#medicine

cannabiscomrade:

krist0pher:

ironicdavestrider:

superluminalflower:

abomination-of-gender:

kiriamaya:

starduststarling:

I appreciate that this site has info on the differences between heart attacks in girls and in boys, but like

As a trans girl that’s been on hormones for almost two years now, I have no idea what to look for lmfao

Yeah, I reallywish posts like that would specify whether it’s caused by hormones or something else, because like, they’re not much help if you’re not cis.

Speaking as someone who is trans and is a researcher: The horrific thing is actually that we don’t know.

Trans science is new, and we don’t know whether any given gendered trait is altered by hormones. It’s unfortunately as simple and awful as that.

Of the tiny amount of medical research which exists on trans people, the lion’s share focuses on HIV, because that is where the funding is, or on endocrinology, for obvious reasons. In other words, it’s all applied: there is almost no basic research on trans health.

additionally: even in people who have not taken hormones the signs are not that binary and much of that info is inaccurate to begin with

Hey!! I can help with this!! I’m certified in first aid/CPR and have been for years, and I’m about to get my next level of certification to become an instructor.

Trans girls can experience a mix of symptoms, so it’s best to know what symptoms present most commonly, as well as the different appearances symptoms can present as. Since the reason why heart attacks somewhat have “gendered” symptoms isn’t totally known, it’s hard to determine exactly who will experience what, and whether gendered symptoms are psychological (like some other illnesses), physiological or both.

One of the problems is heart attack awareness is generally divided explicitly between the recognized sexes. So the symptoms seem cut and dry, at least in the mainstream.

What you need to look for:
>Sudden arm pain: can be in your left arm only, but can be in both arms. The pain may build
>Nausea/cold sweat or heartburn
>Sudden chest ache or pain, or even a squeezing feeling
>A feeling of dread/severe anxiety or nagging mental discomfort. Most commonly described as a feeling of impending doom.
>sudden back/neck/jaw pain

When in doubt, call the emergency line (911, 999, etc) or get someone to take you to the hospital asap. If you can’t get transportation, try to make it as easy as possible for EMS to get to you. Go to an open space/landmark, unlock doors if you’re inside, park your car and pop your trunk/open your door, etc.

The biggest symptoms of this list are the arm and chest pain. But trust your gut.

if anyone was wondering the above list applies to a lot of intersex people too!

Would the mix of symptoms also apply to someone afab taking testosterone? This is a thing I’m really paranoid about as well

Yes! Trans men/non-binary people on testosterone need to look out for mixed symptoms as well.

Honestly everyone should know all the symptoms, gendered or not. Dyadic cis people can experience symptoms opposite of binary assignment.

The biggest thing with heart attacks is the symptoms will be sudden. They’re not carry over symptoms that last for days, but people with chronic illnesses that cause similar symptoms should be proactive about symptom tracking. You need to know when things are different so you can act quickly.

As a last note: heart attacks may not present with chest pain at all. Be aware of your body and any abnormal changes you may experience.

Do any of your characters have advanced regeneration abilities? Is it intrinsic to their being, or do they utilize external resources (like magic or medicine) to enact it? At what level of injury does their regeneration start losing efficacy?

elfpen:

lloerwyn:

kingfucko:

stitch-n-time:

petermorwood:

spiderine:

Before oven thermometers existed, one way to check the temperature of your oven was to stick your hand inside and recite an Our Father. The length of time before you snatch your hand out was timed by how far you’d gotten in the prayer. The shorter the time, the hotter the oven. So you knew that if you wanted a hot oven to bake bread, you wanted your hand out by “kingdom” (for example) but to slow cook a stew, you might want the oven cool enough to get to “trespasses”.

lloerwyn:

I would be extremely surprised if medieval people didn’t use prayers while cooking. You don’t want to roast an egg for too long, have it explode, and get hot yolk in your eye. :P 

I know that church bells were definitely used as timekeepers. 

ladytemeraire:

I wonder if this shows up in other historical areas besides medicine?

I ask because I have a very Italian, very Catholic friend who was once describing how she makes pizzelles. They’re cooked in a specific press, similar to a waffle iron, long enough to get light and crispy but not burnt, and in her own words: “I don’t know the exact time it takes to cook them in seconds, but I usually do either two Hail Mary’s or an Our Father and a Glory Be.”

shredsandpatches:

The length of time it takes to say a paternoster was a typical method of reckoning time in the Middle Ages. It’s likely that whoever wrote this remedy down was thinking of it both as a prayer and a timespan and that whoever read it would have understood it the same way.

lloerwyn:

Fun little thing about medieval medicine.

So there’s this old German remedy for getting rid of boils. A mix of eggshells, egg whites, and sulfur rubbed into the boil while reciting the incantation and saying five Paternosters. And according to my prof’s friend (a doctor), it’s all very sensible. The eggshells abrade the skin so the sulfur can sink in and fry the boil. The egg white forms a flexible protective barrier. The incantation and prayers are important because you need to rub it in for a certain amount of time.

It’s easy to take the magic words as superstition, but they’re important.

This popped up in “Nanny Ogg’s Cookbook” as well, though there the timing method wasn’t prayer but X verses of “Where Has All The Custard Gone?”

Other timing methods are “a while” (approx. 35 mins) and “a good while” (variable, up to 10 years, which the book suggests is a bit long to let batter rest before making pancakes…)

All absolutely standard, and also varied from region to region. The use of prayer was more common than most, since the Catholic church had a monopoly on… well, pretty much everything. And all the prayers were in Latin, and at a specific cadence, so the effect is similar to watching the second hand on a clock today.

it’s important to note that to the medieval people the prayers were important because of timekeeping AND god. like, i think as modern people we do tend to want it to be “just timekeeping, they weren’t just superstitious idiots, they had a good reasonable scientific reason!” but it’s also important to remember just how culturally steeped in a mystical religion they were, a relationship with christianity entirely unlike the modern relationship found in modern american culture even amongst the most religious people. i have no doubt that in the medieval mind, they were aware of the prayer being the time it took but also if there had BEEN another way to measure that time, the prayer would have been held to be preferable and important in its own right because of the importance of spiritual assistance in worldly things like bread-baking

Definitely, this is a great point! I was talking to somebody in the comments who was saying that medieval medicine was mostly bunkum because it involves spirituality, supposedly meaning it couldn’t also have logical basis behind it. But that’s a really modern way to see it. To the medieval worldview, those things aren’t contradictory. They’re part of each other. Think about how many medieval Christian scientists were monks, nuns, and priests.

*INHUMAN SCREECHING*

M Y    T I M E    H A S    C O M E

You guys don’t understand how excited it made me to read this post, I literally wrote my master’s thesis on this exact topic.

STORY TIME

Sometime in the 10th century in Anglo-Saxon England (for context, this is before the Norman Conquest and near-ish to the reign of Alfred the Great), a dude named Bald asked another dude name Cild to write a book. Not just any book. A leechbook, which was essentially the medieval version of WebMD for practicing doctors. BUT NOT JUST A LEECHBOOK. This leechbook was gonna be the damn Lamborghini of leechbooks. This thing was going to be split into two parts, the first dealing with external medicine and the second dealing with internal medicine—something that was unheard of at the time. It was going to be organized(head to toe, like all the good leechbooks were). It was gonna be nice(leather and vellum). It was gonna use all the best ideas (from all over the known world). And the whole thing was going to be written in Anglo-Saxon. Now, a few medical books had been compiled in Anglo-Saxon before, but none like this. This one was going to be EPIC. And it was—and still is.

Bald’s Leechbook (also goes by the more boring but more informative MS Royal 12 D XVIII over in the British Library) contains a lotof medical remedies. A lot of them rely on things like prayers and chants and odd charms, like one for a headache, which recommends plucking the eyes off a living crab, letting the crab back into the water, and wearing the eyes about your neck in a little sack until you feel better. However, it’s worth pointing out that the really wild remedies, the stuff that makes absolutelyno freakin’ sense, is most often recommended to treat ailments that are hard to treat even today—migraines, toothaches, cancer. These things are really painful or deadly and, without modern medicine, almost impossible to treat. So are you going to make up some nonsense to make your client at least feel like they’re doing something, and hey, if it sort of works, it works? Of course you are. You want to help people. Even if it sounds crazy, what else are you going to do? You have to try something,and the people who are suffering are willing to try anything.

But there’s also things that make complete sense. To echo concepts that have been mentioned by commentators above, there is a recipe that calls for the recitation of the paternoster while boiling a honey-based salve meant to treat carbuncle. The book instructs the physician to bring it to a boil, and sing the paternoster three times, and remove it from the fire, and sing nine paternosters, and to repeat this process two more times. A century ago, historians read the use of the paternoster as a magical incantation, but today, most agree that in lieu of a stopwatch, the paternoster is just meant to make sure you don’t burn the honey.

BUT THAT ISN’T NEAR THE COOLEST THING.

Now, this book was compiled by a master physician (we don’t know if it was Cild himself or if Cild was the scribe for an unnamed author) who was compiling recipes that had been written down for some time, and had, as many things do, gone through various permutations over the years. Many came from Greece or the western Mediterranean, and had been adapted for local English horticulture and herbs. Some came from around what is now Germany, and some ideas came from farther away in the Middle East (King Alfred was a sickly king; some scholars believe that he had his physicians seek out cures from all over the world in an attempt to treat himself). But there is one recipe that has only ever been identified in England. Not only has this recipe only ever been identified in England, it’s only ever been identified in this one manuscript. When translated into modern English, it reads as follows:

Work an eyesalve for a wen [stye], take cropleek and garlic, of both equal quantities, pound them well together, take wine and bullocks gall, of both equal quantities, mix with the leek, put this then into a brazen vessel, let it stand nine days in the brass vessel, wring out through a cloth and clear it well, put it into a horn, and about night time, apply it with a feather to the eye; the best leechdom.

For those who don’t know and/or are lucky enough to have never had one, a “wen” or a stye is a bacterial infection that manifests like a boil or a cyst that on the eyelid. They hurt something awful, and can cause larger infections of the eye. They are usually caused by Staphylococcus aureus. 

With me? Okay. Fast-forward to 1988. A former biologist turned historian called M.L. Cameron decides to take a look at this old medical leechbook to see what he can see. He takes a good look and says “Lads I do believe these Anglo-Saxon leeches weren’t nearly so daft as we thought they were” (he did not and probably would never actually say that, I’m paraphrasing). Cameron was particularly interested in the recipe above. As a scientist, he knew a few things:

1. Garlic and cropleek (leek or onion, or another related plant) have been known to have antibacterial qualities for centuries.
2. Wine (alcohol) also has antibacterial qualities.
3. Bullocks gall (literally bile taken from a bull) is known to have detergent properties, and has long been used as an additive to soap for particularly tough stains.
4. A brazen vessel, or a vessel made of brass, contains a good amount of copper in it. And that copper, when left to sit around for, I don’t know, about nine days, would have plenty of time to react with the acids in the onion and garlic and the tartarates in the wine to create copper salts. 
5. Coppers salts, as it happens, are cytotoxic, meaning they kill everything: tissue andbacteria.

What an interesting find.

Fast-forward again to 2015. A paper is published by a team from the University of Nottingham, who’ve been working on an ‘Ancientbiotics’ project to investigate ancient medical remedies and see if they actually work. They’ve turned their sights to the Anglo-Saxons, and are, as was Cameron, particularlyinterested in this recipe for an eye salve. Without boring you with the finer details of the experiment and its various trials (read it yourself!) I will spoil the ending by telling you that they discovered a few things:

1. This recipe, which was over 1,000 years old when they tested it, worked.
2. It worked well.
3. It worked extremely well. 
4. So well, in fact, that (in a lab setting) they even got it to kill Methicillin-resistant Staphylococcus aureus, or as it’s more commonly known, MRSA. MRSA is a modern superbug that has built up a resistance to the antibiotic Methicillin. And this goddamn Anglo-Saxon witches’ brew freakin murderedit.

Now, as an advocate for modern medicine and sound scientific method, I’m not about to say that we should go throwing this salve on everything in 2019, because it is, if anything, just a starting point for modern scientists. This salve is still incredibly crude by modern standards and comes with a lot of potential problems. But as a historian… it works,you guys, it really works.

Medieval physicians were not idiots. They believed in magic, they believed in all things supernatural, they believed in all those things that are ‘unreasonable’ or unpopular today, and they practiced them too. But they also interacted with the real world with brains and intellects as sharp if not sharper than yours and mine. They were smart, they studied, they talked to each other in Latin and Greek and Arabic and Anglo Saxon. They made old recipes better and came up with brand new ones. They tried dumb stuff and they tried smart stuff. They didn’t have access to even the smallest fraction of the information we have at our fingertips today, and yet they created things like this. 

To this day, no one knows who created the eyesalve recipe. And no one trulyunderstands why this is the only copy of it. If it worked so well, why isn’t it plastered to the headings of every medical textbook from Alfred to Victoria? Speaking personally, I would argue that it has to do with language. Not so long after Bald’s Leechbook was written, the French invaded England and took over. Latin and French became the language of the court, and while Anglo-Saxon lived on throughout the country, and certainly lay doctors would have used Anglo-Saxon books daily, the language of formal English medical education was Latin. Oxford and Cambridge were late to the medical ed game after Salerno, Bologna, Paris, and Montpellier, and naturally fell in step with continental schools as a result, using Latin almost exclusively, and sometimes Greek or Arabic. 

Point being, by the time medical licenses and medical college degrees are a thing in England, not only does almost no one of university-eligible class speak Anglo-Saxon anymore, no one has use for those Old English texts, because they don’t get you your degree, and you can’t make a living as a doctor without a degree and doctor’s license. And no one’s going to translate an old Anglo Saxon text into Latin when Avicenna’s newest old hit, now in Latin, is fresh off the boat from France.

All that to say: 
Never write something off because it’s old. 1,000 years is a long time ago, but human ingenuity and intelligence are hardly modern inventions. The science of the world hasn’t changed; only our tools and our perspective.

Thanks for coming to my TED talk

Further reading:

• The 2015 Ancientbiotics report: A 1,000-Year-Old Antimicrobial Remedy with Antistaphylococcal Activity
• NPR: ‘Ancientbiotics’ Researchers Look For Old Fixes To Modern Ailments
• Mental Floss: 20 Anglo-Saxon Remedies from Bald’s Leechbook
• Read a paper about how scholars are building on the work of the Ancientbiotics project to better understand how to apply ancient ideas effectively to modern medicine.
• Look through Royal 12 D XVIII for yourself! Bald’s eyesalve recipe is on f. 12v and looks like this:

Vintage No Doz travel trial side run from the 1950s and 1960s

cranquis:

sketchshoppe:

This patient isn’t usually mine, but today I’m covering for my partner in our family-practice office, so he has been slipped into my schedule.

Reading his chart, I have an ominous feeling that this visit won’t be simple.

A tall, lanky man with an air of quiet dignity, he is 88. His legs are swollen, and merely talking makes him short of breath.

He suffers from both congestive heart failureandrenal failure. It’s a medical Catch-22: When one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried out by dueling specialists and punctuated by emergency-room visits and hospitalizations.

Hemodialysis would break the medical stalemate, but my patient flatly refuses it. Given his frail health, and the discomfort and inconvenience involved, I can’t blame him.

Now his cardiologist has referred him back to us, his primary-care providers. Why send him here and not to the ER? I wonder fleetingly.

With us is his daughter, who has driven from Philadelphia, an hour away. She seems dutiful but wary, awaiting the clinical wisdom of yet another doctor.

After 30 years of practice, I know that I can’t possibly solve this man’s medical conundrum.

A cardiologist and a nephrologist haven’t been able to help him, I reflect,so how can I? I’m a family doctor, not a magician. I can send him back to the ER, and they’ll admit him to the hospital. But that will just continue the cycle… .

Still, my first instinct is to do something to improve the functioning of his heart and kidneys. I start mulling over the possibilities, knowing all the while that it’s useless to try.

Then I remember a visiting palliative-care physician’s words about caring for the fragile elderly: “We forget to ask patients what they want from their care. What are theirgoals?”

I pause, then look this frail, dignified man in the eye.

“What are your goals for your care?” I ask. “How can I help you?”

The patient’s desire

My intuition tells me that he, like many patients in their 80s, harbors a fund of hard-won wisdom.

He won’t ask me to fix his kidneys or his heart, I think. He’ll say something noble and poignant: “I’d like to see my great-granddaughter get married next spring,” or “Help me to live long enough so that my wife and I can celebrate our 60th wedding anniversary.”

His daughter, looking tense, also faces her father and waits.

“I would like to be able to walk without falling,” he says. “Falling is horrible.”

This catches me off guard.

That’s all?

But it makes perfect sense. With challenging medical conditions commanding his caregivers’ attention, something as simple as walking is easily overlooked.

A wonderful geriatric nurse practitioner’s words come to mind: “Our goal for younger people is to help them live long and healthy lives; our goal for older patients should be to maximize their function.”

Suddenly I feel that I may be able to help, after all.

“We can order physical therapy — and there’s no need to admit you to the hospital for that,” I suggest, unsure of how this will go over.

He smiles. His daughter sighs with relief.

“He really wants to stay at home,” she says matter-of-factly.

As new as our doctor-patient relationship is, I feel emboldened to tackle the big, unspoken question looming over us.

“I know that you’ve decided against dialysis, and I can understand your decision,” I say. “And with your heart failure getting worse, your health is unlikely to improve.”

He nods.

“We have services designed to help keep you comfortable for whatever time you have left,” I venture. “And you could stay at home.”

Again, his daughter looks relieved. And he seems … well … surprisingly fine with the plan.

I call our hospice service, arranging for a nurse to visit him later today to set up physical therapy and to begin plans to help him to stay comfortable — at home.

Back home

Although I never see him again, over the next few months I sign the order forms faxed by his hospice nurses. I speak once with his granddaughter. It’s somewhat hard on his wife to have him die at home, she says, but he’s adamant that he wants to stay there.

A faxed request for sublingual morphine (used in the terminal stages of dying) prompts me to call to check up on him.

The nurse confirms that he is near death.

I feel a twinge of misgiving: Is his family happy with the process that I set in place? Does our one brief encounter qualify me to be his primary-care provider? Should I visit them all at home?

Two days later, and two months after we first met, I fill out his death certificate.

Looking back, I reflect: He didn’t go back to the hospital, he had no more falls, and he died at home, which is what he wanted. But I wonder if his wife felt the same.

Several months later, a new name appears on my patient schedule: It’s his wife.

“My family all thought I should see you,” she explains.

She, too, is in her late 80s and frail, but independent and mentally sharp. Yes, she is grieving the loss of her husband, and she’s lost some weight. No, she isn’t depressed. Her husband died peacefully at home, and it felt like the right thing for everyone.

“He liked you,” she says.She’s suffering from fatigue and anemia. About a year ago, a hematologist diagnosed her with myelodysplasia (a bone marrow failure, often terminal). But six months back, she stopped going for medical care.

I ask why.

“They were just doing more and more tests,” she says. “And I wasn’t getting any better.”

Now I know what to do. I look her in the eye and ask:

“What are your goals for your care, and how can I help you?”

-Mitch Kaminski

Source

THE important question.

buddhawithoutorgans:

yungtorless:

mayfriend:

foreverrwinter:

They’ve found the cause of Sudden Infant Death Syndrome. Babies who die of SIDS have a significantly lower level of an enzyme, the purpose of which is to rouse the baby from sleep if necessary (such as the baby stops breathing). This is extremely huge science and medicine news. There is a biological reason. It’s not random.

Previously, parents were told SIDS could be prevented if they took proper precautions: laying babies on their backs, not letting them overheat and keeping all toys and blankets out of the crib were a few of the most important preventative steps. So, when SIDS still occurred, parents were left with immense guilt, wondering if they could have prevented their baby’s death.

Dr. Carmel Harrington, the lead researcher for the study, was one of these parents. Her son unexpectedly and suddenly died as an infant 29 years ago. (…) Harrington explained what she was told about the cause of her child’s death. 

“Nobody could tell me. They just said it’s a tragedy. But it was a tragedy that didn’t sit well with my scientific brain.” 

Since then, she’s worked to find the cause of SIDS, both for herself and for the medical community as a whole. She went on to explain why this discovery is so important for parents whose babies suffered from SIDS. 

"These families can now live with the knowledge that this was not their fault,” she said.

(…) As the cause is now known, researchers can turn their attention to a solution. In the next few years, those in the medical community who have studied SIDS will likely work on a screening test to identify babies who are at risk for SIDS and hopefully prevent it altogether.

SIDS rates in the US have decreased significantly since the recommendations to avoid placing soft objects in cribs/keep babies on their backs were first released in 1992. SIDS is also consistently lower in countries where cosleeping is the norm and/or people don’t sleep in Western-style beds with soft mattresses and lots of blankets.

If anything, this discovery validates these recommendations because doing anything you can to minimize the chances of the baby suffocating on something and failing to wake up will increase the odds of survival.

Co-sleeping advocates have been saying for decades that the parent/s small arousals through the night also rouse the baby which helps prevent SIDS and they were absolutely right!