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izzy's playlists!
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@happymed
A student in bed will remain in bed unless acted upon by a large enough panic
Genetically Altered Skin Saves A Boy Dying Of A Rare Disease
A child who was on the verge of death from a rare inherited disease has been treated with genetically engineered skin cells that replaced most of the skin on his body.
The treatment represents a notable success for the field of gene therapy, which has suffered many setbacks. And it’s potentially good news for children suffering from a painful and often deadly skin condition called epidermolysis bullosa.
In this disease, children are born with a flawed gene that prevents prevents the outer layer of the skin, the epidermis, from binding to the inner layer. This can cause excruciating blisters to form all over these children’s bodies.
In the case in Europe, a 7-year old boy ended up in the hospital back in 2015 after 60 percent of his epidermis had sloughed off. Tobias Rothoeft, a surgeon at a burn unit at Ruhr University in Bochum, Germany, says he and his colleagues tried everything — including a skin transplant from the boy’s father — to no avail.
“After nearly two months we were absolutely sure there was nothing we could do for this kid and that he would die,” Rothoeft said in a telephone news conference hosted by Nature, which published the study online Wednesday.
Rothoeft and his colleagues took one last look around the medical literature and learned of researchers in Italy who were experimenting with a new treatment for this disease. Michele De Luca and colleagues at the University of Modena and Reggio Emilia, were genetically engineering skin cells to repair the inborn flaw.
De Luca used a virus to insert a healthy gene into cells taken from the boy’s skin. Some of those cells, stem cells, multiply indefinitely. So De Luca was able to grow entire sheets of engineered epidermis, which were shipped to the hospital in Germany.
Continue reading
Photo: CMR Unimore/Nature
It’s sad how much of what is taught in school is useless to over 99% of the population.
There are literally math concepts taught in high school and middle school that are only used in extremely specialized fields or that are even so outdated they aren’t used anymore!
I took calculus my senior year of high school, and I really liked the way our teacher framed this on the first day of class.
He asked somebody to raise their hand and ask him when we would use calculus in our everyday life. So one student rose their hand and asked, “When are we going to use this in our everyday life?”
“NEVER!!” the teacher exclaimed. “You will never use calculus in your normal, everyday life. In fact, very few of you will use it in your professional careers either.” Then he paused. “So would you like to know why should care?”
Several us nodded.
He picked out one of the varsity football players in the class. “You practice football a lot during the week, right Tim?” asked the teacher.
“Yeah,” replied Tim. “Almost every day.”
“Do you and your teammates ever lift weights during practice?”
“Yeah. Tuesdays and Thursdays we spend a lot of practice in the weight room.”
“But why?” asked the teacher. “Is there ever going to be a play your coach tells you use during a game that requires you to bench press the other team?”
“No, of course not.”
“Then why lift weights?”
“Because it makes us stronger,” said Tim.
“Bingo!!” said the teacher. “It’s the same thing with calculus. You’re not here because you’re going to use calculus in your everyday life. You’re here because calculus is weightlifting for your brain.”
And I’ve never forgotten that.
Hi everyone! I can’t believe I’m saying this, but my 2nd book—a children’s picture book called “Not So Different”—will be officially released in one week, on November 7th. I have high hopes for this book, and I truly believe it has the ability to change the way many kids look at disability.
Growing up, being in public meant dealing with blatantly obvious stares from other children. Most kids rarely see people in wheelchairs, so when they saw me, their eyes opened wide and their jaws dropped with wonder. And since kids also have no capacity to filter their thoughts, the stares were often accompanied by silly questions like: “What’s wrong with you?” “Why are you small?” “Why do your arms look funny?”
There’s nothing wrong with curiosity, but I didn’t understand their curiosity as a little kid, which made it hurt. Constantly being treated like a mysterious spectacle as a child definitely impacted how I felt about myself. I’d sit at the dinner table and ask my parents why other kids were so confused by me. My story is not unique; I’m willing to bet most people with a physical disability know the feeling of being gaped at by little kids.
Fast forward twenty years to today. I’m 25 years old, and a large part of my career involves speaking to children about my disease. It’s one of my favorite activities, and I’ve learned so much along the way about how children understand disability. Today, instead of shying away from their questions as I did years ago, I invite kids to ask me whatever they are wondering about my life. The questions I get range from profound to bizarre: “Do you ever get bullied?” “Why is your head so big?”
This book answers many of the most common questions that kids have about living with a physical disability like mine. It’s full of wacky pictures demonstrating how I live my day-to-day life, and it teaches kids that although I might look a little different, and do things a little bit differently, the truth is I’m just a regular person like them who is really not so different!
My goal is that parents and teachers will use this book to help children develop a deeper understanding of disability and life in a wheelchair. I believe that so many of the social stigmas surrounding disability come from an innocent lack of knowledge. I want to change that, and you can help by sharing this book with as many kids and parents as you can.
As of right now, Not So Different is available for preorder! You can get it most places books are sold, but if you’d like a signed copy and want to support our nonprofit organization, you can preorder through our web store. Every purchase from our web store benefits Laughing At My Nightmare, Inc., which helps us spread our message at even more school speeches!
The book releases on November 7th, so you can get your Christmas shopping done early by grabbing a few copies for all the kiddos in your life!
Preorder a signed copy: http://laughingatmynightmare.com/shop
Thank you, everyone. I’m really proud of this project. I hope it makes a difference! If you care to, sharing this post is such a big help!
Shane
don’t forget the feet
Today I had a patient who was a little…off. She couldn’t tell me what year it is. She didn’t even know how to count backwards from 10.
I thought to myself, “She’s 70. Maybe there’s a history of cognitive decline?”
So while she sat and wondered about which day of the week it is, I quickly looked through her chart. But I found nothing. Nothing about memory lapses. Nothing about disorientation. Nothing about short-term memory issues. Nothing.
I preceded to do a full head-to-toe physical. When all I had left to do was the feet, I hesitated. I usually don’t skip the feet. But for this poor woman who sat there mumbling to herself and nodding off, I wondered if I should make an exception. The woman had enough trouble getting out of a chair, let alone pulling on socks and lacing her shoes.
But I knelt down and placed my hands on her shoes. “Ma’am, is it okay if I take off your shoes and check the bloodflow in your feet?”
She nodded and returned to mumbling to herself.
After I got the laces undone and the shoes off, I carefully pulled back the socks.
Then when I examined the soles of her feet, I found this:
Few rashes appear on the soles of the feet. Syphilis is one of them.
Syphilis can lie dormant for decades. Sometimes when it reappears, it can affect the eyes (occular syphilis). Other times, it can affect the brain (neurosyphilis), leading to dementia and behavioral disturbances.
I helped the woman put on her socks, and I tied her shoelaces. Then I left the room and reported to my preceptor. Once I mentioned the sudden cognitive decline and rash on the feet, my preceptor immediately searched the patient’s records at all local hospitals for bloodwork.
Then we found it. A positive RPR dating back a few decades, indicating that at some point the woman tested positive for syphilis. Looking through her records, she never received treatment.
We spent most of the following hour scrambling for an emergency infectious disease consult, and it did create some chaos for the remainder of our scheduled patients. But we managed, and now the poor woman is receiving treatment.
So, friendly reminder:
Don’t. Forget. The Feet.
I’m screaming
😈 [http://bit.ly/2jn9ubb]
This is very important
Reblog if you got vaccinated against influenza this year! Let’s set an example and be proud of our choices to protect those around us!
PATIENT QUOTES
Me: Your blood sugar came back elevated to 800.
Patient: Alright, new high score!
Me: Sir, please put your hand down.
Throwback Thursday
CAN MY DENTIST PLEASE GET THIS?! Or maybe a therapy kitten?
Some helpful differentials for rashes!
This just never gets old. badsciencejokes something for your blog?
Dear Lovely Humans,
In my childhood, my family had a green van with this giant, clunky, highly-impractical metal ramp that folded out of the passenger side sliding door. The whole setup was entirely manual—no mechanical assistance—and the grated metal ramp weighed as much as half a small elephant. So when I needed to get in or out of my van, someone had to basically risk their life folding the metal death trap ramp out of the van for me. It was almost like the ramp manufacturer ~enjoyed~ how absurdly dangerous their product was because they made almost zero effort to safety proof any aspect of it. The grating was literally sharpened metal, like a cheese grater. If a child ran his fingers along the surface of the ramp, he would pull back nothing but stumps.
There wasn’t even a handle to assist the user! You were just expected to bleed a little bit if you wanted to use your van.
Ironically, the only safety mechanism they did include ended up being the thing that hurt me the most. At the base of the ramp, where it connected to the floor of the van, there was a spring-loaded lever, about the size of a #2 pencil, but made of solid heavy-duty steel. This lever pushed against the outwardly folding ramp to reduce the weight of the monstrous beast enough so that my mom only tore her spinal muscles every ~other~ time she pulled the ramp out.
One day, spunky little carefree toddler Shane was sitting in his van waiting to exit after a trip to the supermarket for more Bagel Bites. Dad began the slow, grunting process of pulling the ramp down without flattening himself, when for no good reason at all, the metal lever snapped like a twig under the immense pressure of the ramp. The “spring-loaded” nature of this device turned the snapped lever into an elongated bullet that shot from the floor directly into my face with blink-of-an-eye velocity. Before any of these events registered, I was doubled over in pain, watching as blood poured from my face into my lap. It felt like I’d been smacked in the face with a crowbar. I wailed, and I’m not even ashamed of that. It was grisly.
Dad turned on his panicked parent mode and leapt into action. The bleeding was dealt with and I ended up only needing a butterfly bandage, so the illusions I had of bleeding to death must’ve been slightly embellished by my childish imagination. But had the lever hit me just a few centimeters to the North, it would’ve been my eye, and that could’ve been a very different story.
The really cool part was that without the assistance lever, the ramp now weighed its true amount, so it took two people to wrestle it in and out of the van for each use.
And that’s what we did, for a few years if I remember correctly, because this van was our only way of getting me anywhere in my wheelchair—to school, to therapy, to the playground, to adaptive baseball practice. My parents and family did what they needed to do to get me around, and this is a theme for so many families living with muscular dystrophy. I’m incredibly fortunate that I even had a van. It may not have been perfect, but we made it work and took the spring-loaded facial injuries in stride.
Today, accessible vehicle technology has obviously improved drastically. Everything is electronic now; there’s no more clunky ramps or dangerous maneuvering. In fact, I can get in and out of my van totally unassisted, using an app on my phone. It’s nuts.
My nonprofit, Laughing At My Nightmare, is raising money to provide a fully-accessible van to someone living with muscular dystrophy. We are well over halfway to achieving our goal for the campaign, so now more than ever, we need your help. Every dollar you donate is being 100% matched, getting us that much closer to changing a life in a major way. Sharing this post is another great way to help us be successful!
You can donate here: https://igg.me/at/hbpDQpdDT94
Thank you so much for helping us change the world. I’ve included a photo as proof that there were no lasting scars.
Much love,
Shane
So every week our ANM does a discharge instruction “ hall of fame” and there’s one doctor who has no shame…..
These are so much more amusing than my wordy, wordy discharge summaries…
Stop running around naked at night.
Tag yourself.
I’m “Charm School Recommended”
I’m “fired so fast if I actually wrote this and gave it to a patient” –
But it just might be worth it.
I’m “For nausea if it occurs, I recommend life saving zofran”