#pediatrician mailing list

[gilbertdb]

7 Fascinating Facts Regarding Pediatric Gastropathy

PEDIATRICS EMAIL LIST:

You may contact the top kid specialists by using our pediatric email list, which has been thoroughly validated. To market your offerings to pediatricians, you'll need a thoroughly tested advertising strategy and a robust client database. There is tremendous competition in the market. Without a strong campaign approach at the outset, you cannot establish your reputation. As a top-tier source of medical data, GILBERT DATA offers highly flexible pediatrician mailing lists to assist marketers in connecting with the appropriate pediatric decision-makers with their healthcare products, equipment, and other services. In order to reach out to and offer your medical solutions to as many potential consumers as you can, we will give you access to a broader network.

With birth rates in the millions each year, pediatricians are among the busiest doctors in the United States. Pediatricians provide excellent targets for marketing initiatives involving continuing education invitations, medical equipment and supplies, drugs, and other healthcare-related products. Since we value the confidence of our customers, we only supply datasets that don't result in bounced or rejected emails or messages.

You have undoubtedly started learning about gastroparesis and have more questions if your child has recently been diagnosed with it. Here are some further details on the condition:

7 ADDITIONAL FACTS ABOUT GASTROPARESIS IN CHILDREN

1. THE FUNCTIONS OF THE STOMACH

The heart, fundus, body, antrum, and pylorus are the five main components of the stomach. When all of these components are working properly, food can be accommodated, stored, compressed, digested, and pushed into the small

intestine. However, any combination of these five areas may be faulty and result in symptoms in a child with gastroparesis. Additionally, foods or liquids may be to blame for the symptoms.

We now lack a good test that can identify which one or more of the five components is malfunctioning, though we can perform a four-hour gastric emptying scan to see if the stomach empties slowly and can discriminate between liquid and solid emptying. We do, however, have drugs that target certain aspects of the stomach. Therefore, based on which medication helps reduce some of the symptoms, we can figure out which section is the issue after some trial and error. To treat the symptoms, we may occasionally need to take many drugs.

2.AN INCIDENCE

While not particularly prevalent in youngsters, gastroparesis is common in adults. It usually occurs after a viral infection in children. But frequently, the reason is unknown, which is referred to as idiopathic. It does occur when there is diabetes or a neurologic issue present, although it is less common in children. In addition, certain children may experience joint hypermobility, a disorder that can have an impact on various body systems, including the digestive system, and may result in gastroparesis.

3.In children of various ages, IT SEEMS DIFFERENT

Because children can't express their pain, gastroparesis manifests differently in infants and toddlers. They frequently have a feeding issue because they abruptly stop eating and become cranky and vomitous. The diagnosis is simpler in older children because they can express their feelings and report symptoms like bloating, nausea, and feeling full.

4.THE DIFFERENT GRADES OF SERIOUSNESS

Gastroparesis can range from minor to severe. Gastric failure is the term used to describe the severe variant. Children who have it stop eating and constantly throwing up, which causes them to lose weight and get dehydrated. In order to acquire nutrients, they frequently need to be fed through a feeding tube that skips the stomach. Sometimes they can't handle it either, therefore they may need to receive whole parenteral nourishment intravenously (TPN). Thankfully, this is a rare variation of the illness.

5.CONDITION OF LIFE

Many kids might get relief from their symptoms with the correct care. The process of receiving the proper diagnosis and subsequent therapy, however, can be drawn out and have an influence on a child's quality of life. These kids miss a lot of school and extracurricular activities as a result of their stomach pain, nausea, and vomiting symptoms. Most are taught at home. Furthermore, they may improve gradually over a period of several years. Some of them won't get better, and some of them will live with their symptoms for the rest of their lives. In most cases, post-viral gastroparesis gets better in three months to three years. After puberty, gastroparesis typically improves in patients with hypermobility.

6.The best treatment options

Every child will respond differently to treatment for gastroparesis, but alternatives may include prescription drugs, dietary changes, and medical and surgical treatments. A GI-focused psychologist can instruct children in certain methods to lessen the feelings of nausea and abdominal pain and to increase appetite. These methods for coping with pain and nausea can enhance everyday functioning, school attendance, nutrition, and weight growth. Multiple professionals are needed to meet the needs of children with severe forms. We advise patients to work with a team that consists of a neuro gastroenterologist, nutritionist, psychologist, and social services to assist children with their academics.

7.WHEN TO CONSULT A SPECIALIST

I advise having another discussion with your primary care physician if your child has experienced an acute sickness, such as the stomach flu, and if the symptoms, such as bloating, fullness, and pain, have not subsided. Your pediatrician could suggest referring your child to a pediatric gastroenterologist if they have been treating your child's symptoms with medication but they aren't improving.

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[mariacallous]

A doctors’ organization at the center of the ongoing legal fight over the abortion drug mifepristone has suffered a significant data breach. A link to an unsecured Google Drive published on the group’s website pointed users last week to a large cache of sensitive documents, including financial and tax records, membership rolls, and email exchanges spanning over a decade. The more than 10,000 documents lay bare the outsize influence of a small conservative organization working to lend a veneer of medical science to evangelical beliefs on parenting, sex, procreation, and gender.

The American College of Pediatricians, which has fought to deprive gay couples of their parental rights and encouraged public schools to treat LGBTQ youth as if they were mentally ill, is one of a handful of conservative think tanks leading the charge against abortion in the United States. A federal lawsuit filed by the College and its partners against the US Food and Drug Administration seeks to limit nationwide access to what is now the most common form of abortion. The case is now on a trajectory for the US Supreme Court, which not even a year ago declared abortion the purview of America’s elected state representatives. 

The leaked records, first reported by WIRED, offer an unprecedented look at the groups and personnel central to that campaign. They also describe an organization that has benefited greatly by exaggerating its own power, even as it has struggled quietly for two decades to grow in size and gain respect. The records show how the College, which the Southern Poverty Law Center (SPLC) describes as a hate group, managed to introduce fringe beliefs into the mainstream simply by being, as the founder of Fox News once put it, “the loudest voice in the room.” 

The Leak

A WIRED review of the exposed data found that the unsecured Google Drive stored nearly 10,000 files, some of which are compressed zip files containing additional documents. These records detail highly sensitive internal information about the College’s donors and taxes, social security numbers of board members, staff resignation letters, budgetary and fundraising concerns, and the usernames and passwords of more than 100 online accounts. The files include Powerpoint presentations, Quickbooks accounting documents, and at least 388 spreadsheets. 

One spreadsheet appears to be an export of an internal database containing information on 1,200 past and current members. It contains intimate personal information about each member, including various contact details, as well as where they were educated, how they heard of the group, and when membership dues were paid. The records show past and current members are mostly male and, on average, over 50 years old. As of spring 2022, the College counted slightly more than 700 members, according to another document reviewed by WIRED. 

The breach exposes some material dating back to the group’s origin. It includes mailing lists gathered by the group of thousands of “conservative physicians” across the country. (One document outlining recruitment efforts states in bold, red letters: “TARGET CHRISTIAN MDs.”) The ongoing recruitment of doctors and medical school students seen as holding Christian views has long been its top priority. The leaked records indicate that more than 10,000 mailers were sent to physicians between 2013 and 2017 alone. 

While the group’s membership rolls are not public, the leak has outed most if not all of its members. A cursory review of the member lists surfaced one name of note: a recent commissioner of the Texas Department of State Health Services, who after joining in 2019 asked that his membership with the group remain a secret. (WIRED was unable to reach the official for comment in time for publication.)

The SPLC’s “hate group” designation, which the College forcefully disputes, haunted its fundraising efforts, records reveal. A barrage of emails in 2014 show that the label cost the group the chance to benefit from an Amazon program that would eventually distribute $450 million to charities across the globe. Amazon would deny the College’s application, stating that it relied on the SPLC to determine which charities fall into certain ineligible categories.

A strategy document would later refer to a “unified plan” among the College and its allies to “continue discrediting the SPLC,” which included a campaign aimed at lowering its rating at Charity Navigator, one of the web’s most influential nonprofit evaluators. One of the group’s admins noted that despite SPLC’s label, another charity monitor, GuideStar, listed the College as being in “good standing.”

The College’s GuideStar page no longer says this and appears to have been defaced. It now reads, “AMERICAN COLLEGE OF doodoo fartheads,” with a mission statement saying: “we are evil and hate gays :(((”

The Google Drive containing the documents was taken offline soon after WIRED contacted the American College of Pediatricians. The College did not respond to a request for comment.

The Talk

Leaked communications between members of the group and minutes taken at board meetings over the course of several years speak loudly about the challenges the group faced in pursuing its deeply unpopular agenda: returning America to a time when the laws and social mores around family squared neatly with evangelical Christian beliefs.

Many of the College’s most radical views target transgender people, and in particular, transgender youth. The leak, which had been indexed by Google, includes volumes of literature crafted specifically to influence relationships between practicing pediatricians, parents, and their children. It includes reams of marketing material the College aims to distribute widely among public school officials. This includes pushing schools to adopt junk science painting transgender youth as carriers of a pathological disorder, one that’s capable of spontaneously causing others–à la the dancing plague–to adopt similar thoughts and behaviors.

This is one of the group’s most dubious claims. While unsupported by medical science, it is routinely and incuriously propagated through literature targeted at schools and medical offices around the US. The primary source for this claim is a research paper drafted in 2017 by Lisa Littman, a Brown University scholar who, while a medical doctor, had not specialized in mental health. The goal of the paper was to introduce, conceptually, “rapid onset gender dysphoria”—a hypothetical disorder, as was later clarified by the journal that published it. Littman would also clarify personally that her research “does not validate the phenomenon” she’d hypothesized, since no clinicians, nor individuals identifying as trans, had participated in the study.  

The paper explains that its subjects were instead all parents who had been recruited from a handful of websites known for opposing gender-affirmative care and “telling parents not to believe their child is transgender.” A review of one of the sites from the period shows parents congregating to foster paranoia about whether there’s a “conspiracy of silence” around “anime culture” that was brainwashing boys into behaving like girls; insights plucked in some cases straight from another, more notorious forum (widely known for reveling in the suicides of the people it has bullied).

A 2021 prospectus describing the group’s focus, ideology, and lobbying efforts encapsulates a wide range of “educational resources” destined for the inboxes of physicians and medical school students. The materials include links to a website instructing doctors on how to speak to children in a variety of scenarios about a multitude of topics surrounding sex, including in the absence of their parents. Practice scripts of conversations between doctors and patients advise, among other things, ways to elicit a child’s thoughts on sex with the help of an imaginative metaphor. 

While the material is not expressly religious, it is clearly aimed at painting same-sex marriage as aberrant and immoral behavior. Physicians lobbied by the group are also told to urge patients to purchase Christian-based parenting guides, including one designed to help parents broach the topic of sex with their 11- and 12-year-old kids. The College suggests telling parents to plan a “special overnight trip,” a pretext for instilling in their children sexual norms in line with evangelical practice. The group suggests telling parents to buy a tool called a “getaway kit,” a series of workbooks that run around $54 online. The workbooks methodically walk the parents through the process of springing the topic, but only after a day-long charade of impromptu gift-giving and play. 

These books are full of games and puzzles for the parent and child to cooperatively take on. Throughout the process, the child slowly digests a concept of “sexual purity,” lessons aided by oversimplified scripture and well-trodden Bible school parables. 

Another document the group shared with its members contains a script for appointments with pregnant minors. Its purpose is made evidently clear: The advice is engineered specifically to reduce the odds of minors coming into contact with medical professionals not strictly opposed to abortion. A practice script recommends the doctor inform the minor that they “strongly recommend against” abortion, adding “the procedure not only kills the infant you carry, but is also a danger to you.” (Medically, the term “fetus” and “infant” are not interchangeable, the latter referring to a newborn baby less than one year old.)

The doctors are urged to recommend that the minor visit a website that, like the aforementioned website, is not expressly religious but will only direct visitors to Catholic-run “crisis pregnancy centers,” which strictly reject abortion. The same site is widely promoted by anti-abortion groups such as National Right to Life, which last year held that it should be illegal to terminate the pregnancy of a 10-year-old rape victim.

The Professionals

The effort to ban mifepristone, legislation the Supreme Court paused last month pending further review, faces significant legal hurdles but could ultimately benefit from the appellate court’s disproportionately conservative makeup. Most of the legal power in the fight was supplied by a much older and better funded group, the Alliance Defending Freedom, which has established ties with some of the country’s most elite political figures—former vice president Mike Pence and Supreme Court justice Amy Coney Barrett among them.

A contract in the leaked documents dated April 2021 shows the ADF agreeing to legally represent the College free of charge. It stipulates that ADF’s ability to subsidize expenses incurred during lawsuits would be limited by ethical guidelines; however, it could still forgive any lingering costs simply by declaring the College “indigent.”

In contrast to the College’s some 700 members, the American Academy of Pediatrics (AAP)–the organization from which the College’s founders split 20 years ago–has roughly 67,000. The rupture between the two groups was a direct result of a statement issued by the AAP in 2002. Modern research, the AAP said, had conclusively shown that the sexual orientation of parents had an imperceptible impact on the well-being of children, so long as they were raised in caring, supportive families.

The College would gain notoriety early on by assailing the positions of the AAP. In 2005, a Boston Globe reporter noted how common it had become for the American College of Pediatricians “to be quoted as a counterpoint” to anything said by the AAP. The institution, he wrote, had a rather “august-sounding name” for being run by a “single employee.” 

Internal documents show that the group’s directors quickly encountered hurdles operating on the fringe of accepted science. Some claimed to be oppressed. Most of the College’s research had been “written by one person,” according to minutes from a 2006 meeting, which were included in the leak. The College was failing to make a splash. In the future, one director suggested, papers rejected by medical journals “should be published on the web.” The vote to do so was unanimous (though the board decided the term “not published” was nicer than “rejected”). 

A second director put forth a motion to create a separate “scientific section” on the group’s website, strictly for linking to articles published in medical journals. The motion was quashed after it dawned on the board that they didn’t “have enough articles” to make the page “look professional.” 

The College struggled to identify the root cause of its runtedness. “To get enough clout,” one director said, “it would take substantial numbers, maybe 10,000.” (The College’s recruitment efforts would yield fewer than 7 percent of this goal in the following 17 years.) Yet another said the marketing department advised that “the College needs to pick a fight with the AAP and get on Larry King Live.” Another, the notes say, felt the organization was too busy trying to “walk the fence” by neglecting to acknowledge that “we are conservative and religious.” 

[whatisreggieshortfor]

Happy Mother’s Day

I know Gary is higher on your mutual list, but Jake fit the idea better. Happy Mother’s Day to my favorite mums, @rebelrayne and @csmicletters.

Jake x MC

The time of year had completely slipped her mind, too engrossed in getting back to work after her maternity leave ended and figuring out schedules with her husband so their infant didn’t spend too long at day care each day- not to mention she moved too far to visit her own mother for the holiday, each year turning into video calls and mailed gifts while the plane tickets waited for Christmas.

The chaos of a three month old’s sleep and feeding schedule was wreaking havoc on their lives, so when Angela’s alarm didn’t go off that morning, her exhausted body turned off it’s own internal clock to rest- no part of her sleep ridden mind seemed to register the time growing later until she finally awoke to realize the sun was no longer casting long morning shadows through her window. As her phone read eleven o clock, Angela startled. Shouldn’t she have heard her son? Or her husband? Where was Jake and Ethan? Calling out quietly, she hoped to find Jake in the kitchen. Maybe Ethan was just napping. Instead, she found a note stuck to the fridge.

Relax, love. Happy Mother’s Day. I’ve seen to the arrangements, wear your comfiest clothes and your ride will arrive at noon to pick you up. Just enjoy your day.

All my love,

Jake

Damn, she really hit the jackpot with him, huh? With a lovesick smile, Angela busied herself with a hot shower before finding her softest comfort clothes.

When the knock came, she eagerly ran to answer it, only to find Tim with a grin wearing a chauffeur hat and tuxedo t shirt, “What up, Angie? I’ll be you driver!”

She cocked an eyebrow as she let herself laugh, “How’d he talk ya into this, mate?”

“Just asked, ya prick, now let’s get a move on! We have places to be and shite.” Tim clapped his hands, overdramatically bowing and gesturing toward the lift, “After you.”

The drive was as entertaining as she anticipated, Tim never stopped making her laugh or dropping new rhymes, until he was pulling up in front of a fancy looking glass building and the door was being thrown open.

“There you are, babes!” Talia’s beaming face obscured the sun as she leaned in, grabbing Angela’s hand with a call to Tim, “See ya in a few hours!”

“Don’t break her, Tals! Jakey was very specific on timeframe!”

Angela laughed as Tim pulled away, greeting Talia and a waiting Jen with a hug, “What are you two doing here?”

“Spa time and girl chat!” Jen answered excitedly, “Jake wanted to give us a chance to catch up, poor guy felt bad that Ethan has taken up so much of what used to be girl time.”

Talia nodded, “No matter how much we told him that the little babe you had together is worth all the missed time, and Auntie Tals is perfectly happy with spoiling him and getting wine time when we can fit it in.”

Angela just hugged them again, “I love them both more than anything but it’s so good to chat to my babes again.”

Talia checked her watch before ushering the two of them to the entrance, “Schedule to keep, reservations to make.”

“Mrs Wilson?” The desk clerk looked up as they entered, and Angela blinked.

They’d been married for nearly three years now and she still wasn’t used to the change in address. “Yes?”

“Very good,” he offered a kind smile, “We have the three of you booked for a mani-pedi session, followed by a sauna treatment and a full body massage. Mr Wilson has left a message here, just to let you know that he’s already checked with the pediatrician so you don’t need to worry about the nails. The length has been selected to the safest for your baby.”

She felt the initial panic at the thought fade away as he explained, Jake had really thought this day through.

“Did I tell you guys that they hired some new bloke while I was gone?” Angela asked as the technician filed down her new nails to the baby safe length.

Talia perked up at the gossip, “Can they even do that without you?”

“If he’s a temp,” Jen offered, “My dad has walked me through the process when board members are on leave.”

Angela nodded, “Come back from maternity leave and everyone is saying their hellos and such, and this bloody prick walks up and starts telling me where things are, who’s best to get help with what, even offered to take me to dinner if I needed help getting up to speed.”

“No!”

“Yes! Mug actually said ‘if you’re here to see the VP, sorry to tell ya she’s still milking having a kid so she’s not back yet’.”

Jen’s jaw fell open, “I know you didn’t just let that slide.”

“No way in hell she let that slide!” Talia added, “What did you do, babe?”

Angela smirked, “I excused myself to my office and watched him go through panic. Didn’t fire him- told his manager to have the team give him all the work they didn’t feel like doing themselves. He tried to file a complaint but HR just told him that the VP must’ve thought he could handle it.”

“You ever gonna let him off the hook?”

“Maybe. When he learns to respect the sacrifices I’ve made for the job I do, and understands that taking maternity leave isn’t ‘milking having a kid’.”

“As you should, babes.”

Walking through the door of the flat she shared with her family, Angela felt more relaxed than she had in ages. The stress from working her ass off for promotions at work, planning their wedding- and honeymoon- followed by her pregnancy and Ethan’s newborn months had built up and boiled over until she forgot her starting point. Jake was her constant from the beginning, no matter how hard he worked at the restaurant he always made time for her and their son. He always did his best to encourage her and help her relax, he would take the midnight feedings when he could, and today was a reminder of how much he saw her. He saw her getting tense and stressed out, and he did what he could.

As she slipped her shoes off, she finally registered soft music mixing with the sounds of spoons clanging on metal, and she followed them to her boys.

Jake milled about around the kitchen, Ethan strapped to his burly chest and looking impossibly small as his tiny hands reached for whatever Jake held, “No, sweetheart, I don’t think mum is ready for you to try something like this yet. Don’t worry, I have some yummy milk ready for you.”

She giggled softly to herself as Jake noticed her presence, coming over to press a kiss to each of their cheeks, “Mum is glad to see her two loves getting along so well.”

Her husband leaned down, giving her a sweet kiss before he pulled away, “I hope you had an enjoyable day, love.”

“It was exactly what I needed, but it feels so much better to see you two again.” She carefully pulled Ethan from the carrier, letting Jake take it off and begin moving the food to the table, that he’d set with flowers and candles, “Hey, bug. Mum missed you so much. Were you good for daddy?”

“We spent the day visiting my mum, so he had a lot of excitement,” Ethan fussed softly, eager for his bottle, “and didn’t get much of a nap. My mum says he should sleep pretty well tonight, and she’ll be by in a few minutes to pick him up.”

Her face bloomed with a hopeful smile, “We’re going to have the night to ourselves?”

He nodded, holding the two of them as she started to feed their baby, “She would’ve just kept him when I visited but I knew you’d want to see him.”

“You are the perfect husband, you know that?”

“Anything for the perfect wife.” Jake chuckled, “Now, give me our little poop machine. You sit, relax. I’ve made your favorite.”

“You didn’t need to go through all the trouble, you know? I would’ve been happy to spend the day with you eating take out.”

“Never.” Jake argued, giving her another kiss on the cheek, “Today is all about you. Happy Mother’s Day, my love.”

Masterlist

#litg #litg fanfic #litg season 1 #litg jake x mc #litg jake #litg tim #litg talia #litg jen #mothers day

[healthexedatagt]

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[jimbabu]

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[ourlittledinosaur]

From Baby to Toddler

New Post has been published on https://www.ourlittledinosaur.com/from-baby-to-toddler/

From Baby to Toddler

My Big Ole One Year Old!

My son turns 1 year old here in a couple weeks. As my husband said today, “I’m in denial.” Watching him grow up from a newborn to this newfound toddler stage has been such a joy, even though sometimes it makes me tear up. Time is just passing so quickly!

As I often do, I have been reminiscing about those first days. Lately, I’ve been thinking about his very first day, in his very first few hours. My husband and I were sitting on the bed in the birthing suite, watching the midwife do his newborn testing. We noticed that his feet were flexed upward and laid all the way against his tiny shins. My midwife mentioned that if we didn’t see a change to take him in to his pediatrician in a couple days.

My husband and I spoke about it in the days afterwards, when my son’s feet started to look more normal. Both of us had the thought, though we didn’t verbalize it in those early hours that our son may never walk.

Aaaaaand He Walks!

I am happy to share with you that as of this past week, we have a happy, brave, and fully WALKING child. He is no longer a tiny, helpless baby, but a waddling, mobile toddler. (Ok, ok, he’s still my baby.) Remembering those scary moments in the beginning has made us all the more grateful for his progress and health in both mind and body.

We have truly loved each stage with our son more than the last. Looking forward to all the many moments, milestones, and stages to come.

“Children are a heritage from the LORD, offspring a reward from him.” Psalm 127: 3

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#Milestones #Parenthood #Teaching and Guiding our Children

[neovora]

[mickeymouse-moshpit]

street lights, people

A/N: Hello, kind readers of this fic that I have taken entirely too long to update. I’m so sorry for the wait! And I also have to apologize because there is a whole first part of this that is stored on my computer, which is currently in the mail for repairs. I will post that part as well once it’s back, just please hold on and know that 1) there’s definitely context to being on Fennec’s bike in it and 2) there will be spicy things in the next part. Anyway, uh, if there’s typos I’m very sorry, and enjoy!

Description: Fennec and peds!Reader go on a date

Warnings: Some brief verbal harassment, brief description of dissociating, a little angst if you squint hard enough, Fennec and peds!Reader doing their thing 

Rating: T

Word count: 2.7K

January 24th 

Read part one here

You followed her out and down the lined path, hands sitting in the pockets of your jacket to keep warm. She threaded her arm through yours, and led you down the street to a book shop of all places.

“I remembered you telling me about that new series you wanted to read, something about gay witches? And you’re always talking about how much you want to go to the bookstore but you never do. So, go browse. I want to see what your process looks like.”

“Th—that’s really thoughtful. I don’t know that I really have a true process, but yeah let’s go look!” You opened the door for her, a light going on inside you as you got your first waft of bookstore smell: the paper, the ink. You got the first wave of the noise: the low music playing in the background, the people there talking in hushed tones. You couldn’t make out any conversations happening, could barely hear that there were lyrics in the music. You stopped for a moment, scanning the layout of the room. Your eyes landed first on the display of bookmarks and postcards, making a mental note to get one or two of each to remember this little town so you could find it one day. But then your train of thought halted: could you come here alone?

Best not to dwell.

Your eyes resumed their scanning, noting the different sections. You wandered to the right, letting your gaze drift over the painting beside the door. It was line art of two bodies intertwined, splashed with color to resemble a galaxy where they met. The notecard below it gave the title and artist’s name. And a price. You were struck by how nice it would look on your art wall. But that was for another day.

You started your first pass through the stacks, letting your eyes skate over the spines of the books, pausing to read the note cards when they gave a recommendation from one of the workers. Your fingers started to take on a mind of their own, catching on books here and there, bringing them out for you to investigate. Every couple of them, you would open to the first page, let the author’s words try to entice you. You put most of them back, but a green paperback one with a bent cover stayed behind. You held it close as you continued on, pacing with no purpose at all. If someone didn’t know you, they would think you had a system, but really you were just letting yourself be on autopilot. That is, until you got to the section that housed the series you had read about and wanted.

“This is it!” You hoped your whisper would convey your excitement to Fennec. You had been watching book recommendation videos and this series had come up, promising both a love story and adventure. “I hope th—they do! They’ve got both!”

You plucked both the paperback and hardcover from the shelves, adding them to your little stash. Your small smile would not leave your face.

Fennec watched as you dragged yourself away from the section, mentally patting herself on the back for this idea. You looked so happy, at peace. If she was a part of that? She would consider herself both clever and immensely lucky. As she followed you back to one of the sections you had drifted through, she watched your perusing turn into a hunt. You furrowed your brow as you sank down to kneel and scan for what she wasn’t quite sure. She pulled two more books from the shelf.

“Have you read this one?” She held up a copy of a book called Circe.

“No, but someone at work was talking about it the other day.” She hoped you wouldn’t be disappointed, and wasn’t disappointed when you slid the book back into its place with a mischievous look. Fennec’s mind went straight into the gutter for a moment, imagining you in a very different situation but with the same look.

“Good, you’ll borrow my copy.” There was no arguing, it was a fact. She would.

You stood up again, still holding onto the other book. You were off again, and while she thought you clutching four books to your chest was possibly the cutest thing she had ever seen, you were going to drop one if you kept getting distracted. When you stopped again, she held her hands out.

“Here, let me carry them. You use your hands to browse.”

You nodded once and sank down again, grabbing one of the recommended titles and popping up again. You paused, before setting it on the pile Fennec was holding, warmth building in your face as she gave you one of her smiles.

You set off with one more stop in mind. The waiting room library at your office was lacking in chapter books as of late. You let your feet carry you to the children’s section.

“What are we doing here? I didn’t take you for the Warrior Cats type. “

“The selection of chapter books in my waiting room is looking a little sparse here lately. I want to see what the kids are into so I can update the wishlist.”

Fennec looked at you like you had suddenly turned purple with polka dots and sprouted antennae.

“I have a bookshelf in the waiting room, and I always make it clear to kids and parents that the books on it are meant to be read, cherished, read again, both while waiting and when they go home, with no expectation of return. The Little Golden Books usually do come back, just like most of the other books meant for the teeny-tinies. The chapter books get sparse and don’t tend to come back, but I like it that way. It means I’ve got another reader who gets to learn about the magic of words.”

“But where do the books come from?”

“Well, at first it was just me. There were some parents who made it very clear when I mentioned the shelf that they were perfectly capable of providing their kids with books and how dare I assume otherwise. There were others that you could tell were extremely grateful. There were also a few that had a problem with it but not for any good reason but I’m sure you know what kind of parents I’m getting at.”

She did.

“Then one day I was in the little shop in town and one of the little ones who had started on chapter books saw me and ran up, telling me all about how she had saved her allowance and she was able to get the sequel to the book she had gotten from me. The owner of the shop heard it, and when I went to buy the book I had picked out along with some chapter books for the waiting room, he told me he would let me start a wishlist and he would put it by the register for people to see and maybe buy one or two.”

“Do you usually get what you ask for?”

“It depends on the time of year. During the holidays people get more generous so it’s time to update the list. Hence the reading castle.” You gestured to the structure before you, an alcove that had a castle facade and was filled with still more books. “And the wall of chapter books.”

Before she could formulate a response, you had pulled out your phone and started making a list. Fennec watched you with an emotion she wasn’t sure how to name. The earnest way you took on your task had her pulling out her own phone while you weren’t watching to send a message to the garage group chat. When you had finished, you brushed a hand over her shoulder as you walked by.

You wandered to your last stop: the display at the front. You picked out a pack of bookmarks that were little magnetic trees before turning your attention to the display of postcards. You chose one that was a picture of the gazebo in the middle of town at night, surrounded by twinkle lights with “wish you were here” in small text at the bottom.

You walked up to the register and Fennec plopped your pile of finds on the counter.

“Did you find everything you were looking for?” The older salesperson behind the register had half a smirk on his face as he queried you. “I haven’t seen someone quite as methodical as you, even covered the section for children.”

You weren’t sure if the sarcastic tone was real or meant as a lighthearted joke, but either way you felt your cheeks warm again, and not in a good way. You wondered for a moment if the ground would open up and swallow you whole. You felt Fennec’s arm wrap its way around your torso again as the salesperson started ringing up the books.

“Being thorough is one of the best things about her. And this is just me, but I think it would be kind of nice if my kid’s pediatrician knew enough about what their media looked like to be able to talk to them at their level about things other than their health.”

“Oh so she’s a big kid is what you’re saying? What, does she play with dolls, or are toys more for the bedroom?” That definitely wasn’t meant in a kind way.

Fennec’s arm tightened around you before you got the chance to just slip away and out the door, as if she knew that was something you might do.

“I would stop talking about them if I were you.” Her voice was low, had taken on a dangerous edge that matched what others saw in her leather jacket.

He got the hint, hurrying up with the transaction. When the final total came up, you reached into your pocket, not really feeling anything for that moment or registering the number that flashed in your general direction. Before you could get your card liberated, Fennec was already sliding hers into the chip reader. You wanted to protest, wanted to tell her it was too much, but the interaction was a sea witch that had stolen your voice and you could only look on as the books and other small items were wrapped and put into a bag and Fennec was turning you in a circle to get you out of the shop.

You weren’t even aware that your feet had moved until you were in front of her bike and she had distributed the books into the two saddle bags. She faced you and put her hands on your shoulders.

“Are you okay?”

You looked at her, answering her question with the question mark that had seemingly etched itself on your face.

“Hello? Earth to Doc? Are you in there?” She gave your shoulders a little shake, before she wrapped you in her arms. You finally felt like you could take a deep breath again as you rested your head in the crook of her neck, letting the pressure she was providing ground you again.

“I’m sorry,” you whispered into the collar of her sweater.

“You have nothing to be sorry for. He should be sorry. If he hadn’t stopped talking, I would have made him sorry.”

“I wanted to stop you from paying, it was too much.”

“No. I wanted to do that, it was the plan from the beginning.”

“Really?” You pulled back slightly, peeking at her, searching her face but not having much luck in the low light.

“Yes really. Now, I had something else planned, do you want to know what it is so you can decide if you still want to do it?”

You considered it, but the phantom hollow in your chest and the way your arms and legs still didn’t feel like they belonged to you gave you your answer.

“I want to know, but not yet. Keep it secret, show me next time. I’ve got my own idea though. Will you take me home? I want to show you the Books.”

***

You didn’t want to let go of her, but you needed to if you were going to go inside where it was warm. So you did. When she had taken the books out and put them back in their bag, you headed for the three steps that led up to the door of your half of the duplex. You unlocked the door, nearly dropping the keys because your hands were so cold. You caught them before Fennec could tease you about it.

You clicked on the light in the entryway, lighting the way as she took a few steps inside again. You took the bag from her, and nodded to your left. Behind the stairs to the loft, there was a doorway. You walked through it and to the right, knowing the room in the darkness. You stepped on the clicker for the floor lamp, bathing the room in a soft glow. You walked over to the electric fireplace that added some extra heat to the room, switching it on.

You went back to where she was standing in the doorway, like she wasn’t quite sure what to do with her hands. You took them in yours and brought her in.

Her eyes widened as she took in the space.

The room screamed comfort. All four walls were covered by bookshelves that reached the ceiling, with two interruptions. The first was around the fireplace, if you could even call it that. There was a painting in front of it, but her eyes were too busy wandering to take it in just yet. Her gaze drifted to the window, where either you or the previous owners had built a seat large and plush enough to recline in. While that should have been the star of the room, it wasn’t.

In front of the fireplace was a massive sectional sofa. She was sure it had to have a pull out option you were taking advantage of because it looked more like a bed-sofa hybrid with the way the middle was seemingly filled to the brim with throw pillows and faux-fur blankets.

You stood watching her take it in, as she eventually started looking at the books lining the shelves, punctuated by the odd piece of memorabilia. There was such a variety, all alphabetized, with the only delineation by genre she could see being poetry and prose. As she browsed, you placed your books on the window seat, and from under it produced two stamps: one to mark the books as yours, and one to put a place for people who borrowed them to sign. Others always asked if it was to make sure they came back, but you always replied with no, it was to make sure people could see if they had borrowed them before. You put the books onto the rolling cart that already had a small pile to be put away. Some of them were new, some you had reread and needed to return.

Task complete, you perched on the back of the couch to watch her.

“I should start referring to you as a dragon. You’ve got quite the hoard, baby.” Her words were quiet, wrapped with kindness. “It’s impressive. Thank you for showing me this part of you.”

“I just really like them.” Your smile was growing as she got closer to you. You stood and wrapped yourself around her again. “Does that make you the maiden in need of rescue?”

“Oh, no, you can keep me here as long as you want. Besides, don’t you know the dragon needs saving too sometimes?”

“In that case…” You paused, stealing yourself. “Would you stay a while? I can make tea, we can read, if you’re okay with you could do that pressure thing again?”

“You mean will I hold you close, let you hide your face in my neck for a minute again? Let you whisper things you don’t think I’ll hear but I will anyway?”

You nodded once.

“In that case, I’ll do ‘that pressure thing’ for as long as you need me to. But you have to let me try out this couch nest thing because it looks amazing.”

“Of course, but the first rule of the dragon’s lair is this: no jackets.”

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

More author’s notes: if you’re curious about what series peds!Reader was looking for, it’s These Witches Don’t Burn and its sequel by Isabel Sterling. She wants Fennec to read Circe by Madeline Miller, and she bought The Song of Achilles, also by Madeline Miller

Tagging: @phoenixhalliwell @promiscuoussatan @maybege @jangofctts 

#street lights people #Fennec Shand x reader #fennec shand #biker!Fennec #biker au #the mandalorian fanfic #star wars fanfic #wlw #the mandalorian fanfiction #Star Wars au

[inkedstarlight]

Bittersweet: Chapter One

Summary: Nesta up and moved the minute she graduated high school. Now, seven years later, her father has died. After years of separation, Nesta is now living in the same city as her sisters, with Elain as her roommate. Feyre introduces Elain and Nesta to the Inner Circle. But they're missing a certain member... Cassian returns to the Marine Corps to find two new members of the Inner Circle. He pushes Nesta's buttons more than anyone ever has. Cue heavy angst, mutual pining, and a very, very slow burn. Note: So I’m reposting this because I made a lot of changes to the fic and just wanted to start fresh. I had deleted the last things I posted for it, but now it’s officially here! I also just uploaded it on AO3 too, and you can read chapter one here! Warnings: heavy angst Bittersweet Masterlist

June

Nesta was accepted into graduate school today, and she didn’t know whether to cry or smile.

To throw a pity party or a celebration.

To be or not to be.

She was trifling through her mail this morning when she saw the large envelope with the words ‘Prythian University’ printed front and center. She wasted no time ripping it open, and a gasp left her mouth when she read the first sentence.

We are pleased to inform you that you have been accepted into the Master’s program of English at Prythian University.

She had grabbed her phone to tell someone about the news, but her smile quickly faded when she realized she had no one to call, no one to celebrate with. No one to tell her, “I’m proud of you.”

Nesta had scrolled through her contact list, which consisted of only fourteen people. Fourteen people and not one of them close enough with her to warrant such a text. Heart sinking in her chest, Nesta slammed her phone on the coffee table and fell on the couch. A lump formed in her throat, but she refused to let a single tear shed.

But she was in no position to complain. Nesta chose to move away. She chose to be alone. She was the only person to blame for her own unhappiness.  

Nesta had lived in the dreary state of Massachusetts since she graduated high school, leaving her family behind in Maine. The place that conjured nightmares, that was teeming with ghosts. Every corner she turned in her hometown, she was met face to face with her past – the one she so desperately tried to forget. Her family had lived there since Nesta was born. They didn’t have the funds to move to a better town or a bigger house. Up to this point, Nesta’s entire life happened in that horrible town.

Her younger sister, Elain, cried when Nesta announced her decision to move to Massachusetts for college. Feyre’s eyes remained dry, but she wished Nesta good luck.

Nesta and her two sisters had been close as little girls. Sure, they were wildly different from each other – Elain was intelligent and soft-spoken, Feyre creative and stubborn, Nesta hot-headed and brash. They argued. They resented each other in ways sisters did. But they looked out for each other. Since Nesta was just five years old, she did everything she could to protect her sisters, whether they knew it or not.

When Nesta was just fourteen years old, their mother left them. She walked out of the door forever, and everything changed. Elain was crushed but she continued to look out for their father, whose depression worsened when his wife left without saying goodbye. Feyre took her absence the hardest. She had the closest relationship with their mother as the baby of the family, relying on her more than her other sisters. Feyre was the last one to see her. Apparently, their mother made her promise to look out for the rest of the family. She said Feyre was the only one who could do it. And because Feyre was stubborn to a fault, she kept that promise every damned day.

And Nesta? Nesta was relieved and confused and angry and heartbroken. She still was.

So, when Nesta left for college, she promised that she would keep in touch with Elain and Feyre. They all promised. However, they inevitably got busy with their own lives and grew apart. When Elain graduated high school just two years after Nesta, she chose to remain in Maine to tend to their sick father. She attended community college, even though she’d dreamed of being a pediatrician since she was just nine years old. She sacrificed her opportunity for a higher education, and Nesta admired her for that. At the same time, however, she also wanted more for her sister. She had a habit of being too selfless. Always giving, never receiving.

Just a year later, Feyre became the last to graduate. She too flew from the nest, heading west to Colorado. Nesta wasn’t the only one who had a distaste for their hometown. Feyre was born an adventurer. She wants to explore, create, travel. More importantly, Feyre was doing something for herself. Feyre had assumed the role of provider when their mother left them in their youth. At only thirteen, she managed to find a job, and continued to do so until she was eighteen. Feyre had grand plans to visit every New England state during her high school career. She wouldn’t shut up about the places she would see, the people she would meet.

Feyre didn’t stepped foot outside of Maine until she graduated.

The only person Nesta completely cut loose was her father. Elain and Feyre had tried to rationalize with her about this many times, but Nesta put an end to every discussion.

Elain was very close with their father. Feyre was neutral. Nesta resented him. She knew they judged her for that, even if it wasn’t explicitly said. She also understood their reasoning.

They just didn’t understand hers.

Last Nesta heard, Feyre had found her niche at college. Back when they called more often, she had gushed about her new friends and latest conquest. His name was Rhysand (to which Nesta sniggered – who named their child that?), and the pair had recently begun dating after a year of pining for one another. Nesta told her that their love story sounded like the kind of fanfiction she (shamefully) loved. From what Feyre told her, it sounded like she was head over heels, despite her sarcastic deflections.

That was two years ago.

Of course, Nesta had spoken to both her sisters since then. It was rare for them to call, but they would share occasional text conversations. Just last month, Nesta texted Feyre to congratulate her on graduating Summa Cum Laude. It didn’t go much beyond that, though.

Nesta and Elain’s text message history was quite sad to look through. Once a month, Elain would send her an update on their father’s wellbeing. Nesta would not respond. The next month, she would receive another update. No response.

It never angered Nesta to see those texts; it only saddened her.

Elain wore her heart on her sleeve, ever the peacemaker in the family. Her intentions were pure, but she didn’t know the story of Nesta and their father’s relationship. She’d asked, but Nesta was always quick to shut her down.

Despite their one-sided texting, Elain called Nesta every couple of months. It was awkward, but it warmed Nesta’s heart to hear her sister’s voice. Their calls never lasted more than ten minutes, Nesta the one to end the conversation. When they hung up, however, guilt crushed her. Nesta was slowly losing everyone she loved, and it was entirely her fault.

After Nesta had gotten her undergraduate degree in Massachusetts, she worked at two minimum wage jobs for three years to save up enough money to pay for grad school (along with several loans). Her first choice, Prythian University, happened to be just outside of Boulder, the town where Feyre was living. It was also one of the best graduate schools for an English degree in the country.

Nesta considered telling Feyre her news. Obviously, she had to share it at some point. But anxiety crept into her chest whenever she picked up her phone to tell her. What if Feyre wasn’t happy about it? What if she didn’t want Nesta living near her? She had created her own life in a new state. Nesta couldn’t just interrupt after years of shutting her out.

After spending the entire day overthinking, Nesta decided to venture downtown in the evening for a small, lonesome celebration. She would treat herself to a drink (or two), go home, and read a romance novel or two while Iroh, her black, grumpy cat, snuggled in her lap.

So, there she was. Sitting at the local bar, legs crossed as she people watched. Nesta had even dressed up for the occasion. She wore a dress that fell to her ankles, the forest green color complimenting her golden-brown hair. Her arm sleeve tattoo was on full display, and her other ink that disappeared beneath her dress. Dark kohl coated her eyes with a smokey finish.

The bar itself was a welcoming environment. String lights latticed the ceiling, the bulbs providing dim lighting for those who had secrets to keep. Wooden tables faced a small stage at the opposite end of the building – presumably where they held open mic nights. Dark oak walls were plastered with photographs, license plates, and other décor.

It being a Tuesday night, there weren’t many people out. Nesta noticed a couple middle-aged men drinking beers together, an older couple sitting close in a booth, and a small group of what looked like college aged women. Smiles were etched on all their faces. Nesta lifted her hand to touch the frown she wore. It only deepened.

Just be happy for once, Nesta thought to herself.

As the bartender refilled her gin and tonic, someone approached the barstool to her left. Nesta glanced sideway to discover a young man with a hard face. He looked about her age with dark hair and a tanned complexion. He was handsome in a rugged kind of way. Removing his leather jacket, he revealed the fitted shirt he wore, which clung a body that screamed “I go to the gym every day.” Before he sat next to her, the man dropped a duffle bag on the floor with a loud thud.

He didn’t seem to notice her as he flagged down the bartender and ordered a drink. His voice was low, tired. She recognized the sound. It was the sound of someone who was exhausted, and not just in the physical sense.

“Running away from home?” Nesta asked. The man turned his head to find her gesturing to his oversized bag.

Why did I just say that? she asked herself. Nesta rarely made conversation, much less with some stranger at a bar. It was abundantly clear that she had certainly drunk enough alcohol to wash away any and all inhibitions.

He chuckled. “Something like that.” The man peered at her closer. His hazel eyes twinkled in the dim lights as he inspected her. “Bad day?”

“Care to elaborate?”

A sober Nesta would have shut him down before he had the chance to even ask. A sober Nesta wouldn’t have even made conversation with this dark, handsome man.

Alas, she was three drinks down and had no intention of stopping anytime soon.

“I got into my dream school,” she started. “It has a really great grad program. When I read the letter, I reached for my phone to tell someone. Only, I realized I had no one to call. I… I realized that I’m all on my own.”

He stared at her for a moment. “That’s quite a feat. You should be proud.”

Nesta shrugged, uncomfortable with the man’s genuine tone. She never figured out how to tolerate a compliment, much less accept it.

They fell silent before he spoke again.

“I’m about to be on my own, too,” he confessed, focusing his attention on his calloused hands that rested on the counter. “And I don’t know how to feel either.”

No wonder he looks so exhausted, Nesta thought. She could see the conflict in his body language, his tone. War was waging in the stranger’s eyes, and it didn’t seem like the first time he’d gone to battle.

She wanted to ask where he was going. What was in his bag. Who he was leaving behind. But Nesta only nodded with understanding.

I see you.

In that moment, they formed some sort of kinship. They weren’t just two strangers at the bar. It was longing, Nesta realized. Longing for a connection, a companionship. To escape from the perpetual loneliness.

They stared at each other until the man broke his gaze when he checked his watch. He cursed.

“I have to leave now if I want to catch the bus,” he explained. Nesta watched him down the rest of his drink and stand up.

“Good luck,” Nesta said feebly as he shrugged on his jacket.

She wanted to say more. He seemed to need it… and so did she. “Whenever you get lonely, just remember that strange girl at the bar. She’ll be thinking about you.”

His face softened. “Good luck,” he whispered.

#nessian #bittersweet #nesta archeron #cassian #acomaf #acotar #acowar #acosf #a court of mist and fury #a court of thorns and roses #a court of silver flames #my writing #fanfiction #angst #fic

[medical921]

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From annual sports physicals to playground injuries, kids have a tendency to head to the doctor far more often than adults. When you're making that several journeys to the doctor's office, it's specifically important to see a doctor that both you and also your youngster really feel comfy with. As you're trying to pick the best doctor for your youngster, you may be perplexed regarding the distinction between a pediatrician as well as a family practitioner.

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The most significant distinction between a pediatrician as well as a family practitioner is the age of the clients they deal with. Doctors typically only see clients that are under 18 years of ages, though some will certainly see people approximately 21 years old. Family physician may see clients of any kind of age or might just see patients who are above a particular age. Medical.

More About Medical

The initial step is to ask your kid exactly how they really feel about their doctor and also if they would certainly fit making the button. Some might feel highly that they prepare to see a new doctor, while some might favor to proceed seeing one they're already acquainted with. Older kids and teenagers might express passion in seeing a "full-grown doctor" as they age.

Medical Things To Know Before You Buy

If you have an interest in transferring your child to a family practitioner, schedule an appointment with one of our caring family medicine specialists to obtain the procedure began.

If you are looking for a job that offers high levels of employment safety and security, then becoming a doctor is something that you need to consider as a future profession. Also throughout the worst of times in an economy, there is a requirement for medical professionals to deal with diseases, condition, and also injuries. This career has actually existed in every well-known human world.

5 Simple Techniques For Medical

Medical professionals serve their patients as well as communities in a variety of methods. Some decide to become family professionals to make sure that they can become the initial line of protection for adults and also children who need look after daily concerns. Others determine to function in emergency clinic, go after medical specialties, or enter into research study to ensure that they can optimize the favorable impact that their job can make everyday.

If you are believing regarding an occupation in medicine today, then these are the bottom lines you will certainly wish to evaluate. Listing of the Pros of Being a Doctor The income that you can make as a doctor relies on your experience, the specialty you practice, the setup where you function, as well as your geographic place.

Not known Details About Medical

According to info from the Bureau of Labor Stats, the ordinary income for a person working as a family specialist or generalist is regarding $190,000 each year. If you determine to operate in a specialized area, such as neurology, then your wages can be much higher. Medical. It is not unusual for someone practicing in this area of medicine to make upwards of $700 per hour.

The American Medical Association performs normal researches to see just how doctors are really feeling concerning the job that they do every day. Around 42% of medical professionals state that they are highly pleased with their occupation choice. Not only do they have the opportunity to aid people accomplish much better health and wellness, but they additionally obtain the chance to carry out study, get included with recurring training opportunities, as well as even conserve lives.

9 Easy Facts About Medical Explained

If you like to be discovering all of the time, then being a doctor is just one of the very best occupation choices that you could seek. Attending medical college is just the very first step in a lengthy procedure of education and learning when you become a physician. Also when you have been operating in the very same specialized for years, there are distinct situations, developing modern technologies, and also brand-new treatments to find out about to make you a much better doctor.

[buoyantsaturn]

Hey Kids additional notes

hey folks!! i’ve been working on expanding the I’m in Hell universe for the last few days, so i thought i’d make a bullet point list of will’s side of the story after the events of Hey Kids, Can You Rock and Roll?

if you haven’t read Hey Kids - do that first!

will struggles a LOT trying to raise bianca while going to classes. it’s usually fine in his lecture classes, but when he has labs, he can’t bring bianca with him

sometimes naomi’s schedule lines up just right that she can babysit, other times will begs a few of his classmates to watch her when they don’t have class

will hardly sleeps between his class schedule and taking care of a baby, and one night he goes out to the kitchen for a glass of water and finds naomi looking over budgets and he realizes that like,,, they really can’t afford to buy baby food and diapers or even a bed for bianca who is still sleeping in her baby carrier

will tries to think of any possibly way he can get a part time job where he can still study and work around his class schedule AND bring bianca with him so his mom doesnt have to work herself to the bone but there’s no way for it to work and all will can do is apply for as many scholarships as he possibly can because at least that’ll help in the long run kind of

it’s basically the last possible moment financially where will is practically in tears as he realizes that no, he can’t keep bianca, when Naomi comes inside with the mail and there’s an envelope with will’s name on it - but no address which means it must have been dropped off by hand - and there’s a note inside that says “consider this child support - don’t expect anything else” and a check for $5000 and will actually does burst into tears

it’s a stretch, but really its just enough for them to figure things out and will gets to keep bianca

it sounds like a lot but like. consider: a bed, clothes, food, diapers, that all adds up quick

the problem then becomes that legally,, will has no actual claim over bianca - they can’t really take her to the doctor, but naomi is able to sneak her in to see the pediatrician at the hospital she works as a nurse at, will won’t be able to put her in daycare or school - so will figures. time to get parental rights

bianca’s a little over a year old at this point, and the cheapest lawyer will can find tells him that will should have no problem getting parental rights

i don’t know anything about court processes or adoption or whatever but the way i see it. will shows up to court, apollo doesn’t, and the judge decides right then and there that will is clearly the more capable father

there’s still a lot of financial struggle - especially after will has to pay a laywer - and it gets worse when will graduates and has to start paying back his student loans, but Chiron recommended will to multiple great residency programs and that should help

unfortunately he’s either rejected because of the medical school he went to, or the residencies are already full, so will only gets into a lesser known, more local hospital, but at least he can still stay with naomi to save money

after his first year of residency, a spot opens up at a hospital in new york city, and while the pay is better, it’s still super expensive to live in new york, so will almost doesn’t take it, but once naomi convinces him, he moves away

boy oh boy that’s a lot of time to fill and i still skipped over a lot of it but i think i have the important stuff down!! if you have any questions or just want to talk about this au, hmu!! i’d love to talk to yall about it!!

buy me a coffee | read I’m in Hell

#solangelo #will solace #i'm in hell #mine

[brodymeetsworld]

This Christmas.

When I was a little girl, Christmas was my favorite holiday of the year. My grandmother would cook for days in preparation for the entire family( 6 grown children, 10 plus grandchildren) to gather around the table together (or the infamous kids table.) It was one of the only times of the year I was able see my extended family, and I soaked up every second of the time we had together. I have so many memories from learning how to cook with my Grandma, Aunts, and my oldest cousin Erin. To watching football in the living room with everyone including Granddaddy snoozing in “his chair”, to secretly learning how to play the card game “bullshit” (at a very young age I might add lol) with all of the cousins on the back enclosed porch. We would always end our evening the same way, after dinner we would sing the “Happy Birthday” song to Jesus, and because my little brother and I were the babies of the family, we usually got to blow out the candles on the cake. Afterwards, most of us would attend Christmas eve candlelight service at the Monterey Methodist Church. I didn’t get to go to Church very often, so these services were so special and beautiful to me. Those memories are some of the best memories of my childhood. 

After my grandparents passed away, the glue that held our extended family together dissolved. Everyone decided to host their own families for the holidays, and no longer wanted the financial or time burden to feed and host twenty-thirty family members. It saddens my soul to never see my aunts, uncles, or cousins anymore. The only way we see each other and communicate now is through social media or phone calls. One big portion of our family even moved half way across the country to Missouri, so the chances of seeing them anytime soon are slim. I truly haven’t felt the magic of Christmas since Christmas in Monterey, and that was 15 years ago.

After I met and married my husband, and when I became a mom, at the age of 26 and again at 27, I thought that magic would suddenly just appear again! Wrong, if anything, Christmas was harder all around. Not only did my two babies want nothing to do with Santa Clause, or the presents my husband and I worked so hard to buy, wrap, put together, but they were determined to destroy all of our decorations, including 3 separate artificial trees. I was completely emotionally and physically drained the first two Christmas’s with our children. I always just threw it off as of well this is life with two under two, or two under three. It never occurred to me, that one of my children may have special needs.

Fast forward to today, this will be my 30th Christmas. This will be my boys 4th and 5th Christmas. This year they have finally left our beautiful tree alone, and most of the presents underneath it as well. They both love to sing Christmas songs, and watch the snow fall on the ground. Our favorite thing to do right now is make Christmas crafts, and go searching for Christmas lights at night in the car. The proof of them growing and learning is obvious this year, and it brings so much joy to my heart. We also started going to church this year. What brought us to church was learning about our oldest son, Brody, diagnosis of Autism Spectrum Disorder over Easter weekend this past year. 

You see, my husband and I always knew Brody was special, but we had no idea how special he really was. We were first time parents, and when Bentley came along just 14 months after his brother, we entered survival mode and did our very best. Looking back, I think Brody started showing signs of Autism shortly after his brother came into the world, around 16 months old. I was in denial for a long time, as well as my husband. I can remember looking back and thinking how hard it was in the beginning with both boys, and I never thought of the hard times as Brody being “abnormal”. I always blamed myself for “not being a good enough parent”, and that’s why he is crying all the time. Or “I’m not a good cook, that's why he won’t eat any of the meals I make for him”. And the one I really truly believed, “I guess I don’t talk to him enough and that's why he won’t speak”. All of these things would torment me every day, and all I could do was vent to my husband or his pediatrician. I even took him to see a ENT doctor determined because he had so many ear infections as a baby, maybe he had a hearing problem. It wasn’t until a close family member kept Brody over night that Autism even crossed our radar. Bless her heart too, she tried to tell me, but instead of accepting help, I was angry with her. The first time I reached out for help with our children and my biggest fear was being confirmed.(crazy when I think back, I really was scared of this diagnosis) I was so deep in denial there was nothing she could have done at that time that wouldn't have upset me. It took a toll on our relationship, and I regret the time we lost together over it.

Before we even received Brody’s diagnosis, we enrolled him into the special needs pre school in our county. He qualified right away, and he started right after his third birthday. He went from speaking one word sentences, to three to four word sentences in a year and half time so far, and most importantly he can communicate his needs and wants. His eating has improved, and we have a list of foods he will eat as oppose to 4 things total. Brody will dance with us down the hallway, and sing silly songs for us. He knows how to say please and thank you, I’ve been told by his teachers he is showing empathy to his classmates, and he can finally say “I love you, mommy” or “I love you, daddy” without signing them to us at the same time. All of these things are so bittersweet for us, because there was a time not too long ago we weren’t sure they were even a possibility. 

Easter 2019 comes, we receive our sons test results in the mail. If you’ve never read ADOS results before, they can be a bit confusing. My husband and I read the results, googled our sons comparison score of “4″, and thought he was on the severe end of the spectrum. It wasn’t until the next day did we find out we were wrong, Brody is in fact on the mild end of the spectrum. But the night before was rough, we both cried and cried. Why did we cry? I really don't know the answer to that question. When you receive a diagnosis for your child, no matter the diagnosis, a part of you inside just breaks into a million pieces. I can’t speak for my husband on this, but I know for myself, as a mom, I blamed myself for a long time. I spent so much time trying to think back through out my pregnancy with Brody what I could have done wrong. I think back through out his infancy what could have went wrong, “what did I do, what did I do that made him different.” The end of the school year was coming, and we have a yearly IEP meeting with all of Brody’s team members. In that meeting, the school psychologist who tested Brody, told us it was imperative for Brody to constantly be put into small social circles. She recommended t-ball, soccer, church, birthday parties, etc. So that is exactly what we did. Brody wasn’t old enough to enroll into sports in our county yet, so we accepted every single birthday party invite, and focused on finding a Church family.

We had several invites to different churches in our community, but because I myself hadn’t been to church in over 15 years, I was a nervous wreck deciding which church to attend. Going anywhere, by yourself (my husband works A LOT), with two rowdy boys is hard. It’s 10x harder when you have a child with Autism. I knew I had to get over my fears of my sons meltdowns, and do this not only for my sons social interaction sake, but also so our children could learn about our Lord and Savior, Jesus Christ. I always wanted to learn about the Lord when I was growing up, but no body ever wanted to wake up sunday morning to attend a church service with me. In fact, the only times I ever attended church was during Christmas or if I stayed the night with one of my friends whose family attended. Now its my turn, it’s my duty as a mother, and as a daughter of the King, to teach my children his word and of his sacrifice for all of us. 

I choose our church family, Redeeming Grace Outreach Worship Center. The boys and I go almost every sunday. Both boys wake up excited to go to church, and really enjoy singing and dancing for the Lord. After a bit of a transitioning period in the beginning, Brody will finally go to the nursery without mama having to be there too. I am finally able to read the bible and worship God and take something away from each and every service, and that truly has been a game changer in our life as a family. 

So for my 30th Christmas this year, this will be by far my best Christmas yet. Its been a year of ups and downs, a year of believing in miracles (Ezekiel Rhett), a year of building our faith, and a year of learning acceptance. Our son is exactly who he is supposed to be, and he was made in the eyes of our father. Through him, I’m learning exactly who I’m supposed to be too. God has a purpose for each and everyone of us, and our mighty King makes no mistakes. This Christmas will be magical because we made it that way.

#autismawareness #autismacceptance  

[picardonhealth]

Toronto Star investigation reveals Ontario’s top billing doctors

Data also shows need to address relativity and gender equity in how physiicans are paid

ANDRÉ PICARD, The Globe and Mail

JUNE 30, 2019

After years and lord-knows-how-much in legal fees fighting ridiculous lawsuits trying to keep secret the amount of public dollars paid to individual physicians, it looks like the Ontario Medical Association has finally come to its senses and acknowledged the obvious: Transparency is in the public interest.

“We’re all taxpayers as well, and it’s important for us actually, frankly, to ensure that tax money is well spent,” Dr. Sohail Gandhi told the Toronto Star.

He even proposed that Ontario adopt a law that makes the billings of all 31,500 physicians in the province public, following the lead of British Columbia, Manitoba and New Brunswick.

The OMA’s road to Damascus moment seems to have come only after the Toronto Star published a series of articles on the province’s top-billing physicians. Through the Access to Information law, the paper obtained the billing information of 194 doctors who were among the top-100 billers from 2011 to 2018.

Despite dire predictions that making this kind of information public would be inherently biased and unfair, and lead to shaming of doctors, there was no outcry and, frankly, few surprises.

The OMA’s position that the public was too stupid to know the difference between billings (gross revenues) and income (net revenues) never held any water.

Still, the Star’s reporters, Theresa Boyle and May Warren, did a masterful job of presenting the data in a fair, nuanced manner.

What easily could have been “gotcha” journalism turned out to be a thoughtful exploration of why some physicians are paid so much money, and more of a reflection on the inherent flaws of the predominant fee-for-service payment model than the singling out of individuals.

We have known for years that there was a doctor who billed the province more than $6-million a year on average. Now we know his name, Narendra Armogan, and that he is an ophthalmologist who runs OCC Eyecare in Mississauga. Because the information is public, journalists were able to report that he employs 70 staff and rents more than 50,000 square feet of office space – in other words, the operation has massive overhead.

We still don’t know Dr. Armogan’s take-home pay, but that doesn’t matter. Transparency in billings is about knowing that public monies are being spent delivering care to the public. Nobody begrudges doctors making a good living.

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Publicly released data, however, can expose those who deserve scrutiny. Stefan Konasiewicz, a neurosurgeon who is No. 2 on the list with billings of $4.6-million for the 2017-18 fiscal year, has been sued for malpractice at least a dozen times, and has faced disciplinary action in three U.S. states.

Similarly, Kulbir Singh Billing, an anesthesiologist who ranked eighth on the list with billings of $3.5-million for 2017-18, has resigned his licence after being investigated for overbilling for pain treatments known as nerve blocks, and has previously been charged with fraud.

Alexander Hartman, a diagnostic radiologist who is No. 5 on the list with $4-million in billings, saw an eye-popping average of 265 patients a day and billed for 364 days over the 2017-18 fiscal year.

High billings do not imply something nefarious is afoot. The data can remind us that doctors are hard-working, sometimes to a fault.

Rajeev Muni, an ophthalmologist at St. Michael’s Hospital and the Hospital for Sick Children, is one example. Dr. Muni, 10th on the list at $3-million in billings, is one of the only doctors who can treat retinal emergencies so he is essentially on-call 24/7, year-round, and worked 335 days over the 2017-18 fiscal year.

The billings data, obtained by the Star after a legal battle that went all the way to the Supreme Court of Canada, highlights, more than anything, that in the province’s $12.1-billion physician services budget, there is an inherent unfairness in how doctors are paid.

Those whose practices are procedure-based – meaning they do stuff such as eye tests, radiology scans, injections for pain – can see hundreds of patients a day and bill enormous amounts of money. Those who practices are more cognitive – meaning they spend a lot of time interacting with patients, such as pediatricians and geriatricians – have billings that are far, far lower.

That equally trained and hard-working specialists can make orders of magnitude more/less money makes no sense.

It is telling, too, that among the 194 physicians who were top billers, only nine were women.

Men and women use the same fee schedule, and charge the same rates, but they practise differently and gravitate to different specialties.

These issues, relativity and gender bias, are ones that the medical profession principally has to work out itself, but government, in contract negotiations, can help them along.

With the distracting canard that transparency is harmful out of the way, we can now focus on what really matters to physicians, fair payment for the valuable work they do, and what matters to the public, getting value for money for the payments physicians receive.

[architectnews]

Windmill House, Ponta Delgada Azores

Windmill House, Ponta Delgada Real Estate, Azores Home, Portuguese Building Development, Architecture Photography

Windmill House in Ponta Delgada Azores

6 Dec 2021

Design: BOX arquitectos

Location: Ponta Delgada, Azores, Portugal

In a consolidated urban mesh, at the center of Ponta Delgada, the approach for Windmill House answers to a program of an extremely small single family house with two flights of stairs, where the lower floor accommodates a single social area, while the two small bedrooms are located at the upper floor.

With only 4.20 meters at the front, with no space for urban pediatrician circulation space, the facade results in the child’s imaginary of a house drawing… one door and one window.

Windmill House

In that sense, the main facade is exclusively the boundary between interior and exterior, with no reason for a relation between both, besides being in its way.

The program develops without the need of transitioning or dividing spaces. The only social space of the house gains dimension in its depth when it finds the garden at the end of the space.

The garden establishes the balance with the house and the private addition at the end of the lot. At the upper floor, the East Bedroom gets a terrace, from which you can visualize the houses that make the urban form, so characteristic of the neighborhood.

The necessity to simulate a greater spatial amplitude is made possible by the skylights in the pitched roof, which receives the light and spreads it throughout the interior spaces, working as a ” diaphragm”, increasing the “vertical perspective”.

Windmill House, Ponta Delgada Azores – Building Information

Project name: Windmill House Architecture Office: BOX arquitectos Main Architect: Barabara Morgado + Oscar Catarino E-mail: [email protected] Facebook: https://ift.tt/31pbPd2 Instagram: https://ift.tt/3pzOMUV

Location: Ponta Delgada, Azores, Portugal Year of conclusion : 2021 Total area: 110 sqm

Constructor: Vicor caetano engenharia & construção, unipessoal, ldª Engineering: SOPSEC Açores Interiors Team: BOX arquitectos

Architectural photographer: Ivo Tavares Studio Facebook: https://ift.tt/3icjIGK Instagram: https://ift.tt/2TdTnjo

Windmill House, Ponta Delgada Azores images / information from Barbosa & Guimaraes

Piscinas da Povoação architect : Barbosa & Guimarães

Location: Povoação, São Miguel, Açores, Portugal

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Comments / photos for the Windmill House, Ponta Delgada Azores page welcome

Website: Azores

The post Windmill House, Ponta Delgada Azores appeared first on e-architect.

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[literaturepublisher]

Case Reports in Pediatrics

One of the many things you need to do to prepare for your baby’s arrival is to choose a doctor to monitor their health care. A pediatrician is a medical doctor who cares for the physical, behavioral, and mental care of children from birth to 18 years of age. Pediatricians are trained to diagnose and treat a wide range of diseases, from pediatric illnesses to serious illnesses. 

The main purpose of case reports in pediatrics is to provide a forum for experts involved in clinical practice, clinical and basic research and to share the results of their research. Case reports from pediatricians serve as a practical guide for pediatricians to improve and diagnose conditions in infants, children, and adolescents.

The pediatrician graduated from medical school and completed a 3-year residency program in pediatrics. Board-certified pediatricians have passed rigorous examinations provided by the American Board of Pediatrics. To remain certified, pediatricians must meet regular ongoing education requirements.

Pediatricians are specially trained medical doctors who work with infants, adolescents, and adolescents.

Children experience rapid physical, emotional, and behavioral changes as they grow older. Children and adolescents have specific medical needs that primarily go beyond the expertise of physicians treating adults.

Continue reading to learn more about pediatricians, including what they do, who they treat, and the qualifications needed to become a pediatrician. This article also provides a list of pediatric subdivisions. And pediatric case reports

What is a pediatrician?

A pediatrician is a medical doctor who specializes in treating infants, children, adolescents, and young adults. Childcare can begin before pregnancy and continue during pregnancy.

According to the American Academy of Pediatrics, setting an upper age limit for pediatric care is not straightforward. The academy discourages people from setting age limits on childcare, as it depends on a person's physical and mental needs.

As children get older, they experience rapid physical and mental changes. Pediatricians understand this fact and assess the child's health status according to their normal age range.

Pediatricians can help diagnose a child's medical condition. Depending on the situation, parents or caregivers may take their children to a pediatrician or pediatrician for primary care.

Types

Many pediatricians work as primary care physicians. This type of pediatrician regularly checks health and wellness. They provide a comprehensive diagnosis and treatment of general health conditions, provide vaccinations, and provide appropriate health advice to young people and their parents or carers. 

Other pediatricians specialize in treating specific medical conditions or age groups. Examples of pediatric subtypes include:

Adolescent medical experts focus on adolescent care, ranging in age from 11 to 21 years.

Critical Care Pediatricians facilitate a team of healthcare professionals who treat children with unstable or severe health conditions. These pediatricians usually work in a hospital-based intensive care unit.

Developmental Behavior Pediatricians evaluate the developmental behavior of children and adolescents. Experts in the field diagnose and treat developmental, educational and behavioral problems in young people.

Child Abuse Pediatricians have specialized training, experience, and skills necessary to assess whether a child has been abused or neglected.

Pediatric oncologists specialize in diagnosing and treating a variety of cancers in children.

Pediatric cardiologists diagnose and treat various diseases of the heart in children. Many pediatric cardiologists work with pediatricians to determine the best treatment strategy.

Pediatric pulmonologists diagnose, treat, and manage respiratory problems and lung disease.

Pediatricians Children and adolescents who have musculoskeletal disorders, such as juvenile arthritis and acute pain.

Pediatric nephrologists specialize in treating conditions that affect the urinary system, including urinary tract infections and kidney disease.

Pediatric neurologists treat and manage neurological disorders in children. Neurological conditions present in childhood can persist into adulthood. Pediatric neurologists take care of their patients from diagnosis to adolescence.

A case report in pediatrics is a pediatrician who not only provides medical care to children with acute or chronic illnesses but also provides preventive health care for healthy children. Pediatricians monitor the physical, mental and emotional well-being of children at both the stage of illness and health under their supervision.

Submit your journal of pediatric surgery case reports via Online Submission at: http://www.literaturepublishers.org/submit.html 

Or as an e-mail attachment to the Editorial Office at E-mail id: [email protected] 

For More Details Visit: https://www.literaturepublishers.org/journal/journal-of-pediatric-surgery-case-reports.html 

#journal of orthopedic case reports #case reports in pediatrics #journal of pediatric surgery case reports #case reports in Microbiology #Clinical Microbiology Case Reports #case reports in Genetics #Case Reports in Toxicity