My 3.5 yo is definitely going through the change in sleep patterns that happens around 4 months. Went from falling asleep easily STTN with just a couple of quick feeds to basically awake every 1-2 hours and hard to get to sleep, so my stretches of sleep are very short. We did Ferber with my first at just under 5 months and it worked like a charm but I don’t think I’ll make it another month like this. I really don’t think I can safely drive a car with this level of sleep deprivation and it’s only been a few days. Obviously I’m trying to nap with the baby during the day and get help when I can, but is there anything I can do prior to being ready to sleep train to help the baby sleep better? We already try to do minimal intervention to get him to sleep (most of the time just pacifier and maybe some rocking the crib or my hand on his chest) but he still wants to nurse every time he wakes up.

I passed the FNP exam with ANCC!!! I’m honestly still riding my emotions. 🥹💙😭 I wanted to share what I used as my study materials. They were either helpful or not helpful. Please do understand that this is just based on my views of the study materials. Everyone has their own different experiences and opinions. I studied for 2 months before taking my exam.
Note: I have 7 yrs of experience as a RN primarily in cardiac ICU and oncology.
Study Materials 1) UWorld Q-bank (Not helpful) 2) Leik Book (Helpful & recommend) 3) Sarah Michelle 1 Day Crash Course (Not helpful) 4) ANCC/ANA Practice Exam (Helpful & recommend)
*UWorld Q-bank: I used UWorld back when I prepped for the NCLEX so I was stoked when I found out they recently launched a FNP Q-bank. UWorld is good for those who don’t want to read through a textbook. The questions are accompanied by very thorough rationales. However, I felt like the rationales did not focus too much on treatment plans or pharmacology. It was great at explaining pathophysiology. But when it came to treatment, there would be phrases like “This disease will need medical treatment or this infection will need antibiotics.” It wouldn’t go into depth as to what medications would be recommended or prescribed. With UWorld, the questions were also very lengthy and did not correlate much with the format of the ANCC exam. There is a category for professional practice/ethics, but it had maybe less than 40 questions.
*Leik Book: An upperclassman recommended Leik to me as a study tool. I purchased the e-book version which did not come with the Q-bank. Leik was very thorough and helpful. I liked that the rationales included medications that would needed to be prescribed or recommended. The book also had tips and pointers along the way such as “this may be a possible ANCC or AANP question/topic.” Leik also explains the difference between ANCC and AANP questions which I found was super handy as testing strategies. At the end of each chapter were knowledge review questions which were either 10-40 questions long. There are also 2 practice exams at the end of book.
*Sarah Michelle 1 Day Crash Course: I know a lot of students swear by Sarah Michelle courses. I enrolled for this course 1 week before my exam date. This is a rapid course that covers all the body systems with 2 instructors. The course provided a study guide for the students to follow along. I don’t know if it’s the ICU nurse in me, but I felt the outline and organization of the session was very hard to follow. One minute we would be reviewing a question about GI and the next question would be about cardiac or endocrine and then back to GI. Alot of students mentioned in my session they would have preferred if it was structured to be 1 system with all the questions instead of jumping around too. But information wise, this review session does not go into full details. If you want to know about the explanations for diagnosis, interventions, and treatment/management, this review is not for you. This was a rapid fire question review session. A lot of the times, the instructors referred to alot of mnemonics which I was not familiar with. I’m assuming they were covered in the regular SM courses.
*ANCC/ANA Practice Exams: My advise… don’t freak out about the topics that were on the practice exams lol. I bought the practice exam to familiarize myself with the formatting of the questions. You wont need to know things like reportable diseases (which scared me because I did not study that at all). But the ANCC exam did similarly follow the practice exam format. I definitely felt less stressed as I was taking the FNP exam. The questions are more theory based than clinical base. But having studied mostly clinical scenarios, you can pretty much narrow your options down to 2 answers.
I hope this post helps everyone who will be taking their boards! Remember to breathe!

Uncommon opinion: care plans aren’t a thing for students to complete because it’s a nursing degree intervention, but rather so students have a better understand of the process to a complete recovery for patients rather than just the role as a nurse.
I hated them as well, but looking back - I get why we did them.

This thread is about to be very long, and I will be adding to it frequently, but this is how I would write season 3 of Euphoria since Sam is obviously preoccupied with god knows what. This came to me in a dream so call it fate ig.
Background- since season 2 ends with the card that Rue stayed sober through the rest of junior year, and Lexi’s play takes place in the spring, I thought it’d be best to pick up on the first day of their senior year in the fall. This means that Cassie, Maddie, and Nate have all graduated, leaving us with Rue, Jules, Lexi, Elliot, Bobbi, Ethan, BB & Kat. Also Gia, the Parents, and Ali. Anyways here goes.
Episode 1- I Stayed Sober (Mostly)
[Scene 1]: The Last First Day Episode One opens with a black screen that has flashes of red and blue, like police sirens, that increasingly become more intense and vibrant, to indicate Rue coming out of a dissociative state. She narrates over the screen:
“You want to know the worst part about staying sober? It’s not the withdrawals or the cravings, even though they’re pretty fucking bad. It’s not even the depression or the emptiness you feel without your poisonous security blanket protecting you from your worst thoughts and emotions. The worst part about staying sober, is that you’re trapped back in the fucked up world that made you want to do drugs in the first place”
The red and blue screen shifts to police sirens with cops yelling in an attempt to evacuate everyone from the school. It’s raining and the sky is gray and muddy. All the students are now wearing muted uniforms in the school colors, blue black and white (the uniforms are explained later) The scene looks very muted and drained. As the students flood out of the school in a frenzy, we see Rue and Lexi standing at the exit, uninterested in the theatrics and significantly changed from last season.
Rue has a brighter disposition to herself, appearing more soft and bright, while keeping her moody demeanor. Her look shows that she is trying her best to be more optimistic, despite going through hell from her plethora of mental illness that have now taken over due to her sobriety. Still, she looks healthier and brighter.
Lexi, on the other hand, has a more goth like appearance. In addition to her new dark black hair with red colored streaks (red to signify her stepping into her power) she also looks less approachable with more gothic motifs such as skulls and roses on her increased accessories. We learn later that this is an attempt to reinvent herself after last year’s play incident and fez dying. She seems uninterested and annoyed, but has a more confident air after being put in the spotlight and no longer having to live under her sisters shadow. She has become more monotone, speaking her mind and embracing her realistic perspective of life.
They begin walking to the parking lot, looking for Lexi’s mom among the waves of chaotic students pushing past them.
Rue: Of course, just our fucking luck that someone decides to shoot up the school our first day of senior year.
Lexi: It wasn’t even a real shooting. I heard some kid brought a gun to show off and got tackled by his teacher. Everyone started freaking out, and now I’m missing the first day of my AP English class.
Rue: Not like you need it. I think you proved that you can write a good story that makes waves and changes lives (sarcasm)
Lexi: 😐 that’s not funny Rue. That play is all anyone could talk about all summer. Everyone hates me because they think it’s my fault that we all have to wear these stupid uniforms.
Rue: actually that was Cassie’s fault, that fight got a new edit every week. My favorite was the #mollywhop dance (starts doing a dance that is significant of Maddie slapping Cassie and Cassie riding a carousel)
Lexi: Rue I’m serious. I got so sick of living in the background that I put my entire life on display in front of all of East Highland just for my sister to make everything about her.
Rue: Well good writing is supposed to be controversial. And take it as a victory, at least you’re not a nobody anymore.
Random Guy: Hey Lexi, I got a horse you can ride (does the dance)
Cop: Keep it moving sir!
They get to the end of the parking lot and sit on the pavement.
Lexi: 🙄of course she’s late.
Rue: hey, it’s a new year. You’re no longer the girl whose sister was the hottest cheerleader in school and I’m no longer the resident drug addict that everyone is waiting to die.
Lexi: you’re right. That’s Elliot. Or Jules. Have you checked on either of them since his overdose?
Rue: no…fuck them both. They seem happy in their stupid relationship with their stupid anniversary posts. I had to block them both before I killed myself or worse. They can die for all I care.
Lexi: well he almost did. I heard he had a stroke and is in a wheelchair until he learns how to walk again.
Rue: trying to hide that she’s concerned really?…i mean i don’t care, but that’s what he deserves right? Can’t do drugs that carelessly without consequences. Ask me how I know.
Lexi: I don’t think anyone deserves to OD. I hope he gets some help.
Rue: he has help, that bitch is playing housewife which she probably loves. Attention seeking whore. You know I’m sick of talking about Jules and Elliot and Cassie and every other narcissist with a victim complex that keeps trying to make themselves the main character. pulls her closer with a shoulder hug this year it’s about us. Starting over and getting a chance to finally make it out of this stupid town. You have colleges lined up at the door and I’ve been sober for almost a year. No one is going to take this year from us. That why you blocked Cassie, and that’s why I had any memory of Jules permanently erased from my brain. Out of sight out of mind.
Lexi: I guess you’re right. New year, new us.
Rue: alright. Now call your mom so we can get out of the rain. I hate cops more than I hate being fully clothed and wet.
Lexi: (finally smiling) almost as much as they hate you
Rue: hey fuck you, I still have to go to court for that.
Lexi: too soon? 🤭
Rue: just dial the fucking phone
Rue [vo while it shows Suze driving up and the girls walking across the parking lot]: Despite how terrible last year was, I feel like Lexi and I finally got back to how things used to be. Before the drugs, before the funerals. Just Rue and Lexi like it’s always been. Sometimes I forget how great life was when I was just a kid. But drugs tend to take away everything that makes life, life. I just wish Fezco had stayed alive long enough to finally see me sober. Then maybe Lexi wouldn’t be so serious and emo these days. But she took care of me, and now it’s my turn. I just don’t know what’s worse, losing the love of your life before you get a chance to say it love you (shot of Lexi rubbing a cross chain fez gave her looking at the sky before getting in the car) or thinking you found the love of your life just to end up as strangers. (As Rue opens the door to get in, she sees Jules wheeling Elliot across the parking lot. She stares for a bit before getting in the car.) Either way, we all died. (Rue gets in the car before Jules can see her.)
Jules looks over at the car but doesn’t see anyone. She looks distraught, hoping to catch a glimpse of Rue, who she hasn’t seen since the play. She’s dressed in a mostly black school girl uniform with a short skirt and corset that she’s clad in neon accessories and coquettish garters and bows. Her hair is longer than in season 2 but shorter than season 1. This is to signify that she’s embracing her femininity more with Elliot, but is stepping into a more powerful, dominant version of femininity. She’s content with her relationship, and rebuilding herself after the abuse she endured in relationship with rue. Now she’s just worried about repeating the same story with Elliot. She looks off into the distance, paused in a state of reflection.
Elliot: babe are you good? Jules: what? Yea just thought I saw something. (Continues wheeling him across the parking lot) Elliot: It was probably a ghost. HEY CASPER, LOOK BUT DONT TOUCH HOMIE Jules: (laughing) you’re so unserious Elliot: what do you mean? I’m serious. I don’t want his ectoplasm fucking up your makeup. Jules: You’re the one who keeps fucking up my makeup Elliot: and I’ll do it again kisses her winces ow fuck Jules: relax dude. You know the doctor said you can’t stretch your spine much after your stroke. Elliot: and you know I told that doctor nothing can kill me and I’m basically a god Jules: even when you’re sick you’re still crazy Elliot: crazy for you Jules: yea yea, just be happy it was a stroke and not a death sentence. whispers in his you know if you would’ve died I would have to kill you. Elliot: besides the fact that that makes zero sense, you know it wasn’t my fault Jules: I’m just glad that Laurie lady got put behind bars. Who the fuck puts fentanyl in Weed? Elliot: a plug who can’t find enough junkies to buy their fentanyl. That’s why I always sniff my weed before I smoke it. Jules: and that sniff put you in a wheelchair, so who’s god now? Elliot: mmmm, still me. I live close enough to the school that I don’t have to pay for a van, and I have a hot chick with a huge dick as a nurse. Not to mention loads of settlement money from suing the biggest plug in our area and a med card with all the unlaced weed I can smoke. I’m up as fuck. Jules: or too high to be traumatized Elliot: And (dances her around his chair like a waltz until she falls in his lap) my dick still works. Jules: nice try Romeo, but your ego is showing (zips up his pants and continues pushing) Elliot: fuck, has it been like that all day? That’s embarrassing Jules: no more embarrassing than the whole school thinking you’re in a wheelchair because you couldn’t hold your oxys Elliot: it was Percs actually, thank you very much. And fuck what those bots think, I’ve been sober since that intervention. I guess you can say Rue knocked some sense into Me. Jules: (avoiding the topic of rue) did you see the comments on our last post, they called us percinstein and the coke bride Elliot: damn I guess they did know it was Percs (Now on his front porch)
Jules: (standing in front of him looking in his eyes with sentiment ) Elliot I’m serious. I’ve been the topic of conversation ever since I moved to this fucking town. I just want to have a normal year for once in my complicated life. Elliot: babe listen it’s high school. Everything is the topic of conversation and no one is normal. People talk shit because they’re bored and have no personality or sense of self outside of the useless drama they can create in their minds. But you have a life, and a future. You have an amazing, sober boyfriend who loves you and a portfolio that can get you into any art school in the world. You’re at the last step before your real life begins. I’m just happy that I have the privilege to watch. And you know I like to watch. Jules: you’re a lunatic. Elliot: I love you. Jules: I love you too. kiss
Elliot: Are you sure you can’t stay tonight Jules: I wish, but my dad is serious about making sure I get into the best school, which means spending hours look at boring virtual tours and applying early admission. Elliot: ok well I’ll be here figuring out how to pee without standing up Jules: how do our conversations always center back to your dick Elliot: I can’t talk about anything else, it’s too hard Jules: wow, you sound like my dad and I’m turned off [starts walking away] Elliot: it’s not me it’s the weed. now you make sure you make it home safe. There’s a shooter on the loose. Jules: [grabbing her bike] the gun wasn’t even loaded. besides, getting shot would not be the worst thing to happen to me. Elliot: you’re American. It always gets worse. Jules: [riding off] that’s depressing Elliot: text me when you’re home Jules: [almost gone] you have my location! Elliot: [to himself] and I still never know where you are

I‘be been out of EMS for more than 20 years. The last big trend we had in BLS airway management was combitubes, and the last big thing in ALS were the studies being done with RSI. Has anything interesting evolved in “the future of airway management” since I’ve been away?
I became a psych nurse, doing primarily mobile crisis intervention. Same basic idea as EMS; stabilize in field and transport, only with psychotherapeutic measures and psychiatric drugs instead of all the cool stuff I got to play with in EMS.
Also, the last big thing in ACLS was that the world supply of Bretylium was drying up, what ever happened with that? There were several candidates for new drugs.
Other questions: do we still do manual CPR on long hauls or did they ever come out with a simple device to deliver high quality chest compressions?
Anything new in trauma? Did they ever come out with anything better than the flexible splint like a pneumatic mechanism, or is it still the gold standard?
Cric kits: issued to medics or no?
Did EMT-Bs ever get to start using pulse oximeters? (I’m pretty sure the answer is yes!) If so, when?
Did they ever settle the fentanyl vs. morphine debate?
Do ALS units still carry meperidine? Does anybody new to EMS even know what meperidine is?
Are BLS providers carrying naloxone intranasal? What about intramuscular? What about ALS?
Oh god, the flood gates are open. I have so many more. I haven’t even thought about this in twenty plus years, and I’d rather hear from humans than GPT at this point.
Thanks ahead of time!

Sorry if this sounds selfish but this is really only a one time thing for a friend. I need someone to use there undetectable AI account to paraphrase this please.
IntroductionThe rise of fast food chains in the United States from 2000 to 2010 had an impact on both the culture and economy. This period saw an increase in obesity rates among Americans, which coincided with the growth of these eateries. In this essay we delve into the connection between the expansion of fast food franchises and the obesity epidemic examining factors that influence health. Through an analysis of data, health studies and relevant literature our goal is to provide an understanding of how consuming food has played a role in fueling obesity during this particular decade, in America.The Growth of Fast Food Chains
Between 2000 and 2010 there was a rise in the fast food industry. Popular chains such as McDonalds, Burger King and Subway expanded their reach by opening stores to meet the demand for budget friendly meals. Data from the U.S. Census Bureau shows that the number of fast food eateries increased by around 20% during this timeframe (U.S. Census Bureau, 2011). This expansion made fast food more convenient for a range of people, including kids and teenagers.
Obesity Trends in the U.S. (2000 2010)
The prevalence of obesity in America has been on a trajectory during the early years of the 21st century. According to the Centers for Disease Control and Prevention (CDC) the rate of obesity among adults rose from 30.5% in 2000 to 35.7% in 2010 (CDC, 2011). Similarly among children and teens aged between 2 and 19 years old obesity rates increased from 13.9% to 16.9% over that period. This continuous increase signals a concerning public health issue with impacts on illness rates, mortality rates and healthcare expenses.
The Impact of Fast Food, on Eating Habits
food is commonly known for its levels of calories, excessive saturated fats, sugars and sodium with little nutritional value. These aspects of food are closely associated with weight gain and obesity. Studies show that regular consumption of food is linked to consuming calories and maintaining poor eating habits (Bowman & Vineyard 2004). Research conducted by Pereira et al. (2005) revealed that individuals who ate food than twice a week were more likely to gain weight and develop insulin resistance compared to those who consumed it less frequently.
Influence of Socioeconomic Factors
The easy availability and affordability of food make it an attractive option for people with incomes. Fast food establishments are often concentrated in low income areas where residents have limited access to dining choices (Powell et al. 2007). This situation, referred to as "food deserts " , worsens the issue of obesity because disadvantaged groups tend to rely on food as their main source of nutrition.
Impact of Advertising and Promotion
The aggressive advertising tactics used by fast food companies also have a significant influence on eating behaviors particularly among young individuals, like children and teenagers.
Many businesses invest sums of money each year in marketing showcasing their products across platforms, like TV, the web and social networks. Kids are especially influenced by these strategies that highlight the appeal and ease of food reinforcing harmful dietary patterns early on.
The impact of obesity, on health is significant and variedObesity is a factor in chronic illnesses like type 2 diabetes, heart disease, stroke and certain cancers (Flegal et al., 2012). The rise in obesity rates has led to an increase in health issues putting a strain on the healthcare system. The financial implications of obesity are also noteworthy with studies indicating that medical costs linked to obesity made up around 10% of healthcare expenses in the United States during that time (Cawley & Meyerhoefer 2012).
Policies and public health effortsIn response to the escalating obesity crisis, different policies and public health efforts have been put into action at state and local levels. These initiatives aim to encourage eating habits through measures like food labeling requirements, restrictions on advertising foods to children and campaigns raising awareness about the risks of obesity (Koplan et al., 2007). Schools have been a point for intervention well, with endeavors to enhance the nutritional value of school meals and boost physical activity among students.ExamplesVarious real life examples and stories showcase the effectiveness of taking action to address the issue of obesity. For example, New York City put in place a set of strategies to combat obesity, such as displaying calorie information on menus and prohibiting trans fats in restaurant dishes. These initiatives led to improvements in people's eating habits and a slight decrease in obesity levels, within the community (Dumanovsky et al. 2011).ChallengesThe obesity epidemic still poses challenges despite the efforts to address it. Unhealthy eating habits deeply ingrained in society, the presence of the fast food industry and disparities in status all add layers of complexity to this issue. Moving forward it is crucial to focus on creating an environment that encourages choices for vulnerable communities. This entails advocating for policies that restrict the marketing of foods to children, enhancing access to options in low income areas and urging food companies to improve the health profile of their products.
Psychological marketingWhen it comes to food marketing companies go beyond advertising tactics by leveraging deep rooted psychological triggers that influence consumer behavior. Bright colors, catchy tunes and recognizable mascots are commonly used in food ads to build a memorable brand image. This technique is particularly effective with audiences like children and teenagers who're more susceptible and likely to develop lasting brand loyalties. Research indicates that exposure to these advertisements can lead children to prefer calorie, nutrient foods ultimately impacting their dietary decisions and contributing to weight gain (Boyland & Halford 2013).The impact of portion sizes
One overlooked but significant factor contributing to the obesity crisis is the increasing sizes of portions served by food chains. Over time portion sizes have substantially grown, with meals exceeding the recommended calorie intake for a single meal. Young and Nestles (2002) study reveals that fast food item portions have expanded over the years with some items now more than double their size. This phenomenon of "portion distortion" results in calorie consumption as individuals tend to eat when faced with larger servings often underestimating the actual caloric content.
Changes in lifestyle and time constraints
The contemporary way of life characterized by schedules and time limitations has also played a role in the heightened dependence on fast food. With an increase in dual income households and longer work hours many people find themselves lacking the time to cook meals. Fast food emerges as a solution offering cost effective options that align with busy routines. Nonetheless this convenience comes at a price as frequent consumption of food is linked to dietary patterns and increased calorie intake contributing to the surge in obesity rates (Smith, Ng & Popkin 2013).Another significant measure involves restricting the promotion of foods to children. By reducing kids exposure to food ads policymakers aim to lessen the impact of marketing on their eating habits. Some cities have also imposed taxes on beverages and unhealthy foods in an effort to discourage consumption through penalties. While the effectiveness of these strategies may vary they mark progress in combating the obesity crisis.
Approaches Rooted in Communities
Community based strategies for addressing obesity highlight the importance of initiatives and grassroots movements. Programs that concentrate on enhancing access to foods encouraging activity and educating community members about healthy eating have shown positive outcomes. For example community gardens and farmers markets can offer produce to residents living in areas with access to healthy food options promoting better dietary choices. Schools and community centers can also play a role by providing nutrition education and physical activity programs.
The Impact of Technology
Technology has increasingly become an asset in the battle against obesity. Mobile applications and wearable gadgets enable individuals to monitor their calorie intake and exercise levels offering feedback and motivating lifestyle choices.
Furthermore social networking sites can play a role, in advocating for public health initiatives and sharing details on diet and wellness. Although technology isn't a solution to the issue of obesity it provides avenues to involve people and groups in embracing healthier habits (Stephens & Allen 2013).
Future Directions and Recommendations
The approach to tackling obesity needs to be multi-faceted and should involve collaboration between government departments, health workers, local communities, as well as the food industry. In future, there is need for more efforts in creating an atmosphere that supports healthier selections particularly among the disadvantaged groups. This means that one should continue to campaign for policies aimed at reducing children’s exposure to unhealthy food advertisements, improving availability of healthy foods in deprived neighborhoods and encouraging manufacturers in the food sector to change their products into a healthier version.
Further still public health campaigns will try and focus on having balanced diets regularly done exercises. Schools and offices can succeed by developing well-structured meals alongside opportunities for exercising. More research is also needed to understand why some people are poor eaters or overweight than others.
Policy Proposals
To further combat the menace of overweight, policy makers should think about enacting a variety of evidence-based strategies. Some of them could be: Sugar-Sweetened Beverage Taxes: Taxes on sugary drinks can decrease consumption and raise funds for public health projects. Zoning Regulations: By controlling the number of fast food restaurants in given areas, intake will subside and encourage establishment of grocery stores among other healthier alternatives.Menu Labeling Laws: This makes sure that restaurants indicate calorie counts as well as other nutritional information to assist customers in making informed choices. School Nutrition Standards: Schools meals and snacks in the course of learning ought to meet recommended nutrition levels so that students are eating healthy. Addressing Behavioral FactorsBehavioral interventions also play a significant role in dealing with obesity. Cognitive-behavioral therapy (CBT) and other psychological approaches aid individuals to develop better eating habits and deal with triggers involved in overeating. Programs addressing weight control which incorporate behavior change counseling together with diet and exercise components show promise towards helping individuals achieve successful long term weight loss.Long-Term Commitment and Sustainable Change
Society must collectively make a commitment that will last over a long period to reduce obesity rates. The approach should be ongoing and flexible enough to accommodate changing circumstances and new information. For this change to be lasting, there must be continuous investment in public health infrastructure, research, and education. Therefore, significant strides can be achieved in reducing obesity rates by nurturing a culture that appreciates wellness.
Cultural Shifts and Public Perception
In addressing the obesity epidemic another critical factor is shifting public opinion as well as cultural norms with regards to food and health. The acceptance of fast food and oversize portions as normative has been one of the major drivers towards unhealthy eating habits over the past few decades. This would involve public health campaigns focused on what constitutes healthy balanced meals and promoting on good home cooked fresh meal benefits instead. To change public perception cooking classes nutrition workshops media campaign advertising preparation advantages of healthy meals at home for instance.
Strengthening Health Care Interventions
Routine screenings, counseling and support for weight management by health care providers are crucial in handling obesity. Obesity prevention and treatment should be integrated into primary care to ensure consistency and comprehensiveness in people’s health. Personalized advice can be availed by the healthcare practitioners and also set realistic targets as well as referring patients to dietitians or structured weight loss programs.
Advancing Research and Use of Proven Practices
To better understand the intricate contributors to obesity and curate effective interventions, it is important to sustain research. Longitudinal studies that follow diet patterns, activity levels, and disease outcomes offer useful information on how to prevent or reduce obesity. By exploring behavioral, environmental and genetic factors that affect obesity, this will enable us to make interventions that are specific for different populations and situations as well.
Conclusion
The period between 2000 and 2010 registered a sharp increase of obesity rates that is closely linked to the spread of fast food outlets across America. This public health menace can only be fought with multidimensional approaches that will change public attitude, improve education, enhance corporate accountability and support inclusive research plus health care interventions. By creating an environment where good health is appreciated through provision of necessary resources and support, we can achieve significant milestones in curbing cases of obesity within our population as well as overall improvement in their welfare.
Citations:
Boyland, E.J. & Halford, J.C.G., 2013. Television advertising and branding. Effects on eating behavior and food preferences in children. **Appetite**, 62, pp.236-241.
Brownell, K.D. & Frieden, T.R., 2009. Ounces of prevention—the public policy case for taxes on sugared beverages. **New England Journal of Medicine**, 360(18), pp.1805-1808.
Drewnowski, A. & Specter, S.E., 2004. Poverty and obesity: the role of energy density and energy costs. **American Journal of Clinical Nutrition**, 79(1), pp.6-16.
Krieger, J.W., Chan, N.L., Saelens, B.E., Ta, M.L., Solet, D. & Fleming, D.W., 2013. Menu labeling regulations and calories purchased at chain restaurants. **American Journal of Preventive Medicine**, 44(6), pp.595-604.
Ogden, C.L., Carroll, M.D., Kit, B.K. & Flegal, K.M., 2014. Prevalence of childhood and adult obesity in the United States, 2011-2012. **JAMA**, 311(8), pp.806-814.
Smith, L.P., Ng, S.W. & Popkin, B.M., 2013. Trends in US home food preparation and consumption: analysis of national nutrition surveys and time use studies from 1965-1966 to 2007-2008. **Nutrition Journal**, 12(1), p.45.
Stephens, J. & Allen, J., 2013. Mobile phone interventions to increase physical activity and reduce weight: a systematic review. **Journal of Cardiovascular Nursing**, 28(4), pp.320-329.
Story, M., Kaphingst, K.M., Robinson-O'Brien, R. & Glanz, K., 2008. Creating healthy food and eating environments: policy and environmental approaches. **Annual Review of Public Health**, 29, pp.253-272.
Walker, R.E., Keane, C.R. & Burke, J.G., 2010. Disparities and access to healthy food in the United States: A review of food deserts literature. **Health & Place**, 16(5), pp.876-884.
Young, L.R. & Nestle, M., 2002. The contribution of expanding portion sizes to the US obesity epidemic. **American Journal of Public Health**, 92(2), pp.246-249.
Fulkerson, J.A., Story, M., Neumark-Sztainer, D. & Rydell, S., 2008. Family meals: Perceptions of benefits and challenges among parents of 8-to 10-year-old children. **Journal of the American Dietetic Association**, 108(4), pp.706-709.
Huang, T.T.K., Drewnowski, A., Kumanyika, S.K. & Glass, T.A., 2009. A systems-oriented multilevel framework for addressing obesity in the 21st century. **Preventing Chronic Disease**, 6(3), A82.
Kumanyika, S.K., 2008. Environmental influences on childhood obesity: Ethnic and cultural influences in context. **Physician and Sportsmedicine**, 36(1), pp.45-51.
Larson, N.I., Story, M.T. & Nelson, M.C., 2009. Neighborhood environments: Disparities in access to healthy foods in the US. **American Journal of Preventive Medicine**, 36(1), pp.74-81.
Ludwig, D.S. & Pollack, H.A., 2009. Obesity and the economy: from crisis to opportunity. **JAMA**, 301(5), pp.533-535.
Powell, L.M., Chaloupka, F.J. & Bao, Y., 2007. The availability of fast-food and full-service restaurants in the United States: associations with neighborhood characteristics. **American Journal of Preventive Medicine**, 33(4), pp.S240-S245.
Sallis, J.F., Floyd, M.F., Rodríguez, D.A. & Saelens, B.E., 2012. Role of built environments in physical activity, obesity, and cardiovascular disease. **Circulation**, 125(5), pp.729-737.

I benefitted a lot from the advice on this subreddit and used a lot of it to guide my approach to M3 year; now that I've had the chance to sit the exam, I wanted to create an exam write-up in the hopes that it will be useful to others. This write-up is lengthy, as I wanted to include advice for any new M3 students about how to maximize 3rd year, as well as some Step 2-specific strategies and advice.
A little about me: I am a non-traditional student (in my 30s) at a mid-tier US MD school. Pre-clinical grades were good (honored 2nd year, 0.5% away from honoring 1st year). Honored every rotation in 3rd year. I am a peer tutor at my medical school and was actively involved in tutoring 1st and 2nd year students throughout my M3 year and dedicated.
I am a big believer in students teaching students and the idea that if we all work together, we all become better students and clinicians. In that spirit, I welcome you to ask me any questions that you have below.

Overview

In general, my advice boils down to:

1. Don't try to use EVERY resource. Choose a few high-quality resources and really know them well.
2. Doing well on Step 2 (and shelf exams, tbh) requires active learning strategies and continually trying to think about what the next step would be. Practice questions are a great way to do this, but challenge yourself to go beyond what each individual question to build a broader knowledge base. That way, you won't only know the answer to that specific question, but also to a whole host of related questions.

General studying tips for 3rd year + dedicated
I am a big believer that the most effective study strategy involves four big components:

1. A question bank (UWorld) - gives you primary exposure to the material and helps to identify where your gaps are.
2. A system for continuously reviewing content - I used Anki (I discuss this more below). You can also use other strategies (note-taking, old school flash cards), but the important thing is that your review strategy needs to be ACTIVE (i.e., not just re-reading your old notes, but actively quizzing yourself and covering up the answers) and it needs to be CONTINUOUS. I did not pause any Anki cards during 3rd year, so by the time I got to dedicated, I had been actively, continuously reviewing content for months.
3. Resource(s) for primary sources - this is where you go when you need to refresh on pathophysiology, look up treatment/diagnostic testing for a disease, or understand the symptoms. I prefer UpToDate for this broadly, and used some additional resources on specific clerkships that I will discuss below.
4. Practice exams - NBME practice shelf exams ("CMS forms") and NBME Step 2 practice exams; do them timed to practice pacing.

A note on AMBOSS vs UWorld
A lot of people I know use AMBOSS and like it. Some people want an additional bank of questions to study from. I didn't personally use AMBOSS at all during 3rd year, and only used it for Ethics and QI during dedicated (and honestly, it was only marginally useful - may have gotten me 1 or 2 extra points on the real step 2 exam, but not more than that).
I think the smartest way to approach Q-banks is to make sure you have enough time to complete and thoroughly review at least one. For me, UWorld was more than enough to prepare well for each shelf exam and step 2 (honored every rotation). I think that a lot of people who try to use both AMBOSS and UWorld never finish either Q-bank in its entirety, or don't really review the Q-bank adequately. I decided it was a better use of my time and money to review only one but really know it well.
A note on Anki
Anki is a powerful tool that can really help with your long term retention, but it is dangerous if used incorrectly. I suspect that many people who don't find Anki helpful simply don't use it effectively.
The purpose of Anki is spaced repetition. In order for this to work, you have to keep up with reviews and you can't pause cards. I also caution students I tutor to be cautious of relying solely on a premade Anki deck; I used the AnKing deck, as well as this deck and a home-brew deck at my medical school.
During M3 year, I would start each rotation with UWorld from day 1, and as I came across each concept in UWorld, I would do a search through my Anki cards and unpause all the cards that related to that topic (so, for instance, when I got a question about diverculitis, I would then unpause all the diverticulitis cards). I found that doing this ensured that the new Anki cards I was adding were reviews of concepts I had just studied (via UWorld), so I was able to both reinforce the new content via Anki and also ensure that the new Anki cards I was adding were concepts that I was actually familiar with. I recommended this approach over the one that I saw many classmates using (just unpausing all the cards tagged for a clerkship at the start of the clerkship and "raw dogging" them, as my friend put it). It's also a good way to keep your daily new cards (and thus, your reviews) at a manageable number. On a typical day in 3rd year, I added between 50-100 new cards and averaged 250-350 reviews daily. I was nearly always able to complete my reviews while I was at the hospital each day, leaving my home study time free for UWorld.
More on how to effectively use Anki
A note on staying sane and prioritizing high-yield content
As others have said, I think that the best way to do extremely well on Step 2 CK is to approach M3 as a yearlong dedicated period. Doing well on Step 2 is not just about your preparation for the Step 2 exam, but also your learning during each rotation and your preparation for your shelf exams. Even if you're not at all interested in a particular specialty, there is a lot to learn from each rotation that will be valuable to you as a future physician. Additionally, each specialty has its own way of approaching medical decision-making, and paying attention to these patterns of thought can help you to reason through questions on exams, as well as be a better communicator with physicians in each specialty when you become a resident and attending.
As you progress through 3rd year, there are also a few things that I think it's wise to keep in mind:

• Remember that you are a person first and a medical student/doctor second. I put this first because it's the most important. It's hard to learn when your basic needs aren't being met or you're so anxious, stressed, or depressed you can't remember anything. Find something that keeps you grounded and whole and sane and make that a priority. For me, it's distance running. I ran nearly every day of 3rd year and dedicated (often at 3 AM, before rounds). I finished 3 marathons during M3 and dedicated, including running the Boston Marathon 2 weeks before I took step 2. Running relieves anxiety, gives me an excuse to step away from studying, and evens out my mood. In total, I ran over 2500 miles during my M3 year. I don't think I would have done anywhere near as well in M3 without it.
• Get really, really good at preventive care. The US Preventive Services Task Force guidelines are highly tested on all shelf exams and on Step 2, and there really aren't that many of them. Before my family med rotation, I made an Anki deck of the A and B recommendations based on the most recent updates and kept those in rotation through Step 2 (about 150 cards total). If you're at the beginning of M3 year, (or really any point in M3) I would suggest doing this right now. Every time you see a patient in clinic, think about "what screening exams should this patient have". If you get in the habit of always doing this, by the time you get to the exam, those screening questions will be free points (and there are usually a bunch of them).
• Try to approach every patient encounter as though you are the sole physician responsible for that patient's care. Formulate your own plan independently of residents or attendings. Ask questions about all these things in your patient interview, and present the answers to your attending. You will learn more if you push yourself to try to think about management from the beginning of 3rd year rather than relying on plans from your residents.
• Pay attention to sensitivity and specificity of tests. This is becoming a bigger and bigger deal on NBMEs and Step 2. Knowing sensitivity and specificity can help you determine whether a given finding in a question stem is significant or not.
• Look up every imaging test and diagnostic procedure you come across, whether in clinic or on a practice exam. A good rule of thumb for whether you understand a test is "Do I know when this test is appropriate, when it is inappropriate, and could I explain it to a patient?". I had a surgery fellow pimp me on when to order an ERCP vs MRCP; this stuff is important because it prevents unnecessary testing and allows you to get the most "bang for your buck", both in terms of diagnostic accuracy and scoring points on the "next step" questions on exams.
• Pay attention to thresholds for follow-up observation vs treatment. If a patient has a AAA that's 3 cm, you do serial ultrasounds and watch it clinically; if it's 7 cm, you operate. Many, many conditions have similar thresholds, and you should look for the differences in how you manage a condition based on the thresholds. Sometimes this stuff is buried in the UWorld explanations, so when you see it, make a flash card or add it to your review.
• Know the USPSTF screening guidelines like the back of your hand. There aren't that many of them, and it's basically free points on every single shelf exam + step 2. Make a flash card deck with the most updated versions on day 1 and review it throughout 3rd year. Especially high yield on FM + IM, but they appear on every shelf.
• Think about what things a specialty "cares about" when you're rotating on that specialty.
  • OBGYN: gestational age, STI history/screening, social/fam Hx of risk factors for gyn cancers (breast, cervical, ovarian, endometrial).
  • Surgery: is the patient safe to take to surgery (comorbidities, heart failure, coagulopathies, meds, etc)? When is surgery indicated (i.e., do they have to go now, or can they wait)? Antibiotic prophylaxis (who needs it, and what antibiotics)? Post-op complications (the "5 W's", leaks, nearby structures that can be injured)? Normal post-op care/patient safety (DVT prophylaxis, catheter removal, infections, etc).
  • Peds: developmental milestones/normal development/growth curves, rashes (pediatricians love rashes), upper respiratory infections, stuff that gets treated differently in kids (ex. febrile UTI), neonatal hyperbilirubinemia (basically guaranteed to get at least one question on this on any peds exam)
  • IM: Preventive care/screening, vaccines, hypertension, diabetes, heart failure, ACS, liver failure/cirrhosis.
  • FM: IM + Peds + OBGYN, with a heavy focus on preventive screenings
  • Psych: Pay attention to timelines; think of every psych disease as a continuum (i.e., <1 mo = brief psychotic disorder, 1-6 mo = schizophreniform, 6+ = schizophrenia, schizophrenia + mood symptoms = schizophreniform). Find something that makes sense to you for the personality disorders (I personally mapped them all onto Harry Potter characters and now I will never have to re-learn them).
  • Neuro: Differentiating causes of stroke, multiple sclerosis, when to get an MRI (answer: always get an MRI in neuro), different types of dementia

Subject Review

This section is intended for those who are starting or still in the midst of M3 year. If you're already in dedicated, this section may be less useful.
For all rotations, my strategy was generally:

1. Complete the UWorld Shelf exam Q-bank with 1-2 weeks to spare
2. Make/unpause Anki cards as I worked through UWorld
3. Take timed NBME practice shelf exams regularly throughout the rotation(I sat down at the start of each rotation and planned these out every 1-2 weeks so they were evenly spaced throughout the rotation). Get through every practice exam by the end of the rotation. Doing them timed is important because it helps you to practice pacing. One 50-question exam at 90 seconds/ question = 75 minutes total. I also wrote down the diagnosis for each question so that when I reviewed the exam, I could see whether any wrong answers were a problem with making the wrong diagnosis vs knowing the next step. Doing the NBME shelf exams also gives you a good sense of what the "pet concepts" that tend to occur over and over are (for instance, SCFE vs Legg-Calve-Perthes comes up shockingly often)

Order of rotations:
I did my rotations in the order listed below and I really liked this order. I know many people advocate for finishing on Internal Medicine, but I was very glad I started with it, because I think it laid a strong foundation for everything else. As long as you have a solid strategy for reviewing the IM content continuously throughout the year, I think it's a smart choice for the first rotation, especially because basically every other shelf exam will have 5-10 IM questions on it.
Medicine
Resources: UWorld (IM shelf bank + 1/2 of Ambulatory), Case Files Internal Medicine (did ~50% of it), USPSTF A & B guidelines, NBME practice shelf exams ("CMS forms"), Emma Holliday review
Advice: If you have free time 1-2 weeks before starting IM, get through as much of Case Files as you can. It lays a good base and helps you get into the mindset of IM. Once you start the rotation, crank through UWorld. I'd suggest trying to finish the UWorld Q's with 1-2 weeks to spare at the end of the clerkship in which you can review incorrects and/or shore up any weak areas.
Raw Score: 85
Neurology
Resources: UWorld, Case Files: Neurology, NBME practice shelf exams ("CMS forms")
Advice: Case Files Neuro is a little in the weeds, but it will help a lot with some of the more off-the-wall pathologies that aren't really seen in the UWorld bank.
Raw Score: 90
Psychiatry
Resources: UWorld, Case Files: Psych, NBME practice shelf exams ("CMS forms"). A lot of people swear by First Aid for the Psychiatry Clerkship; I didn't use it (but I think Case Files accomplished much the same purpose)
Advice: Pay attention to timelines + enjoy the psychation! This is the lightest rotation for most people. Take it in the summer if at all possible and enjoy the nice weather and free time. If you can, get it somewhere in the middle of 3rd year so you can have a little break.
Raw Score: 94
Family Medicine
Resources: UWorld (FM bank + 1/2 of ambulatory bank), Case Files: Family Med, NBME practice shelf exams ("CMS forms"), USPSTF A & B guidelines, CDC vaccination schedules
Advice: Try to take FM after IM, if at all possible. DO NOT underestimate the family medicine shelf exam. It is the broadest shelf exam, and it's heavily weighted towards prevention, so plan your studying accordingly. Know the USPSTF guidelines and vaccine schedules like the back of your hand (this is at least 25-30% of the shelf exam).
Raw Score: 85
Surgery
Resources: UWorld (Surgery bank + EM bank), de Virgilio's Surgery, NBME practice shelf exams ("CMS forms") for EM and Surgery, American College of Surgeons TEAM (Trauma Evaluation and Management) course book, Emma Holliday review
Advice: The surgery shelf exam focuses heavily on the pre- and post-surgical management of surgical patients, trauma assessment (hence the EM questions/CMS forms above), and knowing the indications for surgery. You will not be asked how to do a surgery on the shelf exam, but you will be expected to know when a surgery is indicated vs when medical management should be used instead (and also what that medical management is). De Virgilio's is a great and under-utilized resource that has a fantastic question bank at the end of each chapter. I would recommend reading at least the GI, vascular, breast, endocrine, and trauma sections (and honestly, as much of it as you have time for).
Raw Score: 85
Obstetrics and Gynecology
Resources: UWorld, Case Files: OBGYN, NBME practice shelf exams ("CMS forms"), ACOG guidelines, UWise questions
Advice: OBGYN is all about timelines (at least, the OB part is). Pay attention to gestational age requirements for diagnosis of various conditions. Know the various labs that are used to diagnose Pre-eclampsia with severe features, and really pay attention to risk factors for the various obstetric complications. As one nurse midwife I worked with put it, "The biggest risk factor anything in L & D is usually a history of the same complication". I didn't really find the UWise Q-bank that useful, but if you have extra time, it's a nice source of extra practice questions, or a good way to reinforce any trouble spots.
Raw Score: 87
Pediatrics
Resources: UWorld, Case Files: Pediatrics, NBME practice shelf exams ("CMS forms"), CDC vaccination schedule, Emma Holliday review
Advice: Know the general trends of pediatric vital signs (what's normal for an adult is abnormal for most pediatric patients and vice versa), pay attention to rashes and dermatology, and review these as often as possible. It's well worth your time to do a good review of all the glycogen storage diseases, inborn errors of metabolism, lysosomal storage diseases, etc that you forgot after Step 1. For this reason, if you can do Peds as your last rotation before Step 2 it's kind of nice...then you only have to re-learn all this stuff once. This stuff is fair game for Step 2 (and I did personally get questions on it on my exam).
Raw Score: 91

Dedicated Study

I completed my first pass of UWorld during my M3 core rotations with an average of 74%. I did reset UWorld and begin a 2nd pass during dedicated, but I found that the questions repeated a lot of content that I knew well, and ultimately decided it wasn't a good use of my time. I only completed about 20% of my 2nd pass of UWorld with an average of 92%.
My main resources during dedicated were NBME practice exams (I did 8-14 timed), UWSAs, and the Free 120. I also listened to some Divine Intervention episodes on my runs and reviewed the Emma Holliday shelf exam reviews (I had previously listened to these during my M3 rotations). Of the podcasts, I found the Divine Intervention Free 120 review the most helpful, and would strongly recommend listening to those episodes after you take the Free 120. It did a lot to help me with some test taking strategies that I used on exam day.
General advice for dedicated:

• Keep on a regular sleep schedule, even on your days off. I went to bed at 10 and got up at 6 every day, because I wanted my schedule to be close to what I would need to do on test day.
• Take days off. I took at least 1/2 a day off every week. I also ran a major marathon 2 weeks before my test day, so that was a very light weekend in terms of studying.
• Keep exercising and doing things you enjoy. For me, this meant running a marathon (something I do regularly). You don't have to go as crazy as I did, but do something to get outside and stay active. It will help you keep the anxiety under control and see the sunlight every so often.
• Take practice exams regularly and spend plenty of time reviewing them. I made a google doc to keep track of incorrects and assigned each one to a category of "why I got it wrong" (i.e., "overthinking", "knowledge gap", "guessed wrong of 2", etc). This helps to identify trends. I found that I have a tendency to overthink questions, so identifying this helped me to address this weakness and gave me confidence to go with my gut instinct on the exam.
• Don't be afraid to adjust your study plan during dedicated. I started a 2nd pass of UWorld, but after about 2 weeks of dedicated, I felt like I wasn't really getting anything additional out of it and I was remembering too many of the questions from my 1st pass, so I just stopped using it. I spent that time on other resources instead (more practice exams). Take the time to really analyze which activities are actually helping your learning. Don't just do something because that's what everyone else is doing during their dedicated.
• Keep up with your review strategy. For me, this was Anki. I spent 2-4 hours every morning during dedicated doing Anki. At times, I worried that this was too much time on Anki, but part of what makes Step 2 (and all USMLE exams) challenging is the sheer breadth of content. The best way to prep for this is to keep consistent with your review strategy.
• If there's a concept you dread seeing in a question stem, STOP, do not pass Go, do not collect $20. Take a second to go to a primary source (UpToDate, a textbook) and review that content. Make some flash cards and review it regularly.
• Practice your timing. I came up with my exam day break strategy at the start of my dedicated, and every time I took a practice exam, I practiced my break strategy (at least, the first 5 blocks of my break strategy). This made it very easy for me to execute on test day because I was already used to doing 5 blocks in a row exactly this way. I took my lunch break after block 5 instead of block 4 (because I liked the psychological factor of knowing the exam was more than halfway done). Coming back for 3 more was no problem on test day.

My practice exam scores:
CCSE: 254 (my school requires this, and it was given a few days after the final shelf exam, right at the start of my dedicated period)
NBME 9 (30 days out) 269
NBME 10 (21 days out) 268
NBME 11 (18 days out) 262
NBME 12 (15 days out) 251
NBME 13 (7 days out) 264
NBME 14 (2 days out) 264
UWSA 1 (25 days out) 254
UWSA 2 (9 days out) 268
UWSA 3 (5 days out) 266
New Free 120 (3 days out) 85%
Predicted score: 265

The Day Before

Just take a break, for the love of all that is good. I went for a run, watched some old TV, read for fun, had a nice pasta dinner, and tried to go to bed early. Laid out everything I needed (lucky t-shirt, snacks, testing permit, ID, keys, etc).
Of course, I ended up tossing and turning most of the night and slept very poorly. When I woke up, I considered trying to postpone my test, but ultimately I decided I just wanted it over and done with and I wasn't willing to wait any longer. My point here is that even if you have anxiety and/or a single bad night of sleep before the exam, you can still do very well if you've done the work. As we say in the marathon world, trust your training.

The Test

Got to the testing center 45 minutes early. Made sure the last thing I did before going through security was to take a bathroom break. Brought plenty of snacks, headache medication, chocolate, and a healthy and delicious lunch (I think there's some psychological power in knowing you have a delicious lunch awaiting you).
During the exam, I took a break of at least 5 min after every block. Personally, I found the mental break was extremely helpful. On the whole, I found the exam to be quite reasonable.
Step 2 CK: 277
My last piece of advice will be that I think doing well throughout third year is the best thing you can do. If you've had a break after 3rd year or you are an IMG or someone coming from a non-traditional program, doing a thorough content review with the CMS forms before starting Step 2 specific practice exams is a good idea.
Ultimately, I think the most important things are:
1.) Choosing a FEW, QUALITY resources to review
2.) Continuing your ACTIVE, CONTINUOUS review strategy
3.) Keeping a consistent schedule with time for sleep, healthy eating, exercise, and something you find fun (ideally something other than TV).
4.) Staying off Reddit. Really, I mean it. Especially during dedicated, it's just a black hole of anxiety and angst and you should avoid it at all costs. Come back after you get your amazing scores and pay it forward to others.

For context I’ve been a nurse for 4 years. I have worked peds cardiac icu my whole nursing career. 2 years as a staff nurse and 2 years as a travel nurse.
I decided to go staff at a hospital I did a contract at for 7 months. I had a great experience as a traveler there working dayshift. The staff were amazing, supportive and encouraging. I’ve been doing a condensed staff orientation for the past 5 weeks and it’s been going great. My dayshift preceptor and coworkers know me, they know my skill and are just as supportive as they were when I was a traveler.
I’ve been orienting on nights the past week and it’s been a struggle. The nightshift nurses only know me as “the traveler” but don’t know my skill level. I understand until they get to know me and see my work ethic and skill things will improve but man, my shift last night has me feeling so defeated. My patient needed consistent interventions, was a sedation nightmare and all around extremely busy. I don’t feel like anything we did was out of my depth but my preceptor was on top of me questioning every thing I did, down to even how I collected my labs.
I tried to be gracious and accept the “education” and take the constructive feedback but it totally beat down my confidence. The more my preceptor second guessed everything I did the more I started to second guess myself and the more timid I became. I felt like I couldn’t even use my own nursing judgement because my preceptor would tell me I need to do this or that. I felt like a new grad nurse all over again.
I knew transitioning from traveler to staff would have its bumps in the road but now I’m really questioning whether I still wanna deal with this level of stress and headache, especially for staff pay. I’m trying to stay positive but I don’t know if bedside nursing is even for me anymore. If you’ve made it this far thanks for listening to a tired nurse and drop some words of encouragement if you have any.

i was born and lived most of my life in an area what is occupied by the nation state switzerland
shortly after my birth this nation state switzerland has coersed me into being associated to it what is a theft of my ability to determine my own life
i do propose to all fellow human beings living on planet earth to consider rethinking how we relate to each other as in, we would best not associate anyone to a regional and or nation state without the person and or its parents expressly wanting the newborn human being to be associated to that state
further i propose a reform of constitutions of regional and nation states everywhere on the planet what would allow every human, animal, tree and artificial intelligent entity who wants to be its own person to leave the coersed association to the state at any moment without any condition
having repeated this most important theme of how it would best be a voluntary decision, a choice wether one would want to be associated to a state or not
i would like to highlight a people initiative for freedom and physical intactness
( volksinitiative fuer freiheit und koerperliche unversehrtheit )
what citizens of switzerland will have an opportunity to vote yes or no on the 9th of june 2024
the text what is at the core of that proposed constitutional reform could be translated with:
interventions into the physical or mental intactness of a person require the approval of the person
the person is not allowed to be punished nor given other social or professional disadvantages based on the refusal to give consent ( to an intervention )
in german:
eingriffe in die koerperliche oder geistige unversehrtheit einer person beduerfen deren zustimmung die betroffene person darf aufgrund der verweigerung der zustimmung weder bestraft werden noch duerfen ihr soziale oder berufliche nachteile erwachsen
i have allready dropped my written yes vote today into the mailbox of the village where i live because i do think this is a most important principle what would best be adopted on a global scale as in i believe that it would be good for human beings everywhere on planet earth if their choice to not have this that or the other stuff introduced into their bodies such as vaccines or micro-chips or nano-bots or whatever science might invent next to introduce control or and dominating and or disturbing informations into the human body
i hope that all human beings everywhere on the planet would want to allow each other to protect their own bodies against any overbearing intrusive demands
i hope that all human beings everywhere on the planet would want to respect every fellow human beings mental and emotional and bodily autonomy
my mind, my feelings, my body my choice
sadly, the national parliaments of switzerland and the federal council with 7 human beings as members have decided to recommend to reject this proposition of changing the constitution of the nation state switzerland in that way
why ?
the main reason is that these politicians and governement executives want the state and people working for the state such as police, judges, medical and or psychiatric doctors and nurses to be able to violate the principal of phsyical intactness
for example by forcing persons to ingest or be injected with medications / vaccines / whatever they would choose to harass people with in the future
in switzerland every day a lot of human beings are forced by the state to ingest pharmaceutical medications or and to tolerate being injected with those
these abusive and or medical torture is part of a punishment and or oppression mentality what the psychiatric universitary system is promoting and the parliamentary assembly together with the federal council are building their domination power upon

i was born and lived most of my life in an area what is occupied by the nation state switzerland
shortly after my birth this nation state switzerland has coersed me into being associated to it what is a theft of my ability to determine my own life
i do propose to all fellow human beings living on planet earth to consider rethinking how we relate to each other as in, we would best not associate anyone to a regional and or nation state without the person and or its parents expressly wanting the newborn human being to be associated to that state
further i propose a reform of constitutions of regional and nation states everywhere on the planet what would allow every human, animal, tree and artificial intelligent entity who wants to be its own person to leave the coersed association to the state at any moment without any condition
having repeated this most important theme of how it would best be a voluntary decision, a choice wether one would want to be associated to a state or not
i would like to highlight a people initiative for freedom and physical intactness
( volksinitiative fuer freiheit und koerperliche unversehrtheit )
what citizens of switzerland will have an opportunity to vote yes or no on the 9th of june 2024
the text what is at the core of that proposed constitutional reform could be translated with:
interventions into the physical or mental intactness of a person require the approval of the person
the person is not allowed to be punished nor given other social or professional disadvantages based on the refusal to give consent ( to an intervention )
in german:
eingriffe in die koerperliche oder geistige unversehrtheit einer person beduerfen deren zustimmung die betroffene person darf aufgrund der verweigerung der zustimmung weder bestraft werden noch duerfen ihr soziale oder berufliche nachteile erwachsen
i have allready dropped my written yes vote today into the mailbox of the village where i live because i do think this is a most important principle what would best be adopted on a global scale as in i believe that it would be good for human beings everywhere on planet earth if their choice to not have this that or the other stuff introduced into their bodies such as vaccines or micro-chips or nano-bots or whatever science might invent next to introduce control or and dominating and or disturbing informations into the human body
i hope that all human beings everywhere on the planet would want to allow each other to protect their own bodies against any overbearing intrusive demands
i hope that all human beings everywhere on the planet would want to respect every fellow human beings mental and emotional and bodily autonomy
my mind, my feelings, my body my choice
sadly, the national parliaments of switzerland and the federal council with 7 human beings as members have decided to recommend to reject this proposition of changing the constitution of the nation state switzerland in that way
why ?
the main reason is that these politicians and governement executives want the state and people working for the state such as police, judges, medical and or psychiatric doctors and nurses to be able to violate the principal of phsyical intactness
for example by forcing persons to ingest or be injected with medications / vaccines / whatever they would choose to harass people with in the future
in switzerland every day a lot of human beings are forced by the state to ingest pharmaceutical medications or and to tolerate being injected with those
these abusive and or medical torture is part of a punishment and or oppression mentality what the psychiatric universitary system is promoting and the parliamentary assembly together with the federal council are building their domination power upon

Hi all! At my son’s two month vaccine appointment the public health nurse noticed a flat spot on his head. She said it was “very, very mild” and that the early intervention program would turn us away if she sent us to them. Flash forward to his four month appointment, I had to mention the spot because they said they’d check to see if it got worse, but there wasnt any kind of note in his file about it. Between appointments we increased tummy time and moved his head to his other side while sleeping whenever we could.
The nurse at this appointment offered a referral to the early intervention program. He has an assessment with a physio at the end of the month. I’m so, so terrified he’ll need a helmet. I really thought flat spots only happened when babies were on their backs 24/7. He has a strong side preference and is such a great sleeper, so I guess I shouldn’t be too surprised, but I’m still devastated.
Does anyone have any experience with this early intervention thing? Does it mean a helmet straightaway? TIA!

Genuinely seeking advice here because I can be quick to jump on my sister and be a little testy with her because our relationship is kind of iffy. I 22F have one year left of nursing school. I’ve been really enjoying myself, as my family knows well. I enjoy answering questions about school and certain conditions, and even answering occasional questions people have about their own issues. my problem is that now, when my sister 30F has any sort of medical problem, she comes to me and asks me questions. It makes me nervous to give advice because God forbid I tell her the wrong thing and she either A) seeks medical care for something that didnt require further intervention, or B) she doesn’t seek medical care because of my recommendations and blames me when it was something more serious than I thought. I don’t want to give the wrong advice, especially because I’m still in school and learning lots of things. I try my best to give her advice I think is appropriate but like I said, I don’t want to risk being wrong once. WIBTAH if I told her to stop asking me so many questions?

I was on Lexapro for at least 3 years, probably closer to 5. I was on 10 mg. I tapered myself off approximately 2.5mg per 3 to 4 weeks. Once I got to 2.5mg I took it every other day for about 2 weeks. Didn't notice any symptoms. [Very different from Celexa that I was on for 2 yrs and stopped cold turkey due to my doctor not sending my prescription]
One of the reasons I came off the lexapro, and I feel silly for not realizing it as the cause, was trouble swallowing. Idk why I didn't make the connection sooner. I thought maybe I was just eating too fast? But I always needed water when I ate. I had 2 major choking incidents that required intervention and several smaller ones I was able to resolve myself. My partner was convinced I was going to choke to death when I was home alone. It took me just a few months before tapering to figure out that's what was causing it.
Other symptoms that I had been experiencing include emotional blunting, low libido, general numbness. However, it did significantly reduce my depression.
I've been off of it for about 6 months. And, as usual from past experiences, my depression is back. Idk if I even want to try another drug.
I'm curious what other people have tried after lexapro if they found it helped but had unbearable side effects?
Only other one I've used is Paxil and it made me a complete zombie. I couldn't stay awake on it.

Me: Wouldn't it be fun to wait to post this in the summer so you can say happy Christmas in July for once? Also me: that's a terrible joke. Just publish the thing.
Apologies for publishing in 2 parts. I'm not trying to drag it out I'm just aware this is the length of 2 episodes, reddit will only allow me 20 pics per post, and there's just too much going on for our beloved idiot in this one, so. I'm pacing myself.
It's not Christmas in July, it's Christmas 1919 at Downton and I spent an embarrassing amount of time wondering if Mr Fellowes really wants me to believe that the Crawleys decorated the Goliath of Christmas trees themselves (they didn't, but I like that Mary was sipping her tea and offering her view on things. Queen👑 ).
Plus, the setup for this episode intro had an actual checklist:
Tree? Check
Family arriving? Check
Violet judging this year's Christmas cards and looking for the contenders for worst cards of the year (they judge them on both content, and actual card)? Check
https://preview.redd.it/ul3aegl7cv0d1.jpg?width=710&format=pjpg&auto=webp&s=1c86f2409e193f7f68461f9ca06c72c7c424af66
Anna gets a gold heart brooch from Mary and Mrs Hughes is as excited about it as she is. Also, I can see the inspo for the entire Anna/Mary tag on AO3 right here. And Mrs Hughes ships it.
Just kidding, Bates is in prison, and we're all very sad.
https://preview.redd.it/wxhn89x9cv0d1.jpg?width=710&format=pjpg&auto=webp&s=04d813b9202a58a7c31f35d6b398bb6d53ced28b
Carlisle is wondering why the Crawleys are being kind to their servants by letting them have some time off at lunchtime on Christmas Day, and I'm wondering if anyone (namely, us, the viewers) is supposed to be surprised by his behaviour.
I mean, blackmailing Lavinia just because? Blackmailing Mary into an engagement with him? Trying to manipulate Anna and Carson? Being physically abusive to Mary, and trying to control her life and behaviour? Bringing Lavinia back to "sacrifice" her to a lifetime as Matthew's nurse, so Mary won't spend that much time with Matthew (not because there was something off about that, just that Carlisle didn't want her to)?
He is an asshole. He was an asshole. He will always be an asshole. Glad we're finally all on the same page.
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Matthew and Mary are exchanging presents behind Robert's head in one scene and I'm very upset by it. Please, if anyone has any ideas, submit what you think they got each other for Christmas.
If you need any inspiration, here's what people would buy each other as presents in the 1920s according to the British Newspaper Archives:
Lots of cigarette paraphernalia Cocktails Banjos PENCILS Dance Frocks Shaving Kits Vacuum Cleaners
Keep that list in mind if you're disappointed with your presents next year.
https://preview.redd.it/9y1mgw5fcv0d1.jpg?width=996&format=pjpg&auto=webp&s=fc993eeff4617e298b7ab85b9c8266ac3f683942
Matthew got a telephone call telling him that Mr Swire is very ill, and he will got to London to visit him. Mary gives him some condolences and he says "I'm sorry if I'm casting a gloom". I have a feeling the poor man had been pretty depressed for quite long, probably perked up a bit for Christmas and thought he was bringing the mood down again, but Mary responds with compassion. Oh Matthew.
Carlisle saw Mary go after Matthew in the hall, to ask about Mr Swire, and literally took his newspaper with him and followed her out there because that's completely normal behaviour. Just picture the ridiculousness of it: Mary and Matthew talking about Mr Swire and Bates' trial, romantic themes that they are, and Carlisle is so annoyed by it he's standing there in the background. Reading a newspaper, just to make sure they know he's still around (who could forget, mate).
Also, Mary saying she'll attend Bates' trial to support Anna, and Matthew immediately going "Would you like me to go with you?". Because of course he wants to support Mary in all things.
And this is Matthew's first villainous act for the episode: He asks Carlisle "or will YOU do that?" as in, since you're here, will you be supporting Mary in this endeavour.
Of course he isn't. Carlisle could never understand the concept of being there as emotional support for a Servant. He can't even understand why one would give a servant a few hours off on Christmas Day.
And just like that, Matthew scores one point in showcasing that Carlisle is a waste of space.
Matthew's Villainy points so far: 1
https://preview.redd.it/m927qezhcv0d1.jpg?width=996&format=pjpg&auto=webp&s=de05e12b244424e5fe126c6be6bab3597c83549b
Btw, Matthew has a few sets of looks reserved for Carlisle: Derision, derision, and more derision.
https://preview.redd.it/ujldjjrkcv0d1.jpg?width=696&format=pjpg&auto=webp&s=7a4e7e1312a82e1632254aff103056c775a33db4
They're playing charades (aka The Game), Mary is mimicking falling down, Matthew has a front row seat to it, and they're not playing on the same team so she can't rely on him to guess. Which means he can sit back and have the time of his life.
Carlisle complains about not liking the game and I'm left to wonder why he wanted that life so much since he could find nothing to enjoy in it.
https://preview.redd.it/kqzfvl2ncv0d1.jpg?width=696&format=pjpg&auto=webp&s=c7f333dbc8c9eed822751ed352061d4b13db1bdc
Mary IS still trying with him, however. He complains again on New Years Eve about the servants having some time off, and she reasons that it only happens twice a year, and he complains again that she doesn't understand because she didn't have to work for what she has.
Fellowes finally does the work on these two. I was having a conversation with another user recently, who was wondering why Mary picked Carlisle when she could have picked someone like Evelyn Napier.
Let's forget the Pamuk Scandal for a moment. Mary clearly wanted something more other than a traditional marriage. When we meet her, she's 21. She already has a husband in her pocket, if all she wanted was a position in society and a title, she'd have already been married to Patrick in 1912. But clearly, she wanted more out of life than to be someone's wife.
She wanted love, and she wanted to have something to do, whatever that was. She would have found both in Matthew, if things hadn't gone to complete shit, so why not consider Carlisle (back when he seemed normal)?
He was a working, self-made man, so he was interesting to her. He wasn't the run-of-the-mill rich boy she'd been exposed to her entire life, and if she married him she'd have a job in establishing him in London society and helping him build his empire. She'd Work, in short. She'd be allowed to use her brain.
But they don't match. At all. He offered her a marriage of convenience, and then was upset that she loved someone else, when Carlisle never offered her love in the first place. She wanted to be able to go about her life, he wanted her under his thumb to do his bidding. She was raised to have a certain respect for other people (e.g. the servants in the house), he thought that because he had money he could do whatever the fuck he wanted.
In short, they don't work together. Not even taking into account he was blackmailing her with a scandal, and Matthew was off stage left being Villainous (according to Carlisle. Villain, Perseus, it's all a matter of perspective.)
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I love how they contrast Carlisle's ruthlessness with Matthew's compassion (and look how she looks up to him). Because Matthew is also a working man, but he's kind. And even though he didn't have any connection to mr Swire anymore, he stood by him in his hour of need, to the bitter end.
Speaking of contrasting Carlisle's assholery to Matthew:
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Rosamund's WhatsHisFace of a suitor points out there's only three women following the shoot, and they should divide their time between the men taking part in said shoot (God forbid women are not around to entertain these assholes gents). Carlisle immediately rebuffs him before Mary can get a word in, saying "Lady Mary will stand by ME". Mary is about to, very politely, put him in his place, when Matthew comes in for his second act of Villainy so far, saying "I thought you said you'd stand by me for the first shoot, isn't that what you said?"
He doesn't push her to go with him, he's just giving her an exit plan. So that Mary doesn't have to bring herself in an awkward position in front of all those people, to defend her right to an opinion. And Mary takes it. Of course she does. She can show Carlisle he doesn't get to dictate what she does, and do so in a way that doesn't create gossip.
Matthew's Villainy points so far: 2
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Look how he looks at her. He's so happy she took him up on it. Whatever else happened beyond this, they were friends. He cared for her, and she cared for him. And he has her back here, and she accepted it, so easily. And that made him happy (and so, so smug. A true Villain).
https://preview.redd.it/1fzkc8n5dv0d1.jpg?width=560&format=pjpg&auto=webp&s=96c18b3b6203ddaebccedf3173fa4d0bb7c87619
She loves how un-selfconscious he is. She's always loved it, all those years ago at the flower show when he'd mock himself for her benefit, to make her laugh. He does it here still but now she's not surprised by it, just endlessly fond. Dozens of men spent years showing off their (probably mediocre) skills, to win her favour, and of course she'd fall for the guy who was just being honest. Mary likes honesty, she never got much of it. Her world is a show of mirrors where nothing is what it seems, and it must have been so refreshing to be with someone who was exactly what he showed the world. It's only sad that it took her so long to realise that just as she loved him for who he was, he'd do the same. But I'm getting ahead of myself.
"He does rather beg to be teased" - this asshole has been deliberately messing with Carlisle for ages, hasn't he. I've only counted 2 Villainy points, but I bet he earned himself dozens before. Whenever he'd get pissed off at something Carlisle said he'd just whisk Mary away, just to show him that he could. Even if Carlisle was the fiance, Matthew was still an important person in her life, and he'd always be, and he made sure Carlisle knew that (and took great, great enjoyment in it).
Mary: The awful truth is, he’s starting to get on my nerves. Still, you’re not the person to burden with that.
Matthew: You’re still going to marry him, though.
Mary: Of course. Why wouldn’t I.
Matthew is not happy about this. He appears to not understand it, and I wish I could give him a a nice shake. Regardless of the information he doesn't have, Matthew, mate, it's not like she hasn't met other men. Like it or not, most of your lot back in the day belonged in the bin.
And Mary, as a high-society woman, didn't have a lot of options. She had to get married. And at least Carlisle wanted to buy Haxby, she'd be near her family, spend time in London. Before she'd have hoped to actually get some work done, within the capacity her marriage would allow her, but with things being as they are with Carlisle I think she's now hoping he'd be busy with his work and she could get on with her days and maybe not see much of him, as most couples of their class did. And that's not taking into account the actual reason why Mary thinks she absolutely Must marry Carlisle.
https://preview.redd.it/5u0162z7dv0d1.jpg?width=560&format=pjpg&auto=webp&s=792e7b9d4ab2bad74d90c90aea70b51766e0eb66
Also, Matthew, let's not pretend you'd like any man she brought home. So either take a deep breath and confess some things, or get on with it.
Carlisle asks Mary why she and Matthew were laughing together. He asks "Am I never to be free of him?" and her answer is, of course not. Because, of course not.
First of all, sorry to say Richard, but, they're a package deal. I can't see either one of them giving up the other willingly, not after all this. But of course, the main thing is the aristocracy thing. He's the head of the family, you'll see A Lot of Matthew, if you and Mary get married. And Matthew has spent almost every minute of the episode so far making sure Richard knows this. One would say, he's trying to push him out (like a villain), through his sheer presence in Mary's life.
"I might understand if you let me think for a solitary minute that you preferred my company to his."
Here's another problem: He should know, this wasn't part of their terms. Of course, he's not an aristocrat, so he's not aware of how loveless marriages of convenience work, but since it WAS a loveless marriage of convenience he was offering, I wonder why THE FUCK, he demands her attention now.
Mary would perform her duty to him. She'd be the best hostess London ever saw. She'd be the pretty wife on his arm, and she'd charm his contacts, and she'd be the stepping stone for him to be accepted in aristocratic circles, and she'd give him children and hold his house. And yes, she'd love spending time with her family, and that included Matthew.
Richard is just being a petty, controlling, fuck. Because he wants more than she's willing to offer, and he wants more than what he'd originally asked. So he, can shove it.
https://preview.redd.it/4gr6ycqldv0d1.jpg?width=854&format=pjpg&auto=webp&s=eeb0c9806c1b0fc1830c35c63510ee879ce480eb
Richard: I’ve done everything I can to please you.
Mary: Do you mean you bought a large and rather vulgar house?
Richard: You cannot talk to me like that! What have I done to deserve it? What?!
Would you like a list of your crimes, Richard? I've posted it a bit further above.
Also, Mary. She was hoping he'd offer her an interesting life (before he turned out to be an asshole). But all he's offered so far is the same old bullshit she's been offered all her life: A big empty (emotionless) house. A demanding husband. A life full of constraints and limitations, set to her by a husband who expects to dictate everything she does.
It's at this point that Matthew, clearly the villain of the story, shows up because he hears Richard yelling at Mary and that just won't do.
My beloved idiot covers for Richard here. And she does it because of something she said to Matthew before "He's starting to get on my nerves, but you're not the person to burden with that."
She doesn't want Matthew to feel like he has to come to her rescue. She heard him, when he told her they can't be together (many times) in the previous episodes. And she loves him, so she's let him be. She knows he's got his own troubles, that he's been through a lot, and that shows with how she watches him walk away with a fair bit of worry in her eyes. Plus, she doesn't want him to do anything for her out of obligation. She just wants them to be friends, and friends don't solve your marital (or, in this case, pre-marital) problems. They can provide comedic relief, and support, but that's about it.
And as we said, Matthew is clearly the villain of this story.
Speaking of which, Matthew interrupted Richard's yelling at Mary so, I guess that means - Matthew's Villainy points so far: 3
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Speaking of friends: Matthew will be there, for Mary (and Anna) at Bates' trial, and Mary asks to be there when he brings back Mr Swire's ashes, since the man wanted to be buried next to his daughter (who had to be buried at Downton, and not near her home in London, for maximum guilt-trip points I guess).
I love how those two care, and support each other in difficult times. It IS what friends do. Of course, Carlisle is not happy about that either. And listen, if he was in love with Mary, I'd be very understanding. I'd be telling him to cut his losses and run. I'd be empathising. But I'm like, you've been an absolute tool for years now mate, how am I supposed to see your POV, when you're basically worrying that if those two, at some point, get their heads out of their asses and realise they make a great couple, you'll lose your trophy wife you've trapped in a marriage, through sheer luck (on your end).
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Carlisle, after that entire day of watching Mary and Matthew having a nice time out with the family, pressures Mary to set a wedding date. Mary wants to wait, I guess she hopes for some godly intervention because she definitely doesn't see any other way out of her current situation, and he goes so far as to literally grab her, and in front of her family too.
I'm finally not the only one who wants to shoot him dead. Of course, Robert won't do anything about it because when has Robert ever done anything for Mary (so far), but Matthew looks tempted.
(I had to cut out poor Carson because there's too many people on this frame as it is, but shout out to him for also worriedly watching in the background).
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Matthew: Mary. Can I help?
Mary: After today, I won’t insult you by asking what you mean.
Matthew: You don’t have to marry him, you know. You don’t have to marry anyone. You’ll always have a home here as long as I’m alive.
First of all, I LOVE, that his reaction was to ignore Carlisle, run after Mary, and ask her if he can help. He's not offering to be a saviour. Mary doesn't need one of those (she does need to find that steel in her spine though). But he's offering to support her, and he says it in a way that implies he'd do pretty much anything she asked (Do you want to poison him? I'll help carry him to the pigs pen).
Second of all, Matthew, you absolute Idiot.
Mary supporting you in your grief, you supporting her with Bates' trial, that's normal friend behaviour.
You telling her she can LIVE with you forever, and so she doesn't have to Marry Any Man, is so, so dumb.
What is she going to live with you as, Matthew? Your cousin again? Where is the cousinl-y behaviour line drawn? Private dinners? Maybe with some candles and soft music? Holidays in Europe together?
Also, where is that imaginary limit you've put to your happiness with her for the sake of Lavinia's (very real, according to canon) ghost, mate?
You clearly seem happy enough to spend time with Mary, support her, laugh with her. Is it just the romance that's killing your mood?
Is it that that's the harshest punishment Matthew could imagine, spending his life next to Mary without actually spending his life WITH her, or is it that in spite of how much he wanted to suffer for his mistake, he just couldn't bring himself to cut ties entirely? Or is it that her happiness was more important than his self-imposed martyrdom, so he couldn't keep himself away and let her throw away her life for God knows what (her own mistake, is the answer, because they both like making themselves suffer for past sins. They've got A LOT in common).
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Mary: Didn’t the war teach you never to make promises? And anyway, you’re wrong. I do have to marry him.
Matthew: But why? Not to prove you’ve broken with me, surely? We know where we stand. We’ve no need for...gestures.
Mary: If I told you the reason, you’d despise me, and that I really couldn’t bear.
She makes me so sad. She's so certain she'll be ruined and kicked out of her house if the scandal ever came out.
And I get it. It was how she'd been raised. And all she's heard so far is how she's "a slut" and "damaged goods" and Mary's self-image is in tatters. She doesn't view herself as anyone worth fighting for, she doesn't want anyone else to fight for her, and she won't even fight for herself, and to me that's the saddest part of all.
She's entirely defeated, has been for a long time. This entire season. She's taken every blow and hasn't dodged them at all. Welcoming Lavinia, accepting Matthew as a friend and nothing more. Being by his side when he got injured, taking care of him and accepting his rejection without a peep. Listening to him announce his wedding and helping Lavinia plan it. Baring herself to Carlisle, giving him "the tools to destroy her", willingly, to salvage the family name, and to help Bates. And later letting Matthew call her, and himself "cursed", and walking away from it, somehow. Probably because she believes it.
https://preview.redd.it/qit578gnev0d1.jpg?width=400&format=pjpg&auto=webp&s=051641f1ae8d012e74d70975b12d71852fa2cfbe
She told Carson, after Pamuk died, that "she knows what it means to be happy, but she knows she herself will never be happy" and she has proved to have embraced that sentiment, fully. Her despair back then is reflected here. Mary is not looking for happiness. She's just looking for cover. Some place where she can be sure she won't be hurt anymore.
She didn't believe that would be in a marriage with Matthew, and Matthew's strict morals so far, and his own self-hatred, have only further proven to her that she had been correct. She thinks that if Matthew can't excuse himself a kiss with a woman he loved, he won't ever excuse her having sex with a man she didn't love. And for all the unhappiness, all the cold comfort she sees in her future, she at least has his friendship. And how could she ever risk losing that? What would she be left with? Who else is there in the world, that supports her like he has? Her mother, who brought back Lavinia to push her away from Matthew? Her father? Who values the family above all else? Nothing. And no one. Just Matthew.
So she can bear Carlisle's cruelty, his moods and his demands. And she can bear the thought of living life on his arm to be paraded around London society for his benefit. But she can't bear the thought of Matthew thinking ill of her. Can't bear having him look at her the way her mother, or her sister did. And she's so honest here in her pain. She hasn't shown any of it, of the backloads of it, to anyone other than Anna, all season. But she can't keep it in now, after all that, in front of Matthew.
My poor broken child 💔
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She hears Cora yell her name and there's despair in her eyes. Even now she has family obligations to fulfil, so whatever emotional breakthrough she could have made, gets interrupted because heaven forbid she's not there for the Crawleys to play card games with.
Before I forget, Matthew goes after Mary, hoping to help her in her hour of need therefore, Matthew's Villainy points so far: 4
Matthew directs that accusatory look to Cora and I'm so proud of him for that. Cora's involvement in Mary's life has been nothing short of catastrophic. With her only saving grace being the fact that she wasn't actually willing to throw her daughter out of her house. I don't know how she gets to be so worried about the situation now, considering it's, largely, of her own making.
This whole season has been about pain and loss, in its various forms. And Mary's has been largely contained, because that's who she is, she keeps everything close to her heart, especially the things that hurt her. But it's all spilling out in this episode. There's so many things she can't contain, like Carlisle's jealousy, her own grief, at this point, after so many years. And for all those who look, it's the most obvious thing in the world, that Mary is suffering.
Well. Almost all.
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Robert calls Carlisle grabbing Mary in front of her family "an awkward moment", and calls Mary "tired" of Carlisle.
Yes, Robert. Of all the things Mary is feeling at the moment, tiredness is one of them. Not sure if it's the most obvious one, but with you I've learned to bring a small basket.
He also, unlike Matthew, doesn't respect Mary enough to go up to her and ask her if she needs anything from, idk, her father. Some help, some advice. He asks his wife to tell him if he's overlooked anything, and how is the answer to that not "Pretty much everything that's ever happened in this house".
And at this point, I will leave you, because we're half way through and I've already hit both my word, and my image limit. The first one is self-imposed, for the second one, send your grievances @ reddit.

PC

Discord Tag: 7up
Name and House: Ronnel Arryn
Age: 33
Cultural Group: Valeman
Appearance: Cheekbones poised like a falcon perched, an aquiline nose after a raptor's beak, a stature rivalling a mountain's (if it were the size of a tall man), and blue eyes the same color as the sky. Aside from a propagandist's parallels to whatever sigil their patron displays, Ronnel Arryn errs from the example of the aloof falcon. Once possessed of a heedless will, a brashness and an impatience, those qualities have been tamed in turn by fatherhood, husbandhood, and rulership—though those traits still persist, merely tinged by the manner that an elder brother might take with the younger. His hair has shifted from dirty blond to sandy brown with age, and a trimmed beard covers his jaw.
Trait: Inspiring
Skill(s): Blunt Weapons, Cavalryman, Tactician, Cunning (e)
Talent(s): Falconry, hunting (non-mechanical 🤫🧏‍♂️), dragonriding
Negative Trait(s): N/A
Starting Title(s): Lord of the Eyrie, Lord of the Vale, Defender of the Guarded Domains of Arryn, Warden of the East, Warden of the Green Fork, First and Last of His Name, the King Who Flew, Rider of Vhagar (sometimes), and the Last King in Westeros
Starting Location: Feast
Family Tree

AC

Name and House: Marq Hardyng
Age: 32
Cultural Group: Valeman
Appearance: A broad and ruddy man, blonde, brown-eyed, and bearded. Marq Hardyng wears his duty on his sleeve; that duty mostly being hunting with his milk brother.
Trait: Hale
Skill(s): Swords, Investigator (e)
Talent(s): Tourney lore x3
Negative Trait(s): N/A
Starting Title(s): Scion of House Hardyng
Starting Location: Feast

Biography

Little of the Last King’s early years are of much import; Ronnel Arryn was born to King Joffrey I and Queen Sharra Arryn. His few memories of his father were that of a pallid man, wan and sickly but still a king who bloody well fought the illness that plagued him.
Or perhaps those were just fanciful tales, an imagined story that supplanted the truth of the matter.
Joffrey Arryn did at least survive, if he did not fight. Ronnel’s siblings, Jonos and Roland, would be born in succession. The falcons grew in number, Joffrey’s ailment ceased, and—the gods took him away and brought Arwen Arryn into the world.
Shortly after his sister’s birth, Sharra Arryn dressed her son in royal regalia and placed a crown on his head, assuming rule as sole regent while the boy distracted himself with toys and games. He would be nursed with Marq Hardyng, and he and his milk brother grew to be quick friends.
The Queen Sharra could not rest. There were new contenders on the horizon, greater than what meager assaults the Hoares could occasionally muster against the Bloody Gate: the threefold conquerors atop their dragons. Where the ravens sent by Aegon were met with scorn by Durrandon and hubris by the Hoares, Sharra offered alliance. Her hand in marriage and the left bank of the Green Fork to be annexed into the Guarded Domains.
The dragons rejected the offer, and instead, a Velaryon fleet was sent to take Gulltown and establish a foothold. They were repelled and the Targaryen ships were sunk for that transgression, but Vhagar’s fire consumed the Grafton fleet with them.
Ronnel knew what war was. It was like those tales in storybooks, that of the Griffin King and the Winged Knight, the legends of the Battle of Sevenstars. He, Jonos, and Marq fashioned themselves as Jaime Corbray or Luceon Templeton and fought each other over who could best live up to Artys Arryn’s example. When the Gates of the Moon swelled with men-at-arms, knights, and levied smallfolk, the three would find the most fearsome looking of them and challenge them to duels. Once he heard of dragons, though, Ronnel was consumed. He begged his mother to let him lead a parlay under a peace banner just so that he could see them, but Sharra sent him off to the nurses or left him to kick rocks in the courtyard.
The banners gathered, and the defenses were headed by Lord Rodrik Hardyng. Orders were given, the soldiers were drilled. And Vhagar’s wings cast a shadow so large that it engulfed the Bloody Gate whole. Shouting on the ramparts and in the valleys, but high above in the Eyrie? Ronnel, then just eight, was in awe at the sight.
Sharra could only muster a smile when she returned to find her son on Visenya’s lap. An accord was struck, on Ronnel’s terms this time: he asked to fly on Vhagar and his mother would surrender the crown to the Targaryen Queen. The mercy that Visenya afforded was well-taken, though in Sharra’s mind, the threat of dragonfire crystallized.
A marked shift came then. There were no battles to be won, no politicking to be done that outweighed the import of her sons and her daughter. The Queen-Regent, now the Lady-Regent, empowered her son’s advisors and devoted her time to looking after her children. When Visenya returned after burning House Sunderland whole and gave reprimands, Sharra frowned and offered blunt words in turn, which the Queen acquiesced to. Their relationship thawed hence, though Ronnel had never wavered in his admiration of the Targaryen. A Winged-Knight-Come-Again. Perhaps he could ride a dragon of his own one day.
Ronnel was a rowdy lad and by the time he was of squiring age, he was content to leave the rule of his lands to his mother and whoever she picked as an advisor. Lords such as Lyn Egen, Willem Ryger, and Rodrik Templeton would come to advise the young lord or hawk with him. Lord Mathos Grafton became the most prominent of that cadre, his wisdom in old age allowing him more room for criticism. Ronnel wanted to while his time away with falconry and training, while the old lord reminded him of the issues that Targaryen reign brought.
At four-and-ten, Ronnel stole away from the Eyrie and gathered what boys and knights he could to face the mountain clans. He knew what war was; it was the Root Father and his savages, stealing and laying waste to the lands he was sworn to protect. It was in the throes of battle that Ronnel would be dubbed as a knight by some unknown dying man. The knighthood was left unmentioned, though the purpose he found for his rule—no, his guardianship—lingered.
In his victorious return to the Eyrie, Ronnel would be clouted on the ear for the stunt then barred from leaving for months. Visenya Targaryen landed once more in the Vale. This time, she took it as a home, and she was welcomed with open arms. Aegon’s heir was born in the Eyrie that year, dubbed as Laenor Targaryen and soon practically adopted by the Arryns as their younger sibling. Sharra would grow close to the dragon queen in the years to come.
A year later, Ronnel was sent to King’s Landing to squire for Orys Baratheon. Only a few months elapsed before he grew incensed with the Hand over one thing or another, and the squireship ended when the Arryn came to blows with his knight-master. Ronnel was sent back to the Vale, where he earned his spurs once more. Publicly this time, before a crowd of tourneygoers and then holding a vigil with oaths modeled after those of the Winged Knights.
Though he gave off the impression of a true knight by that time, he was more preoccupied with wine and women and the hunt than statecraft. In any room he entered, he laughed the loudest, boasted the loudest, fought the hardest, always with Marq at his side. Nothing but a scolding from his mother Sharra or a clout on the ear from his second mother Visenya could fetter him. He was a falcon, and he flew high and bright.
Such a lofty stature is bound to attract envy. As any elder brother would, he butted heads with his siblings often. His rivalry with his brother Jonos was much more than a sibling spat, however, though the nature and root of their rivalry is unknown to all but a select few. In later years, their quarrels grew louder and their rifts deeper, with Jonos having been sent thrice to play second fiddle to the Knight of the Bloody Gate, and threatened with taking the black twice as many times. Still, their early quarrels proved to be mere distractions, and they wreaked what havoc boy-lords would in taverns and winesinks.
But his lip had to become stiff the day his mother died, just a few months after he came of age and assumed power. Sharra Arryn's last words of advice ate away at his spirit.
"Kill the boy."
So he was offered at the altar, and so did Rhaenys Targaryen seize the opportunity. Ronnel Arryn would be wed to the Queen’s lady-in-waiting, Serena Stark, and that match was confirmed by Sharra’s will. Yet numb, he received his wife to be in Gulltown with courtesy, and they were wedded with haste. Once a Princess of the North and now the Lady of the Vale, Serena found no home in the Eyrie. Ronnel came to avoid her; going on hunts, staying at the Moongates or even the Bloody Gate, and offering only short conversation in their rare meetings.
It came to a head when Serena stated her intention to return to Winterfell. Ronnel gave a shrug in response, and asked when she wanted to depart. Jonos could be his heir if need be, and his mother’s death still dragged his thoughts, so why bother at all?
The intervention of one dragon queen then another halted the split: Visenya reminded Ronnel that Aegon made two marriages work at once. A raven carrying a letter from Queen Rhaenys arrived, affixed with a ring wrought of Valyrian steel. Ronnel gave it to Serena as a peace offering.
There was no parting from the Targaryens’ grand plans, it seemed. So Ronnel’s marriage with Serena began anew. She would be introduced to the Vale and its customs with feasts and tourneys, sitting on councils and holding court as the Lady of the Vale. In the same vein, more familiar items and furnishings were brought in from the North, and Ronnel would journey to the weirwood tree that the mountain clans held sacred to try to pray with his wife. He did not hear the old gods’ whispers and could not bear the stillness, but the two came to understand one another, and their marriage grew warm. Their first child, Robar Arryn, was born a year later, and the Tourney by the Maiden’s Bay would be held in his honor.
Ronnel settled into his reign. His liveliness returned, though boyish pursuits were restrained with fatherhood. He replaced the Keeper of the Gates of the Moon after the Cavaliers proved more competent, sent tax collector after tax collector when Witch Isle grew silent (and nearly called the banners before being dissuaded), and ensured that the mountain clans and any other would-be invaders were quelled while Lae Targaryen was raised to be a greater king than their father. The Brotherhood of the Winged Knights, once decrepit, grew stronger after pieces of the Winged Knight’s armor were found.
His second child, a daughter, would be born then. Faced with the choice of naming her after Sharra or Visenya, she would instead be named after her great-grandmother Cynthea. Artos Arryn would follow four years later, his name chosen by the Lady Arryn.
Another day in the Eyrie. Five-and-twenty years after Aegon's Conquest, and near thirty years into Ronnel's reign. He slides a razor over his cheek and coughs once into a fist. Ronnel opens his palm to see droplets of blood. He wipes his cheek. A shaving cut, no doubt and no matter.
The next week while he sups with his family, the coughs come back. He excuses himself, blames his trip to the valleys with a chuckle, and Jonos meets his gaze with a sidelong glance before shirking away.
He sees his maester without telling anyone. And once more after a hunt. Soon, he is left sitting on his bed with grains of sweetsleep in hand and a warning: he would die. And soon.
Ronnel Arryn is honorable. He is just, or at least just enough. But when he bounces his son on his knee and looks into smiling grey eyes where his Stark mother's are oft stern, he wonders whether the next Targaryen to come to the Eyrie would let little Artos fly or burn him and his family whole.
It is not enough. Ronnel Arryn is not just enough. As the last king yet walking on the earth of this damnable regent's kingdom, he needs to ensure that the next monarch in Laenor Targaryen sits firmly on the Iron Throne before he dies—honor be damned if need be, by any means fucking necessary. That is his duty to the realm. That is his duty to his wife and children, and that will be his legacy.

Timeline

• 8-9 BC (33 now idk how BC works): Born the first child to King Joffrey I and Queen Sharra Arryn.
• 3 BC: Joffrey I dies of a chill. Ronnel is crowned king at age six.
• 1 BC: After House Grafton’s fleet is burned, the armies of the Guarded Domains gather at the Bloody Gate. Visenya’s landing.
• 2 AC: The Three Sisters burn.
• 4 AC: Ronnel begins squiring for Elbert Waynwood.
• 6 AC: Ronnel fights his first battle against the Sons of the Tree, and undergoes his first dubbing.
• 7-9 AC: Visenya arrives at the Eyrie. Ronnel departs for King’s Landing to squire for Orys Baratheon, returning after a fight with his knight-master. He is knighted once more at a tourney.
• 10-11 AC: Sharra Arryn dies, and the Arryns’ grief is cut short by a match arranged by Rhaenys and approved by the Lady-Regent before her death. Serena Stark and Ronnel Arryn are wed, and the marriage nearly falls apart before the intervention of the dragon queens.
• 12 AC: Robar Arryn is born. The Tourney by the Maiden’s Bay is called in the new heir's honor.
• 13 AC: The Cavaliers fight off the Painted Dogs outside the Gates of the Moon, and are given wardenship over them as reward. Marq Hardyng begins pursuing the tourney circuit.
• 15 AC: Cynthea Arryn is born.
• 19 AC: Artos Arryn is born.
• 23 AC: With Jonos Arryn settling into a discontent life at the Bloody Gate, the need for a sworn sword is lessened. Marq Hardyng travels to Essos to search for clues linking the Winged Knight to the Andal conquerors. He finds none, and returns a year later.
• Early 25 AC: An illness wells in Ronnel’s lungs. His maester tells him that he has about a year to live.
• Late 25 AC: The Arryns travel to the celebration near King’s Landing.

Sup porting Characters

• Cortnay Arryn, 54 (General): Ronnel’s uncle. Once a prince, Cortnay served variously as the Knight of the Gate, the Captain of the Guards, or an advisor. Cortnay is known for his exasperated sighs, and struggles to keep up when he hunts with his nephew. Still, he has a good head for tactics and participated in actions against the Mountain Clans and the Hoares.
• Jasper Arryn, 19 (General): Ronnel’s second cousin. Though removed from the main line of House Arryn, Jasper was raised in the Gates and remained a fixture in the Arryn household. He swore vows modeled after the Ash-Branded, though his cheery disposition seems to contradict them.
• Cynthea Corbray, 78 (N/A): The Queen-Grandmother claims to have been asleep when Visenya landed in the Eyrie, and preserved her coronet by hiding it in the Gates. She resides at the Gates of the Moon with the Cavaliers, and it has become tradition to pay one’s respects to her when passing through.
• Jonos Arryn, 31 (N/A): In another world, Jonos would be known as the Kinslayer, and he certainly possesses that propensity. Wed to Maris Grafton and perhaps favored by her lord grandfather, he has long since hated the Targaryens, and blames Visenya for his true mother’s death. Jonos’ truculence precedes him, and he is kept fettered with thankless offices.

As a nurse, is it regular practice in your ER to administer enemas(milk of molasses inparticular) or disimpact when you are discharging the patient? It feels like it’s such a time consuming thing that it’s not an intervention that’s appropriate for an ER setting. Is my ER the only one doing it???

TW: past medical abuse, mentions of miscarriage, preemie baby and Nicu stay.
This is my second baby, and my last! He was due in early May. Two years previously, I had his older sister at 36 weeks, so I knew that there was a possibility of going into labor early. So I scheduled my maternity leave at school to start at around 36 weeks, thinking if I relax I could keep him in for another week or so and have a full-term baby. Nope!
I had had a lot of previous issues with this pregnancy, like a hemorrhaging incident at 10 weeks in which we thought I had a miscarriage, some continue to bleeding and cramping at different points in my pregnancy, and a premature loss of my mucus plug. I was told each time that everything's fine and there's no sign of anything wrong and he should be a healthy full term baby. I felt like everyone around me thought I was being dramatic or looking for attention, but I really just wanted my baby to be okay and had this constant feeling that something wasn't right. Well, something wasn't right.
I, just like with my daughter, spontaneously went into labor at 34 weeks. PPROM, with my water breaking impressively around midnight at home. We of course we're not expecting this, so my husband ran to a neighbor to get them to come house sit until his mother could arrive to watch our sleeping toddler upstairs, and we drove to the hospital. I originally had wanted to drive myself because I just didn't want to leave our daughter without a parent at home, but I was gushing so much water that I couldn't hardly string two words together, let alone walk.
We got to the hospital, went into the emergency room entrance because it was after hours, and went to labor and delivery triage. Won't behold, I'm a couple centimeters dilated and in labor. The nurse I had was pretty rough giving me a cervical check, and it was the only one I've ever had between the two children have given birth to that hurt. The same nurse also failed to get my IV port in and left in half, and thankfully another nurse who wasn't in a bad mood came in and got it on the 4th attempt. My poor arms were covered in massive bruises for a couple weeks afterwards. Amazingly we were put in the same in sweet Nicki room as we were for my daughter 2 years ago, good old room 350!
Labor progressed well I'm without need for any intervention, like pictocin. I handled the contractions better than I did with my first, but wanted to make sure I got my epidural before I progressed to pass the point of no return-- I in no way wanted to experience the feeling of possibly ripping my vagina 🫠
It was really tough mentally, getting my epidural. With my first baby, the anesthesiologist was horrible. You can look at my previous birth story if you want the full rundown, but he assaulted me, so I was really nervous this time around. The nurse caught on that I was feeling apprehensive, and with talking to her I came to found out that the previous anesthesiologist had been fired for assaulting multiple women the same way he did me! Really hope he never works again. They brought in the new anesthesiologist, and he was the most gentle and kind person! It went very smoothly, and it was nice to have a relief from the contractions and pressure.
I was hoping I could maybe rest or even nap once I got my epidural in like I did was my first. But nope, 10 minutes later I was being told he is right there and ready to come out, about half a day after labor started. I don't know why, probably because he was so little, but he was incredibly easy to push out. I was told to stop pushing, and not push so hard, and got him out in about three gentle but steady pushes. Thankfully I had no damage at all, no tearing or even bruising or swelling. After my epidural wore off it literally just felt like I had written a bike for the first time in a while. As immensely grateful, because I was going to be run through the ringer taking care of my family and a Nicu baby.
When he first came out, my son was very small, yes, but incredibly pink, very lively and noisy, and he peed all over me immediately lol. They let him have extra time with his cord before they clamped it due to him being early, and I got to do my wonderful hour with him before they wished him over to the NICU attachment of the room. He had respiratory distress for the first 24 hours of his life, which was gut-wrenching to watch. He could not regulate his body temperature at all, so unless he was snuggled under many blankets on me, He stayed on the warmer. He couldn't eat by himself so his NG tube was placed and used for the majority of his stay. His blood sugar was monitored very religiously, and it was so tough watching his little feet be pricked over and over and over.
I was released after 2 days from the hospital, and I probably could have been released earlier but I wanted to stay officially as a patient for a little longer. It was hard, being away from my toddler daughter was a special kind of hell. But then when I was with her, my heart was torn to pieces that I wasn't with my baby. No matter where I was, I felt horrible guilt. I triple fed, pumping every 3 hours, and if I was a NICU nursing him before they topped him up with his special increased calorie premium formula. Any milk I produced was fortified to give to him as well. He steadily lost weight despite them constantly increasing the size of a speeds, the point of him constantly spitting up from having way too much in his tummy. But I was told that this is just what they do until they start gaining weight. I was told with preemies that they just won't put on weight for the longest time, and then suddenly start putting it on, and suddenly eating on their own.
I was starting to lose hope of that, when on about the 10th day he put on weight overnight. They took out his tube and we worked on feedings with him, which he seemed to struggle so hard with. But then just like with the weight, he suddenly started eating well. On day 12 we could take him home! In a way it was even harder at home to keep up with the pumping, fortifying the milk I pumped myself, mixing the special recipe of extra calories preemie formula, and nursing. He gained weight so well that I was given the okay after a few days at home to stop pumping if I didn't want to. I very gratefully stopped pumping
. He eventually started showing signs of a milk protein intolerance, just like my daughter had, and just like I had as a baby. It was no surprise to me when he was put on hypoallergenic formula. We're still dealing with all of that right now, with me trying to keep dairy out of my diet and struggling with the decision of whether I want to keep combo feeding or just switch over completely formula. He will be 2 months old in about a week and he is put on 4 lb so far, almost doubling his birth weight!
Right now we are also struggling with his head shape. This was new to me, because my first born head no issues with any flat spots or head shape at all. But being in NICU, they always faced him in the same direction, facing the nursing station when I was not there. He developed a tendency to put his head to the right, and developed a bit of flat spot. We've been working with him on tummy time, gently repositioning his head the other way, and just doing everything in our power to help correct this... All to know avail. His spot has gotten worse, and we are fairly certain that he will be getting a helmet soon. I know it's no big deal, but apart me feels like I failed somehow 😭 his poor, cute little lopsided noggin 🥺 otherwise, besides his head shape and figuring out his dairy intolerance, he's doing well!
I've tried multiple times to figure out why my babies were born so early, why my body couldn't keep them in to be full term. The OB had no answers for me and just sort of shrugged her shoulders at it, saying that since I showed no signs of having an incompetence cervix or anything else, it was just something that we'd never know why. She was relieved though to hear that we did not plan to have any more children, as that would have made things a bit more complicated given my history of early birth.
It's hard of me is sad that I'm not having any more children, but the possibility of having another preemie baby, especially one even younger than my first two, is sobering. I will just enjoy my two very healthy and happy babies I have 💕

Neonatal hypoglycemia treatment
I (36F) G2P1 gave birth to my son at 39+1. Pregnancy was complicated by uterine arterial notching, and bilateral hydronephrosis (resolved after birth). No GDM. Baby was AGA 7lbs 5oz. APGARs 8 and 8.
Approximately 6 hours after birth, I noticed my baby was shaky. Our pediatric NP was in the room and I asked her to look at it. At first she said it was nothing, but decided to take a temp. It was 97.0. She had the RN take a glucose level which resulted as <20. He was sent to the transition care nursery.
He was given dextrose gel and formula. BG rechecked 1 hour later and was 20. Given a second dextrose gel and formula. Rechecked in another hour and was 22. Instead of treating, whoever was taking care of him re-did the test and it resulted at 39. No intervention was done. Three hours later it was checked and again resulted at <20. Given dextrose gel and transferred to NICU.
Glucose resolved on DOL 4 (had been receiving 12.5% dextrose infusion) and he was weaned off the dextrose infusion. DOL 4 my baby began having seizures and was found to have cytotoxic edema in his left occipital and parietal lobes.
I’ve collected all of his medical records from the hospital and now what to know if a case should be pursued? The transition nurse who disregarded the third reading of 22 despite protocol saying to contact MD seems like a delay in critical care. Any advice?

DC Next Proudly Presents:

THE NEW TITANS

In Shadow of Kestrel
Issue Nine: War Dove
Written by AdamantAce, GemlinTheGremlin & PatrollinTheMojave
Edited by Deadislandman1 and Voidkiller826
 
Next Issue > Coming Next Month
 
 
“Raven!”
Slade’s gruff voice pierced through the deafening, wave-like roars in Raven’s head, but the rage was too much to bear. Her hands sizzled as hellfire danced in her palms, her body readying for another attack. She locked eyes with a reptilian soldier, dismounting his simian steed and charging on foot, but as she lunged forwards to strike him, she watched a man fly into her path. Slade Wilson caught the young Titan’s hand and pushed, throwing Raven backwards.
“Come on, kid, snap out of it!” But as Slade’s words fell on deaf ears, he felt the familiar sting of a fist to his jaw, a crack echoing in his ears. He recoiled from the attack but powered through his injury and stood his ground. Sinking his heels into the ground, he locked eyes with the girl before him. Her face seemed contorted and uncanny, as if all of the rage she was feeling was pouring out of her. She groaned angrily as she thrusted her head downwards, her forehead making contact with Slade’s teeth, before pulling her head back up again in preparation for another attack.
Before she could make one, however, one of the lizardmen had almost reached the warring duo’s sides, and as he lunged forward with his long spear, he made contact with Raven’s side. A small rip formed in the side of Raven’s outfit, which seemed to only anger her further. However, it did seem to distract her enough; Mar’i fired off a single Starbolt which struck only the ground - a warning shot.
“Raven! Please!” the half-Tamaranean cried out. But the Raven she knew was buried under unfathomable amounts of fury; she ignored her teammate’s call and instead flew forwards and swung out at the reptiloid. The strike glowed with red flame, sending the creature skidding across the floor, barely conscious. Slade spotted a flash of something else on her face, as if she was finally able to fight back against the endless rage - pain, perhaps, or anguish. But in an instant, it was gone.
That flicker of something other than white-hot anger was enough for Slade.
He clutched his side as his still open wound began to ache, the bandages feeling wet with fresh blood. His jaw felt crooked, and as he gritted his teeth, it felt as though they sat differently atop each other. And yet, he clutched his staff tightly in one hand, and with the other he beckoned to Raven.
“Kid, you’re fighting it, I know you are!” Slade felt his mouth filling with blood rather than saliva.
Within a moment, Raven’s attention was locked on the white-haired man once again. She fired bolt after bolt of black and red flame, but Slade was still dextrous despite his pain. He dodged and dived, weaving through the fire, until he finally managed to make contact with his opponent. He drove his staff into her chest and pushed his weight against the weapon, forcing her backwards. She rose into the air, a black mist pouring from her arms and over her face, a large ghostly corvid taking her place. He felt the deathly cold shadow of the bird’s wing fall over him, his feet leaving the ground as she scooped him into the air.
He looked down at the ground far beneath him. A fall from this height would kill anyone, he thought, let alone someone beaten half to death.
Then, as a verdant bolt of energy struck it in the side, Raven’s Soul Self shrieked and the shadows retreated inwards. Slade felt himself falling through the air for a second, then two, before he felt his back collide with something soft and cushioned. As he looked up, he met the gaze of Conner, who soared to the ground in an instant, placing the snow-haired man on the ground and giving a swift nod.
Raven let out a pained, frustrated yell as she returned to the ground, aided by a grappling line expertly positioned by Tim, and in response, Conner jetted off towards the sound of her cries. Slade’s feet faltered beneath him, and he stumbled to keep his balance. His breathing was laboured and his vision was becoming fuzzy. It felt as though, he realised, all the blood loss and violence he had suffered over the past few hours were finally catching up to him. Was this what dying felt like?
“Slade!” shouted a voice, followed by the dulled drumming of hurried footsteps. Slade pulled his hand across his face to wipe away the mental haze and drops of blood. It was Don, sprinting towards him. When Slade felt Don clasp him by shoulders, he realized just how slowed he was by his injuries. “Plan?” Slade coughed out.
“You’ve seen what she can do. I only see one way out of these without one of the kids getting hurt. I’d do it myself, but I’m out of practice and this is too important to leave to chance.” Don looked around anxiously, his face betraying that he had a lot on his mind. “I’m giving you the powers of a god.” Slade opened his mouth to ask a question, a million came to mind. He glanced across the battlefield. Through a blurry film, he saw Raven’s Soul Self bat Conner away with its wing. He careened into the trunk of a thick tree, uprooting it with a deep crunch. “Are you sure?,” Slade asked, breathless.
“I’m not losing another Titan.” Don squeezed his eyes shut. His grip on Slade tightened as pale, almost blinding light enveloped them. It felt warm. No, better than that: it felt peaceful. With his enhanced senses, Slade could hear his erratic heartbeat slow. Fleeting visions bubbled up in his mind, opening up his awareness beyond the wildest dreams of Project Veritas. He felt rivers of magical energy flowing through the air and earth. Each of them spiralled towards a depression. Towards Raven, he knew instinctively. Iridescent blue light spread outward from his shoulders. It washed over his body armor, bleaching the jet black panels until his entire body shone with radiance. The pain from wounds old and new faded, replaced by serenity - and power. Don opened his eyes again and sighed gently; a concoction and joy, relief, and quiet mourning.
“There,” Don remarked. Slade felt lighter, less angry, less burdened. He looked down at the iridescent light enveloping his body. Magical energy buzzed against the surface of his skin. “The powers of the Dove - officially yours.”
Slade sucked in a nervous breath. “Don…” Even rejuvenated, he was still lost for words.
“They’re yours now,” Don smiled weakly. “Now go earn them. There’s a Titan in dire need of our help.”
Conner floated out of the dense jungle, rubbing his forehead. “Is Slade glowing or do I have a concussion?”
Slade looked over at Raven. She seemed less erratic, her movements driven by her brain rather than her gut. Tim’s staff batted fiercely against her, each strike buffeting her back more and more, but it was clear to Slade that Raven was not any weaker physically - her mind, however, was another story.
Slade began marching towards her, the ache in his side dulled. “Raven. You’re strong. Fight this rage inside of you.” Raven glared at him, a spark of something in her eyes, as she swooped in towards him at top speed. As she neared him, however, Slade readied his staff, stretching it out in front of him. As the tip of the weapon struck Raven, a beam of white energy coursed through her, as if she had been struck by lightning, and her body was flung backwards across the dirt.
Slade danced a hand over his rifle, but something felt different. He pulled it into his hands and inspected it swiftly; nothing seemed out of order. Raven rose slowly from her supine position, snarling softly to herself. Her movements had slowed, the expression on her face becoming closer to horror than rage. She was doing it.
“You’re nearly there, kid,” Slade soothed, his words suddenly like butter. He watched Raven’s shoulders start to relax. “That’s it. Just fight this, Raven. You’re almost there.”
Despite her tremendous progress, Raven’s blistering fury won out once more, and she charged a large bolt of hellfire in her hands. Slade fiddled with his rifle and crossed his fingers. There was a standstill between the two. Slade analysed his rifle again; there was something different about the barrel, as if it had been swapped out for another similar model. The stock felt lighter, too, as if the weight had been–
Raven roared at him, swiping wildly with glowing fists, and in an instant Slade instinctively pulled the trigger.
What fired from the gun was not a silvery bullet, but a familiar glowing bolt of white light, cloud-like in appearance. As it struck Raven, she sucked in a deep breath, the energy engulfing her. Her face softened and her posture relaxed. Then she swung out for the man’s weakened side, his bandages poking through the aura of light. And yet, as he stayed steadfast, not even attempting to dodge the attack. Sparks flew from the point of contact. Slade just readied another shot and fired.
Her body swayed with the blow. Slade closed the gap between them and focused on the new warmth he felt, concentrating it into his staff as best he could. Then, as he held it out in front of him at arm’s length, he swiped at Raven and struck her in the side of the shoulder. Each blow seemed to be more effective than the last, but as Raven’s movements continued to slow, Slade held fire.
“You’re doing it, Raven,” Slade encouraged. He watched as the other Titans surrounded Raven, each of them ready for any further attacks. Everyone watched with bated breath as their teammate and friend thrashed and recoiled from the hit. Her breathing was rapid, although it felt closer to panic than unabashed fury. She clasped her hands over her head, groaning. Then, suddenly, she stopped.
Her face had softened completely, her jaw slack, and tears filled her vision. She looked up at Slade with a comfort in her eyes. The aura emanating from him was pervasive and contagious, and although she had felt lost in a sea of impossibly vast emotions, its warmth and comfort cut through. The anger was still there somewhat, the last remaining dregs still working its way out of her system, but the comfort, the peace that Slade was providing was the anchor for her to stabilise herself. She had only ever seen this kind of power when Don…
Raven’s eyes widened as she realised what that meant. She collapsed to her knees, suddenly feeling the bone-deep fatigue her rage had suppressed. Her teammates rushed in around her. Mar’i dropped to a knee by her side and put a hand on her shoulder. “It’s OK. You’re safe. Everyone’s OK.”
“Don I’m—” She wiped away a stream of tears, stumbling her way out of the emotional vortex she’d been sucked into. “I’m so sorry. I don’t know what happened. I’ve lost control before, but never like this.”
Don looked older. Creases ran across his forehead and around his eyes. His smile hadn’t changed. “Raven, my brother and I got those powers when I was a kid. We didn’t ask for them. We weren’t ready for them. We didn’t know how to use them, let alone control them.” He laughed dryly, recalling Hank. “I don’t regret anything. Giving my powers to Slade is the best thing I’ve done with them in years. I know Hank would feel the same way.”
In the moment of silence that followed, Raven rose to her feet and pulled her cloak tightly around herself. She was still shaking. Tim’s eyes drifted from her to Slade. “Something’s gnawing at me. Kestrel’s powers are weakened in Skartaris. Don’s…” He coughed, “Slade’s powers are amplified. If this place is what affected you—”
Mar’i’s face flashed with recognition, “—your powers must be tied to the Lords of Order and Chaos!”
Tim furrowed his brow. “Maybe.” He hardly had time to consider further when a thundering crack tore open the sky. Two bolts of swirling energy - one red and one blue - met above them, forming a swirling portal at their vertex. The Titans readied their weapons, expecting the worst.
“It’s them.” Slade murmured, still put off by his uncanny awareness. Terataya and T’Charr descended from the sky, one wreathed in mist, the other, magma. The two elementals stopped a few feet above the ground, hovering.
Terataya was the first to speak. Even at a whisper, her voice reverberated through the air. “I don’t usually care for surprises, Don, but this was a pleasant one.” A thin smile appeared on her face.
“Slade Wilson.” Terataya’s neck turned at an unnatural angle to face him. “You wield the powers of Order with great skill. Who understands the dangers of unchecked War better than a soldier. Become my champion. Protect the balance.”
Slade took a step back, then glanced at Don.
“She’s right.” Don said, with only a hint of hesitation. “It took me years to use the powers like you used them today. You’re a natural.”
Slade looked at his hands, still gently pulsing with pale blue light. “Thanks.” He allowed himself a weak smile. “But no thanks.”
“What.” T’Charr’s voice boomed.
“It doesn’t take Zatanna to realize an old soldier like me makes a piss-poor Avatar of Peace. I fight for a living, and I’m not deluded enough to think that makes me good at anything but fighting. If you want someone who understands the need for balance, Don just sacrificed everything special about him for it.”
Don raised an eyebrow. “None taken.”
“His actions today were noble, but they do not make up for years spent squandering the gift.”
“Squandering? The Titans wouldn’t exist today if he hadn’t pulled them together. Everything they’ve done. Everything they’ve achieved for your balance wouldn’t have happened without him, including stopping that monster you made.”
“Watch your tone, mortal.” T’Charr threatened.
“There may be a vein of truth to his words, lover.” Terataya said. “But *if we were to restore Don Hall’s power, we would need assurances. His indecision led down this path.”*
Rocks ground against each other as T’Charr landed beside Don. “You would have weeks, not years, to select a counterpart and return to your duties.”
Don’s response was instantaneous. “I’ve made a decision.”
“You’ve decided if you’ll take up the mantle of Dove again?”
Don nodded. “And who should be the new Hawk.”
Terataya giggled. “Full of surprises today. T’Charr?”
“We should discuss this.” He said. “In private.”
The three of them vanished, leaving the Titans and Slade alone on a battlefield riddled with bits of dino meat and ape fur.
 
○○ Ⓣ ○○
 
“You don’t think they’re gonna come back in like, 200 years, right?” Conner asked. He sat beside the depowered Slade Wilson, who was downing aspirin to make up for the sudden deficit in peace energy.
“I don’t know.” Tim said. “But we should give them more than fifteen minutes.”
As if on cue, the skies opened again. Again, the chromatic energy lit the sky and again a portal opened its swirling maw. This time, however, it wasn’t two elemental Lords to descend. Raven squinted to make the figures out.
“Oh my god.” Conner said, having a far easier time with his super-vision.
“What? Who is it?” Tim asked.
“Donna!” Mar’i shouted. She shot off the ground towards her. Her black combat armor was replaced with a crimson and white bodysuit studded with stars that seemed to twinkle as the light shifted around her. The sword at her side was gone too, replaced with a coiled loop of rope suffused with the same brilliant energy. The two collided into an embrace, spinning through the air as they held each other tightly.
Don was the first to land, restored with the powers of Dove. He looked stronger than ever, and maybe more importantly, happier. Even Tim’s typical thoughtful brooding has been pierced by an unimpeachable joy.
“I don’t understand,.” Raven said. “S-She’s alive. How is this possible?”
“I knew there was only one person who could be trusted with the powers of War, with Hank’s abilities.” He scratched the back of his neck, a bit guilty. “And she’d been staring me in the face for years. It took some doing, but eventually T’Charr and Terataya saw that too.”
Donna landed beside him, Mar’i only a step behind. By now Conner had stepped forward. He tried not to choke over his words. “I’m sorry. If I’d—”
Donna didn’t let him get the words out before pulling him into a grapple-turned-hug that quickly grew as the rest of the team piled in. Slade flicked another aspirin into his mouth.
“Danyah!” A voice called out from over the ridge. It was Travis, mounted atop a fanged reptilian creature in the vague shape of a horse and flanked on either side by his gold-armored honor guard. He broke into a gallop, stopping just short of the Titans. “When I saw the skies, I feared the worst. Is it really you? Has sorcery brought you back to us?”
“It’s me, Travis. A Lord of Chaos brought me back.”
“Not to interrupt,.” Slade said, still nursing his wounds. “But did either of you ask them to bring us back to Chicago?”
“I…” Don grimaced. “Donna, how do we get home?”
“How did you get here? Surely you could return the way you came.” Travis said.
“No, we can’t.” Tim said, pressing a few buttons on his wrist’s holographic display. “Whatever magic pervades Skartaris is also causing some extreme time dilation. I can’t guarantee we’d return to the 21st century, or even to Earth.”
“I spent a decade in Skartaris and returned to Earth nearly two centuries later. It’s the influence of Chaos. We’d need a Skartaran mage of overwhelming power to stabilize our return.” She spat the word mage with disgust. Travis’s expression seemed to confirm the reputation of Skartaran spellcasters.
Before their anxiety could spiral, the sky above began to churn. Moments later, the ground shook as a violent bolt of lightning cleaved the air, striking with such ferocity that all but Conner and Donna were flung backward. Mar'i skidded across the damp undergrowth, her senses overwhelmed by the acrid scent of ozone. Her mind was racing; their victory was hard fought, and she doubted they had much left in the tank for another confrontation. She dug her hands into the ground and pushed herself up as she choked from the smell. The Warlord Morgan and his military guards snapped to attention, forming a protective ring around the crater that now marred the earth.
From the smoking pit, a figure rose, unfolding from a crouch like something out of Terminator. Adorned in a red and white jumpsuit that accentuated his lithe build, the young man's appearance was marked by a red cowl and goggles, with sandy brown hair rebelliously spilling out.
Conner squinted through the dissipating smoke, murmuring under his breath, “A speedster?” The Flashes had had a variety of different sidekicks and other allies over the years, but none of them recognised this one
With a nonchalant flair that seemed at odds with the charged atmosphere, the newcomer greeted them. “Hey, everyone chillax. I'm here to get you guys back home.”
Donna, ever the leader, stepped forward and spoke with a commanding curiosity, now emboldened with the war aura of Hawk. “And who are you exactly? Why should we trust you with such a claim?”
Flashing a cheeky grin, he tilted his head and responded, “Well, I’m a speedster for one. Name’s Impulse. If I run fast enough, then I can… well, I guess bend time.”
Behind Donna, the group exchanged sceptical glances. Raven's face remained shadowed by recovery, Mar'i and Conner braced for action, and Tim discretely checked his gadgets, no doubt for something that he could use on a speedster should the need arise.
“Yeah, we figured that much,” Don cut through the tension, his voice calm yet insistent. “Who sent you?”
Impulse chuckled, his demeanour remaining unfazed by their scrutiny. “Look, the details aren't the fun part. Trust me, I can get us back.”
As a silence thick with doubt and scepticism settled over the group, Impulse seemed to realise his casual assurances weren't sufficient. With a theatrical sigh, he reached up and removed his mask, revealing a face familiar to both Mar'i and Raven.
“Brody!?” Mar'i exclaimed, her surprise echoing through the clearing as she stared at the boy who had once hobbled through their college classes with his leg in a cast.
The young man’s grin widened, his eyes sparkling with mischief and a hint of pride. “Actually, it’s Bart.”
 
○○ Ⓣ ○○
 
When Slade emerged from the shower, his skin was glistening with moisture, the water tracing the contours of his scars. He wrapped a stark white towel around his waist, and crossed the plush carpet to sit on the edge of the hotel room bed. He released a slow, deep breath; it was a good job the speedster kid arrived when he did. The notion of being stranded in an alien land or, worse, a different time had gnawed at him with a ferocity that was hard to admit. Without Bart’s intervention, every one of Slade’s meticulously crafted plans would have been utterly dashed.
Facing him, a wall-mounted mirror caught his rugged reflection. Drawn to his own image, Slade studied the scars that mapped his trials, the slick white hair that crowned his head, and the deep lines etched into his face. A familiar discomfort nagged at him, focusing his attention on his right eye. Unable to alleviate the irritation through the skin, Slade exhaled heavily and carefully removed the eye altogether. The movement, fluid and practised, spoke of years of adaptation.
He placed the prosthetic gently on the bed beside him and as he massaged the socket, a decades-old habit, his mind wandered. He wasn't accustomed to keeping the prosthetic in for extended periods. Showering with it had been an uncomfortable experiment in necessity - he didn't like it, but understood the importance of maintaining the facade. The Slade he would have people believe he was would have never lost an eye, because that Slade had led a life far from by the darker paths Slade had truthfully trodden.
His thoughts wandered to his brief time wielding the potent powers of Dove, and Slade felt a twinge of regret at their loss. The clarity and strength those powers had provided were intoxicating, yet he recognised that he had a more important goal, one he couldn’t compromise. His current role demanded not the accumulation of power but the perfection of his deceit, ensuring that all believed he was not the Slade Wilson they knew, but a Reawakened, more innocent doppelganger.
Now, with the glass eye resting beside him, Slade stared at his unmasked visage. Maintaining the myth of the noble Slade was critical. The ruthless mercenary, the World’s Deadliest Killer - those identities had to remain buried. The Titans had believed him enough to entrust him with divine powers, their faith a testament to his performance, but the game was far from over; in fact, it was entering its most critical phase.
 
 
Next: Return to normality in The New Titans #10
 

Hi. You guys might remember that I posted in here and the cancer family support group not long ago looking for some advice about looking ahead at my dad's treatment and care. Please let me know if I should change the flair, but support and advice is definitely wanted.
To revisit, he was diagnosed with stage 4 squamous cell lung cancer, metastases virtually everywhere in his body except brain and spine. We found out at the end of March/maybe very beginning of April. They told him 4-6 months without treatment, up to 18 months with treatment. So.. what happened?
I flew out to be with him and got here on the 15th of April. I took over his full time care. He declined so fast. Tuesday the ​30th, we had an interview with a home based palliative care nurse and he recommended that we send my dad to the hospital. Dad had been getting more and more foggy mentally and having a lot of difficulties communicating, tremors, etc. I questioned this very much and was told throughout the two weeks that I was here that it was probably the pain medication and we alternated through a couple options for pain management up until Tuesday. When the nurse was asking him questions, my dad couldn't remember the date or his address. So we made the call to send him to the hospital because the nurse thought it was more than just the pain medication. He was a complete angel on earth, he stayed with me the entire time until after the EMTs left with my dad and he made sure I was okay.
The doctors found out my dad had hyper calcemia, high calcium levels, which can happen in cancer patients. He had every single symptoms. They tried to give him a bunch of fluids and he got a bit better on day 2. But day 3, Thursday, he was much worse. The physician said, in the kindest way possible, that he didn't think my dad would get better. He tried one more option for a diuretic to help get fluid flowing because dad was having very wet/rattling breathing by that point. It didn't work. I had to make the hardest decision of my entire life to switch my dad to comfort care. It was what he would've wanted and made clear he would've wanted in his advanced directive/polst/etc. He told me for my entire life that if he ever was incapacitated, he wouldn't want to be a vegetable or prolong his suffering, he'd want it to end. Over the past ~month since his diagnosis, he made it clear through his legal forms and telling me/his other family that he would not want to suffer longer for no reason. He was a DNR and he chose "limited intervention" for his preferences. So I did what he wanted, I didn't prolong his suffering since it didn't look like it would help. The doctors and nurses were the most incredible I could've asked for and they gave him a lot of pain medication and meds to help him relax and be comfortable. They were wonderful to me and brought m​e and my family food and water and were just there the whole way through. He passed around midnight Friday morning. He was peaceful and at rest.
I know that I was true to what he wanted. But I'm struggling so fucking much. My heart hurts beyond words. I don't know how to live the rest of my life without him. I'm mourning that he will never get to see my boyfriend and I get married, that he'll never be able to do a first look with me or walk me down the aisle, that he'll never see my boyfriend and I finish our advanced degrees or see my boyfriend's son graduate high school. I had dreams of getting to have an inlaw suite at our future house to have him with us. Even after getting his diagnosis, I had thought we had so much more time. I feel so lost. What do I do now? How do I cope? I already got his ashes back because he wanted to be cremated, having a celebration of life this weekend. Waiting on death certificates to close out accounts and get things taken care of. I don't know what to do with myself. I felt like I was treading water before, barely staying afloat. Now I feel like I'm at the bottom in the silt, running out of air. It hurts so much. Please share any advice or even words of comfort. I'm trying to make sure I have a list of everything that needs to get done. Thank you. So sorry you're along for this journey too ❤️🫂

Hi. You guys might remember that I posted in here not long ago looking for some advice about looking ahead at my dad's treatment and care.
To revisit, he was diagnosed with stage 4 squamous cell lung cancer, metastases virtually everywhere in his body except brain and spine. We found out at the end of March/maybe very beginning of April. They told him 4-6 months without treatment, up to 18 months with treatment. So.. what happened?
I flew out to be with him and got here on the 15th of April. I took over his full time care. He declined so fast. Tuesday the ​30th, we had an interview with a home based palliative care nurse and he recommended that we send my dad to the hospital. Dad had been getting more and more foggy mentally and having a lot of difficulties communicating, tremors, etc. I questioned this very much and was told throughout the two weeks that I was here that it was probably the pain medication and we alternated through a couple options for pain management up until Tuesday. When the nurse was asking him questions, my dad couldn't remember the date or his address. So we made the call to send him to the hospital because the nurse thought it was more than just the pain medication. He was a complete angel on earth, he stayed with me the entire time until after the EMTs left with my dad and he made sure I was okay.
The doctors found out my dad had hyper calcemia, high calcium levels, which can happen in cancer patients. He had every single symptoms. They tried to give him a bunch of fluids and he got a bit better on day 2. But day 3, Thursday, he was much worse. The physician said, in the kindest way possible, that he didn't think my dad would get better. He tried one more option for a diuretic to help get fluid flowing because dad was having very wet/rattling breathing by that point. It didn't work. I had to make the hardest decision of my entire life to switch my dad to comfort care. It was what he would've wanted and made clear he would've wanted in his advanced directive/polst/etc. He told me for my entire life that if he ever was incapacitated, he wouldn't want to be a vegetable or prolong his suffering, he'd want it to end. Over the past ~month since his diagnosis, he made it clear through his legal forms and telling me/his other family that he would not want to suffer longer for no reason. He was a DNR and he chose "limited intervention" for his preferences. So I did what he wanted, I didn't prolong his suffering since it didn't look like it would help. The doctors and nurses were the most incredible I could've asked for and they gave him a lot of pain medication and meds to help him relax and be comfortable. They were wonderful to me and brought m​e and my family food and water and were just there the whole way through. He passed around midnight Friday morning. He was peaceful and at rest.
I know that I was true to what he wanted. But I'm struggling so fucking much. My heart hurts beyond words. I don't know how to live the rest of my life without him. I'm mourning that he will never get to see my boyfriend and I get married, that he'll never be able to do a first look with me or walk me down the aisle, that he'll never see my boyfriend and I finish our advanced degrees or see my boyfriend's son graduate high school. I had dreams of getting to have an inlaw suite at our future house to have him with us. Even after getting his diagnosis, I had thought we had so much more time. I feel so lost. What do I do now? How do I cope? I already got his ashes back because he wanted to be cremated, having a celebration of life this weekend. Waiting on death certificates to close out accounts and get things taken care of. I don't know what to do with myself. I felt like I was treading water before, barely staying afloat. Now I feel like I'm at the bottom in the silt, running out of air. It hurts so much. Please share any advice or even words of comfort. I'm trying to make sure I have a list of everything that needs to get done. Thank you. So sorry you're along for this journey too ❤️🫂