NYC Pride 2017: "Take my hand, pup. Let's be proud together."
Today’s the day Master and I met at Penn Station. After coffees and Shake Shack, we made our way to the hotel. We stayed at Paramount in the Theatre District. Master was so exhausted, I offered to check us in early. SUCCESS! We slept for a few hours then began our afternoon. Master took me to my first ever barber. It was a special place for Master and Alpha: Made Men in Chelsea. After, we journeyed to Nasty Pig and Mr. Turk while stopping for poke along the way. It was such a beautiful day. We had to leave a little sooner than expected from Mr Turk for our date day plans. Master gave me permission to plan a date day for him. I planned our date to be meaningful and packed our itinerary with memorable experiences.
[Before writing about our date, I feel it’s important to share a beautiful and significant pillar of our relationship. This part of our relationship is that we are driven to grow for each other. Love, trust, intimacy, and more. This pride was special in that I not only was pushed to be more submissive, but I was also pushed to grow the more dominant side to Angus (please take note of the “A” in Angus versus the “a” in pup angus). When Angus’ dom side is being stroked and nurtured, there is an internal *buzz* that is felt. Master ordered it to grow to be able to take better care of pup krypto. Krypto makes Angus buzz when he submits, melts into my arms, expresses so much love and emotion he cries, lets me take care of him, and allows me to spoil and pamper him like he has always deserved. Angus shows krypto how much he is loved, wanted, cared for, and that Angus is always going to be there for krypto. Together, our dom and sub energies flow in such a way that we fall more in love with each other and our relationship grows. Thank you for trusting Angus with such a beautiful, needy, giving, and loving pup, Master. Krypto is the most important person in Angus’ life. Angus loves krypto so incredibly much and feels so lucky to have krypto in his life. I love you so much, Master.]
Leaving Mr. Turk, I turned around, blinked, and there in front of me was krypto! Angus took over and in the lyft, presented krypto with a video from krypto’s Sir and a card from Angus.
[It important to also thank kyrpto’s Sir (Alpha) for allowing Angus to take care and treat his pup to a very special date. Thank you, Alpha. I love you, Alpha.]
Krypto was so overjoyed and overwhelmed with how Angus was going to spoil and take care of him. Krypto was in tears. *buzz*
The Date Itinerary
A picnic in central park (rescheduled for Friday on the High Line)
A couples deep tissue massage
We struggled to arrive on time for the massage but the spa was so willing to accommodate. We were even able to enjoy some couples time alone in the spa before and after our massage. Oh it was amazing. Krypto was so relaxed he even fell asleep during the massage. This was my first deep tissue massage. I never realized how tight my muscles had been.
After making it back to the hotel and stopping for a Times Square photo or two, we rested briefly before walking to the restaurant for dinner reservations. Krypto dressed so handsomely. *buzz* I brought krypto to a Japanese BBQ. We had the kobe omakase. It was delicious. Krypto made perfect suggestions for courses. He made me so happy that my dom buzz got even stronger as dinner continued. With our dessert course, krypto to was adorable and giving when be offered to make Angus a s'more over the grill. Thank you krypto. It was so delicious. We made our way back to the hotel. Once there, krypto said goodnight and Master joined angus for bed. What an incredible first day of pride.
We began our day with sleeping in, lunch at Juniors with Masters friends, and getting ready for our picnic on the High Line. As we neared Chelsea Market, Master ordered Angus to wait inside in front of The Lobster Place. Master needed to do Master things. I walked inside and krypto found his way to me and Angus couldn’t have been more eager to see his pup. I felt so loved and happy to be joined by him for another date filled afternoon. *buzz* We had sushi and sodas. Krypto picked an amazing blood orange, lime, and jalapeño soda for me knowing how much I would love the flavor vignettes. Oh what a good pup. After we enjoyed the best oysters I’ve ever had. So good that krypto food-gasmed over the Ichobad oysters. And lastly, we ordered meat pies to enjoy on the High Line. We found seats, took some beautiful photos and walked the park to the most southern end. After such a perfect and romantic date with krypto, it was time for Master to come back. Thank you Master. Thank you for giving Angus time with krypto. I love you so much, Master.
[I love you, krypto. Thank you for joining me on such a romantic date. We had a perfect date on the High Line. I keep falling more in love with you every time I’m given time with you. You’re amazing and I will always keep growing for you. *buzz*]
Master and I walked over and a couple blocks to Magnum and made our own ice cream bars. This was more fun than we thought! And delicious too! Master made a vanilla bar with chocolate coating topped with cacao nibs, Himalayan sea salt, and chipotle seasoning.
I made a chocolate bar with dark chocolate coating, dark chocolate vermicelli, gold sugar crystals, and Himalayan sea salt. We ended our day with tacos and a disco nap. After I would need to get ready for Furball. I was dancing and couldn’t wait to show off for Master.
Furball highs: Master was there, I danced for Master, Master and I met Joe, DJ Jack Chang played a good set, and I was paid.
Furball lows: the small/crowded venue, the fog that made it impossible to see or breath, and the terrible gogo boxes.
I came home to Master patiently waiting with dinner. Thank you for coming to see pup work and for dinner, Master. I presented Master with the night’s earnings. I love you so much Master.
We slept in and enjoyed a small brunch in HK. Master got a sandwich and I had eggs benedict. After, we prepared for the VIP Roof Top Tea Dance. The venue was small, we weren’t really able to dance or flag much, the crowd was weird. Master did get a chance to flag on the gogo box before the dancers arrived. *whimpers* It’s so beautiful when Master flags. We left after an hour, regrouped at the hotel and headed to the Musclebear Cruise. It was an amazing choice! We had an amazing time and took so many wonderful photos along the Hudson. There was food, great music and Master taught me how to flag. Thank you so much for teaching me Master! I can’t wait to flag with you again! It was a great way to get ready for the main party: BRÜT.
BRÜT was held at the PlayStation Theatre. We arrived and made our way to the clothes check. While everyone else there was dressed for in their black leather and fetish gear, we lit up the halls in pink thongs, calf high socks, and Master in his crotch-less and ass-less singlet. His pe'a showing through, muscles pumped, rump so perfectly framed in his singlet; I was so overwhelmed in his presence. Master is so incredibly sexy and I couldnt keep my eyes off him. Master ordered me to follow him around the venue as we explored its amenities and features. The venue was perfect with multiple dance floors and DJs. The lighting spectacular. The crowd was good too. There were water fountains and concessions too!
All night and into the morning, we danced, flagged, and had sexy intimate time. The dance floors had special lighting. The main floor had spotlights from the ceiling that were black lights. Master shined like a God; his chest so big and body beaming. *whimpers* I was so entranced it felt like we were the only ones there. I grinded up against Master and danced and showed off for him. Master flagged and hypnotized his pup with his power and perfection. I felt the butterflies in me growing and it felt like I was twisting up inside. I can’t believe how lucky I am to be his pup. I’m so grateful to be owned by you, Master. *whimpers* The other dance floor was all black lights and dark which provided ample space for us to be intimate. Master pulled me aside to a more private area and intamacy in there. He adorned my neck with marks of love and ownership. I begged Master for them and cried out “Thank you Master! I need your marks, Master! I love you so much Master!” I moaned louder as Master pressed harder. He pushed me deeper and ordered me on my knees to present his pup.
My heart was racing and I fell deeper and harder for Master. He led me to the couches and ordered me on his lap. I kissed Master deeply. I held to Master tightly feeling our energies flow and as our lips separated to breath, Angus was over krypto. We held each other tightly falling more in love. Angus and krypto danced together and Angus took care of krypto’s needs at the party.
I led him to the dance floors and halls for water and fresh air. I was buzzing watching krypto dance for me and letting me take care of him in the early hours of the morning. Krypto even flagged so beautifully for me. His gift made me buzz too. Later, we were able to get onto the lit gogo boxes and flag under the black lights. I was so incredibly hypnotized by krypto’s dancing and flagging as he kept shining. His rump bounced and chest and arms looks like they were growing right in front of me while he glowed under the lights. Thank you for giving me a beautiful display of your art and rhythm, krypto. After dancing we shared more private intimate time with each other. On the couches I strattled krypto and we shared a macro growth fantasy. I kept pushing krypto to grow bigger and he wanted to make me happy. I led krypto through a fantasy where he out grew the theatre quickly. Then Manhattan…The continent… describing to him more and more how and what grew faster. Krypto joined and shared what he would grow bigger. I began to pre on his lap. It was dripping through my pink thong. Krypto was so eager and ready to pick it up. I love you so much, krypto. Thank you for dancing with me and letting me grow you to macro proportions.*buzz* Oh krypto is such a special pup to Angus. He is such a good pup.
We looked at the time and agreed 6am would be our time to walk back to the hotel. Master returned and made sure angus made kt hoke safely. I resumed place at Master’s feet and thanked Master. I was whimpering as we talked about how much fun and how amazing BRÜT was. I love you so much, Master. We had such an incredible time. Thank you for an this exceptional evening. Master led us back to the hotel and after we fell asleep to get ready to close our pride weekend.
This day was the struggle day. Struggled to eat Shake Shack for brunch, struggled to stay hydrated, and struggled getting to the last pride party. Despite the behavior of some straight women, the bad music, and overcrowded pier, we really had a wonderful time. Dancing with Master free VIP upgrade from some strangers leaving early, free vitamin water, a less crowded area to flag, and getting to meet some of Masters friends. We left before sunset and headed back to the hotel to rest. We needed to pack and rest for our travel day on Monday would come early. We stayed up in bed that night distracting ourselves from the bad party. I watched endless YouTube videos of flagging in the park to try and find Master (I did!!!) And Master edited photos of our weekend *swoon*
It was an emotional “see you soon”. We went separate ways at Penn Station. Master treated me to a protein filled Jamba Juice and bagel with lox and cream cheese. Thank you so much Master. We waited for our trains. Before we knew it, it was time to board. Master to Montreal and myself to Providence. “5 more days pup” Master would keep telling me. *whimpers* I love you Master.
Thank you for joining me on such and incredible weekend and offering me your hand to be proud together. Thank you for your gifts and generosity, Master. I will always feel more lucky and grateful every day to be owned by you, Master. I love you more and more every day Master.
I’ve had countless sessions and lectures on ECGs. I don’t know how many websites I have bookmarked, or how many times my eyes glazed over reading Dubin. I’m also terrible at cardiology. I was on my way to accepting my fate of being horrible at ECGs forever, until I had a life changing session on ECGs taught by a great ER doc. I want to post it here because it was probably the most useful thing I learned in med school, and it will stick with me for the rest of my career.
WHEN LOOKING AT ECGs FOR THE FIRST TIME:
1. One ECG is never enough. Always get old ones for comparison. If none available, do another one. Because. One ECG is never enough.
2. RATE. Look at the number on top of the printed ECG. It’s stupid not to use that number. Yes, you should know the rule, 300-150-100-75-60-50. People say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. This is true. I don’t like to look at their “diagnosis” until I have gone through it myself. But the rate is just a number. Plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. If the machine is telling you it’s 200 and if it looks tachy, then it’s probably the right number.
3. RHYTHM. Is there a p-wave for every QRS and a QRS for every p-wave? Is the p-wave upright in lead II and down in aVR? Good. Done. BOOM. It’s sinus rhythm. ***if you cannot clearly see the p-waves then you cannot call sinus. move on. 4. AXIS. Again, look at the number at the top of the page. If it’s between 0 and +90, then it’s normal axis. If the number isn’t provided, or if your preceptor doesn’t believe in the convenience of machines/technology, look at the QRS complex of lead I and lead II.
up in lead I, up in lead II: normal axis
up in lead I, down in lead II: left axis deviation (most common causes are left anterior hemi block and left ventricular hypertrophy)
down in lead I, up in lead II: right axis deviation (most common causes are right ventricular hypertrophy…PE)
5. did someone say HYPERTROPHY?
look at V1
is the R wave tall? (greater than 7mm?) right ventricular hypertrophy.
is the S wave tall? (greater than 11mm?) left ventricular hypertrophy.
look at lead II
is it wide? left atrial enlargement.
is it tall? right atrial enlargement.
7. PR interval
should be between 0.12 sec and 0.2 sec (3-5 small boxes). I used to always get this interval and QRS complex (less than 0.12 sec) mixed up. Think: atria depolarizing + shit getting to ventricles is gonna take longer than ventricles depolarizing. [2 things happening] versus [1 thing happening]. [0.12 sec-0.2 sec] versus [<0.12 sec].
long PR interval means there’s some sort of block at the AV node.
1st deg block. PR interval is long. everything else is normal. cool.
2nd deg block
type I: PR interval progressively gets long. eventually a dropped QRS.
type II: PR interval is constant, but randomly dropped QRS.
3rd deg block “complete block”
there is no association between P waves and QRS. they run separately. **QRS does NOT have to be wide. Just look for P wave/QRS complex disassociation. I sometimes get this and 2nd deg type II mixed up. The only difference I try to remember is that PR interval is constant in 2nd deg type II, but is variable in 3rd deg.
8. QRS complex
narrow or wide?
narrow: good. signal coming from somewhere above ventricles.
wide: think BBB (bundle branch block)
LOOK AT V1 ONLY.
if the last deflection of QRS is DOWN, then it’s a left BBB
if the last deflection of QRS is UP, then it’s a right BBB. super easy. no more of this bunny ears crap.
9. ST segment
always look from J point, and compare with the isoelectric line of T-P segment (NOT PR interval).
look for reciprocal changes of the heart. if ST elevation in lateral leads, could see ST depression in the septal leads. PAILS:
posterior up, anterior down
anterior up, inferior down
inferior up, lateral down
lateral up, septal down.
LBBB can look like STEMI. How to tell?
disconcordant changes is normal. (QRS and STEMI on opposite sides of the isoelectric line.)
concordant changes is abnormal.
massive discordance is abnormal. (STEMI is greater than 5mm)
this isn’t that important. Moving on.
Inferior STEMI. Could right ventricle be involved?
DO NOT GIVE NITRO DO NOT GIVE NITRO DO NOT GIVE NITRO.
order a 15 lead
is STE in lead III > lead II? likely RV involvement
INFERIOR MI? 15 LEAD NO NITRO
INFERIOR MI? 15 LEAD NO NITRO
INFERIOR MI? 15 LEAD NO NITRO
10. T waves
is it inverted? indicates recent ischemic changes.
11. Q waves
is it significant? indicates old ischemic changes. will likely be present if followed rule number 1 of reading ECGs. (1 ECG is never enough= look at old ECGs).
I literally go through this list of 11 points in my head when I’m reading an ECG, regardless of whether or not I have an atrial flutter jumping at my face or if I see a massive anterolateral STEMI. Obviously I needed background knowledge on ECGs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. It might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart.
Anyway. I still don’t love ECGs, but it feels pretty wonderful to be able to be able to evaluate it in a systematic manner, and get the theory behind interpreting the scribbles of an ECG reading. I don’t get these moments as much as I would like to, but it’s that crosspoint where my classroom learning actually meets real-life applications that gives me happy brain-gasms for days. I love knowing things and more importantly, knowing why.