Date: 15/12/22 Support Tips: Preparation: in order to best prepare some actions might include ~ Considering your sensory needs- pack a bag with sensory aids such as headphones, earplugs, coloured glasses, stim tools, comfort items and so on to support your comfort whilst at your appointment. Considering your communication needs- perhaps take a trusted friend or family member to support with verbal communication, a hospital passport that you can share with staff or notes including scripted comments or responses that you can refer to during the appointment to support with or replace verbal speech. Wear suitable clothing that can be easily taken on and off. To minimise uncertainty, research what is involved in the procedure before attending so that you have a good idea what to expect. Write out a list of questions to avoid relying on memory during a potentially stressful experience. Plan your travel route in advance and leave plenty of time to get to your appointment to minimise anxiety and allow time to adjust to the environment upon arrival. Engage in calming, grounding techniques prior to the appointment start time. During: whilst at the appointment it may be helpful to ~ Ask for the nurse practitioner to talk you through the procedure in full before it commences, preferably with use of images or demonstrations with relevant equipment. Be open about which aspects of the experience you might struggle with as an Autistic person and request particular adjustments. Engage in grounding techniques such as mindful breathing. Hold on to a stim object that is comforting or acts as a stress reliever. Listen to music to support self-regulation. Share your concerns or worries with the nurse practitioner to invite reassurance or helpful advice. Remember your reason for attending and why it is important for you. Aftercare: following the procedure, it is a good idea to plan in some time for self-care and self-regulation, some ideas might include ~ Get yourself into a sensory safe space where things feel predictable and calm (for e.g. a quiet room with dim lighting, weighted blanket etc). Arrange to debrief/chat to a friend or another supportive person about your experience after leaving your appointment. Arrange to meet with a trusted person following the procedure to support you with getting back home or perhaps to do something you might enjoy together. Engage in your dedicated interest. Acknowledge your achievement in attending and getting through the appointment. Journal about your experience to help with emotional processing. Engage in your favourite stim to release any tension that may remain in your b0dy. Allow yourself to physically rest or sleep once back at home. Date: 15/12/22

Date: 15/12/22 Autistic qualities such as differences in how we understand what our body is feeling (interoception), our experience of pain (hypo/ hyper sensitivity) and difficulties in noticing and identifying how we feel (alexithymia) Nurse practitioners and doctors may have a limited understanding of the unique and significant ways in which autism and its associated issues impact a patient’s experience of a given medical procedure. This means that the particular supports that might help to alleviate discomfort could be lacking. We might encounter resistance to our own attempts to self- regulate and take care of our sensory and emotional needs during the appointment. We may even experience medical gas lighting or invalidation when attempting to express our experience or request much needed accommodations ( we know that this happens at higher rates amongst female presenting people, people of colour and those with additional learning disabilities in our community). For those of us with a history of these types of experiences, just being in a medical environment could feel threatening and unsafe. * Autistic person with a particular set of qualities and traits, this is not a prediction of what others might encounter or an attempt to generalise my own experience to the broader community. Date: 15/12/22

BLOODYPAWS PLEASE MAKE A GOTH/NURSECORE/BLOODCORE THEMED BIO?

Cͨaͣrͬdͩiͥoͦрⷬhͪoͦвⷡiͥaͣ (feͤaͣrͬ oͦf hͪeͤaͣrͬᴛⷮ dͩiͥs͛eͤaͣs͛eͤ oͦrͬ hͪeͤaͣrͬᴛⷮ aͣᴛⷮᴛⷮaͣcͨᴋⷦs͛). нⷩeͤmͫoͦрⷬhͪoͦвⷡiͥaͣ (feͤaͣrͬ oͦf вⷡloͦoͦdͩ). Noͦs͛oͦcͨoͦmͫeͤрⷬhͪoͦвⷡiͥaͣ (feͤaͣrͬ oͦf hͪoͦs͛рⷬiͥᴛⷮaͣls͛). Рⷬhͪaͣrͬmͫaͣcͨoͦрⷬhͪoͦвⷡiͥaͣ (feͤaͣrͬ oͦf mͫeͤdͩiͥcͨaͣᴛⷮiͥoͦn). ᴛⷮoͦmͫoͦрⷬhͪoͦвⷡiͥaͣ (feͤaͣrͬ oͦf mͫeͤdͩiͥcͨaͣl рⷬrͬoͦcͨeͤdͩuͧrͬeͤs͛ liͥᴋⷦeͤ s͛uͧrͬgeͤrͬiͥeͤs͛). ᴛⷮrͬaͣuͧmͫaͣᴛⷮoͦрⷬhͪoͦвⷡiͥaͣ (feͤaͣrͬ oͦf iͥnjuͧrͬy).

TOOTH AFTERNOON i Karen remained fixed on her husband, Plankton, who lay on the chair, his mouth slightly agape. Her screen flitted to the doctor's assistant, who offered a sympathetic smile and nod. “The wisdom teeth extraction was a success. You can stay with him as he wakes up from anesthesia, but it’s normal if he doesn’t act like himself for today, as it’s a strong medicine.” The nurse emerged. “Yes, everything went well, Karen. We’ve removed the offending teeth and he’ll be on the mend soon. Just keep an eye on him for the next twenty-four hours, and he’ll be fine.” Karen watched, hands clasped tightly in her lap, as the doctor closed the door with a soft click. She felt the weight of the world lift, but she didn’t dare move. The surgery was done, but she knew the battle was only beginning. The room was quiet except for the faint beeping of monitors and the steady rhythm of Plankton’s breathing. The anesthesia had done its job, keeping him in a deep sleep. His face was serene, a stark contrast to the chaos of the day’s events. Drool pooled at the corner of his mouth, and Karen reached over to gently wipe it away with a tissue. She didn’t want him to wake up to that. Karen’s mind raced with thoughts of home, of the quiet comfort that waited for them. She knew the next hours would be a test of patience as the drugs will linger in his system. The doctor’s words echoed in her head: "Don’t be alarmed if he’s groggy or doesn’t remember much." As Plankton’s eye fluttered open, Karen leaned in closer, her voice a gentle whisper. “Hey, everything’s okay. You’re all done.” But his eye closed again, his head lolling back into the pillow. A sigh escaped her. The surgery was over, but the anesthesia’s grip remained strong. Moments later, Plankton stirred. “Whathapennn...?” he slurred, his tongue thick and unwieldy. Karen stifled a laugh with love for his vulnerable state. She squeezed his hand, trying to offer comfort. “You had your wisdom teeth out, sweetie. You’re ok now,” she soothed, but he didn’t seem to comprehend. His eye searched the room, a dizzying swirl of confusion and drugs. He attempted to sit up, but his body didn’t obey. He fell back with a grunt, hands flailing to the sides. The nurse bustled in, placing a firm but gentle hand on his shoulder. “Take it easy, Mr. Plankton. You’re going to be a little loopy for a bit.” The words didn’t register. Plankton’s mouth was a cottony abyss where coherent thoughts went to die. He felt his tongue swell and thicken, his teeth floating in a sea of numbness. Karen watched, a mix of concern and amusement. “Thish isn’t right,” he mumbled. “Shomeone tookh my teethh!” Karen couldn’t help but chuckle at his slurred protest. “They just took the wisdom ones, hon. The ones that were giving you grief. You’re okay.” The doctor poked his head in, smiling at the sight of Plankton’s bewilderment. “How’s our patient doing?” Karen's amusement grew. “He’s under the influence, Doc. Thinks you took all his teeth!” The doctor chuckled, his eyes crinkling with good humor. “It’s the anesthesia. Give it some time to wear off, and he’ll be back to his charming self.” Plankton’s eye searched for her, blurry and unfocused. “Kareb, did they shteal my teef?” Karen’s chuckles grew louder. “They didn’t steal them, Plankton. They just removed the ones that were causing you pain. Your mouth is just a bit numb from the surgery.” Plankton’s eye widened. “Arrr, matey?” Karen’s laughter bubbled over. “No, you’re not a pirate, you just had surgery. The feeling will come back eventually.” Plankton blinked at her, his eyelid heavy. “Marrnin’, Karen. Wher’ arr we?” his words jumbled as he tried to piece together the fragments of reality that drifted in and out of his consciousness. The room was still, the only movement being the occasional twitch of his mouth as the anesthesia tried to keep him in its grasp. Karen’s screen sparkled with mirth. “We’re at the dentist’s, Plankton. You had your wisdom teeth removed.” “Wiz-dom...teef?” he slurred, his mind a foggy haze. Karen nodded, her laughter now a gentle rumble. “Yes, the doctor took them out so you don’t hurt anymore. You’re going to be okay now,” she cooed, stroking his forehead. But Plankton’s confusion was unyielding. “Marrnin’, Karen,” he mumbled again, as if trying to anchor himself in the familiar. “It’s afternoon, Plankton. You’ve been out for a while. You’re okay, though. Just a bit slow on the uptake, that’s all,” Karen teased, her voice filled with affection. Plankton blinked again, his eye trying to focus. “Af...ter...noon?” He felt the world spin around his head and groaned. “Wheh?” Karen nodded, her smile soft. “Yes, it’s afternoon. You’ve been asleep for a bit. But don’t worry, everything went well. The doctor got all the teeth out and you’re going to be fine.” Plankton’s eye searched hers, still not fully comprehending. “Teesh?” he mumbled, his voice barely a whisper. Karen nodded, her smile growing. “Yes, teeth, sweetie. The doctor took out the ones that were causing you pain. Remember?” Plankton’s face contorted in thought, his mouth a limp mess of numbness. “Oooh, yea...teefh,” he managed, the word dragging out.

💉❤️♥️♥️❤️💉

💉 💊 🩹 🫀 ✒️ 🩸 🕊 ❤️‍🩹 🩺

💉 ❤️‍🩹 💉 ❤️‍🩹 💉 ❤️‍🩹 💉 ❤️‍🩹 💉

🏩🦷💊🌸🧸💉🩹🔪

💙 https://www.spectrumnews.org/features/deep-dive/unseen-agony-dismantling-autisms-house-of-pain/ 💙

𓏲 　🍼　ﾟ⠀⠀ ･₊ ˚ ⠀ ࿐ 𝗒𝗈𝗎𝗋 𝗋𝖾𝗆𝗂𝗇𝖽𝖾𝗋 𝗍𝗈 𝗍𝖺𝗄𝖾 𝗒𝗈𝗎𝗋 𝗆𝖾𝖽𝗂𝖼𝗂𝗇𝖾, 𝗂𝖿 𝗒𝗈𝗎 𝗍𝖺𝗄𝖾 𝖺𝗇𝗒 ♡ 　ɞ ⠀⠀ ⠀ . 　🌸　⋆༉

|🥩💉🩸🏥|~Bloody hospital~|🏥🩸💉🥩|

┣▇▇▇═─

⊢—[͟﹉͟﹉͟﹉͟﹉͟﹉͟﹉]>———💦

🍨🐾🪚🍰🏥🩺🩹💉🍧💊🎀🏩🍓🌀

ᵃⁿ ᵃʳᵐ ᵃⁿᵈ ᵃ ˡᵉᵍ ⁽ᔆᵖᵒⁿᵍᵉᴮᵒᵇ ᶠᵃⁿᶠⁱᶜ⁾ ᶠʳᵉᵈ ᵃʷᵒᵏᵉ ᵃˢ ᵗʰᵉʸ ʳᵒˡˡᵉᵈ ʰⁱˢ ᵇᵉᵈ ⁱⁿ ᵗʰᵉ ʳᵉᶜᵒᵛᵉʳʸ‧ "ʸᵒᵘ'ʳᵉ ᵒⁿ ᵗʰᵉ ᵐᵉⁿᵈ‧" ᵀʰᵉʸ ᵗᵒˡᵈ ʰⁱᵐ ᵃˢ ᵗʰᵉʸ ᵉⁿᵗᵉʳ ᵗʰᵉ ʳᵒᵒᵐ ᵃʳᵉᵃ‧ ᶠʳᵉᵈ ⁱⁿʲᵘʳᵉᵈ ʰⁱˢ ˡᵉᵍ⸴ ˢᵒ ᵗʰᵉʸ ʷᵉⁿᵗ ⁱⁿ ᶠⁱˣ ⁱᵗ‧ ᴬⁿᵒᵗʰᵉʳ ᵇᵉᵈ'ˢ ᵈⁱᵃᵍᵒⁿᵃˡˡʸ ᵃᶜʳᵒˢˢ ᶠʳᵒᵐ ᶠʳᵉᵈ⸴ ᵐᵃᶜʰⁱⁿᵉʳʸ ᵇᵉᵉᵖⁱⁿᵍ ⁿᵒⁱˢᵉˢ‧ "ᵂʰᵃᵗ'ˢ ʰᵒᵒᵏᵉᵈ ᵘᵖ ᵗᵒ‧‧‧" ᶠʳᵉᵈ ᶠᵒˡˡᵒʷᵉᵈ ᵗʰᵉ ˡⁱⁿⁱⁿᵍ ᵗᵘᵇᵉˢ ᵃⁿᵈ ˢᵃʷ ᴾˡᵃⁿᵏᵗᵒⁿ⸴ ʰⁱˢ ᵃʳᵐ ⁱⁿ ᵃ ᶜᵃˢᵗ⸴ ⁿᵒᵗ ᵐᵃᵏⁱⁿᵍ ᵃⁿʸ ⁿᵒⁱˢᵉ‧ 'ᴴᵉ ᵐᵘˢᵗ ⁿᵒᵗ ʰᵃᵛᵉ ᵉᵐᵉʳᵍᵉᵈ ᶠʳᵒᵐ ʸᵉᵗ' ᶠʳᵉᵈ ᵗʰᵒᵘᵍʰᵗ⸴ ˢᵉᵉⁱⁿᵍ ʰⁱˢ ᵉʸᵉ ᶜˡᵒˢᵉᵈ ᵃⁿᵈ ⁿᵒᵗ ᵐᵒᵛⁱⁿᵍ ᵒʳ ᵃʷᵃʳᵉ ᵃᵗ ᵃˡˡ‧ "ᴹᵃʸ ᴵ ᵃˢᵏ ʷʰᵃᵗ'ˢ ᵘᵖ ʷⁱᵗʰ ʰⁱᵐ?" ᶠʳᵉᵈ ᵃˢᵏᵉᵈ ᵗʰᵉ ⁿᵘʳˢᵉ‧ "ᴶᵘˢᵗ ᶠⁱⁿⁱˢʰᵉᵈ ᵃ ˢᵘʳᵍᵉʳʸ ʳᵉᵖᵃⁱʳⁱⁿᵍ ᵃ ᶠʳᵃᶜᵗᵘʳᵉ ᵇʳᵉᵃᵏ ᵃˢ ʰᵉ ᶜᵃᵐᵉ ⁱⁿ ⁱⁿʲᵘʳᵉᵈ‧ ᵂʰᵉⁿ ᵗʰᵉ ᵇᵒⁿᵉ ᶜʳᵃᶜᵏᵉᵈ⸴ ⁱᵗ ʷᵃˢ ʷᵒʳˢᵉ ᵗʰᵃⁿ ʸᵒᵘʳ ˡᵉᵍ'ˢ ˢᵒ ᵗʰᵉ ᵈᵒˢᵃᵍᵉ ᵐᵒʳᵉ ˢᵗʳᵒⁿᵍ ᵗʰᵃⁿ ʷʰᵃᵗ ʸᵒᵘ ʰᵃᵈ‧ ᴴⁱˢ ʷⁱᶠᵉ ᵇʳᵒᵘᵍʰᵗ ʰⁱᵐ ⁱⁿ ˢᵃʸⁱⁿᵍ ʰᵉ ᵍᵒᵗ ʰᵘʳᵗ ʷᵒʳᵏⁱⁿᵍ ᵒⁿ ᵗᵒ ᵍᵉᵗ ᵏʳᵃᵇᵇʸ ᵖᵃᵗᵗʸ‧" ᵀʰᵉ ⁿᵘʳˢᵉ ᵗᵒˡᵈ ᶠʳᵉᵈ‧ "ᔆᵒ ⁱᵗ'ˡˡ ᵗᵃᵏᵉ ʰⁱᵐ ᵃ ˡⁱᵗᵗˡᵉ ˡᵒⁿᵍᵉʳ ᵗᵒ ᶜᵒᵐᵉ ᵒᵘᵗ ᵒᶠ ⁱᵗ‧‧‧" "ʸᵒᵘ'ʳᵉ ᵃˡˡ ᶠⁱⁿⁱˢʰᵉᵈ ᵃⁿᵈ ᵈᵒⁿᵉ! ᶜᵃⁿ ʸᵒᵘ ᵒᵖᵉⁿ ʸᵒᵘʳ ᵉʸᵉ?" ᴴᵉᵃʳⁱⁿᵍ ᵃ ᵛᵒⁱᶜᵉ⸴ ᴾˡᵃⁿᵏᵗᵒⁿ'ˢ ᵉʸᵉ ˢˡᵒʷˡʸ ᵒᵖᵉⁿᵉᵈ ᵃʷᵃᵏᵉ‧ ᴴᵉ ⁿᵒᵗⁱᶜᵉᵈ ᵗʰᵉ ⁿᵘʳˢᵉ ᵘⁿʰᵒᵒᵏⁱⁿᵍ ʰⁱᵐ ᶠʳᵒᵐ ᵃⁿᵈ ʰᵉˡᵈ ᵘᵖ ᵃ ˢˡⁱⁿᵍ‧ "ᴵ'ˡˡ ᵍᵒ ᵍᵉᵗ ʸᵒᵘʳ ʷⁱᶠᵉ‧‧‧" ᴾˡᵃⁿᵏᵗᵒⁿ ˢᵃʷ ᶠʳᵉᵈ ᵃˢ ᵗʰᵉ ⁿᵘʳˢᵉ ˡᵉᶠᵗ ᵗᵒ ᵍᵉᵗ ᴷᵃʳᵉⁿ‧ "ᴵ'ᵐ ᶠʳᵉᵈ⸴ ᵃⁿᵈ ᴵ ʰᵘʳᵗ ᵐʸ ˡᵉᵍ‧ ᴳᵒᵗᵗᵃ ᵇᵉ ᵐᵒʳᵉ ᶜᵃʳᵉᶠᵘˡ⸴ ʸᵒᵘ ᵏⁿᵒʷ‧‧‧" ᶠʳᵉᵈ ᵗᵒˡᵈ ʰⁱᵐ ᵃˢ ᵗʰᵉʸ ʷᵉʳᵉ ⁱⁿ ᵗʰᵉ ᵃʳᵉᵃ‧ "ʸᵒᵘ'ʳᵉ ᵃᵗ ᵗʰᵉ ᶜʰᵘᵐ ᵇᵘᶜᵏᵉᵗ ᵃᶜʳᵒˢˢ ᶠʳᵒᵐ ᵗʰᵉ ᴷʳᵘˢᵗʸ ᴷʳᵃᵇ‧‧‧" "ʸᵉᵃ⸴ ˢᵒ‧‧‧" "ᔆᵒ⸴ ᴵ ᶜᵃⁿ ᵍᵉᵗ ᵃ ᵖᵃᵗᵗʸ ᵗᵒ ᵍᵒ ᵃⁿᵈ ᵈᵉˡⁱᵛᵉʳ ⁱᵗ ᵗᵒ ʸᵒᵘʳ ᵖˡᵃᶜᵉ‧‧" "ᴵ'ᵈ ˡᵒᵛᵉ ⁱᵗ! ᵀʰᵃⁿᵏˢ‧‧‧" "ᴵ'ˡˡ ʷᵃⁱᵗ ᵗᵒ ᵈᵒ ⁱᵗ ʷʰᵉⁿ ᴵ'ᵐ ᶠᵉᵉˡⁱⁿᵍ ˢᵒᵐᵉʷʰᵃᵗ ᵇᵉᵗᵗᵉʳ⸴ ᵗʰᵒᵘᵍʰ‧" ᶠʳᵉᵈ ᵗᵉˡˡˢ ʰⁱᵐ ᵃˢ ʰᵉ ⁿᵘʳˢᵉ ᵃⁿᵈ ᴷᵃʳᵉⁿ ᶜᵃᵐᵉ ⁱⁿ‧ "ᴴᵉʸ⸴ ᔆʰᵉˡᵈᵒⁿ‧‧‧" ᶠʳᵉᵈ ˢᵃʷ ᵗʰᵉᵐ ᵍᵒ ᵗᵒ ᴾˡᵃⁿᵏᵗᵒⁿ‧ ᵀʰᵉ ⁿᵘʳˢᵉ ʰᵉˡᵖᵉᵈ ʰⁱˢ ᵃʳᵐ ⁱⁿ ᵃ ˢˡⁱⁿᵍ ᵃˢ ᴷᵃʳᵉⁿ ʰᵉˡᵈ ʰⁱˢ ᵒᵗʰᵉʳ ʰᵃⁿᵈ‧ ᴾˡᵃⁿᵏᵗᵒⁿ ʷᵃˢ ˢᵗⁱˡˡ ʳᵉᶜᵒᵛᵉʳⁱⁿᵍ ᵃⁿᵈ ᵘⁿˢᵗᵉᵃᵈʸ ʷⁱᵗʰ ᵗʰᵉ ᵐᵉᵈⁱᶜⁱⁿᵃˡ ʷᵉᵃʳⁱⁿᵍ ᵒᶠᶠ⸴ ᵘⁿᵃᵇˡᵉ ᵗᵒ ˢᵗʳᵃⁱᵍʰᵗ‧ "ᴶᵘˢᵗ ᶜᵃʳʳʸ ᵐᵉ‧‧‧" ᴾˡᵃⁿᵏᵗᵒⁿ ᵗᵒˡᵈ ʰⁱˢ ʷⁱᶠᵉ‧ ᵀʰᵉ ⁿᵉˣᵗ ʷᵉᵉᵏ⸴ ᶠʳᵉᵈ ᵒʳᵈᵉʳᵉᵈ ᵃ ᵖᵃᵗᵗʸ ˡⁱᵏᵉ ʰᵉ ᵖʳᵒᵐⁱˢᵉᵈ ᴾˡᵃⁿᵏᵗᵒⁿ ᵗᵒ ᵗᵃᵏᵉ ⁱᵗ ᵗᵒ ᵗʰᵉ ᶜʰᵘᵐ ᵇᵘᶜᵏᵉᵗ‧ ᴴᵉ ᵇᵉᶜᵃᵐᵉ ᵃ ʳᵉᵍᵘˡᵃʳ ᶜᵘˢᵗᵒᵐᵉʳ ᵃᵗ ᵗʰᵉ ᶜʰᵘᵐ ᵇᵘᶜᵏᵉᵗ ᵃˢ ʷᵉˡˡ‧

🥩🍖💊🧸💌🌙🌈🧪👁️🩸🥩🍄🩺🖥️🏴 ☠️📓✒️🕷️☎️🔗⛓️⛓🖇️📷🌙🪐🍥🍓

(❁´◡`❁)🌈🍓🌞🧃🍄🌱🍓🛹🧸🧚‍♀️🥧🌷🦋🐛🪱🦄💤🐸🍄🎠✨🌈✨./づ~ 🍓"/ᐠ_ ꞈ _ᐟ\ɴʏᴀ~🐈‍⬛”ʚ(*´꒳`*)ɞ“💅🏼:(⁄ ⁄ᵒ̶̶̷́⁄⚰⁄ᵒ̶̶̷̀⁄ ⁄):🔡👩🏼‍⚕️

🤍🐇🍼🩹🦴🦢🥛₊˚ʚ ᗢ₊˚✧ ﾟ.👼

ᔆᵃⁱⁿᵗ ᵀʳʸᵖʰᵃⁱ́ⁿᵉ̄ ʷᵃˢ ᶠʳᵒᵐ ᴷʸᶻⁱᵏᵒˢ ᵒⁿ ᵗʰᵉ ᴴᵉˡˡᵉˢᵖᵒⁿᵗ ᵃⁿᵈ ʷᵃˢ ᵗʰᵉ ᵈᵃᵘᵍʰᵗᵉʳ ᵒᶠ ᵈᵉᵛᵒᵘᵗ ᵖᵃʳᵉⁿᵗˢ ᔆᵉⁿᵃᵗᵒʳ ᴬⁿᵃˢᵗᵃˢⁱᵒˢ ᵃⁿᵈ ʰⁱˢ ᵛⁱʳᵗᵘᵒᵘˢ ʷⁱᶠᵉ ᔆᵒᵏʳᵃᵗⁱᵃ‧ ᔆʰᵉ ʳᵉᵛᵉᵃˡᵉᵈ ʰᵉʳ ᶜʰʳⁱˢᵗⁱᵃⁿ ᵘᵖᵇʳⁱⁿᵍⁱⁿᵍ ᵃⁿᵈ ᶜᵒᵘʳᵃᵍᵉ ᵈᵘʳⁱⁿᵍ ᵃ ᵖᵉʳˢᵉᶜᵘᵗⁱᵒⁿ ʷʰᵉʳᵉ⸴ ⁱⁿ ᵒʳᵈᵉʳ ᵗᵒ ˢᵗʳᵉⁿᵍᵗʰᵉⁿ ᵗʰᵒˢᵉ ʷʰᵒ ʷᵉʳᵉ ʷᵉᵃᵏ⸴ ˢʰᵉ ᵇᵒˡᵈˡʸ ᶜᵒⁿᶠᵉˢˢᵉᵈ ʰᵉʳ ᶠᵃⁱᵗʰ ⁱⁿ ᶜʰʳⁱˢᵗ⸴ ᵃⁿᵈ ⁱⁿ ᵗʰᵉ ᵘˡᵗⁱᵐᵃᵗᵉ ᵗʳⁱᵘᵐᵖʰ ᵒᶠ ᴼʳᵗʰᵒᵈᵒˣʸ‧ ᴬˢ ˢᵒᵒⁿ ᵃˢ ᵗʰᵉ ʳᵘˡᵉʳ ᶜᵃᵉˢᵃʳⁱᵘˢ ʰᵉᵃʳᵈ ᵗʰᵉˢᵉ ᵗʰⁱⁿᵍˢ ʰᵉ ᵇᵉᶜᵃᵐᵉ ᵉⁿʳᵃᵍᵉᵈ ᵃⁿᵈ ᵒʳᵈᵉʳᵉᵈ ᵗʰᵉ ᔆᵃⁱⁿᵗ'ˢ ᵃʳʳᵉˢᵗ‧ ᴴⁱˢ ᵒʳᵈᵉʳ ʷᵃˢ ᶜᵃʳʳⁱᵉᵈ ᵒᵘᵗ ᵃⁿᵈ ᵗʰᵉ ᵗᵒʳᵗᵘʳᵉˢ ᵇᵉᵍᵃⁿ‧ ᶠⁱʳˢᵗ⸴ ᔆᵃⁱⁿᵗ ᵀʳʸᵖʰᵃⁱ́ⁿᵉ̄ ʷᵃˢ ᵖᵘˢʰᵉᵈ ⁱⁿᵗᵒ ᵃ ᶠⁱᵉʳʸ ᶠᵘʳⁿᵃᶜᵉ⸴ ᵇᵘᵗ ᵐⁱʳᵃᶜᵘˡᵒᵘˢˡʸ⸴ ˢʰᵉ ʷᵃˢ ˢᵃᵛᵉᵈ‧ ᵀʰᵉⁿ⸴ ˢʰᵉ ʷᵃˢ ᵗʰʳᵒʷⁿ ᶠʳᵒᵐ ᵃ ᵗᵃˡˡ ᵗʳᵉᵉ⸴ ᵒⁿᵗᵒ ᵃ ᵇᵉᵈ ᵒᶠ ⁱʳᵒⁿ ⁿᵃⁱˡˢ‧ ᴬᶠᵗᵉʳʷᵃʳᵈ⸴ ˢʰᵉ ʷᵃˢ ᵍⁱᵛᵉⁿ ᵗᵒ ˢᵒᵐᵉ ʷⁱˡᵈ ᵃⁿⁱᵐᵃˡˢ ᵗᵒ ᵇᵉ ᵈᵉᵛᵒᵘʳᵉᵈ ᵇʸ ᵗʰᵉᵐ⸴ ᵇᵘᵗ ᵗʰᵉʸ ᵈⁱᵈ ⁿᵒᵗ‧ ᶠⁱⁿᵃˡˡʸ⸴ ˢʰᵉ ʷᵃˢ ᵏⁱˡˡᵉᵈ ᵇʸ ᵃ ᵐᵃᵈ ᵇᵘˡˡ‧ ᴵⁿ ᵗʰⁱˢ ᵐᵃⁿⁿᵉʳ⸴ ᵗʰᵉ ᔆᵃⁱⁿᵗ ʳᵉᶜᵉⁱᵛᵉᵈ ᵗʰᵉ ᵍˡᵒʳⁱᵒᵘˢ ᶜʳᵒʷⁿ ᵒᶠ ᵐᵃʳᵗʸʳᵈᵒᵐ ⁱⁿ ᵗʰᵉ ᶠⁱʳˢᵗ ᶜᵉⁿᵗᵘʳʸ‧ ᴵᵗ ⁱˢ ˢᵃⁱᵈ ᵃ ˢᵖʳⁱⁿᵍ ᵒᶠ ᵖᵘʳᵉ ʷᵃᵗᵉʳ ʷᵉˡˡᵉᵈ ᵘᵖ ᵃᵗ ᵗʰᵉ ᵖˡᵃᶜᵉ ʷʰᵉʳᵉ ᔆᵃⁱⁿᵗ ᵀʳʸᵖʰᵃίⁿᵉ̄'ˢ ᵇˡᵒᵒᵈ ʷᵃˢ ˢʰᵉᵈ‧ ᴬᶠᵗᵉʳ ᵈʳⁱⁿᵏⁱⁿᵍ ᵗʰⁱˢ ʷᵃᵗᵉʳ⸴ ʷᵒᵐᵉⁿ ʷʰᵒ ᵍᵃᵛᵉ ᵇⁱʳᵗʰ⸴ ᵇᵘᵗ ᵈⁱᵈ ⁿᵒᵗ ʰᵃᵛᵉ ᵃⁿʸ ᵐⁱˡᵏ⸴ ʷᵉʳᵉ ᵃᵇˡᵉ ᵗᵒ ᵖʳᵒᵈᵘᶜᵉ ᵐⁱˡᵏ ᵗᵒ ⁿᵘʳˢᵉ ᵗʰᵉⁱʳ ⁿᵉʷᵇᵒʳⁿ ᶜʰⁱˡᵈʳᵉⁿ‧ ᔆᵃⁱⁿᵗ ᵀʳʸᵖʰᵃⁱ́ⁿᵉ̄ ᶜᵃⁿ ᵘˢᵘᵃˡˡʸ ⁱⁿᵛᵒᵏᵉᵈ ᵇʸ ʷᵒᵐᵉⁿ ʷʰᵒ ʰᵃᵛᵉ ᵈⁱᶠᶠⁱᶜᵘˡᵗʸ ⁱⁿ ⁿᵘʳˢⁱⁿᵍ ᵗʰᵉⁱʳ ᵇᵃᵇⁱᵉˢ‧

These levels of sedation under anesthesia are defined by the American Society of Anesthesiologists (ASA) and are crucial in determining the appropriate level of sedation for each patient and procedure, ensuring patient safety and comfort throughout the perioperative period. Minimal Sedation: Also known as anxiolysis, minimal sedation involves a drug-induced state during which patients respond normally to verbal commands. Their cognitive function and physical coordination remain unaffected, and there is no compromise in airway reflexes or protective reflexes. This level of sedation is commonly used for procedures requiring minimal discomfort or anxiety relief, such as minor dental procedures or diagnostic tests. Moderate Sedation/Conscious Sedation: Moderate sedation, also referred to as conscious sedation, induces a drug-induced depression of consciousness, during which patients respond purposefully to verbal or light tactile stimulation. While maintaining spontaneous ventilation, patients may experience decreased anxiety and may have impaired cognitive function and physical coordination. However, they retain the ability to maintain their own airway and respond to commands. This level of sedation is commonly used for procedures such as endoscopic examinations, minor surgeries, or interventional radiology procedures. Deep Sedation: Deep sedation involves a drug-induced depression of consciousness, during which patients may not respond purposefully to verbal or tactile stimulation. Patients under deep sedation may require assistance in maintaining their airway, and spontaneous ventilation may be inadequate. However, patients still maintain cardiovascular function. This level of sedation is often used for procedures requiring significant analgesia and amnesia, such as major surgical procedures or certain diagnostic imaging studies. General Anesthesia: General anesthesia involves a drug-induced state during which patients are unarousable, even in the presence of painful stimulation. Patients under general anesthesia require assistance in maintaining their airway and ventilation, and cardiovascular function may be impaired. General anesthesia is characterized by a complete loss of consciousness and protective reflexes, allowing for surgical procedures to be performed without pain or awareness. This level of sedation is utilized for major surgical procedures or invasive diagnostic procedures where unconsciousness and muscle relaxation are necessary. Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decreased level of consciousness while maintaining the patient's ability to breathe on their own. Airway protective reflexes are not compromised by this process

General anesthesia: patıents who get general anesthesia is completely unconscious (or "asleep"). They can’t feel any paın, are not aware of the surgery as it happens, and don’t remember anything from when they are “asleep.” Patients can get general anesthesia through an IV (into a vein) or inhale it through their nose and mouth. With general anesthesia, you're typically given a combination of medications through a mask or intravenous (IV) needle. This will render you temporarily unconscious. The combination of medications used to put patients to “sleep” before surgery or another medical procedure is called general anesthesia. Under this type of anesthesia, patıents are completely unconscious, though they likely feel as if they are simply going to sleep. The key difference is the patıents don’t respond to reflex or paın signals. Regional anesthesia: This type of anesthesia may be injected near a cluster of nerves in the spine. This makes a large area of the bødy numb and unable to feel paın. Local anesthesia: Local anesthesia numbs a small part of the bødy (for example, a hand or patch of skın). It can be given as a shot, spray, or ointment. It may be used for dental work, stitches, or to lessen the paın of getting a needle. General and regional anesthesia are used in hospitals and surgery centers. These medicines are given to patients by specially trained doctors (anesthesiologists) or nurses (nurse anesthetists). Health care providers can give patients local anesthesia in doctors’ offices and clinics. Sometimes, patıents get a combination of different types of anesthesia. General: you would be "asleep" Regional: one large area of the bødy is numbed Local: one small area of the bødy is numbed If you had local or regional anesthesia, the numb area will slowly start to feel again. You then may feel some discomfort in the area. Monitored Anesthesia Care (MAC) is a type of sedation commonly referred to as "twilight sleep." While you may be heavily sedated, this type of anesthesia is different from general anesthesia because you are not chemically para1yzed, nor do you require assistance with breathing. Still, your vital signs are closely monitored to make sure you're stable throughout the procedure. This type of anesthesia wears off in as little as 10 minutes. Depending on the medications used and the doses given, you may or may not remember the procedure. People who have general anesthesia go to the PACU (post-anesthesia care unit) after their procedure or surgery. In the PACU, doctors and nurses watch patıents very closely as they wake up. Some people feel irritable, or confused when waking up. They may have a dry throat from breathing tubes. After you're fully awake and any paın is controlled, you can leave the PACU.

June 11, 2014 • Anesthesia induces a deep state of unconsciousness in a matter of seconds, but it can take several hours to return to normal after waking. Many people experience confusion, sleepiness, and even delirium. Consciousness is the awareness of subjective states such as emotion, inner thoughts, ideas, intentions, and mental states. Without consciousness, an organism has no awareness, while consciousness is often explained as the awareness of emotion, the ability to think and to remember past events and anticipate current ones. General anesthesia affects your entire body. Other types of anesthesia affect specific regions. Most people are awake during operations with local or regional anesthesia. General anesthesia dampens stimulation, knocks you unconscious and keeps you from moving during the operation. General anesthesia has 3 main stages: going under (induction), staying under (maintenance) and recovery (emergence). A specially trained anesthesiologist or nurse anesthetist gives you the proper doses and continuously monitors your vital signs—such as heart rate, body temperature, blood pressure and breathing. The first is an inability to remember things, but can’t recall them after waking up. Next, patients lose the ability to respond. Finally they go into deep sedation. General anesthesia looks more like a coma—a reversible coma. You lose awareness and the ability to feel pain, form memories and move. Once you’ve become unconscious, the anesthesiologist uses monitors and medications to keep you that way. Lack of Consciousness. Keeps you from being aware of your surroundings. Analgesia. Blocks your ability to feel pain. Amnesia. Prevents formation of memories. Loss of Movement. Relaxes your muscles and keeps you still during surgery. Stable Body Functions.

Sedation: Who Provides Anesthesia? Several types of medical professionals are able to provide anesthesia, including: Physicians (anesthesiologists) Nurse anesthetists Dentists/oral surgeons Anesthesiologist assistants The level of training varies between different types of providers, with anesthesiologists having the highest level. If you are receiving nitrous oxide (laughing gas), you will be fitted with a small mask inhale the anesthesia. If intravenous (IV) sedation is used, a needle is placed in the vein to administer the sedative. Regional Anesthesia Regional anesthesia is provided by injecting specific sites with a numbing medication. This may be done with a needle or via a flexible catheter line through which anesthetics and other medications can be administered as needed. With this type of anesthesia, only the body part being operated on is numbed, which means you are awake—that is, sedated, but still conscious—during the procedure. The anesthetic works on the nerves, causing numbness below the injection site. You are monitored throughout your procedure. Your anesthesia provider will continuously monitor your vital signs, including heart rate, blood pressure, and breathing, during your procedure. Local Anesthesia This type of anesthesia is typically used to numb a small site for minor procedures ,a numbing medication is either applied to the skin as a cream or spray, or injected into the area where the procedure will be performed. Monitored Anesthesia Care (MAC) This is a type of sedation commonly referred to as "twilight sleep." It's usually used for outpatient procedures to make you feel sleepy and relaxed. While you may be heavily sedated, this type of anesthesia is different from general anesthesia because you are not chemically paralyzed, nor do you require assistance with breathing. Still, your vital signs are closely monitored to make sure you're stable throughout the procedure. This type of anesthesia wears off in as little as 10 minutes. Depending on the medications used and the doses given, you may or may not remember the procedure. When the surgery is done, other medications can be used to reverse the effect of the anesthesia. You will also be monitored in this recovery phase. After the procedure is complete, the nitrous oxide gas or IV drip is stopped, and you'll be brought slowly out of sedation. They control the level in your body by increasing, decreasing, or eventually stopping the infusion, which wakes you up.

💙 Most kids with ASD are either hypersensitive or hyposensitive to stimuli like noises, lights, touch, etc. If someone has Autism and/or PTSD, he/she may be more prone to sensory overload and startle more easily. That means there’s not much information about how typical treatment methods can or should be adjusted for patients with ASD. According to this article, a nurse could… Offer home-based services Use more visual aids, such as gradient scales to describe degrees of emotion Keep appointment times regular and predictable as much as possible Provide sensory toys or allow children to bring their own Emphasize the possibility of a “happy ending” after trauma―​“this correlates well with the documented effectiveness of social stories, narratives and role-playing in therapy involving individuals with ASD” Be mindful of how often society dismisses the emotions of autistic people Involve other trusted caregivers …and more. Essentially, the therapist should keep the child’s unique strengths and limitations in mind at each step and be open to flexibility. Remember to… Not take behavior personally Be willing to listen without pressuring him/her to talk Identify possible triggers and help him/her avoid them Remain calm and understanding when he/she is emotional Let him/her make age-appropriate choices so he/she feels in control of his/her life Be patient 💙

Info tips for practitioners w/ autism and/or sensitivities First, thank you for caring. Not trying to question your expertise in health. Now, Autism is a spectrum. It’s not something one can turn off. It’s not a choice. Most of us are not trying to be demanding. If any thing, we’re afraid of being seen as childish, picky, high maintenance, bossy, rude, etc. We can easily get overwhelmed. We want to compromise with you. If we ask for another nurse to do something or if we know we cannot handle a procedure without certain accommodations, it’s not personally attacking against you. You have the power to provide the care and provide us any options; individuals know their own personal tolerance and needs. We do not ever want to start arguments. We do not want to inconvenience you over something, as we do not feel entitled. Having sensitivities not by choice, as it is more than inconvenience but also painful. We always feel when you do your best. We’re both human, autistic or not. It is not a choice.

KAREN AND THE TEETHIES iv The nurse finishes up and turns to Karen with a gentle smile. "He'll be waking up soon," she says. "Why don't you talk to him? Sometimes hearing a familiar voice can help bring them around better." Karen nods, leaning in. "You did so good," she says, her voice filled with love. "It's almost over." Plankton's snores remain consistent, his mouth slightly open as he drools onto the chair. She reaches over and carefully wipes it away with a tissue. The room is quiet except for the soft beeps of the monitors and the sound of Plankton's deep, even breaths. The assistant begins to remove the I.V. from Plankton's arm, his hand steady despite the tiny vein he's working with. The nurse stands by, ready with a cup of water and a comfortable chair for him to sit in when he wakes. Karen's eyes follow her every move, eager for the moment she can take him home. The minutes tick by, the only sound in the room the soft hum of the surgical lights and the occasional snore from Plankton. His drool forms a tiny puddle on the chair, and Karen dabs it away with a tissue. His breathing is deep and steady, the anesthesia keeping him in a peaceful slumber. Dr. Finnegan checks the monitors one last time before nodding to the nurse. "Due to the numbing medication we administered into his mouth, Karen, Plankton probably won't immediately feel his mouth or talk fluently, not to mention the normal confusion from anesthesia." The nurse starts to lower the chair into a more upright position. Plankton's snores become less snuffly, more like a soft purr. "Okay, Karen," Dr. Finnegan says, "You can start talking to him now. It'll help him come around." Karen nods, leaning in closer. "Plankton," she whispers, her voice filled with warmth, "it's almost over. You did so well." Plankton's snoring morphs into a gentle snuffle as his head lolls on the chair. His drool forms a tiny stream down his chin, and Karen wipes it away with a tissue, trying not to laugh at the sight. The nurse smiles at her, patting his hand. "He's just about ready." The chair slowly reclines back, and Plankton's snores change pitch again, his mouth opening slightly more, revealing his swollen gums and the freshly stitched sockets. Karen's heart swells with love and concern. This is her husband, her rock, currently a ragdoll in the hands of anesthesia. The nurse puts down her tools and gently shakes Plankton's shoulder. "Mr. Plankton, it's time to wake up," she says in a soothing voice. Karen squeezes his hand and whispers, "You can do it, babe. It's almost over." Plankton's snores begin to soften, turning into small moans as he stirs in the chair. Karen's voice grows slightly louder, "Plankton, wake up, you're okay." The nurse nods, her hand still on his shoulder. "Come on, Mr. Plankton," she says, her voice gentle. "Time to wake up now." Plankton's snores taper off into quiet, shallow breaths, his mouth still slightly open. A string of saliva stretches between his bottom lip and the chair, and Karen quickly wipes it away with the tissue. His eyelid flutters open, his gaze unfocused and glazed. He blinks slowly, looking around the room as if trying to piece together where he is. Karen's eyes are on him, a mixture of love and concern, as she smiles down at him, and he looks at her with a confused expression. "Welcome back," she says softly. His mouth moves, but a sound comes out, being a slightly slurred mumble that sounds like "Mmph?" The nurse laughs gently. "It's normal for the mouth to be numb. You just had your wisdom teeth out." Plankton's eye widens a little, and he tries to speak again, "Wheah...?" The nurse chuckles. "Your mouth is still numb, don't worry." Karen takes the cue and reassures him, "You're at the dentist, honey. You just had your wisdom teeth removed." Plankton blinks again, his eye slowly focusing on her face. He then looks at the nurse with confused suspicion. His eye widens a bit more, looking at his arm where the I.V. had been, now just a small bandage. The nurse nods. "Yes, you're all done. We're just waiting for you to wake up fully before we let you go ho-" Plankton interrupts with a slurred, "Huh?" His tongue doesn't quite cooperate, and he ends up drooling a bit more. Karen laughs, the tension in the room dissipating. "You heard her, you're okay," she says, patting his hand. But Plankton's not quite convinced. His eye narrows as his mind fights the fog of the anesthesia. "Wha... wha... youw nee thoo do my teethies! Youw shupposht to taketh them out!" The nurse laughs lightly, a kindness in her eyes. "Don't worry, Mr. Plankton, we did. You're all done. Dr. Finnegan took them out." Plankton's gaze shifts to Dr. Finnegan with curiosity. "Who's 'Dr. Finny-gwan'?" he slurs, his voice thick with confusion. Karen laughs softly, "It's Dr. Finnegan, sweetie. He's the dentist. He's the one who just took your teeth out." Plankton's unfocused eye swivels towards Dr. Finnegan, his expression one of disbelief. "Y-you're not... 'Dr. Finny-gwan'?" he stammers, the words sliding out of his mouth like molasses. The dentist chuckles, his face appearing over Karen's shoulder. "It's okay, Plankton," he says, his voice calm. "I'm right here, see?" Plankton blinks heavily, his eye darting between the nurse and Dr. Finnegan, trying to make sense of the situation. "bu’... my teethies," he mumbles, his hand rising to tentatively touch his swollen cheeks. The nurse's smile never fades as she says, "Yes, Dr. Finnegan performed the surgery. You're all set." But Plankton's not so sure. He looks at her hand on his shoulder, the same one that was so gentle when he was unconscious. "You... youwre not... a... nentis," he asks, his words thick with drowsiness. The nurse laughs gently, her patience unwavering. "No, Mr. Plankton, I'm not. I'm just here to help you wake up. Dr. Finnegan is the one who did the surgery." She gestures to the dentist, who smiles back at Plankton. But Plankton's mind is still swimming in anesthesia. "Thent... then wha... who dat?" he slurs, pointing a shaky finger at the figure behind the surgical mask. The nurse laughs gently, not offended by his confusion. "I'm just here to assist Dr. Finnegan," she explains, her voice soft and soothing. "I didn't do the surgery. He did." Plankton's eye squints suspiciously at her, his hand still hovering over his cheek. "Buth... youw... you haz... hands..." he mumbles. The nurse's smile doesn't falter. "Yes, I do. But I promise you, it was Dr. Finnegan who performed the surgery." Plankton's gaze swings to Dr. Finnegan again, his expression a mix of confusion and accusation. "Den... den who... who ish... ish..." his voice trails off as he tries to form coherent words, but his mouth isn't cooperating. The dentist laughs, a deep, hearty sound that fills the room. "It's okay, Plankton. You're just a little out of it right now." He reaches out to give Plankton's shoulder a gentle squeeze. "Let's get you into the recovery chair." Karen helps to lift him up, his body feeling like a rag doll in her arms. He leans heavily on her, his legs shaky and unsteady. The nurse supports his other side as they guide him to the chair. "Whathish ish...?" he mumbles, his eye glazed and unfocused, his hand feeling along the chair as if trying to understand what it is. "It's your chair, Plankton," Karen says with a smile, helping him to sit upright. Plankton's gaze travels slowly to the chair. "Chair?" he slurs, his voice barely a whisper. He looks back at Karen, then at the nurse, his eye wide with bewilderment. "Whath... whath do I do wiff thish... chair?" The nurse and Karen both chuckle, the tension of the surgery lifting slightly. "You just sit down, sweetie," Karen says, her voice soothing. "Let's get you comfortable." Plankton looks at the chair with a mix of suspicion and exhaustion. "Buth... I don't know how to siht," he slurs, his mouth barely moving. His hand grips the armrest as if it's a life preserver. Karen laughs softly, supporting him as he sits. "You've got this," she says, adjusting his posture. "Just let yourself lean back." Plankton's eyelid flaps weakly. "Buth... buth how do youw siht?" he repeats, his words slurring into each other. His head lolls back, and Karen and the nurse share a look of amusement. The nurse gently pushes his head back. "Just and relax, Mr. Plankton," she instructs. "We've got you."

😷 https://lifehacker.com/what-your-pediatrician-should-and-shouldnt-do-during-a-1822524179 😷

r/shortscarystories 8 hr. ago k_g_lewis The Family Secret The red-headed girl in the summer dress stepped into the old man’s room. When he didn’t acknowledge her presence, she cleared her throat. The man looked up from the puzzle he was building, gasping and clutching his chest when he saw the child, “Autumn?” he whispered, “Is that really you?” “Hello, Grandpa,” Autumn smiled. “What are you doing here?” he asked. Autumn crossed the room until she was standing in front of her grandfather. “I’m here because I need your help,” she replied. The grandfather stared at her for a moment before turning his attention back to his puzzle. “There’s nothing I can do to help you,” he said. “That’s a lie and you know it,” Autumn snapped at him. “Please go,” he whined, “You shouldn’t be here.” “I’ve got nowhere else to go,” Autumn said, “That’s why I need your help.” The grandfather ignored her, reaching a remote on the table next to his puzzle. Once it was in his hand, he pressed the large button to call the nurse. A minute later, one of the nurses walked into the room. “What can I do for you, Mr. Sinclair?” the nurse asked. “I would like her to leave,” he pointed at Autumn. “You’d like who to leave?” the nurse looked around the room, “There’s nobody in here but you.” “You know she can’t see me,” Autumn said, “Only you can because you know what happened to me.” “No,” her grandfather shook his head, “No, I don’t.” “Are you okay, Mr. Sinclair?” the nurse asked, “Should I call your son?” “No,” he snapped, “Don’t call him. I’m fine.” “Are you sure?” “I’m positive,” he insisted, “You can go.” “Okay,” the nurse turned and left the room. Autumn stood there, staring at her grandfather. “Stare all you like,” he said, continuing to work on his puzzle, “I can’t help you. In a rage, Autumn swept the half-finished puzzle off the table. “If you ever want to see Grandma again, you’ll do the right thing and help me,” she spat the words out. Tears started to fall from his eyes. Seeing his resistance starting to crack, Autumn continued. “You’ll never get to if you don’t tell someone what happened to me.” “But I didn’t have anything to do with it,” her grandfather insisted, “Your father is the one who needs to confess, not me.” “What did my father do to me?” Autumn whispered. Her grandfather poured his heart out, telling her everything that happened to her. “I’m sorry,” were the last words he said. “That’s all we wanted to hear,” the girl pretending to be Autumn reached up and pulled the wig off her head. A moment later the nurse walked back into the room, but she wasn’t really a nurse. When she returned to the room, she had a police badge hanging around her neck. “That was an Oscar-worthy performance,” she said, putting her arms around the girl’s shoulders and leading her into the hall.

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