i am not in the tunnel at all

it may not be the time
to say that i’m proud of this body
to say that this mind is unwavering
to say that this heart is strong

because i know i have flaws
and some days they devour me
more often than not i don’t see
someone who i can be proud of

but dawn puts an end to the night
i see now that despite my flaws,
despite these blemishes and scars,
despite the idiosyncrasies i’ve tried to hide

i, at least, see someone 
true and scarred and bared
au courant with the world’s harsh realities
a survivor despite all odds

and in a place deep inside
where cobwebs and shadows can’t reach
a ray of truth is at the end of the tunnel
a realization of a pure, beautiful truth

i would be enough

—  i am enough || t.c.

When I was born, my Grampy gave me the nickname “Penny”. Penny is me in my purest, most authentic form. On July 19th 2012, I lost my brother Miyagi to an inoperable brain tumor. He was 26. My brother and I were very close. We were only 2 years apart. I never thought of him as a separate person, but an extension of myself. He was my reflection. In his presence I was confident and always so sure… I was Penny. Since that day I have been incomplete, losing all direction and sense of self. Since that day I have been lost trying to find him… trying to find my way back to my self… back to Penny. I turn to writing as my form of therapy, but it’s never quite enough. I released 2 projects since then, but I wasn’t quite myself. I try to find my brother’s love in other men, but they never can compare. I try to get closer to my brother by doing different drugs, hoping that if I get high enough I can reach him, but they only take me further away. I distract myself with work, which buys me things I wish I could share with him. I distract myself with work, which causes stress I wish he were here to help me with. The presence of my daughter, my siblings, my parents… only make his absence more apparent. And so, I find myself taking trips, trying to escape any person, place or thing that is too familiar. Physical trips by car, by plane… Mental trips with controlled substances… Trips in solitude in hopes that the quiet will bring me and my brother back together. Through out these travels I’ve been keeping a record of my dreams, feelings and experiences in notebooks. I turned these notebooks into a MAP. a Movie (TRIP short film), an Album (TRIP) and a Poetry book (2fish) This map has been helping me navigate through my suffering, uncovering the righteous path that has been carved out before and for me… Helping me identify my pain and my mistakes so that I can move forward and reach my full potential and find the light at the end of the tunnel… My personal “hero’s journey". and although I am not there yet… I know I’m getting closer. This map was made by me, for me… but I feel obligated to share because I know that I am not alone in my suffering. If there’s one thing I’m sure of it’s that every single person on this planet is suffering. Not a single soul in this world is immune to the pain of losing someone they love. The reality of this life is, at some point we will all lose someone we love. In sharing this MAP, I hope to inspire others to be more present in the lives of the people they love. I hope this MAP encourages honesty, empathy and compassion. In sharing this MAP, I hope to inspire others to share their own mistakes, imperfections and fears… because I believe in doing so we can understand each other better and realize we are more alike than different. In sharing this MAP, I hope to inspire others to share their grief and pain because I believe suffering can be alleviated when we understand we are not going through any of it alone. - Jhené Aiko Efuru “Penny” Chilombo

🌙💕May Your Self Confidence Rise Like The Moon 🌙💕

A request from @tarotprose , since joining the community many of you have showed me so much support and encouraged me in many ways. Ivan more than most has been there to lend me advice, inspire me, and support me in pursuing my dreams. You have all helped me grow in my having faith in myself and learning to truly love who I am inside, I hope this spread can do the same for you. 💕

The First Card: This card represents where you currently are or what state you’re currently in. Perhaps something is weighing you down, this could represent your current level of self-esteem or amount of love you have for yourself.

The Second and Third Card: We often lose sight of our best selves and tunnel vision onto our flaws. These cards are here to remind you of your admirable qualities, what it is about you that makes you fantastic and unique. It’s ok to need a reminder. 

The Fourth Card: This represents something you’ve overcome, a struggle either within yourself or with another. Remember what you’ve overcome, you are so strong.

The Fifth Card: This is a simple act of self-care you can practice to help you center your mind and focus on loving yourself and believing in yourself. 

The Sixth Card: This is a summary of everything the cards have told you so far, it explains how everything is tied together. How can I bring all of this together and apply it to gaining more self-confidence?

You can see some of my readings and spreads here and you can get your own reading by me here. 💖

Mickey Deserved Better, But...

Here’s the thing, I’m the first one to say Mickey deserved better. But think about what that really entails. What we actually mean when we say he deserved better, is that he deserves to be happy. Ergo: He deserves Ian. Because, Ian made him happy.

Originally posted by mickeyandmumbles

I’ve seen a lot of commentary about how Mickey loved Ian more. Some weird internet pissing contest because, let’s face it, Mickey is love goals isn’t he? He’s a man who went from this scared shitless, self-hating, insecure child and grew into a strong, caring, and passionate man. One you’d kill to have fight for you. He came out of the closet for Ian. 

Let me emphasize that point. In a homophobic upbringing, environment, in front of the man that literally beat the shit out of him for being gay, (before having him raped by a prostitute to “fuck the faggot” out of him); Mickey Milkovich came out as gay, in a dive bar on the Southside, for Ian Gallagher. Whether you love or hate Mickey, that is goddamn significant.

Originally posted by nerds-place

Now, possible domestic abuse issues aside, cuz, let’s face it folks: we’re cutting both Ian and Mickey a lot of slack when it comes to the fact that there was physical abuse in their relationship. But that’s what makes it so beautifully real. It’s not that the writers are glorifying an unhealthy relationship, or even that the fans are. It’s real. This is EXACTLY what it would look like if two, fucked up, Southside thugs, fell in love against the societal expectations of their socioeconomic status and environment. And to quote Tupac, their love is a rose that grew from the concrete. 

THAT is what is so beautiful about this pairing. Again, I am not advocating or condoning IPV (Intimate Partner Violence), which is actually a problem in the LGBT community; what I am saying is the reason there’s an inordinate amount of people who ship Ian and Mickey is because they were a light at the end of a dark and dismal tunnel. Well, they were until reality literally bitchslapped both of them.

Originally posted by myemptymind

But I think there’s something pretty damn important we are all forgetting: and that’s the hell Mickey put Ian through in the beginning. I’m not trying to justify the shit Ian pulled after Mickey had his personal epiphany that made him into the man we have all grown to adore. But here’s the thing: Ian was falling for Mickey when shit was still raw and relatively unrequited.

Ian loved Mickey when he was still just a filthy thug. Ian loved Mickey, despite his refusal to kiss him. Ian loved Mickey, despite the serious internalized homophobia. Ian loved Mickey when he knew he shouldn’t, when Mickey made it clear that Ian was nothing more than a warm mouth to him.

Originally posted by mrsmilkovich

So, here’s the thing. Mickey deserved better… but so did Ian. They both deserved better. And what I mean by that, is not that Mickey deserved better than Ian, or Ian deserved better than Mickey. No. They both deserved to be happy. And honestly? They were their happiest together. Whatever bullshit aside, what their relationship represented was a love that managed to bloom from a dark and hopeless place. And if they could find love, couldn’t we all?

Originally posted by smuchshypush

Originally posted by smuchshypush

Thanks for reading my rant. <3

zodiac signs as katya quotes
  • Aries: "I am a dog-woman who barks at the moon while sniffing my own anus after shitting out worms."
  • Taurus: "Once you stir the pot, what do you get at the end of the day? Quiche."
  • Gemini: "I tried to go to bed, couldn’t sleep – I just kept thinking about murder and satanism."
  • Cancer: "I wear my heart on my sleeve, and my limbs in my underpants."
  • Leo: "Pain is the key that unlocks the door of more pain… and then that door is a tunnel through the palace of beauty."
  • Virgo: "I am my own worst enema."
  • Libra: "I love all my children equally, except I love the attractive ones much more."
  • Scorpio: "If a tree falls in the forest, and no one is there to touch me… does my vagina make a sound?"
  • Sagittarius: "I do not clean. I conceal. And then I come to find."
  • Capricorn: "I do not jump for joy, I frolic in doubt."
  • Aquarius: "I went to community college, so I know everything about dream theory."
  • Pisces: "I am a riddle. Wrapped in a mystery. Covered in spandex."

I highly doubt this will reach an audience, I mean I have like no followers. But. I have to try.
In light of 13 Reasons Why coming out on Netflix, I’ve been reminded lately all to well of my own past. And I wish teenage me knew then what I know now. I wish SOMEONE would have told me that there is indeed light at the end of the tunnel.
I am a suicide attempt survivor. Not just once either. I attempted to kill myself SEVEN times, and did not succeed. And for that, I am grateful. Now stick with me, this is a long story.
I was the girl in the back of the classroom that no one liked. I was called parasite. People spread untrue rumors that I was a whore and I was easy (fun fact, I was a virgin until I was 17). I had no friends. I discovered the internet at the young age of 10 (2005 for you young ones that don’t agree 10 is young). And when I was 14 I became the victim of a very cruel internet joke. I met a guy online, or so I thought, his pictures were fake and I didn’t know. I printed them off and put them in my binder at school and proudly bragged of my new boyfriend. The other kids realized “he” was fake before I did, they made fun of me relentlessly, I was devastated. When I was 16, a boy in my class said “If you think Laren should kill herself raise your hand” and all but one person raised their hand. No one thought about how their words would stick to me well into my adult years, no one realized how vividly I would remember all of that, and no one cared. Absolutely no one in that school cared if I lived or died, at least not the kids. My 17th birthday should have been a good memory, I finally had a friend and I had her over that night and it was AMAZING. Until some kids from school had somehow got my number and called that night, I’m thankful that I don’t remember what they said anymore. But it didn’t end there. After a 3 year on and off relationship that was horrible, I was entirely too naive and forgiving but I don’t want to go into it, I moved on. And that, my friends, is where I found the light and all the bad became worth it because of the good. I met the man who is now my husband. It didn’t take long to realize he was my soulmate, you may not believe in those; I didn’t either until I met him. In October of 2015 I found out I was pregnant. I was overjoyed. And nervous, I think that’s a natural side effect of finding out you’re growing a life. I had a rocky pregnancy, but June 9, 2016 my beautiful daughter was brought into this world. That moment that they tell you to wait for? That was mine. That was my blinding happiness, the start of a whole new chapter of my life and for the first time I was able to put my past behind me. Shortly after she was born, I got married to her father. The most loving and dedicated man I have ever met. And I’m happy. I’m finally truly no strings attached happy. All the pain I suffered, all those years I wished for nothing but the end, every single moment that led up to this, was worth it. I sit here and watch my daughter play, and read her a bedtime story and watch her learn and grow and I am SO glad I failed.
Your pain will end. Your life will be bright. Don’t snuff out your flame early, please, just trust that this world is going to be a good place for you very soon. Keep on holding on.

The Journey Story: Writing the Boring Parts

Anonymous asked: “In a part of story I’m writing currently, the characters are doing a lot of… walking. So aside from letting them stop and rest occasionally, or just throwing enemies at them or just simply I don’t know - writing about the environment, could I instead spice up the story with POVs of characters in different places and/or make the time pass faster by introducing character relevant stories/flashbacks? Or would it just make it too chaotic at this point?”

Inevitably when writing a journey story, you’re going to hit a few dull bumps where the characters are just en route. When it comes to writing these scenes, the important thing to remember: be frugal. A little walking goes a long way. In fact, the reader will assume a lot of walking and tedious travel is happening with just a few sentences a few times and maybe one scene that involves walking. I’m generalizing, but a good rule to go by is “less is more.”

Keep reading

Okay okay. I finished those two hipster punkies fast. Because I thought, the last picture was not the best “ending” for our beloved JM-Month. So take that babes ;)

You know, this month was reeeaalllyy great, but all the time I felt as if something is lacking in my style… I was lightly uncomfortable while drawing all the stuff… And I think I know what the reason was. Maybe. So I will try to go with the “lighter” shading… or so I think. Gna. I am unhappy ;_; buhuuuu. ~

send me fob songs

Evening Out With Your Girlfriend

Honorable Mention+ Have you ever had detention? what for?
Calm Before The Storm (eowyg)+ Do you ever catch yourself daydreaming? What about?
Switchblades And Infidelity+ You can press a button that will make anyone or anything explode. Who or what would you choose?
Pretty In Punk+ What dream color(s) would you love your hair to be?
Growing Up+ Your most favoritest age you’ve been so far?
The World’s Not Waiting (For Five Tired Boys In A Broken Down Van)+Name one thing you have wasted time on.
Short, Fast And Loud+ Short or tall? Fast or slow? Loud or quiet?
Moving Pictures+ Would you rather watch a movie at home or at the theatre?
Parker Lewis Can’t Lose (But I’m Gonna Give It My Best Shot)+ What is your favorite day of the whole year?

Take This to Your Grave

Tell That Mick He Just Made My List of Things to Do TodayDo you get jealous easily?
Dead on Arrival+ How do you start a conversation?
Grand Theft Autumn/Where Is Your Boy+ What do you think of people who cheat?
Saturday+ Who is your bestfriend?
Homesick at Space Camp+ What is your favorite planet?
Sending Postcards from a Plane Crash (Wish You Were Here)+ Who would you absolutely love to punch in the face?
Chicago Is So Two Years Ago+ Is there anyone in the world you would want next to you right now?
The Pros And Cons Of Breathing+ Do you hate anyone?
Grenade Jumper+ Is there anyone you would take a grenade for?
Calm Before The Storm (tttyg)+ What phobias do you have?
Reinventing The Wheel To Run Myself Over+ Do you consider yourself sucessful?
The Patron Saint Of Liars And Fakes+ Has anyone ever lied to you?

My Heart Will Always Be The B-Side To My Tongue

My Heart Is The Worst Kind Of Weapon+ Weapon of choice in zombie apocalypse?
“It’s Not A Side Effect Of The Cocaine, I Am Thinking It Must Be Love”+ Do you have a promise that you will always keep?
Nobody Puts Baby In The Corner (Acoustic)+ Have you ever been to prom?
Love Will Tear Us Apart+ When was the last time someone told you they loved you?  
Grand Theft Autumn / Where Is Your Boy (Acoustic)+ Are you keeping a secret from someone?

From Under The Cork Tree

Our Lawyer Made Us Change The Name Of This Song So We Wouldn’t Get Sued+ What name(s) do you dislike?
Of All The Gin Joints In All The World+ First Fall Out Boy song you’ve ever heard?
Dance, Dance+ Favorite line in a song that you would so get tattooed on your ass cheek?
Sugar We’re Going Down+ Favorite pet name to be called?
Nobody Puts Baby In The Corner+ Are you the rarest pepe?
I’ve Got A Dark Alley And A Bad Idea That Says You Should Shut Your Mouth (Summer Song)+ Have you ever gotten into a fight? if so, what was the outcome?
7 Minutes In Heaven (Atavan Halen)+ Least favorite thing about school/college?
Champagne For My Real Friends, Real Pain For My Sham Friends+ Your house is on fire. What are the things/people/animals you’d grab on your way out?
I Slept With Someone In Fall Out Boy And All I Got Was This Stupid Song Written About Me+ Bandmemebers you have a crush on?
A Little Less Sixteen Candles, A Little More “Touch Me”+ Night owl or early bird?
Get Busy Living Or Get Busy Dying (Do Your Part To Save The Scene And Stop Going To Shows)+
What do you want to do before you die? Do you have a bucket list?
XO+ Are you reliable? why?
Snitches And Talkers Get Stitches And Walkers+ Have you ever fractured/broken any bones?
The Music Or The Misery+
What band(s) do you absolutely hate?  

Infinity On High

Thriller+ What is one thing you would like to go back and tell your 12 year old self?
“The Take Over, The Breaks Over”+ Do you like having picture taken of you or selfies?
This Ain’t A Scene, It’s An Arms Race+ If you were the president, what is the first thing you would make illegal and legal?
I’m Like A Lawyer With The Way I’m Always Trying To Get You Off (Me & You)+ You get three wishes, what are they? (you can’t wish for more wishes)
Hum Hallelujah+ Have you tried to be someone you’re not to impress someone?
Golden+ Favorite gem stone/mineral?
Thnks Fr Th Mmrs+ Best memory of someone who has left your life?
Don’t You Know Who I Think I Am? Bands you’ve seen perform live?
The (After) Life Of The Party+ Would you rather be a ghost or skeleton in the after life?
The Carpal Tunnel Of Love+ Favorite flavor of icecream?
Bang The Doldrums+ Do you wear makeup? if so, what kind?
Fame < Infamy+ Cursive or print hand writing?
You’re Crashing, But You’re No WaveHave you ever been to court? why were you there?
I’ve Got All This Ringing In My Ears And None On My Fingers+ Do you plan on ever getting married?
G.I.N.A.S.F.S.+ What is your eye color? if you could change it, would you?
It’s Hard To Say “I Do”, When I Don’t+ What was the most hurtful thing that someone said to you?

Folie à Deux

Lullabye+ A song you would want your children to listen to.
Disloyal Order Of Water Buffaloes+ Can you describe yourself in 5 words?
I Don’t Care+ Favorite month of the year? why?
She’s My Winona+Wa aoh oh ooh. What song popped into your head?
America’s Suitehearts+ Andy the Candy, Pete the Treat, Joe the Hoe, or ‘trick the frick?
Headfirst Slide Into Cooperstown On A Bad Bet+ Have you ever lost a bet?
The (Shipped) Gold Standard+ What is the one song that has helped you push through?    
(Coffee’s For Closers)+ How do you like your coffee?
What A Catch, Donnie+ What two bands/musicians should make a song together?
27+ What do you think about aliens?
Tiffany Blews+ Are you scared of the dark?
w.a.m.s.+ Do you like snow?
20 Dollar Nose Bleed+ Would you pay 20 dollars to punch someone in the face?
West Coast Smoker+ What do you think of the ocean?
Pavlove+ Are you happy with the way you look? is there something you would change?

Save Rock And Roll

The Phoenix+ You’re wearing the same thing as someone else. Are you going to be the one to change or are they?
My Songs Know What You Did In The Dark+ Do you enjoy bonfires?
Alone Together+ You are the last person on Earth, but you can choose someone else to be with you. Who would you choose?
Where Did The Party Go+  What is the last thing you drew a picture of?
Just One Yesterday+ What did you do yesterday?
The Mighty Fall+ What is the best pick up line you’ve heard lately?
Miss Missing You+ Do you think anyone misses you at the moment?
Death Valley+ Have you ever broken a promise?
Young Volcanoes+ You are a killer in a horror movie. What song is playing in the background? 
Rat A Tat+ Favorite time of day?
Save Rock And Roll+ Would you get revenge on those who have hurt you?


We Were Doomed From The Start (The King Is Dead)+ Your funeral song?Art Of Keeping Up Disappearances+ Have you ever written your own music or poems?
Hot To The Touch, Cold On The Inside+ Do you think tie dye is still cool?
Love, Sex, Death+ What are your favorite scents?
Eternal Summer+ A summer you will never forget?
Demigods+ What is your favorite type of dinosaur?
American Made+ Do you prefer cooking or ordering take out?
Caffeine Cold+ Ice coffee or hot coffee?

American Beauty / American Psycho

Irresistible+ Favorite city you’ve visited?
American Beauty / American Psycho+ Would you reffered to as the beauty or the psycho
Centuries+ Do you like heavy metal? or hardcore/screaming music?
The Kids Aren’t Alright+ Have you dedicated a song to someone before? what song was it?
Uma Thurman+ Do you believe in miracles?
Jet Pack Blues+ What are your favorite colors?
Novocaine+ Vest, Jacket, or Hoodie?
Fourth Of July+ Do you collect anything? if so, what do you collect?
Favorite Record+ Favorite album?
Immortals+ Favorite animated movie(s)?
Twin Skeletons (Hotel In NYC)+ What is the best thing about Halloween?


Alpha Dog+ Favorte dog breed(s)?
From Now On We Are Enemies+ Do you have more enemies than friends?Lake Effect Kid+ Is there somewhere you rather be?
Roxanne+ Have you ever called the police?
Save Your Generation+ Ever had a rumour spread about you?
Start TodayYou have a free ticket to any concert of your choice. Who would you go see?
Yule Shoot Your Eye Out+ What do you want for christmas?

a moment.

When news of Viserion reaches Winterfell, Jon takes Daenerys aside to grieve. [a jon x daenerys fic, set just after the season seven finale]

She doesn’t question him as he leads her silently to his quarters, hand hovering just over the small of her back, unwilling to touch her only to have her recoil from him. He’s not certain he could bear it, if she were to reject his physical affection. Not today.

Her quiet should be indication enough of her mental state, silent and shuffling at his side, curled in on herself and seeking the cover of shadows cast by his flame. He’s never seen her look quite so small, chin tucked into the furs about her neck – firelight dancing along her porcelain skin.

The woman, instead of the queen.

The grieving mother, instead of the fierce conqueror.

Keep reading

[TRANS] 170721 HWASA’s Fancafe Reply to a High School MooMoo who is Having a Hard Time

You’ve gone through a lot. I wanted to speak comfortably to comfort you, but if I were to consider you as a dongsaeng, I would tell you to think of these emotions you’re feeling right now, the worries and pains, as a natural process that you must go through in order to become stronger.

If there are only good things in life, when you are faced with difficulties, you won’t be able to overcome it. Also, what I am saying right now might sadden you, but this is only the beginning. You might think that your most difficult times is during your third year in high school (T/N: when students need to take the college entrance exam), but after climbing over this mountain, you will actually see other mountains waiting for you. We all say to try to live, but why is the world so intense? hehe Am I right? You are bravely striving right now too.

If there is something you want to do, do it. Even if it might not come true, there will be something left that is worth trying your best to fulfill it. Of course, your parents’ opinions are important as well, but your judgement is entirely up to you. Although there will be responsibilities that come with it, you must bear with them yourself. This is something you must experience. Think of it as a growing tunnel that leads you to somewhere further. 

Problems with your family or friends, these normal friendship problems must have hurt you a lot. hehe For me as well, no matter how hard I tried to be loved by all, there were only a few [friends] who stayed behind~?? But I was sufficiently happy with my friends even when there were only a few of them!
These people are the ones who will run to you when you’re having a hard time until you die. I’m sure it will be the same for you. If you look closely, you will realize they are actually the people you treasure that you have forgotten. I sound like someone who has lived for 50 years kekekeke ^^

The difficult times only last for a while. There are no unfortunate people for life. The one who can make you unhappy is none other than yourself. The fact that you are not avoiding the situation, are hitting your head, worrying and in pain, to me you look awesome! You are a precious person! To me, the standard of life is myself. To you, the standard of life is yourself. 

Looks like I have written a lot.. though I am still inexperienced to give advice ^^
But even just for a bit, I hope you were able to cheer up. Whatever people say, you are still the best!

Trans by tgc. (@tgcnim)

kazliin  asked:

Lily, you know what I'm going to ask ;) Because that Viktuuri Eurovision commentator/contestant AU is something the world needs to see

guess who has two thumbs and no sense of self-preservation? IT’S ME

so basically kaz and i were talking about eurovision and then i had this sudden thought of a fake rivals-verse fic idea where yuuri’s an exasperated commentator who’s suddenly been forced to host esc and viktor’s the winning contestant from last year who is co-hosting with him and…. because this is rivals-verse, yuuri hated viktor’s entry last year. hoo boy. 

Love Love, Peace Peace

Yuuri Katsuki and Viktor Nikiforov to Co-host 2016 Eurovision Song Contest in Saint Petersburg
Beloved TV commentator Yuuri Katsuki, known for his sharp and witty commentary during previous contests, and 2015 ESC winner Viktor Nikiforov will be co-hosting the 2016 Eurovision Song Contest in Saint Petersburg, Russia. This year’s theme will be “Making History” and will be held at the Alexei Panin Arena from 11-15 May. 

Nikiforov won last year with his stunning ballad “Stay Close to Me”, featuring a figure skating segment halfway through the song… (more)

Yuuri clicks out of the article with a groan and takes a sip of his coffee, waiting for his new co-host to arrive. The office is a busy drone in the background, with only the sounds of ringing phones and beeping machines filling the silence. He checks his mobile. Nikiforov is late.


Keep reading

Patient assessment

For everyone entering or returning to school, welcome back and I am officially back!

What I am about to go over is basic stuff today, but it seems we all get a bit lax with and I feel review for us all is important at this time.

Patient assessment falls on the back steps at times. It is key for our jobs as medical professionals, but quickly forgotten when we use to our tools. We get tunnel vision at times and treat what we hear. This is true of EMTs, Nurses, PAs, NPs, MDs and any others.

Chest pain usually means the following things

  • Vitals
  • EKG
  • Labs
  • Chest X-ray
  • IV/IV fluids
  • Nitro
  •  ASA

We as providers are trained to think heart attack first. While it is good to put this in your differentials, it’s not always good to jump the gun to it either.

Doorway Impression

A doorway impression is simple that. When you walk in, what do you see?

If you’re in the hospital, how they got to their room, where they sit, how their physical appearance is can all be clues. While we shouldn’t judge, seeing an obese male in his 60’s with a pack of cigarettes in his pockets, you can probably put cardiac related issues in the “possible” pile.

If you see a 20-year-old college student who appears in shape that is curled up with his knees to his chest and taking rapid shallow breaths, your first opinion might not be cardiac, so it should shift in your list possible Dx.

That first impression won’t give tell you what it is most the time, but it might have a few clues.


If these weren’t pounded into your skull in medical school at any level, we need to chat later.

Airway, breathing and circulations are easy tools and tell you a lot. I will throw in their mental stats here as well.

If they are talking with you, their skin is warm dry and pink, and pulses are strong regular-regular radial; It’s safe to assume that they probably aren’t having a major issue at the moment. Their airway is patent, breathing appears unlabored and after some auscultation lungs to be clear to be sure. Strong pulses that are regular-regular is helpful. Skin condition tells you they’re probably not in shock.

You walk in to a patient that is pale, diaphoretic, barely able to get a few words out, before taking gasping breaths. That alone should tell you something is up. Airway may be patent, but breathing obviously isn’t good. Lung sounds might present with wheezing, which will give you the impression of allergic reaction or asthma attack. When do feel a pulse, is it bounding or stringy might give you a bit more information. This is all just from assessing their ABC’s.

Now, if they are not breathing and there is no pulse, for the love of god, start CPR!

Patient history

Time to get the story down. There is a lot to ask the patient, start with why they seek medical attention at this time. What is the chief complaint.

You’ll then go through you OPQRST and SAMPLE. Ask you these questions, you can add things that may assist in leading you toward what is going on with them. Remember not get tunnel vision when you find a single detail, but try having some solid follow up questions.

Tip: try to have the describe things. Don’t give them a lot of “yes” or “no” questions.


Vitals can say a lot and pending where you work, they maybe be done early on in your assessment process and that is perfectly fine. They will play a role in determining if your patient is stable or unstable, but this can still determine early without vitals.


Now you can get their testing, but with it won’t be just chest pain now. You might be looking for an MI, but PE. There maybe be a bruise on that 20-year-old chest from when he got hit with a bat three days ago. You patient that came in with difficulty breathing might have a Hx of COPD and today just got worse.

Test should be done here to assist with further Dx of the pt. This is where you do your EKG, BG, X-rays, and everything else.

Final Notes

Diagnosing a patient is more than a few tests when related to a chief complaint. It is a series of steps that require you as health care provider to look at and break things down. The list above is not a steadfast list either, it is a general outline that we should all look at as the basics.

Ultimately, how you perform these steps pends on how you work and the way you develop your questioning habits. The major point of this is that we need to get past our labs, ekgs, x-rays, TCs and other toys. We need to look at the patient first and ask ourselves what are all the possibilities and then begin looking through out differentials and picking our exams from there.

Written by: MedDaily

Luster or the Lack There Of

It’s all so hollow,

I don’t know,

Like wind through a tunnel,


It shines (at times) but theres no glow

Why is that so? Am I the only

One putting on the happy face show?


The Ni/Se Dynamic, and the Misunderstanding of Inferior Se (from an athletic INFJ)

SUBMITTED by aanau

I recently went rock-climbing with my friends, and believe or not, I (an Inferior Se) was the only one not freaking out and who was totally comfortable taking these scary steps from one rock to another. Come to think of it, I’ve always been pretty athletic. I was no high school star, but I definitely was one of the better sports players, and was always “one of the guys” in gym class where I was competitive and enthusiastic to get a good sweat going. I’m pretty fearless with physical activities, and I never get seriously injured. I can pick up on many skills just by watching once or twice.

Yet I’m a Se-inferior. Aren’t INxJs detached and clumsy? How is it that I’m so clearly NOT a sensor if you knew me in person, yet I seem to have no problem with using my Se?

And the way I see it (or rather, feel it) is, inferior Se is like moving through a Van Gogh painting. At all times, my environment feels like Starry Night, with these hypnotic brush strokes swirling around. I’m more focused on the physical world in relation to the whole picture, just as the seemingly chaotic nature of Starry Night creates the perfect painting. I AM clumsy and detached… when I’m not consciously aware of my environment. It takes effort for me to use Se. It takes me to say to myself “okay, pay attention; be aware” to use it, and once I get myself into that mode of thinking, I get that iconic Se “in the zone” feeling.

It’s tunnel-vision. It’s when you can be (emphasis on can because skill and practice is involved) masterful at physical skills and being aware of your environment when your environment doesn’t include your peripherals. I’m able to be good at sports and climbing and all that kind of stuff because every action is planned and deliberate. That means I can easily keep up with higher Se-users… until they do something unexpected, or the environment throws something at me I didn’t calculate in my head. Running down the field with a ball in field hockey, I’m an expert at. Getting it to the circle I can do, because my laser focus has predicted every move up until then. It’s when I didn’t account for the goalie, or that one defensive player being faster than me, that I get clumsy. Otherwise, look out, because I’ll be knocking girls down left and right. And really, that’s a microcosm for how Se works for me all the time. I’m physically unstoppable until something unplanned happens, or I have to make a split-second decision that I hadn’t already made ten yards before.

In retrospect, I have an unhealthy mindset with Se. I feel like I have to prove myself to everyone that I’m strong or fast or competent. I block out pain because I weirdly see pain as proof that I can handle things, and I don’t want to be seen as weak. I got punched in the face at work by a patient and my reaction was to be like “Did anyone see that?! That was awesome!” because dang I’m like an action hero from the movies I just got punched in the face! Does it hurt? I don’t know I’m not thinking about the pain right–oh. Oh yeah it hurts. I’ll just keep tuning it out though.

And I do have a ditziness to me with sensory things. At work, as a CNA, I feel a lot dumber than I actually am. Even when I’m “in the zone” in completing tasks and being on my feet and challenging myself to get all the trash out within the hour, I’ll get told I missed something completely obvious. Like, forgetting to seal the really smelly trash even though I should’ve smelt it myself. Or not seeing someone’s dinner tray on the counter. Well I didn’t notice those things because I was focused on getting all the trash done on time! I get forgetful, and just plain feel like an idiot.

Grip reactions are hard for me to pinpoint, because I lose self-awareness. I don’t go overboard with drinking and sex, but I become self-destructive in other ways. I become either extremely lazy to the point my brain feels like mush because all I’m doing is watching mindless television, or I become overly active to the point of overworking my body. I procrastinate and don’t want to make big decisions, and I get this anxiety that I’m missing out on life and I’m not really feeling anything. That in itself might be what manifests in excessive drinking and partying for others, but for me it just makes me shut down and not be productive. It’ll make me lose sight of my future, and my ability to make all my actions meaningful.

Inferior Se is often stereotyped, and just because you’re active and good at sports must mean you’re a high Se user. But people forget that Se works with Ni, and with Ni at the forefront, it just instructs Se rather than the other way around.

Two movies come to mind: Moana and The Secret Life of Walter Mitty. Both star Ni-dom characters, and people doubt their types because they’re physically active. But both movies are so led by a Ni-dom mindset about Se. Walter Mitty is a love letter to inferior Se specifically: the Ni dom wants to engage in the world and in their Se, but can’t do so unless there’s meaning behind it. Hence the themes in the movie about life! people! experience! connections! you need these to make your life matter! The movie isn’t about Se, but about the Ni outlook on Se as the Ni-dom character embraces it. Moana is less so, being a fun-for-everyone kids’ film, but the theme is still there: Se is meaningless without Ni leading it. She doesn’t use Se for Se’s sake (taking in the world as it comes in, being fully immersed in the present), but for Ni’s sake (how does this create meaning and impact the future?).

To sum up my point: inferior Se isn’t just clumsy and accidentally ruining your life overnight, and it’s often misunderstood how the Ni/Se dynamic works. You don’t use one function by itself, and that’s what makes inferior Se on typing posts kind of shallow, because the functions are reduced to individual components, and behaviors are being looked at rather than the motivations. Of course, with fictional characters it’s harder to discern those motivations, but with characters like Moana and Walter Mitty, you can easily see how they’re led by Ni in their Se actions.

Clinical Burn-out

Most of the time, I enter the veterinary teaching hospital excited to learn and possibly save some lives.

Most of the time, I am enthusiastic about my cases and will eagerly research things I don’t know.

Most of the time, I understand that I won’t know everything and that I will grow with time and practice.

Most of the time, I enjoy educating clients and discussing cases with other vets.

Most of the time, I embrace scary or new situations because I know I will learn from them.

Most of the time, I am okay with doing paperwork until 11 pm or cleaning things when needed.

Most of the time, I am fine with getting up at 5:30-6:00 every morning.

Most of the time, I am content with being busy and not having much social or downtime.

But sometimes…….

Sometimes, I dread or get nervous to talk to clients or attending veterinarians.

Sometimes, I get frustrated at not knowing something or frequently forgetting things I try so hard to remember.

Sometimes, I’m dread waking up at 11 in the morning, let alone 5:30 am.

Sometimes, the last thing I want to do is to take even one step into the veterinary teaching hospital.

Sometimes, I am so overwhelmed with things to know and things to do that I become paralyzed and don’t feel like I can do anything.

Sometimes, I anguish over how unfair it is that I am doing more paperwork and cleaning than I am actually learning for my career.

Sometimes, I get depressed and upset that I am spending such much time at the hospital instead of being a normal, happy, and mentally well, human.

Sometimes, I have massive amounts of anxiety over preforming new procedures or doing something outside my comfort zone.

And sometimes, I am so burnt-out that I can’t see the light to this tunnel that is vet school. 

And that’s okay. Because everyone can, and is allowed, to become burnt-out sometimes. To anyone else struggling with me, know that this is temporary, and that there are ways to find recovery, and ways to reach out and help one another. You are not alone, and we are all going to get through this together <3

Normal Conversation vs. Viking Conversation

Minor Injury


“Hey, hows your leg doing?”

“Pretty okay, but it still kinda hurts.”


“Hey, how’s your leg doing?”

“Well it’s gone, so…”

Talking About the Furture


“When I grow up, I wanna be a doctor.”


“When I grow up I wanna be a dragon trainer!”

Hanging Out


“Lets go to the park.”


“Lets run through the Whispering Death tunnels.”

Shower Thoughts


“I wonder what I’m gonna do today…”


“I wonder where Hiccup’s other leg is…”


Snow Day


*snows 12 inches*

“Ugh, how the heck am I supposed to shovel all of this?!”


*snows thirty feet*

*entire house covered in snow*

*climbs through chimney*

“How in the name of Thor… SVEN, GET THE SHOVEL!” *mutters* “Gods help is all.”


If none of yall have seen this drama I high key recommend to watch OCN Duel.

Plot: Story about Jang Deuk-cheon, a hardened detective cop whose daughter is kidnapped. He starts to chase down the suspect using the one clue he has: Two men with the same face were at the crime scene.

Key words: Clones, hot guy, crime, murder and mystery

I’m absolutely addicted to this drama and all of the characters. It’s thrilling and keeps me biting my nails in anticipation on what is going to happen to next. Yang Se Jong (the one who plays as the clones) has me already in love with him both the good clone and the evil clone.

So far the drama is not disappointing me in the slightest and for it to deal with clones in world where that makes no sense they make it work and not seem far fetched.

I never recommend dramas at all (this is my first time) but this drama is on par and should have more people watching it and falling in love with it like I am.

If you liked and seen the drama OCN Tunnel I guarantee you’ll love this as well.

The Road to Redemption: Arrow 5x11 Review (Second Chances)

Arrow introduced Tina Boland tonight, the new BC, and while we didn’t hit a lot of thematic new ground with her character, they set up an interesting juxtaposition between her, Oliver, Felicity and the road one takes to redemption.

My reference to the three characters in no  way means that I see a love triangle. Sometimes I’m gonna have to write their names all together in a sentence. 

Let’s dig in…

Keep reading

Teen Wolf 6x20 [finale]

-Wait, what’s happening?
-That look is like Season 3B Scott!! The one in the trailer, remember?
-Oh, Scott looks so hot on his bike!!
-Wait, is this like a flashforward? Really?!
-Scott: “I’m gonna tell you a story, maybe it’ll sound familiar.”
-Oh no, it’s barely a minute and I’m gonna cry already.
-Aww, he saved a new werewolf. I wonder if he’ll join the pack.
-Scott: “I’ve got my own story. There were parts I didn’t expect. People who I thought would’ve be with me forever… are the ones that I lost.”
-Chris’ face!! It’s obvious that Allison was hinted there!!
-Scott then looks at Chris: “Some people I thought I could never trust… ended up saving my life. More than once.”
-“Your story, how does it end?”
-Okay, and then we go back to the present. Or would it be the past? Past! Yes, past!
-Fuck these hunters.
-Deucalion is still alive!! He’s crawling!!
-Stiles: “You didn’t think you’d do this without me, did ya?”
-Derek appears.
Derek: “Without us?”
-The last time we’ll get to see the intro.
-Monroe coward!! She’s running away!!
-Stydia banter! Hahahaha!
-Deucalion is dying :c
-“He can’t beat you… and he knows it.”
-Deucalion being an Scott fan ‘till the end.
-RIP Deucalion.
-Aww, Scott’s face. Crying!!
-That Scerek hug!!! I’m crying!!!
-Scott: “You came back for Beacon Hills?”
Derek: “No. I came back for you.”
-Fucking Gerard, die already.
-Drop dead, I’m serious.
-Jackson: “Come a little closer. I’m gonna shove that thing so far up your ass!!”
-“I’m going to tell you where to find all of them.” FUCK
-Parrish!! :(
-Papa McCall! :(
-Scott calling Theo to go and save Liam (and Mason and Corey). Like you need to tell him to save his boyfriend.
-Stiles telling them how he and Derek meet again and came back together to BH.
Lydia: “You convinced the FBI to bring an intern on a extremly dangerous field operation?” THAT’S MY STILES!!
-Stiles’ version vs Derek’s version
-Even if you don’t ship them you gotta admit that was a pretty good scene!
-Nolan is still alive YES!! THANKS!
-Mama McCall to the rescue!!
-Fuck Gerard and Monroe!!
-Scott about the Anuk-ite: “It will find us.”
-Peter, close your eyes!! Peter!!
-Lydia and Stiles to the rescue!!
-Aww, no matter what everyone says, I loved seeing how Lydia and Jackson reacted to the other :)
-Fuck all the haters
-Jackson: “You did that?”
Lydia: “Yeah, I did that.”
Stiles: “I kicked down the door.”
-Loved how the two of the reacted to Jethan. Sweet~
-Loved Lydia.
-Fuck, he’s got a gun! Liam!!
-Liam: “What are you doing here?”
-Lydia’s face as she says “You still have a tail.”
-I’m soo happy to see Thiam together once more! And I was so waiting for the elevator scene!
-I love that hospitals/elevators are their thing.
-theo: “I’m not dying for you.”
Liam: “I’m not dying for you either.”
Me: *gasps*
-Ohmygod, did you see the way Theo looked at Liam and then at his lips. JUST FUCKING KISS HIM!! DO IT!!
-WHY YOU WON’T KISS AND LET ME DIE HAPPY?!! *strangled whale noises*
-Liam: “….But I will fight with you.”
Me: *can breathe again*
-Oh yeah, they’re going to fight together!! Ohshitohshit!
-Power couple
-I’ve always thought that couples that fight badass together, stay together. It’s just a fact.
-Theo and Liam turned to the other at the same time! To protect the other!!
-Also when they got shot they fell beside the other! #Thiam4ever
-Derek worried about his Alpha
-Derek gently helping Scott to lie down *wipes away tear*
-Ethan: “How about we don’t fight it, just get out friends and get the hell out of here?”
-Parrish!! :C
-“Is only three of you.” YES
-“Sheriff. You refer to me by my proper title… deputy.”
-There you have your “60”!!! KICK THEIR ASSES!! #LOVESHERIFFFOREVER
-Jackson, don’t open them! DON’T!!
-Me *sees Ethan*: FUCK
-Yes Papa McCall!
-Oh no…
-Not this bitch.
-I made a post about it and I knew I was right!! Fuck
-Wow, Kate’s already there?
-Family reunion
Kate: “I’m your daughter. I’m an Argent.”
Gerard: “But still one of them.
-Wow, that even hurt me
-FUCK he shot her!
-Did Chris just saved Kate? Wow.
-Fuckfuckfuckfuck VoidStiles VoidStiles
-I’m not ready for that shit nope
-Jeff, how could you do that to– the Nogitsune NOPE
-"You failled everyone. Especially her” AHHH!!
-Poor Scott!!!!!
-“Shoot both of them” that was mean.
-Scott sees everyone! Even the bad guys! (a Berserker, Oni, one Dread Doctor)
-I’m crying!!
-The rules of being a shapeshifter!!
-Scott: “We’ve got weaknesses. And we’ve got lines that we can’t cross.”
-Mountain ash.
-Fuck, Monroe is getting away!!
-Aww, that Jethan moment and then they’re interrupted!!
-“Now it’s over.”
Jackson: “Good to see you, coach.”
Coach: “You too, Jackson.”
-Ow, now that the Anuk-ite is gone and so is the fear, mostly everyone is back to normal. Inlcuding Gabe.
-Theo’s face as he looks down at Gabe, I’m crying! Because even if that kid just tried to kill them (and actually shot him and Liam) he’s still a kid!! And he was afraid!
-Gabe: “It hurts… It hurts.”
-We all thought/wanted Theo taking Liam’s pain but he’s taking Gabe’s!!! Ohymgod!!!
-Character development
-For me, they’re cannon. I don’t care if they didn’t kiss or held hands/hugged or anything, neither did Stydia in this episode and they are cannon.
-Thiam is cannon y'all!!!
-Even Nolan was crying :c
-I never thought I would be sad about Gabe but here I am, bawling my eyes out.
-Back at the Argents
Chris: “Your family… is right in front of you.”
-Wait, Chris, don’t turn around! He can still shoot you!
-Werejaguar eyes!
-Oh, Chris let Kate have him!!! YESS!!
-Chris walking away all badass and leaving Kate to kill Gerard YESS!!
-I never thought I would be saying this to her but YOU GO GIRL!!
-Papa Stilinski, Parrish and Papa McCall was a team I neve knew I needed!
-“Parrish. Drop the weapons.”
“Yes, sir.”
-Monroe: “Someone pick up the radio and tell me what’s happening!”
Liam: “You lost.”
-THAT WAS SO BADASS!! LIKE, DAYUUM, LIAM!! And Theo standing behind him like a proud boyfriend.
-Stydia holding hands, aww.
-Lydia: “Malia, kiss him.”
-Wait, did she just remembered when she stopped Stiles’ panic attack with a kiss? That’s so sweet!!! I hope all Stydia shippers are happy!
-Scott’s eyes are back!! fuck, I was so worried.
-The pack can breathe again.
-Stiles’ reaction, ohmygod
-Scalia :)
-Ohmygod, the people of BH aren’t against the pack!! THANK GOD!! I WAS SO WORRIED ABOUT THAT!!
-Liam and Nolan as co-capitans.
-Just like Scott and Jackson were and they also had bad blood between them but got over it.
-Liam: “You did. Because you’re a great coach.” aww my heart
-Coach: “You’re right. I am a great coach.” *cries in Spanish*
-I don’t know if you’ve realized but the shots of Theo, Peter and Morey with Deaton are all from previous episodes. Just saying.
-Because some people were complaining about Theo being in the tunnels and Morey learning about supernatural stuff (and not being Stiles the one to learn). Calm down your tits.
-“Now we’ve got allies who used to be enemies” and they show Theo, I’m so happy!! #rendemptionaf
-“We have protectors.” and they show Peter glowing his eyes!!
-“We have friends willing to fight for us.” - Deaton showing a book to Mason and Corey
-I think that part described the other members of the pack so well :)
-Mama McCall and Papa Argent!!! YESS!!!!! AWWWW!!
-Jethan!!!! AWWWWWW!!!
-Aww, Scott saying goodbye to Chris as he held his hands *crying*
-Monroe, that bitch
-YES, THE PACK!! They’re coming together!!
-And it’s raining, nice touch.
-You know, I know it’s supposed to be like, the central pack (no offense to the others) but I would’ve loved to see Mason, Corey and Theo with them as well. Or maybe under different circumstances, but all of them together.
-Scott’s speech!!
-That wink!! Sciles4ever
-Alec: “Who are they?”
Scott: “My friends. My pack.” YES!!!!!!
-Scott: “And you can be with us if you want. But you’re gonna have to fight.” that’s right, homie boy!! If you want to be in the McCall pack, you’re gonna have to fight!!
-Scott: “You’re not a moster. You’re a werewolf. Like me.” DECEASED
-Slow-motion as the pack comes together!
-I’m not crying you’re crying!!
-The first ones who get together are Derek, Scott, Stiles and Lydia!! That’s like the four that where from the very beggining!!
-And then comes Malia and Liam, important members as well!
-It was weird seeing the new kid between them but meeh…
-Scott should’ve flashed his eyes at the end.
-Oh, the moon!!