neonators

Changes in the heart at birth

A newborn’s body undergoes many changes to adapt to life outside the womb, one of the most dramatic being the heart. Before birth, very little blood is sent to the lungs - most is diverted away from the lungs through a vessel called the ductus arteriosus. Before birth, the ductus arteriosus is as large as the aorta.

  • The placenta helps the baby “breathe” while growing in the womb. 
  • Oxygen and carbon dioxide flow through the blood in the placenta
  • At birth, the baby’s lungs are filled with fluid. They are not inflated. 
  • The baby takes the first breath within about 10 seconds after delivery. This breath sounds like a gasp, as the newborn’s central nervous system reacts to the sudden change in temperature and environment.
  • Lungs inflate and begin working, moving oxygen into the bloodstream and removing carbon dioxide (exhalation).
  • Lungs become distended, the capillary network dilated and their resistance is reduced drastically so that a rich flow of blood can take place.
  • Pressure in the right atrium sinks in comparison to left 
  • pressure turn around in the atria causes the septum primum to be pressed against the septum secundum and the foramen secundum becomes functionally closed
  • Towards the end of the first year, it has also grown together in 99% of the babies –> the hole between the left and right atrium is closed.
  • Fluid drains or is absorbed from the respiratory system.

Cutting of the umbilical cord gets rid of the placental low resistance area, increasing peripheral resistance in systemic circulation

  • pressure in the aorta is now higher than that in truncus pulmonalis 
  •  pO2 pressure in the aorta increases since the blood is now oxygenated directly in the baby’s lungs
  • Triggering a contraction of the smooth musculature in the wall of the ductus arteriosus - closing

Atrial Septal Defects

  • The ductus arteriosus closes within the first day or two.
  • However this doesn’t always happen smoothly - resulting in a congenital (from birth) heart defect - ASD (atrial septal defect)
  • The severity of the defect depends on the size of the hole -it may be very small (less than 5mm) with minimal leakage, allowing the individual to live a normal life. Location also plays a role in blood flow and oxygen levels.
  • ASDs are defined as primum  (linked to other heart defects of the ventricular septum and mitral valve) and secundum defects (a single, small or large hole). They may also be more than one small hole in the septum or wall between the two chambers.
  • The hole may stay the same size, or grow with the rest of the heart during development and consequently will be monitored throughout childhood development, then more infrequently throughout adulthood.

MRI of the Fetal Brain

Advancements in MRI are giving us an unprecedented look at the fetal brain.

Until approximately a decade ago, what researchers knew about the developing prenatal brain came primarily from analyzing the brains of aborted or miscarried fetuses. But studying postmortem brains can be confounding because scientists can’t definitively pinpoint whether the injuries to the brain occurred before or during birth. 

Over the years, however, improvements to MRI are finally enabling researchers to study the developing brain in real time. With these advancements, researchers are just beginning to understand how normal brains develop, and how abnormalities can manifest over the course of development. Scientists cataloguing typical infant brain development with the mini-MRI hope to use it eventually to study the brains of premature babies, who have a high risk of brain damage. Ultimately, clinicians hope to intervene early with therapies, if available and approved, to prevent developmental disorders when there are signs of brain damage in utero or shortly after birth.

Read more here in Nature Medicine. 

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grey’s anatomy meme ≡ 5/10 attendings → addison montgomery
“I may be a board certified OB/GYN, but I also have fellowships in Maternal-Fetal medicine and Medical Genetics, and am one of the foremost neonatal surgeons in this country. When you can top that, you can mouth off. Until then, you will do your job and you will do it right. Which at this point in time means you keep your mouth shut unless I give you permission to open it. Understood?”

Hospital Jargon (as explained by an American floor nurse)

Writing something that takes place in a hosptial? Consider this list of phrases to add a sense of realism:

HOSPITAL LIFE:

Report/ in report: When one nurse hands their patients off to another

PACU can f*ck right off until 1930, we’re in report.

Sign-Out: When one doctor/resident hands their patients off to another

*returning page* “Are they dying? I’ve barely gotten sign-out here

EPIC- Electronic charting system. Literally any electronic charting system. Does not have to be Hyperspace/supplied by the EPIC corporation to be called this.

Hey, could you put those vitals in EPIC for me since you’re already logged in?

Bed 45/46-2/47-1/48/etc…: how we refer to patients, by their bedspace number, denoted “room-bed”.

Hey Nikki, do you remember what 45-2′s blood sugar was?

Assignment: The patients any one particular medical professional has responsibility for- be they a nurse, doctor, aide, respiratory therapist, physical therapist, etc…

My assignment is rooms 43-45, how about you?

The Board: Where the status of the patients on your floor get listed, including who is to be discharged, who has certain needs, and the day’s expected admissions. Used to be a physical white board, but now is electronic. Usually used to talk about how many patients a floor is about to admit.

“Jeeze, did you see they just put four new patients on our board? We’ve already got 16- call the nursing supervisor.”

Flexed up: Taking more patients than you’re staffed for on a floor

Well, we’re staffed for 15, but they ‘found’ three more bedspaces so they’re flexing us up tonight.

Code/Call a code/They’re coding: A Code Blue. When a patient’s heart stops on The Floor and everyone shows up to practice CPR and transfer them to The Unit.

They’re coding, get a crash cart to 75-2 and call a code blue

Rapid/Call a rapid/Rapid response team: Almost a code, but their heart is still beating. For hospitals who have a separate “Rapid Response” nursing team. Two Crit Care nurses show up and handle things. Also who you call if you and everyone else on your floor can’t get an IV.

They have an INR of 9.5 and the doc doesn’t want to do anything- I’m gonna call a rapid.

Float/they’re floating you: When you don’t have enough patients on your floor so the nursing supervisor sends you to a different, unfamiliar one.

They’re making me float to 9C. Again. Can you believe that??

Full: Can’t take any more patients, either due to physical space or nursing staff.

Tell the nursing supervisor to stop putting patients on our board- we’re full

Clinic: Outpatient. Where you want your patients to be.

Tell them we’ll see them in Clinic in three days. They have no medical need to be here anymore and they know it.

KINDS OF PATIENTS:

Contacts/isolations: Any patients who’s rooms you have to don a gown, gloves, mask, and/or respirator to enter.

Are you sh*tting me? I have five patients today and four of them are isolations.

Frequent flyer- Someone who, for medical or social reasons, just can’t seem to stay out of the hospital

Did you hear Darlene is back?” “Yeah, we’re officially engraving her name on the Frequent Flyer wall of fame

Crump/Crumpy/Crumper: Colloquial term for patients who are medically unstable/at a lower level of care than they need/will be transferred to The Unit when a bed becomes available or when the inevitably code, whichever comes first.

73′s a crumper if I’ve ever seen one. Rapid’s in there working her now.

‘Seeker: Someone in the hospital with their own agenda, but who largely has no medical need to be there and will threaten to sign out AMA (even though they’ve been discharged four times and keep refusing to go) if they don’t get what they want- be it drugs, social interaction, or over-the-top waitressing. Will probably threaten to give a horrible review of the hospital on their social media platform of choice and mention you by name if they don’t get what they want.

49′s a total seeker. When she’s not begging for pain meds, you’re getting her crackers, juice, tea, hot packs, cold packs, everything you could think of. I didn’t sit down all night and my other patients slept pretty much the whole night. Give her some percocet and get her the hell out of here before I have to deal with her again tonight.

Heavy: A patient that takes up a disproportionate amount of your time, but usually for a legitimate reason.

Dr. P’s patients are really heavy. Something’s always going on with them and they have tubes coming out of everywhere that need care of some kind every hour… I had two of his patients today and I’m so tired… could we break up the assignment for the next shift please?

HOSPITAL PLACES:

The Floor: Medical and Surgical floors, sometimes specialty floors- basically anywhere that’s not the ED, Psych, or The Unit. These have higher staffing ratios (more patients per nurse) and lower patient acuity than The Unit

They didn’t really need a bed on the Unit so they were transferred to the Floor

The Unit: The Intensive Care Unit. Where crumpy patients go, comes in the following flavors (though smaller hospitals may have just one): MICU (medical), SICU (surgical), PICU (pediatric), TICU (trauma), NICU (neonatal), NICU (neurological), BICU (burn), and Stepdown (in the days after an ICU discharge).

They weren’t doing so hot, so we called a rapid and had them sent to The Unit.

The ED: The Emergency Department. Oh dear lord it is not called the ER.

They’re sending up that new admit from the ED in like 5 mins, do you have the room ready?

PACU: Post Anesthesia Care Unit, where people are stabilized after surgery.

PACU’s calling again, they’re backing up and need to give report.” 

THE NURSING HIERARCHY:

Director of Nursing: One Nurse to rule them all. Directs all facets of nursing, from training to hiring to staffing to quality improvement.

Nursing Supervisor: One nurse to rule them all… on a given shift. The nursing supervisor assigns patients to nursing units and makes sure everywhere is staffed accordingly.

Nurse Manager: In charge of the general staffing and personnel management of a particular floor, including scheduling, patient satisfaction, staff development, and service recovery.

Charge Nurse/Charge: The “shift manager” of nursing. Has final say on a lot of things you don’t want to be the bad guy on, as well as creating assignments/checking the crash cart, and submitting service requests when the nurse manager isn’t there. Also has a patient assignment.

Staff nurse: The nurses who do assessments, pass meds, start IVs, carry out orders, give updates to doc’s, chart, manage a patient’s day, make sure they get to tests/procedures on time with the right paperwork, and are overall responsible for managing patient care and providing first-line response to issues that arise throughout the shift.

Nurse Aide/Nurse Tech: Provides the majority of basic patient care. Counts intake and output, gets blood sugars and vital signs, sets up rooms for new admits, cleans and clothes patients, gets blood and urine samples, transports patients if necessary. Staff nurses are responsible for this when aides/techs are not available.

Would someone please add the Medical Hierarchy if you know it? I don’t feel I know it well enough to do it justice. Thanks!

How to give a vampire a headache

Some context. Classic WoD campaign, Chicago. A group of hapless neonates, freshly arrived to the city and accused of pretty much treason, we’ve been given 48 hours to investigate and try to save our asses. I play a Tremere investigator and we also have a Gangrel forest ranger, a Brujah gangbanger, a Toreador tattoo artist and a Giovanni emo teenaged hacker.

We’ve all been rolling pretty spectacularly bad all night and chuckles at our fails abound. Earlier I had made a low roll on an Intelligence + Occult roll to identify whether a ghoul was under another vampire’s thrall (despite my high stats on both the dice just hated me). Later on, our Giovanni has another look at the ghoul and rolls high in the same. The following occurs.

ST: You’ve rolled high enough, [Giovanni] and you identify something in her behavior as suspicious that reminds you of what you’ve read about the Dominate discipline.

[Giovanni]: I’m pretty sure she’s dominated.

ST: [turns to me] [Tremere], you rolled real bad earlier so you’re still convinced that she’s not and that [Giovanni] is wrong.

[Giovanni]: Here, I’ll explain it to you in short words.

(They both happen to have the highest Intelligence stats in the coterie)

Me: I listen to his arguments and explanations. I elect to ignore the fact that he’s patronizing me.

OOC Me: [Tremere] is just 100% done with these dice rolls so he’s like, whatever, maybe he’s right.

ST: [Giovanni] Roll me a Manipulation + Expression. Difficulty [Tremere]’s Willpower. [he succeeds] Excellent, [Tremere] what [Giovanni] tells you shakes something loose in that ginger head of yours and you recall a detail you recently read in the many, many books your Sire made you read through as part of your training. [gets technical about how Dominate 3 can be undone by someone of appropriate power and experience, things my character really ought to know]

OOC Me: [I am so done with my shitty rolls] [Tremere] makes a face as realization sets in and it’s so humiliating he thumps his head against the nearest wall. [Jokingly] Do I roll for head-desking?

ST: …Do it.

Party: [sniggering]

OOC Me: Well shit. [rolls… and botches so spectacularly I am speechless]

[Gangrel]: All those 1s…

ST: Well, somehow your irritation makes you overdo it and instead of a simple boop you straight up head-butt the wall. Roll to soak the damage.

OOC Me: OH MY GOD. [I roll my crappy soak… and botch spectacularly again] NO!

ST: Congratulations, your Tremere takes 2 bashing damage from the wall. You have a sizeable bump on your head and a headache.

OOC Me: …….I need a mortal to take some aspirin so I can bite them.

Party: [just dying]

anonymous asked:

I'm curious about what procedures you think need to change in the livestock industry?

Practically, or philosophically? There is so much that can be talked about in this field

From a practical standpoint, there are a number of areas where current livestock practices are far from ideal. Farming has a huge history behind it, and many of these practices are ingrained and so difficult to change.

Before I go through the list, I should preface that if you’re not comfortable with the fact that farmed animals die for human benefit, if you just want all farms to stop using animals, then you’re not going to find this list satisfactory. If you’re fundamentally uncomfortable with livestock industries, and you haven’t already questioned why you consume the products it produces or what your alternatives are, then it might be worthwhile.

For now, these industries are not going anywhere. They’re certainly not perfect but we could improve them. Regardless of whether you personally believe all these industries should be ‘just stopped’ you have to agree that will not happen overnight, and that other welfare improvements could happen today.

  • Pain relief being more widely used. There has historically been an aversion to using pain relief medication in livestock due to expense, drug residues and the lack of products made for and tested in the species. This is beginning to change so there are not more options for pain relief at castration and mulesing , for example, but this needs to be more widely used. Another hurdle to this is that they are prescription products, and in order for a veterinarian to prescribe them they must have been out to that farm within the last year and be familiar with their set up and stock. Not every farm will call out a veterinarian on a regular basis.
  • Minimize transport time. Transport, whether by road, train, boat or plane, is incredibly stressful for livestock of all kinds. We can measure their physiological stress, so this is definitely not just anthropomorphism. Livestock are more stressed in transport than they are by witnessing death, which is the opposite to what many people would think. 
  • On-farm slaughter and refrigerated transport. Following on from the previous point, we have the technology to transport chilled carcasses. Performing slaughter on farm removes or eliminates a large percentage of the transport an individual animal needs to be exposed to, and will improve their welfare. Animals don’t perceive death the same way we do, having a mini abattoir at the farm entrance isn’t going to bother them.
  • Using genetics instead of procedures. It astounds me in this modern day that we still have breeders of hereford cattle that breed the horned version, and then de-horn the calves, instead of selecting stock with the polled (no horns) trait. If you want horns then fine, but if you’re going to cut/burn/cauterize them off anyway when why not remove them genetically? The polled gene exists! Similarly there are a small number of merino sheep with a ‘bare breech’ trait, which don’t need mulesing. It would be ideal to spread this trait through the Australian sheep population, but with millions and millions of sheep and a ram only about to impregnate about 60 a month, that will take time.
  • Enrichment. Toys. Something for animals to play with, to investigate, to do. This has been historically neglected for a long time because originally animals weren’t though to have souls, or to be thinking, feeling entities. We know differently now. Enrichment only improves the lives of these animals, and often reduces unwanted or destructive behavior, like piglets biting off each others tails.
  • Dam-neonate bonding in certain industries should be reconsidered. In some situations, the dairy industry in particular, neonates may be taken from their mothers within 24 hours to reduce disease transmission in eradication of certain diseases, like Johnes disease, but in other situations it’s because for some mind boggling reason it is more cost efficient for a farm to sell the mother’s milk and feed the neonate on milk replacer.  
  • In a similar vein, giving sows enough space to nurse their litter would be great. They’re kept in sow stalls (basically a cage that they can stand up or lie down in that the piglets can run through) so that they don’t squash their piglets and kill them. That’s great and all, except you can accomplish the same thing by giving the sow more space to turn around it and slopes on the wall of the pen.

So, the important question I hope you’re asking is why don’t we do these things already?

There are lots and lots of reasons someone could grab, but the short (and I dare say more honest) reason is this: Money.

Granting an animal more space costs you money because it reduces the number of animals you can stock in your space. Using more pain relief medication costs you money. Calling out a vet costs you money. Providing enrichment costs you various amounts of money. On-farm slaughter and refrigerated transport is more expensive than the current system.

So if this is all about money, is it the fault of greedy farmers? Well, generally no.

Most farmers actually like the species of animal they work with. And most of them, especially with recent droughts, the current political climate and monopolization of the companies that buy their products, are not making big buckets of cash. More and more farms are selling up and small producers are not keeping up.

They are under constant pressure to lower the prices of their animal products because there’s only a few big buyers, and right now it’s the buyers that dictate what price they’re willing to pay. Because these animal products are perishable, you can’t save them for a rainy day if you don’t sell them, and these buyers are big enough, they can hold out and only pay what they want to pay. This severe downward pressure means farmers get paid progressively less, and these companies make more profits while claiming it’s good for consumers.

^ Look familiar?

So we get cheaper food, the company makes more profit, and the individual farms get screwed.

Especially with milk, there was a huge crisis recently where one of the big milk buyers suddenly declared it had been overpaying dairies, and that not only was it now going to pay them much less for the season (on contract mind you), but that all their dairies now owed them thousands of dollars. After years of downward price pressure on their product many farms could not, and can not, afford this. You can get an overview here.

The point I’m trying to get to is that if these industries are gong to improve, then we need to value the individual animal and its experience of life more than we currently do. 

If we value the experiences of the individual animal, and consequently put our money where our mouth is when it comes to their products, then there should be both motivation and financial ability to improve their lives. We could progress from mere ‘prevention of cruelty’ and minimum standards towards animal welfare and good welfare states.

Changing consumer patterns is probably the only way to do this, and it’s quite hard when you’re already paycheck to paycheck, but a in depth rant/discussion about politics/policy/economics etc is beyond my scope, though I would happily add veterinary and industry specific detail to a discussion if someone wants to tackle that side of it.

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A 5 month old girl with alobar holoprosenceohaly. This condition was diagnosed prenatally in utero and understandably resulted in severe enlargement of the child’s head. The child was oriented to sound, able to move all extremities and responded to external stimuli, however the long term prognosis for this condition is poor as it is typically fatal in the neonatal period.

anonymous asked:

My friend and I got into an argument about whether or not animals find other species babies cute. I argued that any small mammal with babyish traits could possibly evoke a protective reaction in some mammals. in other words, they find them cute. That would explain some of the strange interspecies adoptions. What is your opinion?

@why-animals-do-the-thing might want to weigh in on this one.

The current theory is that the things humans find ‘cute’ basically look like babies. Kinderschema is the technical term for this, and it’s basically a list of features that human babies have, which we as a species seem to be hardwired to find ‘cute’ and therefore want to protect and care for those things. These traits include big eyes, large heads and small mouth/noses. These traits are easiest to spot in cartoon characters that are considered ‘cute’.

But you will also notice them in our smaller dog breeds.

As a species, humans have a really strong urge to care for our neonates. We have to, babies are dependent on adults for a really long time.

So for another species to have a ‘cute’ response, they would likely need the following traits:

  • Juveniles dependent on adults for survival
  • Juveniles with different physical characteristics from adults.

Whether those traits be appearance, sound or smells doesn’t really matter. I’m told wolves often mistake dog sounds for wolf pups, but don’t know how true that is.

With that criteria it might even be possible for a parental reptile to have a ‘cute response’ to something. It’s also possible that certain bird species find cuckoo chicks ‘cute’, since the cuckoo chick is adapted to encourage the host birds to feed it.

It’s certainly possible that this is the reason why some species have been recorded ‘adopting’ juveniles of different species, but whether their behavior patterns are analogous to the human ‘cute response’ is difficult to determine.

Becoming a Queen

You knew your ship was doomed. You were the only one left alive, though as far as you could tell, there was only one of those /things/ left, too. You wanted to set a course to crash into the planet then use one of the escape pods to get to safety.

But that was before one of those leaping fuckers found you.

Your ship had been on expedition to explore some hitherto undiscovered locations. There were rumors that there was xenomoph activity in this area, which had you and the other scientists all excited. You’d heard about them, but you’d never had the chance to observe them. The plan was if you found them to watch from afar and remain as hands off as possible.

You never counted on how diligent they could be, or how gah damned smart they were. For alien creatures who’s only drive seemed to be to breed and kill, they exhibited almost human levels of intelligence. They ambushed your crew, sticking them to the walls to allow facehuggers to inject eggs into them to make more. You’d never seen it happen in person. You’d seen them dissected, seen pictures of their probing ovipositors, but watching it happen in person had been the most horrifically fascinating moment of your life.

The soldiers that had accompanied the expedition had done an excellent job of isolating and eliminating most of the aliens, burning the eggs you had recovered from a stranded ship and blowing said ship into stardust.

But one had escaped.

If they were smart, this one was a savant. It had not only figured out how to work doors, but also to let its victims scream to lure more along. You observed it (no..him) several times, noticing that the elongated cranium that was usually smooth and round had begun to flatten out, black carapace forming a hard hood more often observed in queens. But you understood what was happening: he was adapting to his environment, taking on a needed role. You’d only heard of alpha xenomorphs as a theory, a sort of last ditch effort that some of their amalgamated biologies allowed. Some theorized is was the human members of their species, allowing for remarkable adaptability both environmentally and biologically.

The soldiers had set another trap, and the alpha had just set it off as a lure to kill several of them. A few of the remaining soldiers had tried to attack him then, only to end up cut off and killed on by one.

You had a close encounter with him, and you thought it would have been the end of you. If only that had been so…He cornered you and your team, slaughtering two of them. When he raised a clawed hand at you, he hesitated. A low growl came from him, and his lizard like lips relaxed over his dripping teeth. He growled and sniffled, butting his muzzle against you. You thought for sure you were dead…instead he pressed his head against you, rubbing at you almost like a cat would.

He ran off when the few remaining soldiers tried to attack him. Your heart was pounding and you could barely breathe. They asked if you were alright, and you suddenly realized you were the only one of that group left.

Things seemed to go downhill from there. You always had the sense that he was following you, hearing his claws on the gratings around you, seeing his long tail whip around corners. The last of the soldiers and crew began to dwindle, getting picked off in the mad attempts to get back to the ship’s bridge. By the time there was a clear path, you were the only one left.

That was when it found you. It looked like a chestburster, only larger with longer legs and tail. You ran, keeping an arm up level with your head and neck. But this one wasn’t concerned with your mouth. It flung itself at you and landed on your lower back, its tail clamping around your waist. Its legs gripped your buttocks and thighs, and you felt two sharp points ripping at your jumpsuit. You felt the tapered end of the ovipositor probing you, searching. You tried to pull it off, but its grip was iron. You slammed backward into walls, but its back was covered in a hard shell like the aliens themselves. It shifted itself between your thighs, the same shell forcing your legs apart.

It found your warm hole and thrust in. You screamed and frantically grabbed for it, but it was pressed up against you so tightly, you couldn’t even wiggle a finger between it and you. You screamed again, feeling it thrust upward into you. It reached impossibly deep, and you felt your stomach pushing outward with its movements.

Then you felt it. A lump against your hole. You threw yourself on the ground and tried to make it stop, but you were powerless to stall the inevitable. You felt the large sacs on the thing convulsing and sending ripples down its ovipositor. Your belly felt hot suddenly, and you gasped, clutching at it. Your hole was wet with some sort of alien goo it filled you with. Every lump was more goo, and the feeling of heat spread through you.

Another bump pressed to your hole, this one large and solid. You screamed no over and over, trying to thrash free of this thing attached to you in a death grip. Your hole stretched wider and wider to the point where you swore you would rip in two. Convulsing on the ground, you sobbed in mixed pleasure and pain, gasping when the hard thing passed into your body. You felt every inch it moves, and look down to see it pushing your belly outward.

Everything from there was fuzzy. The thing pumped more goo into you until your belly looked like you’d had a meal that was far too large. You crawled down the corridor, tears streaming down your face as you realized there was no salvation for you, not now. You only had one option left: crash the ship to destroy everything on board. You felt your stomach surge and convulse, churning and growing steadily heavier. By the time you reached the bridge, you looked like you were pregnant, your belly almost brushing the floor.

It took the last of your strength to pull yourself up to the navigation computer. Even as you key in the commands, overriding the ship’s safety protocols for a steep descent, you feel something happening inside you. You sob, knowing this must be the moment they punch through you and rip free…

But they don’t.

You see them moving inside you, writhing and slithering like snakes. Your belly is so full and heavy it’s all you can do to stay upright. You fumble your ID code, blinking back tears as you put it in for the fourth time. The computer finally accepts your trajectory, and you let yourself fall on the floor.

As you scream and hold your belly, you’re aware of not being alone. You know the sound of hard claws on the metal of the ship, scrabbling as the creature moves closer. He shrieks, though you don’t know why. You don’t really care either. You would have loved to study him, learn why he grew so large and why his head grew as it did. He looked like a king somehow.

All thoughts of that leave you as your stomach convulses. The movement in you shifts, and you scream as you feel the writhing mass move lower. You lay on your back, legs spread. Screaming and panting, you press your back to the floor and push with all your might. You feel your hole bulge and stretch, something smooth and wiggling pressing against it. You push and scream, feeling a long thing slither out of you. Before you can even see what it is, the pressure builds again. You push, screaming as two more press out of you side by side.

It feels like eternity as you lay there, panting and pushing, countless things slithering out of your hole. You finally see them as a couple of them climb across you. They’re neonate xenomorphs, their soft skin still fleshy and covered in the greenish goo the strange facehugger forced into you. Most of them scatter when the alpha pads toward you. He growls and lays over you, his smooth body cool against your flushed skin.

All around you, sirens are going off, the ship’s warning systems kicking on. It’s placidly screaming the descent is wrong, it’s too fast, too steep. You hope the ship burns up in atmosphere. The last thing you remember is heat, the ship’s life support falling to critical levels as the white hot burn of planetary entry seared the plating off the hull.

You never expected to wake up. Blinking blearily, you looked around, wondering where you were. Pieces of the wrecked ship surrounded you, and you could see huge trees between them.

Somehow, you survived the crash.

You can’t move, looking up to see your arms have been carefully secured in glossy black resin. The same kind the xenos restrain their chest burster victims in. You try to move, but you’re dangling about 10 feet off the ground and are powerless to so much as twist. You look down at yourself and see your belly is still slightly distended. You don’t feel the writhing weight inside you anymore, but it still feels..wrong.

Below, you see several small xenos run back and forth, one of them looking up at you and screeching. The trees shudder, and the alpha appears. He’s grown even larger, almost 9 feet tall now. He easily climbs up to you, the long fingers of one hand forcing your mouth open. His lips curl back and his huge teeth part, and you see his secondary mouth shoot forward. You scream and writhe as he forces it into your mouth and angles to shove it down your throat. He growls and his torso jerks, and you feel something sliding down your throat. He’s..feeding you?

This becomes a regular routine, him returning from the forest and pushing his secondary mouth into yours to share his hunts with you. You beg him to stop, to let you go or let you die, but he just growls and rubs his smooth head against you.

You’ve lost track of time. Your body is changing, you can feel it. Slowly, day by day, your belly is growing again, though much more than before. The alpha begins to nose and prod along your body, often trying your hole with the smooth swell of his nose. You realize your hole has become softer and larger, and each day it feels like he can slide his muzzle further against you.

You start to notice him changing, too. The carapace between his hind legs seems to have softened, swelling outward slowly, growing. You realize somehow, he’s grown a penis. As far as you know, that’s completely unheardof. Yet there it is, dangling between his legs.

He climbed up to where you were hanging, taking you in his hands. He growled and settled his head over your shoulder as his body bowed. His hips work their way between your legs, and you feel the head of his newly grown cock spread your hole. You can’t resist, you can barely cry out when he thrusts into you. There’s no pleasure to it, not tenderness or love. He thrusts roughly, pushing deep into you. You feel your body react, everything in you suddenly alive with sensation. You cry out and thrash, then scream in pleasure as he cums inside you. Your already distended belly grows larger as he pumps you full.

Time passes. Your belly grows until it’s hanging between your legs. The alpha and the smaller xenos you birthed on the ship connect your growing belly to the broken ship with more resin, taking the burden of weight bearing off of you. You’re grateful to them. The alpha fucks you almost daily, further distending your belly.

Little by little, black patches appear on your skin. Hardened plates cover your arms and legs, then your chest above the swell of your belly. From your ribs downward, you are nothing but belly, your legs dangling comically on either side. Your hole continues to stretch, and though you can’t see it, you’re fairly certain it’s moved.

The skin over your belly becomes thinner. Inside, you can barely see the movement of large objects, shuffling around within you. Your spine has grown its own cage-like carapace which wraps around your ribs and hips. It’s only then you realize the flesh of your back and ass have changed, stretching backward. Your hole has begun to shift downward, dangling just off the ground from your massive belly.

No…not belly…Egg sac.

The hard cage along your spine helps support the ever growing sac. The alpha and smaller xenos dutifully tend to you as you begin to understand your new place. They didn’t have time for a queen to be born and grow..they had to make do. Your belly ripples, the translucent skin shifting and pushing, moving the hundreds..no, thousands of eggs through you. The small xenos have brought back living creatures and restrained them to the walls of the ship and the surrounding trees. Day by day, the skyline gives way to a lattice work of resin construction. They build a sanctuary for you.

The alpha rarely leaves you now, staying always at your side, climbing around you and tending to your every need. He caresses your egg sac, soothing the discomfort of the eggs moving inside you, easing your burden.

You feel your egg sac convulse and cry out. Your voice sounds like their’s now, a shrieking growl that echos in your chambers. The alpha is beside you at once, rubbing his crested head against you. The convulsing contractions travel all the way down your belly, and you feel your hole begin to bulge. Slice and goo pour from you, sending the small xenos scurrying to your hole. You feel the birthing tube of your hole stretch and elongate until it almost touches the ground. The bulge of an egg moves through it, and you groan at the tight pucker you feel before you stretch around it, easing it to the floor.

Another egg soon follows, then another. You find yourself in a haze, trapped in a feeling of pleasurable pain as egg after egg travels through your birth canal to be deposited on the ground.

The smaller xenos collect the eggs and move them, setting them in front of their captives. The creatures writhe and scream, exactly the wrong thing to do. The eggs blossom open, and facehuggers wriggle their way free. They leap and plant themselves over the screaming mouths, muffling them as their ovipositors force deep into their throats.

Some time later, you coo as you watch your children burst from their incubators and wriggle onto the ground. Your children, your second brood. They skitter around you, finding places to shelter their small, soft bodies until they grow. The alpha purrs at you and rubs himself along your belly. You want him to seed you again, and he obliges, thrusting into your hole even as you try to push out more eggs.

Your new life as their queen will be full of pleasure and offspring. You will make a new home of this world, together with him and your children. Your species will thrive. Even as hard plates cover your face, and the soft skin of your cheeks falls away to expose your huge, gleaming teeth, you feel every inch a queen. Your crest soon grows from what was once a rounded skull, just like his did.

Every day you lay more eggs, and every  day your children burst free. This world is yours, your realm, your home, your kingdom.


(by supernona)

9

Dr. Karev, I may be a board-certified OB/GYN, but I also have fellowships in maternal-fetal medicine and medical genetics, and I’m one of the foremost neonatal surgeons in this country. When you can top that, you can mouth off. Until then, you will do your job and you will do it right, which at this point in time means you keep your mouth shut unless I give you permission to open it. Understood?

anonymous asked:

Hi ! After knowing harry's meaning of SOTT what do you think of it? Honestly that's not what i was thinking... like i never thought it would be a perspective of a mother dying. all the interpretations everyone's made idk harry is so difficult to read what are your thoughts?

Lol!

The Rolling Stone/ Cameron Crowe interview was quite a nice bit of theater this morning, wasn’t it?

On the one hand, we have Harry state in radio promo interview that SOTT was his most literal and personal song on the album. On the other hand, he offers an interpretation of a mother dying in childbirth and urging her child forward. He paints quite a dramatic tableau– but if it’s personal/ literal, which one was Harry? The mom? Or the child?

Was the dying mother the one shouting, “We’ve got to–away”? Because she, this dramatic character, wasn’t going to make it. Or was it the baby talking to– the neonatal intensive care unit staff?

Then we have contradicting versions of how the song was written. A prior interview had said Harry sat down at a piano, thrummed out some chords in the rented Jamaica house that ended up being the opening of the song.

The Rolling Stones interview says, “The song began as a seven-minute voice note on Styles’ phone, and ended up as a sweeping piano ballade.”

So which one was it? A spontaneous improvisation on a Jamaican piano, or a voice note?

I think the clue to these contradiction lies in the one true thing Harry said:

“Like, fuck, I don’t know what Prince eats for breakfast. That mystery … it’s just what I like.”

I was talking to @lawyerlarrie about the French deconstructionists, Foucault and Derrida. Deconstructionism is a movement of literary criticism which focuses on literary texts to the exclusion of authorial intent. “Pride and Prejudice” means something because of the words (the text) themselves, not because of what Jane Austen wanted them to mean. In this school, it doesn’t really matter what Austen wanted. What we have is the text.

Similarly, when songs are written, they acquire an existence of their own, regardless of what the songwriter wants them to mean.

You can carry this to an absurd end, of course. Other ways of interpreting are valid, including a psychosocial reading connecting the song to a songwriter’s biography. For example, we now know that Stevie Nicks wrote “Sara” about her abortion of the baby she conceived with Don Henley. That fact is relevant to the song, no matter what the literary interpretation is.

SOTT’s lyrics describe separation and oppression; a promised end that never comes; a relationship in which one person has been given reprieve/ freedom while the other person is left behind. It is about false reassurances, about someone giving comfort despite knowing that a situation is hopeless. It’s a song about an impossible escape. And about the guilt of the person (the singer) who has been given the freedom. The cost of his freedom was pain to the person he loves. That meaning is unarguable.

These words have meaning, no matter what the writers want them to mean. A mother dying is one way to express this situation. But a mother dying is a metaphoric representation of the situation. In other words, it can’t be literal– not for Harry. The literal meaning is hidden. Harry didn’t say it; he didn’t want to say it.

So much is left unsaid or obfuscated in this interview. I (with some discomfort) admire Harry the Escape Artist. He has left just a smoky outline of himself on the page. There’s an irony in his honesty. “I’m honest because I’ve told no lies”; this isn’t the same as “I’m honest because I’m telling the truth.”

We say he’s “swerving,” but I don’t think that’s a great description either.

I think the whole solo promo has been about creating another theatrical persona for Harry– one who is a hip, down-to-earth, creative, sweet, genuine, charming, HONEST musician who doesn’t get many dates, and whose heart is broken over and over by intense (heterosexual) love affairs, which are then converted to art. And who, finally, gets to do exactly what he wants– so it’s all above ground and transparent, right?

Wrong. It’s all illusory.

Harry has created an iron curtain between his public and private lives, which no one but family are privy to. I’m not just talking about his sexuality, but the whole question of his privacy. The iron curtain deflects peskier personal questions and allows him to work. It separates his celebrity status from his artistic achievements. Not that he’s above using celebrity to promote his art– why else would he do the interview? Of course he’s going to use his celebrity when the occasion arises. But he’s treading a thin line.

The iron curtain lets him swim in the private cove of his Jamaican imagination without being under public scrutiny.

The ocean doesn’t care who he is. It doesn’t care whether he was in love with Taylor Swift. It is big enough for him to disappear in.

So if his whole album is filled with love songs dedicated to female pronouns, so be it. He has raised the wall.

“The mystery … it’s just what I like.”

youtube

As a neonatal intensive care nurse, Lauren Bloomstein had been taking care of other people’s babies for years. Finally, at 33, she was expecting one of her own. The prospect of becoming a mother made her giddy, her husband Larry recalled recently— “the happiest and most alive I’d ever seen her.”

Other than some nausea in her first trimester, the pregnancy went smoothly. Lauren was “tired in the beginning, achy in the end,” said Jackie Ennis, her best friend since high school, who talked to her at least once a day. “She gained what she’s supposed to. She looked great, she felt good, she worked as much as she could” — at least three 12-hour shifts a week until late into her ninth month. Larry, a doctor, helped monitor her blood pressure at home, and all was normal.

On her days off she got organized, picking out strollers and car seats, stocking up on diapers and onesies. After one last pre-baby vacation to the Caribbean, she and Larry went hunting for their forever home, settling on a brick colonial with black shutters and a big yard in Moorestown, N.J., not far from his new job as an orthopedic trauma surgeon in Camden. Lauren wanted the baby’s gender to be a surprise, so when she set up the nursery she left the walls unpainted — she figured she’d have plenty of time to choose colors later. Despite all she knew about what could go wrong, she seemed untroubled by the normal expectant-mom anxieties. Her only real worry was going into labor prematurely. “You have to stay in there at least until 32 weeks,” she would tell her belly. “I see how the babies do before 32. Just don’t come out too soon.”

When she reached 39 weeks and six days — Friday, Sept. 30, 2011 — Larry and Lauren drove to Monmouth Medical Center in Long Branch, the hospital where the two of them had met in 2004 and where she’d spent virtually her entire career. If anyone would watch out for her and her baby, Lauren figured, it would be the doctors and nurses she worked with on a daily basis. She was especially fond of her obstetrician/gynecologist, who had trained as a resident at Monmouth at the same time as Larry. Lauren wasn’t having contractions, but she and the ob/gyn agreed to schedule an induction of labor — he was on call that weekend and would be sure to handle the delivery himself.

Inductions often go slowly, and Lauren’s labor stretched well into the next day. Ennis talked to her on the phone several times: “She said she was feeling okay, she was just really uncomfortable.” At one point, Lauren was overcome by a sudden, sharp pain in her back near her kidneys or liver, but the nurses bumped up her epidural and the stabbing stopped.

Inductions have been associated with higher cesarean-section rates, but Lauren progressed well enough to deliver vaginally. On Saturday, Oct. 1, at 6:49 p.m., 23 hours after she checked into the hospital, Hailey Anne Bloomstein was born, weighing 5 pounds, 12 ounces. Larry and Lauren’s family had been camped out in the waiting room; now they swarmed into the delivery area to ooh and aah, marveling at how Lauren seemed to glow.

Larry floated around on his own cloud of euphoria, phone camera in hand. In one 35-second video, Lauren holds their daughter on her chest, stroking her cheek with a practiced touch. Hailey is bundled in hospital-issued pastels and flannel, unusually alert for a newborn; she studies her mother’s face as if trying to make sense of a mystery that will never be solved. The delivery room staff bustles in the background in the low-key way of people who believe everything has gone exactly as it’s supposed to.

Then Lauren looks directly at the camera, her eyes brimming.

Twenty hours later, she was dead.

Focus On Infants During Childbirth Leaves U.S. Moms In Danger

types as university majors

istj: engineering
isfj: sociology
estj: business
esfj: linguistics
istp: computer studies
isfp: liberal arts
estp: game development
esfp: theatre studies
intj: analytical chemistry
infj: english literature
entj: public service
enfj: midwifery and neonatal medicine
intp: astrophysics or biomedical science
infp: creative writing and journalism
entp: architecture/maths
enfp: history or music tech

jkm59  asked:

I am writing a story about family where the main character ends up pregnant with natural, identical quadruplets. After some research, I found she's likely to need to give birth by C-section and is likely to develop preeclampsia. I can't find a definite answer, but could she breast-feed all four children or will she need to supplement with formula? Especially if she suffered from preeclampsia? Thank you so much for your help!

Preeclampsia and breastfeeding do not, to my knowledge, have any correlation. She may be able to breastfeed, but honestly, with quadruplets, there are a few things that make me say “proooobably not?” 

Most likely these kiddos are coming out early. “Normal” human gestation is 40 weeks (That’s ten months for those doing the math at home), though anything after 39 weeks is considered “full term” under a new set of definitions from 2013. Anything over 37 weeks or so is really pretty much fine. 

Before 37 weeks, though, kiddos might be in some trouble, and if they’re early-early (as most quads are), they’ll probably stay in the NICU for a couple of weeks in incubators to help them grow and make sure they’re healthy kiddos. 

Honestly, a great many moms have trouble breastfeeding even one growing infant. Your mom character is likely going to need to pump and bottle-feed, and she’ll likely be supplementing with formula. 

Good luck with your story! 

xoxo, Aunt Scripty

[disclaimer

NICU Nurses

“Don’t you just like, I don’t know… hold babies all day long?”

Yes. I hold a baby when I hand him to his mother for the first time, three weeks after his birth date.

I hold a baby when teaching a new mother how to breastfeed her child.

I hold a baby to feed him, to rock him to sleep, to bathe him and bundle him.

I hold a baby when nothing but morphine and walking the halls 24 hours a day is the only thing that will quiet him down while he’s withdrawing from the illegal drugs his mother took.

I hold a baby’s arm still when my fellow nurse inserts an IV.

I hold a baby’s head still while we bag oxygenated air back into his tiny lungs.

I hold a baby when he has no family to hold him.

I hold a baby when he takes his last breaths because his parents didn’t make it to the hospital in time.

I hold a baby when I’m placing his lifeless, tiny hands in plaster to make a keepsake for his parents… because there is no baby to hold anymore.

Yes.

I hold babies all day long.

I don’t know the source, but this is beautiful.

2

Source and to listen to video: http://variety.com/2017/tv/news/jimmy-kimmel-opens-up-about-newborn-sons-heart-surgery-in-moving-monologue-1202406149/

❤️this. (Tissue warning) It is worth 13 minutes of your time. Kudos to Jimmy for naming all the doctors and nurses who took care of his newborn son. Prayers that baby Billy will continue to heal and thrive and that his second surgery will be a success a few months down the road.