#the doctors at this clinic have been pretty good about me being trans. thank god | Explore Tumblr Posts and Blogs

kinkyacademia · 5 years

Note

Mod Pasta, welcome back! I hope your classes went well! Could I please request something nsfw with Overhaul and medical play? Those gloves of his just instantly make me think "doctor" every time, oof. Thank you!

Of course, thank you! I’m running out of requests :O oh no!! Argh, I’m also really wanting to get into writing Marvel sometime. It seems interesting. Also, I just realized that if this request was for Chronostasis, I would have totally had him administer shots until he came (Hope you didn’t forget about my general Hari headcanons).Also, I assumed this with a female! If you would have liked a male, trans male, trans female or otherwise, their checkups are entirely different from female-bodied exams (at least in terms of genital exams).

-Mod Pasta🍜🍝

In a way, Kai was your doctor. He didn’t trust you going to another doctor, perhaps one that would even touch your arm or administer a shot, so he took the liberty of becoming your doctor (After having you fall off the face of the Earth, of course. He couldn’t have police snooping around to see why you didn’t have an official doctor).

That didn’t mean that he didn’t take certain… “liberties.” Your genital health was important, after all, and how better to check it than to test it?

He asks you, obviously, if the idea even seemed appealing to you. To have sex with your doctor wasn’t on your top priority list, usually, but when you already were sleeping with him outside of the “clinic” (A very clean, pristine side room of the bunker), it made your stomach flutter. His only requirement was for you to treat him as a doctor, and you knew he secretly loved the idea of being one himself, so you knew that this was going to end well for the both of you. You agreed to do it, and the next day, you were heading to the “clinic.”

He treated you without much regard, asking you a couple questions about your sex life as if he didn’t already know about it. He wore a typical doctor uniform and a hospital mask, along with gloves. When he asked if you were sleeping with anyone, you paused, “I… am?” You had no idea how to respond to that. He nodded, writing something down that you assumed was “idiot,” and asked if he was allowed to know who that person was, “Oh, just someone, nobody important,” You physically saw the grip on his pen tighten. Perfect.

Then came the check up. When he reached inside your shirt and under your bra to check your breasts for lumps, you shivered at the plastic gloves he adorned. It wasn’t like you hadn’t felt gloves there before, but his personal ones were soft and leathery. These ones were new and exciting, and when he pulled back, he calmly asked if you wanted a vaginal checkup. You hesitated, and he raised an eyebrow that made your heart skip a beat, “Y-Yeah, I think it would be best if I had one.”

“Of course.”

Instead of bringing the strange device out for you to prop yourself up on, he simple had you lay down on the bed-like table. You don’t remember exactly where he got the checkup table, but it was quite comfy for something so hard with crinkly plastic underneath you. You already had the blue gown on, so you removed it and became fully naked. You laid back, and he grabbed your legs propping them up on his shoulders while he took a flashlight to start examining. Everything felt so official, yet so risque.

He asked questions you didn’t know the answer to, then some you could shakily respond to. What was strange was the lack of air blowing on your lips while he spoke, the mask covering all that. He then asked if he could “Feel for any odd shapes.” Your heart picked up speed when he asked, and you obviously agreed.

He started with one gloved finger. It was pretty easy to hold back any noises you would have made otherwise despite the intoxicating feeling of soft plastic, and he didn’t pump his fingers at all. Instead, he paused as if he had found something, “I’ll need to insert two fingers to properly asses you. Your quite tight, so I’m going to have to stimulate you to do so.”

You knew for a fact you weren’t tight, hell, you were overflowing with excited, sticky liquids.

So he started pumping a single finger, and you swallowed hard to not moan. He was always an observant lover, not quite caring, but very observant. He knew exactly how to drive you mad. Every twist and pull was laced with experience. Soon enough, he inserted a second finger, and you couldn’t choke back a very short whimper. He paused, “What was that?”

“Oh, nothing sir. D-Did you find what you were looking for?” Your voice was croaky, but he had the decency not to comment on it.

“No, I need more access… Unfortunately, this hospital requires lubrication for anything above two fingers,” He began to reach into a lower compartment, grabbing a bottle, “Please relax, we will figure this out.”

“Of course, sir.”

You really shouldn’t have trusted him with that many fingers inside of you. Just two was leaving you reeling, and you were pretty sure you just had an orgasm. Instead of stopping, though, your masterful boyfriend pulled his drenched fingers out and lubricated them even further, then slowly inserting three. It was really, REALLY hard for you not to react. Of course the stretching was uncomfortable, but god damn did he know how to use his fingers.

You were a shaking mess once again, under his spell and biting the inside of your cheek while curling your fingers in. Your attempts were probably extremely fetal in his eyes, but in your own, your reactions were minimal. He pumped a couple times, fingers still massaging your g-spot and causing your head to continue being fuzzy, but his hand on your thigh snapped you back into focus, “You’re shaking.”

“Sorry, sir, I’m just nervous is all,” You grit your teeth as he pushed his fingers deeper into you, and he pressed against your walls for a second before nodding to himself.

“You have every reason to be.”

He pulled his fingers out, took the gloves off, and washed his hands. As he did so, you thought about his words, “What’s wrong with me?”

“Oh, nothing terrible. I will have to examine you further, Miss (L/N),” You felt a twinge of surprise at how he addressed you, and nodded slowly.

“Alright, whatever you think is best, sir,” You nodded, and then glanced away when he started to take his belt off. He was wearing formal clothing, the usual for a doctor’s office. Once his belt was off, he unbuttoned his shirt as if afraid that he would get it messy. That’s the Kai you knew, as well as the Kai who put condoms on despite having had unprotected sex with you before and made you take birth control.

Soon he was at your trembling entrance, still wet and puffy from his previous “checking.” You glanced up at his masked lips, then to his eyes, “Is this really n-necessary, sir?”

“Yes. To provide the best patient care, I must exhaust all non-invasive options for treatment,” He pressed himself against your entrance, already fully hard from what he had done to you before. As he pushed into you, his masked shifted slightly, “Even if I’m inside of you regardless.”

Kai never knew when he would made jokes or puns. He was so socially deprived that he never was conscious of his words in the case of puns. When he said that, though, you couldn’t hold back the smallest chuckle despite the need to burst out laughing.

At your chuckle, he pulled back and thrust himself deeper. You shut up quickly, your breath cut off by you gritting your teeth to not moan. Once he was properly positioned inside and on top of you, he started thrusting, his hips meeting yours slowly. As if trying to keep up the act as a doctor, he didn’t look at you, and instead seemed to be thinking about something. You were a mess, and soon enough you let out of moan of pleasure.

His eyes snapped down to your own, and yours widened with guilt, “I appreciate the compliment, Miss (L/N), but I am currently very serious about trying to help you,” There was a twinge of raw effort in his voice as he snapped his hips forward.

“I’m sorry, you’re just… Really…” You couldn’t find a good word for it. As he continued to fuck you into the table, you realized that this was the first time you had sex with Kai where it was purely for fun. Usually there was a sense of dominance or an expression of his power of you, but now you saw him grinning under his mask, enjoying your awkward struggles to not make a sound.

You did, though, and the growing pleasure from your doctor was mounting. His angle, missionary, was all he needed to drive you mad. He knew where he needed to be, but he was always the silent type, so he didn’t really have to try to hide his sounds.

When you orgasmed, it was so much more intense than you thought it was going to be. Your skin had been getting warm, and you even commented on it to Kai in hopes of garnering a doctor-ee response, but he simply said it was a “part of the treatment.”

You hadn’t expected the wave of pleasure to cause your leg to spasm for a second, pushing down on Kai while your hips bucked up. He yelped in surprise, losing his grip on the table and falling on top of you. There was silence for a second, and then he began to shake. You hoped he wasn’t shaking with anger…

You quickly found out that he was laughing. You had to laugh as well - that was honestly one of the funniest sexual experiences you had ever had with him. Obviously it hurt that he had crushed your breasts, but you waved that off at being able to hear him laugh. You hadn’t heard him actually laugh yet, just a chuckle or an evil snicker, but it must have been the situation and his own orgasm that made him loosen up enough to cackle and shake.

Once he was calmer, he threw the condom away and started to re-clothe, his expression reverting back to calm within a minute. You had to sit for a second to get over the weird situation that had just happened, but you eventually grabbed your gown and wrapped it around yourself once again.

“Your appointment is over, go back to our room,” He pointed rudely to the door. You nodded, grinning in glee and exiting. While he was back to his off-putting self, you still held the memory of him laughing after you accidentally caused him to fall on top of you.

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dimples-of-discontent · 5 years

Text

Hwæt: I'm Waging a Campaign

Hwæt. We Gardena in geardagum, þeodcyninga, þrym gefrunon, hu ða æþelingas ellen fremedon.

So. The Spear-Danes in days gone by and the kings who ruled them had courage and greatness. We have heard of those princes’ heroic campaigns.

(Beowulf, trans. Seamus Heaney)

Hello friends,

I’m cross-posting this from a CaringBridge site that I could link to but which will reveal my secret IRL identity since the URL is my name for ease of finding! (I actually think that’s fine but, y’know, use the info respectfully since I have worked to have separation between my professional social media and my fandom social media.)

This is an introduction and update on how things are going with my breast cancer. I’ll do some cross-posting, but most updates will be on CaringBridge and, potentially, a sideblog here that will be less family-approved and/or full of reflections on the whole process. I’ll link you to that if I make one. Thanks for all the good wishes and the gentle hellos and the positivity. It has been sustaining and I am lucky in my friends and family here. 💜💜💜

(Author's note! This is a long post with a fair bit of technical stuff that I find fascinating but don't expect you to. It's just hard to know how to catch you all up without going into detail but, if you like, feel free to skip to the last couple paragraphs.)

If you're here that means you already know many of the basic info, which is that about 6 weeks ago I was diagnosed with triple-negative, metastatic breast cancer. It's pretty nasty and aggressive and moved quickly from a large tumor in my left breast to my axillary lymph node to my lungs to the soft tissue next to my spine (with probable bone marrow involvement). It's probably about 6-9 months old. I wasn't looking for it since, at 34 with zero family history, I wasn't even old enough for screenings. But genetic mutations come from somewhere and it looks like I am the mutation.

Is there good news? Not much. (Not yet.) The tiniest bit is that more aggressive cancers tend also to be more responsive to treatment. The fact that it's triple-negative breast cancer (TNBC) means that the tumor is negative for the three types of receptors that can be used for additional therapies: progesterone, estrogen, and HER2. (A second test actually put my ER number at 20%...which sounds a little like me in general: although I seem very negative at second glance you'll see that I'm about 20% positive.) It's also negative for androgen. This means that the only potential kind of supplementary therapy that might help along with chemotherapy would be immunotherapy. I'm not a candidate for either surgery or radiation since the spread of the cancer is so pervasive and those are highly localized.

I haven't started treatment yet. For these past weeks I've been in a really difficult phase of undergoing a lot of tests to determine the character, extent, and location of the cancer. This was a surprise to me (and to my parents, who came out to NJ immediately and who have been living with me throughout this process). I sort of imagined that when you got the cancer diagnosis--which I did on January 24th at 11am when I was sitting in my office filling out a performance evaluation for my job at Princeton--they'd rush you off to an emergency room where they'd start treatment immediately. I definitely didn't anticipate having to schedule (a challenge in and of itself) and undergo so many tests and to have to wait, terrified, for each series of events. So far, this has been the hardest and worst part.

Being whisked off is more like what happens if your cancer is localized in the breast and associated lymph node. The big first question was whether the cancer was metastatic or not, which they found out with a CT scan that showed it, first, in my lungs. This was maybe the worst news of the whole thing because it meant that radical options to contain it (mastectomy, radiation) were out and that we had to do a bunch more investigating to figure out where the cells had hidden. There was a worry about my liver which showed a large mass that had been there since 2016 when I'd actually been tested for cancer--thanks to chronic fatigue and consistently elevated white blood cell counts--and come up clean. (Luckily the consensus is that the liver mass is benign since it "grew" only .7cm in 2 years, a possible measurement error.) This left the bone scan, which did show the tracer being absorbed, which led in turn to MRIs and a biopsy to confirm metastasis.

Every time I got a new result I learned that you really have to read the fine print when you wish to be exceptional. All of this is so statistically unlikely...and yet it's true.

All-in-all I had two biopsies of three tumors (breast, lymph node, soft tissue next to the spine), two mammograms, two CT scans, and three MRIs. This is in addition to office visits and blood work. I began working with a medical oncologist at Memorial Sloan Kettering (MSK) in Manhattan which brought me back to the city more times than since I left after college. It was looking like the only possible treatment option was single-agent chemo. Most clinical trials for TNBC require that you have been treated first. (I have "de novo" metastatic disease, meaning it had already spread when they first discovered it rather than that it was treated locally but spread anyway.) Others require hormonal receptor positivity. The few I was eligible for were often not enrolling.

However, thanks to the tireless research efforts of my dad, we found out about a clinical trial at the Dana-Farber clinic in Boston that I am potentially eligible to join. It's testing an immunotherapy agent that has already proved effective with TNBC with one chemo agent with a different one. (It actually just got approved by the FDA.) The only trick is that the way the immuno agent works requires that you have a specific protein (PDL1) to really see results. Essentially, one way cancer cells sneak around is switching off your immune system so it can't "see" that they are invaders. The turning off of the immune switch happens with a protein bond involving PDL1; the immuno agent being tested blocks that bond so that the "lights" stay on and the cells can't sneak around as easily. Clever! But if I don't have the protein it's not clear that either being in the trial or getting the now-FDA-approved treatment will benefit me more than single-agent therapy.

So that's the test it's all depending on right now. I should hear in the next couple days. If you want to send positive vibes and wishes and make sacrifices to your god(s) of choice, do it for PDL1 positivity. I feel discouraged, since I've been negative for everything so far, but these are all independent events.

I am also waiting for genetic testing to see if this is a germline mutation--like BRCA--that I inherited. This might affect future treatment and, if I did have one, could be good news because BRCA1 and BRCA2 are very heavily researched...in fact, when I worked in breast cancer research at Wash U Med School I was working with the BRCA lines. (For those who don't know, I started college wanting to go to med school--or at least get a PhD in genetics--so I spent 3 summers between age 16 and 19 studying breast cancer. It's equipped me well to have these discussions, though I certainly imagined being the doctor rather than the patient.)

There are three treatment options that I will (hopefully, hopefully) finalize soon.

I will have the PDL1 protein and will enroll in the clinical trial at Dana-Farber. This will require traveling to Boston every 3 weeks for intensive assessment and new rounds of chemo. The agent involved will make regular life a little rougher since it's by IV and only every 3 weeks. (And I might be in the control group, in which case I'd only be getting the chemo agent. I will, however, know which group I'm in.)

I will have the PDL1 protein and will receive the now-FDA-approved immunotherapy/chemo combination in Princeton with a local doctor and Dana-Farber only doing big-picture stuff.

I will not have the PDL1 protein and will receive single-agent chemo in Princeton, probably orally (twice a day) which is less intensively bad and more low-grade bad all the time. (There is, I guess, a kind of 3b. in which I decide to enroll in the trial even if I don't have PDL1 but it seems less likely.)

So, if you are keeping track of the big decisions that will allow me to actually, finally, begin actively fighting against this that's the last one. I appreciate all the notes that you've been sending so far. I get "message fatigue" but I see all of them and, in fact, have been saving all of them to look back on when things get even harder. So if you'd like to leave love and encouragement here too please know that I will see it and it will be helpful. I'm very unfortunate in this but incredibly fortunate in the number of people I have out there pulling for me and offering support.

Love to you all.

Site link

#personal #medical #health update #not spn #my life as a cancer patient #spn family #YANA #AKF #bex writes

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tmitransitioning · 5 years

Note

im sorry if youve answered something like this before, but do you or your followers have any advice for talking to a doctor about top surgery? i live in BC and its a totally viable thing, but im very awkward and shy, plus anxiety on top of that. is there an easy way to bring this up to my doctor?

I could have sworn I did write a post about this, BC-specific too (same hat!), but I can’t for the life of me find it via search, which means that you probably wouldn’t have been able to either. I think it depends on whether your doctor is your family doctor/GP or if they’re already seeing you for hormones. The latter doctor has probably done a lot of referrals for surgery, and the former may not be as familiar. Bear with me here, because you have a couple different options and it’s early in the morning. c:

I’m going to go under the assumption that you’re familiar with Trans Care BC’s guide, but are getting stuck on the first part, which requires asking about a readiness assessment. They also have a specific page on readiness assessments (second tab, if the link doesn’t open properly); the important part here is “qualified”, because medical professionals in BC do some extra training to be able to assess people for trans-related surgeries. If you’re on hormones, and still seeing the doctor who originally prescribed them to you, then they are almost certainly qualified to do this. Let’s call that Scenario A. If you’re not on hormones, or if you are and no longer seeing the original doctor, but you have a GP, let’s call that Scenario B. If you don’t have a GP, or talking to yours isn’t an option, let’s call that Scenario C.

Scenario A (trans-competent doctor): At your next appointment, you can say something like “what’s the process like to get assessed for top surgery?”. You can say this even if you already know—it’s just meant to let your doctor know you’re interested and want to gather information. The doctor will probably tell you about the readiness assessment, and say whether or not they are able to do it. Sometimes, if you’re on hormones, the assessment of your health that they did for that will count, and they can jump straight to writing the referral letter for you.

Scenario B (doctor, but not necessarily trans-competent): I think that the least anxiety-inducing way of handling this would be to ask them at your next appointment if they “have any experience doing readiness assessments for transgender surgeries”. They may say yes, in which case you’re golden. They may say no, in which case you can say “okay, thanks, do you know of anywhere I could get referred to have one done?”. They might refer you to another clinic, or to a psychologist; they might also say that there’s no referral required and that you can contact another clinic/practitioner directly. Which leads me to…

Scenario C (no GP): You can contact Trans Care BC directly and ask them to help you look up assessors near you. They even have an email form on that page, so you don’t have to call them on the phone. It doesn’t have to be elaborate, and you don’t have to justify yourself to them; you can say something as simple as “Hi, my name is [X] and I live in [region/city]. I’m trying to find a doctor that I can talk to about top surgery, and who can assess me for it. I [have/don’t have] MSP coverage [or any secondary insurance]. Thank you for your time!”. You have my full permission to copy/paste that message and fill in the blanks if it’s helpful for you; the folks working there have been very nice whenever I’ve talked to them. You’ll also be asked, either on the email form or over the phone, how old you are + your nearest city + what health coverage region you fall under.

If you’re under Coastal Health/live in Greater Vancouver/can easily access Davie or Broadway in Vancouver, you can also call Trans Speciality Care directly; they refer to Three Bridges downtown and Raven Song off Broadway. I’ve been to both (for HRT/assessments and injection training respectively) and they’re very nice. [EDIT FEB 21: I’ve since been told they no longer run trans services through Raven Song.]

If saying something out loud, to a doctor’s face, is too stressful, I think C might be a good option for you—I personally find email contact a lot easier than the phone, and Trans Care BC exists in large part to help people coordinate healthcare services. They also handle all surgery referrals in the province anyways; that’s where doctors send your referral letters once they’re done, and then they go into a queue, and then you get a phone call from Trans Care BC once your name comes up giving you surgeon options and possible dates. (You don’t have to decide on the spot.)

You could also write your question down on paper and physically hand it to a doctor! If that sounds awkward, you could preface it with “I want to ask you something, but I’m anxious to say it out loud. I wrote it down; can I just hand the paper to you?”. Chances are they’ll say yes. You can also read the question off of paper, like a script.

And, finally: This is less tailored advice than it is a weird fact of… anxiety in general, but especially this situation. It seems a lot more terrifying in your head than it ends up being. For you, this is a major step in your life; for the doctors, it’s something they do all the time, and the mismatch can feel pretty weird if you’re internally going “oh my god, I can’t blow this” and then you speak to someone who has the same casual air as if they’re seeing you for a chest cold.

It’s not a bad thing, and this isn’t to knock doctors at all—I mention it because a doctor who advertises themself as trans-friendly here, and who operates in the network of trans health services, that doctor is not seeing you as weird or a medical anomaly based on your trans identity. They’re seeing you as part of their patient demographic, and likely know that you’re anxious about this. You’re not doing anything wrong and won’t be yelled out of the office because you’re shy.

- Mod Wolf

#bc #canada #british columbia #surgery #surgery referral #top surgery #mastectomies #mod wolf #is overtagging so they can find this post later

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pitiless-achilles-wept · 5 years

Text

Hwæt: I’m Waging a Campaign

Hwæt. We Gardena in geardagum, þeodcyninga, þrym gefrunon, hu ða æþelingas ellen fremedon.

So. The Spear-Danes in days gone by and the kings who ruled them had courage and greatness. We have heard of those princes’ heroic campaigns.

(Beowulf, trans. Seamus Heaney)

[I’m archiving this, from March 11th, here since I’ve decided to use a sideblog for cancer thoughts and updates.]

Hello friends,

This is an introduction and update on how things are going with my breast cancer. I’ll do some cross-posting, but most updates will be on CaringBridge and, potentially, a sideblog here that will be less family-approved and/or full of reflections on the whole process. I’ll link you to that if I make one. [This is the sideblog.] Thanks for all the good wishes and the gentle hellos and the positivity. It has been sustaining and I am lucky in my friends and family here. 💜💜💜

(Author’s note! This is a long post with a fair bit of technical stuff that I find fascinating but don’t expect you to. It’s just hard to know how to catch you all up without going into detail but, if you like, feel free to skip to the last couple paragraphs.)

If you’re here that means you already know many of the basic info, which is that about 6 weeks ago I was diagnosed with triple-negative, metastatic breast cancer. It’s pretty nasty and aggressive and moved quickly from a large tumor in my left breast to my axillary lymph node to my lungs to the soft tissue next to my spine (with probable bone marrow involvement). It’s probably about 6-9 months old. I wasn’t looking for it since, at 34 with zero family history, I wasn’t even old enough for screenings. But genetic mutations come from somewhere and it looks like I am the mutation.

Is there good news? Not much. (Not yet.) The tiniest bit is that more aggressive cancers tend also to be more responsive to treatment. The fact that it’s triple-negative breast cancer (TNBC) means that the tumor is negative for the three types of receptors that can be used for additional therapies: progesterone, estrogen, and HER2. (A second test actually put my ER number at 20%…which sounds a little like me in general: although I seem very negative at second glance you’ll see that I’m about 20% positive.) It’s also negative for androgen. This means that the only potential kind of supplementary therapy that might help along with chemotherapy would be immunotherapy. I’m not a candidate for either surgery or radiation since the spread of the cancer is so pervasive and those are highly localized.

I haven’t started treatment yet. For these past weeks I’ve been in a really difficult phase of undergoing a lot of tests to determine the character, extent, and location of the cancer. This was a surprise to me (and to my parents, who came out to NJ immediately and who have been living with me throughout this process). I sort of imagined that when you got the cancer diagnosis–which I did on January 24th at 11am when I was sitting in my office filling out a performance evaluation for my job at Princeton–they’d rush you off to an emergency room where they’d start treatment immediately. I definitely didn’t anticipate having to schedule (a challenge in and of itself) and undergo so many tests and to have to wait, terrified, for each series of events. So far, this has been the hardest and worst part.

Being whisked off is more like what happens if your cancer is localized in the breast and associated lymph node. The big first question was whether the cancer was metastatic or not, which they found out with a CT scan that showed it, first, in my lungs. This was maybe the worst news of the whole thing because it meant that radical options to contain it (mastectomy, radiation) were out and that we had to do a bunch more investigating to figure out where the cells had hidden. There was a worry about my liver which showed a large mass that had been there since 2016 when I’d actually been tested for cancer–thanks to chronic fatigue and consistently elevated white blood cell counts–and come up clean. (Luckily the consensus is that the liver mass is benign since it “grew” only .7cm in 2 years, a possible measurement error.) This left the bone scan, which did show the tracer being absorbed, which led in turn to MRIs and a biopsy to confirm metastasis.

Every time I got a new result I learned that you really have to read the fine print when you wish to be exceptional. All of this is so statistically unlikely…and yet it’s true.

All-in-all I had two biopsies of three tumors (breast, lymph node, soft tissue next to the spine), two mammograms, two CT scans, and three MRIs. This is in addition to office visits and blood work. I began working with a medical oncologist at Memorial Sloan Kettering (MSK) in Manhattan which brought me back to the city more times than since I left after college. It was looking like the only possible treatment option was single-agent chemo. Most clinical trials for TNBC require that you have been treated first. (I have “de novo” metastatic disease, meaning it had already spread when they first discovered it rather than that it was treated locally but spread anyway.) Others require hormonal receptor positivity. The few I was eligible for were often not enrolling.

However, thanks to the tireless research efforts of my dad, we found out about a clinical trial at the Dana-Farber clinic in Boston that I am potentially eligible to join. It’s testing an immunotherapy agent that has already proved effective with TNBC with one chemo agent with a different one. (It actually just got approved by the FDA.) The only trick is that the way the immuno agent works requires that you have a specific protein (PDL1) to really see results. Essentially, one way cancer cells sneak around is switching off your immune system so it can’t “see” that they are invaders. The turning off of the immune switch happens with a protein bond involving PDL1; the immuno agent being tested blocks that bond so that the “lights” stay on and the cells can’t sneak around as easily. Clever! But if I don’t have the protein it’s not clear that either being in the trial or getting the now-FDA-approved treatment will benefit me more than single-agent therapy.

So that’s the test it’s all depending on right now. I should hear in the next couple days. If you want to send positive vibes and wishes and make sacrifices to your god(s) of choice, do it for PDL1 positivity. I feel discouraged, since I’ve been negative for everything so far, but these are all independent events.

I am also waiting for genetic testing to see if this is a germline mutation–like BRCA–that I inherited. This might affect future treatment and, if I did have one, could be good news because BRCA1 and BRCA2 are very heavily researched…in fact, when I worked in breast cancer research at Wash U Med School I was working with the BRCA lines. (For those who don’t know, I started college wanting to go to med school–or at least get a PhD in genetics–so I spent 3 summers between age 16 and 19 studying breast cancer. It’s equipped me well to have these discussions, though I certainly imagined being the doctor rather than the patient.)

There are three treatment options that I will (hopefully, hopefully) finalize soon.

I will have the PDL1 protein and will enroll in the clinical trial at Dana-Farber. This will require traveling to Boston every 3 weeks for intensive assessment and new rounds of chemo. The agent involved will make regular life a little rougher since it’s by IV and only every 3 weeks. (And I might be in the control group, in which case I’d only be getting the chemo agent. I will, however, know which group I’m in.)

I will have the PDL1 protein and will receive the now-FDA-approved immunotherapy/chemo combination in Princeton with a local doctor and Dana-Farber only doing big-picture stuff.

So, if you are keeping track of the big decisions that will allow me to actually, finally, begin actively fighting against this that’s the last one. I appreciate all the notes that you’ve been sending so far. I get “message fatigue” but I see all of them and, in fact, have been saving all of them to look back on when things get even harder. So if you’d like to leave love and encouragement here too please know that I will see it and it will be helpful. I’m very unfortunate in this but incredibly fortunate in the number of people I have out there pulling for me and offering support.

Love to you all.

#medical update #archived

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humansunshineao3 · 6 years

Text

New Eyes: A Mundane Soulmate AU

“Remember, the safe word is watermelon. If you see the word watermelon, we stop this whole thing.”

“Oh my God, you’re not going to need a safe word.”

“That’s bad BDSM etiquette, Miss Fray,” Magnus insisted, pacing back and forth in front of the restaurant.

Clary sighed, and Magnus could sense that she was rolling her eyes at Izzy, who he could hear giggling softly in the background. “A dinner date is not equal to tying someone to a St Andrew’s Cross, Magnus.”

“You’re right, it’s much more traumatic.”

“I’m hanging up now,” Clary groaned. “You have to swear to me that you’re not going to traumatise him. He’s Izzy’s brother, and he’s going to be her best man at our wedding. If you want to be my best man, you have to at least not totally hate each other.”

Magnus wrinkled his nose. “Why did you have to go and say that? Now my lizard brain is telling me to self-sabotage.”

“Oh my God!”

“I’ll be good! At least, I’ll try,” Magnus promised, fiddling with his necklaces. “I’ll call you later.”

Alec Lightwood was late. In his defense, Magnus had been early, and Alec was apparently a doctor, but still. It was seven minutes past seven, and Alec hadn’t even texted to apologise. If this was a normal blind date, Magnus absolutely would have left at two minutes past seven. He’d dated enough ego-maniac career men to know that being late to a first date does not set a good precedent for any relationship. There was only room for one ego-maniac in any relationship, and Magnus had that position resolutely filled. However, this particular ego-maniac was the brother of his secretary’s fiancee, and so Magnus would never hear the end of it if he stood up Alec Lightwood.

“Oh, fucking hell.”

Magnus turned around at the sound of the muttered curse to see a tall, ridiculously handsome man checking his reflection in the window of the restaurant. He had dark hair and lovely broad shoulders, and he was wearing beautifully fitted clothes, clearly tailored specially. Magnus narrowed his eyes. There was no way he wasn’t related to Isabelle.

“Alec Lightwood?” He asked tentatively, and the handsome man looked around at him. His eyes lit up as they fell on Magnus, and he grinned warmly.

“Magnus Bane?”

Oh, Magnus would have to kiss Clary square on the mouth on Monday morning.

“Yes, that’s me. You’re late,” he accused, tilting his head to the side.

Alec grimaced, “yes, I’m so sorry. I left the hospital an hour ago just in case, but… Well, there was an incident with a dog.”

“A dog?” Magnus repeated, narrowing his eyes.

“Yeah… First thing to know about me… I can’t pass a stray dog without feeding it.” Alec admitted sheepishly, walking around Magnus to open the door for him. “Honestly I’d have taken him back to my apartment if I wasn’t supposed to be meeting you. As it happens, the poor little guy’s on his way to the shelter right now.”

Magnus couldn’t believe his ears. “I have two dogs at home. Both strays.”

“No way!” Alec beamed. “What are their names?”

“Charlie and Lorenzo.” Magnus shrugged, unable to keep from smiling as Alec dug in his wallet for a photograph.

“I have the tiniest apartment in the city, so I can only really have one at a time, but here. Her name’s Bourbon. I found her about a year ago, now. Usually I just foster, but I couldn’t let her go. Izzy named her; apparently she’s the colour of bourbon. Not that I would know,” Alec shrugged, “haven’t found my person yet.”

“Table for two?” The maître d' asked, and Magnus nodded, taking the photograph from Alec to examine it as they were led to their table. Like Alec, Magnus couldn’t see the colour of her, but her big, beseeching eyes were irresistible, and he could see why Alec couldn’t give her up.

“She’s beautiful,” Magnus smiled, his eyebrow quirking when he looked up from the photograph to see Alec holding out his chair for him. “A dog-lover and a gentleman. Remind me not to touch you until after dessert.”

Alec chuckled, taking his own seat across from Magnus, the two of them barely noticing the maître d' handing them their menus and leaving. “Why? Were you going to jump me before you found out about my love of dogs?”

Magnus smirked. “Something like that. Though I doubt you really are my soulmate.”

“Oh?” Alec leaned forward, elbows on the table. “Why’s that?”

“Because you’re a doctor with a tiny apartment,” Magnus hummed, “you’re clearly hiding some kind of gambling addiction.”

Alec laughed, resting his chin on his hand, batting his eyelashes a few times. “And your soulmate doesn’t have a gambling addiction?”

“Nope, my soulmate has a low key alcohol dependency, like me.” Magnus answered flippantly, eyes searching Alec’s face for signs of judgement. It wasn’t judgement that he saw, but there was definitely something there.

“I’m afraid I’m not as interesting as that,” Alec shrugged, looking down at the menu. “I pay my little brother’s tuition. He’s in a boarding school in Washington. My parents aren’t… Well, they don’t approve of his choice in career, so they refused to pay for his education.”

Magnus frowned, his heart sinking. This was never going to work. Alec adopted stray dogs and looked after his family? And he didn’t even drink? There was no way he was ever going to settle for Magnus.

“Anyway, I hear you’re an architect. Must be a pretty high-stakes job.”

“Oh, yes,” Magnus nodded, putting a smile back on his face as he glanced at his own menu. “Though nowhere near as high stakes as holding people's’ lives in your hands, I’m sure.”

Alec shook his head. “Oh, my job is nothing as dramatic as that. I’m in the Gender Identity Clinic, so I mostly just prescribe hormones and discuss surgery options.”

“You work with trans people?” Magnus asked, sitting up a little straighter in his seat. God, was there anything about Alec Lightwood that wasn’t perfect?

“Yeah, it’s not the big of a deal. It’s very rewarding, of course, and I love my job, but it’s nothing glamorous.” He explained, fiddling with his menu. “I’m sorry, didn’t Izzy tell you… About me?”

Magnus looked at him for a moment, wracking his brain for what exactly Alec was referring to, and smiled as it clicked into place. “Oh yes, she did. Sorry, I forgot. Of course, it makes sense that you’d work to help people like yourself.”

Alec breathed out a sigh of relief, visibly destressing. Magnus smiled, endeared. “Thank God. She’s always like ‘it’s none of their business!’ but honestly, I prefer for people to know in advance. Makes it less weird if they’re not okay with it.”

“I get it. I imagine it makes dating even more difficult than it already is in this God-forsaken city.”

“Christ, you have no idea. And you know, I could honestly lean over and kiss you right now because I swear to God, you are the first person I’ve dated in years who hasn’t waxed lyrical about how brave I am or some bullshit. Like… God. It gets exhausting.” Alec grumbled, knotting his hands together between his knees.

Magnus chuckled, leaning back in his chair a little. “Not that I’m trying to downplay what you go through, but I could honestly count on one hand the amount of times I’ve been on a date and someone hasn’t asked me if I’ve ever had a threesome when I mention that I’m bisexual…”

“Right?! They know full well it’s a stereotype and it’s gonna annoy you, why do they have to do it?!” Alec laughed.

“It’s like they have this compulsion to try and piss you off to see if you break.”

“Ugh, exactly!” Alec exclaimed. “It’s so weird!”

Magnus shook his head. “Well, for the record, I have had a threesome. But it was with two girls, so my bisexuality had nothing to do with it.”

“And, for the record, I am the biggest coward in the Northern hemisphere,” Alec shrugged, “I am a lover, not a fighter.”

“I can’t imagine anyone wanting to fight you, Alexander, you’re way too charming.”

“Charming?!” Alec spluttered, shaking his head. “Listen, you know how many coffees I had today just so I’d be able to talk to you like a normal person? This is all a caffeine high, I’m telling you. I’m going to crash after dinner and you’ll be so bored you’re going to fall asleep.”

Magnus laughed, his hand shifting to reach for Alec’s, but thinking better of it at the last moment. Part of him was hoping that Alec really was his soulmate. He’d never clicked this instantly with anyone before, and his matched friends all said that was what happened when you met your soulmate. Clary said that she’d known Izzy was it for her the moment she saw her.

Could Magnus handle the disappointment if he touched Alec’s hand and everything stayed black and white?

~~~~~~~~~~~~~~~~~~~~

Magnus insisted on picking up the check at the end of their meal. “Unlike you, I don’t have any dependents,” he insisted, handing the waiter his credit card, “well, unless you count the dogs.”

“Thanks,” Alec bit his lip, “I can pay next time though, right?”

“Next time?” Magnus repeated, keeping his eyes on the chip and pin machine so Alec wouldn’t see the eagerness on his face, “yes… I imagine so.”

Alec sighed, nodding to himself. “Good. Good.”

Once the bill was paid, the waiter gave them a little bow, and bid them goodnight. Magnus and Alec looked at each other, neither making a move to go. For a long moment, as the two of them wracked their brains for a reason not to part, there was a comfortable silence between them. Alec couldn’t help but hope that he got to see the colour of Magnus’ eyes someday; they shone like there were diamonds hidden in them, sparkling with every smile the other man gifted him. Magnus had to be his soulmate, Alec told himself. There was no way that he’d feel this much this fast for just anybody. In the two hours that they’d managed to spend drawing out dinner, Alec felt like he’d fallen fully in love. He couldn’t believe that he ever thought he was content before he’d heard Magnus laugh.

“Did you say you took a taxi here?” Magnus asked.

“Huh?” Alec blinked out of his reverie. “Oh, yes, I did.”

“Well, personally I’m quite full from dinner. I think I could use a few blocks’ walk.” Magnus said coyly, toying with his ear cuff.

Alec smiled, getting to his feet. “Sounds perfect.” He watched Magnus put on his coat, and gestured for him to lead him from the restaurant, nerves rising in his stomach as they stepped out together into the cool night air. “Magnus?”

“Hmmm?”

“Do you want to, uh… Hold my hand?” Alec requested, moving so he and Magnus were stood facing each other in front of the restaurant, half a foot apart. Magnus’ breath hitched in his throat, his eyes dropping to Alec’s hand, held palm-up between them.

Magnus said a little prayer to a God he didn’t believe in, and met Alec’s eyes. “You sure you’re ready?”

Alec tilted his head to the side, eyes tentative. “I’ve always dreamed of meeting someone like you.”

It took everything Magnus had not to forget the hand-holding altogether and throw himself against Alec’s lips, but he just barely resisted, closing his eyes. Alec’s eyes slipped shut too, and when he closed his fingers, he felt the warmth of Magnus’ hand slip into his grip. The world around them melted away when they opened their eyes, and Alec grinned, almost faint with relief.

Magnus’ eyes were the most beautiful colour in the world.

It was the first colour he’d ever seen, but he knew it would be his favourite forever.

“Alexander,” Magnus breathed, reaching up to cup his face, his eyes greedily drinking in every technicolour detail of his face.

Alec’s hands slipped around the other man’s waist, and they hugged tightly, overjoyed tears welling in their eyes. They stood there hugging for a long time, occasionally feeling the brush of stranger’s bodies pass them, and it was only when someone yelled at them for hogging the sidewalk that they broke apart, giggling like children.

“So… Wanna come meet my dog?” Alec asked, forcing his tone to be light even though all he wanted to do was holler and fist-pump.

Magnus laughed, twining his fingers with Alec’s. “I’d love to.”

Requests are open!

#malec #malec fanfic #malec fanfiction #shadowhunters fanfic #malec au #writing #content

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common-mushroom · 7 years

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Aahhhhh I think a cute fic would between a farmer who's a trans boy with Harvey? They go to Harvey asking to get testosterone since their prescription ran out and ZuZu City is far away, making Harvey curious as to how a healthy boy would need it. After some explanation, Harvey seriously studies trans medical practices like HRS and talking to the farmer about what he should know and how to better cater to their needs since he's never had a transgender patient before??

This prompt is awesome!! Video games totally need more representation for trans people. This might actually be a good candidate for a full-length multi chapter fanfic in the future! Anyway here ya go:

Summer was a slow time of year for Harvey at the clinic. Although he needed the money from taking care of patients, he was more than okay with less of it knowing that the people of Pelican Town were healthy. This is why he was shocked to see the farmer appear at his door.

“He’s just doing a drop-in. Hope that’s okay with you, Harvey.” Maru called from the waiting room.

“No problem. Come in, MC.”

The farmer came in. Harvey was still amazed at how far he’d come since he’d first came to the town only a month ago. MC was pale, skinny, and reeked of the city at the time of his arrival. Now, he had built muscle and acquired a healthy tan, and somehow permanently smelled like freshly-cut grass. Harvey wondered what the farmer was doing in his office at all.

“I’m sorry to drop by at the last minute. I wouldn’t be here if it wasn’t important. I just...I miscalculated how much I had left of my prescription. I thought I’d have enough to last me until I went back to visit my family in Zuzu City at the end of August, but it looks like I’m a bit short.” The farmer’s face, for some strange reason, flushed a dark pink. Harvey was curious.

“You would like me to refill your prescription?”

“I’d owe you so much. Please, Harvey. I’ll do anything. It’s just a real pain in the ass to go all the way to the city, you know?” The boy looked Harvey in the face with pleading eyes. Harvey’s heart leapt in his chest. He looked down at his paperwork awkwardly, lest his gaze accidentally linger too long.

“Well, depending on the medication, we can usually just fill it right here in the office. But it’ll depend if we have it in stock,” Harvey sighed. “What is it you need?”

The farmer hesitated. Suddenly, a million thoughts began to race through Harvey’s head. Did the farmer have a terminal illness? Was he in trouble? What could be so embarrassing that MC, who was always friendly and loud, suddenly clams up?

“Testosterone injections.”

Harvey’s pen froze mid-word. Testosterone? He looked up from his paper, slowly. He gave the farmer a once-over. What in the hell would he need that for? The farmer handed him a nearly-empty bottle with his name inscribed on the tag.

Harvey realized that his silence could be taken for hostility, and he shook his head quickly.

“Sorry. You caught me a bit off-guard there. Testosterone, no problem. We’ve got that.” He blushed and wrote out the prescription. “What’s your normal dosage?”

“300 milligrams.”

Harvey continued to write, struggling not to look at the farmer again. The last thing he wanted was to embarrass the boy.

“Okay. We can have that ready for you in a couple of days. Is that fast enough for you?”

The farmer let out a sigh of relief.

“Yeah, definitely,” without warning, the farmer raced over to Harvey and gave him a tight hug. Harvey’s heart dropped into his stomach. “Thank you so much, Doctor. You have no idea how much this means to me.”

“Oh! No problem, MC. That’s what I’m here for.”

The farmer pulled away and looked Harvey in the eye.

“This is probably going to come as a shock to you, but...I’m actually transgender. I need those hormones so my body functions the way I want it to. That’s why this is so important to me.”

Harvey paled. Transgender?

“Oh. I’ve never met a transgender person before.” He said, lamely.

“Well, now you have,” MC smiled stiffly. “Thanks, Doctor.” The farmer waved and left the room, giving him a skeptical glance over the shoulder before closing the door.

Harvey slumped down into his seat. MC was born...wow. He couldn’t believe it. But...he looked so...masculine. Harvey quickly booted up his dinosaur computer. It was time to do some more research.

A few days later, the boy was back in Harvey’s office. Harvey prayed that he wouldn’t bring up the awkwardness at the end of their last interaction. He hung his head in shame.

“Hi, Harvey,” the farmer sat down in the chair across from the doctor’s desk. “I just wanted to say thanks again for helping me out.” Harvey smiled and handed the boy his prescription.

“No problem, MC. I actually wanted to talk to you, if you have the time.” Harvey blushed and stared at his hands.

“What’s up?”

“I wanted to apologize for the other day. It was completely unprofessional for me to be so reactive.” The farmer chuckled nervously.

“I’m pretty used to it. I know you probably didn’t mean it in a transphobic kind of way.” Harvey’s eyes widened.

“Oh, God, no! I hope it didn’t come off that way. I just...I’ve never had a transgender patient before. I didn’t quite know what to say. I’ve read about it in the past but I’ve never practiced care for it before.”

The farmer and Harvey made eye contact. Harvey smiled shyly.

“I’m sorry.”

“Don’t be.”

“Well, since you asked me for a favor, I wanted to ask you for one, too.” Harvey said. He raked a hand through his hair anxiously.

“What is it?” The farmer grinned.

“I’ve been practicing medicine for years, but I am still in the dark about...your situation,” Harvey gulped. “I want you to tell me everything you know about being transgender.” The farmer blushed and nodded.

“For that, I have all the time in the world.”

~~Hope you enjoyed! I don’t have a ton of knowledge about the medical side of trans issues but I tried my best to be accurate. If there’s anything I should fix let me know! This is just a lil sample :)

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