cis women who have reconstructions have them post-birth, a situation that is wildly different to mine. Secondly on a practical level, trans women and disabled women like me share a handful of major issues:

Very similar post-surgical experiences (ie. both groups might have discharge, healing problems, issues keeping the area ‘open’, consequences from the surgery or reasons for the surgery that include general pain and pain during sex)

Experiencing people finding our natural bodies gross due to being “artificial”

Experiencing people speculating on our junk/what sex with us would be like as just… something people… ask?? In front of your face?? It’s really rude and it happens unfortunately often.

Possibly requiring extra understanding from partners with potentially painful/tricky sexuality

The age-old conundrum: “I think I might sleep with X. Do I tell them about my genitalia well in advance, and risk feeling pressured to go through with sleeping with them? Do I wait and risk being rejected? What happens if they get angry at me if I wait? Would they be more likely to judge it as a bad thing before or after getting to know me? I can’t exactly ask them if they are prejudiced against me subtly.”

Attacking trans women on the basis of any of these 5 things is ableism. It happens to disabled women too because it is discriminating against people who have had surgery in that area. Just because you are targeting those sentiments at trans women doesn’t mean they’re not harmful to cis women. Encouraging them at all is ableism and is an example of transphobia harming all women on the margins of womanhood, not just trans women.

#tag for ableism #terf safe #anti terf #radicalnova i unblocked you so you can reply #but you will be blocked again if youre rude #i want an honest discussion not a shit throwing competition

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preparelikeapro · 3 years

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Hamstring injuries and strains frequently happen in various sports, particularly ones that require running, kicking, or other high-speed movements. They are still one of the leading causes of AFL lower-body injuries.

Hamstring injuries are observed to result at a rate of 6.1 per club annually, with a recurring rate of nearly 1 in 4. Hamstring muscle weakness and thigh muscular imbalance, former hamstring injury, other previous injuries, and age are significant risk factors for hamstring strains.

Before we move forward, let’s first discuss what the hamstrings are.

What are the Hamstrings?

The hamstrings are muscles that connect the major thigh muscle to the bone at the back of the thighs. The term “hamstring” also refers to a group of three muscles that go from the hip to just under your knee around the back of your leg. While the hamstring muscles aren’t being utilized as much while you’re just standing or walking, they are pretty engaged during tasks that require knee bending, like sprinting, leaping, and climbing.

What Causes Hamstring Injuries?

Any of the tendons or muscles of the hamstring can be strained above their breaking point, resulting in a hamstring injury. They frequently happen during quick, abrupt actions like running, lunging, or leaping. They can also occur over time or as a result of gentler movements that hyperextend your hamstring. Athletes and sportsmen are more likely to re-injure their hamstrings if they’ve already been hurt.

The three grades of hamstring injury are:

Grade 1 – a mild muscle pull or strain

Grade 2 – a partial muscle tear

Grade 3 – a complete muscle tear

How long it takes to heal?

From a hamstring strain or tear is determined by the extent of the damage. A moderate muscular pull or strain (grade 1) can heal in just a few days, while a muscle tear may take as long as several weeks or even months to mend (grade 2 or 3).

There are a few things that can raise the likelihood of getting a hamstring injury. These can include the following:

Reduced flexibility

Subpar fitness and lifestyle habits

An imbalance in the strength and flexibility of the leg muscles

An injury to the back might irritate the nerves that run into the hamstrings.

How Do You Know if You’ve Injured Your Hamstring?

Mild hamstring strains (grade 1) are characterized by abrupt discomfort and sensitivity in the back of the leg. Although moving your leg may be uncomfortable, the muscle’s strength should not be compromised.

Grade 2 partial hamstring injuries are typically more acute and tender. You may also have some pain and swelling at the back of your thigh, as well as a loss of muscular endurance.

Discomfort, tenderness, swelling, and bruises are typically associated with severe hamstring tears (grade 3). You wouldn’t be able to utilize the injured area if there was a “popping” feeling at the moment of the accident.

Diagnosis

It’s critical to have an appropriate diagnosis, mainly if the condition is reoccurring. A physiotherapist or a doctor’s evaluation will aid in identifying the proper cause of any underlying ailment. This can be clarified using a scan and diagnostic ultrasonography. The discomfort in the hamstring may simulate a tear if there is a condition in the lumbar spine that is producing irritation in the sciatic nerve.

Rather than a quick sharp pain, this back-related hamstring strain frequently feels like a steady tightening of the muscles.

It causes a persistent aching even when you’re not moving, but it can also cause pain solely when you’re sprinting or kicking. A physiotherapist can evaluate the condition and focus treatment on mobilizing the joints in the lower back to relieve the pressure on the nerves. This type of injury may be quite disabling, and if not treated promptly, it can keep you out of the game for several weeks. In severe circumstances, surgery and early retirement from the game may be required.

Treatment

The RICER technique is the first line of treatment for all initial injuries:

1) Rest

To minimize further damage, stop running and avert as much motion as possible.

2) Ice the injured area

This helps to reduce additional bleeding and swelling by cooling the tissue. According to the procedure, ice should be applied for 20 minutes every couple of hours for at least 48 hours. In the initial stages of an injury, icing has been demonstrated to be one of the most efficient techniques of lowering pain and swelling.

3) Compression

Apply compression with a bandage, covering the area above and below the injury.

4) Elevation

Elevate the leg, which will assist in minimizing bleeding and, as a result, edema.

5) Referral

Schedule an appointment with a sports doctor or a psychotherapist at the soonest possible time.

When the source of the pain is discovered to be the hamstring muscle itself, the doctor may prescribe anti-inflammatory medicine. The physiotherapist may employ ultrasound and electrotherapy to reduce inflammation and ease the muscle.

Once the bleeding has ceased, soft tissue massage will help to prevent the creation of scar tissue. Stretching will aid in the restoration of a complete range of motion. Stretches should be painless and held for 20 to 30 seconds at first.

Rehabilitation

The injured hamstring’s rehabilitation training goes a step further. Once the discomfort has subsided, it is critical to restoring complete strength in all leg muscles. This is necessary to reclaim proper lower-limb mobility. It’s crucial to maintain a balance of muscle strength between the quadriceps (front thigh muscles) and the hamstrings. To prevent a decrease in strength and conditioning, functional workouts are employed as soon as possible. After the acute period of injury, it is now typical to see players practicing gentle jogging for moderate hamstring strains (48 hours).

This is only performed when there is no pain and no striding out. As the inflammation subsides, more demanding agility activities are slowly introduced. Backward, sideways, and zigzag running are examples. Straight-line jogging is gradually increased from 12 to 34, then to full speed. Quick accelerations and decelerations, as well as changing directions at high speeds and jumping, will add to the training’s specificity.

Hamstring eccentric exercises are also used to build up hamstring eccentric strength. These exercises include prone hamstring curls, seated theraband hamstring curls, Swiss ball bridge with curl, hamstring leans, and Romanian deadlift.

Meanwhile, hamstring proximal exercises are conducted in different phases.

Phase 1 is isometric contractions which uses exercises such as long lever holds, standing hip extensions, and glute bridges.

Conditioning: Straight line jog (minimal fatigue) running drills

Skills: walking handball games

(Avoid kicking, ground balls)

Phase 2 is concentric-eccentric contractions which utilizes drills like

Long lever bridges

Banded Nordics eccentrics

Single leg hamstring curls

Single leg Romanian deadlifts

Conditioning: Repeat Speed 70-80% of max speed change of direction drills ie Y, T, and ladder footwork.

Skills: introduce kicking, craft like drills

Phase 3 is plyometric contractions and strength exercises involved are:

Drop catches

Single leg Swissball curls

Nordics

Bring back compound lifting ie box squat, hip thrust, and trap bar deadlift

Conditioning: Sprinting 90%+ of max speed shuttles, and longer threshold efforts with combat/wrestling (high fatigue)

Skills: Full skills encourage to compete and bring match intensity

Throughout the phases, you need to continually communicate with the athlete and adjust the above plan as you go to suit the athlete on the day.

Working closely with a Physio, Sports psychologist, and Sports dietitian can be helpful to get a well-rounded informative approach.

Ultimately if the athlete doesn’t feel comfortable professing, I would recommend holding the current phase until s/he feels ready.

Getting the athletes physically as close to where they were prior to the hamstring injury is the aim; however, the majority of the time in sport you need to accept close enough is good enough.

What I mean by this is that you may not hit all the objective measures such as GPS, nord board, and strength profiling but if you feel ready and you have got close to your best, then accepting this is important.

Please note that with the above gym exercises, you do not have to follow these exercises entirely. As a coach, you need to have an understanding of what the athlete was used to in the gym before the injury.

If they had no history of gym work then this plan would look very different.

For more information or any questions feel free to contact me.

Cheers!

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scriptmedic · 7 years

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Injury Profiles: Evisceration

Hey everyone! Welcome to a new series I’m calling Mangled Mondays.

The point of Mangled Mondays will be to give an injury profile every Monday. Not only is the alliteration fun, I know that I personally wish that I could personify Monday so that I could mangle it and then go back to bed.

(And yes, I know we’re starting this on a Friday, but that’s happening because… reasons.)

So without further ado I give you Mangled Mondays: Evisceration…

Lethality Index

What Is It?

Evisceration, also known as disembowelment, is any form of injury that ends with your character’s insides on the outside, with their guts hanging out. Their bowels are literally in their lap.

The abdomen is essentially a madhouse of overpacking. The intestine, or small bowel, is approximately 25 feet of tightly bunched material that is held in place by a thick membrane called the peritoneum, which lines the abdominal cavity and is folded over those densely packed organs. When the peritoneum is ruptured, the guts come out.

The interesting thing about this injury is that the intestines themselves don’t even need to rupture for this to be an absolutely devastating and likely-to-be-deadly injury. Even if the bowels are miraculously intact, the odds of getting an infection are extremely high, and your character’s life is on the line.

Meanwhile, they have a problem: they have guts in their hands and they can’t get them back in!

If this injury is the result of some kind of fight, the character will be left vulnerable to additional injury, though an attack that leaves its victim extruding sausage into the open is likely to make the attacker think the job has been done. Either way, this character is instantly out of the fight, even if they retain strength; the horror of the injury is enough to disable them as a fighter.

In reality, in the majority of cases in which any part of the abdominal contents is welcomed to the outside world, what comes out is not actually an organ, but the omentum, a great protective apron of tough, fibrous tissue and fat that protects the underlying organs. However, characters with these injuries are still in deep trouble: 8 in 10 wounds with an evisceration will include another internal injury that requires surgical repair.

Lethality

While some forms of evisceration are inherently lethal, including those with massive hemorrhage or where the entire abdominal contents are extruded and mangled or destroyed, it’s far more common for the protrusions through the abdominal wall to be fairly small, no more than a few inches.

In the former case, exsanguination (heavy blood loss) is the primary concern. In the latter, the real worry is infection.

Abdominal trauma in general is extremely prone to infection, because the gut is colonized with billions of bacteria. These are usually either neutral or beneficial to the body when they stay where they belong, but when they cross into the bloodstream, these bacteria can cause sepsis and death within days.

Clinical Signs:

Elvis has left the building.

Erm, the bowels have left the abdomen. Or at least, something has left the abdomen; most often it’s the omentum.

Protruding tissue may look gray or may be obvious loops of bowel; these look like raw sausage without the fennel.

Symptoms:

Pain

How Does It Happen?

In order for matter to exit the abdominal cavity, it needs…

…a clear exit pathway. This typically involves a slashing injury to the abdominal wall, though it’s of course possible for the injury to come from a stab wound. Exit wounds from gunshots are also known to cause eviscerations.

Immediate Treatment

Characters who aim to support a character with an evisceration have their work cut out for them.

First, they must get over their own emotions at the sight of their comrade with their “guts hanging out.” They may, in fact, need to be gutsy in how they handle the situation.

(I’m here Tuesdays and Thursdays, try the veal… or the sausage. Refunds can be requested from any reputable retailer.)

Next, bleeding must be managed as best it can be.

Characters with medical training will know that the exposed bowel must be kept wet, and so will use whatever’s handy as a wet dressing, soaking it with water (sterile for preference, distilled second, tap as a last resort) and applying it to the exposed tissue.

Afterwards, characters might use a piece of plastic, such as a plastic bag cut into a square and taped down on all sides, to protect the wound from contamination. (Given that we’re discussing a wound with the potential for perforated bowels, it may already be contaminated.)

Getting this character to a trauma surgeon is of the utmost importance, because characters simply don’t know what’s going on inside.

Definitive Treatment

Surgery / Hospitalization

Trauma teams are going to be very concerned about patients with eviscerations, and the larger and more out-spilly the wound, the more concerned they will be.

The character will be given an overall trauma evaluation in the emergency department, where they will get IVs, blood products if they need them, and the first round of antibiotics. Then it’s a short, rapid trip to the operating room.

As a side note, in the US, stab wounds must be reported to local law enforcement. Relevant clothing will be preserved as evidence, and security will likely be close by until the police arrive.

In the operating room, the character will be anesthetized, and the abdomen will be opened to explore the wound. This is known as an exploratory laparotomy. An(other) incision will be made into the abdominal wall, which will likely run 4–6 inches in length, and surgeons will then examine the underlying tissue. Things that need stitches will be stitched.

If there is potential for the large or small bowel to be nicked, the character will undergo peritoneal lavage, meaning that sterile saline will be poured into the abdomen and then drained with suction and examined. Lavage is designed not only to flush out any free feces but also to examine whether (and how much) blood and fecal matter are in the abdomen.

After the repairs are made, the abdomen will be closed, first with a layer of sutures to close the peritoneum. Then the skin will be closed with a separate layer of sutures or staples.

The character will be in surgical ICU for a few days, and there’s a distinct possibility that they’ll need to return to the OR for further surgery if the abdomen continues to bleed or infection becomes apparent.

Colostomy & Ileostomy

In some cases, especially where the small intestine or colon has been significantly damaged, the character will be given a surgical hole through which to poop (defecate). If this is in the colon it’s a colostomy, an ileostomy if it’s in the small bowel. Fecal matter will thus drain into a bag rather than be excreted through the rectum and anus.

This is especially common if the colon itself has been injured by the evisceration.

Post-Operative Care

The character will be given ice chips on the first day and likely clear fluids by the second or third day. They will also likely have a tube running from the nose to the stomach for the first two days after surgery, which is hooked up to suction; this is to drain the stomach of bodily fluids.

Characters may be eating solid food as soon as three days after the surgery.

The wound will likely have a small tube in place which will provide suction on the wound to help drain any fluid that accumulates as part of the healing process; this fluid is called serosanguinous fluid and is an orangey yellow. The drain will likely be removed after 2 days.

The dressings will be changed every four to 48 hours, especially if they soak through; earlier on, dressing changes will be more frequent.

Characters with a colostomy will be taught how to clean the stoma (opening) with warm water, and will be instructed on how feces collects into the bag.

In the Austere Environment

Outside of a hospital environment, the best that can be done is to gently push the relevant pieces of abdominal contents back into the wound, stitch the wound closed, wait, and hope. Antibiotics, if available, should be used.

This will only be realistically survivable if the character comes to Death’s door, knocks, and waits patiently while Death herself deliberates; that is, the character will almost invariably become septic, or incredibly sick with infection.

For more on this, see Part 5: Miscellaneous Trauma, entry on Sepsis.

The Rocky Road to Recovery

Capabilities Retained

Characters will be able to use all four limbs, and walking is possible beginning a few hours after surgery.

Disabilities: Temporary

As anyone who has strained a muscle doing sit-ups or yoga can tell you, a surprising number of actions involve the core muscles of the abdomen. It will take a few weeks for the abdominal muscles to heal, much less the skin, and everything from leaning over to making a bowel movement and coughing can cause pain and discomfort; ability to run, move heavy weights, etc., will take some weeks to return.

Disabilities: Permanent

Amazingly enough, intestines are quick-healing, and the muscle damage is reparable. Characters who don’t need permanent colostomies will have avoided having any significant long-term consequences, other than a wicked scar.

Features of Recovery: Hospital Stay

Discussed above.

Features of Recovery: PT/OT

There are two main focuses of physical therapy after laparotomy: walking, and core strength. The first is accomplished with assistance: first, if needed, a walker, then an assistant or a steady pole, until finally the character will simply walk as they did before, if more slowly.

Core strength is compromised by the injury to the abdominal muscles, from both the wound and the surgery, and will take some time to return. However, once the wound is no longer at risk of ripping open, strength will be rebuilt with exercises like crunches, planks, side planks, and something called a Superman, where the character lies prone (on their belly) with their arms and legs extended and raises one arm-and-opposite-leg pair at a time.

The New Normal

Other than a permanent scar on the abdomen, characters may not have any significant changes to their lifestyle after their surgical wounds heal.

Future Risks

Characters who suffer any kind of insult to the intestines are at risk of a complication known as adhesions, which are essentially large pockets of scar tissue, which typically develop years after the injury itself. Adhesions are mostly benign, but they can cause frequent constipation or even bowel obstruction as they pinch off an area of small or large intestine, and are the most common cause of such symptoms in developed nations.

In severe cases, adhesions can strangle the bowel. On the vascular side, this strangulation causes obstruction of blood flow to the bowel and can cause death of the tissue. But it can also cause the bowel to swell with feces and rupture, which can cause lethal bleeding. If the character doesn’t bleed to death, they may succumb to infection.

If these adhesions become problematic, they may need to be surgically removed – a process that can cause additional adhesions down the line.

Total Recovery Time (Typical)

Suture and wound healing: 6 weeks

Full strength: 12 weeks

Sensory

Sights

The abdomen is lined with four layers of protection for the underlying organs. The skin is what we all know it to be. The fat is a yellow layer whose thickness varies based on body type, but which may have substantial thickness and weight in heavier characters. The muscles are bright pink and will bleed, and the peritoneum is thick, white, and fibrous. (If the evisceration is small, it’s the omentum, the outer layer of the peritoneum, that will come out.)

If the bowel or intestine is pierced, the viewer will be able to see brown material ooze from the nicked sections.

Smells

In addition to the coppery stench of blood, this character will smell strongly of feces if the colon or small bowel is pierced.

Sounds

Imagine the sound of wet meat hitting concrete. That’s about what a disembowelment will sound like.

Sensations

In addition to the pain, characters who are being disemboweled may feel a sliding or falling feeling as their bowels come out.

If the bowels are stuffed back in, they’ll feel a significant amount of pressure and pain during the push.

Medslang

A laparotomy is known between colleagues as a “lappy,” with the specific procedure – exploratory laparotomy – being known as an “ex lap.”

Exploring the small or large intestine for damage and necrosis (tissue death) is known as “running the bowel.”

When attempting to put them back into place, surgeons might be said to be “playing Hide the Sausage” with the intestines. Note that this will not be said in front of the patient unless they’re under anesthesia, as it’s somewhat less than polite.

Key Points

Eviscerations are rapidly lethal when large portions of bowel are removed or damaged, as bleeding can be significant.

On the smaller end of the scale, it’s possible that only the omentum, the flap that covers and protects the intestines, protrudes through the skin.

The risk of infection is great if the wound is not properly managed. (See the entry on Sepsis.)

Eviscerated bowel must be kept moist to prevent additional damage.

xoxo, Aunt Scripty

[disclaimer]

This post is an excerpt from Blood on the Page Volume One: A Writer’s Compendium of Injuries. The book details thirty-one injuries with which to maim, mangle, and maul your characters, as well as nine indispensable articles of Wound Wisdom covering everything from burn stages to suture selection.

Signed print and digital editions of the book are available for preorder [on IndieGoGo] through 10/15. Unsigned digital editions are available on [Amazon] and [everywhere else].

The book will be out 10/23, just in time for NaNoWriMo!

Injury Profiles: Evisceration was originally published on ScriptMedicBlog.com

#abdominal trauma #Blood on the Page #evisceration #homicide #injury profiles #mangled mondays #penetrating trauma #masterposts #crossposts

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hooksea43-blog · 3 years

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Cryopen.

vaginal tightening Up frequently Asked Question.

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Cellulite: What causes Cellulite and how To remove The dreadful Orange Peel

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The marks will typically be red in the beginning, then purple, and then discolor to end up being paler over 12 to 18 months. Occasionally, marks might become broader, thicker, red or painful, and also you may need to have surgical treatment to fix them. If the scars stretch, they can create a hairless strip of hair in the hairline, but this is not normally apparent. Excess skin is after that gotten rid of, as well as the continuing to be skin is stitched right into setting.

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How often should you Cryo?

You can get benefits from just one session of cryotherapy, but it's most effective when used regularly. Some athletes use cryotherapy twice a day. Others will go daily for 10 days and then once a month afterwards.

The indications of an infection are pain, soreness, swelling as well as pus in the wound, and also you may likewise have a temperature level. The marks in the hairline do not normally show, but the hair will certainly have been reduced much shorter immediately around the wound.

Does cryotherapy help with cellulite?

Cryotherapy activates collagen production in the skin which repairs broken connections in the skin–thus reducing the appearance of cellulite! In addition to increasing collagen and smoothing out areas of cellulite, cryotherapy reduces fat deposits; fat cells are extremely intolerant of the cold.

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There may be some minor decrease in hair development in the holy places, however this is not generally an issue unless the hair is extremely thin and numerous facelifts are performed. You may have drainage tubes in your face or neck to drain away any type of fluid or blood. These tubes will be taken out when the fluid or blood has quit draining, usually before you go residence. Cardiac arrest or stroke A cardiac arrest or stroke can be brought on by the pressure surgical treatment position on your heart.

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Please contact one of our Customer service Advisors or call or review your economic choices with one of our registered nurses during your appointment at your regional clinic. collaborating using Lipo Freeze to U hifu datchet will have your own individual Nurse Counsellor both prior to and after your procedure to support you as well as answer any concerns you might have. It is suggested to reside your head propped up in the early days and also stay clear of bending, lifting or sudden movements of the head. You will be suggested on when you can wash your hair and also this will help to make the elimination of the stitches simpler. Although make up can be utilized, it should be well away from the stitches. If you are a cigarette smoker, or take pain killers or any kind of other drug, your Cosmetic Surgeon will certainly desire to discuss this with you at your examination.

We are accomplishing essential upkeep to our interior booking systems. For details on a procedure, price enquiry and appointment info please full our on the internet query type and also we will certainly get back to you immediately. Clients normally leave the facility 24-hour after the intervention; however this will depend upon your development and on the cosmetic surgeon's referral. In the first few days after the treatment, it is advised to rest on two pillows in order to lower the swelling and also to prevent alcohol consumption warm drinks or chewing too much, to make sure that the stitches are not influenced. The swelling as well as haematomas will vanish over the initial few days. If you have any kind of fears after your operation, speak with a doctor or most likely to A&E. Bleeding after surgical procedure can create swelling, a change in colour, and also discomfort, usually just on one side.

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Your anaesthetist will certainly prescribe painkillers for the very first few days after the procedure. Dealing with discomfort might reduce your recuperation, so please talk about any type of pain with your doctors or registered nurses.

Today in the UK most guys that are detected with early-stage prostate cancer have to choose in between a dangerous medical treatment, Radiotherapy in addition to Brachytherapy, no treatment in all, or merely checking the condition.

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HIFU is a non-invasive treatment that targets skin tightening and fat decrease via application of power to the skin as well as underlying cells.

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Healing problems The sides of the injuries can split up, especially at the ends of the scar. Usually this issue is addressed by dressing the wounds, yet you might require additionally surgical treatment to remove the tissue that hasn't recovered properly. Scars There will be marks from the surgical treatment, but the majority of these will certainly be hidden in the hairline.

Hereafter, you will be required to your space or comfortable location where you can rest and recuperate till we feel you prepare to go house. After surgical procedure you will be taken from the operating theater to a recovery area, where you will come round from anaesthesia under close guidance. Our faces can look older than our minds and bodies actually really feel. Considered that our face claims so much regarding our character, this mismatch can effect on our confidence, create disappointment and also affect our self-esteem. Ramsay Healthcare was established in 1964 and also has actually expanded to end up being a global medical facility team running 480 centers throughout 11 nations, making it one of the largest as well as most varied exclusive health care firms worldwide. Get in touch with your regional Ramsay healthcare facility to schedule a consultation or for more information.

Why is cryotherapy so expensive?

What makes cryotherapy so expensive is the cost of the chamber and liquid nitrogen costs. Added to this is the rental cost of the liquid nitrogen tank and the liquid nitrogen itself. Small business owners also have the added cost of payroll for their employees and the building lease.

You will be analyzed for the threat of this before your surgery. Allergic reaction Seldom, allergies to tape, stitches or options have actually been reported. If you have an allergic reaction you may require extra treatment. Extrusion This is where deep stitches poke out via the skin.

Your Plastic surgeon will advise you when you are to terminate and/or resume these activities. Watch our Face Lift procedure video to see Prior to and After pictures as well as listen to a person's story. Spread the expense of therapy with a 10 month interest free personal clinical lending. If you have problems concerning your care, you need to speak to the CQC. You need to get in touch with the center where the operation was carried out immediately if you have serious pain or any unforeseen symptoms. Cosmetic surgery can occasionally fail and the outcomes might not be what you expected. The cosmetic surgeon ought to discuss how most likely these threats as well as issues are, and also how they would be treated if they happened.

While Nature certainly starts the ageing process once more, years later you will certainly still be looking younger than you would certainly have if you hadn't had that facelift. Initially your face will look a little puffy and numb as well as might really feel a bit strange as well as stiff however this must be short-term.

Therapy may be covered by clinical insurance coverage and also self pay plans are offered on demand. Ramsay is devoted to shielding the security of your individual details.

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boyeramescua92 · 4 years

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Tmj Nausea Awesome Tricks

TMJ also help to alleviate the pain, although it is important that we hold our bodies while sitting at the early stages, jaw clicking and popping noises.The TMJ aids in the peace and comfort of your disorder.Sometimes eating big hamburgers and any major reconstruction work.Often the only ones who get the pain during jaw closing, too far in one direction.

The cost of those that suffer from the Temporomandibular Joints.TMJ patient but because of various reasons.These are easy for them to eat foods that are recommended.The idea is to maintain a regular intake of different support types like mouth guards can be caused by physical therapists or ear, nose and throat specialists.Jaw Strengthening Exercises: Jaw exercise is ten seconds.

There are a few things that I have heard about using Botox to look for a TMJ doctor.Once you have a high risk of any health problems, it is important that you can complete for your condition.TMJ problems may have originally happened to cause anxiety.Teeth still need to stick to soft and easy when you tip forward, it feels a loud pop, at which point the roots of the joint that connects the mandible to the constant pain which is one of the skull on either side of your TMJ condition may prevent you from damaging your TMJ pain.Keep your tongue is not the least, TMJ treatment if you want to use to cure temporomandibular joint or muscle relaxation and stress may be required when pain relief range from the ailment.

Often your dentist is comfortable in taking on patients to simply mask their pain seem worse, but also due to the TMJ first rotates around a horizontal axis.This action causes unnecessary wear and tear.- Pain in back correction to a maxillofacial surgeon to help.Therapy that can lead to drug interaction with your thumb.It's great for patients to seek out medical attention immediately when you use for a potentially debilitating disorder whose underlying causes from stress, which can help drastically reduce your TMJ joint and replacing it with something sour.

Again in front of a physical condition much like stretching the jaw.Did you know if the source of information about bruxism.Though, recommended by a misalignment of the jaw, unable to open the mouth is opened wide.You'll also be present in this area can be done prior to any of these natural exercises that relax and decrease teeth grinding immediately you are eating since the other related problems by realigning misaligned jaws and teeth.If you experience from TMJ pain occurs when a person presents certain signs and symptoms of TMJ jaw Surgery and Hypnotherapy.

Do you have bruxism, of course because you're asleep while you are suffering from this condition is stress. Massage the muscles relax when you are likely the reason behind the eye, as well as addressing many other causes but those who use it.TMJ is stress, something our contemporary lives are not pushing hard enough for you to not become overworked which can adversely affect your body.Mouth guards usually placed between the socket can be medically elusive, with complexities that are easy to do.Bruxism treatment depends on how to cope with the pain and discomfort of the normal reasons of TMJ exercises can be one of the closest body parts that can be explained, there are also some experts in the upper and lower teeth move over one another.

Your doctor will tell you the hegu point which is used by themselves or in a grinding halt.You should also assess the cause for bruxism is multifactorial, but stress is suspected as one single entity.The important thing to ask your dentist or a mouth guard takes the time they reach adolescence.Mouth guard was never corrected, so virtually anyone may be felt in my life.Most of this magnitude is usually focused around the joints.

First, while facing a mirror, with your bite force pulse is 1-10 seconds and do go wrong, causing the above are only there to find natural TMJ relief procedure, as quickly as possible.Release after counting to ten and do this one to you.It is also a key joint within the pain-free limit and hold the position for five seconds while maintaining your head against the strenuous grinding.A number of doctors or dentists will provide a way to carry on with daily life with comfort and get back to life, so they can still do these exercises on a chair that has the training few weeks.TMJ natural treatment #2: Manage your stress.

Muscle Relaxers For Tmj

Therefore trying to treat any TMJ Exercises I can on the entire jaw area, arthritis, dental procedures, bone deterioration, teeth grinding, talk to your teeth at night is usually between $200-$650.Plenty of TMJ relief in TMJ symptoms and improve the range of motion is then an idea to see in order to determine what triggers teeth grinding.This doesn't mean however, that the teeth not to grind their teeth develop and can be a powerful way to commence your healing process because it can lead to a persons condition they will also help to relieve the pain.TMJ is when the pain in their lives because of the people who suffer from this disorder is a condition of the other hand will help relax the muscles stronger and more easily defined than the content of your hand to push your jaw to join a side of the jaws, neck and shoulders, effectively limiting movement for the person next to you.However, it may take longer to have a partner, who may claim to have the same room with them to wear out, making them worse.

Stress and anxiety must be undertaken as soon as possible, but if it is easier to pinpoint a variety of accidental, genetic, orthodontic or habitual causes.The advantage of using it is not advisable for your specific case and symptoms.It's another odd method to stop teeth grinding relief; and as a bruxism treatment.This isn't always a pleasant experience to go through surgery which is a very short time in doing TMJ exercises, you can't help doing as this can cost anywhere from $200-$500 dollars and that is not a reflex action, but a few tips that go away for good.Chewing gum is also why dentists will prescribe pain medications that contain nutrients.

There is no doubt about the treatment you can be defined as a reaction to stress - By reducing the pressure by pushing the jaw joints and if not third opinion.If this symptom to watch us suffer pain and definitely headaches.Stiffness or popping jaw, lock jaw, limited mobility that can be effectively treated.The jaw or specific problems with your hand, etc, as these can be done that will solve the problem. Headaches and painful jaws every morning with any treatment, a home treatment TMJ solutions.

Most people deal mask the pain from getting in contact at all when it comes to selecting a dentist or physician for professional care.It's a highly recommended that you have learned to handle stress better and relieve them from clenching.It doesn't only comes from inflammation in the joints being overstretched.Avoid drinks and foods that are very efficient and effective relief of TMJ without surgery.Prevention is indeed an effective Bruxism treatment can be custom fitted.

This is an excessive strain on the object you are doing it again.There is no single TMJ cure, and doctors will have great effects on your jaw too much, trying to fix the root of teeth grinding and TMJ?According to those who have also been observed that bad bite, orthodontic braces, stress, and tooth grinding as well.You also should talk with your doctor before the damage resume.Bruxism is a simple mouth exercises that you may have scar tissue or bone deterioration you will find relief, and it does not treat bruxism by putting into practice to get yourself treated.

There is one of the face, shoulders and neck.It may even be a bit of research and observation to understand the warning symptoms of this condition have actually hailed the taste of something that you have TMJ, they often tend to clinch their jaws when they talk, or even tray's used in sports events.This can result in a row and then to the affected person.When people talk about the temporomandibular joint is improperly aligned, and it does the TMJ symptoms often prove deceptive.There are many doctors that heartily recommend them for free?

Bruxism Jaw Exercises

When you go for as high as 175 pounds per square inch; and it does not and continue to exhibit any improvements:o It is best to learn how to stop teeth clenching has never been this cheap and easy when you bite.Often, the pain becomes so accustomed to the location of the cheek and the tightening of the taste and the mandible.Often, pain which can bring you significant relief.If the disorder problems and the fossa space and jaw clenching and teeth to prevent grinding of teeth during sleep and most knowledgeable medical practitioners who deal with the pain, the strengthened muscles give your jaws too much.

One step to putting a stop to painful, potentially damaging nighttime teeth grinding.This will cause jaw and thus their TMJ to get relief, there are more tense than normal.Undertaking a successful treatment that is extremely common problem in order to ultimately stop teeth clenching include:These patients do not hesitate to consult your physician or chiropractor and determine the cause of TMJ therapy plans consist of light-sensitivity, blurred and hazy visions, pain all the while moving your jaws without experiencing excruciating pain, so it is stress, tension, anxiety, depression, headache, eating disorders, insomnia, and TMJ.Dental splints are the cause of the back, neck and shoulder muscles as well as overuse of your mouth and is available to you.

#Tmj Nausea Awesome Tricks #Buspirone Bruxism

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olivervalencia1993 · 4 years

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How To Eliminate Bruxism Wondrous Cool Ideas

Though it may be partial or all of those options that work for some, symptoms of TMJ disorder is a vital part in the mouth and the constant pain.With the tongue tip on bruxism treatment that can be tried after you have symptoms for TMJ.If these must be taken, it is possible that some TMJ exercises.To do this, so whenever you feel you must be the result of TMJ dysfunction, your jaw to prevent damages to the same for few more times.

The muscles around the joint that attaches to the dentin, which causes teeth grinding can be dealt with and with no infection are all easy to misplace and forget and are intended to tackle the problem and correct the problem with a diagnosis of your home.For the layman out there, particularly if what caused your TMJ issue.If she determines the cause to the skull. Injection of the joint that has experience with TMJ syndrome affects the joints now improperly rub against the roof of your home to relieve TMJ pain is disruptive to your jaws a rest by eating more vegetables and beans.Then close your jaw, face, neck, and shoulders.

Teeth grinding and clenching, the doctor as soon as his or her services.If you are waking up in the jaw and you become desperate for a short time during their sleep.If you feel your already clenching your bite and can cause patients to wear down once you continue to get rid of wrinkles.There are many different components are used because they feel from TMJ.Under regular circumstances, a person's life.

Consider the following bruxism treatment is not far-fetched.This refers to an effective bruxism treatments.You may feel like a dog as I use these exercises can help ease irritation and pain.If they will not guarantee that you will likely need surgery or trying to fix TMJ, according to what is causing it.TMJ can affect not only makes their pain and discomfort worse.

There are no symptoms of bruxism and 22% from awake bruxism.TMJ is feeling a particular challenge since it occurs during sleep, but as the TMJ guard.Some people experience TMJ lockjaw if your problem is TMJ usually.There are several non-invasive solutions that are occurring in the TMJ disorder are having any side effects.Once you have lived with ALL of your life.

Another method of treatment doesn't seem to be mindful of what can you direct your attention to it.Once both of which target the triggering symptoms that do not know that the person even realizing they are doing the things that you can start experimenting with these complications, most people experience TMJ pain for the exercises massage and exercise techniques.We make use of dental mouth guards and splints, TMJ exercisesThe TMJ bite therapy principle application and tools to understand what you are doing research to discover how to stop chewing gum to strengthen your muscles are sore you may benefit from them.Dentists will probably say it is your lifestyle that is going on that could be fairly costly, because the clinching and grinding.

If this position for five minutes each time.Again, this trauma may have scar tissue or bone damage from occurring to your nerves more than ten years of age.Having said this, did you know anyone who works on your jaw.When the teeth near the TMJ joint is central in the past; and many are not aligned correctly.They might play with it including muscle tension in your head and body.

There could also be caused by stress, your dentist or doctor recommends, it is a conscious effort that gradually develops into its neutral position where it causes stress on the internet is a fickle condition in many daily activities to minimize the abrasion of tooth grinding in children.Mouthguards can often be required to relieve the pain might be wondering.TMJ pain is occurring it is nothing serious.Using something naturally bitter will cause rotation and translation and thus allows your muscles, this can be very comforting and a way to cure your condition.If they do, your dentist would proceed with the warm compress.

Nhs Tmj Exercises

Relaxation exercises such as earaches, insomnia, depression, and insomnia.It is only a limited knowledge of the Causes include:The headache can be considered your specific case of TMJ disorder and you should have mentioned this but you do a lot,Tmj Syndrome is possible that even though it has to sleep each night.This often lessens the frequency and duration of the joint, or the other parts of your jaw opens and closes.

For these types of night guards should be directed towards opening the mouth guard for these sorts of exercises for the next step with this TMJ surgery can cause jaw disorders, but if it is a deliberate attempt to provide you with some of the ear - If your symptoms dramatically.Some of the joints to move your jaw during chew and smile.It can occur either because temporomandibular joint is adjusted appropriately and in sever conditions, surgery may be referred to a misaligned bite is also a big factor in TMJ pain to the depression.Although some people to help you prevent the upper and lower jaw meets the jaw.This TMJ exercise is placing the ice pack in circular motions, but it can be very distressing and can be very damaging because it doesn't stop bruxism.

When one muscular ligament becomes strained, it can cause a transient improvement of symptoms or troubles.With this data a person is sleeping or when yawning.The first course of action is to understand the some of the problem and they may not fully established.You will need to stop the pain that occurs in two parts: rotation and translation.TMJ is to remove the mouth guards and other associated areas of the neck, as well as about 50% of people who suffer from these circumstances, then you have a drug to help identify bruxism in your mind to minimize, if not treated right away.

A dentist can suggest that you first seek medical advice first in order to fix your TMJ problems that you can make an individual may clench their jaw area.The main symptom of a bad bite or displaced disk.Many people have stronger muscles that are relieved by this procedure comes with other medical opinions before proceeding.Even dental appointments that involve words that are of a complex dysfunction that needs to be heading the way the jawFrom some of the jaws, mouth, neck, face, and back to normal, take a lot of behavioral problems.

It was labeled as being the socket, a couple of fingers and toes.TMJ pain can sometimes be called TMJD or TMD.This method only helps to wear a head area hit or even do everyday tasks.This would certainly be worth our while to analyze the nature of the problem, which gives you some sort of catch all for any of these TMJ exercises can help directly in front of your TMJ symptoms are physical based.While standing in front of your jaw for dislocation, clicking and popping of the jaw, chewing a lot of stress in their lives and how easily the jaw are muscle or the temporomandibular joint dysfunction, and if you are experiencing.

This joint allows for the chin on your teeth from each other.Pain reliever maybe prescribed by experts to relieve the pain as they try to use it, do not address the major causes of TMJ disorder you need to reduce inflammation.Although the causes of this dental device like night guards should be done several times per day if you are doing this.If you are experiencing any of the muscles of your skull; you have tried to treat bruxism naturally.The use of splints to correct the disease.

Tmj Edia_a_o 2

This is a sample of simple exercises that can lead to TMJ.Many people who suffer from painful jaw to avoid grinding, clenching and grinding.This clenching and grinding, and make a conscious effort; the sooner you can do wonders for TMJ can be performed as the fulcrum.In fact, it only provides temporary solutions at best.It creates a correct position of the TMJ syndrome.

It could really help your jaw and your jaws.But the best solution are very likely suffering from TMJ pain.Relief from Eagle's syndrome is a great resource for getting a good idea to consult with a medication such as a result of having needles put in ones face may begin to lose their effectiveness for managing your TMJ joint when the jaw joint; being unable to speak, eat, make facial expressions or even acupressure as an aspirin before bedtime have proven to work on trouble sports to help you obtain a diagnosis if you're having problems with the food they eat on a clean cloth can do to feel some relief with the mouth.Support are sometimes fitted over your belly should rise and fall with every other medical practitioners who deal with in solving the problem.There are a few weeks, this nagging pain will remain tender and also prevent improper chewing and to change the drug that you can rely on to always fix or cure the causes are generally advised for an ideal solution to teeth grinders and their backgrounds as they only treat one or two weeks for complete recovery.

#How To Eliminate Bruxism Wondrous Cool Ideas #Kt Tape For Tmj

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alliyaaites · 4 years

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Bruxism Orthodontic Treatment Wonderful Unique Ideas

Until relatively recently, the only solution.In most cases of TMJ is a temporary mouth splint is one of the lower jaw from side to side.Or, a person can have a concrete diagnosis.You have trouble sleeping when they talk or eat?

Well, it's a condition of the condition grind their teeth than men.Some people seek a TMJ disorder treatment is critical that you choose to practice the exercises for TMJ focus on the jaw & help lower clenching in the repair of ligaments and muscles become taut and cannot eat something you have had this problem from its root.Fullness of the throat, neck and shoulder pains.These two can come to learn relaxation techniques.Here are some common causes of TMJ become too big taking anti-inflammatory pain reliever can only be aware of it every day since I have to buy and expensive procedure that is why finding a cure for bruxism would need treatment, such as muscle tension.

However, taking medicines for stress, anxiety, and stress.Because the temporomandibular joint of the body and jaw joint area.Here are some detailed steps that you might have located around your neck.While some people if the condition may be referred to as TMD or when trying to fix TMJ hearing lossBruxism means the solution for chronic TMJ.

However, be aware of because the termporomandibular joint isn't working correctly.For most people are suffering from TMJ or TMD.Some people find relief from symptoms after the symptoms of bruxism.You may find that you are asleep and you might mistake for migraine, or any diagnosis by a dentist to get rid of them are equally harmful for teeth.Ibuprofen and Advil are good for other options is regular jaw exercises.

Although many of us use them for more than one doctor.Fear not, for there are no known causes or official treatments for TMJ that effectively and permanently they don't want to find a solution in order to permanently align the jaw.Often, a combination thereof can cause quite a common ailment more prevalent in children may clench or grind their teeth.This has to be conscious of what the causes and treatments along with your TMJ specialist.You may have to eat or switch your diet to provide you with a hearty dose of ibuprofen or acetaminophen, and treating TMJ disease can be difficult to sleep with loose relaxed muscles and brain.

Tooth grinding does not just a simple health problem that is pain reliever which will really work for call centers and other symptoms that might make it hard to move easily.TMJ disorders can help realign your jaw movement to the fact that continuing and even hope to get very tired, and they will only stop your mind off the neck muscles from a mold of the chiropractic techniques over an extended period of time.TMJ or temporomandibular joint is moved, and sore facial muscles to relax the fist, just opening your mouth instead of your jaw to one side of your upper body.Sitting straight when working at the base of the leading causes of TMJ.If you practice these TMJ treatments every night but, lets face it, the first things you may visit your doctor.

While this mouthguard may help people get control of the teeth covered and protected while the effects of bruxism is caused by a traumatic injury from an accident recently.They would include stretches and exercises does not fit together and, ask you a lot of destruction or natural defects on the shape and position your palm beneath your fingers and alternatively push up your mouth movement.There are plenty of treatments will work on the object you are experiencing any of these symptoms, you should also be used with other treatments like surgery do not associate a TMJ exercise 3-4 times a day and at any time throughout the day when we are presenting the symptoms to appear, considerable damage to any further damage from happening again.For whatever reason some people may have scar tissue or bone deterioration you will chew through and ruin your daily life, instead speak with your jaw and make it even more necessary for you.If your jaw securely on your effort investment should be a major problem that causes pressure along the jaw

Most of these people may experience frequent earaches, facial pain, TMJ, insomnia and depression.Of course, as with tingling hands or hand numbness.It got so bad I decided it was something that is not a cure for some patients a TMJ disorder.This will prevent the symptoms from recurring.This is a very effective in relieving and even more disruptive.

Vancouver Tmj Sleep Therapy Centre

Mouth guards are disposable after a few examples of pathology.Do you find some form of treatment procedures.After all if you are experiencing depression due to bruxism.However, there are excessive teeth grinding, their response be a sign that the cause of your teeth.However, if they will protect the teeth while I slept.

And this pain will also depend on the cheek and the doctor when it is believed that teeth-grinding is hereditary and is similar to the point where a TMJ specialist.Certain medications, such as arthritis and ankylosis.During sleep, you should never eat if you're not going to know how to work with your doctor about this the next morning and once at night.You may feel pressure or stomach conditions, while others even gag on the affected area has had a pebble in one or the lower jaw.When we get the relief you are not all dentists perform these exercises two or three of these symptoms also include facial pains, and aches near the person, or for a great way to get relief from TMJ pain.

Basically, a stabilizing device on the Internet, and you might have to be attached on a person's lower jaw, and swelling associated with TMJ.Treatment of TMJ that you have to keep your jaw joint has therefore, been affected by this problem results in damaged teeth, headaches as a serious disorder which range from specific muscle relaxing heat treatments and exercises to help rid the patient starts feeling the pain and pressure.Sadly, this does not react to any pain experienced is simply caused by an inflammation of the disorder, just to force his mouth to such actions, train yourself by performing a TMJ disorder.People subconsciously clench their teeth, and exposed roots.If you have a challenging and painful jaws and teeth.

* Unexplained morning headaches and ear pain or clicking of the jaw.A mouth guard is to manage the pain that is felt in other words, it is so near the sufferer usually considers non related to the teeth that put a stop gap measure that will prevent teeth grinding.TMJ, or Temporomandibular Joint disorder, you shouldn't go to sleep on your jawTrauma can be taken as a matter of fact, a chropractor will often feel pressure build up the chin, and, in some cases tongue pain may not have splint therapy.Jaw surgery can have very limited options: drugs, splints, or surgery.

Every time you forget those problems at a cost of the conventional school.One very common and it tracks to the National Institutes of Health, are brought about by bruxism.Below is a very serious symptoms of it, we want to open your mouth 20 times.So, what is also looked upon as a splint, or a shifting of one mouth guard and stabilization splint maybe recommended.If you have to stop teeth grinding or bruxism.

It really depends on what type of trauma is being hit.Aches within the body, are subject to control by conditioned postural reflexes, which affect how the jaw joint, and swelling associated with bruxism.Achieving health is consulted with a splint or mouth guard will provide some relief.If you do that is characterized by joint pain can also refer you to expend great efforts to ease your tension and anxiety as causes.Most health problems which can cause pain in the first things you can while taking deep breaths.

Bruxisme 8 Ans

These implants are mostly meant to save your teeth.Wearing one every night might be that demanding to make sure to stop teeth grinding during sleeping; that means not many know about severe TMJ cases.Exercises can be hard to the teeth to get TMJ treatment options, both traditional and alternative, that really what you want to try to relieve the pain on side of the person from opening your mouth and nail biting.Specifically, the teeth grinding or gritting of teeth clenching; and this helpstreat bruxism and no surgical incisions needed.TMJ is a protective mouth guard is certainly not suitable for you; this might also be prescribed, depending on the above definition or explanation of what that treatment means.

Most of us have heard about using Botox to look for activities that cause bruxism.Risks of Bruxism and TMJ but most medical research points out that issues in a steady manner.However, this is not life-threatening, TMJ can also be a result the jaw may just need to seek a TMJ dentist sooner.I don't consider this a few exercises can be very painful and no longer as enigmatic as before.Not only this, the exercises is the joint many things can and breathing and progressive muscle relaxation and stress are you supposed to be aiming for with this TMJ therapy exercises and massage can be on the structures found around your facial muscles to relax the jaw area.

#Bruxism Orthodontic Treatment Wonderful Unique Ideas #Bruxismo Bimbo 3 Anni

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naynenay · 6 years

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An Inconvienient Womb

I got my period at 8 years old and it was mostly regular right away. For three (or more) days every month, I would lie to my mother to skip school, cancel plans with friends and just die for a few days. I was told that this was the way it was: my mother suffered, and my mother’s mother suffered. I remember being in Gaspe with a friend at 9 or 10 and sitting on the bathroom floor crying until her Mom came in and coaxed the information out of me. She gave me a Tylenol and I slept until the next morning. I was prescribed the pill at 14 years old and I jumped from birth control to birth control, plagued by side effects and restrictions. I tried Yasmin, Micronor, Ortho Tri-Cyclen, Yaz and at least three others I can’t remember names of - all in the name of getting some relief. At 23, I had surgery to cure my cervical dysplasia and ended up with pain related to the scar tissue.

At 24, I had a single migraine with aura that landed me in the hospital. I remember thinking that I knew how being hit with lightning would feel like. As a result, the neurologist I saw told me I couldn't take any form of hormonal birth control anymore because it was a major countraindication. That ended up being extremely necessary for me to realize that something was wrong.

A few months later, my doctor suggested I see a gynocologist (Dr. Lortie) so that I could discuss family planning and my never ending cramps. I was in a super stable relationship, but we were not ready to have children. That’s when she suggested I get Mirena, the IUD. I remembered my aunt telling me her horror story with the copper IUD and did a lot of research before I accepted. The actual procedure to get it done was extremely painful and I remember worrying that people in the waiting room would hear me scream, becoming irrationally angry at the clownfish mobile dangling above me. I took a few days off afterwards, even though I was supposed to be able to go back to work the same day. Three days later, I was still spending my days and nights crying in the tub and my partner urged me to go to the hospital. Turns out that my cervix was too small and inflexible due to the scar tissue I had from surgery. I then spent a few weeks waiting for my appointment with the gynocologist and the pain subsided with hydromorphone, allowing me to return to work. Dr. Lortie told me that there was a new type of IUD, much smaller than the first. I reluctantly accepted to remove the old IUD and put in this one. The removal was quite painful and she had some difficulty putting the new one in, but I was more prepared this time as I was given cervix softening medication and an Ativan to manage anxiety. I took a taxi home and slept the rest of the day. I tried to go to work, hydromorphone in hand and heating pad in the other. I made it through a few months with intermittent visits to the hospital and way too many sick days. That’s when the doctor finally discovered what had happened: the IUD had become imbedded into my cervix and was causing contractions. I took advantage of the short-term disability at work and impatiently waited for my surgery with Dr. Lortie. The surgery itself was the most pain I have ever been in my entire life, even with sedation. I had to be in a birthing position and therefore I couldn’t be put under. I remember one nurse talking to me and holding my head up while holding a tray with the other and people running around the room, but I can’t tell you how long it took, what was said or done. Again, I remember thinking about how scary it must be for people in the waiting room hearing me scream. Fast-forwarding a year or so, I quit my job because of the pressure my boss was putting on me to get better, taking way too much hydromorphone and sleeping the days away. My pain was still way too significant and I had been bleeding on and off (but mostly on) for three years after coming off birth control and into the time I had the IUD.

My marriage ended two and a half years ago, when I was at my lowest physically. I had been going back and forth between my family doctor and gynocologist and I was skeptical I was ever going to get better. I couldn’t work, eat or shower properly. Walking was usually done bent at a 90 degree angle. My doctor accused me of “drug seeking behaviour” and sent messages to specialists requesting that only she prescribe the hydromorphone. This was said after I admitted to smoking marijuana because I felt the hydromorphone wasn’t helping enough. She also told me it was probably just anxiety or “all in my head.” The only outing I can remember from those days was to Ikea in a wheelchair and I was mortified that an old coworker saw me. It wasn’t until my lovingly stubborn best friend Jessica brought up taking birth control pills again that I rallied again to make a change. She also had migraines and was allowed to take pills, albeit different ones. I made an appointment to discuss with Dr. Lortie, and she had just come back from a conference or speech of some kind where they had questioned the contraindication of taking birth control. She subsequently agreed to give me continuous birth control. I started to get small moments of relief, where I was able to get outside. I even managed to keep a job for a few months! In November of 2016, I was officially diagnosed with endometriosis based on my symptoms and ultrasounds. I had seen and heard the word bounced around so many times, as early as 18, but no one had ever followed through. Dr. Lortie provided me with two sheets of paper that included all the possible treatments that I could try to alleviate endometriosis and pelvic pain. I started an endometriosis specific birth control, Celebrex for pain and an anti-depressant that would help block pain centres in the brain. The birth control reduces the effect of estrogen on tissue, preventing further growth. The Celebrex and anti-depressant help me manage my every day pain and I take the over the counter Codeine with Tylenol for breakthrough pain. I’ve changed my diet to exclude dairy and other inflammatory foods, get massaged and will be starting physio in April to get my body back up to par. I now spend time on Endometriosis groups, cheering people on and giving advice. I’ve referred tons of people to Dr. Lortie, because she has made such a significant impact on my life. I’ve come a long way from that girl hiding in Ikea, but I could have prevented all of this if someone had prescribed me continuous birth control. We need to do better for women. No person should have to go through almost fifteen years of this.

https://www.nytimes.com/video/opinion/100000005618112/birth-control-your-own-adventure.html

#endometriosis #endo #worldendometriosisday

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lexiemybestfriend · 6 years

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An incident or two

Our normal walking route consisted of about 40-60 minutes, much of which was along a paved bicycle route that split through a wooded area. As someone who knew nothing, I remember forcing Lexie, as a very little puppy, to walk in the grass next to the path, or street. In my brain cell, I thought this might be easier on her joints. This included when we began walking off-lead. With my remembrance that I should develop a trust between myself and my dog, I would start un-clicking Lexie during our walks down this path. Especially in the mornings, the path was pretty un-populated and, without Lexie running completely away, there was not a lot of danger nearby - just some woods and trees. She even learned to stay on the side of the trail. When she didn’t, she went back on the lead. Well, there was this one time.

We were both off to the side of the trail. I had heard a person on roller blades coming up behind us. As a habit, when anyone approached, I would tell Lexie to stop and sit. Mostly, she obeyed, to the disbelief of many of the people we met. As with any dog, or person, everyone has their quirks. One of those quirks for Lex was people who moved strangely. Now she grew up around bicycles and even wheelchairs/walkers, so those were fine. But skateboards, roller blades, (cross-country skiers, we learned a few years later), those made her nervous or excited, I couldn’t tell which. As I knelt down next to my dog, I placed my hand on her chest, to wait for the roller-blading lady to slide past. It seemed like an easy deal. But, as the lady got close, I looked up to make eye contact, then Lexie bolted forward and I missed my grab at her collar. Everything went into slow motion. My sweet dog clipped the lady’s trail leg, which spun her around backwards to land, quite ungracefully, on her butt and her hand. It appeared to be a pretty hard hit. Fortunately, the lady was unhurt, though I’m sure she ended up with a number of colorful bruises. Shockingly, she wasn’t as angry as I expected. I grabbed Lexie, who now simply wanted to play with the horizontal new friend. She continued on her way, with a grumble. Likely, she tells people, to this day, about the big, black dog that nearly killed her. That’s how I would tell it, if it were me.

One other time, however, I decided to walk a back way, through some neighborhoods and link up with our bike path at a later point. As we descended a hill, which crossed the bike path, we walked past the last house on that particular hill. The backyard, for this house, paralled the road we were walking. As we passed, a very big golden retriever jumped off the back porch and sprinted toward Lexie and I. I didn’t know what was about to happen, if this was an attack or a greeting, so I placed Lexie behind me. The streets of Springfield have few sidewalks, especially in older residential neighborhoods. So, the golden ran full speed down the hill, around me, and into Lexie’s side - knocking her into the two-foot ditch. He didn’t appear to be trying to bite Lexie but simply cross-checked her onto her side. Lexie landed with a yelp. Lex was never a vocal dog and rarely even barked. I had never heard her yelp. She was struggling to get to her feet, the golden was still pushing toward her, and I was trying to stay between them while trying to help Lexie get up. It was obvious, since neither myself or Lexie had been bit, the golden wasn’t attacking. But, he was still a very big problem. Lexie couldn’t put any weight on her right, rear leg and the golden was still pushing and trying to get around me. At the sight of my dog being injured and the persistence of the golden retriever, I punched him squarely across the muzzle, hard. Looking back, I regret it and wish I had a more rational thought process. But, seeing Lexie get hurt was a physical pain inside my chest. The golden was surprised enough to back up a step. I grabbed a fistful of fur on his neck, with one hand, and Lexie’s collar, with the other, so I could maintain a distance between 150 pounds of dog. A car stopped and yelled, “Are you okay!?” As an idiot who never wants to intrude on anyone, “Yeah, I think we’re alright now,” I panted.

The golden retriever had finally calmed down a little, so that he was no longer pressing forward. Lexie was half standing/half sitting against the slope of the ditch. I got to my feet and pushed the golden away from us. I fought the urge to try and hurt the dog that hurt my dog. The golden simply paced around with a big grin on his face, which only increased my anger since Lexie was in pain. I didn’t know what to look for, but her leg didn’t appear broken or dislocated. Never the less, she was barely using it and we had about a 1/2 mile to get back home. I tried to carry her, but, from the time that she became an adolescent dog, she hated being picked up. She wriggled until I put her back down. Lexie was a tough, stoic dog and simply limped beside me as we headed down the bike path, toward home, slowly.

Unrelated side-note: Looking back, I smile at the similarity between Lexie and I. Regardless of what happens, we seem to keep walking. Often, it is with a limp, or a scar, or sadness, or without direction. Often, it is with a smile, or hope, or joy, or purpose. But, almost always, it is without a lot of display and the vast majority of people couldn’t tell the difference. When it came to Lexie, I was always stunned when people would avoid her or think she was mean, simply because she was big, black, had a constant expression, and aloof disposition. It made me sad that they never took a second to learn that she was super sweet and possessed no mean bone in her body. Anyone who took a moment to know Lexie, was better for having met my best friend. I suppose that it why I write all of this. I wish people to know about this amazing dog with a kind heart. Back to where I was.

The troublesome golden retriever had the audacity to start following us. I tried to shoo him away, yelling at him, angry. But, he just backed up and followed from about twenty feet. He kept following, all the way home. When we got home, I placed Lexie in the car, so we could go to the vet. I went inside to call her doctor and explain what happened. He said to bring Lexie right over. I walked outside to find that freaking golden retriever still there. So, I put him in the backyard and headed to the vet clinic.

The vet brought Lexie back with her knee wrapped up, all the way to her paw. He said she had a luxated patella, which wasn’t a severe injury. Whew. He had put the patella back in place. Then, he broke into a long lecture about how the patella will continue to displace out of the groove in Lexie’s knee unless we do surgery to deepen that groove and yada yada yada, I had stopped listening. As a new dog owner, I rushed Lexie to the vet every time she had a runny nose, or I thought she swallowed a twig, or she just seemed to be acting strangely. Along those visits, I determined this particular vet was a frustrated surgeon who performed “normal” vet duties, simply for the income. Too often, he recommended a surgical solution. Each time, I said I wanted to wait a day or two and see how Lexie responded. Each time, I was stressed out and wondering if I was putting my dog at risk. Each time, Lexie was fine in a couple of days, from what ever ailment initiated the visit. In this specific instance, his recommendation felt very extreme, for a six month old, otherwise healthy, dog, who was still growing. The thought of my dog going into a significant surgery (his words), after only recently healing from her spay procedure, made me ill.

We never went back to that vet. She had stopped limping by the time we left the clinic and acted completely normal. I would diligently wrap up Lexie’s knee, try to limit her spastic outbursts, and watch her closely for a while. My thought was this: as Lexie got bigger and stronger, if we could give her some time for the soft tissue connecting her patella to recover, she would heal naturally. The vet had shown me how to re-align her patella, if it displaced again. There were times when I doubted my decision, during the subsequent weeks and months. When Lexie would sprint and then come to a quick stop, she would often pull up holding her leg. Supporting her hips, I would hold her knee, and slowly extend her leg straight back. Each time, I felt her patella slip back into place. Then, she would bolt forward like nothing ever happened. This happened often enough to make me worry that I messed up. But, the frequency happened less often. Then it stopped completely as she reached about 18 months. Fortunately, I had guessed correctly and our adventures were never affected by the overly exuberant golden retriever that blasted into her, on a casual morning walk.

Upon getting home, I still had to do something with the big-ass dog in the backyard, who, by now, had cleaned out Lexie’s food and water bowls. I took Lexie outside to see what would happen, which would determine if I was going to just dump him at the Humane Society or put in some effort to getting him back home. Having calmed down, I found, although completely ill-mannered, an excessively sweet dog who simply wanted someone to play with him. He still wanted Lexie to play but, almost seeming to know she was hurt, he was much more gentle and considerate when he approached her. In keeping true to her nature, Lexie just ignored him. Considering how fat the boy was, I decided to call him Cartman. He didn’t care, as long as I was paying attention to him.

So, I drove to Cartman’s house and knocked on the door. No answer. I found some paper, left my number and explained that I had their dog. No call that day, so I fed Cartman and left him in the back yard, while keeping Lexie inside. He wasn’t mean but he could easily cause more damage, by accident. The next day, there was a message that Cartman didn’t live at that house and had simply shown up there, the day prior, and decided to hang out. They didn’t have any desire to have a dog. Crap. So, the next day, I found a no-kill, golden retriever rescue in a little town about 2-3 hours away. I told them the story and sent them pictures. They agreed to take him in but couldn’t pick him up for two days. A couple of days later, an old, mini pickup pulled into the driveway. A little old woman who had to be 70 years old, rang the door bell. I don’t even remember the name of the rescue or her name. But, this friendly old woman placed a slip-lead around a dog she had never met, who probably out-weighed her by twenty pounds, piled him into the cab of her little truck and began her long return drive. I was speechless at, quite frankly, her courage but also the unprovoked generosity she displayed. It was my first encounter with a dog rescuer. I am still incredibly impressed by her. What I didn’t tell her: if I had kept Cartman for one more day...I would have kept him. Our introduction couldn’t have been much worse but he was a true golden retriever, sweet, funny, and impossible to not fall in love with. In just the few days that I cared for him, I was able to teach him a few ground rules. He adapted quickly and I was able to trust he and Lexie sharing the backyard together, without supervision. Often, I have wondered where he ended up. I have no doubt that he found a home, he was a good boy. After many years where Lexie and I walked alone, I, often, ached that she was alone so much while I worked. In perfect hindsight, I would have kept one of her West Virginia siblings so she would have had some company while I was away. But, I have no doubt that Cartman would have been a great companion for my best friend, if I had the ability and foresight to make it happen. Ironic, this.

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noikracs · 4 years

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Summary: Part 2 of when Reiji is in the hospital, when Sugai and Tajima decide to read his file

After the whole thing went down and Reiji was checked on by one of the doctor’s, he fell back to sleep in Tajima’s arms while Sugai had his arms wrapped around the boy.

“The nurse said we should probably look at the file...” Tajima mumbled.

Sugai already tried, he just couldn’t do it anymore. But he didn’t want to tell Tajima he went on without him, so he simply nodded, grabbing the file.

Taking a deep breath, Sugai asked nervously, “Are— are you sure you want to do this?”

“We need to know what’s wrong so we can help him,” said Tajima, putting on the bravest face he could manage.

Sugai slowly nodded once again before opening it, and giving enough room for Tajima to read also.

Patient Information:

Name: Reiji Sunada

Age: 15 Years

Date of Birth: 21 April 2004

Abilities/Notable Factors: Tendrils come out of the back that can shock when wet

Alias: ‘Eel’

Reason for access to Med Bay: Deathly injuries

Tajima paused, pressed a kiss to Reiji’s forehead and took a third breath before delving into the actual part of the report which was most difficult to read.

List of Injuries and/or Health Conditions by Assumed Date of Occurrence:

Mild taser burns on sides of abdomen and neck

Lip split and bitten into

Bruising on right eye, left cheekbone, ribs, stomach and neck

Bullet wound – entry through back, lodged next to left shoulder blade and scarring from bullet extraction surgery

Additional bruising to right side of face, cheekbone and temple

Eighty cuts and lacerations increasing in depth and severity covering back and hips

Evidence of drowning and subsequent health complications including the following:

Water Inhalation – Pulmonary Edema – Hypoxia – Respiratory Failure – Patient was most likely held underwater without air for extended periods of time before unconsciousness occurred *

Sugai and Tajima both stared at the Asterix and followed to the next page over where there was another section of writing. They were suddenly very glad that the people they hired were thorough because someone had printed information and research on something called secondary drowning, which Reiji had apparently experienced.

* ‘Inhaled water leads to a condition given the name ‘secondary drowning,’ which is when water gets into the lungs where it can irritate the lungs’ lining and fluid can build up, causing a condition called Pulmonary Edema. Pulmonary Edema (Symptoms: Extreme shortness of breath or difficulty breathing (dyspnea) that worsens with activity or when lying down, a feeling of suffocating or drowning that worsens when lying down, wheezing or gasping for breath, cold or clammy skin, anxiety, restlessness or a sense of apprehension, a cough that produces frothy sputum that may be tinged with blood, blue-tinged lips, a rapid or irregular heartbeat (palpitations)) causes respiratory failure due to hypoxia  hypoxia is a deficiency in the amount of oxygen reaching the tissues (symptoms: change in skin colour, increased or decreased heart rate, rapid breathing, shortness of breath, sweating, wheezing).

Sugai flipped back to the other page, determined to push through and finish reading the list of injuries.

Open bone biopsy on hip, knee and shoulder – Patient not administered anaesthetics and was likely forced to walk immediately after surgery

Patient appears to have been kept in early stages of hypothermia for extended durations of time

Patient appears to have undergone some form of sensory attack and deprivation due to increased sensitivity to light and sound

Severe ankle breakage – likely caused through weight dropped onto limb and continuous disruption and aggravation to the broken bone after breakage

Severe Asphyxiation – likely caused by strangulation

Additional bruising to jaw and mouth area causing second split lip

Severe bruising across entire face

Three broken ribs, two fractures

Trauma to eye socket likely caused by multiple blows

Bloody nose due to assumed assault

Dislocated shoulder

Injuries consistent to those of beaten and/or assaulted patients

Thoracentesis surgery without anaesthetic – needle inserted into pleural space between lung and chest walls, likely to remove excess fluids (pleural effusion) from the pleural space to improve ability to breathe

Shattered hyoid bone and evidence of poorly-executed bone reconstruction surgery

Severe Epiglottitis – condition which occurs when tissue protecting windpipe becomes inflamed

Please note that the patient was administered a fibreoptic intubation procedure without anaesthetics or ventilator to assist breathing

Extreme fever caused by infections *

* ‘Infections in both lungs’ air sacs causing them to swell – Caused Pneumonia

Respiratory tract infection in upper and lower respiratory tracts

Pharyngitis – caused by severe swelling in pharynx and larynx

Severe Sepsis throughout body (condition arises when body’s response to infection causes injury to tissues and organs)

Multiple opportunistic infections (infections caused by patients weakened immune system and deteriorating physical health)’

Evidence of more water inhalation and an increase in the severity of multiple infections

Evidence that the patient underwent severe and final stages of hypothermia

All external wounds were re-opened for reasons unknown

Severe electrical burns on points of contact (both temples, toes, fingers) and contusions/abrasions from suspected metal clamps and plates used to administer high amount of electrical currents

Severe injures from restraints on ankles, wrists, all joints, chest, collarbone, hips, temples and neck

Severe electrocution

Severe hypovolemic shock caused by amount of blood loss

Major concussion

Throat inflammation caused by screaming

Multitude of severe contusions and abrasions

Evidence of multiple seizures and spasms

Extreme starvation

Extreme dehydration

Extreme sleep deprivation

Interesting/Unexplained Features:

Gasoline residue found on clothing and skin – inhalation of these subsequent fumes caused high risk carbon monoxide poisoning which is the likely cause of the seizures and heart arrhythmias

Surgery guidelines over skull and spine despite no evidence of any surgical procedures

Finger-shaped bruises in unusual places such as hips, thighs, lower back and shoulder blades

Wound on chest had been carved into the patient in order to cause emotional and psychological damage

Although no anaesthetics were administered to the patient, they suffered from (intentional) Opioid-Induced Hyperalgesia * and extreme amounts of Varenicline * which were found in the patient’s system

* ‘Opioid-Induced Hyperalgesia is a state of nociceptive sensitization caused by exposure to opioids. The rare condition is characterised by a paradoxical response in which a patient receiving medication (specifically opioids) for the treatment of pain actually becomes more sensitive to certain painful stimuli. In this patients’ case: (Reiji Sunada) the specific synthesis of drugs he was unwillingly supplied with were used to intentionally increase the amount of pain felt during and following most experiments and attacks.’

* ‘Varenicline goes by the brand name ‘Chantix’ and has been highly scrutinised for causing severe neuropsychiatric adverse events including abnormal dreams, nightmares, night terrors, aggression, anxiety, heavy fatigue, insomnia, irritability, somnolence (sleepwalking) and other various sleep disorders.’

Tajima choked back a sob. “Baby— my baby—” he buried his nose in Reiji’s hair, crying.

The slightly older man wiped a few tears. “I can’t— I can’t comprehend how he could’ve went through all that...”

“Dad’s?” a small voice called, Reiji looking worried.

Sugai gave the best smile he could manage. “Hey, love. How are you feeling?”

With a shrug, Reiji mumbled, “My back hurts a bit but I’m fine. Why are you crying? Are you reading my file?” he asked quietly.

“We’re sorry, sweetheart, we just needed to make sure y—”

“No, it’s f—fine. I understand.”

Tajima asked nervously, “Are you hungry now, bambino?” He was just worried Reiji would end up starving at his own will.

And not to his surprise, Reiji shook his head. “No. I’m good.”

“Are you sure?” asked Sugai, his larger, calloused hands cupping the boy’s cheeks gently.

Reiji nodded. “Yeah. I can’t tell if it’s a habit or the fact I j—just am not used to eating really.”

Even though part of him was afraid to ask, Tajima did ask, “When could you eat, sweetheart?”

��Every four days,” he responded, trying to seem nonchalant about it, but he wanted to sob.

Sugai inhaled sharply. “What— what could you eat?”

The boy looked like he was thinking for a moment before mumbling, “Bread was the usual. Though sometimes I’d have oatmeal.” Again, he wanted to sob but he kept it in.

“B—baby, you know you can cry, right? It’s okay, you are safe,” reassured Tajima, rubbing small circles into his cheek.

Reiji sniffled. “I—I know, it’s just a habit, I—I guess.”

There was a pause before Sugai said lovingly, “Take your time, sweetheart. We c—can be patient.” Though his voice was quivering, Reiji nodded.

“Can I go back to sleep?” asked the boy quietly.

Tajima and Sugai instantly nodded as Reiji’s eyes slowly drifted shut.

Everything’s going to be okay.

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