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macgyvermedical · 1 year

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Building Your Home Pharmacy

So you're in the OTC med section of the pharmacy. You've got 100 bucks burning a hole in your pocket (or maybe like $15 cause you're just starting). You're a new adult who wants to build yourself a tidy home pharmacy.

Well first you've got to know some stuff about over the counter (OTC) meds. This is the post to help you do it.

What are OTC meds? They are medications you can buy from a pharmacy or grocery store without needing a prescription. They have been deemed relatively safe and relatively easy to dose without a doctor's intervention. This does not mean they can't be dangerous, just that the general public can generally be trusted not to accidentally kill themselves with them on the regular. Keep that in your mind for later.

Note that all the medications discussed below are given in their generic names. In order to find these names, look below the brand name on a medication bottle:

Pain Medications:

Acetaminophen/Paracetamol: This is a non-NSAID pain reliever and fever reducer, so it's great for people who can't take NSAIDs due to stomach or kidney issues. Works best for headaches and fevers, but works on other types of pain as well. Technically works best as a suppository, but still works some orally. No increased risk of bleeding. Don't take more than directed. Seriously. This one can kill you or seriously damage your liver.

Ibuprofen: NSAID. Works against pain, inflammation, and fever. Take on a full stomach or you could get ulcers. Don't take if you have kidney problems. You can take this with acetaminophen.

Naproxen: NSAID. Probably the most effective for pain, but works against inflammation and fever as well. Lasts 12 hours. Don't take high doses continuously or you will get kidney problems. You can take this with acetaminophen.

Aspirin: NSAID. This was the first NSAID and it's definitely here to give you stomach ulcers if you don't take it on a full stomach. Technically it works for pain, inflammation, and fever. Most people today take it as a blood thinner. You can take this with acetaminophen.

Allergy/Cold/Congestion Medications:

Diphenhydramine/Doxalamine: First Generation Antihistamines. These are great for nighttime allergies, coughs, insomnia, nausea, and itching. Most people get drowsy from these, but some people get really hyper, especially kids.

Cetirazine/Loratadine/Fexofenadine: Second Generation Antihistamines. These work for allergies and itching and don't cause as much drowsiness.

Phenylephrine/Pseudoephedrine: Decongestants. These work by mimicking epinephrine, making the blood vessels in the nose and sinuses smaller. This makes the nose and sinuses less stuffy, but it raises blood pressure (so don't take if that's a problem for you). Pseudoephedrine is also restricted- you must be an adult to purchase and you can only buy so much. You have to talk to a pharmacist to get it because it can be used to make methamphetamine.

Triamcinolone/budesonide/fluticasone Nasal Spray: These are steroid sprays. They work similarly to the decongestants but only in the nose, and generally don't travel to the rest of the body.

Guifenesin: This is an expectorant, not a decongestant. It works by thinning the mucous in the lungs and airway. This makes it easier for you to cough it up. You have to drink a lot of water with this for it to work, though.

Dextromethorphan: This is a cough suppressant. It works by blocking signals in the brain that tell you to cough. Pretty much everything interacts with this one so if you take any medications talk to your doctor first. Depending on where you live you may have to talk to a pharmacist to get this one due to the potential for abuse.

Digestive Medications

Loperamide: This is an antidiarrheal. It works by decreasing the amount of squishing around your intestines are doing, which helps you hold your diarrhea and lets you continue to function. It is an opioid, but is not absorbed from your digestive tract so it doesn't make you high.

Bismuth Subsalicylate: This works for diarrhea as well, but also nausea, heartburn, and the prevention of traveler's diarrhea. Don't take if you're allergic to salicylates or aspirin. Taking this for an extended period of time can also cause bismuth toxicity.

Calcium Carbonate: This is an antacid. It is very basic pH wise, so can help change the pH of stomach contents pretty quickly. This is usually used for heartburn. If you take any other medications, this can prevent you from absorbing them if you take them within two hours. Using for long periods can cause rebound heartburn when you stop taking it.

Cemetidine/Famotidine/Ranitadine: These are gastric acid reducers, and they work by blocking the type of histamine that is necessary for the production of stomach acid. They are usually used for heartburn and ulcers.

Omeprezole/Esomeprezole: These are also gastric acid reducers, but they work by blocking a different part of the very complicated way our stomachs make acid. After years and years of taking these you might get some bone density problems.

Bisocodyl/Senna: These are laxatives. They work by increasing the movement of the intestines. It's important not to take these consistently unless you can't poop at all without them, or you seriously will not be able to poop without them.

Docusate/Propylene Glycol: These are stool softeners. They work by increasing the amount of water in the intestines. These are pretty safe to take all the time if you need to.

Simethicone: This is a surfactant. It works by accumulating all the gas bubbles in the intestines so they can be expelled. It's usually used for painful gas.

Topical Medications:

Clotrimezole/Miconazole: These are antifungal preparations. They treat yeast infections, athletes foot, jock itch, and ringworm.

Triple Antibiotic Ointment: This is a cream that contains antibiotics. Ostensibly you're supposed to put this on small cuts to decrease risk of infection. IRL just clean it with soap and water and then put some vasaline on it. Studies have shown it works just as well.

Hydrocortisone: This is a steroid cream. You put it on itchy things (bug bites, poison ivy, etc...) and it makes them not itch as much. This one actually works and is generally better than diphenhydramine creams that can't be used on poison ivy.

Permethrin: This is an insecticide. It will help get rid of head and body lice.

Zinc Oxide: This is a skin protectant. It helps prevent diaper rash and chafing. It also makes things feel better once you've already chafed. Technically it is also a sunblock, but it will make you look like a ghost while you're wearing it.

Family Planning:

Levonorgestrel: This is known as the morning after pill. It works by blocking ovulation, so that a sperm and egg cannot meet, preventing pregnancy. It can be taken up to 5 days after unprotected sex, though it works better the sooner it is taken.

Devices:

Blood Sugar Meter/Strips/Lancets: These help measure the amount of sugar in your blood. They are usually used by people with diabetes.

Blood Pressure Cuff: This measures blood pressure automatically with a cuff around the upper arm or wrist. It is usually used by people with high blood pressure.

Ketogenic Test Strips: This measures the amount of ketones in the urine. Ketones are a byproduct of fat breakdown, usually found when the body cannot breakdown carbohydrates for energy and begins to break down fat instead. Usually people who are on a ketogenic diet or people with diabetes use these.

Peak Flow Meter: This measures the amount of air that can be used by the lungs. They are usually used by people with asthma or COPD.

Great, Which Ones Do I Need?

I'd recommend look over the list and see which ones would be most useful for you, and start with those. Over time, collect ones that would be most embarrassing to not have, and then the ones that you're pretty sure you'll never use.

Note that in a dry, unopened package (including inside blister packs), drugs last well beyond their expiration dates. So if you don't use a certain med all that often, get a smaller package of it.

Great, Which Ones Can I Take at the Same Time?

Good question. I'm going to say that if you take any prescription medications, you always want to check with your doctor before taking anything OTC. However, I recommend you use an interaction checker like this one if you want to take more than one OTC med at the same time. One can be found here.

Note:

Loperamide CANNOT be taken with cimetidine/ranitidine/famotidine. This causes bad heart rhythms.

Don't take two meds from the same category together (like cimetadine with ranitidine, or ibuprofen with naproxen, or diphenhydramine and fexofenadine unless a doctor tells you to).

Most antacids (calcium carbonate, sodium bicarbonate) will prevent the absorption of other medications, so take them two hours apart from anything else you take.

Don't drink alcohol with loperamide, detromethophan, acetaminophen, or any antihistamines.

#Adulting #Adulting reference #young adults #new adults #whump reference #writing reference #medications #over the counter medication #OTC #reference

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foone · 1 year

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Electrolysis

So some info on this hair-removal procedure that I thought might be useful for anyone starting it or considering starting it. PSA: I'm not a doctor or an electrolysis tech, so this is not Expert Advice or anything. I'm just an interested amateur undergoing the procedure, with access to the interweb's collected knowledge.

I stuffed it under a readmore because it's long.

How's it work?

Basically they poke a needle into the hair follicle, and then pass electricity through your body. You'll be holding onto something or putting your hand in (salt) water to provide a path for the current.

This generates sodium hydroxide (aka Lye) though electrolysis, hence the name. The lye kills the follicle, and then the technician pulls out the hair with tweezers. If done correctly, that hair will never grow again.

Importantly: This is an external procedure. You see that pink layer around the follicle? That's a layer of skin. Your skin is not being punctured by the needle, it's simply sliding down the pocket in your skin that the hair lives in. So the needles need to be sterile because of the risk of accidental puncture, but this isn't like surgery or anything.

Does it hurt?

Yep. You're being zapped. Generally in my experience the needle doesn't hurt, but the current being on does hurt. It's not too severe, and importantly IT CAN BE ADJUSTED. See, the amount of time it takes to generate lye depends on the voltage used. If the pain is too intense to manage, your technician can lower the voltage. This'll make it take longer per hair, but it will hurt less. (And similarly, if it doesn't hurt much at all, they may be able to go faster by turning up the voltage)

It's not a "shock" type zap, where it's unexpected and high-intensity. You don't jump with fright. It's more of a "burning" (but without heat) kind of zap, where it's uncomfortable/painful over several seconds, slowly increasing and decreasing in intensity. You may want a stress ball to squeeze.

What should I do before the appointment?

Ask your technician! Generally they'll have a sort of pre-appointment appointment to talk about what you need to do, or they'll send you instructions.

But basically you're gonna want to have short hair in the area you're getting electrolysis done on: My technician suggested 1-4th to 1/8th inch (3-7mm). The idea is that it's long enough that they can grab it with the tweezers, but not so long it curls or gets kinky (lewd). I use an electric razor which comes with one of the shields for cutting hair to a specific length (which my wife bought to buzz her undercut!) and it works great. I just give it a once over the day before my appointment.

You should also make sure you're hydrated. Being dry makes it harder to get the hairs out. Try to do this the day before or early in the day: Not only because it takes a while for the water to make its way through your body and affect the tissues, but because you don't want to have to interrupt the hair removal session to go piss.

I tend to take some painkillers an hour or two before my procedure. Ibuprofen and Tylenol/Acetaminophen/Paracetamol are both over the counter and can be safely mixed, and work well for this. My roommate used to vape some THC before going into her appointments, that may also be an option for you.

You should also ask about topical numbing cream and if your technician wants you to use it. Sometimes it's not a good idea because it can make your skin slimy, but it can definitely help.

The stuff I use is topical lidocaine 5% cream: You will typically find this in the hemorrhoids section of your pharmacy: it's butt cream. Just make sure you are getting a kind that's not got a bunch of added "flavors" like aloe and oatmeal and coloring and the like. You want the most generic cheapest kind.

You put it on "like you're icing a cake". I get the 30g/1oz tubes, and I basically use one per session. You don't rub it in, you just cover the skin with it, as thick as you can. You want to put this on an hour before your session so it has time to sink in. After putting it on, you should cover it with some plastic wrap so it'll stay in place and not get on your mask or shirt or glasses. (You will probably still get it on your shirt. That's okay, it washes out easily)

You probably want to ask your technician which area you're going to be working on before the appointment, so you know where to cover. It's a waste of cream (and less effective) to cover your whole face if they're just going to be working on the moustache area! Speaking of which...

What should I do after the appointment?

Again, ask your tech, but general stuff is:

Ice the affected area. You'll probably have some redness and swelling from the procedure, so this helps minimize that.

Keep that area clean. Don't scratch it, and have some kind of sanitary wipes (I used witch hazel wipes) for when you forget and touch it accidentally. Get a new/clean mask and be careful with headphones, so you don't introduce any surface bacteria into the area.

Again, painkillers. They'll help.

This'll last 1-3 days depending on how fast you heal. It's not hugely noticeable on my skin, but be warned that it might be, like you got a big sunburn on your face.

How do sessions go / how many will it take?

So the thing about electrolysis is that it's not exactly fast. Basically they have to stick a needle in every single hair on the area of skin they're de-hairing, and typically this is the face, which has relatively dense hair. It takes a long while. So for example, in one of my first sessions, they basically started at my right sideburns and went down, making it maybe 2 inches (5cm) down my face, over 2 hours.

It's slow going. You will need a bunch of sessions. I'm sorry. The electrolysis tech who runs the clinic I go to said it could be anything from 30 sessions to 600, depending on your hair density and how much area needs to be covered.

But once they've gone over a section, that section is done, right?

Sadly, no. Hair goes through a cycle of growth-regression-resting, over a cycle that's dependent on where on the body it is and your particular genetics (and some environment conditions! this is why stress can make your hair fall out). If the hair has been shaved before and is in the resting phase, it's not there for the technician to get at. They'll need to go over that spot again to get the hairs they missed. How much this needs to be done depends on your body's hair growth. And sometimes you can be "done" and then a year later some hair pops out of nowhere because it decided to take a long nap and you need to go back for touch-ups. Those will be minor and quick, however, since you'll have far fewer hairs to need to be treated.

It's permanent in the long run, right?

Absolutely. And I mean that: ABSOLUTELY. It is the gold standard of hair removal. Properly electrolysised hair simply cannot come back: you are hairless there forever. There is no longer any living follicle in your skin to grow hair.

Is there only one type of electrolysis?

Nope! There's 2, or 3, or 2 and a half. or, arguably, only one. Basically the idea of "zap someone with electricity to get rid of hair" comes in three(ish) forms:

Galvanic Electrolysis

Thermolysis

Blend

The one I explained is Galvanic Electrolysis. You pass DC current through a follicle, it creates lye, the lye kills the follicle. This was the first one, and is nearly 150 years old. It was originally developed to treat ingrown eyelashes, which could cause blindness.

The second, Thermolysis, doesn't actually use electrolysis, so technically it's a type of "Electrology", the practice of hair-removal-with-electricity, of which Electrolysis is only one method. Instead of creating lye in the follicle, the probe is instead an RF transmitter, broadcasting several watts of high-frequency radio waves at a frequency where they'll be absorbed by the hair matrix, kinda like a microwave. This creates high temperatures (50°C/122°F) causing electrocoagulation, basically denaturing the proteins and killing the follicle that way.

The third (or 2.5th) method is Blend. As you might guess, this is simply mixing both of the above methods. It's relatively easy to do, as they both need an electrical probe, and you can just build one machine that switches between the two methods or combines them at the same time.

My particular electrolysis clinic manager feels very strongly that galvanic electrolysis is the way to go. It's slower than thermolysis or blend, but she believes this is more reliable and has fewer side-effects on the skin (as it's possible but hopefully unlikely for the skin to be damaged by the heat of thermolysis). But I think those are mainly her opinions rather than a scientific consensus, so you may want to do your own research if your local clinic does Thermolysis or does Blend. Maybe she's wrong.

Are there other methods/how effective are they?

Kinda. So the big competitor to electrolysis is Laser Hair Removal. Despite the name, the FDA (who regulates hair removal tech in the US) says it's not actually a form of hair removal, just a form of "hair reduction". It's not allowed to be advertised as permanent hair removal because of this.

Basically it works something like Thermolysis: A laser is fired at the skin, using a wavelength of light that will be mostly not absorbed by the skin, but will be absorbed by the darker and denser hair follicles. They'll heat up from the laser, and electrocoagulate, and die.

This has several advantages over electrolysis: It's far faster, it requires less training for technicians, and it's less painful. Note that that's less painful, not "painless". It still hurts, as you're being SHOT IN THE FACE WITH A LASER. (It also has the side-advantage for trans femmes that you can keep shaving while doing it, vs electrolysis which requires some hair growth)

So, the problems: First of all, even when working, it is less effective in general. You're unlikely to get all the follicles at once, and you'll need many passes over the same area to get anything like consistent coverage.

The second drawback is that it can have some very negative effects on your skin. If you can get photosensitive rashes, firing a laser at the skin will probably cause them to show up really badly. It also (anecdotally, at least) can have same negative effects on skin that thermolysis sometimes causes: all that heating causes damage to the skin, making it harder, less smooth, and potentially darker from the heat damage. Making sure to ice your face after treatment can help with this, reportedly.

But the third and final drawback is probably the biggest one: it's very color-sensitive. Basically for laser to work, you want VERY DARK HAIR on VERY PALE SKIN. If you have any other combination, it's simply not going to be very effective. The laser light needs to pass through the skin without being absorbed, then hit the hair follicle and dump all its energy there. If your hair is blonde, it'll keep going. if your skin is dark, it'll end up absorbing all the energy instead of the follicle, and they're basically giving you a suntan instead of hair reduction.

And even for someone who is pale with dark hair, it can STILL not be terribly useful! See, I'm in my 30s, so I have a couple grey hairs.

At least, that's what I thought, until I got laser hair removal. It turns out something like 5-10% of my facial hair was grey, and once you remove the 90-95% of the dark hair, guess what's left? 100% grey hairs! Basically laser hair removal just gave me a grey beard. Whoops.

And finally, there's IPL: Intense Pulsed Light. There's less to say with this one except that it's basically the same as laser hair removal, just at lower power levels and less specific wavelengths of lights (ie, it's more full-spectrum). Reportedly this gets near the effectiveness of laser (it's like 66% reduction after 6 months of treatment, vs 71% for laser), but can be done at home by the user. It has all the same side-effect problems, but worse as the light isn't as precisely targeted to a specific wavelength. If you can't get anything else, it's an option, but I wouldn't recommend it unless you're very pale with dark hair and no history of photosensitivity.

On a side note, both IPL and Laser do involve flashing very bright lights at your face. I don't think they're going to be repetitive or quick enough to cause issues with photosensitive epilepsy, but you should definitely ask your doctor if that's an issue. You can't close your eyes to avoid the flash, it will travel through your skin and hit your retinas through closed eyelids, it's both absolutely wild and a little scary.

How expensive is it?

Obviously this is going to vary a lot as healthcare is a nightmare, but generally if your health insurance covers trans-related things like hormones, it'll be covered for at least the face.

If it's not covered, the price will of course vary with your location and the clinic you go to, but it's not going to be cheap. Sessions are going to be like 1-2 hours and they're trained medical professionals. They get paid for their time. In the cheapest areas of the US, you're looking at like 30$ an hour, and in the most expensive, 130$ an hour.

Is it just for the face?

Nope! Anywhere you can get hair, you can do electrolysis. chest, back, arms, legs, crotch, whatever you want (I don't know if anyone has done their whole head to become permanently bald, but probably!)

Combined with the last question, that'll probably not be covered by insurance, as they'll be considered "cosmetic" rather than "medically necessary" (other than some non-face electrolysis that's done before bottom surgery to avoid issues with hair growing inside neovaginas or having a hairy neopenis).

Areas outside the face tend to go far faster as you don't have the same hair density there.

But what do you actually DO in an electrolysis session?

Lay down on a massage table in a dark room, with one hand in a metal bowl of salty water. A tech wearing a flashlight on their head pokes you with needles and zaps you for a few seconds, yanks the hair, then repeats the process. You can talk (if they're not working on the chin or other areas where it'd cause problems) and we usually chat for a half hour or so about random stuff, before settling into mostly silence, listening to some music playing off a streaming service. I spend most of the time thinking about stuff to write, either stories or programs.

It's not a continual procedure, they're repeatedly poking and pulling, so you can interrupt them whenever if you need to use the bathroom or shift position. I was worried that my ADHD would have trouble handling "do nothing for two hours" but honestly it's not too bad in my experience.

Is this only a trans thing?

Absolutely not! I'm writing this from that perspective, but anyone can get electrolysis. For example, often post-menopausal women get it on their upper lip, as the hormone shift causes them to grow facial hair. But you don't need a big trans and/or medical reason to get electrolysis: You can just go "HEY I HATE SHAVING AND ALSO I HATE HAVING HAIR" and decide to do it. You'll probably have to pay out of pocket for it, but it's your money. Have fun.

Just keep in mind that it is absolutely permanent. Make sure you are certain before doing it, because I think your only option if you change your mind would be an expensive hair transplant (if that'd even work. I'm not certain, off the top of my head)

#electrolysis #transitioning #trans

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toomuchracket · 1 year

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im so sick today but working from home and all i can picture is d word matty and assistant girl and him being so annoyed at her not taking any type of rest while she’s sick and hopped up on cold and flu meds having to concentrate twice as hard to get anything done (me right now)

oh i hope you're ok, get well soon!! and yeah, matty would be so exasperated with you for just insisting you're fine and continuing on with your work. thinking you wake up on a wfh day and you're quite wan and feeling a bit more tired than normal - matty's immediately concerned, but you're like "it's ok it's the end of the financial year it's just so busy and it's catching up with me i'll be fine after a coffee". and matty's like "ok whatever you say babe", and you do perk up a tiny bit after caffeine so he lets you be, but resolves to keep a closer eye on you than he normally would on a mutual wfh day. you start off work alright, but you plod into the kitchen after about an hour and a half to ask "have we got any soluble paracetamol? think i'm getting a pressure headache"; matty gets you the meds, squinting at you as he passes them over, and says "sweetheart if you're not feeling great you should rest. phone jamie and tell him you're taking the day off", but you're furiously shaking your head (and wincing in pain at it) like "no it's fine i'm fine there's too much to do for me to phone in sick", and you thank him for the meds and go back to your laptop. matty sighs, but he leaves you to it because you're so stubborn - that is, until the sneezing starts shortly after, at which point he brings you a lemsip and some cold and flu tablets (and a kiss on the head). and he sits at the desk with you - you wrapped in his hoodie, your big cardigan, and a blanket - while you sneeze your way through responding to emails, periodically glancing up from his lyric notebook to check you're alright. the final straw for matty is watching you take fifteen minutes to mentally process a one-sentence reply, blinking hazily at the screen while you sneeze repeatedly; he's like "my darling, i love you, and i love how focused and hardworking you are, but you really can't work when you're like this. let me call jamie, please", and he can tell you're ill because you open your mouth as if to argue and then just deflate like "alright". so he calls jamie, holding the phone to you so your boss can hear how awful your sneezing is, and sorts that, then scoops you up and carries you to the bathroom like "c'mon, let's shower" - you're slightly delirious from the flu meds like "mmm no too tired to fuck right now", and matty's like "no of course not sweetheart, we'll get all cleaned up and then go back to bed, hopefully sleep it off, yeah?", and you nod into his chest like "mhmm". and that's what you do - shower, sleep, snuggle, matty also making sure to take meds so he doesn't get ill as he strokes your hair and stays with you to help make sure you get better <3

#mads muses #mads answers asks #matty asks #fluff asks #d word matty

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headpainmigraine · 1 year

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Migraine isn't a Headache Part Four: but what if a headache is all I get?

I was reading through the notes on some other posts and realised that a lot of people are looking for answers re: what their headache could be.

Migraine is underdiagnosed and grossly misunderstood as 'headache' when it isn't a headache, but likewise, some people might dismiss their headache as migrane when they're dealing with a different beast entirely.

If you're bothered by persistent headaches, frequent (weekly/daily) headaches, but don't really experience the myriad of other symptoms that form a migraine, there are a host of differential diagnoses that should be investigated.

It might be worth taking some small measures first before going through the hassle of seeing a doctor. Headaches can be caused by:

Dehydration (I know 'have you had water' is a common thing to be asked when you say you've had a headache, but make sure that you are actually consuming enough fluids - dehydration can absolutely cause bastard headaches, and it's REALLY EASY to be dehydrated if you're busy working and don't look up to drink something)

Eye strain (It might be easier for you to see an optician/optomertrist than a doctor, plus if there ARE any issues, they're usually easier to sort out with glasses, a new prescription, or different types of lenses. Even if you have 20/20 vision, they can at least a) rule out eyestrain)

Hunger (Food is a touchy topic, so I'm not going to linger on it, but eating something small when you have a headache might help. Sometimes I don't feel hungry, but make myself eat a banana or a cracker or something, just to appease the beast)

Bad Sleep (Not enough sleep, too much sleep, poor quality sleep, sleep apnea, so many sleep things can cause headaches that it's a topic of it's own; you can help by practiscing good sleep hygeine, but a routine bedtime/waketime factoring in sufficient hours is really helpful with this)

Stress (This one isn't something you can easily fix at home, especially if your stress is, you know, the cost of living, working your job and every other thing life can throw at us, but noting that you get headaches when you experience stress can make you more aware of when you might need to pamper yourself a little, or to tell a doctor if you're seeking diagnosis)

Caffeine (the whole thing about 'caffeine addiction' is medically disputed, but you can definitely get headaches from stopping drinking caffeine, but also from drinking too much. A lot of people with migraine find relief when drinking caffeine, and it's included in a lot of painkillers, but if you suspect caffeine might be something to do with your headaches, maybe avoid those. It's easy to tell, you just need to stop caffeine for maybe a week or two and see if your headaches improve.)

I'm going to mention Medication Overuse/Rebound Headache here, because it can be eased without medical treatment, but there are all sorts of issues around that.

This apparently doesn't happen if you're taking painkillers for something other than headache, because why not make life harder for people with them. If you take the same painkillers for, eg, back pain, neck pain, arthritis, etc, you don't tend to get rebound headaches.

If you have headaches usually migraine or tension type) and are taking painkillers too frequently (more than 10 days per month) for too long (more than 3 months) you can develop headaches caused by taking too many painkillers.

Messed up, right?

I've had these headaches alongside migraine and they are EVIL. I can only describe them as seething.

Overuse of opioids and triptans are most likely to provoke rebound headache (yeah, the ones migraineurs take, can't catch a break)

Paracetamol and aspirin are the next culprits, with NSAIDs like ibupfrofen and naproxen having less likelihood, but still very much there.

Medication overuse headaches can be resolved by not taking pain medication.

That sounds simple, but in reality, living it, it's hell. For the first few days after you stop taking painkillers, the headaches are… spectactular. Intense, crunchy, sparkling pain, acid in your blood pain. Not to mention that you have no treatment for whatever you were taking painkillers to cope with in the first place.

Coming off everything for 2-3 weeks does seem to beat MOH, and the relief when they stop happening is as great as the pain is in those first few days, but you can always redevelop it if you go back to taking more painkillers.

So, what do you do to prevent medication overuse headache while not leaving yourself untreated for the headache you were taking the painkillers for?

Medical advice is to limit the usage of headache medications, no more than 2-3 days a week, or less than 10 days a month, and to avoid opioids and triptans as much as possible.

That doesn't really help if you're getting a headache every other day of the month. This is where preventative treatments are supposed to be utilised, to treat the headache instead of just dulling the pain. I don't have to tell anyone who's already a spoonie that trying to get this treatment is difficult, and that's assuming the preventative measures work for you.

But honestly, personally, I'd rather have a migraine than medication overuse headaches, seriously.

There are so many different types of headache, and other illnesses where headache is a symptom and not the illness itself, that I can't list them all.

You shouldn't diagnose headache disorders over the internet.

I'm not going to pretend that seeing a doctor isn't a financial/energetic/emotional/time scale difficulty for a lot of people, but a) headache can be a sign of something serious, b) even if it's not there may be "easy" treatments for it and c) there are treatments for headache that you can't buy over the counter.

It's one thing to go to a doctor and say you have XYZ symptoms, so you suspect you have headaches/migraines, but treating for, example, migraine when you have another type of headache is just going to waste your money and possibly harm you.

Other types of headaches can include:

Tension Headache - usually felt like a tight band around the head, not necessarily caused by tense muscles, but often triggered by stress, among other things; very commonly confused with migraine, they don't present with other symptoms of migraine like nausea, aura, etc; there's a LOT of information about tension headaches online, and is one of the most common causes of persistent or chronic headache complaints

Cluster Headache - also called 'suicide headache', the pain is so bad that sufferers often can't sit still, rocking, pacing or banging their head into a wall. this is a 'something in one side of my face pulling my cheek away from the skull' pain, that also usually presents with a red/watering eye, sinus disruption on that side, drooping eyelid. onset is fast, with headache lasting 15 minutes to 3 hours and occuring 1-8 times a day. they usually appear in bouts, followed by remission and then reappearance.

Thunderclap headache - sudden onset, reaches intensity in less than a minute, extremely severe pain; if you have one of these for the first time, you should seek immediate medical attention; they can be benign, but they can be a sign of brain injury, stroke, blood vessel tears/ruptures/bloackages

As well as:

hemicrania continua

ice pick headache

sinus headache/other sinus disorders (not a headache disorder in and of itself)

hormone/menstrual headache

hypertension headache

post-traumatic headache

chiari malformations (not a headache disorder, rather where the brain starts to slip into the spinal canal; headache can be a symptom for some people; it's not often talked about, so I thought I'd put it here)

This isn't everything, they all have different diagnosis paths, different symptoms that come along with them, different experiences between people who have them.

Headache is a massive area of differential diagnoses, it's always worth seeing a doctor for diagnosis and proper treatment, if you can.

Back to Migraines in the next part

#headache #headache awareness #migraine awareness month #migraine #chronic headache #chronic migraine #spoonies #chronic pain #migraine isn't a headache

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spoonyglitteraunt · 9 months

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Vent post incoming. Feel free to skip.

So after the last one of these, which included the anxiety meltdown, my dad has since had surgery to remove the whatever. (Results of if it's the c word pending.) He was supposed to go in on Friday stay one night and come home on Saturday. I say supposed to since that was not what happened. Not by a long shot.

Cue everything going wrong that could go wrong, including very uncaring and incompetent hospital personnel. And eventually they just kicked him out on Tuesday despite the ongoing issues and severe unmanaged pain. Because and I quote "They needed the bed, they already had to delay someone's surgery". Funny how there were several empty rooms nearby, huh?

So he came home. And he's definitely getting more caring care and actual food here. But it keeps going from one problem into the next. His pain levels are hardly touched with paracetamol. And he keeps leaking despite a catheter. Not even just a bit. So they went back today and he just got waved off with an extra pill that does nothing and more pain.

The thing, as you probably know by now, is that I'm severely chronically ill and disabled. I need a lot of care and can do very little. While I can push myself a bit, it quickly comes back to bite me in the ass. If I continue to push it will just floor me entirely. Uncaringly. For long periods of time. My mom has a lot of pain issues. Both her knees are entirely broken, we even recently found out both her shoulders have completely torn through muscles where the injuries are so old (and thus unfixable) they created injuries of their own. Not to mention the padding between her joints and verterbea being little to non existent. My dad was the most "functional" of us all. Except now he isn't. He needs a LOT of care to even try to pull him through this. And I don't know how he will. This is before even knowing if the c word is involved.

We're suffering and struggling and barely keeping afloat. Yesterday I was some help, but by the end of the night I was shaking and crying from exhaustion. Today each time I stood up my body made it very clear we were either sitting down right the fuck now, or it would lay me down. Instantaneously. Also the heart rate was going through the roof. And so almost everything fell to my mom.

There is such guilt and agony in seeing your parents suffering and not being able to help. To be a hindrance more than a help. At best I can provide moral support, but it feels like nothing. I want to help so much. I would take his pain in a heartbeat. I'm used to it. But I can't and it's hard to deal with. It makes it so crystal clear just how disabled I am and how much he keeps me alive. And how after him, after both of them, there will be nothing.

And if that thought doesn't keep you up at 2am, as you listen to him snore for the short moment he found some sleep. Typing out a post on your phone to post on Tumblr in some attempt at coping that you'll probably feel bad about in the morning. As you contemplate the black hole that is your future. Then I don't know what will.

#vent post #feel free to ignore #I just need some outlet #it's this or risk waking someone up with too many emotions and they need any sleep they can get #but if the universe and murphy could chill the fuck out that would be great #also the irony of this being the time the therapist is unavailable is not lost on me #the one time I could actually use you ma'am

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shishuka-hospital · 2 years

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How to care for your baby’s first fever?

Fever is normal in small kids. They're a typical part of experience growing up, and they're normally innocuous. They normally vanish all alone. Fever is the body's instrument of killing diseases by expanding the temperature. Microorganisms, like strep throat, or infections, like influenza, can cause it. It is typical and regular for a child to get fever and in this way, nothing to be terrified of. One simply has to know when a kid can be kept an eye on without anyone else and when one requirements to see a child specialist hospital near me.

Children can be given antipyretic meds, for example, paracetamol or ibuprofen on specialist's recommenadation only.A wipe shower in tepid water might help with bringing down your kid's fever. Ensure the water doesn't turn out to be excessively cold, and eliminate them assuming that they start to shudder.

Gently dress your youth. Cover them in bed with a sheet as opposed to a cover.

Every now and again breastfeed or give your baby recipe. Consider giving your child an oral rehydration drink like Pedialyte. Urge your young person to hydrate after they've been weaned. Stay away from pop and charged drinks, which can dry out you.

Summon your PCP right in the event that you have a child 12 weeks old enough or more youthful with a temperature over 100 degree celsius . For an offspring of all ages, summon your PCP right in the event that their temperature climbs over 104, on the off chance that they won't quit crying, or has any of the accompanying:

Firm neck

Serious cerebral pain

Serious sore throat

Ear torment

Continued retching or loose bowels

A seizure

Rash

You ought to likewise call your PCP assuming the fever has dropped however your kid is as yet acting debilitated or on the other hand on the off chance that they appear to be deteriorating.

At shishuka Hospital (best child hospital), you're protected in light of the fact that you are putting your kid in the most secure consideration conceivable in all of Bangalore. Our Ovum family thinks often about your youngsters like they're our own. This is made conceivable through our group of child care hospital near me who not just spend significant time in the field of kid care yet in addition practice empathy which prompts ensuring that your youngster is given the most potential thorough type of care. Your child's most memorable fever is normal and inescapable yet the tension could be overpowering a result of the continuous pandemic which is the reason we're here to direct you and in the event that it comes to it, deal with your kid alongside you to guarantee their prosperity. This makes us the best youngsters emergency clinic in best child hospital in bangalore. Furthermore, we're the best in light of the fact that our group contains the best pediatricians in all of Bangalore.

#best child hospital #best child hospital in bangalore #child care hospital near me #child specialist hospital near me

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thatfibrolife · 4 years

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Breaking down my pain killer use

I have different pain killers for different occasions. After a few years of fibro, I think I've figured out the best way to use pain meds. Disclaimer: I live in South Africa, so the product names may be foreign to you. I'll try to include the ingredients as well. So, here's what I do.

1. Gen-Payne/Myprodol

This contains 10 mg Codeine, 250 mg paracetamol and 200 mg ibuprofen per capsule

In SA, you can get this over the counter at a pharmacy.

Even though this isn't strong, it's my go-to, because it helps for different types of pain.

It has anti-inflammatory, muscle relaxer and analgesic properties. This means that it's the one pain killer I have that actually alleviates muscle pain a little. Seriously, there's a pill that helps somewhat for fibro muscle pain!

Plus, it doesn't make me drowsy or loopy. And it doesn't keep you awake either.

The only downside is that too much ibuprofen can be bad for your stomach.

My life would be so much harder without this med.

2. Panado

This is just 500mg of paracetamol. In the US, I believe this is called Tylenol.

You can get this at the grocery store + it's super cheap.

So, this is not a strong pain killer. It's not going to take away your pain.

BUT it will make you sleep like a baby.

Painsomnia is a thing. A lot of people with chronic pain can't sleep because the pain keeps them awake.

So, if I have higher-than-usual pain levels that prevent me from falling asleep, I'll take 2 paracetamols. Half an hour later, I'm fast asleep.

It's also super safe to take. (but I still wouldn't recommend taking it every night)

3. Ultracet

This is the strongest pain killer on my list. It's usually given to people after intense surgeries/when other pain meds don't work.

It contains 37.5 mg of tramadol (an opiod) and 325 mg of paracetamol.

You can only get this with a doctor's prescription.

Despite being so strong, I've found that Ultracet doesn't alleviate my body aches. I just feel loopy, but still have a lot of pain.

So, what does this bad boy help with?

Headaches! Most fibro sufferers have a lot of headaches. Not a week goes by where I don't have some kind of headache - be it sinus, tension, migraine, occipital etc.

And this pain killer works for all of them!

The downside is that these pills really put me on a trip. I can sometimes feel so loopy an hour after taking them that I have to lie down.

Also, if you take these in the evening, they will keep you awake the entire night.

5. Advil CS

So, this one isn't strictly fibro related. I just also have chronic sinusitis.

And this helps so much to alleviate that pressing, congested feeling of sinus headaches.

Each tablet contains 30mg pseudoephedrine and 200 mg ibuprofen.

If I have a really bad cold/flu, I sometimes take one of these with 2 paracetamols and sleep for the whole day.

Only downside is that, because it has ibuprofen, it can be harsh on the stomach if you take it too often.

So, yeah. This is my pain killer regime. I'm not a medical professional. And what works for me won't work for everyone else. But I thought I'd share anyway.

#fibromyalgia #chronic illness #spoonie #chronic fatigue #chronic pain #chronicpain #chronically ill #disability #fibrofighter #fibrofog #fibro flare #fibro

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onlydreamofmysoul · 4 years

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Can someone who get's migraines explain the difference from a migraine and just a bad headache. Because I think I might be having migraines but it could be I'm just very headache sensitive because I have a high pain tolerance otherwise. Then the pain is so severe sometimes I cry or feel nauseated and Advil typically doesn't help much. I don't find that light affects it much but noises make it worse. If they are migraines, is there anything I can do about it?

I get migraines so I hope I can help you out a lil :)

Quick warning; I’m going to go into an in-depth description of migraines for anyone who doesn’t want to read that :)

Okay to start, symptoms can vary a lot between migraines. There’s even types of migraines you can get without the actual headache. I’ve had a few different types of migraines over the years. When I was going through puberty I got migraines from a hormonal imbalance. They were extremely sharp, like shooting pains. I was sensitive to light, noise and just about anything else and they were so intense I’d always end up throwing up with them.

Now I get a different type of migraine. They’re more like an extremely bad headache for me now. Personally I’m much more sensitive to light more than sound but it can of course go the other way. I always know they’re migraines because you even know yourself that this is too much pain for a regular headache. They usually last a whole lot longer than headaches too and medication doesn’t take that much effect.

I too have a really high pain tolerance. I always have a headache in the background. But with headaches while uncomfortable I can still function. With migraines I can’t so that might help a little maybe.

Many people with migraines have found that caffeine can help a lot. It always helped me if only for a little while but I can’t have caffeine anymore so I just have to wait it out. It’s definitely worth giving that a shot. You can get paracetamol or whatever with caffeine in it if you don’t want to be downing a cup of coffee when you feel one coming on.

I have a friend who has chronic migraines and she’s been on a lot of different medications trying to help but she hasn’t had too much success so far. I think the best advice I can give is to find the darkest, quietest room you have and if you can, try sleep. That was always my go to even though I’m a person who hates sleeping during the day but migraines always ruin my energy levels and it’s a little bit of an escape if you can get yourself to sleep.

Above all I would highly recommend going to a doctor. You can read up as much as you want but the only person who can confirm/deny is your doctor and most importantly, they can treat you. There may be a way of managing it that they can help you with.

#cliona's corner #question time with clíona

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fancifuldressage · 6 years

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So u have a migraine.

Here's some tips for busting it right now, not just dealing with it, from a chronic sufferer and med student.

(My knowledge is from my own experience and I highly encourage you to speak to a doctor if it's so bad that you're reading this. I can't guarantee all of this will help you, but it helps me. It does not replace the advice from a trained medical professional)

-Anadin helps way more than ibuprofen since it's designed for migraines. (It's a mix of Aspirin, paracetamol, and caffeine to kick the other drugs into gear quickly.). 2 tablets, and the foe is vanquished overnight.

-Sumatriptan isn't a painkiller, it literally stops the cause of the migraine. Doesn't always work, but I recommend going to your doctor and asking them to prescribe this. Take 1 tablet. If it doesn't work, don't take another one.

-Drink a lot of water. I know it's always said, and I know it can be hard when you're stomach is grumbling at you about anything you swallow, but make sure you drink water and don't skip meals. One of the biggest triggers for migraines is missing meals.

-Go out for a walk. You won't want to. Your brain will scream that it will hurt. But do it. If you have someone to walk with, that'll help even more. The fresh air, natural light, exercise, and the distraction will all do wonders.

-Call your local non-emergency number. If it hurts enough that it's affecting your life - just taking a day off work counts - then please see your doctor TODAY or call your non emergency health advice team (111 in the UK).

-Chill somewhere the lights are dimmer, lie down, and shove something on TV quietly. Let yourself nap. DON'T SLOUCH as having your neck bent could make it worse.

-Put a cool or warm thing on the back of your neck. It will help ease tension.

-Find a smell that eases your tension. Citrus or peppermint can open your airways and makes you feel more open. Lavender is relaxing and calming. I find orange oil helps me best.

IF THIS DOESNT WORK AND YOU SUFFER MIGRAINES 4+ TIMES A MONTH, PLEASE TALK TO YOUR DOCTOR ABOUT PREVENTATIVE TREATMENT. It is not good to keep taking painkillers or triptans regularly.

Always check the patient leaflet before taking any of the drugs I've recommended. Stay safe and healthy ♡

If you ever need to talk to me, I can give more personal advice or just encourage you or talk to you. You can always message me.

ONE OF THE MAIN THING THAT HAS HELPED ME WITH MY REGULAR MIGRAINES is maintaining a regular daily schedule. I get up at the same time each day, have an alarm set for breakfast, lunch, and dinner to make sure I eat all of them, get through a specific amount of water each day, turn of my screens and go read before bed, and go to bed at the same time each day. It has improved every aspect of my life.

Do I have a migraine or a normal headache?

You might not even know that you get migraines. Here are some key points about the different types of headache.

NORMAL (TENSION) HEADACHE

Can occur anywhere in the head/neck, usually across front

Doesn't come with many external symptoms

Mild to moderate pain

Feels like a 'pressure' - like a rubber band around your head

Often caused by stress/anxiety

MIGRANE HEADACHE

Occurs usually across one side of head, sometimes frontal

Feels like throbbing

Can be accompanied by nausea/vomiting

Moderate to severe pain

Pain worsened by movement of head

Photophobia (avoiding light)

Preference for lying down

Can get an aura - these are visual/sensory disturbances that come before the migraine hits

Feel slow in body and mind, possibly dizzy

Can't concentrate

CLUSTER HEADACHE

Occurs behind an eye (usually the same eye each time)

Severe pain.

Feels like a screw in your eye, or similar.

Irritable

Can be accompanied by hypersensitivity, difficulty gripping things

Come in clusters - you will get a lot for a few days and then none for a few weeks/month/years

Comes on very suddenly. Stays for between 10mins to 3hours. Leaves just as suddenly.

That cycle repeats itself over the course of a few days.

You might get a teary, redened eye or blocked nose on the same side as the headache.

If you get these, please go to a doctor to learn some coping methods. They are the most painful type of headache and are sometimes known as suicide headaches because of this. Getting them can affect your mental health.

So u get regular migraines and don't know why?

Here is a pretty comprehensive list of things that could be 'triggers' or make it worse, and how to find them:

POSSIBLE TRIGGERS

Caffeinated foods (chocolate, tea, coffee)

Hormonal changes (including period)

SKIPPING MEALS

Aged cheeses

Processed food

Aspartame (sweetener)/MSG

ALCOHOL

Stress

STRONG SMELLS - e.g smoke, paint

Bright lights - especially fluorescent ones

WEATHER CHANGES - sudden rain or shine changes the air pressure

CHANGES IN SLEEP pattern - sleeping too little, too long, too late, in too bright an environment.

Physical exertion

Medicines - ORAL CONTRACEPTIVES can trigger.

HOW TO IDENTIFY TRIGGERS

Get a diary/notebook

Write in it: what you eat/drink, when you do anything particularly strenuous (e.g gym, an argument), when you went to bed and woke up, if you took any medicine (and if it worked), how much water you had that day, your mood, whether you're on your period, and what the weather is like.

Write in it any headache you have, how severe it is, and where it is.

This is an example of what my migraine diary looks like, if you're stuck for inspiration. I use different colours for: symptoms, potential triggers, and medicine notes.

After 6 weeks, look back and see if there are any patterns. What you are looking for are any migranes, and then any potential triggers in the 6 hours prior to that. If you see the same one pop up a few times, eliminate it and keep doing the diary for a bit. Does it help? Then you've found a trigger!

LASTLY, a very helpful link if you want more help - it includes lifestyle changes you can make to help you cope!!

#migrane #headache #headaches #health #help #please look after yourself #this is horribly laid out and im sorry #pls msg me if you need more help

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kpopaganda · 7 years

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Allied, Part 9

Group: GOT7

Member: Jackson

POV: 1st Person

Type: Angst/Fluff/Series/Other

Word Count: 2,200

Summary: The world is in turmoil. There are few functioning governments left and an incurable disease has wiped out most of the human population. It’s every man for himself until you find an ally who becomes more.

Parts: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15

“You’re an idiot, you know that?”

Jackson doesn't say a word, just scowls, as I walk around the room preparing things to fix him up.

After coming ashore and finding out Jackson was injured, our new little group decided that the number one priority was treating Jackson. So the three of us set out on a trek that led us to a road and then an old, abandoned gas station. After checking that it was safe, I pulled Jackson into the bathroom while Jaebum kept watch outside. It was in pretty bad shape and there was nothing left to scavenge, but it at least got us out of the elements to focus on getting that bullet out of Jackson.

That was one thing we determined on the way. Only one of the bullets went all the way through; the one in his abdomen. None of us were doctors, but as far as we could tell, the one that went all the way through didn’t cause serious damage. We would have to wait and see, but he kept pressure on it until we got to the gas station. I knew if I left it the other bullet in, it would get infected and risking any kind of infection was asking for trouble. The deadly kind and as much as I didn’t want to admit it, I didn’t want to lose Jackson.

It was stupid really. He was just a guy I met along the way, or at least he used to be. Now he was someone to look to, someone to help. A companion, a comrade, a friend. And I would be a monster to let my friend die because of a fucking infection.

“We might be dead if I didn’t take over,” I heard Jackson say and turned around to look at him.

He was leaning against the counter where the sinks were, looking very uncomfortable and very shirtless, but I couldn’t appreciate it through all of the blood. He also looked annoyed. I was as well, but at that point I couldn’t figure out who was annoyed with what. If he was annoyed with me, himself or our situation in general. I got the feeling it was all of the above.

“What?” I asked.

“If I didn’t step in to get the motor going and get us out of there, we might be dead.”

I scoffed. “I’m not calling you stupid because you took over from me. I’m calling you stupid because you didn’t consider the consequences and because you didn’t tell us sooner that you got hit.”

He tried crossing his arms to make a snarky comment but winced when it made him engage his injured shoulder. I almost laughed at how quickly the look on his face shifted from sassy to hurt, but I stopped myself. There was no point in either of us getting any more riled up than we already were.

“Let’s get that bullet out of you.”

I set down everything I had in terms of first aid next to him on the counter. All I could find was some gauze, a little bit of antiseptic I had left in my bag, fabric scraps, and a needle that I would need to close up the hole in his shoulder. The two in his abdomen were small enough to close up with butterfly stitches and then wrap some gauze and fabric around to keep closed, so I did that first. He gritted his teeth and hiss harshly when I applied the antiseptic, but the worst was still to come. I touched the skin around the bullet wound in his shoulder and Jackson pretty much jumped out of my reach.

“That hurts,” he yelled in a high-pitched voice.

“It’s going to hurt a lot more than that when I pull the bullet out,” I told him. “This isn’t going to be easy.”

He flinched when I tried to reach for him again. It was weird seeing Jackson, the usually brave and reckless, shying away from my touch. I needed to help him but he was too scared to let. I was going to need to try a different strategy.

“Wait here,” I said.

Jaebum was right outside the bathroom, leaning against the wall with a gun in hand. He looked very casual, but I knew he was being vigilant. I was actually surprised he was still with us at all. His head shot up when I came out and he looked at me with enquiring eyes.

“So?” he asked. “How’d it go?”

“I’m not getting that bullet out of him without some help. We have nothing to numb the pain and he’s so sensitive right now. He is going to scream his lungs out when I try to get that bullet out and let everyone within a five-mile radius know where we are.”

He thought about it for a second before nodded. “You have a point. What do you need me to do?”

The truth was I didn’t know. My medical knowledge was limited, but I knew the tools needed to be sterile and that we needed to manage Jackson’s pain somehow, for his sake. But we only had so much at our disposal. All we had for pain were some paracetamol for headaches, nothing that could make a gunshot feel like less of a big deal. We also didn’t have anaesthesia, which meant Jackson was going to be in a world of pain. I didn’t look forward to seeing that or being responsible for it, but we didn’t have a choice.

“We need to find him something to bite on,” I said to Jaebum, letting my words sink in. “And I’m going to need you to hold him down.”

I waited while he processed what I told him, a looking of determination settling over him before he nodded. It was bizarre to me how ready he was to tackle stuff like this. I knew we’d all seen our fair share of shit and had to learn to work through it, but Jaebum was on another level. Being part of the rebels really affected him.

We search the shop one more time before deciding that a souvenir t-shirt would be the best thing for him to bite on. I’ll rip off a piece, wad it up and stuff it in his mouth. Hopefully that will stifle most of the sound.

Jaebum follows me into the bathroom where Jackson is sat on the counter looking like a fidgety mess biting his nails. We get him to lie down on a pile of t-shirts we brought in from the shop, tearing a piece off of one for the gag. I sterilise a pair of stainless steel chopsticks with a lighter and prepare some more fabric scraps with antiseptic liquid while we wait for them to cool down. Jackson’s eyes keep shifting between me and Jaebum, waiting for some kind of reassurance, but it wasn’t time for that yet. I accidentally put pressure on the hurt shoulder and he hisses loudly before I apologise. It was too sensitive. He was going to have to wear a sling for a while and that would put him at a disadvantage.

“This is going to suck,” I tell Jackson before putting a wad of fabric in his mouth.

His eyes widen briefly and then he looks away from me entirely. I grab the chopsticks and take a deep breath before sticking them into the wound. Immediately Jackson flinches and tries to scream, but the fabric does a good job at muffling him. Jaebum holds him down while I try to find the bullet.

“Hold on,” Jaebum says to try and console him. “She has to do this.”

But Jackson keeps screaming the same muffled cry of pain and I see tears running down his face. It makes it so much harder for me to concentrate, but I have to get it done. Two torturous minutes late, I finally get the bullet out and I drop it on the floor where it rolls into one of the stalls out of sight. We all take a relieved breath, but Jackson is still in a considerable amount of pain and he’s also bleeding pretty badly.

I quickly apply the antiseptic liquid to a rag and press it to the wound, making him flinch and squeal again. Jaebum keeps holding him down without any hint of expression on his face.

When everything was finally under control and I had Jackson’s wound dressed, everything was quiet. Jackson’s eyes were still squeezed shut and his breathing heavy. It was the only other sound I could hear over my heart pounding in my head.

“You’ll be okay,” I whispered to him. “I promise.”

We decided to stay at the gas station that night. Jackson and I were still too wiped out from the bullet removal to really think about moving around. Jaebum wasn’t too keen on the idea, but for some reason he also didn’t want to venture off on his own. It was comforting to know he would be around to have our backs. I think he’s proven his trustworthiness at this point.

I build us a small fire around the back of the building in an enclosed service area. The corrugated steel up against the chainlink fence told us that someone tried to reinforce the station, but they weren’t very successful by the looks of things.

Jackson was asleep inside in what seemed like a staff room. His arm was in a sling and he was pretty much dead to the world not even ten minutes after I took care of him. In all honestly, I was very worried about him. I’d done the best that I could with my limited resources, but there was still the risk of infection. There was only so much I could do in the shitty circumstances.

I was tending to the fire and trying to keep warm at the same time when I felt someone take a seat beside me. It almost scared me half to death before I remembered Jaebum was still awake.

“You shouldn’t be up,” I said. “You’ll be too tired to take the next shift.”

“I’ll be fine,” he said, staring into the fire.

I didn’t have anything to say to that. I didn’t want to be a nag. If he didn’t want to sleep I wasn’t going to command him to. So we just sat like that, staring at the fire and listening to its almost rhythmic popping. It would almost be soothing if it wasn’t pitch black around us in every direction.

“So,” said Jaebum suddenly. “You and Jackson.”

I turned to look at him. “Me and Jackson what?”

“Are you two, like, together?”

“No.”

“Why not?”

“We don’t feel that way about each other.”

“That’s not true on his part.”

“And how would you know that, stranger?”

My emphasis on the last word makes him smile. “I don’t have to know either of you very well to notice the way he looks at you.”

His gaze on me is too intense and I have to look back at the fire. “And how is that?”

“Like you’re his whole world.”

My skin prickles at that. “Your skills of observation are off.”

He chuckles. “They’re definitely not. Jackson is so in love with you, it’s almost sad. Why are you doing this to him?”

I jump to my feet. “Why are you doing this to me?”

He just looks up at me with his dark eyes and the slight smirk on his face tells me that he’s gotten what he wanted. All he wanted was to get a rise out of me and I gave it to him on a silver platter.

“Do you think this is easy for me?” I continue. “You’re a loner too. You of all people should know what it’s like to not want to get close to anyone. We’re both going to get hurt eventually and this is the lesser of all those possible evil. So, just leave it alone. I’m going to sleep. You can take this shift.”

I march off into the building before he can get another word in, but I know what I said will resonate with him. It wasn’t as simple as jumping into a relationship with the first person you find. I wanted to minimise the damage I did to other people and getting romantically involved with anyone increased the chances of doing just that. I needed to keep my options open. If, for whatever reason, I needed to make a run for it, I could because I’m essentially on my own. Yes, Jackson and I were travelling together, but that doesn’t make him my responsibility. All I wanted was to do right by him without things getting too serious.

As I walk into the staff room and see Jackson asleep on the floor, I’m struck with the realisation that I would be forever indebted to him. He has saved my life so many times that I don’t think I would ever be able to repay him.

I lie down in front of him and as I watch his steady breathing, I fall asleep too.

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