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devilfic · 1 year

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❝right place, right time❞

II. of niceties and awkward second meetings.

parts: previously / next plot: bruce makes an offer you actually can refuse... at first. pairing: battinson!bruce wayne x gn!reader. cw: surgeon!reader, secret identities, slow burn, bruce wayne is still a masochist, bruce wayne is ALSO reckless :). words: 3.5k. edited: 2/28/24.

After every surgery—good or not so good—when you’re rinsing off and getting patted on the back for a job well done, you elect to feel hope. And then you hurry to lock yourself in your office and try to catch your breath.

The weight of a life on your hands follows you from room to room, from work to bed, from daydreams to night terrors. Even when it’s good, it rarely ever feels good. Questions bloat your brain: what if there’s something you missed? What if, despite it all, it’s not enough? Is the blood on your hands, then? Is the life yours to save or the patient’s to endure?

There was no solid answer. All you could do was wait for full recovery and try not to let it consume you.

Maybe tonight was a night for Thai. Maybe you’d call up your old roommates and get together at your place. Maybe you could finally tell them about the night Batman broke into your house, and how you stitched up his bullet wound, and then fell asleep 20 feet away because you had to meet Bruce fucking Wayne the very next morning and God help you if you embarrassed your boss by being late. So far, the only person who’d heard about it was the old lady who lived in the apartment below you, and all she’d done is pray for you.

You’d assured her you were fine, but she’d insisted on anointing your doors and windows before you left for work. The “demon of Gotham” she’d called him, herald of vengeance. The fact that you’d saved his life meant that you’d be spared in the reckoning... or whatever little old ladies learned in Sunday school.

Whatever she believed, you had no reason to think you’d be struck by lightning twice. Batman would not be returning to your home any time soon.

The thought almost made you sad.

There was no reason for him to return. Batman probably had a team of doctors waiting to tend to him if his arsenal of weaponry was any indicator of wealth. He wasn’t just any ol’ run of the mill vigilante, that was for certain.

You were just a blip. A freak accident. A glitch in the matrix. The chance that you’d been in the right place at the right time when Batman needed you most was just that: chance. And you were no gambler, but you could bet on your license that that man would never darken your doorstep (or window sill) again.

Maybe you’d stop by the liquor store too on your way home.

You’re rounding the corner when you collide with your boss, frantic as usual.

“Oh! Finally, there you are,” he grips your upper arms like a vice, eyes frenzied as they look you over, “why do you look like that?”

You imagine he’s referencing the dew of sweat on your skin and your scrubs out of whack. “I finished an operation fifteen minutes ago.” You answer, unimpressed. “I was just heading back to my office.”

Your attempt to sidestep him—to free yourself of the shackles that were his hands—proves useless. He spins to keep you in his grip, “You can’t! Not yet.”

“Why not?”

“You have a visitor.”

You frown, “A patient? No one’s on my schedule.”

“I’d like you to make an exception for this one.” His voice drops to a whisper. He readjusts your shirt sleeves as if dressing you up, prettying you for the highest bidder, and that sets you on edge, “Just trust me.”

You almost (almost) flinch away when he pushes you to your office door—now, a looming boulder instead of a gateway to your safe haven. Before you can even ask just who is waiting for you on the other side, your boss is rushing off down the hallway to do God knows what.

As if disarming a bomb, you slowly open the door to peek inside.

It scares the both of you, clearly, if the wide-eyed look he gives you says anything.

It’s like it hasn’t been a week since you’d last seen him. Bruce Wayne is wearing what looks like the same suit he’d worn last time, tie and collar stiff, jacket open underneath his billowy coat. But he looks awkward standing in your modest little office. He looks like he’s not supposed to be here, or at least not without his right hand man and the fanfare to follow.

He keeps his hands in front of him to show you he means no harm, “Your boss said it was okay to wait here for you.”

You’re still bracing yourself against the door, trying to figure out what he could possibly be doing in your office, what he’d possibly be waiting around for you for.

You think about the last time you’d seen him, when you’d grabbed him out of nowhere and his companion (Alfred, was it?) looked like he would have no problem breaking your spine if you dared manhandle him again. Oh God, he wasn’t going to sue, was he?

You swallow, “Uh, right. Can I help you?”

Bruce straightens up. His hands fall to his sides. You search his face to predict his next move but you’re puzzled to find that he’s just as clueless as you.

You didn’t know much about Bruce Wayne, that much had been established. What little you did know was some amorphous figure of nobility, the “prince of Gotham” as the press dubbed him.

Yet, standing before you in your simple little office, Bruce Wayne feels less like nobility and more like a stranger in foreign land. He keeps his hands in front of him and you’re able to make out purple dusting his knuckles. Bruised. Not bloody. Not recently. This piques your interest.

“How long have you been a surgeon?” Is his first question.

You slink into the room and debate on shutting the door, deciding to leave it open a crack; whether it is so you can escape or for him to feel unwelcome, you’re not entirely sure. “Four years. Not including the 12 years of school and residency.”

Bruce perks up just a tad to your bewilderment. “Did you study here in Gotham?”

“I did. I considered Metropolis.”

“What changed your mind?”

“Cheaper tuition.”

“Do you like it here in Gotham?”

“I don’t mean to be rude, Mr. Wayne,” your voice comes out clipped—nervous—all the same, “I just got out of a surgery and I didn’t even know you’d be here so I haven’t got the faintest clue what you want-”

“I’m sorry.” Bruce apologizes, “I can come back another time.”

Come back? You assess his face once more, double checking for any sign of where this conversation is going, “Come back for what?”

For the first time since you entered the room, Bruce takes a step forward. A few, actually, ‘til he’s standing only a foot away and his whole deer-in-headlights deal is on full display. “A proposition.” Your head swims with big ideas. You’re thankful you’re still standing still. “I’d like to hire you.”

If Em could see you, she’d be laughing her head off at the look on your face. The emotions you're hit with are akin to blunt force trauma.

Bruce catches onto your distress and begins to explain, glancing away from your eyes to give you room to breathe, “Due to the nature of my job and the... events that transpired last November, I’m careful about my position in the public eye. I’ve decided to have a doctor on call, someone I can rely on in the event that something drastic happens again. It would be more menial work, but you would, of course, be greatly compensated: full benefits, triple your salary here. Nothing is out of the question.”

As the last word melts in the air, he finally locks eyes with you. Less deer-in-headlights now, more spotlight. More "I eagerly await your response".

You couldn’t even fathom the price point: triple your salary? You already made good money here, any more would be excessive. And then there’s the reality of the situation. You would be employed, solely, by Bruce Wayne. At his beck and call—perhaps moved into a nicer place within chauffeur distance of Wayne Tower—the support staff of the upper echelon.

Your mom wouldn’t bug you about moving out of Gotham ever again.

This all felt too good to be true. So good that your intuitive pendulum swung violently in warning. Bruce awaits your reply, wringing his hands before him and those glaring purple knuckles catch your attention again. How a CEO had managed those was a question you hesitated to entertain. Something else was going on here.

You knew Gotham was a corrupt city. It festered with crime in every aspect, that much the Riddler had made clear last Halloween. The late mayor, the DA, the police commissioner... and amongst his targets, Bruce Wayne had survived. Something else was definitely going on here.

“...I serve the public, Mr. Wayne. I reserve my skill for the citizens of Gotham without the... ability to seek better. I’m flattered you would consider me and I would be more than happy to point one of my talented colleagues your way in my stead. But I’m sorry, I can’t accept your offer.”

Bruce’s face falls for just a second. After all, if he were to wear his emotions on his face all the time, you doubted he’d be much of a successful businessman.

You’re thankful that he takes a step out of your personal space and doesn’t fuss, doesn’t try to shove a wad of cash at you, doesn’t throw more offers at you until you concede. “I appreciate your consideration, but that won’t be necessary. I should let you return to your work. Thank you for your time.”

You nod a little dumbly, the weight of what has just transpired starting to settle fully on you. Em would be far too angry at you to laugh, now.

With the grace of his pedigree, Bruce Wayne nods silently to you and leaves.

You notice once the muscles in your shoulders stop shaking that there’s something in your office that wasn’t there before. There, on the loveseat where Bruce Wayne had waited for you, was a business card.

You shakily approach the seat and collapse beside it, reaching out to read what adorns the back of the Wayne Enterprises logo.

Bruce Wayne CEO P: 212-XXX-XXXX

It takes the clatter of ceramic to pull you out of your reverie.

Beside you, Em hovers, “And here I thought you weren’t a fan.”

At the puzzled look you give her, Em jerks her head toward where your eyes had been focusing, mindlessly stirring in the events of the afternoon. At some point, the TV’s channel had changed from Days of our Lives to the Gotham News. They were running a story on a charity event downtown. Bruce Wayne was shaking hands on camera, the tagline “Bruce Wayne makes dazzling appearance alongside controversial mayor”. How fitting.

“‘m not,” you grumble, pushing your lunch around in yellowed Tupperware, “just thinking.”

“About?”

You glance at Em. Too little too late, your boss had clambered into your office shortly after Bruce left, pestering you about the conversation you’d had, disappointed when you’d told him you’d turned down the offer. “Imagine the press we’d get, one of our very own working for the CEO of Wayne Enterprises,” he’d argued, “you’ve got to reconsider.”

You hesitated to tell your tale again, fearful that you’d suffer the same reaction, but Em was not your boss. She would never let the topic rest. And it wasn’t like you signed an NDA, a truth that had only hit you hours after the fact, “I got a job offer today.”

Em’s eyebrows shoot up, “From West Mercy? Arkham?”

The very thought of working in Arkham Asylum had you abandoning your lunch altogether, “God, no. It was more like... on-demand. Concierge. A very rich patient wanted to hire me as their private doctor.”

“Wow... was it one of your patients?”

“No, I’ve never examined him in my life.”

“Him?” You recognized that tone of voice. A slew of questions were on the way if you didn’t elaborate fast enough.

Besides yourself and Em huddled in a corner, the break room was relatively empty. One of the ER nurses was napping, another engrossed in a game of Sudoku on their phone. You doubted they would hear even if you raised your voice above a whisper.

Quietly, because you clam up at the thought of saying his name out loud, you fish out his business card and slide it across the table to her.

It takes her but a moment to process. First a deep inhale, then her hand slaps the table (the Sudoku nurse glances up at you both and then changes his mind), then she’s gripping at your scrubs and shaking you violently in your chair, “Shut the front door! Please tell me you said yes!”

You frown, “No, I didn’t.”

“Why the hell not? I know you don’t keep up with the times in this city, but this guy is loaded!”

“I do keep up with the times. I just don’t give a rat’s ass about Bruce Wayne. A crime punishable by death, apparently.”

“But why in the world would you want to keep working here when you could be... having lunch on a terrace? Discussing lab results over Pinot Grigio? Jetting off to the Bahamas to check his vitals on vacation?”

You snort, “Exactly what I told him: I serve the public. I’d like to keep it that way.”

“Could always do both.”

You tried to imagine it, for Em’s sake. The terrace lunches, the Pinot Grigio. You imagined the nice apartment from before and the esteem that your boss was sure you could bring the hospital.

And you imagined Bruce Wayne, with a limp. With bruised knuckles. Always looking at you with those big eyes that somehow told you everything and nothing at the same time. Like an open book in a dead language. You thought about the night that Wayne Tower caught fire and the world that had been crumbling down in Gotham had started to feel truly broken. Politicians die all the time, but the uber rich? Even you had watched the sky in horror.

And now that same man had asked you—you, of all people—to be there in case there was a next time.

You thought about the Batman. Would you say yes if he asked you the exact same question?

You hadn’t considered both.

You’re unaware that Em is leaving until her chair scoots loudly across the laminate, “Think on it. Seriously. It’s the opportunity of a lifetime.” Her hand brushes your shoulder fleetingly. Then she’s leaving and you’re left to think again.

It was a bit ironic that his next visit took place as you were perusing apartment listings.

You hadn't seen him get inside your home the first time. He’d just been there, as if he’d always been there and you just never noticed. This time, he doesn’t have the urgency to break in. He waits at your window… staring in at you. No knocking. Not even a muffled “Can I come in?”

You don’t know how he expects anyone to invite him inside their home with those kinds of manners. You set your laptop aside and walk over to the curtains, his figure becoming clearer, more menacing as eyes silently follow you. By the time you reach the window, your heart is beating at an unhealthy pace. You had been able to get that adrenaline down before. How did you manage that again?

Batman waits patiently. Your hand presses to the glass, the warmth of it leaving behind a visible print as you push up on the glass, “Don’t tell me,” his head cocks to the side as you begin, “another bullet?”

If he is suffering from a wound like the last, he doesn’t look it. He’s crouched on your fire escape with his cape billowing behind him and the light of your apartment giving off just enough of an ominous glow.

After last time, you’d sneaked some extra supplies back to your place under the paranoia that something might happen again. And, let’s be honest, no one would raise a brow at having everything you need to clean a gunshot wound in this city. You couldn’t say it was entirely just for him, though.

The silence goes on uncomfortably long. You start to wonder if he even heard you, the way he stares you down, unmoving. He resembles a stray caught stealing from a trashcan, seconds from sprinting in the opposite direction to avoid being caught.

Eventually, your heartbeat spikes again. What had he told you last time? To run if someone tried to break in? Maybe he had wanted you to sprint the second you saw a human looming on your fire escape, regardless of their vague bat shape. Was he angry? He kind of always looked angry.

“Have you noticed anyone following you?” His question causes just the briefest alarm.

Living on the not-greatest side of Gotham, you had learned how to keep your head down but your eyes everywhere. If some mugger were looking to jump you as you got out of your car, you’d know. You shake your head, palms beginning to sweat.

Batman assesses you for a bit longer. You can’t tell if he’s reading you for a lie or if his instincts are just telling him otherwise, but eventually, he accepts your answer.

And begins to leave.

“Wait,” you stutter out against your better judgement, when he’s already stood to his full height, one boot positioned on the railing to propel himself below. He looks over his shoulder at you very slowly, “how’s your... side? Wound heal okay?

He looks down to where you’d stitched him, where his armor had been mended. “It’s better.”

You sigh, relieved. “You’ve gotten it looked at, then.”

“Someone looked at it.”

His wording gives you pause. “What about your stitches? Did you get them redone?” He hesitates. “You... did get them redone, right? Better. Preferably by someone who wasn’t worried about you dying on their living room floor.” Your skin prickles when you see his guilty look. “Batman, if you’ve been fighting crime every night for the past week with the same stitches I put in you days ago-”

“I’ve been through worse.”

“So you keep saying.” You really don’t mean to grit your teeth at him, practically stomping your foot because you’d, at the very least, expected him to be a bit smart about a bullet wound.

But, then again, you were talking to a man dressed as a bat.

You crawl out onto the fire escape, chilly and biting and unforgiving as the night may be, and watch Batman turn halfway toward you. You have to resist the urge to brush your hand against his side, an act far too intimate with Kevlar in the way. You look up at him, “Don’t suppose you’d let me take another look at it?”

The first time, sure, he let you because he was close to dying. With a motto of “I’ve been through worse” at his disposal, you doubted he would let you do it again unless the circumstances were dire.

Sure enough, he moves defensively away from you. You take heart in that it seems less like he distrusts you and more like he’s got a bravado issue. Not great, but better. Easier to fix.

You think of the medical supplies in your apartment and wonder if you’ve got what it takes to coax him inside. “I thought that you might not come again. Guy like you fighting crime every night must have people on hand for stuff like this, right? You’re not just any vigilante. Couldn’t be.” His unsettling glare makes the cold seep into you just a little bit more, “You don’t. Do you?”

He doesn’t answer you. His eyes shift from yours to the cityscape. Looking for a way out, maybe.

But if he wanted to leave, he would leave. Why would he hesitate?

“I just want to look. Make sure it’s not infected. No poking or prodding, I promise.”

“It’s not. I had someone look at it.”

“A doctor?”

“...No.”

“Someone who knows what they’re looking at, at least?”

He looks down at you. There’s something there that he’s keeping close to his chest, too much information for a stranger (even one who’s saved his life). You wait to see what his decision will be. “You work at Gotham General.” Batman states, matter-of-factly.

“...I know you were bleeding to death when I told you, but you’ve got to keep up in this city.” You see a hint of a smile on his mouth that is just as easily written off as a scowl. “What about it?”

Again, that look.

Just as you’re certain that you’re about to break through to something, a siren goes off in the distance. Sure enough, when the both of you look to the sky, his emblem is carved out in the clouds, beckoning him down to the streets once more. Your heart sinks. You were so close.

Batman waits a beat, positioning himself on the railing again. His eyes find yours over his shoulder, cape fluttering with the promise of taking flight, “They’re lucky to have you.”

He leaves. It feels even colder when he does.

taglist: @yikes-buddy @alexxavicry @moonlightreader649 @maryx0107 @vainillasmil157

#bruce wayne x reader #bruce wayne scenarios #bruce wayne imagine #bruce wayne fic #bruce wayne #batman x reader #batman scenarios #batman imagine #batman fic #the batman #battinson x reader #battinson #dc #mjwrites

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ateriblewriter · 1 year

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Not Like This {4} (q.h)

a/n: this is it. the last part. im sorry for multiple reasons. its kinda rough read. but i wanted to get it out. i might rewrite a part later. Let me know what you think.

italics are a flashback of sorts

warnings: sad. death.

Enjoy!

Part1, Part2, Part3

3ish Years Later

Quinn sat by himself on the edge of the dock watching the waves roll over the water. He found he needed more time to himself when family and friends arrived at the house. They were all here for the memorial they held every year for the past few years. And like always, Quinn was having a hard time processing the death of one of his oldest bestest friends and one of the greatest persons he knew. This is not how he imagined this situation turning out.

If he hadn’t gotten Y/N pregnant in the first place. She wouldn’t have gotten sick and he wouldn’t be missing his brother. Quinn never regretted his child, nor did he blame the baby. He just missed his brother.

Quinn raced Y/N to the hospital. The day finally came that someone died who just so happened to be a match to Y/N and now she could get the heart she so desperately needed in order to survive. His prayers had been answered.

“Hey, what are you guys doing here?” He noticed his parents waiting in the lobby of the hospital. Something was amiss. He hadn’t had the chance to inform anyone of the great news and yet they were here. “Mom. Dad. What’s going on?”

“I’m sorry sweetie.” His mother broke down in sobs. He had never heard his mother cry in his life.

“What happened? Where’s Luke and Jack?”

“Quinn, there was an accident. It was bad. Luke’s in surgery and Jack.”

“No. Fuck. No.”

“Jack’s dead.”

Every ounce of happiness left him when he realized exactly where Y/N’s new heart was coming from. Why did fate have to be so cruel that it needed to take the life of his little brother in order to save the life of the person he loved the most? It wasn’t fair.

“Hey. Whatcha thinking about?” Y/N brought him out of reliving that terrible day for the thousandth time. He must have been taking too long down by the water and she was sent to reel him back into the group.

“Nothing.” He placed his hand over his now wife’s protruding belly. Y/N knew he was lying. She figured he was thinking about that day again. The day Jack died so she could live.

“I miss him too. Even though I literally have a piece of him in my chest. I hate the fact that I can’t talk to him everyday. And I really don’t like how our babies will have to grow up without really getting to know their Uncle Jack.”

“You can talk to me if you want. I know he was your best friend, but he was like a brother to me.” She spoke out again when Quinn didn’t respond. She knew her husband was silently grieving. But she wanted to be there for him. “Please.”

Y/N pulled Quinn closer to her, guiding his head toward the scar on her chest so he could hear her heart beating, his brother’s heart beat. She found it was often something that calmed him when he was in a mood like this.

“Where’s Theo?” Quinn quietly piped up as he continued to stare out at the calm water listening to the thump thump of the heart.

“He’s back at the house. Trevor and Luke found an old pair of rollerblades and are trying to teach him. He’s a natural.” She tried bringing a little joy to his mood, but wasn’t getting through.

“I know what we should name this little bean.” Y/N thought out loud. She had known the gender of the baby for a little while now, but since Quinn didn’t want to know until the child was born, she elected to keep it quiet.

“That’s perfect.” Quinn grinned, it was probably one of the best ways to get back a part of what he lost that day.

“Mommy had my baby?” Theo skipped along holding Quinn’s hand. The new addition to their little family arrived the previous day. Everything went swimmingly this time. Y/N wasn’t sick, her heart was beating strong. Now it was time to introduce Theo to his new baby brother.

“Yeah. Remember what we talked about Theo. We need to be gentle and quiet. The baby is sleeping right now.” Quinn reminded the 5 year old fragile and couldn’t play hockey yet.

“Mommy!” Theo squealed, forgetting what Quinn told him, as he climbed to sit next to Y/N. She was just finishing feeding him. “Is that him?”

“Yeah. This is your baby brother Jack.” Quinn watched as Theo leaned over to place a kiss on top of the baby’s head. From that moment he knew his boys were going to be best friends, like he had been with his brothers.

Please let me know what y’all think. I’d love to hear your thoughts, comments, and complaints! I would really like to know if y’all like this one.

#quinn hughes #quinn hughes x reader #quinn hughes imagine #nhl imagine #nhl fanfiction #nhl imagine #quinn hughes fic #sorry #hockey fic #hockey imagine

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xdemonicheartx · 6 months

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Ive been struggling a lot with my self image to the point I’m having breakdowns in the mirror. I need help from anyone who can.

I’m AFAB agender/non binary and ive got some gripes about me I want help in altering in any way if I could get help finding resources or workouts or anything that would help me achieve a more masculine silhouette I would kiss you on the mouth (with your consent of course )

I am 24 years old, 5’7”/170.18cm, 195lbs/88.5kg, type one diabetic, neurodivergent (diagnosed ADHD, high suspicion of comorbid Autism though i cannot get an official diagnosis because the waitlist closest to home is a 2 year wait as of 2022) fibromyalgia is also present for anyone who needs any context regarding health concerns surrounding medical procedures they might recommend or suggest

Below are the things I need help in changing as a list with some details surrounding my anatomical structure

My goal is to be completely unsure if I’m a male or female with a look alone but with androgyny that can be a pretty broad area. I know if I gain upper body musculature that can help but I cannot afford a gym membership yet

vvv More below vvv

I have an exceptionally voluptuous butt. Its almost comical to me, I would say I’m slim-thick or pear shaped. Its the type of back end that a lot of cis femme women would covet, its mostly muscle tissue due to years of athletics but theres also scar tissue from years of insulin injections

My hips are VERY wide. Like I said I’m pear shaped, I hate the curvy figure I have and its rounded edges, I have small pockets of fat resting on my hips that only add to the figure

I have a very stubborn hormonal fat deposit on my stomach I want to stop oral birth control which is the most likely culprit but I currently cannot until I can get a hysterectomy

I have a muffin top and artificial hip dips due to fat deposits that I am looking to tame

Chest dysphoria, I don’t have large boobs, they’re a perky B/C cup. I would consider top surgery but I don’t know how to bring that up with my partner. I do use a fytist binder and I love how my chest looks flat/with nice pectoral muscle (even if its smushed boob). My partner loves the way I am shaped overall but I do not. (He/him/they/them bisexual)

Facial features are so rounded and I cant contour to save my life. I know losing weight will be seen in the face first but what else can I do?

Speaking of face I have loose skin under my chin thats not a double chin but any type of glance downward makes a pseudo double chin and I’m incredibly insecure about it. I have a relatively feminine jaw line and I have a jaw exerciser/silicone bite that I need to use more. Are neck tucks something available for me?

I have hooded eyes, they make me look so tired. I know eye lid lifts are a procedure but thats something I would need to save up for and plan for, I am unsure if losing weight would change this

The triceps of my arms feel like they’re on the road to bingo wings/bat wings, I know the tricep is supposed to hang freely when relaxed and not in use but when my arm hands at my side there is a bit of pudge above my elbow that says “body fat” and not soft muscle

I understand weight loss can help with a small handful of these and muscle building can too but there are additional features and traits that cannot be worked for aside from medical intervention and cosmetic electives. I’m looking for workouts, medical procedures and price ranges, shapewear, makeup tutorials, diets that help in weight loss or muscle gain, and literally anything else that might help me feel like this is my body. Its becoming a large hinderance on my mental wellbeing

I really cannot keep dwelling on how my body is wrong when its something I am stuck with for life so all I can do is work to alter it and care for it. However I know these alterations are possible. Ive seen incredible transformations and transitions within the trans community and NB communities and I’m really hoping some of your experiences can be passed onto me so that I can live as myself too

I appreciate those that have taken the time to read this far. Thank you

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kate-bishops-waifu · 2 years

Note

Hi! Saw your call for story requests (Thank you for your service, haha). Would love to read anything Siegfried x Audrey, or Siegfried x Reader if that catches your fancy. Thanks!

a.n: Hiiiiiiii! This is my first time writing one of these, and I had a lot of fun, thank you for submitting! It might be more appropriately called a 'blurb' I hope that's all right? It's a new writing style so I'm just getting used to it. I really hope you like it have a lovely day <3

"Excuses"

Siegfried Farnon X gn!reader

Warnings: None! just fluff. Mentions of cat being sick.

Edited: A little.

The Darrowby book and exchange was yours. Every book and every picture on the wall was yours to decide, and as such, you had the right, nay, obligation; to fill it with as many cats as you liked. You would set a bowl of food and water for the neighborhood strays, and they were beginning to take a liking to you. So it was any wonder that you felt obligated by them.

It wasn’t a remarkable day, but you hadn’t seen Molly, the gray haired old lady you had adopted, properly, from one of the Dalesmen who had a liter they couldn’t keep. Molly was the biggest of the group, fat, strong, and a firm god complex which you indulge a little more than you would like to admit. But she was your first cat, and therefore she was the oldest. ‘Old lady’ you would fondly call her.

‘PSPSPSPSPPS Cat? Molly? Where are you hiding?’ It was nearing the end of the day, and your shop had cleared out half an hour ago so you began your search.

Often you could find her hiding on the shelves, or tucked between the overflow stacks. There was precisely where you found her. Between stacks, her fluff squished against the window, and her breathing erratic. She looked, and this is in no way an insult to her highness, terrible. Her eyes were distant and she was wheezing a little. You noticed she had vomited her breakfast, and elected to ignore it for now. The vet wasn’t far away, and you had no trouble closing early today.

It took some looking, but you eventually found the cage, and with some hissing and spitting, managed to get the poor old bat inside. You tried to make it as comfortable as possible, her favorite blanket and pillow from your upstairs apartment, and a sprig of catnip to keep her happy; If she could keep it down. Which you discovered as you made your way through the cobbled streets, she could not.

The practice wasn’t busy when you entered, one other such customer sat by the door with a chicken, looking inconvenienced. And you supposed most people felt such a way in a veterinary practice.

‘Welcome in, why don’t you sit down. Mr. Farnon will be out as soon as he can.’ Mrs. Hall the housekeeper had greeted you.

You took a seat across from the sterile doors of the surgery and settled the old cat on the chair next to you. It might have been a bit hasty, but you didn’t want to wait around with an old cat like her. Better be safe than sorry, you told yourself.

It wasn’t long before the vet emerged, leading out his patient with a smile like he was satisfied with himself. He turned to mrs. Hall and whispered something, glancing back at you. All you could think as you saw those crow feet and kind eyes, was: ‘what a nice face.’

‘So sorry, mr. Dobbins. I’ll have to take this patient first. Shouldn’t be much longer. You understand.’ He said dismissively to the other patient. Mr. Dobbins looked upset, but Farnon was too distracted to notice as he knelt in front of Molly’s cage, ‘Alright. Molly is it?’ He addressed the cage. ‘Right. Let’s see what’s wrong with you,’ He turned his gaze to you, and smiled benevolently. His eyes were perfect as they met yours, and you couldn’t help but be distracted by them. Those kind eyes seemed to hide their youthfulness and play at a much deeper sort of meaning than any he seemed to put on.

Inside the surgery the first thing that struck you was how disorganized it was. Not the sterile table or the platter of instruments, but the desk. Strewn about papers, a jar of papers overflowing onto the ledger that was building dust.

‘Let's see what's wrong with you old girl.’ He pulled the cat from her cage, and set her gently on the table, soothing its raised hackles. He asked you some general questions then began to give her a look over.

‘You own the bookstore right? Down the way?’ He asked out of the blue. It took you a few moments to respond.

‘Yes. Darrowby Book and Exchange. Had it for a few years now.’

‘Right. I like it there. Feels like I can focus. Maybe the place is as organized as my mind so I feel like I fit in.’

That made you laugh. Your store was not very organized.

You didn’t expect it, but after that Siegfried Farnon became a constant in your life. At least once, sometimes twice, every week you saw him. It was getting colder so the cats you took care of were getting sicker and you had just about as many excuses to go see the vet as you could hope. You learned how exceptionally kind he was, though he hid it under a surprisingly hard surface. You saw right through him. After the first month of excuses to go and see him, Siegfried Farnon made his first appearance in your shop. He came in casually and began to peruse silently as you did your best not to gaze. He came up with a few books in his hand and started asking for recommendations, thoughts on the books he’d picked. Pretty soon an hour sped by and you had completely forgotten what he had come in for.

The next time he showed up in your shop, was a surprise. He was carrying tea and some scones and doing his best to look perfectly casual as he set them on the counter. You came out of the woodworks, surprised to see him leaning on your desk like he belonged there, sipping tea. You were beginning to think maybe he did.

Siegfried pretended to ignore you as you took your place behind the counter and you had to speak up for him to acknowledge you.

‘Oh, sorry. Didn’t notice you’d come back. Here. Some tea. And scones. Mrs. Hall made them, I hope you don’t mind?’

You weren’t sure if it was so much a question as it was a statement as he seemed to be quite content, leaning on the desk.

It was hard not to blush as you sipped your tea. Siegfried told you old war stories about the animals he had taken care of. The general chaos that was Veterinary service. You reveled in the way his entire face lit up, telling embarrassing and oftentimes heroic acts of animal doctoring. He might have been embellishing some but you didn't say anything.

It was then two months since you met Siegfried Farnon. Your life felt brighter, more interesting. He never ceased to entertain and it was hard not to imagine a life without your biweekly chats. They could last anywhere from an hour to nearly half the day. It was as if time stood still and simultaneously moved much much quicker than you would like.

But then came the day when you were called away. A family visit or holliday, it doesn’t matter, but the important thing is that the daffodil ball, as Tristan once said ‘the social event of the season’ was set to be the day you came back. The day you would never be able to make it.

And so it went, you arrived home late, the sun was setting and you were tired. As you unlocked the front door you sighed in relief as you set your things down. It was terribly dark, the curtains drawn, the lights off. Your cat sitter must have just left; Molly’s bull was filled with her prescription food. You decided you were too tired to unpack so leaving it for tomorrow was very appealing to you. You made your way downstairs to check on your shop, feeling stiff as you gave it a once over. You collected the cash from the register and noted down where you might need to replace some books.

There came a knock at the door. You weren’t expecting anyone at this hour, or at all. Your shop was closed, you had planned to see your friends the next day, so who on earth would bother you?

Standing outside, his hands in his pockets and his back facing the window was Siegfried Farnon. Doing his best to look casual.

You went to open the door and Siegfried turned to face you, a little surprised.

‘Siegfried? What are you doing here so late?’

Siegfried shuffled slightly where he stood, and you ushered him in, the little bell jingling above the door.

‘I wasn’t sure where you had gone.’ He said.

‘Did I neglect to tell you? I’m sorry, I was on a trip.’ You felt a little guilty, wishing you had said something and not just disappeared. You didn’t mean to, it was all a little last minute for you, but none of that seemed to matter now.

‘Ah. Well. Tonight’s the Daffodil ball you know.’ He was so awkward, twisting a paper in his hands like a nervous boy.

‘Is it?’

‘Yes. Yes it is, and I was sort of hoping you would be here for it.’

‘You were?’ Your cheeks felt warm at the idea of spinning around a ballroom in Siegfried’s arms, the trumpet guiding your movements as you lost yourself in each other's embrace.

‘Yes. I was.’

‘What’s that then?’ you gestured to the piece of paper.

‘Oh. This? Our tickets. It’s silly I shouldn’t have supposed-’

‘That’s very kind of you Siegfried. I would have gone if I had been here earlier.’ You smiled apologetically.

‘Right. Well that’s a shame isn’t it. I suppose you wouldn’t be up for it at this hour would you?’ He looked hopeful, and you couldn’t help but feel the guilt rise up in your belly.

‘No. I suppose I wouldn’t, I’m sorry.’

He looked so dejected, about to turn and leave, but you grabbed his arm.

‘I wouldn’t mind at least one dance though.’ You were surprised at your own bravery, but it almost came easily to you. Being in his presence, it somehow made you more confident.

Siegfried smiled, that lovely bearded smile that made his eyes light up and his true youthfulness escaped. He took your hand and wrapped an arm around your waist. His hand was so soft, which almost surprised you. He held you close as he could, he radiated heat and you seemed to sink into him. You turned about the room carefully, a silent waltz guiding you as you stared at each other.

His movements began to slow and it became an easy swaying motion.

‘I’m sorry I forgot to tell you. I intended to, I really did. I guess it just slipped my mind.’ You admitted.

Siegfried chuckled and shook his head.

‘I think this is better.’ He tilted his head slightly, curiously. Like a dog. Which made you smile, because of course. He had such a kinship with animals it’s any wonder you didn’t notice before.

‘You know, I have a sudden, maybe ridiculous urge, to kiss you.’ He admitted.

You felt the breath escape your chest all at once and all you could do was nod pathetically as he leaned in and closed the gap.

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mpov · 1 year

Text

That other thread is long as hell.

@h8saltrat

The difference is piercing ears does not remove healthy functional tissue from the body. It's not permanent. If they grow up to not like wearing earrings the holes can be ignored and will likely eventually close. I am however on board with waiting until they are older so they can have input. Much like I let my daughter decide at 12 she wanted her hair dyed black. The wife and I accommodated this.

@r0bilargreenleaf

For the most part no one is trying to make it illegal overall. I'm certainly not. If a consenting adult want to get a circumcision, or any other elective surgery, more power to them. What I want is for little boys to have the same right as little girls to grow up with intact genitals. In the absence of medical need, it shouldn't be done to a child.

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adoptedmadrigal2 · 2 years

Text

Bruno never went into the walls, modern au.

Tia Elena saves the day this time,

@prophetic-hijinks thanks for the oc privileges I won't let you down.

Game day

"Are you and Tio bruno coming to my game tonight?" Isabela asked Elena as she braided Isabela's long hair.

"We wouldn't miss it for the world, and if it weren't for your sisters having to have surgery today you parents would be there too, and Pepa and Félix would be there if they didn't have parent teacher night at Camilo’s school and dolores is leaving for a competition in Bogota this weekend," Elena told the girl. Isabela was 13 and she knew that unless they couldn't her entire family would be at her volleyball game tonight. She hated that most if her family had to miss it, but she was happy her tia and tio, would be there.

"Do you think Mirabel’s and Luisa's surgeries will go OK?" Isabela asked.

Luisa had torn her ACL in a basketball accident, and Mirabel had to have her tonsils removed due to continual complications with infections.

"They'll be perfectly fine, I know the doctor that'll be doing mirabel's surgery, we went to high school together and from what I heard from her the surgeon fixing Lulu up, is her bestie from med school." Elena told Isabela as she packed her game day bag.

"Come on mi flor, we don't want you late to school," Elena told scooping isabela off the floor and throwing her over her shoulder.

"Ok tia," Isabela's laughs as she was sat down to grab her bags.

"Can we take the Jeep today?" Isabela asked, knowing her tia only drove her jeep for special occasions or trips to the city.

"Sure we can mija, but don't tell your tio, he'll get jealous that you got to ride in it," Elena told getting a good laugh out of isabela.

"Dolores? Are you ready to go mija?" Elena called

"Not yet, I just got my period I need a second," Dolores called from the bathroom.

"Ok," Elena said.

"Tia Elena, why haven't I got my period yet?" Isabela asked sadly.

"Well, from what your tio has told me your mamá got her period when she was about 12, so you should get it soon, but it could happen at any time, you could be fourteen when you start. It'll happen when your body is ready," Elena explained as the pair waited for Dolores.

"Ok," isabela nodded happy with her new information.

"Ok I'm good now," dolores said picking up her school bag and her suitcase, since she was going to be gone with her dance company for a weekend competition in Bogota.

The three walked outside and dolores started to head toward the van.

"Jeep today mija. Isabela wanted a ride before her game against Bogota today," Elena said

"Sweet," dolores said walking over and tossing her bags in the back.

Isabela followed suit and the pair hopped into the backseat. Elena climbed into the driver's seat, and off they went.

"Dolores, did you remember the note you need to give to the office about your dance teacher picking you up for competition?" Elena asked dolores

"Si, it's in my folder," Dolores said.

"You both have your phones?" Elena asked

"Si, tia," the pair said

"Dolores, did you grab some tampons before you left? Or do you need some pesos to buy some?" Elena asked

Dolores seemed to think for a moment,

"I need a few pesos to buy some. I had my bag packed already and didn't think about it," dolores said

"Alright mija, when we stop, I'll give you ten pesos," Elena said

"Gracias tia," dolores thanked

"No problem mija, us chicas gotta stick together," Elena said.

"Alright you two, go on, I'll see you tonight isa, good luck at competition Lola," Elena said handing back some money to dolores.

"Thanks tia, I'll see you Sunday" dolores said climbing out

"Thanks tia," Isabela said climbing out behind dolores as the pair grabbed their bags and walked into the middle school.

"C'mon isa we have to get to algebra," Dolores said as isa jogged to catch up with her as they met back up after their electives.

"I'm coming Lola," isa said.

During math, Dolores was called to the office to leave early, as expected. Leaving isa to get through the last half of math class, and survive history on her own.

Isabela hated history, not for the fact that it was boring, but her teacher, Mr Evans. He didn't like her at all, he would ridicule her clothes, give her a week of detention for whispering to Dolores to see her notes so she could copy down the bits she didn't get. And he loved Dolores, he'd compliment her clothes and hair, and wouldn't say a word if she ever whispered to isabela.

When she entered the classroom, Mr Evans asked the class as he took attendance,

"Has anyone seen Dolores today?"

"She left during math for a dance competition in Bogota this weekend," Isabela answered, Mr Evans gave her a glare but said

"Very well,"

Isabela had just about had enough of Mr Evans by the time class was almost over.

Just get out of here and meet up with Ava and Reina.

Isabela thought.

Finally the bell rang and she left the classroom as quickly as possible.

"Hey isa, what's up with you?" Reina asked as she saw the raven haired girl approaching them fast with a murderous look.

"Mr Evans is a inseguro egoista hijo de puta," isabela growled

"Bad day without Lola?" Ava asked

"Si, he not only decided that my outfit made me look fat, but he also didn't like that I was the only one in the class that knew where Lola was. And then he starts going on a whole rant about something stupid. At that point I was boiling so I didn't pay attention to him."

"Yep, he seriously needs to be fired, the first day of class he chooses his favorites and his targets, and his targets get the brunt of his frustrations with the class even if they're excellent students like you," Reina said.

"Anyway, before your blood can boil more, let's go practice some serves before tonight's game, we're up against some serious competition," Ava said.

"Spike it isa!" Ava yelled.

Isa watched as the ball came up and toward her, she jumped up and spiked it over the net, where ava who was practicing her pancakes, saved it.

"Nice one A," Isa said walking under the net to high five her friend and teammate.

"I could say the same for you Jacaranda," Ava said, since Isa had flower powers, Ava likes to call her by flower names, and honestly Isabela doesn't mind it.

"Come on girls, time to get some dinner before the game," Ava's mom called them

"Coming señora Perez" isa called.

Back at casita, Elena was getting ready with Bruno for the game. Pepa being Pepa, pestered them before having to get dressed for the parent teacher meeting later that evening.

"How was Lola this morning Elena?" Pepa asked sitting on a stool near Elena's vanity table

"She was fine, I did give her ten pesos though, she forgot to pack tampons in her dance bag and needed to get some when she got to Bogota. She started this morning before we left." Elena told

"Dios mio, she has a white costume for this competition." Pepa gasped placing her hands over her mouth.

"She told me she was gonna try to get her friend Maddie to swap costumes with her since Maddie had one of the black costumes for the dance." Elena said easing pepa's nerves,

"And even if she couldn't swap, she knows how to take care of herself so she doesn't leak," Elena said as she applied her mascara.

"You're right Lena," pepa said

"mierda," Elena breathed as she clutched her right side.

"You ok? Do you need juli?" Pepa asked, concerned.

"I'm fine, it's just a cramp, and... there's the blood," Elena cringes as she got up and scurried off to her and Bruno's shared bathroom.

"I know how you feel, I woke up covered in blood," Pepa said

Elena emerged from the bathroom in a emerald green rose and headed to her dresser to grab some clean underwear.

"Best investment ever, I swear Pepa, I'll have to pick some up for you and Juli when I go to Bogota again," Elena said

"What's so special about a pair of underwear?" Pepa asked

"They're period proof, they're called Knixwear, and for me, since sometimes I don't have time to change my tampons before they leak they've saved my butt a many a time. Plus the brand makes teen ones too, I'll have to get Dolores and isa some for their birthdays,"

"I definitely need some of those, I can't tell you how many times I've stained my underwear from a leaky tampon. How'd you find out about them? " Pepa asked

"Friend of mine, her daughter showed them to her because she found them while underwear shopping on Amazon. I looked into them and I've sworn to them ever since," Elena told as she emerged from the bathroom in just her black underwear and green bra.

"I bet the girls will appreciate them, Dolores surely will, she complains every time she gets a stain."

After forty five minutes of them talking it was nearing 6 and the game starts at 6 30.

"Come on brunito," Elena called as she stuffed a few tampons and pads into her purse.

"Coming amor," bruno said grabbing the keys to his truck.

When they got to the game, the teams were practicing before they started.

The game went back and forth in fierce competition, until they took a five minute break.

Isabela had her back turned to Elena and if Elena wasn't looking at isabela she wouldn't have noticed the red patch right under Isabela's rear, on her wite competition uniform.

Elena saw someone point the spot out on the court and isa bolted. Bruno turned to Elena after watching Isa bolt.

"Should we go check on her?" He asked

"I'll go, you stay here," Elena said

"Ok amor,"

Elena knew tossing a few pads in her bag would come in handy,

She went to the bathroom near the gym remembering isa seemed to be running that way.

"Isa, are you ok?" Elena asked as she entered, hearing quiet sniffles.

"No, I just got my first period in front of the whole school," isabela said

"Bela, it's barely noticeable," Elena said in attempt to comfort her.

"I can't play in bloody shorts tia, what am I gonna do?"

"I have a pad for you to use, and I brought your extra shorts with me since, you have a tendency to rip your shorts during a play, as your mama told me,"

"Really?" Isa asked hopeful

"Si mija, now get changed, they're getting ready to start again." Elena said

"But the other team saw the stain, what if I get teased for it?" Isabela asked second guessing going back out to play.

"Are you gonna let some comments stop you or are you gonna win this game for the mariposa volleyball team? You're unstoppable isa, I've seen you, don't let this little hurdle get in your way." Elena said as she passed isa the shorts and pad

"You're better than some girls who want to tease about something that happens to them too, embrace it, it's life. Now go show those girls what you're made of bela boo," Elena said as Isabela finally emerged with her bloodied shorts in hand.

"Thanks tia, you're the best ever!" Isa exclaimed giving her aunt a big hug.

When Elena returned to Bruno she filled him in on the goings on, and he texted julieta.

Julieta

Did isabela get hurt during her game?

No but something did happen

What happened Bruno

Isa got her first period

What?!!!

Don't worry Elena had her back, and she's currently kicking Bogota's butt.

I'm still at the hospital with mis niñas, will you take her out to celebrate after the game and ill celebrate with her over the weekend.

Course hermana, how are the girls doing?

Mirabel is sleeping, and Luisa is medically high as a kite because she's still coming off the anesthesia, but their surgeries went well, they took Mirabel first and when they wheeled her out after, I told Luisa to climb into the bed, and then after a four hour delay due to a car crash related emergency surgery, Luisa went under after mirabel’s anesthesia wore off really well, when they came to get Lu she and Mirabel were watching minions in their shared room.

Give mira a big hug for me for being such a brave niña, and when Luisa comes back to earth tell her I love her too

Ok hermano, I love you, the girls and I should be home tomorrow afternoon.

Bruno shoved his phone in his pocket as he watched isabela pancake to save the ball after a Bogota girl spiked it.

After the game Bruno and Elena took Isabela to celebrate her first period and that awesome save right at the end of the game.

"Great job mija, we need to head across town to the strip mall to get you some pads that aren't so long. And while we're there we can get you something to celebrate this huge milestone in your life," Elena told as she turned the key in the ignition hearing the truck roar to life.

"Can I get some stuff for my room?" Isabela asked

"Of course mija, what are you thinking," Elena asked

"Plants, some little shelf trinkets and maybe a new set of sheets," isa answered

When they arrived at the strip mall. They entered the large department store.

Elena explains which pads isa needs and places them in the shopping cart.

Bruno went to look at the toys nearby, wanting to buy Mirabel something for being so brave for her surgery. Elena and isabela had wandered over to the bedroom things. Picking up a couple plants as they went, they went to the bedding section choosing a nice leaf patterned bed set for isabela.

They paid for their things and left. To get some much needed sleep after Isabela's game and first period

The next morning isabela mostly stayed in her bedroom riddled with cramps she didn't even notice yesterday.

"How are you feeling Florecita?" Elena asked bringing isabela hot chocolate, with a seven year old camilo clinging to her back as she did so.

"Like I've got a cactus underneath me," isabela groaned from her position lying on her stomach. The back of her favourite pyjamas visible from under her blanket.

"I brought you some midol and hot chocolate mija, why don't you come to mine and your tio's room, we can talk and I can let you borrow my heating pad to help." Elena suggested trying to get isa out of her bedroom.

"Ok, can you get my pyjama pants from my desk por favor, I kicked them off last night, I got too hot."

Elena retrieved the Harry Potter themed pants, and turned around letting isabela pull the pants on. Isabela stepped up beside Elena when she had her pants on, and she supported her mug of cocoa.

"Camilo, can you go downstairs to breakfast with tio bruno, I hear tio bruno has made some special waffles just for you," Elena said getting the boy off her back letting him run downstairs.

"Now that it's just us, how are your first period cramps?" Elena asked as she guided isabela to her bedroom.

"My entire body hurts, and I feel like my stomach is tied in a knot." Isabela said

"Ooh, painful. I know how you feel, do you want anything to eat?" Elena asked

"Not really, Im not hungry," isabela answered

"You sound like me on my period, I lose my appetite for the first two or three days, then I eat everything on day four then by day five I'm back to normal. You may be different though," Elena said, a slight chuckle following.

"Tia? How do you know how to do all this?" Isa asked

"Do all what mija,"

"How do you know how to make me feel less weird and embarrassed about this, plus you cheer me up too, how do you do that?" Isa elaborated

"I volunteered at my old orphanage for years before I met your tio and moved here to settle down. Lots of the girls that were there trusted me the most and so I did a lot of talking to them and just picked up a few things from my experience with them," Elena explained, "have you got any more questions mija,"

"Do you have any stories from when you got your period?" Isabela asked.

Elena blushed this was gonna be a long funny and embarrassing afternoon.

When Julieta came home she was carrying mirabel, who was sleeping soundly on her shoulder. Luisa following behind on some crutches. Everyone seemed to be quiet. Camilo was watching cartoons with Bruno Agustín and Felix, Dolores was at a dance competition in Bogota, and Elena pepa and isabela were nowhere to be seen.

"I'm going to my room mama," luisa said.

"Ok amor, I'm going to find your sister and Tias" julieta told as she helped Luisa upstairs, with further assistance from their casita.

Julieta walked with Luisa so she could check Isabela's room, where she found an empty unmade bed.

She quickly laid Mirabel in the nursery on her bed before heading off to find Isabela.

She walked past pepa’s room and checked her brother's room first, where before she opened the door she heard Elena tell Isabela.

"Oh my God, I got my period at a pool once, a little piece of advice for you don't buy a white bikini, it always ends in disaster. Whether that disaster be your period, or the fact that when white gets wet, it's see through,"

A quiet knock and she could see her hermana cuñada and hija, sitting on the large bed laughing about Elena's myriad of period stories.

"Mind if I join you three?" Julieta asked announcing her presence.

"Mama!" Isabela smiled as she flung herself toward julieta, she was still small enough for julieta to pick her up with ease.

"Hola mi corazón, congratulations on your first period, how are you feeling?" Julieta asked as she sat on the bed with isabela in her lap.

"Better since tia Elena gave me the midol and told me her first period story and all of her embarrassing stories,"

"Good" julieta smiled

Hope you enjoy ❤

I hope I did Elena justice in this @prophetic-hijinks

#bruno magridal #encanto au #encanto bruno #encanto comic #encanto disney #encanto headcanons #incorrect encanto quotes #madrigal cousins #madrigal sisters #women's rights #isabela has to wear white for her sports #she was due to get it soon #isa is a late bloomer #volleyball #winter sports #elena is a good aunt #bruno loves his nieces #isa got her first period playing volleyball #the encanto girls beat the bogota team

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chavezholck58 · 1 year

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Beloved Doctor Dies Of Organ Failure

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When Gemma suddenly becomes the caretaker of her orphaned 8-year-old niece, Cady , Gemma’s not sure and unprepared to be a mother or father. Under intense stress at work, Gemma decides to pair her M3GAN prototype with Cady in an try to resolve each problems—a decision that may have unimaginable consequences. Further to sensors and alarms, Thobois reviews that the portable machine, which may be transported with the patient from theatre to ICU, has a back-up system that delivers the gasoline in the occasion of an internal machine failure or a power outage. The NO dosing and monitoring gadget can be utilized for different medical functions, similar to heart issues in young children. With the assistance of the Pulmonox Mini, value about R , cardiothoracic surgeons Dr Gregory Hammond, Dr Atul Patel and Dr Martin Sussman have given hope to many, after they carried out the lung transplant on March 18. The transplant saved the lifetime of Dr Lucky Tooe – a medical physician specialising in opthalmology at Ga-Rankuwa Hospital – on his 29th birthday.

#dr gregory hough south africa #dr greg hough south africa #dr gregory #dr greg hough #greg hough #dr gregory hough #dr gregory images #dr greg hough images #dr gregory facebook #dr greg hough facebook

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northernpansy · 2 years

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cw: talk about doctors and a minor medical procedure

i got my anti baby force field topped up yesterday (nexplanon implant replaced) and the doctor who does it at my gp is genuinely a wild individual like she's actually pretty nice i think? but just. so chaotic the most chaotic

got the first one in 6 years ago and she literally made me faint during that by talking about all the things that could go horribly wrong with the coil while waiting for the local anaesthetic to kick in most of which i already knew which is why i elected to get the implant instead and definitely did not need to hear about and because there was a student doctor in (who despite being prolly 1/3rd the size of me valiantly caught me before i crashed off the bench lol) i got to hear the doctor say "i have never seen a patient faint during this procedure. this is literally the only time this has ever happened." which is in hindsight hilarious but did not help with my self-consciousness at the time ha

then three years later i go to get the old one out/new one in and i tell her up front "hey i don't know if you remember but i fully fainted last time so watch out in case you need to catch me" and then while we're waiting for the local anaesthetic to kick in she starts to tell me about how they've changed the guidelines on placement because some people were putting them in too deep and there's a chance that if it's too deep it can get loose and she'd read a journal where they found one in someone's lung???? that they then needed surgery to get out??? and i didn't faint that time but it really felt like she was trying to make it happen. and then she told me to look into arnica cream for my bruises and used the word homeopathic which i really really hope she was using in the way some people do to mean all alternative medicine and she wasn't actually recommending the dilution of a dilution of a dilution stuff

and then yesterday while we were waiting for the anaesthetic she started talking about how the guidelines had changed yet again and saying like, ~why do they keep changing the guidelines everyone's so obsessed with sticking very strictly to the guidelines because their afraid it's terrible the way things are going we're going to end up like america where you can get sued for anything~, kind of like a "you can't even make jokes anymore" rant except about i guess? medical malpractice? anyway i still let her stick a scalpel in me after that so ¯\_(ツ)_/¯

despite all that she's actually one of the only doctors i’ve ever seen who seems genuinely upbeat and happy to be doing doctoring (instead of looking at you like you're massively inconveniencing them by being a patient) and although it's the Wildest shit that comes out of her mouth i've never had to worry about there being an awkward uncomfortable silence and she seems genuinely caring and interested in the chat i give in response and i'm always completely distracted from the actual procedure going on so like. all in all a pretty good experience comparatively actually lmao

#medicine cw #needles mention cw #doctors cw #idk i feel like i should tag this as more stuff but i don't know what #people can block words that appear inside post now as well right? i really hope no one sees this who doesn't want to #please feel free to ask me to cw tag this if there is something i missed #can't move my left arm rn and i keep forgetting i'm going to end up smashing something because i picked it up with the wrong arm

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helthcareheven · 3 days

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Discovering Healing Havens: A Guide to Medical Tourism

Reasons for Seeking Medical Care Abroad

One of the primary factors driving the growth of surgical tourism is the high cost of healthcare in developed countries. For many elective and non-emergency procedures, the costs in the United States, Canada, United Kingdom and other Western nations have become prohibitively expensive for average citizens and even those with health insurance. Medical tourists are able to travel abroad and receive treatments at a fraction of the price they would pay at home. In many destination countries, the overall package of medical care, travel, lodging and other ancillary costs is 30-90% cheaper than equivalent treatment in a developed country.

Another motivation is shorter wait times. In countries with universal healthcare systems, there can be lengthy waits for non-emergency surgeries and procedures. The average wait time for a hip replacement in Canada is over 6 months, while knee replacements in the UK have 18-month waits. By traveling abroad, medical tourists are able to get treated more quickly without delay. India, Thailand and other popular destinations generally have minimal to no wait times.

Medical Specialties and Treatments Sought

While originally centered around dental care and cosmetic surgeries, medical tourism has expanded to cover a wide range of specialties and treatments. Some of the most common include:

- Cardiology - Angioplasty, angiography, bypass surgery and stent placement are popular cardiological procedures sought by medical tourists.

- Orthopedics - Knee replacement, hip replacement, spinal surgery and arthroscopic procedures feature prominently. The use of robotics and computer navigation systems allows for less invasive techniques.

- Dentistry - Dental crowns, veneers, dental implants and oral surgery make up a major portion of surgical tourism, especially to Thailand, Hungary and Mexico.

- Fertility Treatment - In vitro fertilization (IVF) costs a fraction abroad versus in the Western world. Countries like India, Thailand and Cyprus attract fertility tourists.

- Cosmetic Surgery - Tummy tucks, breast augmentations, face lifts and other aesthetic procedures drive traffic to countries such as Thailand, South Korea and Costa Rica.

- Ophthalmology - Cataract removal and lens replacement surgeries are commonly sought abroad alongside refractive procedures like LASIK eye surgery.

Popular Medical Tourist Destinations

Certain countries have built strong reputations as top destinations in medical tourism. Some of the leaders are:

India - Advanced facilities, JCI-accredited hospitals, large pool of English-speaking doctors and very low costs have made India the world's fastest growing market. The Indian healthcare sector earns over $3 billion yearly from medical tourists.

Thailand - Known especially for quality dental and cosmetic work at bargain prices. Thais are perceived as being quite skillful with bedside manner. Hospitals meet international standards.

Singapore - Highly developed medical infrastructure, including the promotion of integrated surgical tourism clusters with hotels. Singapore attracts Asian patients as well as those from the West.

Malaysia - Healthcare quality equals that of Western countries at half the cost or less. Malaysia Medical Council regulates facilities, and English is widely spoken in the healthcare industry.

Mexico - Popular for procedures like dental work, bariatric surgery, and eye/laser corrective surgeries due to competitive pricing. Many accredited JCI hospitals near the US border.

Challenges and Risks of Medical Tourism

While surgical tourism provides considerable benefits, certain risks and challenges exist that need to be considered. Post-surgical complications may arise, and standards of aftercare can vary in different countries. The legal recourse and patient rights available may not equal what patients expect at home. Medical records and follow-ups may be difficult between multiple healthcare systems. Travel itself poses some health threats like the transmission of new infections or bacterial strains. Cultural differences, language barriers or unfamiliar practices can affect the levels of comfort experienced abroad. Medical tourists need to carefully vet facilities and providers through organizations that accredit and certify hospitals overseas. With prudence, most risks can be minimized to allow patients to reap the rewards of affordable, timely medical care in internationally accredited centers worldwide.

Growth Outlook

The global medical tourism industry was estimated to be worth around $10-40 billion worldwide as per different surveys. Advanced Asia-Pacific destinations capture approximately 45-65% market share of the entire pie while the remainder is split between Latin America, Eastern Europe, Middle East, Africa and other regions. India alone serves an estimated 150,000-200,000 medical tourists every year currently. Going forward, the worldwide numbers are forecasted to grow substantially in the coming years. Driven by factors like the shrinking value of most foreign currencies against the USD, an expanding medical infrastructure abroad, more trade agreements lowering travel barriers, and persistent high healthcare costs domestically – surgical tourism is emerging as a multi-billion dollar industry worldwide with potential for further significant increase in the future if present trends continue.

#HealingDestinations #WellnessAbroad #HealthcareGetaways

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scarlettjade420 · 9 days

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PT. 5

if you haven't seen pt 4 you can find it here or you can follow the links back for the other parts. PT 5 isn't all that muchm but i haven't been super motivated to write the last couple days, but here you go anyway! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

“womp-womp-womp-woooomp” “Oh you shut up.” they simply laugh in response. On the day of the fundraiser, I make sure to bring a sufficient supply of energy drinks and snacks with me, using the last little bit of funds I have from working over the summer. I should see if I can start working over Thanksgiving break and stop after winter. The manager at the store I worked at did say they would take me back the next summer too, I wonder if that can apply to other school breaks. Anyway, with a backpack full of surgery heart-attack-inducing drinks and some salty chips, I made my way to the school fund raiser, it’s easy, really easy to help out. I just sit out at a booth, talk to and help customers, deal with whatever other person is there and occasionally help take boxes. So I get to avoid my home for at least like, 14 hours, more if i can do an overnight shift, and I barely have to do anything for a full 2 weeks. It’s amazing. Would be more amazing if I got paid for it, but alas, volunteering doesn’t work that way. I walked into the parking lot where this stupid fundraiser was being held and found my way to the tent booth thing I was gonna help run today. When I got there there was a tall androgynous person with dyed light gray hair, already at the stand. “Hello! I’m Lux, what’s your name?” how did I get paired with someone so chipper.“Hi, I'm Onyx” I replied as we shook hands. Soon enough we’re both sitting at the stand, waiting for people to come up that we can help. Thus begins the long hall of continuous waiting. A few hours pass. And then a few more. We started at 3:45 and it was now 6:33. “How long you plannin’ on working here for here today” Lux asks “Till at least 9. Longer if they allow me too.” “Damn, that’s a long time for an event that’s so slow. You must be pretty dedicated to the whole competition.” really the commission was just to try and get more people to sign up to volunteer. The contest was that whatever grade got the highest hours worked would get some kind of prize, and the kid who worked the most hours over all would get some chicken nuggets and fries from the nearest fast food place. It wasn’t that awesome, but what do you expect from a school for us people, trophies and shit? The school is funded “equally” but they would never put enough money on a trophy or something for a group that was socially deemed dangerous and grotesque. Last year the winning grade was the seniors, and all they got was everyone in the grade got 2 extra credit points for any elective class they individually chose. Despite this, everyone gets fired up and competitive anyway. “Not really, I don't care much about the contest at all.” “Then why put in so many hours today?” they asked with a puzzled expression. “I guess you could say I'm kind of uh, avoiding something.” “Avoiding something?” “Avoiding something” I say with finality. “I see, so you’re spending a bunch of time here so you have to deal with what ever it is you’re avoiding? Surely there are more..entertaining ways to avoid a problem.?” “Not if you live with them” I reply with a snort as I open my first energy drink.

#art #art tag #artists on tumblr #writers and poets #writers on tumblr #writing #writeblr #writerscommunity #writer #writer community #stories

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newstfionline · 2 months

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Tuesday, February 20, 2024

Trudeau’s welcome mat for immigrants wears thin amid Canada housing crunch (Reuters) Canadian Prime Minister Justin Trudeau has relied on immigration to drive economic growth and plug labor gaps, but now he is hitting the brakes after a seismic shift in public opinion that could undermine his chances to win the next election. It was Trudeau’s father, Pierre, who championed immigration as prime minister in the early 1970s, promoting “multiculturalism” as government policy. Over time, Canadians have come to see the country’s diversity as part of its identity, like the maple leaf and hockey. But when international students led a surge in immigration in the wake of the pandemic, the public mood soured as rental costs soared and services like healthcare came under strain.

Jimmy Carter’s spirit ‘as strong as ever’ after year in hospice, grandson says (CNN) As former President Jimmy Carter marked one year in hospice care on Sunday, his family celebrated his resolve and expressed gratitude for the support they’ve received. “After a year in hospice, on a daily basis we have no expectations for his body, but we know that his spirit is as strong as ever,” Jason Carter, Jimmy Carter’s grandson, said in a video that aired on “CBS Sunday Morning.” Now 99, Jimmy Carter is the oldest living US president in history. He has survived metastatic brain cancer, liver cancer, and a number of health scares, including brain surgery after a fall in 2019. He entered hospice care in February 2023 after a series of hospital stays. In hospice, an interdisciplinary team of professionals who specialize in end-of life-care address the whole person. There is no time limit on how long a person can receive hospice care. Many patients choose to receive care at home or in other familiar environments.

Illegally adopted during Chile’s dictatorship, they’re now reuniting with biological families (AP) Romina Cortés couldn’t pronounce her sister’s last name. Cortés, 43, waited impatiently Sunday at the airport in Santiago, Chile, where she would soon meet her sister, Maria, whose existence Cortés learned of just a month ago. That’s because Cortés’ sister, María Hastings, was one of thousands of Chilean children trafficked or illegally put up for adoption over the last 60 years or so, most during the dictatorship of Augusto Pinochet from 1973-1990. The illegal adoptions—20,000 of which are being investigated by Chilean justice officials and other social groups—extend back to the 1960s. Largely poor, young and indigenous women in vulnerable situations were either forced to give up their children or were told they died shortly after childbirth. Now, families like the Cortés’ are finally reuniting after decades.

The Death Throes of a Ukrainian City (NYT) Even from a few miles away, the death rattle of another Ukrainian city echoed through the mist and fog. Russian warplanes were dropping more thousand-pound bombs on Avdiivka in eastern Ukraine, reducing an already battered city to rubble and ashes. Since Jan. 1, President Vladimir V. Putin’s forces have dropped around one million pounds of aerial bombs on an area encompassing just 12 square miles, according to estimates by Ukrainian officials and British intelligence. Avdiivka fell to the Russians on Saturday, after some of the most horrific and destructive fighting of the two-year-old war. In the end, Russia’s superior firepower and manpower overwhelmed Ukrainian forces over many months, even as Russia incurred a staggering number of casualties. The Ukrainians withdrew under withering bombardment, fighting intense battles across ruined streets to break out of Russian attempts to encircle them. Russian warplanes bombed the hulking coke-processing plant on Avdiivka’s northern outskirts, using incendiary munitions to blow up fuel tanks at the plant, unleashing a toxic smog, according to Ukrainian soldiers fighting in the plant.

The Taliban vowed to change Kabul. It’s starting to change some of the Taliban. (Washington Post) More than two years after Taliban fighters streamed into the Afghan capital, seizing power here and vowing to cleanse the country of Western decadence, many of them have come to embrace the benefits of urban life. Some spend their weekends in the city’s theme parks. Some watch cricket matches on large outdoor screens. Others are filling their Facebook pages with skyline selfies or buying self-help books published in the West. Most mornings, Kabul’s English schools are crowded with Taliban soldiers and employees in camouflage jackets, who appear as eager as other students to study abroad. As the Taliban continues to change Kabul, some here have started to wonder if the city may also have begun to remake the Taliban.

Tribal violence in Papua New Guinea (AP) At least 26 combatants and an unconfirmed number of bystanders were killed in a gunbattle between warring tribes in Papua New Guinea, police said Monday. A tribe, their allies and mercenaries were on their way to attack a neighboring tribe when they were ambushed Sunday in Enga province in the South Pacific nation’s remote highlands, Royal Papua New Guinea Constabulary Acting Superintendent George Kakas said. Police Commissioner David Manning later described the clash as a “gunbattle between warring tribes.” An unconfirmed number of villagers also were killed.

The head of the UN’s lead agency helping Palestinians accuses Israel of seeking to destroy it (AP) The head of the main United Nations agency supporting people in Gaza alleged that Israel is intent on “destroying” the organization along with the idea that Palestinians are refugees and have a right to return home one day. Philippe Lazzarini accused Israel in an interview with the Swiss newspaper Tages-Anzeiger of having a “long-term political goal” of eliminating the U.N. aid agency he leads, which is known by the acronym UNRWA. It was created more than 70 years ago to assist Palestinians who fled or were forced from their homes during the 1948 Mideast war over Israel’s creation. “At the moment, we are dealing with an expanded, concentrated Israeli campaign, which is aimed at destroying UNRWA,” Lazzarini said in the interview published Saturday. Lazzarini, who has served as UNRWA’s commissioner-general since 2020, said Israel apparently believes that “if the aid agency is abolished, the status of the Palestinian refugees will be resolved once and for all—and with it the right of return.” Israel rejects Palestinian demands to allow descendants of refugees to return to what is now Israel, arguing it would dilute Israel’s Jewish majority.

Overwhelmed by War, Another Gazan Hospital Is Declared ‘Not Functional’ (NYT) The largest medical facility still managing to function in wartime Gaza is now a hospital in little more than name only, the head of the World Health Organization said on Sunday. After a week of siege by the Israeli military, there are only about 20 critically ill patients left at Nasser Hospital—but even that is too many for it to handle, said Tedros Adhanom Ghebreyesus, the W.H.O. director general. “Nasser hospital in Gaza is not functional anymore,” Dr. Tedros said on social media. Dr. Tedros said on Sunday that some 200 patients remained at the hospital in Khan Younis, in the southern Gaza Strip, and that about 20 of them urgently needed to be transferred elsewhere. Israel has justified its military actions at the hospital by saying that Hamas militants have been using it and other medical centers to conceal military activities, and on Sunday it said it had found both weapons and Hamas militants at the Nasser complex. Hamas has repeatedly denied using hospitals as cover.

As Gaza war rages, top U.N. court to hear arguments on Israeli occupation (Washington Post) The top U.N. court is set to begin public hearings Monday into the legality of Israel’s occupation of Palestinian territory. The six-day hearing could add to the political pressure on Israel over the war in Gaza, though its focus is on a broader issue: control of the occupied West Bank, annexed East Jerusalem, and the Gaza Strip. Israel does not consider that it “occupies” Gaza, arguing that it ceded control over the enclave in 2005, when it unilaterally withdrew. However, human rights groups say that Israel has maintained control over Gaza in other ways, including through a blockade, which Israel and Egypt imposed when the militant group Hamas took power in 2007. Meanwhile, the U.N. Security Council is expected to vote this week on a resolution drafted by Algeria that calls for an immediate cease-fire in Gaza. Washington—one of five permanent council members with veto power—has said it won’t support the measure.

Dubai International Airport had 86.9 million passengers last year in a post-pandemic surge (AP) The number of passengers flying through Dubai International Airport, the world’s busiest for international travel, surged last year beyond its total for 2019—just before the coronavirus pandemic grounded global aviation. The number of passengers passing through its cavernous, air-conditioned terminals, home to the long-haul carrier Emirates in Dubai, long has served as a barometer for the aviation industry worldwide and the wider economic health of this city-state. Overall in 2023, the airport had 86.9 million passengers. The airport’s 2019’s annual traffic was 86.3 million passengers. The airport had 89.1 million passengers in 2018—its busiest-ever year before the pandemic.

South Africa’s main opposition party lays out plans to unseat the African National Congress (AP) Thousands of South Africans gathered in the capital Saturday to show support for the country’s biggest opposition party as it prepares for a much-anticipated national election in which it hopes to wrest control of the government from the ruling African National Congress. Many of the Democratic Alliance backers assembled in the Union Buildings, the official seat of South Africa’s government in Pretoria, expressed faith the party would deliver better basic services and address some of the country’s daunting challenges. These include a worsening electricity crisis that has caused rolling power blackouts for households and businesses on a daily basis. Participants at the Democratic Alliance conference also highlighted South Africa’s unemployment rate of over 32%.

Falls are a leading cause of bone breaks, brain injuries for U.S. seniors (Washington Post) About 1 in 4 U.S. adults 65 and older—more than 14 million people—suffer a fall each year, according to the Centers for Disease Control and Prevention. Falls are the leading cause of injury among those 65 and older, even though not all falls result in an injury, the CDC says. About 37 percent of older people who have fallen have sustained an injury that required medical treatment or activity restrictions. For instance, the CDC reports that 95 percent of hip fractures result from a fall, and falls also are the most common cause of traumatic brain injuries. The National Institute on Aging notes that the odds of falling increase with age, but falls often can be prevented. Standard suggestions include fall-proofing your home space (making sure all stairs have hand rails and are well-lit, eliminating most throw rugs and keeping walk spaces clutter-free), careful management of medications (especially those that can cause dizziness or confusion), having regular vision checks and staying as active as possible (including doing exercises to maintain strength and balance).

#headlines #news

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avo-kat · 3 months

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lemme check the news! :)

federal office for the protection of the constitution: the right-wing party AFD is right-wing extremist

news: Members of the AFD (+ other nazis) have a meeting talking about “remigration”, aka a plan to deport all foreigners (immigrants, asyl seekers and not assimilated german citizens) living in germany there

AFD: umm, that wasn’t an official party meeting, it was just a private meeintg??? :/

some german politicans: maybe we should ban the party… their idee of deporting ppl is clearly against our constitution... But that may be too difficult? :/

news: prognosis: the AFD will most likely get a bunch of votes in the next elections and may be in the government according to surveys

the current government: hey we wanna send bullets to israel to fight hamas :) #neveragain

news: 900.000 social apartments are missing that are needed

politician and human scum called spahn: we should punish unemployed people on social security even more. Oh we cant because of the constitution? Hmm we should change the constitution so we can do that. :) yes, the parts talking about human dignity. Who cares about poor people? Lmao

“social” party SPD: oh yes. This cannabis legalization thing we promised to do in our campaign and weve worked on for two years and promised to bring this year? Actually, we voted against it, because. Um. Concerns. Ur welcome.

ALSO, theres a poltiician whos even TOO RIGHT-WING for germany and people are demanding to REVOKE HIS CONSTITUTIONAL RIGHTS so his free sprech wont be protected anymore and he wont be able to vote or be voted for. Hes too much of a nazi even for germany!!!!! ?????? why yes, he’s part of AFD, why are you asking? And yes, its possible to revoke constituional rights for people who are a serious danger to our democracy. Lmao.

news: hospitals are overloaded, regular clinics are overloaded, the phone hotline is overloaded, long waiting times, not enough employees

news: the government promised “climate money” as a reward for ppl for use less energy, because energy prices are rising. But alas the money that was supposed to uhhh last year wont come until, um, maybe 2027?

government: hey we promised a new & better law for trans ppl! Now, instead of having to pay €€€ and letting urself be humiliated in front of judges, changing ur name and gender will be soooo easy! Just fill out this form. And… we’ll save ur prev name for security reasons in this list. And give this out to basically anybody who asks. Also, surgeries will no longer be covered. Because. Saftey. Also this law will come…. End of this year… maybe??? :)

news: 100 days after the hamas-attack. A whole society is re-traumatized. Poor israel. :(

news: the rich are getting richer and the poor are getting poorer

news: the economy is shrinking… people arent buying enough. Because of the war. (russian war, duh) and inflation.

news: we are sending medicine to the israeli hostages! Don’t worry the red cross will make sure the medicine will reach the hostages! We need pictures as proof hamas isnt using the medicine themselves and giving it to the hostages tho. Some of the hostages are sick! Also apparently 160 palestinians died in the last 24 hours?

-> DISCLAIMER: all information to this conflict CANT be verified by an independent source! Any information on the war progress, attacks and number of victims cant be relied upon!!!! Careful!!!!!!!!!!!

news: Israel drones shot a car where the LEADER of TERROR CELL was inside who had been planning to ATTACK. Good thing israel killed him!!! And several other people! Yay!

news: the US defended a ship from a ROCKET shot by HUTHI, yay. With a fighter jet, cool! The US and allies started an attack on 30 milita stations in yemen last Friday. President joe biden warned, that huthi had to prepare for additional military actions, if they don’t give in. the US is supported by the uk, the netherlands, canada, australia and bahrain. Apparently ships are stuck with gas. If they cant continue, they have to sail around the cap. Some british politician says “freedom of shipping is an internation right”.

-> at the very bottom: The huthi are supported by iran and have been recently attacking trade ships in the red sea. they want to pressure israel because of the war in gaza. They see themselves as part of a self-named “axis of resistance” against israel. Hamas in gaza is also part of that.

????????????????????????????????????????????????????????????

#going insaaaaaaaaneeeeeeee #ah wait nvm im already mentally ill #aaaaaaaaaaaaaaaaaahhhhhhhhhhhhhhhhhhhhhhh #“private meeting” u dont understand how thats not better????#like at least theres tens of thousands of ppl protesting #but lolllllllllllllllllll #sigh #also news: eu elections will be up and for the first there may be a majority of nazis there!#yay..........#nazis going: wow nazis are bad. somebody stop these nazis! why are there nazis everywhere? its so weird!

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outsourcingmedicalservices · 4 months

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An In-Depth Overview Of ASC Billing Services

ASC billing is not the same as traditional physician billing or facility billing. In contrast to physician medical billing, which needs to adhere to a few highly specialized rules to be reimbursed, ASC coding and billing are not focused on a specific medical specialty. As ASCs combine every medical specialty in one location, the coding system does not revolve around certain types of treatments, procedures, or diagnoses.

This does not imply that being an ASC biller necessitates knowing a totally new set of codes or billing procedures. ASC billing follows all of the same codes, billing process, and billing and coding criteria as the rest of the medical sector. Let’s have a look at some of the rules of ASC billing and coding services:

Guidelines for ASC Charges Billing & Coding

An Ambulatory Surgery Centre uses a combination of physician and clinical or hospital billing by utilizing the CPT and HCPCS level codes (as do most physicians). In fact, some insurance companies allow an ASC to bill using ICD-10 procedure codes, just like any hospital. Currently, Medicare requires all ASC charges to be submitted electronically via the CMS-1500 form, while most other insurers use the UB92 form.

When reporting charges to Medicare, the modifier SG must be used to indicate that services were performed in an ASC. Other payers may wish to see the SG modifier to help differentiate between a facility’s charge and a physician’s bill. Always check with specific insurance companies to determine their Overview of ASC billing rules.

Points to Remember:

The ASC pays for device-intensive processes, such as pacemaker insertion, but not as a separate line item.

The cost of the device would be included in the procedure code and submitted as a single line item by the centre.

Most ASCs are not allowed to base their prices on the allowed code on the Medicare Physician Fee Schedule.

Determination of Covered Procedures — CMS’s Regulations

When dealing with Medicare, centres must remember that not all processes permitted in a hospital setting are allowed in an ASC setting. To be “approved” by Medicare, a procedure must demonstrate that it does not represent a significant safety risk or need an overnight stay following the surgery. If you are unsure, call Medicare.

The following criteria are used to compile the list of approved procedures:

They cannot be life-threatening or emergency procedures, such as a heart transplant or reattaching a severed limb.

They cannot be performed safely in a physician’s office.

They can be urgent or elective.

Common ASC Coding Errors

First, ensure that the ASC”s charges correspond to what was really performed in the form of services.

One of the most prevalent coding errors is coding based on the headings of the procedure rather than the actual surgical report. Many ambulatory surgical centres and other freestanding outpatient clinics wisely wait for the whole surgeon’s report before billing for previously planned services, as the final report may contain fewer (or different) operations.

This will almost certainly result in denial once it reaches the payer. Thus, a coder should always read the complete operative report and investigate any differences.

Misreporting open and arthroscopic methods as one surgery is another typical inaccuracy. This occurs when an arthroscopic operation is initiated and subsequently converted to an open procedure for any reason. Many coders incorrectly bill for both, while only the open process should be coded.

Note that this does not apply when the practitioner combines an arthroscopic operation with an open procedure. They can be invoiced separately as long as they are two distinct operations.

Benefits of Outsourcing ASC Billing & Coding

Though many freestanding surgery centres and similar facilities have their own in-house billing departments, more complex billing and reimbursement issues frequently necessitate the attention of skilled ASC billing specialists. In fact, understanding significant legislation changes to ASC billing standards can take time for your in-house billing team to comprehend and apply efficiently!

Outsourcing and partnering with a reliable ASC billing and coding company is one of the quickest and easiest ways to automatically adopt new billing and coding guidelines. Such outsourcing will give your office personnel more time to focus on providing the best service and care possible. Instead of spending hours on the phone trying to collect unpaid bills, an outsourcing ASC billing company may focus on growing the practice’s patient base and improving its healthcare experience to keep the patients it already has.

See also: Tips To Increase Surgery Billing And Collections

About 24/7 Medical Billing Services:

We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians, hospitals, medical institutions and group practices with our end to end medical billing solutions. We help you earn more revenue with our quick and affordable services. Our customized Revenue Cycle Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative burden or losses.

Contact:

24/7 Medical Billing Services

Tel: +1 888–502–0537

Email: [email protected]

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petinsurancenewzealand · 5 months

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How Pet Insurance Can Save You from Unexpected Vet Bills

Pets are more than just animals - they are members of our families. We care for them, love them, and want the best for them. But just like humans, pets can get sick or injured, and veterinary care can be expensive. This is where pet insurance nz comes in.

In this blog post, we will explore the importance of pet insurance in protecting your furry friends and how it can save you from unexpected vet bills.

Understanding Pet Insurance Basics

Pet insurance is a type of health insurance for your pets. It works similarly to human health insurance, where you pay a monthly or annual premium in exchange for coverage for certain veterinary expenses. These expenses may include accidents, illnesses, surgeries, medications, and even routine care like vaccinations and annual check-ups.

There are different types of coverage plans available, including accident-only coverage, illness coverage, and comprehensive coverage that includes both accidents and illnesses. It is important to choose a plan that suits your pet's needs and your budget. Consider factors such as your pet's breed, age, and any pre-existing conditions they may have.

Benefits of Having Pet Insurance

One of the main benefits of pet insurance is the financial security it provides. Veterinary care can be expensive, and unexpected vet bills can quickly add up. With pet insurance, you can have peace of mind knowing that you can afford the necessary treatments for your pet without putting a strain on your finances.

Pet insurance also allows you to budget for your pet's healthcare. By paying a monthly or annual premium, you can spread out the cost of veterinary care over time. This can be especially helpful for those who may struggle with large unexpected expenses.

Real-life stories and examples can help illustrate the benefits of pet insurance. For example, imagine your dog suddenly falls sick and requires immediate surgery. Without insurance, the cost of the surgery could be thousands of dollars. However, with pet insurance nz, you would only need to pay the deductible and any co-pays, which can save you a significant amount of money.

Key Factors to Consider When Choosing Pet Insurance

When selecting a pet insurance provider, there are several factors to consider. These include coverage limits, deductibles, waiting periods, and exclusions. Coverage limits refer to the maximum amount the insurance company will pay for a specific condition or treatment. Deductibles are the amount you need to pay before the insurance coverage kicks in. Waiting periods are the amount of time you need to wait before certain conditions or treatments are covered.

It is also important to consider any pre-existing conditions your pet may have. Some insurance providers may exclude coverage for pre-existing conditions or charge higher premiums for pets with pre-existing conditions. Be sure to read the fine print and understand the policy's coverage for pre-existing conditions.

Comparing different policies is crucial to finding the best fit for your pet's needs and your budget. Look for a policy that offers comprehensive coverage, reasonable deductibles, and generous coverage limits. It may also be worth considering additional coverage options, such as dental care or alternative therapies, depending on your pet's specific needs.

Common Misconceptions about Pet Insurance

There are several common misconceptions surrounding pet insurance that need to be addressed. One of the most common myths is that pet insurance is too expensive. While it is true that pet insurance comes with a cost, the benefits it provides far outweigh the premiums. Pet insurance can save you from significant financial burdens in the event of unexpected veterinary expenses.

Another misconception is that pet insurance doesn't cover enough. While it is true that pet insurance may not cover pre-existing conditions or certain elective procedures, it can still provide coverage for a wide range of accidents, illnesses, and necessary treatments. It is essential to read the policy in detail and understand what is covered and what is not.

Tips for Making the Most out of Your Pet Insurance

To make the most out of your pet insurance, there are a few tips to keep in mind. First, understand the policy exclusions and limitations. Every policy has exclusions, and it is important to be aware of them to avoid any surprises when you need to make a claim. Submitting claims promptly is also crucial to ensure timely reimbursement.

In addition to insurance coverage, preventive care plays a vital role in minimising future expenses. Regular check-ups, vaccinations, and preventive treatments can help detect and prevent potential health issues before they become more serious and costly to treat.

Conclusion:

Pet insurance is a valuable tool in protecting your furry friends from unexpected vet bills. It provides financial security, peace of mind, and the ability to budget for your pet's healthcare. By considering key factors when choosing pet insurance, debunking common misconceptions, and following tips to maximise coverage benefits, you can ensure that you are making the most out of your pet insurance. Remember to research and compare different providers before making a decision. Your pets deserve the best care, and horse insurance nz can help you provide that without breaking the bank.

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mahendraeyeinstitute · 7 months

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When to Consider LASIK Eye Surgery: A Comprehensive Guide

Mahendra Eye Institute | PRK Training Program

LASIK (Laser-Assisted In Situ Keratomileusis) eye surgery is a revolutionary procedure that has provided millions of people with clearer vision and reduced dependence on glasses or contact lenses. However, the decision to undergo LASIK surgery is not one to be taken lightly. This article aims to provide a comprehensive guide on when to consider LASIK eye surgery, taking into account various factors and considerations.

I. Understanding LASIK:

Before diving into the when and how, let's first understand what LASIK is. LASIK is a refractive eye surgery that corrects common vision problems like myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. It involves reshaping the cornea using a laser to improve the way light enters the eye and focuses on the retina.

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II. When to Consider LASIK:

Stable Vision: LASIK is most effective when your prescription has stabilized. It's essential to wait until your vision has remained relatively unchanged for at least a year.

Age Consideration: LASIK is generally suitable for individuals over 18, as vision tends to stabilize by then. However, the ideal age may vary, and a consultation with an ophthalmologist is crucial.

Healthy Eyes: You should have healthy eyes, free from conditions such as glaucoma, cataracts, or severe dry eye, which might affect the outcome of LASIK.

Realistic Expectations: It's vital to have realistic expectations. LASIK can significantly improve your vision but may not make it perfect. Discuss your goals with your eye surgeon.

Lifestyle Considerations: Consider your lifestyle and whether LASIK aligns with it. If you play contact sports or work in a dusty environment, LASIK might be a great choice.

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Financial Readiness: LASIK is an elective procedure and is generally not covered by insurance. Ensure you are financially prepared for the cost.

III. The Consultation Process:The first step in determining if LASIK is right for you is a consultation with an experienced eye surgeon. During this consultation, your eye surgeon will:

Assess your eye health and medical history.

Conduct a comprehensive eye exam.

Discuss your visual goals and expectations.

Explain the LASIK procedure, its risks, and potential side effects.

Answer any questions you have about the surgery.

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IV. The LASIK Procedure:LASIK is a relatively quick and painless procedure. It typically involves the following steps:

Anesthetic Eye Drops: Numbing eye drops are applied to ensure you don't feel any discomfort during the surgery.

Corneal Flap Creation: A thin flap is created on the cornea using a microkeratome or femtosecond laser.

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Cornea Reshaping: The excimer laser is used to remove precise amounts of corneal tissue to reshape it based on your prescription.

Flap Re-positioning: The corneal flap is gently repositioned.

V. Recovery and Post-Operative Care:After LASIK, you may experience some discomfort, but this typically subsides within a few days. Your surgeon will provide detailed post-operative care instructions. It's essential to follow them diligently to ensure a smooth recovery.

VI. Benefits of LASIK:LASIK offers numerous benefits, including:

Improved Vision: Most patients experience a significant reduction in their dependence on glasses or contact lenses.

Quick Recovery: Visual recovery is fast, with many patients experiencing improved vision within 24 hours.

Long-Lasting Results: LASIK results are usually permanent, although age-related changes may still occur.

Conclusion:

LASIK eye surgery is a life-changing procedure that can greatly enhance your quality of life by improving your vision. However, it's essential to consider the timing, potential risks, and financial aspects before making the decision. Consulting with an experienced eye surgeon is the critical first step toward determining if LASIK is right for you. Remember that the information provided here is general, and your specific case may require individualized assessment.

If you want to have best Lasik training at affordable fees, please visit this website👇

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estemedicalgroup01 · 7 months

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Nose Jobs in Turkey: Costs, Quality, and Expectations

Rhinoplasty, commonly referred to as a "nose job," is a surgical procedure aimed at reshaping the nose to improve its appearance and, in some cases, its functionality. This cosmetic surgery has gained immense popularity worldwide, with individuals seeking to enhance their facial aesthetics and achieve a more balanced and harmonious facial profile. Among the many destinations for rhinoplasty, Turkey has emerged as a prominent choice due to its combination of affordability, quality medical care, and a rich cultural experience. In this comprehensive guide, we will delve into the factors that make a sought-after destination for nose jobs in turkey, including the cost considerations, the quality of care, and what patients can expect when considering rhinoplasty in this vibrant and culturally rich country.

Understanding the Significance of Rhinoplasty

The nose holds a central position on the face and significantly contributes to one's overall facial aesthetics. For many individuals, dissatisfaction with the size, shape, or proportion of their nose can lead to feelings of self-consciousness and a desire for change. Rhinoplasty offers a solution to these concerns by allowing patients to achieve their ideal nose shape while preserving or enhancing nasal function. The decision to undergo rhinoplasty is deeply personal, often driven by the desire for improved confidence and a more pleasing facial appearance.

Why Choose Turkey for Rhinoplasty

Turkey has gained recognition as a global hub for rhinoplasty, attracting patients from various parts of the world. Several compelling factors contribute to Turkey's prominence in the field of nose surgery:

Skilled Surgeons: Turkey is home to a highly skilled community of plastic surgeons, many of whom specialize in rhinoplasty. These surgeons undergo extensive training and often have years of experience in performing this intricate procedure.

Affordability: One of the most significant draws for patients considering rhinoplasty in Turkey is the cost. The price of rhinoplasty in Turkey is notably lower than in many Western countries, making it an accessible option for individuals seeking high-quality care without the exorbitant price tag.

State-of-the-Art Facilities: Turkish clinics and hospitals are equipped with state-of-the-art technology and modern facilities that adhere to international standards. These facilities provide a safe and comfortable environment for patients.

No Waiting Lists: Unlike some countries where patients may encounter long waiting lists for elective surgeries, Turkey offers the advantage of immediate availability for rhinoplasty procedures.

Tourism Opportunities: Istanbul, in particular, is a city that seamlessly combines modernity with rich history and culture. Patients can experience the city's vibrant atmosphere, explore its historical sites, and enjoy its diverse cuisine while undergoing their surgery and recovery.

International Accessibility: Istanbul serves as a major international transportation hub, making it easily accessible for patients traveling from abroad.

High Success Rates: Turkish plastic surgeons have a track record of successful rhinoplasty procedures, with a focus on patient satisfaction and natural-looking outcomes.

Cost Considerations for Rhinoplasty in Turkey

One of the primary reasons patients choose Turkey for rhinoplasty is the affordability of the procedure. The cost of rhinoplasty in Turkey is significantly lower than in many Western countries, including the United States and European nations. Several factors contribute to the cost advantage:

Lower Labor and Overhead Costs: The overall cost of living and labor costs in Turkey are lower than in many Western countries, which results in more affordable medical services.

Currency Exchange Rates: Favorable currency exchange rates often make it more cost-effective for patients from countries with stronger currencies to undergo rhinoplasty in Turkey.

Competition Among Clinics: The high demand for rhinoplasty in Turkey has led to a competitive market, with many clinics offering competitive pricing to attract patients.

While the cost advantage is significant, patients should be cautious about prioritizing cost over quality and safety. It's essential to choose a reputable clinic and experienced surgeon to ensure the best possible outcome.

Quality of Care in Turkish Rhinoplasty Clinics

Despite the lower cost, the quality of care in Turkish rhinoplasty clinics is on par with international standards. Patients can expect the following aspects of quality care:

Skilled Surgeons: Turkish plastic surgeons are highly trained and skilled in rhinoplasty procedures. They often undergo rigorous training and have extensive experience in performing nose surgeries.

State-of-the-Art Facilities: Turkish clinics and hospitals are equipped with modern technology and adhere to strict hygiene and safety standards.

Comprehensive Consultations: Patients typically receive thorough consultations with their surgeons before the procedure. During these consultations, surgeons evaluate the patient's nasal anatomy, discuss their goals, and create a personalized treatment plan.

Post-Operative Care: After the surgery, patients receive detailed post-operative care instructions and scheduled follow-up appointments to monitor their progress and address any concerns.

Patient-Centric Approach: Turkish rhinoplasty clinics often prioritize a patient-centric approach, emphasizing open communication and collaboration between the surgeon and the patient.

Transparency: Reputable clinics are transparent about the procedure, costs, and potential risks, ensuring that patients make informed decisions.

Patient Expectations in Turkish Rhinoplasty

Patients considering rhinoplasty in Turkey should have realistic expectations about the procedure and its outcomes. It's essential to understand that rhinoplasty is a surgical procedure with inherent limitations and variables. Some key considerations for patient expectations include:

Communication with the Surgeon: Effective communication with the surgeon is crucial. Patients should openly discuss their goals, concerns, and expectations during the consultation.

Realistic Outcomes: While rhinoplasty can significantly improve the appearance of the nose, it may not achieve perfection. Surgeons aim to create natural-looking results that complement the patient's facial features.

Individual Variability: Every patient's nasal anatomy and skin type are unique, leading to variations in surgical outcomes. Factors such as skin thickness, nasal structure, and healing processes can impact results.

Recovery Timeline: Patients should be aware that the final results of rhinoplasty may not be immediately apparent. It can take several months for swelling to subside, and the nose to settle into its final shape.

Post-Operative Care: Adhering to post-operative care instructions and attending follow-up appointments is crucial for achieving the best possible outcome.

Potential Risks: Patients should be informed about the potential risks and complications associated with rhinoplasty, although these are generally rare when the procedure is performed by a skilled surgeon in a reputable clinic.

Conclusion

Rhinoplasty in Turkey offers an enticing combination of affordability, quality of care, and cultural experiences for patients seeking to enhance their facial aesthetics. Patients considering rhinoplasty in Turkey should prioritize safety, quality, and a patient-centric approach when selecting a clinic and surgeon. While cost considerations are significant, they should not compromise the importance of skilled surgical expertise and post-operative care.

Ultimately, undergoing rhinoplasty in Turkey can be a rewarding experience for those who have realistic expectations, prioritize quality and safety, and collaborate effectively with their chosen surgeon. The country's reputation as a global hub for rhinoplasty is a testament to its commitment to delivering excellent results and patient satisfaction in the field of nose surgery.

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