some people don’t realize how big Ukraine actually is

My face is having uncontrollable spasms. Great. It hurts really, really, really bad.

I think part of why I have trouble explaining pain to the doctor is when they ask about the pain scale I always think “Well, if someone threw me down a flight of stairs right now or punched me a few times, it would definitely hurt a lot more” so I end up saying a low number. I was reading an article that said that “10” is the most commonly reported number and that is baffling to me. When I woke up from surgery with an 8" incision in my body and I could hardly even speak, I was in the most horrific pain of my life but I said “6” because I thought “Well, if you hit me in the stomach, it would be worse.”

I searched and searched for the post this graphic was from, and the OP deactivated, but I kept the graphic, because my BFF does the same thing, uses her imagination to come up with the worst pain she can imagine and pegs her “10″ there, and so is like, well, I’m conscious, so this must be a 5, and then the doctors don’t take her seriously. (And she then does things like driving herself to the hospital while in the process of giving birth. Probably should have called an ambulance for that one!)

So I found this and sent it to her. Because this is what they want to know: how badly is this pain affecting you? Not on a scale of “nothing” to “how I’d imagine it’d feel if bears were eating my still-living guts while I was on fire”. 

I hate reposting stuff, but I’ll never find that post again and OP is deactivated, so, here’s a repost. I can delete this later, i just wanted to get it to you and I can’t embed images in a chat or an ask. 

This is possibly why it took several weeks to diagnose my fractured spine.

Pain Scale transcription:

10 - I am in bed and I can’t move due to my pain. I need someone to take me to the emergency room because of my pain.

9 - My pain is all that I can think about. I can barely move or talk because of my pain.

8 - My pain is so severe that it is difficult to think of anything else. Talking and listening are difficult.

7 - I am in pain all the time. It keeps me from doing most activities.

6 - I think about my pain all of the time. I give up many activities because of my pain.

5 - I think about my pain most of the time. I cannot do some of the activities I need to do each day because of the pain.

4 - I am constantly aware of my pain but can continue most activities.

3 - My pain bothers me but I can ignore it most of the time.

2 - I have a low level of pain. I am aware of my pain only when I pay attention to it.

1 - My pain is hardly noticeable.

0 - I have no pain.

It’s also really important to get this kind of scale to people who have chronic pain, because chronic pain drastically lowers your perception of how “bad” any kind of pain actually is, and yet something like this pain scale is extremely user friendly. 

For example, if someone asked me how much pain I’m in at any given time, I’d say hardly any, and yet I’m apparently at a chronic 2.5, and it only goes up from there depending on the day. 

There’s also a similarly useful “Fatigue Scale”

I haven’t been below a 5 on this scale for 4 years 

Here’s the fatigue scale

Fatigue scale image desc:

10: can barely move; can’t talk

9: can barely move; can talk

8: can move, but can’t do much more than watch TV

7: can watch TV and play a game on my phone simultaneously

6: can do work on my computer lying in bed

5: can get around the house, but definitely couldn’t go out

4: can run a light errand

3: can get in my 10,000 steps, making my fitbit happy

2: can do three or more activities in a single day

1: going clubbing!

See also the Mental Health Pain Scale by Graceful Patient:

Mental Health Pain Scale transcription:

MILD

1 - Everything is a-okay! There is absolutely nothing wrong. You’re probably cuddling a fluffy kitten right now. Enjoy!

2 - You’re a bit frustrated or disappointed, but you’re easily distracted and cheered up with a little effort.

3 - Things are bothering you, but you’re coping. You might be overtired or hungry. The emotional equivalent of a headache.

MODERATE

4 - Today is a bad day (or a few bad days). You still have the skills to get through it, but be gentle with yourself. Use self-care strategies.

5 - Your mental health is starting to impact on your everyday life. Easy things are becoming difficult. You should talk to your doctor.

6 - You can’t do things the way you usually do them due to your mental health. Impulsive and compulsive thoughts may be hard to cope with.

SEVERE

7 - You’re avoiding things that make you more distressed, but that will make it worse. You should definitely seek help. This is serious.

8 - You can’t hide your struggles any more. You may have issues sleeping, eating, having fun, socialising, and work/study. Your mental health is affecting almost all parts of your life.

9 - You’re at a critical point. You aren’t functioning any more. You need urgent help. You may be a risk to yourself or others if left untreated.

10 - The worst mental and emotional distress possible. You can no longer care for yourself. You can’t imagine things getting any worse. Contact a crisis line immediately.

These are so important! SO SO IMPORTANT SHARE THIS AND SAVE IT TO SHOW YOUR DOCTORS!

This is the first time I’ve seen the fatigue scale, and HOLY MOLY that’s a revelation!!! These should be on all hospital and doctor office walls.

I’ve never seen the mental health one! or the fatigue one! I printed out the pain one and gave it to my GP. 

the “holding out as married” rule is so fucked up

like… not only can I not marry the love of my life without losing my health insurance and the $800 or so a month I’m forced to survive on

but I can’t even CALL her “my wife” casually

like literally the US gov’t has people whose job it is to go and interview the family, friends, & neighbors of disabled people to just make sure that they never refer to anyone in their life as “my wife” or “my husband” etc

and if you DO, then SNAP! You’re defrauding the US gov’t of the pittance you can barely survive on and you are no longer entitled to your disability benefits

(some kinds of benefits might remain in diminished form but if you were disabled before age 22 you are fucked COMPLETELY and can’t get them back even if you divorce… the only loophole is if the other person was ALSO deemed disabled before 22, because that fucking makes sense)

and this is just… legal and no one but disabled activists ever talks about this shit

so yeah I’d love some of that gay marriage shit but I will never be able to get married, and to add insult to injury, I can’t even casually refer to my partner as “my wife” without risking the health insurance and income I need to survive as a disabled lesbian

this is what we mean when we say the USA does NOT have marriage equality yet

Happy Holidays from the Holiday Boar

Christmas/Holiday Boars have always been a thing but it still blows my mind that people choose my Holiday Boar to celebrate. Thank you for all the love, Stay safe and Happy Holidays!

I love the Holiday Boar!

https://t.co/tQNM37KsB0

Santa is on strike due to global warming.  All presents this year will be delivered by Sasha the Christmas Tiger.  Milk and cookies may not be sufficient.

“MUST BRING PRESENTS TO GOOD CHILDREN”

“Yes good”

“AND EAT THE BAD ONES”

“Wait no”

“EAT THEM”

“sasha no”

@burstofhope the Christmas tiger is watching

She is making a list

It is not easy with her paws but she is making it

shes almost here

Okay fine this is the ONE Christmas thing I will reblog before Thanksgiving BUT THAT’S IT

SASHA’S BACK ON MY DASH!

Y’all better behave, you have two months

You better watch out

You better watch out

You better watch out

Sasha!!!!!!

…ok how can I get my family on board so this is my nephews’ Christmas tradition, because that would be fuckin’ rad

“oh, Santa? yeah ok, sounds fake. I get visits from Sasha the Christmas Tiger and my continued existence is proof that I’m excellent. you just have a magic grandpa that’ll cave and give you stuff regardless”

As some of you may know, one of my go-to day dreams for self-care is thinking about building a small farm/homestead, growing my own food, and living a simpler life. 

Well I have a new one I’ve been ruminating on as an escape and it entails the fantasy outpatient clinic I would have. Now this is definitely never going to happen because I want to be a hospitalist and never own my own clinic but this is what it would entail:

The building would have my OBGYN clinic and a pediatrics office sharing the same space. There would also be an on-site day care to provide child care for all of the employees and patients would be able to drop off their kids or their non-sick kids and go to their appointment whether that’s on the OBGYN side or the peds side so they can be present without having to wrangle their kids during the appointment or figure out child care. Kids will be able to play PG video games, play with play-doh, do arts and crafts, play board games, or watch movies.

There would be three social workers within the building and at least one clinical psychologist, but likely more than just one. There would be a victim’s advocate nutritionist, and a lactation consultant available. There would be a small pharmacy stocked with common medications that can be challenging to get filled elsewhere (abortion medications, suboxone for pregnant patients prescribed by MFM etc.) and lactation rooms with little fridge lockers so people can store it during the day and know it’s secure. There would be two conference rooms where breastfeeding, birthing, diabetes education, and other classes would be provided on Wednesday evenings and Saturdays.

On the OBGYN side every employee would be female, there would be at least two large, full-service procedure rooms where we can do MVAs, LEEPs, cones, endometrial biopsies, colposcopies, etc. The gowns would be kept in towel warmers so they’ll be warm when patients put them on. The jelly for the speculums will be warmed. In the bathrooms there will be different colored pens so if someone is being abused or needs help they can write their names on pee specimen cups in a different color. There will be mammograms offered on site and they will use the special heated panels that are more comfortable and less painful for patients and there will be a full ultrasound suite for GYN and OB ultrasounds. An MFM doctor will be in the office as well as a genetics counselor and we’ll be accredited to do all OB ultrasounds except fetal echo. We will also have gyn-oncologists working in this office for patients with cancer, who will have a separate waiting room for safety/protecting the immune-compromised. There would be a separate waiting room for patients who have experienced a pregnancy loss or are in need of a hysterectomy so they won’t need to see or hear children in the waiting room of the pediatrics office. The office will offer LGBT friendly services and support.

There will be phlebotomy services for both clinics so patients can have their blood drawn at the clinic instead of needing to go elsewhere. There will be an XRay machine for the pediatrics office.

The pediatrics office will require (and the OBGYN office with regards to covid, flu, shingles, and pneumovax for older people) patients to be fully vaccinated, the OB office will not take on patients who do not intend to vaccinate themselves or their unborn children. There will be a fun children’s play area and after each visit, instead of stickers or candy, the kids can pick out an age-appropriate book to take home with them that we will buy from library sales, dollar stores, or thrift stores or receive as donations from the community. 

As for how the employees will be taken care of, they will receive full benefits and fair salaries based on their experience level. Everyone will only work three days a week but we’ll be open on Saturdays and until 8pm on Wednesdays. One day a week, lunch will be provided for all employees who are working that day and dinner will be provided for those working late on Wednesday. The meals will be chosen by the nutritionist to promote wellness There will be an area with free snacks (again chosen by the nutritionist) that are for all employees or for patients who may need them (low blood sugar, etc.) and there will be a small food pantry for patients or employees who are food-insecure. 

The day care will provide free or low cost childcare to all the employees and lactating employees will have time to pump or go breastfeed their child at the day care center throughout the day as needed. Employees will be provided with free or discounted gym memberships to a gym in the local community to promote wellness. Therapy will be fully covered under whichever insurance plan we offer. Employees will also be invested in the company and receive profit shares quarterly if the clinics are doing well, this way the employees are invested in providing excellent service and will want to ensure staff are properly trained and being professional and are willing to go above and beyond to serve our patients and community. All employees will be required to complete trauma-informed care training and be fully vaccinated. Employees will have 12 weeks of paid parental leave and one month of PTO for sick time or vacation. Employees will be encouraged to take sick time if they are sick as it’s rude to come infect their colleagues or patients, employees will be encouraged to take mental health days.

There will be hospitalist OB providers and office providers who work in the hospital to do OB care and deliver patients. Office providers (depending on how many we have) are expected to do at least 21 call days a year 8 of which must be weekends (pediatricians will be expected to take more call because there are no hospitalist pediatricians in this clinic), holidays will be covered by either the hospitalists or locum providers or anyone who wishes to cover, they will receive generous bonuses if they volunteer to work holidays.

Each provider would have their own office so they can do telehealth appointments or give bad news privately and just to have their own space. All employees would have the same professional looking scrub uniform but be designated by color (black scrubs for the doctors, blue for nurses, forest green for front desk and office support staff, etc.). It will have the clinic logo on it and be embroidered with everyone’s names. Each staff member will be given 5 free uniforms, and free replacements when they turn in a damaged set. Patients who are pregnant will be given free upsized shirts or pants as they grow. Shoes need to be tennis shoes but can be whatever the employee wants.

Obviously this would never be attainable in the US especially under our current system but it’s a fantasy day dream for a reason. Right now this is what is helping me get through the days.

Oh my god reading this post felt like getting a scalp massage at some boutique spa, the level of emotional burden that it lifted.

And I’d get to do guideline reviews and teaching. Ahhhh!

For those of you who don’t have diabetes, this is sort of what life is like for those of us on insulin:

Imagine driving a car that has a one hour lag between when you turn the wheel and when the car starts actually turning, and imagine that everytime you make any little adjustment it will continue to effect the car’s direction for over three hours.

Plus imagine that:

a.) you can only look up at the road when you stab one of your fingers until you physically bleed OR

b.) you can look up about every 5 minutes, but what your looking at has a 10 to 15 minute delay (and sometimes you just go randomly blind because you were sitting weird or something) AND -for those of us in the US at least- you have to pay a ridiculous amount of money just to have the privilege to be able to see the road.

In addition to all that, imagine that you can never stop driving- you can’t pull over, you can’t stop when you are sleeping or having a bad day. You can’t stop just feel like you need a break. You have to keep the car on the road or you die.

As a med student I’ve seen some other students and even some doctors be very judgemental about how people handle their chronic illness. Some people will assume that people who are struggling are just lazy or stupid. But unless you live with it every minute of everyday, you have no idea how exhausting and challenging it really is. Please be kind, please be supportive we’re all just trying to keep going, however we can.

Keep reading

omfg that is just too adorable

This will always be one of my favorite comics ever. It gives me warm fuzzies~

This is the most perfect.

This kitteh having a little halloween adventure is one of my favourite posts of all time :)

Every fall like clockwork this photo set pops up and we all must reblog it

I remember being a kid and seeing this comic…. And every year without fail i see it every Halloween. It genuinely makes me happy that the kitten got to learn how Halloween isn’t all scary… Especially if there’s someone there to enjoy it with you.

I hope everyone are logging this post has a happy Halloween with someone they love

What if we started actively disincentivizing landlords letting real estate stay empty rather than renting at reasonable prices? Like, give them a maximum of three months to get a new tenant in, and then they start accumulating fines for the unused space.

And some similar system to disincentivize the ridiculous airbnb market as well. Make it unprofitable to have homes sitting empty in a city where people with jobs find themselves living in tents. Hell, make it unprofitable to have homes sitting empty anywhere that has a homelessness problem.

The fine? The full rent amount they're asking for. You think $1700/month for a studio apartment is reasonable? Well, until you get someone into that apartment, you're going to be fined that same sum every month.

For Airbnb, a lower cost, but still based on how many nights/month the space is unused, and the fine will be based on the asking price per night.

This is... really, really sensible.

nautical history friends help

there’s a glass thing aboard wooden whaling ships where it’s like a little crystal they put in the ceiling to let light in belowdecks

what the fuck is it called

it looks kind of like this

???

Deck prism!

#they’re so amazing

YES! THANK YOU SO MUCH!

Sure thing! I remember being so surprised at HOW much light they brought into a space, when I first saw them in action.

[ID: photo of closely clustered ship bunks, lit by an overhead prism. /end ID]

The yellow light is artificial but the blue is from the deck prism, on a cloudy day.

Ok…. okay so they look like Sunstones from Dinotopia. And I love that so much now

@jamesgurney

healing series 31.08.2019

new sound effects to replace the [BWAH] [BWAH] sound in tainted love:

im so obsessed w/ this post i had to make it Real

FUUUUUCK YEAH!!!!!!!!!!!!!!!

I'm having trouble sharing the video, so have a link.

Great video on pediatrics being an "easy" specialty.

The line about our health care system valuing an appendectomy over treating a teenager with depression gave me all the feels, especially with the current climate where the health of children continues to feel like it's taking the backseat to the wants of adults (ie acting like the pandemic is over and refusing to mask despite the vaccine not being available to children under 12, and don't even get me started on the mess that is Texas right now).

Science Posters

Kelsey Oseid on Etsy

Anyone else totally desensitized to the delta variant with a side of futility or is it just me. Im wearing my mask and stuff but the scale of the horror of it is just lost on me now

I heard "delta spreads as fast as smallpox" and felt nothing

Yeah yeah, it's a plague, we get it, we know the drill.

Never thought I’d be so used to crippling, blinding existential fear

“The variant is spreading and causing blindness and…” yes yes yes I’m doing all I can please do talk to someone else who isn’t