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#Skin Enzyme Therapy
myskinmethods · 2 months
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Skincare Salon in West Warwick RI | DMK Paramedical Skin Revision Clinic
Skinmethods, located in West Warwick, RI, offers a comprehensive range of professional skincare salon and rejuvenating beauty services. Our approach centers around whole skin health, considering factors like nutrition and daily stress. Our services include:
1. Customized Skincare: Skinmethods tailors treatments to each client's unique needs, ensuring immediate results that improve over time.
2. Holistic Approach: They focus on the direct connection between overall well-being and skin health.
3. Clean and Cozy Space: Clients can expect a relaxing environment during their treatments.
4. Budget-Friendly Options: Skinmethods provides choices that align with individual goals and budgets.
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As the pioneers in RI, we offer DMK skincare—the global leader in paramedical skincare. Our effective approach delivers long-term corrective results. Exclusively available at DMK-trained skin revision clinics, our treatments harness the power of transfer messenger enzymes. These therapies target deep-seated dead protein and toxins, promoting skin health. Our philosophy revolves around removing, rebuilding, protecting, and maintaining your skin, ultimately restoring its flawless appearance.
Whether you're seeking customized skincare services or the highest quality name brand skincare products, Skinmethods is committed to achieving amazing results for your skin. Book an appointment and experience our expertise firsthand!  
Skinmethods 310 Cowesett Ave West Warwick, RI 02893 [email protected] (401) 903-3242 www.myskinmethods.com
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safimiran · 7 months
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bellecherieau · 1 year
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Lymphatic Enzyme Therapy in Scarborough
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Belle cherie specialises in Lymphatic Enzyme Therapy in Scarborough. It's a manual therapy service designed to improve the functioning of the lymphatic system. Belle Cherie's certified therapists stimulate the lymphatic vessels and encourage the flow of lymphatic fluid, reducing swelling and alleviating symptoms of lymphedema. 
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Bayside Skin and Laser Clinic offers professional DMK Enzyme Therapy Treatment in Melbourne. DMK is a revolutionary product on the market which focuses on the skin's dysfunction at a cellular level rather than the surface, re-educating the skin back to an optimal state. Book an appointment now!
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DMK believes that the origin of most skin conditions is a result of disharmony within the skin. Using the principles of biochemisty, DMK has formulated a range of treatments and products designed to educate skin to perform like youthful healthy skin. By matching formulations with the body's chemistry, the skin is encouraged to respond in a positive manner. DMK's revolutionary concept of REMOVE, REBUILD, PROTECT, MAINTAIN aims to match an individuals biochemistry with the appropriate skin therapy. Botanical-based paramedical products make up the DMK skin care program.
ENZYME THERAPY
The DMK Enzyme therapy mask restores skin to its peak condition. It utilizes transfer messenger enzymes that regulate health and work with certain minerals in the body to form a natural system of anti-oxidants that fight free radicals, remove dead protein and toxins from the skin.
The enzymes aim to strengthen the structural integrity of the skin and create a healthy environment, enhancing optimal skin functioning by working with the internal systems to increase circulation, oxygenation and lymphatic drainage while stimulating collagen production.
Read More: https://baysideskinandlaser.com.au/dmk-treatments/
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januaryembrs · 29 days
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THE KID SWINGS BACK | Spencer Reid x Prentiss!Reader [4]
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Description: The THREE times things feel weird between Spencer and you because you're just best friends.
Length: 21k (this is HALF of what I wrote for this chapter before I split it into two parts :0)
Warnings: explicit hints of suicidal ideation, as I have said in the last two chapters, Bugsy has really struggled with losing Emily and has been in a bad place. it is mentioned once or twice but please read with caution if you feel topics of mental health, not vividly described but the effects of it, are mentioned. Spencer's addiction is also mentioned. Violence, blood, swearing, usual CM warnings. Also there is a brief mention of SA (bugsy gets spanked by a stranger in a casino), again if this is triggering please be cautious. EXPLOSION. Emily and bug argue + fight. Bug + hatch fight. Bugsy takes no prisoners in this one won't lie. Spencer and bugsy turn each other on accidentally.
authors note: this was supposed to be a lot longer (I've had to split it with the next part released in a few days time) and yet every time I tried to upload to Tumblr, it crashed because it was over 30k words ;-; OTHER HALF IS COMING SOON.
previous chpt | next chapter
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‘If you take a swing, the kid swings back,
she say I’m not your punching bag,’
The one where Emily comes back.
She felt the headache as soon as she woke up. She’d experimented with Molly her first week of college, hated every second of it after she had prattled on for two hours to some other random freshman about the breakthrough research in enzyme-replacement therapy like she was catching him up on an episode of the Kardashians. She’d tried the odd few brownies, though they usually turned her stomach the next day and made her paranoid for about a week, before she swore them off entirely for their yummy, sober counterpart. 
She should have known what to expect when she woke up, but then again, if she had been smart enough to pre-empt how awful she’d feel the next day, she probably wouldn’t have taken the little pink pill with a candied love heart on the top at all. 
The duvet was soft against her face, and for a moment she didn’t care about anything except chasing the warmth it provided; just that she was cosy and it smelled nice, smelled familiar. 
Her eyes pinged open when she realised that whatever that familiar smell was, it was very much not her own sheets. And she was very much not in the clothes she left the house in last night. 
Bugsy sat up too fast, that much she knew, because in the time it had taken her to swing her legs over the edge of the bed, reach for the side table where she hoped to find her phone, a home phone, or just any working phone she could call someone off, she felt the room that smelled like a dream spinning around her. 
Her legs turned to jelly, her stomach tossed with a mix of nerves and nausea, and, graceful as ever, she fell face first to the ground with a thud, smacking her temple off the corner of the bedpost on her way down. 
“Fuck,” She whined, raising a hand to her brow that thudded with more than the side affects of last night, and she was quick to hear footsteps approaching as if in a half run. The door to the bedroom dragged on the thick sherpa carpet as it swung open, and she blinked wearily up at the culprit. 
“Alright, up we get,” There were hands slipping under hers before she got a chance to see anything that wasn’t a blurry mess of brown hair and worried eyes, and it wasn’t until she heard his voice she felt herself sigh in relief, “Of course you wake up the second I turn around,”
“Sencer?,” She cleared her throat, hands latching onto his shoulders as he lifted her back onto the bed, “Spencer?” She tried again, her lips chapped, her skin clammy. 
“Good morning, to you too,” His voice was soft, quieter than usual, like he knew just how delicate her head was and changed his tone accordingly, “Did you sleep well?”
“Morgan- where’s Morgan, I thought we…” She murmured, turning her head in confusion to the window where Spence had gone so far as to pull the curtains closed for her, seeing just the smallest crack of daylight filtering over the bed sheets. Her hands ran down his chest, her eyes lost and dazed, like someone had taken her batteries out, and Spencer took it as an opportunity to hand her the glass of water he’d got her and two advil. 
“Morgan’s safe; he went home, he said he had a wonderful night,” Spencer lied, hoping she was just a little out of it that she didn’t catch him in it. She always knew when he was lying. But, as he’d suspected, she barely picked up on it, her lips pouting in confusion when she took note of the medicine he’d given her, “Drink up, Morgan said you did a lot of dancing last night, you’re probably dehydrated.”
“I did…” She echoed him, trailing off when the blur of the nightclub caught up to her, and she remembered exactly the last time someone had handed her a little tablet like those ones. Her heart plummeted, her eyes widening into saucers, and she swore she might have felt the glass crack beneath her palm with how tight her grip became. She looked up at him, and instantly picked apart the pity and the sadness swimming in his honey pooled eyes, “You know,” 
He nodded softly, his hand coming up to stroke her hair away from her face, his gaze falling to where she felt something sore and achy forming on her forehead, bleeding into her brow. 
“Spence-” Her own groan of pain cut her off when he brushed over the bump on her temple, and she understood she had perhaps hit it much harder than she’d initially thought.
“Let’s get you breakfast, and then we’ll talk,” He whispered softly, concern thick in his voice, and for the first time in months, she didn’t fight it. She just listened, and let him love her.
-
“God, I am truly pathetic,” She muttered, sipping her coffee with a scowl in between the maple ladened pancakes going down with a vicious chomp on her fork. Her other hand was occupied holding a bag of frozen peas to her head, where a nice dark bruise was spreading its way over the right side of her face, spider webbing out into a black eye. 
“You’re not pathetic, everyone makes mistakes,” Spencer tried reassuring her, but he couldn’t help but smile as she devoured breakfast with the anger of a raccoon being dragged from a garbage bin, “You’re safe, that’s all that matters,” 
She sighed, and Spencer didn’t actually think she had ever been so grumpy around him before, “Spencer, look at me,” He did, he had been all morning, but he did as he was told anyway, “I’m a federal agent who took molly from a frat boy all because I can’t just grieve like a normal person and cry my pathetic little heart out and be done with it. I crashed your night because I can’t even handle a little ecstasy without needing supervision and I just got into a fight with your bedframe,” She finished with a huff, dipping her next mouthful of pancake in the puddle of maple syrup she’d created on the plate, “And the fucking bedframe won.” 
He smiled despite himself, reaching out to hold her wrist gently, making sure it was her turn to listen to him now, “Bug, I grew up being shoved into lockers and swirlied my whole life. I was the only kid in a classful of seniors that used to wedgie me so hard I had to have the school librarian, Mrs Addler, walk me between classes. Believe me, I’ve seen pathetic and you’re not- why are you crying, Bug, don’t cry,”
He remembered this bit, the mood swings, when he would pendulum between exhaustion and irritation straight into sadness and hopelessness, like there would never be an impasse between them unless he did more of the thing that had made him feel so awful in the first place. Still, he gently took the bag of now slightly soggy peas from her head, wrapping an arm around her back and scooching his chair to sit next to hers as she dropped onto his shoulder with a weepy sniff. 
“I’m crying because I just thought of baby you all alone with Mrs Addler-” She sobbed loudly, and his heart bled out in his chest with warmth. No one had ever cried for him. “How could they be so cruel to you, I swear if we ever see those bastards, I’ll show them how we settled things in Russia-” 
He chuckled, shaking his head, and she snuggled closer to him the way she had last night when the only thing keeping her on earth had been his body heat. 
“It wasn’t all bad, she used to share her butterscotch with me,” He said with a small smile when she raised a wet glance at him. 
“You know, you never have to be alone again, right?” Bugsy murmured, and he swore his heart might have just jumped right up into his mouth then and there, “You’re my best friend in the whole world, and I promise I’ll never leave you again. That was… selfish of me, I’m sorry I was so selfish.” 
Spencer felt his throat tighten as he looked at her, innocent and entirely truthful, like he could ask anything from her right this second and her god’s honest words would be ‘Anything for you, Spencer, I’d do anything for you.’ He had never had anyone look at him like that, nothing even close. 
“You’re my best friend too. And you weren’t selfish, you were grieving,” He choked out, and she tucked herself beneath his chin then, satisfied with the response, but his stomach turned sour when he remembered what he was going to tell her last night, what he should have told her months, years, ago instead of lying to her. Because he knew she would understand, knew she would get him the way no one else had even tried to, because she was just her. “I have to tell you something,”
She sat up straight, sensing the seriousness in his tone, and looked at him with imploring eyes, still sleep-addled and slightly wet around the edges. 
He cleared his throat, “When I told you I was allergic to narcotics since I was born, that wasn’t entirely true, and I’m sorry I lied to you,” Her brows softened, creasing in a way that told him she was worried, or she knew where he was heading but couldn’t find a voice in her to say anything. He ran clammy palms over his pyjama pants, “There was a case, a while back, where we were tracking an UnSub to this farmhouse in the middle of Atlanta. Me and JJ got split up and the UnSub took me hostage in his father’s shed,” 
She stayed quiet, but she quickly took his hand in hers when she saw him fidgeting with it in his lap. He smiled at her weakly, and squeezed her fingers gently, telling her he was okay to talk about it no matter if his chest was rattling and his face felt like fire. 
“He was very sick, the UnSub. Tobias. He took on an alter of his dead father because he couldn't handle life without him. Even though his father was extremely violent and abusive, he still loved him enough to never want to let him go,” His lip pulled between his teeth for a moment, and he couldn’t look at her for what he was about to say, “Tobias tried giving me something to stop the pain of his father’s beatings when he would front and being a drug addict himself, the best thing he had was dilaudid. So, he gave it to me for the three days I was with him before the team found me,” 
“Spence,” She said softly, knowing he would hate to hear an ‘I’m sorry’ because she hated those two words with a passion, “You don’t have to tell me if you don’t want to,” 
“No, I want to, it’s just a little… fuzzy in parts,” He whispered, and she nodded, gently knocking her head against his jaw to let him know she was there to listen, “After the case wrapped up, everyone got home and just sort of pretended things went back to normal, even though I felt like I was drowning in everything that had happened, and the only thing I could think that had stopped the pain was the dilaudid. So I took more, and more, until I was using every other day, sometimes even at work to cope with the cases,”
“Did anyone know?” She asked, lips pressed tight as she scolded herself for talking, but he stroked her hand with his thumb to show he didn’t care if she asked questions, “Did Emily know?” 
He nodded gingerly, “Everyone knew, but no one could do anything, or say anything, because otherwise Hotch would have to file a report on me, and I’d be forced to leave the team,” 
“So no one helped?” She said, and there was an unexpected trace of anger in her tone that he knew too well. He’d be lying if he said that there were more than a handful of times when he was at his lowest he didn’t curse the team out for not giving a single shit about his condition. But when he’d sobered up, when he’d got clean and back to his usual self, he knew they were trying to do what was best, that they were in uncharted waters as to what would be the correct approach to helping him that wouldn’t diffuse a bomb that could ruin all of their careers. 
“There was nothing they could do, Bug. If they said anything they would be just as liable as me for what I was doing, the same way Morgan and I aren’t going to say a word about what happened last night,” He pointed out, and she seemed bitter as if she knew he was right but hated the point of it anyway. 
She held onto herself for long enough hearing that, and he saw it coming before it came as a shock when she threw her arms around him, hugging him tighter than she ever had before, not crying like she had been, but full to the brim of sadness and grief and mourning, as if she was trying to squeeze it all out of him so she could take it on for herself. 
“You’re never going to be alone again, I swear, Spencer,” 
And he believed her with everything in him. 
Bugsy had been back in the field for five weeks now, looking healthier than ever thanks to Hotch’s insistence she joined Beth for triathlon practice despite the fact she really had started feeling more like herself. 
It had only taken six months, but who was counting, right? 
Sure, walking past Emily’s desk had stopped her in her tracks the first day she got back, and Morgan had quickly jumped in to distract her with a cup of coffee, leading her over to the kitchenette and far away from the empty table her sister’s things had once been on. 
She was still adjusting to this alternate reality version of the BAU where Emily wasn’t there to protect her and watch out for her, and where they didn’t bicker about who got to ride shotgun with Hotch because Bug loved when he would drive fast (he pretended not to notice but would floor it when they hit the freeway), or when they would butt heads over who finished off the biscuits Emily kept in her secret stash (it was almost always Bugsy sharing them with Spencer and Penelope, when the three of them would gossip in Pen’s lair at lunchtime.)
She was adjusting, slowly yes, but there was one thing to keep her going, to keep her holding her head high as she walked past Emily’s picture on the way, full of smiles and dark hair the day she’d been instated in the bureau, her excitement tangible even through a piece of paper and a thin sheet of glass. 
There was one thing keeping her going, and it wasn’t Penelope’s cheerful good mornings she showered her in the minute she entered the building, it wasn’t Beth’s runs that would take everything out of her even though she felt stronger than she ever had, it wasn’t Rossi’s insistence on cooking for her once or twice a week because ‘he had more wine he could ever need alone and she could stir the pasta while he chopped the meat’, and it wasn’t even Spencer sticking to her side like damn velcro since she had been back. Although, they played a pretty big part in it. 
No, the one thing keeping her going was revenge. 
Morgan had let it slip accidentally, the morning she had come back into the headquarters to fill in some forms with Hotch and Strauss before Hotch was reassigned to Pakistan, when she had slinked into his office with an apology ready at her lips for the way she had behaved, to which he was going to say he had no idea what she was talking about because that was how things had to be, only to find file upon file upon caseload on Ian Doyle splayed all over his desk, and she quickly realised Derek was not one to let sleeping dogs lie either. 
And, reluctantly, he had let her help, because he hated the idea of them keeping secrets from her. Especially ones that involved them secretly tracking down the guy who killed her sister, who had threatened to abduct, torture and kill her if Emily hadn’t gone after him first. 
Because Bugsy was always going to be her little sister, no matter how grown and headstrong and stubborn as an ass she was. And Emily had had zero intention of letting Bugsy come even close to danger at the hands of Ian Doyle or any other motherfucker dumb enough to think they’d get away unscathed making threats to her sister. Which was why Emily had been the one to track him down first, no matter who she had to trample on, what lines she had to cross.
And now it was Bug’s turn to reciprocate the favour. 
The one thing that bounced around her head with every step she took across the BAU floor was how Ian Doyle would look when she dragged him to hell and back and everything in between, when she made him burn the way she had burnt. 
Hotch had been away on temporary duty for the month, bar the occasional phone call where he checked in on her directly or through Spencer, and it wasn’t until she walked into Morgan in a blunt exchange with his own cell that she realised he was perhaps closer to coming home than she’d thought.
The man nodded, and bid the mystery caller goodbye before he flicked a look up to where Bugsy had entered his office with a cup of to-go coffee and an expression of intrigue. 
“We got him,” Morgan said, and it was the three words she had been waiting to hear for two hundred and fifteen days. 
They had found Doyle. 
She was in the back of an SUV not even two hours later, strapped to her neck with tactical gear and two loaded pistols holstered at her hips. 
“You’re sure you’re alright to do this?” JJ asked from her place beside her, noting the way the girl’s leg was bouncing, her fingers twitching as the three of them crowded around the screen linked to the surveillance camera set up outside Doyle’s apartment, Spencer and David watching an identical feed in the next block over, outside the safe house his son, Declan, was supposed to be in. 
Only, when they’d arrived, the little blonde haired, blue eyed boy that was the only thing Doyle gave a damn about in the world was gone, two agents and his nanny lying dead on the floor. 
“Put it this way, JJ, I’m going in after that son of a bitch whether you guys cover me or not, and it would be real nice to have back up,” Bugsy said simply, like she was reciting the weather, not ready to rain hellfire on anyone who got in between her and wringing Doyle’s neck. 
The blonde woman exchanged a look with Derek, the two of them cautious about her behaviour, but thought better than to try stop her when she had just as much right as any of them for justice. 
Before any of them could say another word, a car sped around the corner of the cul-de-sac, veering and wavering between parked cars, narrowly missing theirs by an inch, and red-blue blaring lights came racing after it within seconds, the siren full blast and no doubt waking the neighbours. 
Or at least one neighbour in particular, as they spotted the curtains twitching in Doyle’s apartment, and they had their first sign of life in hours. 
“He’s in there, someone’s in there,” Bugsy pointed to where the fabric moved in the dead of the night, unholstering one of her weapons and bursting the back door to the SUV open. 
JJ clicked her radio on, speaking into her shoulder as Morgan was a hair width behind Bugsy, equally armed and ready, “We got movement on Doyle, we’re heading up to search his apartment,” 
“Be careful, keep an eye on the kid,” Rossi ordered, he and Spencer adjusting their positions in their SUV, waiting for forensics to show up and investigate the nanny’s house. Spencer licked his lips nervously, and he could only imagine what was going through Bugsy’s mind at that moment, wishing more than ever she could have just stayed with him and let Morgan and JJ catch Doyle. 
But she would never. She had nearly ripped Rossi’s head off for suggesting it even. 
She’d seen him move up to the roof, had taken the stairs in twos, and she felt like kissing Aaron the second she saw him for all that cardio paying off a treat. She heard Morgan panting behind her, urging her to wait up so she wasn’t going in alone, but she didn’t listen, not when she was this close to getting that rat in her grasp and squeezing the life out of him barehanded. 
She kicked down the door leading to the roof from the stairwell, her pistol drawn high and sharp and Morgan’s steps racing up behind her were the only sound for a moment. 
He was here somewhere, watching them, god only hoped they had caught him unaware before he could call in his own backup. 
Taking a careful step out onto the concrete, willing herself to take a deep breath and calm herself; she checked her nine o’clock, checked her three, before her boots crunched under her and she moved further out onto the roofing. Flicking a look around again, her eyes squinted against the moonlight that did little to no good, searching for even the smallest movements that would give him away. 
“I heard you wanted to see me, Doyle,” She said loudly, hoping he would fit the profile they’d put together and want to tie up his loose ends once he realised who she was, “Truth is, I’ve been wanting to see you too,”
She had barely a second to react as she felt something hard slam across the back of her head, and she realised he had hit her with a rogue, loose pipe, hard enough for her to stumble forward, dropping her pistol when his body soon followed to tackle her completely to the ground in the effort to grab for the gun himself. 
But she felt like body was alive with excitement, like the pain in her skull didn’t ache, didn’t matter, because she had him in her reach. 
It took her barely a second to bring her elbow into his stomach, winding him hard enough he weakened his grip on top of her, then another hit square across his jaw, another to his temple, one to his already crooked nose and she threw a downward thump into his groin for good measure. 
He hissed, cursing her something vile, and it was only then she saw the grey-blue eyes of the man who had killed her sister with no remorse, who had taken the person she loved unconditionally within a blink of an eye. 
“You recognise me?” She said, a manic smile on her face as she raised the other gun from its holster, kicking him hard in the knee she’d seen him limping on, a bullet wound shaped scar giving his weakness away in seconds.
She wasn’t the only enemy he’d made in that business of his, but she sure as hell would be his last one.  
He fell to the floor, his eyes wary as he looked up at the girl he had spent weeks collating photos of, the girl he’d had two of his best men tracking, snapping pictures of her going about her day to day life before he sent them to Emily. Because she would know what that meant no words needed. 
This was her sister. Her little sister she had fought tooth and nail for, that she had given her life for. Her sister, who had the same rock solid loyalty to her family as Lauren had. 
“Do you want to know where you went wrong, Doyle?” She asked, and her voice wasn’t calm like her body was, it was hiding the glee she was taking from his alarmed expression, like they both knew she was the last person he would have expected to be grabbing him in the night, “Your mistake, Doyle, was not killing me first,” 
She raised her finger to the trigger, feeling for a second the same thrill as when she popped that molly just to forget everything that was happening. Because she had tunnel vision, and pulling the plug on Ian Doyle’s pathetic existence was the solution. 
Until Morgan’s hand came over hers, and his voice was closer than she’d expected to her ear. She’d barely heard him creep up on her, she realised with a jolt. 
“Don’t do this, kid,” 
“He deserves it,” She spat, hating the sorrow in his voice when he pointed the gun away from Doyle who wiped his fingers beneath his nostrils and pulled back with a wince and a blob of blood over the back of his hand. 
“I know he does. But we need to find Declan, and we can’t do that without him,” Morgan’s voice was deep and bitter, knowing full well he had to be the one to take the reins as much as he would love to just let her have at him. 
Her nose scrunched in disgust when Doyle laughed at her annoyance, and she quickly holstered her weapon, pulling the cuffs out of her back pocket and helping Morgan yank him off the floor. 
“I got some friends that would love to meet you, honey,” Doyle said through a wheezing breath, despite Morgan’s rough hands shoving him forward towards the stairwell. 
She chuckled however, her face still bitter, her eyes something nasty and wild as she flanked his other side, “Don’t worry, I have some friends for you to play with too, Doyle.” She tightened her grip on his arm just to make it hurt, “I wonder how the Chernuses would feel about you and your men being so close to their turf. You ever fucked with the Russian Mob, Ian?”
His smile wiped clean off his face at that.
-
“How’s it going?” Hotch asked, and she barely had time to comment on the fact he looked rather dashing with a beard and a tan, or that he had lost ten pounds, before he was straight back to business, even after an eighteen hour flight. 
“He won’t talk. He said the only person who could have helped us find Gerace would have been Emily.” She replied, rubbing her hands over her eyes with a huff, “Just another dead end,” She threw the file onto the roundtable, which was slowly piling up with documents relating to anyone Ian Doyle had ever had relations with.
Hotch’s face tightened. He took a single moment to enjoy the calm that overcame the room, took a second to enjoy the fact she was looking normal and healthy compared to when he had all but barged into her apartment to force her on a run. 
Because he knew the normalcy they had found themselves in now was about to be flipped on its head, JJ confirming with a nod from the other side of the room that she was on her way. 
He turned to look where Morgan, Rossi and Reid had walked in, Reid stroking a gentle hand over Bugsy’s hair where she hunched over the table and flicked through some files for anything to keep her mind off of going into that interrogation room and ripping into Doyle. She flicked a small smile up at him as he passed her, leaning over her shoulder to take half her workload off her. 
She looked happier than she had in months, and he was about to take it all away again. Hotch swallowed the self loathing that threatened to choke him alive, and opened his mouth. 
“Everybody have a seat,” The team looked up at him in confusion, but followed orders, JJ moving around the table to stand beside him, the same reluctant look on her face when she saw Bugsy’s frown.
“Why?” Morgan asked, seeing as no one else was going to, “What’s going on? Everything alright?”
“Seven months ago, I made a decision that affected this team,” Hotch began, his eyes immediately flicking to where the youngest Prentiss faltered, “As you all know, Emily had lost a lot of blood after her fight with Doyle. But the doctors were able to stabilise her,” 
Bugsy’s ears started ringing just hearing her sister’s name coming from his lips, said so casually and blunt that it felt like he had punched her in the stomach and she thought she was maybe over estimating how well she had overcome the grief. 
And that hadn’t even been the worst part, she quickly realised. The doctors were able to stabilise her. 
“And she was airlifted from Boston to Bethesda under a covert exfiltration. Her identity was strictly need to know. She was reassigned to Paris where she was given several identities, none of which we had access to for her security,” Hotch said, avoiding the piercing eyes that were slowly melting between confusion to heartache to one she finally could land on, horror. 
No one breathed for a moment, no one said a thing as the words sunk in, and she felt her entire body wash over with a gut wrenching numbness as it dawned on her what he was saying. 
Emily never died on that table like JJ had said. She had never died at all. 
“What?” Her voice was tiny and childlike when it came out, and she felt like she was stuck in the world’s worst nightmare, like she could claw and scratch and rip at her skin just to wake herself up from this terrifying dream where Hotch had lied and Emily had left her and everyone who was supposed to care about her had kept her in the dark. 
“She’s alive?” Garcia asked, tears in her own green lined eyes, looking at Hotch with utter shock. 
“But we buried her,” Spencer found it in himself to murmur, because none of this made sense and if any of what Hotch was saying was true, then he knew things were about to become really ugly. 
“As I said I take full responsibility for the decision; if anyone has any issues, they should be directed towards me,” And it was only then he looked at Bugsy fully, properly, since he had opened his mouth. 
He could have swore he had never seen such complete and utter betrayal written across someone’s face, let alone directed towards him. Because he knew that’s what it was. He knew he had taken every scrap and shred of trust she had placed in him since that day she ran away from her own wedding and found herself stuck in that very same office, hugging him tightly with her sodden veil and even more soaked white dress, he had taken everything vulnerable she had ever given him and spat it right back at her. 
He felt like crying but before he could think too hard about it, he saw Emily walking down the hall and her own face was just as, if not more, devastated than his own and he knew he had to be the one to stay strong. 
Garcia’s head snapped to the doorway, the sight of it leading Spencer and Rossi to do the same, and Morgan’s face morphed into anguish when he took a look for himself. 
Because there, looking like a glowing beacon of everything they’d been missing in seven months, was Emily Prentiss, alive and well. 
She seemed lost for words, her eyes falling to her sister who seemed to force herself to look up at her from where she was staring in wide eyed terror at the table, as if she was struggling to comprehend any of this, or like the building was falling down around her and she was in complete fight, flight or freeze. 
But she did, she looked up at her after a second, her face unrecognisable to Emily for a moment, and it took all of three moments where she seemed relieved to see her, before it curled into a vitriolic anger Emily had never, never seen from her. 
She looked like she was ready to kill her with her bare hands herself. 
Penelope was first out of her seat, practically flying across the room to grab her close friend in a hug, a complete bubble of sobs and wails, her pigtails shaking with her rattling chest as Emily hugged her tight to her. 
“Oh, my god, it’s real-you’re real- like I can actually touch you and you’re safe and not in that god awful box-” Penelope was a catalyst for the rest of the team standing up to take their turn crying on the woman’s shoulder. 
That is, the rest of the team except Bugsy. 
She remained in her seat, her gaze falling back to the mess of files that all of a sudden felt a complete waste of time, felt irrelevant in the grand scheme of things. Who cared who was Doyle’s financial advisor between the years of 2005 and 2007 when Emily was alive and they had known the whole time. 
And the more she thought, the more furious she got. And then the more furious she got, the stiller she became; an atomic bomb ready to detonate at the slightest prod. 
“I am so sorry, I really am,” Emily said as Spencer had wrapped his giant arms around her tentatively, smelling her perfume and feeling his heart ache with how warm and alive and healthy her body felt. “Not a day went by that I didn’t-”
But a sound cut her off, one none of them were expecting in the slightest. 
Bugsy was laughing. 
Not the sweet chirp she normally gave, or the hearty one that came from her gut that they hadn’t heard in months, but something manic. Something frenzied, beserk. Deranged. 
Hotch’s head snapped to her, Emily’s too, though she had already taken note of the fact her sister hadn’t so much as moved from her feet, and stupidly she had hoped it was the shock sinking in. 
But her eyes were cruel, her teeth more of a snarl than a smile and the laugh she gave was that of a person over the edge. 
The straw that broke the camel’s back, she believed it was called. 
“She never made it off the table,” Bugsy imitated woefully, her eyes snapping to JJ, who felt smaller than she ever had under the hatred in them, though the girl’s nasty smile hadn’t let up, “You are good, Jennifer. You really got me there, hey maybe if the agent thing doesn’t work out then acting is alway an option for you,”
“Bug-” Hotch started, only for her to stand up so harshly her chair nearly tipped back, but she didn’t seem to care as she rounded the table towards him in a bitter chuckle. 
“And you! I didn’t know you had it in you. But very good, Hotch, very well played out. For a second I thought you actually gave a fuck about me,” She fist bumped his shoulder, a little harsher than something innocent behind it, before something spiteful settled in her tone, “But then again, you are nothing if not professional, aren’t you? I guess a suicide on your team would look terrible on your report card,”
“I think you need to calm down and let’s talk about this for a second,” Hotch tried to jump in, his brows furrowed enough to make him look annoyed but anyone with two eyes could see the worry that brewed there, that chased her as she retreated to where her jacket was slung over the back of her seat. She laughed again viciously, shaking her head. Grabbing her coat, she headed for the door where Emily stood helplessly, not knowing what to say for the best, and she thought for a minute her little sister was going to address her. 
But she didn’t; didn’t even look her way as she approached, and it wasn’t until Hotch rounded the room after her with a fixed gaze she showed any sign of stopping. Not until he reached for her arm with a tight grip, a call of her name, did she even halt in her step. 
“Stop, let’s just talk,”
“Let go of me,” Bugsy snapped, and it was the first time she actually gave way to the anger she felt, the amusement coming from a place of distraught long gone. She sounded pissed.
“Listen to me, we had no choice here,” Hotch barked, because it was the only way he could communicate when he felt this lost. And that’s what he was; he was losing her. They all were. “And I would have thought you’d be able to stop being so spoiled for one god damn second to see we were protecting-”
Her palm whirled around faster than he could have ever anticipated, slapping clean and sharp against his cheek, hard enough the air was sucked out of the room and his words died in his throat. 
Penelope gasped. Spencer’s eyes widened. Emily took a heavy gulp. 
“Bugsy!” Emily said in horror, and it was then her little sister’s eyes actually set on hers, every bit as cruel and hateful she’d expected.
“I want nothing to do with you, do you hear me? I don’t want to talk to you, or see you, don’t even speak that name, I don’t want it from you anymore,” Bugsy pointed at her with crooked, bitten nails Emily knew all too well, “You left me. You left me.”
With those three choked words, the other’s could only watch hurricane Bugsy whirl and burn and crash her way out of the room.
She sat on the steps to the federal building, perfectly dressed agents filtering around her with the occasional tut in disgust. 
She couldn’t really blame them; her face was wet with tears, she was pretty sure there was snot running out of her nose hastily, and between her free hand, the other of which was pulling at her hair, was a cigarette that swirled its grey smoke around her head with a horribly addictive smell. 
She heard footsteps approaching her from the back, different from the rest, and felt someone stop beside her, sliding to their ass on the step.
“Spencer, if you’re going to tell me this is taking seven minutes off my life then please can it wait for another day-” Bugsy started with a tearful cadence, only to be cut off by a woman’s voice. 
“I was actually going to ask if you had a lighter,” Erin Strauss said, pulling her own menthol cigarette between her lips, and Bugsy dug around her pocket for the cheap ‘I <3 Virginia’ lighter she had snagged on New Years, clicking the flame out long enough for her boss’s boss to light the tip, “I heard you gave Aaron a shock,”
Bugsy stayed silent, taking a drag that burnt her lips and tasted awful, but it was the only thing she could turn to that would calm her even in the slightest, even if it was just the chemicals.
“Bit of an understatement,” She mused, exhaling softly with a frown, “Did you know?” 
“Are you going to slap me too if I said yes?” Erin asked, and Bugsy gave a small, wet chuckle, shaking her head, “Would it matter if I did?”
 “No, I guess not,” She replied, breathing in through her nose, “I want to feel sorry, but all I feel is just … empty. Why did JJ and Hotch know what happened to her but she didn’t think to tell her own sister?”
“Probably because you’re the one she loves the most,” Strauss picked over the hem of her navy blue midi dress that had been pressed neatly just that morning, and now here she was sitting on the steps to her building helping a girl in crisis chainsmoke, “It was how she ended up there in the first place, right? Because she wanted to protect you,” 
 “She left me torturing myself for months that her death was all my fault; believe me protection was not what I needed,” Bugsy said harshly, her final drag reaching the brown stub, and she scowled as she doubted it on the concrete floor below her, tucking her knees up to her face and resting her head on them. 
Erin sighed, patting her on the back gently, not wanting to cross any lines for such a fragile girl, but not wanting to leave her entirely alone either. 
“Our most basic instinct is not for survival but for family.” Strauss quoted, taking one more breath of her own cigarette before she squished it under her heel quickly. “Paul Pearsall,”
“What’s that supposed to mean?” Bug asked quietly, tilting her head onto her cheek to look over at the woman.
“It means you can hate her as much as you can right now, but sooner or later, you’re going to need her, or she’s going to need you, and you’ll wish you never pushed each other away,” 
2. The one where you pretend to be a couple.
Her hair was shorter, Bugsy noted, where she saw the back of her sister’s head from her desk. It looked nice, not that she would tell her that. 
She wouldn’t tell her anything. 
It had been eight weeks, three of which Bugsy had spent taking a leave of absence and been forced to see the designated federal councillor for her behaviour towards Hotch. She had gone to the handful of sessions to keep him off her back, but had stayed quiet for most of them, except the one where she got the psychologist to tell her the dirt on her recent, messy break up so they’d have something to talk about at least.
She had only really been speaking to Spencer the weeks since she had returned to work, had handed the slip of paper that declared her fit to work to Hotch with a smug look on her face, daring him to extend her sick leave as punishment for the tantrum she’d thrown. 
She knew it was dragging, knew most of the team were at least trying to adjust to the shellshock of Emily being back from the dead, but then again, the rest of the team hadn’t been writing their own eulogy so the burden wouldn’t fall onto someone else if they ever found her unresponsive. 
In the time Emily had supposedly been dead, her mind had wandered someone cold and dark and alone. Worse than any of them had ever thought it had been, worse than they gave her credit for. 
Only for it to be fake. As though she was the star of her own Truman show, with a laugh track playing on loop in the back; her own friends, people she’d considered family, watching her kicking and screaming and fighting through every breath for some sort of relief from the pain, a pawn in their little sitcom of horrors. 
Morgan had forgiven her sister with little resistance. She’d always known that, to Morgan, trust was higher than anything in his books. Yet with some soft words and tears shed, Derek had cracked and accepted Emily back warmly like nothing had happened. Rossi and Penelope had just been happy to see her, happy to have her back and very much not dead, so convincing them she was innocent had been no big feat. The only other person who had put up nearly as much fight as her had been Spencer. He had told her about the spat he and JJ had gotten into for being an accomplice to their pain, but even he was beginning to warm back up to her sister, not that she could really blame him. 
Emily was putting in overtime trying to get back into her good books, while she couldn’t even stand to look at her without remembering how hard she’d cried when she realised Nico and Sergio would be in her apartment alone and confused if she had been sad enough to do something rash. 
“Good Morning,” Emily’s voice was nails in a chalkboard, two arms winding over her shoulder to plonk two take out coffees in front of her and Spencer, one with his name written in black ink on the lid and the other with a dozen hearts dotted over the cup, a little doodle of a lady bug and a bumble bee cuddling. What she supposed was meant to be the two of them. 
Spencer watched Bugsy fight the urge to roll her eyes, surprisingly somewhat progress for her since the first two weeks of Emily even being near her resulted in the two of them screaming at one another until they were separated. Emily was growing tired of being punished for trying to keep her sister safe, Bugsy was full of hatred for every lie they had told her. 
But he saw the way she immediately knocked the coffee into the trash without a second thought, ignoring the fact she would need to take out a very heavy and wet bin liner later, if only to drive the point home to her older sister. I don’t want your charity. 
Emily faltered for a second, her eyes snapping to him as if he could do or say anything to help her out, but he could only give her one of his awkward, straight smiles, because he had absolutely no intention of pushing Bugsy to heal any faster than she was doing like everyone else was, nor did he want Emily to feel like he didn’t care she was hurting too.
Emily gave a resigned nod, daring to pat her sister on the shoulder. “Better in the trash than thrown over my face, right?”
She moved away from the woman’s desk, shooting a disheartened look at Reid as she passed him and he murmured ‘thankyou’ for his own coffee, until the sound of JJ calling them into the round table room cut off whatever she was going to say back. 
Spencer thoughtlessly handed Bugsy his own latte, smothered with caramel and cream the way he liked it, and she took an appreciative sip without a word. 
He hadn’t brought up that night, hadn’t spoken about the way she’d pressed her lips to his for a split second the night Morgan had dragged her over to his apartment to sober up. And because she hadn’t brought it up either, he assumed she didn’t want to talk about it anymore than she wanted to talk about what had got her there in the first place. 
He had helped her brush her own teeth more than once in the early days of her grief, hell he had even had her lips against his, so when she handed him the coffee cup back, he didn’t think much of it when he continued drinking the hot caffeinated goodness. 
Bugsy was wired differently in his brain, everything about her was different than how he felt about everyone else. So if she didn’t want to talk about kissing him, if she wanted to forget it ever happened, then he would swallow his feelings and accept she didn’t ever want to do it again. If she wanted to keep the bond they had carefully crafted through days and months and weeks of being each other’s solace, then he wouldn’t fight it. Because he didn’t want to ruin it either. 
He just nudged her gently with his shoulder as they meandered up the stairs to the round table room, looking at her with the puppy dog eyes that usually followed her around when she was in one of her silent moods. 
“You okay?” He asked carefully, noting the way she tugged her files to her chest, smiling up at him nevertheless. Because she could never be mad at him, it was Spencer. 
“You don’t have to do that, you know?” She said, lowering her voice as Morgan trailed behind the two of them his own mug of fresh brewed coffee sloshing in his hand, “Pretend like you don’t forgive her for my sake. I want you to be friends again if that’s what you want,”
She’d noticed his sheepish glances when he met Emily’s gaze, unmoving from her side like he wanted to make it clear he was there for her above everything else. But she saw how he would smile and joke with her sister when he thought she was in the bathroom, or when they would return from a crime scene, working together again like a well oiled machine. 
They were still friends, even if she felt sick every time she saw her sister’s noir black bangs flick her way, even if her heart was aching and her chest heavier than she would have ever let on. 
“But you’re upset with her?” Spencer muttered back, with a frown on his face, “I’m upset you got so hurt by the whole thing. I’m essentially hurt by proxy,” 
She snickered, leaning into his side for a moment, pulling away when they reached Rossi’s office and began walking past the long window she saw everyone settling down behind, “I appreciate that, Spence, I do. But you were her friend first, and she’s my sister. It’s different for you guys. And it’s not like we’re dating, because then I’d be allowed to be upset if you were still friends with her,” She explained lightly, though she felt her chest pick up at the very fact she had let that silly little dating word slip past her lips. 
She had no idea where they were. He was the only thing keeping her together some days, the only one who understood her for all her silly, complex feelings and didn’t make her feel dumb or crazy for feeling the world so deeply. He was special to her in a way no guy had ever even come close. 
She just wished she hadn’t made such an idiot of herself that night with Morgan; wished she remembered anything of what was said or done, because things had felt electrified since then and she had no idea why. All she knew was she was falling harder for him every time he stood so close, or offered her his drink, or every time they had a movie night at his and fell asleep on his couch pressed together like they were meant to be that way forever. 
He sighed, still stuck on the situation, and shot her a frown, “I’ll never understand the rules,” Though he hoped she didn’t see how his cheeks tinged pink at the fact she’d brought up whatever it was between them too. 
Because he wasn’t entirely talking about her and Emily. Sometimes, he really didn’t understand the rules of telling your best friend you were in love with her. 
-
The press was calling him “The Circle of Eight killer,” no matter how much media liaison JJ had tried to do to stop them from giving him notoriety and possibly boosting an already inflated ego. But the team had already managed to profile that the killings were some sort of ritual the UnSub was using to turn his luck on a gambling addiction, or whatever suspicion he had mentally linked from the victims needing to die and being dealt a royal flush. 
“Eighty eight dollars, the UnSub’s getting generous,” She said grimly, her gloved fingers counting the wad of cash tossed over the victim’s body. Where they had usually found eight, single dollar bills and an eight card of any suit, his signature seemed to have changed on the most recent body and he had dumped a much larger sum of money, “There’s more remorse with this kill too; shot from behind so he didn’t have to see the victim when he did it,”
Bugsy slipped the cash into a clear baggie to send to forensics to see if they could pull prints, but then again bills usually gave a million possible UnSubs with how many people touched them. “There’s less rage here, an undoing,” Emily chimed in, her own gloved fingers checking the victim’s pockets for anything off. 
When they were in the field, Bug could hold her eye rolls and sharp tongue and resting bitch face for the sake of helping the victim’s families find closure. Because, despite how much she seethed in private about how Hotch, JJ and her own sister had conspired without her, she knew she could choke it down if it meant she could help someone, if it meant no one else had to grieve as deeply and gut wrenching as she had when Emily ‘died’. 
“There’s no sign of robbery either, wallet is still intact except his ID,” Spencer added, standing back from the body while Bugsy handed the evidence off to CSI and the chief on the case headed their way. 
“Is it even the same guy?” Agent Goslin asked, looking between Hotch and Emily for an explanation, Hotch shaking his head with a stoney look on his already tired face. 
“The ritual’s too similar to discount,” He said, Bugsy frowning and tugging her lip between her teeth in thought. 
“The change in MO makes sense if the UnSub is still refining his system, maybe killing the cashier at the gas station didn’t work so he’s back to the drawing board.” Emily speculated, her little sister nodding along with her in the first sign of agreement she’d seen all day. 
“Two eights instead of one could also be significant; I know in China the number eight symbolises prosperity, the more eights the better. As a matter of fact, in Chengdu, a telephone number consisting of all eights recently sold for over a quarter of a million dollars,” Spencer said, and Bugsy flashed a look up at him, her eyes thoughtful. 
“In ancient Egypt, the number seven represented completion in this life while the number eight represented success through ambition and determination in your reincarnated life,” She replied, peeling the gloves down her hands as they clung to her skin with tight clamminess, “And the eight pointed star is associated with the Babylonian goddess, Ishtar, or the light bringer,”
He nodded with her and he hated to admit that he loved that she managed to fill in the gaps in his own knowledge, like they were two puzzle pieces finding a way to fit together; like they were two halves cleaved from the same brain that hadn’t stopped growing in the entirety of her twenty seven years. 
That, and he’d always found her brain one of the most attractive things about her. One of the long list he could think of. 
“Why would he be doubling up on his luck out here, away from all the casinos?” Emily asked, because she was trying not to stand in awe of her sister’s fat brain that rivalled even their pretty boy. 
“There’s been another killing,” Agent Goslin stated, hanging up the phone with a tense frown on her face, “A guest in his room at the Sapphire Lady,” 
“Same ritual?” Hotch asked without a pause, because they were on body number five now and they were barely closer to understanding him than they were a few hours ago.
“No. His neck was broken. And he was robbed of $50,000.” Goslin replied, shaking her head, “Strange thing is? The killer left another $20,000 behind with the body,” 
“Money isn’t his motive here,” Bugsy input, crossing her arms while Hotch got on the phone to Garcia, “Atleast, not that guy’s money,”
“Garcia, is there a casino in the neighbourhood of Penrose and Morningside Avenue?” He asked, clicking the perky woman onto speakerphone. 
They heard a quick clatter of typing, “Uhhh, No casinos per se, but there’s a private gambling establishment right around the corner.” She replied helpfully, with another bout of her long, delicately painted nails against her keyboard. 
“Is it legal?”
“Yeah, but it’s ultra exclusive. They have a monthly high-stakes poker tournament,” She paused for a second, “Today being the day for the month, coincidentally enough,”
“Or no coincidence at all,” Emily said, as they began putting together exactly where this chain of events had come from.
“What’s the buy in?” Bugsy asked, though she already guessed the answer. 
“Yikies, $50,000,” And with that Bug and Reid exchanged a knowing look, her suspicion confirmed, “But, it’s a million dollar guarantee if you win,”
“What time does it start?” Hotch asked, Bugsy already rubbing the bridge of her nose with her fingertip, willing herself not to be right about what they were going to do. 
“Later this evening,” Pen replied and Hotch thanked her, hanging up the phone. A second of silence spread around the crime scene. 
“So, if anyone’s got fifty k lying around, now would be a great time to share with the group,” Busgy humoured herself with a straight face, realising the paperwork that would almost definitely be declined if Strauss had anything to say about it the would enable them to borrow fifty thousand from the government. 
Because if they missed their chance tonight, she had no clue when they would get another. 
“Any luck?” JJ asked, Emily sat to her right, Rossi across from her. Spencer and Bugsy sat on the end of the table, the girl breaking a KitKat in half to share with him, which he accepted happily. 
“No, they don’t want to allocate emergency funds for the buy-in, I’m still working on it,” Hotch said shortly, his phone blowing up with messages, no doubt needing a lot more details if they were really going to get the money they needed. 
“Well, I can’t imagine why not, we’re only asking for fifty thousand bucks of taxpayer money, so that FBI agents can play Texas Hold ‘em,” Rossi drawled, shaking his head with a cynical humour that was all they had to hold onto while they waited in limbo. 
“Hey, what about you?” Emily asked, something mischievous in her eyes as she watched David freeze in his seat, so like the old Emily that Bugsy felt her stomach turn.
“What about me what?” David said with a frown, pausing in his writing for a moment. 
“You could stake us the buy-in,” She suggested, and the other three members of the team turned their attention back to Rossi’s palling face. 
“You’re a best selling author,” Spencer chimed in, devouring the last of the chocolatey biscuit snack as she pulled another out of her bag. 
“No,” Rossi replied, slightly wide eyed at the suggestion of it, to which Emily jumped in. 
“Why not?” 
“One, it’s against regulations and I’d like to hold onto this job for a little while longer.” David said, his arms out in a defensive stance towards the four people who suddenly felt like his kids asking for the newest IPhone on the market for Christmas. 
“It’s a minor administrative violation,” Bugsy pointed out between bites, offering the second half again to her best friend who took it without delay. 
She could have given the whole thing to him to start with, and had the first one for herself, it would have ended the same, but she liked sharing with him. She liked being the one to split things with him when he cringed in horror at other people touching his food.
“And, two, I prefer to spend my money on actual things, like single malt scotch, a fine cigar, beautiful artwork,”
“Poker chips are things!” Emily tried to reason, but it only ended with David scoffing in her cheeky, hopeful face. 
“Maybe just think of it as a new experience, I mean at your age how often does that happen?” Spencer said innocently, licking the chocolate from the tips of his fingers, noticing how Bugsy tensed up and Rossi slowly turned in his seat to face the BAU’s youngest members. 
“At my what?” He asked in an aghast tone, Bug grabbing onto Spencer’s forearm with a gentle squeeze. 
“Reel it in, reel it in,” She whispered, and he looked at her with a lost expression, willing her to explain to him where he had gone wrong, because he knew she would, “What he meant to say was this may be our only chance to get this guy,”
David chewed his words for a second, as if he was trying not to bite at the kids who looked between one another hopefully, and he wondered if this was what being a father felt like; handing his credit card over to two twenty something year olds and watching his bank deposit plummet in seconds. 
“All right. Fine.” He sighed heavily like he’d seen the fifty thousand burned there and then, “I’m a decent poker player, but I can’t promise that I can stay in the game long enough to…”
“You know what? I bet you’re a great poker player,” Emily started kindly, her gaze drifting over to the hazel hues that watched between them curiously, “But what if we sent in Reid?”
“I am banned from casinos in Las Vegas, Laughlin and Pahrump because of my card counting ability,” Spencer said, and Bugsy rolled her eyes. 
“They can’t ban you for maths, that’s the stupidest thing I ever heard,” She said, nudging his side with her shoulder, “They hate to see an underdog win, it’s Rocky all over again,” 
“Tell me about it,” He murmured back, even though he had never watched any of the Rocky movies, he just liked humouring her. 
“Look I know I’m not a genius like the boy wonder here, but poker is not black jack. It’s about bluffing; reading human nature, head games.” Rossi pointed at Reid, who badgered over Bugsy’s shoulder for the cookies she had packed in her rucksack, “The kid does not have a poker face.”
“Which is why we’re going to send him with someone who does,” JJ chimed in, and it was then that the youngest members of the team looked up from where they had cracked open the packet of chocolate chip delights, near identical looks of innocence painted on their faces, like they really were kids caught with their hands in the cookie jar. 
Bugsy looked between JJ and Rossi, who had equal parts hopeful and worried looks on their faces, before she glanced over to Spencer to see if he had any explanation. He looked as lost as she did. 
“Huh?” She asked cluelessly, as Rossi buried his head in his hands. 
At this rate was going to have to remortgage his house for wedding number four, he thought sourly. 
“I swear to god if this dress rides up anymore, it will be me who’s charging fifty thousand per head,” Bugsy growled, her hands frantically tugging the dress down her legs more. She couldn’t deny it was a beautiful dress, bunched around certain areas that made the most of her body, but goodness was it shorter than she would have ever picked out for herself. She was the last person to be a prude when it came to showing off just how alluring she could look when she made an effort, but this was something else. 
It was a striking red, meant to match the ruby of her lipstick and the vermillion of the diamonds and hearts on the cards spread around the tables in the room, flushed in between little plastic chips worth thousands of dollars, handfuls of dice being tossed over the green velvet surfaces, deciding whether the players lost their cars or paid off their kids college fund. 
They queued up to be patted down, as if they were heading through airport security or into a packed nightclub. A handful of bouncers waved metal detectors over patron’s clothing, dipping hands into coat pockets, trousers, even some shoes were ordered off in the name of a fair game. She swore she had never seen so many sets of weighted dice confiscated off one man who swore blind as he was kicked out. 
“Only fifty? You could rinse them for a hundred at least,” Spencer replied, his arm entwined behind her back, if not to hold her up in the clunky heels one of the women on Goslin’s task force had loaned her along with the dress. She smirked at him, pressing herself closer to him when they both saw a dozen eyes shoot towards her as they entered the building, and he tightened his grip just the slightest with a calculating coolness. 
He wished his cheeks didn’t feel so hot feeling her body so close to his, wished she hadn’t made such an effort to look the part of the expensive call girl they knew the UnSub had a history with, not because he didn’t like it, but because she made everything a little more difficult when she looked like that. 
He was having a hard time trying to calm the way his manhood brushed against his pants whenever she showed some of that saccharine affection, even though he knew it wasn’t real. Or atleast, was an extreme version of the love she usually showed him. 
The bouncers called them up next, and he let her go first, because getting her through would be easy. He was the one with the panic alarm disguised as a shot of Halitosis in his pocket. 
Spencer would never admit that his eyes fell straight down to the curves of her butt that seemed to be spotlighted by that damn dress. 
Why did she have to look so irresistible? He supposed that was the point; he was the mysterious young gambler that was going to keep them in the game long enough to spot the UnSub, she was the attractive, woman of the night brought only to boost his ego and as his good luck charm. She certainly wasn’t the only one, she’d already seen a handful of other women, tall as models and so toned it looked as though they hit the gym every morning and didn’t leave until sundown, primped and primed for their player’s delight. 
They were ten times better looking than she was, but to Spencer, she was the only woman in the room who he was envisioning ripping that dress right off. 
She was making it very hard, no pun intended, for him to accept the idea of them as just friends. 
The bouncer patted her down, Bugsy flashing him a cheeky smile just a little too forced for it to be one of her real ones, when the woman patted around her waist and hips for any hidden pockets or stashed bills. 
“You wish this was you, huh, baby?” She teased him with a wicked look in her eyes, and he could only smirk back, hoping his blush didn’t give him away as quick as he reckoned it did. 
He felt his knees weaken, worrying he might just fall to the ground there and then and be forced to crawl towards her if he had any hope of getting into the casino alive, but even that sent a new wave of lewd thoughts through his head, and he was grateful when the other bouncer called him forward to inspection. 
The muscled guy waved a metal detector over his torso, moving down to his trouser legs where he wondered with cynical humour if the rod he now sported in his pants painfully would set off the alarm. It didn’t, and he begged his crotch to let up even the slightest if he had any hope of keeping his head on his shoulders during this game, but the detector sprung to life the minute it waved over the alarm in his pocket. 
He produced the medical looking device, one they’d already planned and checked for faults, showing the fake prescription clearly to the guard, “Halitosis,” 
The guy seemed to frown, took another look over the gangly guy who was with a woman way, way out of his league. A woman who waited for him after her own inspection, a very real diamond necklace that had been a sixteenth birthday present from Steph around her neck, courtesy of her dad’s bank account and ten years worth of emotional distance. Whether he took pity on Spencer because Bugsy looked like the kind of girl who could chew up a guy like him and spit him right back out, or he really didn’t care about his medical condition, he didn’t know, but he waved him through without another thought, and they both took a sigh of relief. 
“You want a drink?” He asked nonchalantly as possible, wrapping his arm around her waist again, and he tried to not let his flustered demeanour show when he found slits cut into the side of the fabric, and he felt the softness of her hips under his fingertips. 
“My treat, to get you started,” Bugsy replied, something unreadable in the teasing of her eyes, and she leaned up to his jaw to steal a quick kiss there like any other girl wanting to be paid the full sum of her night would have done. 
At least that’s what she told herself, pretending as if her brazen action hadn’t caused her heart rate to spike. 
She got him an iced tea, because she knew he wouldn’t want alcohol, and got herself a half shot Moscow Mule, sipping the lime rim appreciatively. 
“See anything yet?” She asked under her breath, one hand trailing over the back of his neck, playing with the curls that sat there with vixen sly eyes that scanned the room. 
He forced himself not to moan at the sensation, and he worried it was too obvious to the other patrons in the gambling room just how easily he melted beneath her fingertips. He felt like a dog drooling after a bone, like she was shaking a lead in his face and asking for walkies, and he was panting beneath her, tail wagging and dopey eyed. 
Not the look of suave, mysterious stranger they were initially going for when they were coming up with identities for their covers. But at least it sold the part of a man desperate to win the jackpot if it meant he could spend the night with the siren woman that clung to him with a giggly sip of her pink straw. 
“No one looking particularly suspicious,” He noted; everyone was almost too good at a poker face, though he supposed that it made sense seeing the value of the prize pool, “You are getting a lot of attention however,” 
And she was. In fact, he was quick to take her hand in his own free one when he saw a group of men dressed to the nines, solid gold rings along their knuckles, diamond encrusted Rolexs staring back at him from their wrists, their faces dead yet starved when they drank in every inch of her skin, their eyes falling to where her dress rode up high, as she had whined about the entire way there. 
She chuckled, and something about it sounded like her own, not the woman she’d had to become for the evening, and she kissed where his jaw clenched in annoyance, “Not from anyone that matters, boy wonder,” 
And he felt his heart rest for a moment, because as long as she was with him he knew he could shift that big brain of his into gear. He loved nothing more than the click he felt when he was with her, like their brains and bodies just seemed to bluetooth to one another and they weren’t Spencer and Bugsy they were just them. A since cell amoeba. 
He smiled at her, and she preened under his attention, so genuinely her that he felt the vignette that had clouded his vision shift into focus, and he knew he could find their UnSub if she was there with him. 
He sat at the nearest table to them that was about to deal in, and within twenty minutes he was racking up a nice, fat pile of poker chips next to his iced tea.
Bugsy knew he was a smart man, knew he was good at magic tricks, but if he had turned to her then and there and pulled a rabbit out her ear hole she wouldn’t have questioned him otherwise. Watching him play was something else. 
It was entirely sordid, the whole hour of his first game was spent trying to keep her focus on any patrons sat at their table and the rest that seemed to be twitching, whilst also trying not to look awed at just how amazing his brain was when he won damn near every time. 
But she did manage to rip her eyes off him when she could, not enough to seem suspicious, just enough to scan the area for someone who could be their UnSub, her eyes quickly jumping to the guy on the table across from them with a large magic 8-ball tattoo across his bicep, unsurprisingly already looking her head to toe as he waited for his hand to be dealt out. He winked at her, a smarmy, cocky grin on his face, almost too confident in his ability to be someone to turn to suspicions and rituals in order to win. 
A serious contender, but nothing that screamed their UnSub. 
She looked around a little more, ignoring the handful of men who tried to grab her attention, who thought they were somewhat validated or interesting for having her look at them for a split second. They were just part of the wallpaper compared to Spencer anyway. 
It wasn’t until she spotted a guy in a baseball cap a few paces away from them fiddling with yet another magic 8-ball, though this time a key chain, giving it a gentle touch every time he picked up his hand as if it really had the power to change the values once they’d been dealt. 
From the quick glance she got of his face, he seemed to be running on an hour’s sleep tops. His eyes were rimmed redder than her lipstick, and his hair was damp with sweat and grease against his temple. 
Unstable if there ever was a man for the word.
She quickly looked back to Spencer’s cards, her hands weaving over his shoulders to rub his muscles gently, the signal that she’d seen something important masked as an affectionate gesture. 
The House called the end of the round, Spencer being awarded a heaped pile of tens, hundreds even a small few thousands thrown in there, to which he collected onto his tray they had handed him at the door. 
Bugsy leaned down with a girlish squeal, giving him another big, cherry lipped kiss to his cheek, to which he felt himself blush under immediately. Quickly dodging to whisper into his ear, it looked to the other patrons as if she was simply promising him an even bigger reward later for his winnings in exchange, “Nine O’Clock at table two, guy in the green jacket has an eight ball keyring he ritually plays with before drawing,” 
Spencer nodded, standing from the table with his winnings, using Bugsy’s as an excuse to angle himself to where she was talking about. He pulled her to him effortlessly, his long arms wrapping over her bare back, his neck craning over her shoulder to serveill the table she had indicated, and she quickly hugged him back with that fake giggle of hers, her body pressing to his desperately like the other ladies of the night he had seen with men three times their age. 
He clocked who she was talking about almost immediately, running a hand down her spine and squeezing her waist gently to let her know he’d seen him. 
They moved in tandem, just like they always had. 
A hostess came over to them, all big smiles and a tight fitted black dress, a log book in her arms of where everyone was sitting in the next round to keep a fair game. Bugsy took a look at him, wiping away the smudged lipstick on his cheek with a loving swipe of her thumb, nodding at him for a small bout of reassurance. 
“I’m going to go get another drink, honey,” She said loud enough for the hostess to hear, as she flashed him a flirty smile, “Don’t forget to wait for your lucky charm,” 
He bristled, a smile twitching at his lips at that, “I wouldn’t dare,” 
Because her message was clear. Don’t do anything stupid while I’m updating the team. 
She swanned through the crowd as if she owned the place, but then again a packed scene had never been an issue for her. She felt through her concealed inseam of the tiny cardigan she draped over her shoulders, until she felt the long bullet shaped object stuffed into a tampon wrapper that Penelope had geniously planted there to look like a feminine product. 
Her own alarm, the one meant to let the team know they had sights on the guy and to be ready. It was Spencer’s that would give them the signal to enter. 
She was fiddling with the damn thing when she felt it, a sharp crack across her ass as she was walking towards the bar, heard the laughter in the second she froze up. 
Turning on her heel with a tight expression, the anger burnt hot in her eyes when she saw the guy with the tattoo who had been trying to get her attention not even a half hour ago, watched him sidling up to her with a conceited smile. 
“So, has that twiglet over there paid for you in advance or are you going home with the highest bidder?” He said, his head flicking to Spencer who now sat at table two, counting his chips out onto the table and paying himself in. 
She smiled at the assailant widely, and it would have been pretty had it not been for the crazy look in her eye that twitched when he made a move to step towards her more. 
“I’m spoken for in advance,” She said lightly, eyes trailing down his outfit like she was trying to commit it to memory, over his defining markers like the slit in his brow and his tattoos that looped over his hands, “But I’m sure I’ll be seeing you real soon, sweetheart,” 
And she flashed him a toothy smile again, yet something was wolfish about it this time, like she was ready to lunge for him there and then. 
The guy wasn’t their UnSub but he had made it to the very top of her hit list in a split second decision. 
She waltzed away, securing herself another Moscow Mule she had no intention of drinking, and headed back to where Spencer was being allotted his hand of cards.  Their round started, Bugsy keeping a close eye on the UnSub who sat directly to Spencer’s right, and she found a little solace in the fact he couldn't have brought in any weapons since they had all been patted down at the door. 
It didn’t shake the feeling of edge the guy with the tattoo had put her into when she watched their guy flick a look over Spencer’s shoulder to look her head to toe, glancing back at Spence who was already glaring at him. 
“Is she part of the winnings?” The other guy to his right chimed in, sliding a stack of hundred dollar chips into the centre, two of the players already bust as they watched the others play on for the house. 
She saw her partner tense in his spine when he heard the man’s drawling voice, and she knew he was struggling to keep a lid on the facade they were putting on for the evening. 
Snickering, she ran a gentle hand through his hair, down the nape of his neck with a sickeningly sweet simper, “Sorry, boys. Only person who’s taking me home tonight is the pretty boy,”
One of the guys who had already busted out scoffed, grumbling under his breath, “Lucky fucker,”
And Spencer knew it too. He felt almost rejuvenated just feeling her near, a damn near cocky smile on his face when he pushed his chips into the centre of the table, barely flicking a glance at his hand when he realised he had almost certainly secured a winning run. 
Maybe she was his lucky charm, he thought cynically. Maybe he couldn’t blame the guy to his right for carrying a silly little trinket around with him in the name of luck if he was no better. 
“I’m calling,” The guy on the far right declared, shuffling two piles of his chips into the middle with the total pooling. 
“I’ll raise,” The UnSub cut in, grabbing some of his black thousand dollar tokens and clinking them one by one next to his opponents, “Eight thousand,”
What a surprise, eight thousand, Bug mused, squeezing onto Spencer’s shoulder again as he was quick to match the bidding and then some with his own checks. 
“$8,000, that’s fifty six months’ wage for the average person in Bangladesh,” Spencer said, doubling the bet with a flick of those long fingers of his. It was heinous how much his brain managed to warm her insides, Bugsy thought, hoping she kept her poker face intact, “Kind of makes you think, doesn’t it?”
The two remaining players, UnSub included, looked at him like he’d grown a second head, and Bugsy fought off the urge to laugh in their face, because for a minute he was so Spencer like all she wanted to do was quip something back equally as smart. 
“Look, it’s eight thou’ to you, are you in or are you out?” The first man snapped, perhaps seethin with jealousy that the pretty woman wanted nothing to do with him or perhaps just pissed that the fresh faced teenager of a man was serving their asses up cold. 
“I am in,” He moved some more chips towards them, his eyes falling back to the guy they suspected was their UnSub with a challenge in his eyes, “And I raise,”
“Three raise,” The dealer declared, and the first guy huffed in defeat. 
“That’s too rich for my blood,” He growled, crossing his arms and flipping his dead cards over. 
“Sir, are you in?” The dealer asked the UnSub, and for a minute his eyes snapped to Bugsy’s where she was keeping a calm look on her face despite the fact her insides were stumbling with nerves. But she never doubted Spencer’s maths, she would stake her life on it in fact. 
“I’ll call,” The UnSub replied, flicking his cards over with another small token of a hundred, an okay run of cards but not an entire failure. 
Spencer met it with a couple hundreds of his own, revealing his four and his eight that met the five, six, and seven he already put down. A winning flush. “Straight.” 
Her smile was genuine, dazzling, when the pile of chips were pushed over to him, and she would have laughed with glee had the UnSub’s face not dropped into something devastated, borderline demented, when he saw his ritual had meant nothing. That he had lost despite killing his own friend and four more people as a sacrifice. 
He was unravelling fast, and it was then Bugsy knew they had only moments to confirm he was their guy obsessed with his suspicions and that damn lucky number eight. 
“I guess you won’t be needing this anymore, will you honey?” Bugsy reached over for the charm with a cheeky grin as the other patrons grumbled at their losses, only for the guy’s hand to come slamming down on top of hers with a brutal grip, hard enough she knew it was going to bruise by morning. 
“Don’t,” He hissed at her, and it seemed to click with confirmation in Spencer and Bugsy’s mind there was no doubt this was their guy.
Spencer stood up to defend the woman, only for both of them to be grabbed by security second’s later. 
“You’re going to let a man put his hands on a woman like that- would you relax I can walk,” Spencer snapped, watching the other security guard manhandle Bugsy just as roughly, pinning her arms behind her back, though she complied with a victorious grin, “Real tough there pal, grabbing on a woman half your size,” 
“Relax honey, I got a taser in my pocket if they really want to behave like bad boys,” The bouncers looked at her in alarm, and it was the distraction Spencer needed to reach into his jacket and trigger the signal. She gave the three of them a shit eating grin, and Spencer thought he might just love her even more, “Don’t shit your pants, I’m kidding. I charge extra for the rough stuff,”
Spencer was still laughing when Hotch and Emily barged past them after the UnSub, who was by now leaving out the back door. 
“Spencer, really, we can go back to the hotel and forget about it,” After revealing their cover with the bouncers, courtesy of one David Rossi and his famous face clearing their names, and the UnSub caught and well on the way to the nearest jail cell for questioning, Bugsy was more than tired and ready to strip out of the impossibly tight dress. 
“I want to see this guy brought to justice, think of him as another UnSub,” Spencer said, his arms crossed over his chest as they sat on the bonnet of a squad car out the front of the building, the tournament slowly trickling to an end with its patrons leaving for the night. 
She rolled her eyes, his jacket over her arms the only thing keeping her warm against the evening air. It would have been so much easier if they had been allowed back in, but FBI agents or not, the guards had clear rules against breaching the peace in such a high stakes game. A bad rep for having the feds show up on their busiest day of the year was not welcomed, just as much as they weren’t. 
“Except he’s not murdered anyone,” She replied, eyes darting between the guests leaving with their earnings spilling out of their pockets, “He’s just some dumb asshole who can’t keep his hands to himself and- it’s him,”
The guy with the tattoos, Mike Folio as would later be printed on the police report, had barely a second to grieve his losses of the night before Spencer had him cuffed against the squad car, yelling and spitting about his rights as an American citizen. 
It wasn’t until he saw the gorgeous woman donned in the candy red dress looking down at him with amusement that he felt the colour drain from his face. 
“Hi sweetheart,” She smiled viciously, “I told you I’d see you again. Spence, read him the Mirandas,” 
3. The one with the bank explosion
The tweed trousers irritated her thighs, the head band fluffed her hair away from her face in a way she kept trying to fix, and the brown pumps squeaked every time she walked, but her smile was dazzling nevertheless. 
“Okay, the TV movie is at Hall H at nine, can we go to that?” Penelope asked, reading from the pamphlet as Bugsy and Spencer all but ran to keep up with her. 
“Absolutely!” Spencer chimed in, “Do you think we can make it to the Captains of Enterprise at eleven?”
“Obvs,” Penny replied, fixing the bow tie necklace her and Bugsy had made not even the week before. She looked over at the younger woman, who had a matching K-9 pendant, because apparently FBI salaries did not take into account life sized robot dogs, “Thanks for coming with me,” 
“Ofcourse, I’ve been knitting this scarf for weeks,” Spencer replied, his eyes falling down to where Bugsy donned a Sarah Jane Smith cosplay. 
“Who are you going as?” She’d asked, the minute he’d asked her to go, because there were few things he did these days without her. 
“The Fourth Doctor,” Spencer replied, because he had explained in length to her about the concept of regenerating and had even flicked on some of the newer series for her to watch with him, “Tom Baker’s Doctor, he’s a fan favourite,” 
He showed her a picture of the time lord stood outside the TARDIS, a younger girl stood opposite him in a pink suit, large white peter pan collar hanging wide over her chest. 
“Who’s that?” She asked, pointing the girl with the cute bangs and pleated skirts. 
“That’s Sarah-Jane, or Sarah-Jane Smith. She’s one of the longest starring companions since she was the Third Doctor’s companion first and also was in the spin off show for her dog, K-9,” He explained, warming inside when Bugsy listened with raptured interest. 
“So like, is she his girlfriend or-”
“No, no! The Doctor is often speculated to be asexual when it comes to relations with humans. Sarah Jane was one of his closest friends however, and in the Tenth Doctor’s third season he even comes back to rescue her from a wedding set up by one of his enemies,” He said, and her smile pulled out widely when an idea popped into her head. 
“Well, can I be her? For your convention?” She asked, somewhat shyly, still a little unsure how the show worked in the fine details, “You know, since you saved me from my wedding?” 
He paused, because she’d never really spoken about that day she’d jumped into his arms in the elevator, holding him to her like he was the only thing that made sense. Bugsy was like that alot; giving him everything he ever dreamed in the moment and then acting like it was never a big deal the next. 
“S-sure! Yeah, that would be really nice.” He said, and she immediately started searching up what she should wear for it, “I didn’t really save you though, you know, you saved yourself,”
She snickered, nudging him with her shoulder, “You all saved me, I don’t know what I would have done if Em-” She stopped herself, swallowing thickly, and he saw the glow leave her eyes. 
If Emily hadn’t been there. 
Things were still awkward between them. There were no more catfights, thank goodness, though there also wasn’t any doting between the sisters anymore. It was like a clean break had slit between them. Emily had given up trying to warm to her, given up trying to get her to come around, and had instead taken the high road of waiting for Bugsy to make the first move. 
But Bugsy was nothing if not stubborn. So Emily would be waiting a while longer. 
“Hey, listen, next time I promise I’ll be the first one to object and then you can say I saved you,” Spencer joked, because he knew the subject of Emily stung her, because he knew she needed to stop thinking about it or she’d unravel into self hatred. 
She chuckled aghast, “Next time? I was kind of hoping to keep the next one, Spence, whoever the unlucky guy is,”
He shook his head, a fake look of disapprovement, “Sorry, rules are rules. You wanted to be Sarah-Jane, I have to crash your wedding with the TARDIS I’m afraid,” 
She laughed, resting her head on his shoulder as they flicked through the TV some more together. 
“Well, I mean if those are the rules,” She simpered, snuggling under his chin, “Does this mean I get a sick robo-dog too?”
She looked every bit the part he would have ever expected her to look. Down to the maroon tie, and the white dress shirt, and the matching tweed blazer and pants that made her look embarrassingly hot. 
He was about to tell her just how great she looked because she still seemed unsure, being a casual fan of the show not nearly as religious as some of the surrounding guests were, when Penelope cut them off in a near gutted voice. 
“Oh my god,”
“Penelope?” 
Bugsy and Spencer looked up to see Penelope’s ex beau, Kevin, dressed in a nearly identical outfit to her (though in Bug’s opinion he didn’t have the same pzazz as she did with the glitter and the sparkliness,) a red headed woman beside him donned in a police woman uniform. 
“Kevin, hi, you came,” The blonde woman replied, her face mortified as she took in just how pretty the other woman was, “And you brought a friend, CSU technician Sharp, how are you?”
Hannah Sharp, from two floors below them in the BAU, grinned tightly, as if she could sense just how disastrous the situation had suddenly become, “I’m fine, uh, you?”
Bugsy gripped onto Spence’s arm tightly, hating the turn this was taking, every second of it. 
“I am also fine,” Pen replied, though she looked as though she was ready to float outside of her body any minute now. “Okay, well, see ya,”
“You’re not gonna go in?” Kevin asked, his eyes crestfallen when he saw Penelope also grab onto the boy genius’ arm, and he cursed Spencer Reid for getting so many attractive women. 
“Actually, we just went in and it’s super lame,” Bugsy interrupted, flashing a disjointed smile at the two of them, turning to usher her best friend away before he could call her out in her lie. “So we’re leaving,”
“Oh, okay,” Kevin replied, his date all but forgotten as the three of them made a sharp exit, a wince on the youngest Prentiss’ face when they got far enough that the girl could cringe in peace, “Well, great costumes,” 
“Yeah, you too,” Penelope called back, her heels practically leaving tire marks with how fast she had sped away from her ex that was opening fresh wounds as they spoke. At work they were separated by a whole floor, so it wasn’t quite so scathing to see each other around or even hear of one another, but to be brought out in front of what she could only assume was his new woman was horrifying.
Bugsy was at her side immediately, grabbing onto her hand with a squeezing grip. 
“Well, that was awkward,” Spencer noted aloud, and Bugsy lightly slapped his arm for him to shut up, her eyes wide with worry. 
He looked at her in alarm, but her face told him everything he needed to know. Girl rules. 
He hated girl rules. He never understood them. 
“Oh my god, we used to come every year, I can’t believe he brought someone else,” Penelope sighed to the younger girl, who watched her with furrowed brows. 
“Well you brought someone else,” Spencer pointed out, only to have his arm whipped at again in a chiding motion, and he watched Bugsy stroke Pen’s back with a bite in her tone. 
“Girl rules, Spencer, girl rules,” He tutted at her, rolling her eyes as if they were a married couple and she was nagging him to wash the dishes. 
Sometimes it felt easy like that with them. Like she really was just his best friend and not the only girl who held any sort of romantic connection to his heart. 
“Yeah, someone I couldn’t possibly be attracted to,” Penelope stated, “Besides, he always thought the two of you were a thing anyway, oh god what if he thinks I’m your guys third-”
“Woah, woah, what?” Bugsy asked with wide eyes, “He thought me and Spencer were, like, dating?” 
Penelope nodded, and Bugsy couldn’t even look at him without stumbling over her words. 
“Well he knows we’re- like I mean we’re not even each other’s seconds so how could you be our third you know?” She said with a forced laugh, because she could feel her face going hot. 
Spencer watched her tongue tie herself into oblivion, thinking of any and every excuse as to why she didn’t want dating associated to the two of them. Because how could she ever feel the same way? He was just him and she was, well, her. So incredibly, beautifully her. 
It wasn’t until she bumped into an older gentleman waiting for his valet she even shut herself up. 
“And I mean Kevin shouldn’t have just assumed- oh sorry,” She whirled around to apologise the man she presumed was a fan of the early seasons of the show, perhaps even around when they first aired, though the thought died in her throat when he turned around, “Oh, Rossi?” 
David Rossi looked suave as ever in his age, a blazer thrown casually over his shoulder, a neat shirt and dress pants ensemble at his hips as he looked between the three of them, their costumes staring back at him entirely too colourful for a Saturday morning. 
He sighed, hard. 
“Why doesn’t this surprise me?” He asked with a tired voice, as Bugsy bounced back over to Spencer’s side with an incredulous look on her face. 
“Are you here for the convention?” Spencer asked, excitement bubbling in his tone as Bug grabbed his forearm gently, already sensing Rossi hadn’t had nearly enough coffee to put up with them today. 
“Who schedules a cigar aficionado event back to back with this?” Rossi asked, his eyes clamping on the pendant around her neck, “What is that, a robot dog?” 
“K-9,” The three of them replied, and it was as if it tipped him over the edge, his hair growing whiter by the second. 
“Kevin brought another woman, I’m plotting revenge. Do you want to help?” Penelope asked, her face still warm from running into the guy who was almost her fiance. 
“Know where we can get any horse heads?” Bugsy asked, her expression lost in though as Penelope gasped, “What? I’m thinking go big or go home. Also, horse head in the bed means they can't have sex-”
“I’m taking that as my cue to leave,” Rossi cut in, just as his valet arrived, “Now you know I love all three of you, but this is Saturday, and it is my day off, so I’m going to love you from afar,”
He ruffled Bugsy’s hair fondly as he took his leave, throwing his blazer over the passenger seat and bidding them a wave goodbye. 
They watched him go, wondering where it left them for a moment before Bugsy spoke up again, “So are we saying a definitive no to the horse head idea, because I’m sure I know a guy in college-”
“No, Bugsy,” Penelope hissed, her face scrunched in disgust, and Spencer swore she turned green, “Definitive no,” 
They had been half way through breakfast when Spencer got an emergency call from Hotch for a team of serial killers robbing a bank downtown, hostages and guns on scene. 
She had barely had time to whip the tweed blazer off her shoulders, keeping the shirt and pants on as Derek threw her a kevlar vest. 
“It’s definitely them,” Will said in his soft Southern drawl, JJ embracing him tightly to her with a worried expression. It had been him and his partner first on the scene, though unfortunately things had not ended well for her when they had ran into the three UnSubs slipping out the back of the bank and had engaged in a shoot out; Will’s partner getting a bullet to the head almost immediately, and Will narrowly escaping unscathed, but not before he managed to gun down one of the UnSubs in the stomach. 
So there they were, the UnSubs back inside the bank for safety since they were now surrounded by the city police, the FBI, the SWAT team and a handful of ambulances and medics on standby. 
“I only saw the King and the Jack but I figured the Queen’s inside too,” He added, JJ peeling herself from his side as they headed towards the building. 
“The media's calling them the face cards,” Hotch informed his team, all eight of them decked in their thickest vests and weapons loaded in full, “Seven bank robberies in seven months. They’ve killed one person at each robbery,” 
“MO?” Rossi asked, now dressed out of his smart, Saturday wear and something more akin to his usual business attire.
“Single gun shot wound, each of the victims has bled out,” Hotch replied, and it wasn’t until they turned the corner towards the bank did Bugsy realise just how packed the street was with law enforcement. 
Three or four choppers circled overhead with snipers and back up SWAT teams at the ready. 
“Serial killers with a thirty day cooling off period, and we’re only just hearing about this now?” Emily asked in an incredulous tone, her voice raised to accommodate the shouting between other chiefs and their units. 
“Headquarters characterised them as robbers first, killers second,” Hotch said, his hands on his hips as they all assessed the situation from afar. Naturally a few new anchors had pulled up to the scene as well and were setting up their equipment despite the officers trying to corral them away. 
“Oh yeah? How did that turn out for them?” Bugsy grumbled behind her thick, dark sunglasses, biting her lip from saying worse. 
“I disagreed with the original assessment, I was overruled,” Her chief shot back, because things had been just as cold between them since that day as they had with Emily. 
JJ was slowly reaching out the olive branch in her direction, and if it wasn’t for Henry being so darn cute every time he begged ‘Buggy’ to come play with him, she reckoned JJ would have taken even longer to forgive as well. 
“Why are we here now?” Rossi chimed in, eyes locked on Aaron’s frown, that seemed to harden every step they took closer to the bank.
“Because crisis negotiation is overseas.”
“What do we know about them?” JJ jumped in straight away with the problem solving, because even if they were out in the field and not in their pretty little round table room anymore, the UnSubs were still just pictures on a white board needing that red string to connect them all together. 
“They’re organised, they're efficient,” Hotch fired off, mentally running through whether he had loaded the pistol he kept around his calf for emergencies, “Each strike lasts about two minutes,”
Derek’s face scrunched in confusion, “They gotta be scouting out the banks in advance, why haven’t we been able to ID them off of surveillance footage?” 
“They hacked the security feed and turn off the cameras both during the initial canvas and during the robbery, until the masks come back on and then were allowed to watch” Hotch replied, and the eight of them slipped into the base of operation for the day; a wide trailer converted to house the high tech computers Penelope needed to keep an eye on the cameras with those magic skills of hers. 
Bugsy’s eyes landed on the black and white feed of inside the bank, her heart lurching in her throat when she saw well over forty men, women and children lined on their knees execution style, facing the doors to the bank to act as a shield if the snipers did happen to get a shot through the windows. 
The woman took the lead, a mask over her face with a doll-like expression on it, the other men soaked in blood as one fought to hold the injured one up for dear life. 
“Why haven’t they cut the feed now that they’ve been cornered,” Derek said with a shake of his head, his lips pulled into a grimace, “Letting us see inside gives us a tactical advantage, they have to know that,”
“Unless they want the audience,” Bugsy suggested, watching the jack slowly growing weaker and weaker as they discussed tactics, “Although the only one who really strikes me as the attention seeker is her, he seems more prioritised with the other male,”
“The masks add to their narcissism,” Spencer input with a nod, “Their personas are the royalty of poker,”
“JJ, you, Bugsy, Reid and Prentiss, look at past robberies, that’s going to be our victimology,” Hotch ordered, and they did as ordered with little delay, heading to the office they had set up in the opposite trailer. 
This was going to be a long day. 
“I can help,” Bugsy offered herself before the team even had a chance to protest. 
It hadn’t even been an hour into them pulling research from InterPol as to who their UnSubs were before they had made their next dramatic move; they had shot a hostage. 
Which meant they needed medics in there fast, fast enough to save the hostage and the jack if it kept the king from unravelling into a massacre. 
“What do you mean you can help?” Emily said with a scathing tone, “Bug, you can’t just throw yourself in harm’s way if you have no clue what you’re-”
“I did three years of a medicine degree alongside my biochemistry before I got bored of doing both and gave up on it,” Bugsy snapped at her sister, brows contorting into a harsher frown than she’d had in months. She preferred it when they weren’t speaking at all. 
“Because you were bored?” Derek asked, his face incredulous at the gall of the twenty year old they’d plucked from college and sent into the midst of the Russian Mob five years ago, “Did you not have anything better to do like partying or making out with guys- a whole medical degree on the side is your idea of downtime?” 
She shrugged, looking back at Emily with a glare who seemed to bristle at the information. 
“Can I speak to you outside please?” Emily said in the coolest tone she could muster, though even that sounded like a bite. 
Something shifted in the air of the tiny, makeshift office and the other inhabitants tensed up at the sight of the Prentiss women gritting their teeth almost identically, staring daggers at one another for a moment before they stood from their seats and waltzed out of the side of the trailer to where there wasn’t the bustle of squad cars or media to be seen. 
JJ looked to Morgan, who looked to Spencer, who seemed to have paled for a moment, and the three of them were out of their own seats to linger at the doorway in case things really did get ugly between the sisters.  
“Do you honestly think that throwing yourself into the line of danger today is a good idea or are you trying to hurt me to get back at me?” Emily seethed the minute they had stepped foot on the ground, and the scoff that left her little sister’s throat was something nasty. 
“Oh, please, don’t make yourself sound so important.” Bugsy snapped, whirling around on her heel to glare at her sister, “I’m not doing any of this to get back at you, I’m trying to save those hostages in there-” 
“So I just happened to have never heard about this medical side quest you set yourself on until now because, what, it just never came up?” Emily laughed, laughed, in her sister’s face, and Bugsy saw red even more, “I thought you were a better liar than that,”
“Maybe if you’d bothered to even speak to me before you needed something from me that day with the Russians then you would have known anything about me that wasn’t being your dumb little sister you can just walk all over like you’re my mom or something,” Bugsy’s voice was getting louder, and Emily’s smirk wiped right off at the sound of that, because she knew she could have been ten times a better sister had she not wanted to get as far away from her mother as fast as possible. “Same with Hotch, he never wanted much to do with me until his wife died and then who did he come to needing help grieving, none a single one of you, and who gets bitten in the ass and punished when I find out I spent seven months grieving like some idiot to that uptight prick who lied to me-”
“Do not speak about him like that,” Emily was shouting now too because Bugsy was truly holding nothing back on her. 
“Why? Are you going to pick him over me, Em?” The younger woman snarked, her eyes hateful and narrowed, “Wouldn’t surprise me in the slightest given your track record-”
Emily shoved her, like, truly shoved her back and it robbed the words out of the girl’s throat. Yet it made JJ gasp where they were watching from the crack in the doorway, wanting to break them apart but knowing they needed to fix it for themselves. 
The three of them hissed when Bugsy’s hand swiped against Emily’s cheek in a territory neither of them had ever wandered into. Emily was always too old to argue with her sister, too big to fight the way most siblings did with slaps and hair pulls and scratches, but Bugsy was a grown woman now; they both were. 
Emily swatted the same back to her own cheekbone, after a second of shock washing over her face, and it was like they were two cats fighting in a back alleyway over a scrap of chicken. 
Bugsy shoved at her around the tits, because she knew it would ache, Emily pulled at her braid with a yank that made Bugsy’s eyes water, the two of them banging against the wall of the trailer, their heads clunking together. 
“Fucking punishing me after months like some insolent child-”
“I would never have left you thinking you were to blame for my death- I would never fucking do this to you-”
This was childish, entirely childish, playground offences and girlish curses in between. The worst part was they knew they could do much worse, they knew they could truly hurt one another if they wanted to. They were both trained to kill, and yet Emily had Bugsy grabbed in a headlock like they were two infants fighting over a sandpit. 
Because they didn’t want to properly hurt one another in any way that would last. Never. 
“Get the fuck off me or I’m punching you in the crotch,” Bugsy barked, trying to wriggle her way out of her sister’s freakishly strong arms with a frown, “EMILY- I SAID-”
“I was trying to protect you- just get your head out of your ass for two seconds and listen to me- I was trying to protect all of you-” But by the time Emily had somewhat gotten her to stop squirming, the girl had grabbed her by the calf where she had been forced to bend at a forty five degree angle, holding her one leg up off the floor while she sweeped at the second one to knock her off balance. 
She had been known to shoot an assailant in the foot from twenty feet away to stop them from getting away, and yet she was resorting to simply pushing her sister over as a way to get one up on her. 
She felt like she was ready to finger paint and take a nap time next; like they were about to be sat in the headmaster’s office and have their wrists slapped with a ruler for not keeping their hands to themselves. 
But it worked, and in seconds the Prentiss girls were on the floor, puffing out of breath, Bugsy’s lip bleeding where Emily’s ring had caught it on the corner, Emily’s cheek red and raised from where her sister had a surprisingly strong right hook. They took a minute to breath, Bugsy glaring at the awfully clear blue sky, much too happy and cheery for the travesty that had been her entire day. And it was only then did she hear the other three members of their team exit the trailer, JJ going to help Emily up while Morgan's face appeared in the middle of the powdered clouds, something sad and sympathetic in his eyes and it was then that he held out his hand to get her up. 
She didn’t want to, had every intention of laying there and staring at the broad daylight until she managed to float far away from there and from where her chest hurt with betrayal and her lip bled with lies. 
He yanked her off the floor, offered her a cold can of coke for where she felt her lip swelling already, and she resigned to sit on the stairs to the trailer with her head in her hands until her temple stopped pounding or at least until she felt herself calm down in the slightest. 
Emily shuffled to sit down next to her, her breathing still uneven but she could tell because she felt a tentative hand on her thigh rubbing gently, in the motherly way Emily had always watched her.
Because Bugsy had always been her baby, whether she wanted to admit it or not. 
“Bugsy?” The younger woman huffed in indignance, pouting as she stared at her lap, because she felt the tears welling up already, “I’m so sorry I left you, you know I never, ever wanted to, you know that right?” 
“Why didn’t you tell me?” Her voice cracked as she finally looked over at her sister’s solemn face, “You told JJ and Hotch but you couldn’t even tell me? Did you just not want to come back for me?”
Emily’s brows pulled up into a sorrowful frown, and she felt her eyes start to burn too. 
“No, that was never a part of it, I swear, there wasn’t a day when I didn’t want to come home to you,” She replied, taking a deep breath in through her nose as not to start bawling her eyes out there and then, “I had to tell Hotch and JJ as a matter of precaution, not because I wanted to tell them and not you. Bug, I missed you every day, I missed Niko and Sergio and those dumb documentaries you made us watch,”  
Bugsy smiled despite herself, wiping a finger under her nose to stop the tears that had already started rolling there, “Well, I don’t know about Niko but Sergio missed you a whole lot,” She sniffled, rolling the Coke over to a cooler side to sooth her lip some more, “But I think he feels like you kind of abandoned him, and like you maybe don’t love him as much because he can be kind of annoying and, like, he’s real torn up about me telling him you died only to find your you’re not, like you can’t just do that to Sergio, Em, he doesn’t deserve that,” 
Bugsy’s lip was quivering by the time she’d finished, but Emily chuckled wetly, wrapping an arm over her shoulder and pressing their pounding heads together. 
“Are we maybe not talking about Sergio anymore, Bug? Are we talking about you-”
“No, we’re definitely talking about Sergio,” She cut in, wiping under her eyes with her sleeve, looking back up where Emily’s face was glistening with tears though it seemed like she had somewhat calmed under her sister’s gaze that wasn’t so full of vitriol hatred anymore. 
Emily nodded, a humoured smile on her lips, “Right, okay, my bad. Definitely Sergio,” She held up her hand, stroking down Bug’s cheek for her where her tears had started pooling, “Well, I want Sergio to know that even if he is annoying sometimes, that there’s nothing that could ever take me away from him again, cause even though I’m not his mom, he’s still always going to be my kid, you know?” 
Bugsy’s face crumpled in pain for a minute, sniffling and meeting Emily’s eyes, dark brown hues watching her sadly, imploring her to know how much her heart called out for her. 
“Really? You promise?” Bugsy whined, and Emily nodded with a sad smile, stroking the back of her braid that looked a little ratted and wispy from where it had been yanked at. She took a shaky breath, looking down to her shoes where they scraped against the steps, “Well, I’m sure he’ll love to hear that, I’ll tell him when we’re home-”
Emily laughed, kissing her sister’s forehead, and pulling her into a side hug. 
“Alright, tough guys. Let’s get back to working on the profile, Sergio can wait for a minute,” Morgan said, though his face fought off the smile that crept on his lips seeing two of his favourite girls finally at peace with one another. 
Bugsy looked five years younger within seconds, and they clicked back into place, hopping up off the steps to get right to work, cursing herself for wasting so much time on silly things like hating her sister, because forgiving her felt cathartic in a way she didn’t understand she needed.
Maybe they had a chance after all.
Bugsy swore she would never have an optimistic thought a day in her life again. 
Because just as they had thought perhaps things could look up; just as they had sent in a different agent medically trained enough to save the jack, their UnSub, that they’d identified as Oliver, had bled out before he could have done anything to save him. Without a second thought, the king, Chris, had shot the agent, and demanded he wanted Will next as retribution for his brother’s death. 
They had of course turned down the offer in a heartbeat but the moment everyone turned their backs, Will, ten times the cop Bugsy could ever hope to be, had walked into the bank with his arms raised in surrender despite JJ screaming for him to stop from where Morgan and Hotch held her back from following him in.
Bugsy and Penelope watched from the CCTV in blood curdling horror when Chris put two bullets in him before he could even declare he was unarmed. 
“Did you see where he was shot?” JJ asked, her tone empty, her eyes bloodshot where she had broken down into a fit of wails as soon as the gunshots had sounded through the street. 
Bugsy opened her mouth to speak, losing all hope as soon as the bluebell gaze fell to her for an explanation. 
“Is he alive or dead, Bug?” JJ snipped, but she knew she didn’t mean it, knew she was just worried out her mind and grasping at straws. 
“I don’t know, I’m sorry,” Bugsy replied, Emily’s hand at the small of her back in a comforting gesture because she sounded scared. She wished Spencer was with her, he always knew how to make people feel better, but he and Kevin had gone back to their office uptown to use Penelope’s personal lair for better coverage on the BAU’s resources. 
“He was wearing a vest,” Emily jumped in, because Bug was tense and upset enough as it was, “He might be okay,”
“Might be?” JJ said humourlessly, her face hollow with sadness, “Alright we need to get inside,”
“JJ, it’s too risky,” Morgan tried as the woman stood up, a new found determination, because she refused to accept her partner, the father of her child, was dead until she saw him in a body bag for herself, “We don’t have eyes in there anymore,”
Jennifer’s eyes welled up again, and she turned to their unit chief; he was the only one who could understand just how desperate she felt right now if there was even the smallest chance he could still be alive. “Aaron.” 
Hotch took a breath, nodding to her with complete empathy, “Let’s go in,”
Bugsy leapt for the medical kit they’d kept in the cupboard, because if she could stop the bleeding as soon as possible he might have a chance. She was taken back to when she had gotten to Emily that night with Doyle, when she had nothing but the clothes on her back and a loaded gun to treat her sister with, when she had felt completely helpless. 
She refused to feel like that again, not now she’d been lucky enough to get Emily back. She refused to let JJ and tiny Henry go through what she did. 
Will wouldn’t die if she had anything to do with it. 
-
“Seeing what’s going on outside doesn’t help us inside,” Spencer said, standing behind where Kevin sat in Pen’s office, his hazel eyes falling to the surveillance footage of the bank live streaming from one of the choppers, where the familiar woman he worried for more than he could ever tell her moved behind a SWAT unit towards the front doors, a large med kit strapped to her back, a pistol at her side. 
He looked down at the blueprints of the bank because if he watched her get even ten feet away the bank he thought he might just throw up, even if there were four armed men shielding her.
“Kevin, can you possibly pull up each of the surveillance feeds prior to Will being shot?” He asked, quickly diverting his attention away from where they were at an impasse waiting for something to happen, Emily’s SWAT team moving slowly towards hers. 
“Sure, what are we looking for?” The other man asked, his fingers sprawling over Penelope’s keyboard as he did as requested, playing the older footage on the opposite screen, though even he was getting cold feet watching their team getting ready to breach the perimeter. 
“The female UnSub disappeared once before, if she wasn’t looking for an escape, what was she doing?” 
Spencer paused, because he couldn’t help when his eyes flicked back to the footage of Bugsy shuffling closer to the entrance behind one SWAT agent, and the doors burst open, the entire street pausing for a second to see what the movement was. 
The hostages. The civillians caught in the crossfire at the bank slowly trickled out of the doorway, their arms raised in peace, some crying in relief though there was no sign of Will anywhere. 
This was bad. Though he felt utmost care that the hostages had been released safely, he knew that the UnSubs keeping Will meant one of two things. One, that Will was already dead and useless to them, or two, keeping him bleeding out as a bargaining chip was their final play. Meaning they had no intention of releasing him, otherwise they would be left with nothing. 
If he wasn’t already dead, he would be any minute now. 
Spencer’s chest crashed in devastation for his friend and his godson, though it soon took a turn of terror when it seemed the same thought ran through Bugsy’s mind and she began stepping forward towards where the hostages were shuffling out in floods of tears. 
He saw Morgan and Emily yelling at her to stop, two of the SWAT team trying to follow her because they had no idea what had come over the twenty something year old rookie with a death wish. Spencer tried to ignore the way his chest clawed in horror, his eyes snapping back onto the surveillance of the female UnSub disappearing into the back rooms of the bank, completely ignoring the vault and the very clearly marked exit, meaning she had no intention of using either.
So what was she doing?” 
Spencer felt his head rattling with a horrid thought, hoping his intuition was wrong when he held the blueprints up to the screen, his skin turning to gooseflesh when he realised just exactly where she had been dipping out to with that backpack of hers. 
“Gas mains,” His voice was numb with fear, his body diving for their comm link to Garcia, where she sat in the trailer with Strauss and Rossi, watching the surveillance just as he was, “Garcia, get them out of there now,”
But no sooner had he said anything, Bugsy’s figure disappeared into the building, the SWAT team confirming that the entrance was clear, JJ and Morgan moving after her with their own agents protecting them. 
But she was already inside, his head screamed at him. Even when he heard David’s frantic voice through the radio they had linked to their kevlars, “ABORT, ABORT!” 
Even when he heard Hotch swear hastily, calling to his team to hold back, trying to yell loud enough JJ and her team could hear his orders to take cover. 
Spencer couldn’t truly take any of it in as he watched the large glass windows wobble for a second, a shock wave of what he knew was about to come.
The lines went dead, and he thought for a second his heart stopped. Because he hadn’t figured it out fast enough, hadn’t warned them before she had chance to throw herself head first into danger the way he should have known she would. 
Because Spencer watched the footage with a terror he had never known, not even in his eight years on the team, not even in his own situations as a hostage, not even when he was at his lowest and he thought the dilaudid was going to finish him off, alone and high in his apartment’s little bathroom, a burnt out drug addict who had so much going for him. 
Spencer had never felt the sheer, spine-chilling dread that he did when he watched, useless and heart broken, as the bank went up in a colossal explosion, a plume of flames bursting out of every window, shattering glass and cracking the brickwork, hard enough he watched part of the building start to crumble inwards. 
And Bugsy went down with it. 
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crosstheveil · 7 months
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Health: Misconceptions with Anemia and "Iron Deficiency"
Iron Absorption & Utilization
Simply taking iron supplements often doesn't cure anemia.
Proper absorption and utilization of iron involve many processes.
1/3 of the population has trouble absorbing and utilizing iron; it's considered the most common nutritional disorder in the world.
Anemia is usually about iron dysregulation, not deficiency.
Iron supplements or injections tend to circulate excessively, potentially causing toxicity.
Iron overload strains the iron recycling system and the liver.
Liver plays a key role in regulating iron uptake.
Iron doesn't regulate itself; it's copper-dependent.
Copper is essential for ceruloplasmin, a protein that mobilizes iron from tissues into the blood. Without copper, iron accumulates in tissue leading to inflammation and tissue damage which can develop into others issues like heart or liver disease and diabetes with increased risk of infection and cancer.
Retinol (Vitamin A) enhances iron absorption and influences genes regulating iron metabolism.
Iron Testing
CBC can detect anemia but it can't necessarily tell you the cause.
Serum ferritin doesn't give a true measure of iron stores.
Approximately 70% of iron is found in hemoglobin, around 20-25% is stored as ferritin and hemosiderin in tissues, about 5% is in myoglobin and enzymes, and roughly 0.1% as serum iron.
For accurate assessment, consider all containers of iron including hemoglobin, serum iron, and ferritin, as well as non-iron markers such as zinc, copper, and vitamins A & D.
The only direct way to measure iron stores is to keep removing blood until anemia sets in, then account for the iron deficit and dietary iron consumed during this time.
Sources (meat, liver, and seafood)
Copper: liver, nuts, molasses, oats, bee pollen, shellfish, pumpkin seeds, dark chocolate, acerola cherry powder, shilajit.
Retinol (Vitamin A): liver, other organ meats, egg yolk, seafood, fish liver oils, dairy products.
Other Insights
Phytates in plants can hinder non-heme iron absorption but vitamin C helps to counteract these inhibitory effects.
Over-supplementing with zinc can cause copper deficiency since copper and zinc need to be in balance.
There are many causes of anemia beyond "iron deficiency", such as vitamin B12 deficiency.
The Nobel Prize in Physiology or Medicine was awarded in 1934 to George Whipple, George Minot, and William Murphy for their discoveries related to liver therapy in cases of anemia.
Other studies have supported incorporating beef liver (which contains copper, iron, zinc, vitamin A and D) into the diet.
The key is to have food that isn't concentrated on a certain vitamin or mineral but provides a mixture of what we need in a way that our body can properly absorb without inhibiting effects.
Men are naturally higher in iron than women and women are naturally higher in copper than men (estrogen levels contribute to the production of copper).
Female menstruation is why iron deficiency anemia is more common among women.
Signs of anemia include fatigue, pale complexion, blurred vision, dizziness, irregular heartbeat, cold hands and feet, scanty menstruation, numbness, insomnia, poor memory, dry skin, brittle nails, vertical ridges on nails, muscle twitches, shortness of breath, chest pain, headache, swollen or sore tongue, unusual cravings, restless legs.
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bethanythebogwitch · 1 year
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Wet Beast Wednesday returns and this time it might be a bit gross because we're talking about leeches. Leeches are annelids (segmented worms) of the subclass Hirudinia. They are closely related to earthworms and have some similar features, including that thick portion called the clitellum, a name that always makes the 12-year old in me giggle. Leeches are also famous for their parasitic behavior, though not all species are parasites.
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(Image: a leech with a visible gut)
There are about 680 known leech species, the majority of which (480) live in freshwater. Of the rest, 100 species live in saltwater and the rest live on land. They can be found on every continent except Antarctica and often in extremely high numbers. While they are annelids, leeches have a very distinct anatomy from others of their phylum. Most annelids are cylindrical, with a large, fluid-filled body cavity called the coelom running through them. In leeches, the body is flattened and the coelom has been reduced to 4 skinny channels, with the rest filled with connective tissue. Also unlike other annelids, the lines on the outside of the body do not correspond to internal body segments. All leeches have a sucker on the back end of their body, with most also having another one on the front. They use these suckers both to attach to a host and to move, inching along like an inchworm. Many aquatic leeches can also swim by undulating their body like a snake.
youtube
(video showing a swimming leech)
Leeches are simultaneous hermaphrodites (having male and female sex organs at the same time) though their male gametes develop before the female ones. Eggs are laid in protective cocoons and usually left attached to a submerged object. On the other hand, members of the family glossiphoniidae practice parental care, a rarity amongst annelids. They carry their eggs on their underside until they hatch and then carry the babies until they find their first meal.
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(image: a leech)
Of course the most famous leech feature (leechure) is how they feed. Around 75% of leeches are parasites while the remainder are predators. Leeched can be loosely divided into proboscis leeches and proboscisless leeches. Proboscis leeches can use their proboscis like a mosquito's, piercing the skin to reach the blood. Those without proboscises have other methods of feeding, including using jaws to bite into a host. At least one species has three jaws, a unique trait. Feeding on blood is called hematophagy and many leeches do it. Blood is a very high energy food source with lots of lipids and proteins and many hematophagous animals, leeches included, can go long periods of time between feedings by storing extra blood inside themselves. Leeches inject their hosts with an anticoagulant called hiruden, which keeps the blood flowing. Predatory leeches target small invertebrates and usually swallow their prey whole. Leeches lack many important digestive enzymes, forcing them to have a symbiotic relationship with internal bacteria who generate the necessary chemicals.
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(image: microscope image of a medicinal leech's mouth)
Leeches are, of course, famous for their use in medicine. Leech therapy or hirudotherapy has been used as far back as 3,500 years ago in Egypt and has been recorded in many places, including India, China, Arabia, and throughout Europe. In Europe, this was driven largely by humeric theory, the idea that four humors (blood, phlegm, black bile, and yellow bile) controlled the body and sickness was caused by them being out of balance. Leeches, particularly the medicinal leech (Hirudo medicinalis) were used to remove excess blood. This fell out of favor with humeric theory, but the use of leeches in medicine saw a comeback in the 1970s. This time the purpose wasn't to grain blood, but to use the hiruden anticoagulant to induce blood flow. Individual leeches have too little hiruden to make extracting it practical, so doctors will put live leeches on the body in places that need that blood flow.
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(image: a leech on someone's hand)
Leeches are rarely harmful to humans. Most species will latch on long enough to drink their fill and drop off when they are done. They can transmit disease (though this is rare) and some people are highly allergic to them. There is also a risk of infection from the wound the leech creates. Some leeches are large enough that their bites are very painful. There is some danger from improperly removing a leech. Their stomachs don't sterilize what they eat and grabbing one can cause it to regurgitate into the wound, leading to risk of infection. To safely remove one, find the mouth (usually on the narrower end) and use something broad and flat like a credit card, dull knife, or long fingernail to slide under the moth and break the suction. You can do the same to the back sucker or just pull it off.
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(Image: a leech showing the front and back sucker)
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cnsmedspa · 9 months
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Age-Defying Beauty: Skin Tightening Solutions for Every Skin Type
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Skin tightening is a universal desire that transcends age, gender, and skin type. As we age, our skin inevitably loses some of its youthful elasticity, leading to sagging, wrinkles, and fine lines. However, the good news is that there are skin tightening solutions available to address the unique needs of every skin type. Whether you have dry, oily, sensitive, or combination skin, understanding the right approach is key to achieving the firmer and more youthful appearance you desire.
Dry Skin: Hydration and Nourishment
Individuals with dry skin often experience more pronounced signs of aging due to the skin's reduced ability to retain moisture. To tighten and rejuvenate dry skin:
Rich Moisturizers: Choose moisturizers with hydrating ingredients like hyaluronic acid, glycerin, and ceramides. These ingredients help lock in moisture and improve skin texture.
Nourishing Oils: Incorporate facial oils, such as argan oil or jojoba oil, into your skincare routine to replenish lost moisture and promote skin elasticity.
Collagen-Boosting Serums: Look for serums containing collagen-boosting ingredients like vitamin C, peptides, and retinol to enhance skin firmness.
Oily Skin: Balancing and Tightening
Oily skin can still experience sagging and loss of firmness. The key is to balance excess oil production while tightening the skin:
Oil-Free Moisturizers: Opt for lightweight, oil-free moisturizers to provide hydration without exacerbating oiliness.
Salicylic Acid: Incorporate products with salicylic acid to help control excess oil and improve skin texture.
Non-Comedogenic Products: Choose skincare products labeled as non-comedogenic to prevent clogged pores while addressing skin tightening concerns.
Sensitive Skin: Gentle Approaches
Sensitive skin requires extra care and gentle solutions to avoid irritation while achieving skin tightening:
Fragrance-Free Products: Use fragrance-free, hypoallergenic skincare products to reduce the risk of irritation.
Mild Exfoliation: Opt for gentle exfoliation methods, like enzyme masks or lactic acid, to promote skin renewal without causing redness.
Patch Testing: Before incorporating new products, patch test them to ensure they don't trigger adverse reactions.
Combination Skin: Targeted Care
Combination skin requires a balanced approach, addressing both oily and dry areas, to achieve skin tightening:
Zone-Specific Products: Use different products for the oily and dry areas of your face. For example, apply a lighter moisturizer on the oily zones and a richer one on the dry zones.
Spot Treatments: Target specific areas with skin tightening serums or treatments, focusing on the regions that need the most attention.
Balancing Masks: Consider using masks designed to balance combination skin, which often combines clay and hydrating ingredients.
Normal Skin: Maintenance and Prevention
While normal skin types may not have extreme concerns, maintaining skin elasticity is essential for long-term skin health:
Preventive Care: Implement a preventative approach by using sunscreen daily to protect against UV damage, which accelerates skin aging.
Collagen-Boosting Ingredients: Use products containing collagen-boosting ingredients like vitamin A, vitamin C, and peptides to maintain skin firmness.
Regular Skincare Routine: Stick to a consistent skincare routine that includes cleansing, moisturizing, and using targeted treatments for your specific skin tightening needs.
Mature Skin: Advanced Treatments
Mature skin often requires more advanced skin tightening solutions to address deeper wrinkles and sagging:
Retinoids: Incorporate prescription-strength retinoids or retinol products to stimulate collagen production and improve skin texture.
Professional Treatments: Consider non-invasive treatments like radiofrequency therapy or ultrasound therapy, which can provide noticeable skin tightening results.
Consult with Professionals: Schedule consultations with dermatologists or skincare experts to explore customized solutions, such as chemical peels or microdermabrasion.
Conclusion
Achieving skin tightening for every skin type is not only possible but essential for maintaining a youthful appearance and promoting skin health. By tailoring your skincare routine to your specific skin type and concerns, you can effectively address sagging, wrinkles, and loss of firmness. Remember that consistency and patience are key to achieving and maintaining skin tightening results. Consulting with skincare professionals can also provide valuable insights and guidance on the most suitable treatments for your unique skin type. Whether your skin is dry, oily, sensitive, combination, normal, or mature, there are solutions available to help you achieve the firm and radiant skin you desire.
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The Best Alternatives to Drinking Alcohol
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Many people turn to alcohol to alleviate emotional distress, but relying on it for comfort often leads to dependence and addiction. Eventually, alcohol no longer alleviates any stress but causes it instead. However, there are safe alternatives to alcohol that are just as relaxing as the real thing.
Stress is one of the most common contributing factors to substance abuse. Developing healthy ways of coping with stress is essential. Below are some alternatives to drinking alcohol for emotional distress that are healthy and safe.
Supplements as Alcohol Alternatives
Dietary supplements contain minerals, herbs, vitamins, or other ingredients like botanicals, amino acids, and enzymes to promote or complement a healthy diet. Supplements may be taken as natural alternatives to medication, although they aren’t a guaranteed cure for anything.
Herbal alcohol substitutes include:
Valerian: an herb that induces sleep and relaxation
L-theanine: an amino acid that helps reduce anxiety, stress, and insomnia
Passionflower: a plant that reduces anxiety and stress and alleviates pain caused by muscle spasms
Chamomile: an herb used to calm anxiety and settle stomach pain
Lavender: an herb that improves sleep, reduces blood pressure, treats skin blemishes, relieves asthma symptoms, and promotes hair growth
Lemon balm: a lemon-scented herb that improves mood and cognitive function, relieves stress, and reduces anxiety
These supplements are often used to naturally treat sleep disorders, anxiety, stress, ADHD, and muscle pain, making them excellent alcohol substitutes. However, speak to your doctor before drinking or taking any of these supplements as some may interact with medications or may not be considered beneficial by your doctor.
Meditation as an Alternative to Alcohol
Meditation is a practice that’s been around for centuries and is known for its ability to help with stress relief. It’s also used in addiction treatment and is one of the several special programs and therapies used in treating substance use disorders. Meditating is adaptable and can be done by focusing on a mantra, an image, a sound, an object, or nothing at all. This practice helps increase attention, gain self-awareness, achieve mental clarity, and reach a calm state of mind.
Exercise as an Alternative to Alcohol
Exercise is another natural way to relieve emotional distress or anxiety that you may have attempted to alleviate by drinking alcohol. Exercising can include running, dancing, swimming, hiking, or any other fun activity that gets you up and moving. Physical activity can reduce stress and contribute to an increase in self-esteem and confidence as you develop a more positive body image.
Hobbies as an Alternative to Alcohol
Hobbies are another healthy alternative to alcohol. Replacing the time spent drinking or thinking about drinking with a fun hobby can be helpful for people who either want to cut down on drinking or are in alcohol addiction recovery. Whether reading a book, painting, making music, or building birdhouses, dedicating some time to fun activities that can help you relax and stay clean is important.
Alternative Drinks to Alcohol
In addition to changes in routine, there are also many replacement drinks for alcohol. Popular alternative drinks to try include:
Soda and fresh lime
Berries in iced water
Kombucha – make sure the sugar content is no more than 5g/100ml
Virgin Bloody Mary
Virgin Mojito
Alcohol-free sparkling wine
Sparkling juices
Alcohol-free gin
Half soda/half cranberry juice with lime
Soda and fresh fruit
Mocktail mixes
In conclusion, drinking alcohol to alleviate emotional distress or cope with stress can lead to dependence and addiction. However, there are many safe and healthy alternatives to alcohol that can provide similar effects without the risk of physical or mental repercussions. Whether it's through herbal supplements, meditation, exercise, hobbies, or non-alcoholic drinks, there are plenty of options available to help you relax and unwind. Remember, seeking professional help and undergoing addiction treatment is crucial for those struggling with alcohol abuse.
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mcatmemoranda · 2 years
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Just quickly reviewing antibiotics I used today. And stuff the ID doctor told me.
Cefepime - fourth-generation cephalosporin antibiotic with the ability to cross the blood–brain barrier. Cefepime has an extended spectrum of activity against Gram-positive and Gram-negative bacteria, with greater activity against both types of organism than third-generation agents. Cefepime is a broad-spectrum cephalosporin antibiotic and has been used to treat bacteria responsible for causing pneumonia and infections of the skin and urinary tract. Some of these bacteria include Pseudomonas, Escherichia, and Streptococcus species. Metabolized by CYP450, excreted in urine, half life of 2 hours; binds peptidoglycan to inhibit cell wall synthesis
Piperacillin-tazobactam (Zosyn) - piperacillin and tazobactam are metabolized in the liver by CYP450. Piparacillin binds peptidoglycan to inhibit cell wall synthesis; tazo-bactam inhibits beta lactamases, preventing beta-lactam degradation. The combination has activity against many Gram-positive and Gram-negative bacteria including Pseudomonas aeruginosa. It is used to treat pelvic inflammatory disease, intra-abdominal infection, pneumonia, cellulitis, and sepsis. Common adverse effects include headache, trouble sleeping, rash, nausea, constipation, and diarrhea. Piperacillin-tazobactam is recommended by the National Institute for Health and Care Excellence as first-line therapy for the treatment of bloodstream infections in neutropenic cancer patients. For β-lactam antipseudomonal antibiotics, including piperacillin/tazobactam, prolonged intravenous infusion is associated with lower mortality than bolus intravenous infusion in persons with sepsis due to Pseudomonas aeruginosa. The most common adverse effect is diarrhea (7–11%). Another adverse effect is inhibition of platelets (thrombocytopenia).
Ampicillin - Ampicillin is an antibiotic used to prevent and treat a number of bacterial infections, such as respiratory tract infections, urinary tract infections, meningitis, salmonellosis, and endocarditis. It may also be used to prevent group B streptococcal infection in newborns. It is used by mouth, by injection into a muscle, or intravenously. Common side effects include rash, nausea, and diarrhea. It should not be used in people who are allergic to penicillin. While usable in those with kidney problems, the dose may need to be decreased. Its use during pregnancy and breastfeeding appears to be generally safe.
Ampicillin is in the penicillin group of beta-lactam antibiotics and is part of the aminopenicillin family. It is roughly equivalent to amoxicillin in terms of activity. Ampicillin is able to penetrate gram-positive and some gram-negative bacteria. It differs from penicillin G, or benzylpenicillin, only by the presence of an amino group. This amino group, present on both ampicillin and amoxicillin, helps these antibiotics pass through the pores of the outer membrane of gram-negative bacteria, such as E. coli, Proteus mirabilis, Salmonella enterica, and Shigella.
Ampicillin acts as an irreversible inhibitor of the enzyme transpeptidase, which is needed by bacteria to make the cell wall. It inhibits the third and final stage of bacterial cell wall synthesis in binary fission, which ultimately leads to cell lysis; therefore, ampicillin is usually bacteriolytic.
From ID doctor I'm working with:
Beta lactams like ampicillin are bacteriostatic against enterococcus (gram positive cocci). Ceftriaxone binds penicillin binding proteins in the bacteria so that ampicillin will work better, so that's why we are combining ampicillin and ceftriaxone in this pt. TEE is needed for endocarditis; it's more sensitive than TTE and will tell you the size of a vegetation; will also be able to tell you whether there's an abscess.
One of my pts has enterococcus infective endocarditis. She is on high dose ampicillin and ceftriaxone. A left sided, highly mobile vegetation is at risk for embolization--> stroke. So cardiothoracic surgery is evaluating her for surgery. She needs daily blood cultures until they're negative. A vegetation greater than 1 cm is considered large. If pt is penicillin allergic, can use vancomycin and gentamicin instead of ampicillin and ceftriaxone. But gentamicin is very nephrotoxic. Vancomycin is also nephrotoxic. Anyway, my pt has 1 major criterion and 3 minor criteria, which make the diagnosis of infective endocarditis: echo showing mass on heart valve; fever, vascular phenomenon (leukocytoclastic vasculitis presenting as purpura on her LEs), positive rheumatoid factor. For endocarditis, you should get blood cultures before starting abxs. Abxs should cover for staph, strep, and enterococci. Tx native valve endocarditis for 4-6 weeks--longer if vegetation is L sided. Repeat echo if complications occur during tx.
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oliviajames1122 · 2 years
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Typical and uncommon IBS symptoms
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Irritable bowel syndrome, or IBS, affects 1 in 4 people, while more than 4 in 10 people have poor digestion or mild IBS, according to study. We are 40% more likely to have poor skin and hair, less energy, trouble concentrating, and high or overwhelming stress if we have mild or severe IBS.
Constipation, diarrhea, and insomnia are just a few of the symptoms that make up IBS, which also includes heart palpitations, muscular aches, and much more. In this post, we go through the causes of IBS, its typical and atypical symptoms, therapies, and the best IBS supplements many business listings.
What brings on IBS?
There are five typical reasons for IBS:
1 - Food sensitivity
Consumption-related food sensitivities cause a little amount of intestinal inflammation. The gut's healthy flora and the synthesis of digesting enzymes may be affected by this inflammation. Gas, bloating, cramping, constipation, and/or diarrhea may result from this.
2 - Inadequate digestive enzymes
For the appropriate digestion of food and nutrient absorption, digestive enzymes are crucial. Certain foods may not be effectively digested if there is a lack of digestive enzymes, which could lead to bacterial fermentation and the production of gas and bloating.
3 - Unbalances in the microbiome
Gut discomfort, gas, bloating, constipation, and diarrhea can all result from abnormalities in the amount of bacteria, yeast, or parasites in the body. In addition to nourishing the gut lining and promoting regular gut motility, probiotics also create short chain fatty acids and digesting enzymes.
4 - Serotonin levels that are out of equilibrium
Though serotonin is most commonly associated with being our "happy hormone," it has a variety of functions in the body, including regulating digestion. Constipation and diarrhea are both symptoms of too little or too much serotonin, respectively business listings.
5 - Weird intestinal motions
A range of factors, including age-related muscular diseases and sports injuries, can lead to anomalies in the nerve and muscle activity of the stomach, which can result in irregular intestinal motions.
7 Typical IBS Symptoms
The most typical signs of IBS to watch out for are as follows:
1 - Indigestion
This is a sign of excess intestinal yeast, food intolerances, or a low serotonin level.
2 - Diarrhea
This can be a sign of intestinal parasites and bad bacteria that are displacing beneficial bacteria. Intolerances to certain foods or an excess of serotonin may also be to blame.
3 - Gas and bloating
Food sensitivities, a lack of digestive enzymes or stomach acid can all contribute to gas, bloating, and digestive pain. Negative bacterial or yeast growth in the intestines is another potential cause.
4 - Cramping
Excess gas and a deficiency in probiotics are the usual culprits for this. The intestines may also become more sensitive to discomfort if there is low-grade inflammation there.
5 - The need to use the restroom immediately
This can also be caused by stomach nerves that are too sensitive, so it's not solely tied to diarrhea.
6. Nausea
A common sign of stomach distress is nausea. It could be brought on by a deficiency in digestive enzymes or by food sensitivities free business listings.
7. Depression and anxiety
Serotonin levels that are out of equilibrium are linked to depressed moods and anxiety. Since the stomach produces 90% of the serotonin in the brain, having a bad gut will have an impact on your mood.
Unusual IBS symptoms
Although uncommon, the following can all be signs of IBS caused by low serotonin levels:
1 - Sleeping problems and insomnia
Our mood and happiness, as well as how well we sleep, are all significantly influenced by serotonin. Melatonin, our sleep hormone, is created by our bodies from serotonin. Sleep problems might be a result of the same low serotonin levels that cause IBS. Our stress hormone, cortisol, is a major contributor to restless nights.
2 - Aching muscles
Serotonin also plays a role in how our muscles work, and low serotonin levels can make muscles ache. IBS brought on by low serotonin levels is frequently associated with a combination of muscle aches, depressed moods, and trouble sleeping.
3 - Palpitations in the chest
Anxiety, which in turn causes heart palpitations, can be brought on by low serotonin levels. However, low magnesium levels can also cause heart palpitations.
4 - Pain during menstruation and during sexual activity
A higher amount of menstruation pain is reported by many IBS sufferers. Because serotonin helps the body copes with pain and low levels may make you feel more pain, it is thought that this is caused by low serotonin levels. Intercourse that is unpleasant or uncomfortable can be caused by low-grade colon inflammation, bloating, and increased nerve sensitivity.
Treating IBS
You should see a doctor if you have persistent common or common IBS symptoms. There are a few self-help strategies to assist treat IBS if your doctor has ruled out any underlying causes.
1 - Food intolerances should be found and eliminated
One of the initial actions is to do this. The easiest approach to figure out which things your body doesn't like is to keep a food diary and go on a "Elimination Diet."
2 - Replace digestive enzymes
Another method to enhance digestion is to boost your body's natural production of enzymes by taking a digestive enzyme or probiotic supplement. Before you eat, consider the meal, chew each mouthful up to 30 times, and check to see if you're anxious.
3 - Detect and correct microbiome imbalances
To figure out what's happening in the gut, a test might be necessary. Simple changes to your diet, such as increasing the amount of fiber and reducing your intake of sugar and processed foods, can have a significant impact on your microbiome.
4 - Optimize your nutrient intake
With symptoms like poor energy and depression, taking additional supplements and eating a healthy, balanced diet can greatly help. Additionally, make sure to include protein and complex carbohydrates in each meal and snack you have.
Vitamins for IBS
Numerous dietary supplements are effective in treating IBS.
1 - Probiotics
For anyone with IBS, increasing the probiotic content of the stomach is crucial. A probiotic supplement can assist in redressing an imbalance even if you are unable to undergo a test to determine what bacteria are present in your gut.
2 - Turmeric and curcumin
The active component of turmeric, curcumin, reduces inflammation throughout the body, including any low-grade inflammation in the gut that might be causing the symptoms.
3 - Milk Thistle, Burdock, and Dandelion
Burdock, dandelion, and milk thistle can all encourage the creation of digestive fluids, which therefore aid in food digestion and breakdown. Any microbial abnormalities in the gut could be resolved by maintaining the proper quantity of digestive juices.
4 - Fennel seeds
A calming and anti-spasmodic action of fennel seeds on the digestive system. Fennel seed also increases the formation of digestive fluids and has anti-inflammatory qualities.
5 - Omega 3
A Vegan Omega 3 supplement is ideal to take in conjunction with probiotics since Omega 3 fats aid to reduce the amount of inflammation in the stomach. When there is inflammation, probiotics find it difficult to adhere to the gut wall; therefore, using omega 3 oil to reduce inflammation can boost the growth of probiotics in your stomach.
IBS can be extremely uncomfortable, and if untreated, it can have a number of negative side effects, such as nutrient deficiencies that result in low iron levels and low energy, as well as low moods, anxiety, and depression due to low serotonin. IBS can also cause dehydration from excessive diarrhea, and it can even cause excessive or rapid weight loss, so you should see a doctor as soon as possible.
To relieve IBS and enhance gut health, you can manage all of these symptoms and side effects by making dietary adjustments, enhancing your gut health, and, if necessary, selecting the right supplements.
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The Role of Human Hemin (Normosang) in Managing Acute Hepatic Porphyria
Acute hepatic porphyria refers to a group of rare metabolic disorders characterized by deficiencies in enzymes involved in the biosynthesis of heme, a component of hemoglobin. These deficiencies lead to the accumulation of porphyrins and their precursors, causing symptoms such as severe abdominal pain, nausea, vomiting, and neurological manifestations.
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Understanding Acute Hepatic Porphyria: AHP encompasses four main types: acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and ALA dehydratase deficiency porphyria (ADP). These disorders manifest primarily through neurovisceral symptoms such as severe abdominal pain, nausea, vomiting, and neurological manifestations like seizures and neuropathy. Cutaneous symptoms may also occur, ranging from photosensitivity to blistering skin lesions.
The cornerstone of managing AHP involves minimizing triggers such as certain medicines, hormonal changes, and dietary factors, coupled with symptomatic relief during acute attacks. Historically, therapies like intravenous glucose, hemin, and pain management have been employed, but they often fall short in providing long-term solutions and may have limitations in certain patient populations.
Human Hemin: A Game-Changer in AHP Treatment: Human hemin (supplied under the brand Normosang), a novel therapeutic option, has emerged as a promising breakthrough in AHP management. It is a formulation of heme arginate, a stable heme molecule that directly addresses the enzymatic defects underlying AHP. By providing exogenous heme, Human hemin replenishes the deficient enzyme, thereby restoring heme biosynthesis and mitigating the accumulation of toxic porphyrin intermediates.
The efficacy of Human hemin has been demonstrated in clinical trials, with notable reductions in the frequency and severity of acute attacks among AHP patients. Furthermore, its convenient subcutaneous administration and favourable safety profile make it an attractive option for both healthcare providers and patients.
In addition to Human Hemin, other treatments for acute porphyria attacks may include medications to manage symptoms such as pain and nausea, as well as measures to prevent future attacks, such as avoiding triggers like certain medications, alcohol, and fasting.
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skincraft-by-alex · 6 days
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Tinted my own brows on Friday, today my skin was so depleted that I used my free time in class to give myself a little light acid facial.
Most of what I used today was from Rhonda Allison, and some of what I used is professional grade only so you can’t really get them for home use.
I used the Creamy Milk Cleanser to start with, and the Maui Cleanser for my second. I love the Milk Cleanser, and wanted to see how my sensitive skin would handle the Maui Cleanser since it’s still within the sensitive skin range of products. I actually really liked it! It smelled like a tiki bar (yum). I did feel really dried out and tight after cleansing, but that had more to do with how depleted my barrier was today since I didn’t do a hydrating mask this weekend.
I also wanted to see how my skin would take the Mint Papaya Enzyme since it’s just one step more intense than what I normally use, and it kinda smelled like Vicks. The spa protocol I based my facial on today uses a dermabrasion before the enzyme, but since I was trying out 2 products that were a little more intense than usual for me I felt like it would have been too much. I used an LED light wand here as well to boost my redness control.
For my toner I went with the Mandelic Defense Lotion for hydration and antioxidant support.
For my serums I used the Sensitive Skin Complex, Therapy E, and Amino Peptide Serum. Since my skin was so fragile today I went with all healing boosters, but I was still stinging a fair amount. Nothing I used today after the enzyme should have even tingled at all, which means my barrier is really damaged. I probably shouldn’t have even used an enzyme at all tbh.
For my recovery mask I used the 12 Flower Mask, which I just love because it’s fairly hydrating and has great antioxidant support. It’s one of my go-to’s for everyone since it’s also gentle enough for the most sensitive or traumatized skin. I also used some chilled ice globes for some cool therapy to further combat my chronic redness and calm my skin down before putting any acids.
For my acids I used the Cell Conditioner for some intense healing boost, and Melanin Suppressant for scar reduction. I’m recovering from some hormonal acne and I don’t want them to take forever to heal and then end up scarring bright pink. These professional use only products are gentle enough to be left on the skin and typically shouldn’t cause any redness on their own. They only did on me because I have rosacea and an impaired barrier, but even then most of my visible redness was more from the walk home than anything else.
After giving myself another dose of the same serums as before, I used Dermalogica’s Barrier Repair moisturizer to lock everything in. It’s a professional use only silicone based product from their UltraCalming line, and I really wish it was available on the retail side since it’s so good for chronically traumatized skin like mine. It feels like nothing, lasts pretty much all day, and leaves a lovely matte finish.
SPF is a *must* everyday, but it’s *especially* important when using brightening products like a Melanin Suppressant. Brightening products across the board make your skin more sun sensitive, so you really do have to be on top of your sun protection when you use them or else risk burning even more than usual and making your pigmentation worse. I went with the class favorite, Dermalogica’s Dynamic Skin Recovery SPF 50 from their Age Smart line.
All in all, the goal of this facial was to really boost my healing and scar prevention to repair my barrier and keep those post acne spots healing correctly. I want to do a more intense acid treatment next week, but if my skin stays fragile like this then I’ll just have to do something lighter again.
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prismpages · 7 days
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Can COPD be treated with stem cell therapy?
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Introduction
Chronic obstructive pulmonary disease, or COPD, refers to a group of progressive lung diseases characterized by long-term breathing problems and poor airflow. The two main conditions that fall under the COPD umbrella are chronic bronchitis and emphysema. As the lungs and airways become damaged from environmental pollutants like cigarette smoke, it becomes progressively harder for the lungs to function normally. This often leads to symptoms like shortness of breath, coughing, wheezing, fatigue, and other issues that significantly impact quality of life.
Currently, medication is relied on to treat and manage COPD symptoms, though it does not reverse underlying damage or restore lung function. Other options like pulmonary rehabilitation, oxygen therapy, lung transplantation, and smoking cessation can also help in severe cases. However, there remains an unmet need for an intervention that can repair damaged tissue and regenerate lost lung cells. This has led researchers to explore whether stem cell therapy may hold promise as a treatment for COPD.
What are stem cells?
Stem cells are unique cells in our bodies that can both self-renew and differentiate into specialized cell types. There are different classes of stem cells:
Embryonic stem cells: Derived from embryos within a few days of fertilization, these cells are considered pluripotent, meaning they can become any cell type in the body. However, research on human embryos faces ethical issues.
Induced pluripotent stem cells (iPSCs): Adult cells that have been genetically reprogrammed to an embryonic stem cell-like state with pluripotency. iPSCs avoid the use of embryos.
Adult (somatic) stem cells: Present in adult tissues like bone marrow, brain, blood, skin, and muscles. They are multipotent, with the ability to become a few specialized cell types.
In the context of COPD, mesenchymal stem cells (MSCs) hold particular promise. MSCs are multipotent adult stem cells that can differentiate into cells that make up muscles, bones, cartilage, fat, and other connective tissues. They are most commonly derived from bone marrow but can also be found in fat, dental pulp, and umbilical cord blood.
How could stem cells help treat COPD?
Research suggests MSCs may help treat COPD through these mechanisms:
Lung regeneration: MSCs have the potential to differentiate into lung cell types like epithelial cells, endothelial cells, and pneumocytes that form the gas exchange surface in the lungs. This raises hopes that MSCs could help regrow damaged or missing lung tissue.
Immunomodulation: MSCs secrete cytokines and growth factors that reduce inflammation and regulate the immune system. Persistent inflammation driven by the immune response is a major factor in COPD progression.
Angiogenesis: MSCs stimulate the growth of new blood vessels. In COPD, impaired vascularization and oxygen delivery to lung tissues are issues that may be addressed in this manner.
Antifibrotic effects: COPD lungs experience fibrosis or scarring of pulmonary tissue. Studies show MSCs help reduce fibrosis and promote wound healing through matrix remodeling enzymes.
Neurotrophic support: Dysregulation of the pulmonary neuroimmune axis occurs in COPD. MSCs secrete neurotrophins to stabilize the local neural microenvironment in the lungs.
Overall, through their multipotent and immunomodulatory properties, MSCs aim to suppress lung destruction, restore lung function, and mitigate symptoms in COPD through tissue repair and regeneration. Let's explore the evidence behind this stem cell approach.
Clinical trial evidence
A range of small, early-phase safety and proof-of-concept trials have investigated the potential of stem cell therapy in COPD patients so far:
Intravenous infusion: In a phase I trial, 20 COPD patients received two intravenous infusions of autologous bone marrow-derived MSCs a month apart. At six months, significant increases in exercise capacity and health-related quality of life were observed compared to baseline, along with decreased emphysema in high-resolution CT scans. Similar improvements were seen in other studies testing intravenous MSC administration.
Endobronchial transplantation: Another phase I study involving 14 patients delivered autologous bone marrow-derived MSCs via a bronchoscope into the lungs. At three months, lung function and walking distance increased while clinical symptoms decreased relative to before treatment. Endobronchial delivery likely enhances engraftment in the target tissues.
Intratracheal infusions: A trial in 16 COPD patients evaluated fat-derived MSCs administered by bronchoscope through the trachea. Post-treatment, they saw elevated levels of the lung surfactant-associated protein-A and reduced numbers of inflammatory cells in bronchoalveolar lavage fluid, implying a dampened inflammatory reaction alongside potential regeneration.
While the numbers are still low, no significant safety issues have been reported with MSC use in COPD trials thus far. Further evaluation in larger cohorts continues across the world. Platform trials like ONE-BRIDGE are also exploring more variables including factors like donor age, route of administration, and dosage levels.
Real-world examples
R3 Stem Cell is a stem cell bank based in India with facilities for treating patients using autologous adipose stem cell therapy for various conditions. On their site, they discuss indications for which they have seen benefits with COPD patients, including:
Improved breathing patterns and lung capacity parameters like FEV1 and FVC. Following treatment, patients demonstrate measurable gains in pulmonary function parameters.
Reduced exacerbations and fewer hospitalizations. Patients experience far fewer worsenings of respiratory symptoms requiring medication changes or hospital admissions post-treatment.
Enhanced quality of life. Patients note returned abilities to conduct daily chores, perform physical work and exercise, and an overall better feeling of well-being.
Improved breathing comfort and exercise tolerance. Shortness of breath is diminished. Patients find they no longer get breathless from routine movements and can walk longer distances without gasping for air.
Mitigation of chronic lung infections. With strengthened immunity and fewer exacerbation-prompted hospital visits where patients are exposed to illnesses, recurring lung infections tend to attenuate.
Disease stabilization halts further decline. For patients whose lung function was progressively deteriorating each year, treatment allows stabilization preventing additional loss.
These observations provide real-world insight into how adipose stem cell therapy may benefit COPD patients outside the constraints of clinical trials. Of course, larger studies are still vital to fully validate the approach.
Future considerations
While preliminary results are promising, stem cell therapy for COPD remains in the exploratory phase. Questions that still need answers include:
Determining the optimal cell dose and route of administration. More research aims to establish standardized protocols.
Longer-term follow-up data. Currently, most trials only follow patients up to 6-12 months. Longitudinal studies spanning years are essential.
Delineating which COPD subgroups benefit most. Further stratification is important based on disease severity, emphysema presence, exacerbation frequency, and other criteria.
Elucidating the precise mechanisms of action via lung tissue analysis. Further validation of stem cell effects on regeneration, remodeling, and inflammation modulation is underway.
Conducting comparative effectiveness studies. Head-to-head trials against conventionally available COPD treatments will help define the treatment landscape.
Ensuring consistent quality and safety across providers. Optimization of donor screening, cell manufacturing, and administration standards on large cohorts will strengthen the field.
As more long-term safety and efficacy results emerge, stem cell therapy could become an accepted component of COPD management. It holds great potential to improve care for a condition representing a major worldwide health burden. Further clinical advances and research remain on the horizon.
Conclusion
In summary, while definitive conclusions are still being drawn, initial experiments show stem cell therapy may effectively treat COPD symptoms through regenerative and immunomodulating actions. Mesenchymal stem cells administered through various routes seem to help minimize lung injury and enhance recovery by regenerating tissue and counteracting inflammation. Real-world cases also confirm gains in lung function and quality of life following treatment through adipose stem cell therapy. While larger controlled studies are still warranted, early evidence establishes stem cell therapy as a promising avenue worth further exploration for COPD, a progressive and irreversible disease currently lacking an intervention that can reverse the damage. Continued investigation will likely optimize this cell-based approach and bring it closer to becoming part of standardized COPD care pathways.
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drkumaragurubaran1 · 8 days
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Chronic pancreatitis is a persistent inflammation of the pancreas, a vital organ responsible for producing digestive enzymes and regulating blood sugar levels. This condition can significantly impact an individual's quality of life, causing severe abdominal pain, digestive issues, and even diabetes. Understanding chronic pancreatitis, its symptoms, causes, and treatment options, is essential for effective management and improved outcomes.
Understanding Chronic Pancreatitis: Chronic pancreatitis is a long-term inflammatory condition characterized by progressive damage to the pancreas. Unlike acute pancreatitis, which typically resolves with prompt medical intervention, chronic pancreatitis involves ongoing inflammation and irreversible changes to the pancreatic tissue. Over time, this can lead to complications such as pancreatic insufficiency, diabetes, and even pancreatic cancer.
Symptoms of Chronic Pancreatitis: The symptoms of chronic pancreatitis can vary in severity and may include:
Persistent abdominal pain: Dull, persistent pain in the upper abdomen, often radiating to the back. Digestive problems: Difficulty digesting food, leading to weight loss, malnutrition, and diarrhea. Nausea and vomiting: Frequent episodes of nausea and vomiting, especially after meals. Jaundice: Yellowing of the skin and eyes due to impaired bile flow. Diabetes: Insufficient insulin production leading to elevated blood sugar levels. Causes of Chronic Pancreatitis: Several factors can contribute to the development of chronic pancreatitis, including:
Alcohol consumption: Excessive alcohol intake is a common cause of chronic pancreatitis. Smoking: Tobacco use increases the risk of pancreatic damage and inflammation. Genetic factors: Certain genetic mutations can predispose individuals to pancreatitis. Obstructive causes: Gallstones, pancreatic duct obstruction, or tumors can lead to chronic inflammation. Autoimmune conditions: Disorders like autoimmune pancreatitis can trigger pancreatic inflammation. Treatment Options: Treatment for chronic pancreatitis focuses on alleviating symptoms, managing complications, and preventing further damage to the pancreas. Treatment options may include:
Pain management: Medications to relieve pain and discomfort. Enzyme replacement therapy: Supplements to aid digestion and nutrient absorption. Lifestyle modifications: Avoiding alcohol, following a healthy diet, and quitting smoking. Endoscopic procedures: Interventional techniques to remove blockages or dilate strictures. Surgery: Surgical intervention may be necessary to remove diseased tissue or relieve obstruction. Consult the Best Gastroenterologist in Chennai: If you suspect you may have chronic pancreatitis or are experiencing symptoms such as abdominal pain, digestive problems, or jaundice, it's essential to seek medical attention promptly. Consulting with the best gastroenterologist in Chennai can provide you with expert evaluation, accurate diagnosis, and personalized treatment plans tailored to your specific needs. With their expertise and advanced techniques, gastroenterologists can help manage chronic pancreatitis effectively, improving your quality of life and overall health.
In conclusion, chronic pancreatitis is a challenging condition that requires comprehensive management to alleviate symptoms and prevent complications. By understanding its causes, symptoms, and treatment options, individuals can take proactive steps to manage this condition effectively. Remember, early intervention and regular follow-up care with a trusted gastroenterologist are crucial for optimal outcomes.
DrKumaragurubaran Best Gastroenterologist Surgeon in Chennai/Hernia/Gallbladder/Fistula/Laparoscopic Surgeon.
Address: Billroth Hospitals, B, block 43, Lakshmi Talkies Rd, Shenoy Nagar, Chennai, Tamil Nadu 600030
Phone: 093603 91740
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sohamdigi · 9 days
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Mumbai's Health Renaissance: Embracing Traditional Therapies for Holistic Wellness
In the bustling metropolis of Mumbai, amidst the towering skyscrapers and vibrant culture, there exists a unique blend of modern medicine and ancient healing practices. While the city is renowned for its advanced healthcare facilities, there’s also a growing interest in traditional therapies like leech therapy treatment, hijama (cupping), and cupping therapy. These age-old treatments are experiencing a resurgence as people seek holistic approaches to health and wellness.
Leech Therapy in Mumbai:
Imagine tiny, slimy creatures making their way onto your skin, but instead of revulsion, you find relief. That’s the essence of leech therapy, an ancient practice that dates back centuries. Leech therapy in Mumbai has found a niche among those seeking alternative treatments for various ailments.
Leeches are used to suck out impure blood and stimulate circulation in the affected area. This therapy is believed to be effective for conditions ranging from arthritis and varicose veins to skin disorders and even certain types of headaches. The enzymes present in leech saliva have anti-inflammatory properties, making them particularly beneficial for reducing pain and swelling.
While the idea of being ‘leeched’ may sound archaic, many in Mumbai are embracing this therapy as part of their wellness routine. Clinics offering leech therapy are gaining popularity, attracting both locals and tourists curious about its potential benefits.
Hijama Therapy in Mumbai:
Hijama, also known as cupping therapy, is another ancient healing practice making waves in Mumbai. Originating from traditional Islamic medicine, hijama involves creating suction on the skin using glass or plastic cups to draw out stagnant blood and toxins.
Hijama therapy in Mumbai is often sought after for its detoxifying and pain-relieving effects. It’s believed to promote better circulation, reduce inflammation, and boost the immune system. Many people turn to hijama to alleviate musculoskeletal pain, migraines, and even respiratory issues.
Licensed practitioners offering hijama treatment in Mumbai can be found across Mumbai, catering to a diverse clientele seeking alternative healthcare solutions. The procedure is relatively simple, non-invasive, and often accompanied by a sense of relaxation and rejuvenation.
Cupping Therapy in Mumbai:
Similar to hijama, cupping therapy involves creating suction on specific points of the body to promote healing and alleviate various ailments. Cupping Therapy in Mumbai has gained popularity not only for its therapeutic benefits but also for its role in promoting relaxation and stress relief.
Whether it’s the traditional fire cupping method or the more modern vacuum cupping technique, many Mumbaikars are turning to cupping therapy to address issues like chronic pain, fatigue, and even digestive problems. The gentle pulling action of the cups helps release tension in muscles, improve blood flow, and stimulate the body’s natural healing mechanisms.
In Conclusion:
As Mumbai continues to evolve as a global hub of healthcare and wellness, there’s a growing recognition of the value of traditional healing practices alongside modern medicine. Leech therapy, hijama, and cupping are just a few examples of ancient therapies experiencing a resurgence in the city.
Whether out of curiosity, a quest for holistic wellness, or a desire to explore alternative treatment options, more and more people in Mumbai are embracing these age-old practices. With licensed practitioners offering these therapies in safe and controlled environments, individuals have the opportunity to experience the benefits of these ancient healing modalities in the heart of India’s financial capital.
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