WeekendWriter

Rey, 31 | Occasional fandom writer | Consumed by BG3 lately | Marvel, Far Cry, Pacific Rim mostly | Icon by the incredible teamhawkeye | 18+ only please

[goodnightngoth]

me: sorry i’ve been busy

me for the last hours:

[sunlightbuck]

me (never reaching out, logging off for days at a time, horrible at responding to asks, forgets all tag games): i do consider all of you my friends 🥺

[sweeetestcurse]

Far Cry 5 Scenery 136/???

[ddeck]

i cannot overstate how good it feels to watch older movies where the actors were still allowed to look kinda weird and not be conventionally attractive. like it is genuinely healing

[bakwaaas]

just another long hard day of contributing to low birth rates

[sowecoulddance]

its christmas eve and look whos on tumblr

all of us

[sharper-and-bigger]

Jesus also spent Christmas in a barn full of animals

[phoenixyfriend]

Reblog if you write fanfic and would be totally down with your followers coming into you askbox and talking to you about your fic

[modmad]

‎

well shit. when you put it like that

[modmad]

[swampthingy]

[actuallyapathy]

[the-lumpfish-queen]

I love environmental storytelling

[belphegor1982]

[hotlegsharker]

[berlynn-wohl]

[harleyklawz]

Its fucking hieroglyphs with you people

[tiredandoptimistic]

Nothing hits like "romantic couple and a third guy who's not dating either of them but is definitely a part of this dynamic"

[terriblygrimm]

[faerieinthehumanworld]

[putridghost]

[thesaltofcarthage]

[unstill-deactivated20260502]

nothing makes me feel more alive than being insane about a little show

[its-beautiful]

this shit boring as hell

[biokitty]

I had a patient come in the other day because she wanted her IUD replaced. It was at the end of it's life and she loved having her IUD, this was her second one. My MA let me know that the patient was very anxious about getting the IUD replaced, she'd had painful experiences in the past with her other replacements and was dreading this visit for that reason.

I spoke with the patient and she was literally shaking with anxiety. I asked her to describe her prior experiences as well as what she liked about her IUD and what she didn't like. She said that she wished she didn't have to get it replaced so often, so I recommended we place a Mirena instead of just inserting a new Kyleena IUD. She was nervous about this because she didn't want an IUD that was big. I explained that the Mirena and Kyleena are essentially the same size but the Mirena lasts 3 years longer and would likely bridge her to menopause given her age whereas with the Kyleena she'd probably need another replacement to get there. She was okay with trying the Mirena.

I then talked to her about pain control during the procedure as this was what she was most worried about. I asked about her prior experiences and then laid out what I wanted to do to try and improve her experience during this procedure. I told her I planned to give her prescription strength ibuprofen, a heating pad, and a very dense anesthetic block in her cervix to hopefully make it a better experience. If she had had someone to drive her home I would've also given her an ativan because we have studies that show patients who report higher rates of anxiety surrounding a procedure also report higher rates of pain associated with it.

She was down for this plan. I gave her a very dense block, she only felt three small injections and then nothing else. She was shocked when I told her that her old IUD was out and the new one was in. She didn't believe me when I told her it was over.

I don't tell this story because I wanna brag about how amazing of a doctor I am because I'm not. I tell this story because this is the way IUD insertions SHOULD go and I want people to know that IUD insertions do not need to be traumatic. And I want other providers who may insert IUDs to know that a paracervical block should be your standard when it comes to IUD insertions.

When people find out I'm an OBGYN, complete strangers, acquaintances, etc. , the two things they like to tell me immediately are their horrible birth trauma story and their terrible IUD insertion story and I'm trying to at least make the latter one a little less common.

If you place IUDs and aren't doing a cervical block, you need to start. This should be the standard but over 90% of OBGYNs in the US aren't doing them and it's unacceptable. We are traumatizing people and it's entirely avoidable. We are scaring people away from one of the most effective and long lasting forms of birth control in a time when people are losing their ability to end unwanted pregnancies all for no justifiable reason.

"It takes too long:" No it doesn't, that visit took me 20 minutes with a highly anxious patient from start to finish.

"It's not worth it for such a short/small procedure." It's worth it for the patient.

"It's too expensive." You can do a paracervical block with just normal saline. You don't even need lidocaine if you use a generous amount of volume. And if you place Nexplanons I know you stock lidocaine in your office, stop being fucking cheap at the expense of women's pain.

"Patient's don't need it, they'll get over it." I'm telling you they do need it and they aren't getting over it as evidenced by literally everyone wanting to tell me about their terrible IUD insertion experience as soon as they find out I'm an OBGYN.

We should do better. The cervix has nerve endings, stop acting like it doesn't.

Make cervical blocks your standard of care, there's no excuse not to.

[hawthorn-and-ivy]

My buddy does EMLA before the cervical block, that seems to help reduce pain even further.

[emi--rose]

I do 20% benzocaine and my patients almost never feel any of the 5 shots ( I do tenac site and then 2, 4, 8, 10.) Buffering the lidocaine and warming it to body temperature makes it work super fast and not hurt at all during infiltration.

Also a block makes insertion easier. No reason not to.

[cazort]

It's wild to me how some providers accept levels of pain for things involving the cervix that would never be remotely tolerated with other things, like, say, dental work.

I have had people freak out and act like it was crazy that I once let a dentist give me a (very shallow) filling without novacaine. Yet it was less painful than itching a bad mosquito bite. The norm in dentistry is to give local anaesthetic before anything that might cause much pain, and use a numbing agent before the injection.

Rarely a dentist might offer to do something without anaesthetic like that one filling, but only if they really know what they're doing and think it's highly unlikely to be painful. And even then if you yell out, they'll stop and numb you if you want. 100% of the time.

I want this to be the norm for basic gynecological care too.

[dippersballoon]

I saw an opportunity and I took it

[offline-kinq]

This is what they mean when they say life flashes before your eyes as you die

[udon-tea]

For those wondering, the song is ”Mr. Blue Sky” by ELO.

Perhaps someone beat me to it, but here are ALL of the featured vines, in order of appearance:

I won’t hesitate bitch

Hi my name is Tre and I have a basketball game tomorrow

Whaddup, I’m Jared I’m 19 and I never fucking learned how 2 read

Kermit the Frog jumps off building

Fr e sh a voca do

back at it again at Krispy Kreme

There is only one thing worse than a rapist

Club Jam (yes a really good book)

At least the taco was free

I am the Sand Guardian, guardian of the sand

Grandma loves ping pong too much

If your name is Junior

Welcome to Target

I’m just cooking pizza

Cole Sprouse dress-up game

On all levels except physical, I am a Wolf

Kid hits ceiling of gym with rope (breaking free)

Kid smacked by fly swatter

Fuck it up Kenneth (my boy going to school)

Um I’m not finished (Tyler the Creator)

WE’RE BREAKING FREE

SAIL

I’m Squidward

So I’m sitting there, barbecue sauce on my tiddies

So no head? (breaking skateboard)

Actually, Megan (I can’t sit anywhere)

No off topic questions (Chris Christie)

What the fuck, Richard

Drop it like it’s hot (its just luke)

Bored as shiiiiii

Liberian accent (plasma globe)

New haircut (Parker Kit Hill)

Summertime sadness (chicken)

More like hurricane TORTILLA

I got an a-bor-tion

All Around the World (TheJasminator)

When there’s a cutie next to you at a red light

Snake licks lollipop

Accept yourself, love yourself

Be whatever you wanna be

Don’t touch Zac’s music (LENARR)

Whoever threw that paper, your mom’s a ho

Can I please get a waffle?

Turn off the flash you fucking moron (Star Wars)

Ebony Jenkins (shut up!)

Kevin, watch the light dude

Horse meditation

A girl a dream & a clothing hanger

Is that a weed? (911 microwave)

Helium balloons (floating car)

Fireplace fairy

I’m your freestyle dance teacher

I can’t believe you’ve done this

Which way the Quiznos is

Impossible paper toss shot

Hemtube (dancing with cat)

I nurture my skin (Shaq)

Why are you running

Happy birthday?

Thicker than a bowl of oatmeal (courtroom)

Farkle falling

Fuck you (soda machine)

Squash banana (the branch I was holding broke)

Take On Me

And now my sock is wet (water gun)

All I ever wanted was some motherfuckin guala

When there’s too much drama at school

Two bros chillin in the Hot Tub

What’s your name? (ouija board)

Chillary Clinton (chillin in Cedar Rapids)

Guy drops slurpee (7-Eleven)

Girl scared of convertible car

Guy who is self-conscious about his lisp (Rice Krispies Treats)

Would you like the spider on your hand?

Shopping cart crash

We actually have the chip reader now

I’M A GIRAFFE

Dinner with Zayn Malik (Chihuahua eating spaghetti)

I HOPE IT’S HELPFUL TO SOMEONE! Peace ( ͡~ ͜ʖ ͡°)

[leaveittotegan-deactivated20181]

this gave me such a warm feeling i legit teared up no joke

[ch4nn3l4st4tic]

[therisingking]

[chuckhansen]

far cry 5 + favorite songs

[jellyfish-everywhere]

EVERY BODY KNOWS SHITS FUCKED