ysabetwordsmith: (repose)
After writing the post about coping with grief, I got to thinking about how Terramagne-America handles this sort of thing. As with many social aspects, they do it better. One thing I had spotted in passing earlier was the use of followup calls after bereavement, and questionnaires to identify people who would welcome such contact. That sounded really useful, so I found one and wrote it down. This is typical of handouts available at funeral parlors, hospitals, counseling centers, and other places where people may interact with death and mourning. It can also be used for self-assessment; although that approach doesn't provide the same level of support, it can still illuminate what is happening in your grief process.

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ysabetwordsmith: (repose)
Death poses challenges to the survivors. Let's take a look at some of those and ways of handling them. A friend asked me about this recently, so I gathered some resources ...

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Used to be, good advice for this sort of thing was easy to find. Now the clinical advice is increasingly bad, according to my lived experience and observation of other people. What's worse, all kinds of advice in books, online, and from experts is now conflicting with each other. So here is a discussion of first aid for scrapes and cuts.  It is based on awareness of how science works, rather than a medical profession.  Use your judgment accordingly.

Read more... ) notes: "Having been undergoing fortnightly debridement and associated home wound care for over 2 years now I have learned to love 2% lidocane gel. I have determined that the household will not be without it. The brand I've been using is MPM Regenecare, same as used in the wound care office I go to, and it is available OTC. Also helps in cases of "picking the gravel out of road rash"!"

* For someone who tends to pick at injuries, it may be best to cover all of them completely, even if it wouldn't otherwise be necessary.  If the wound needs air, you can always use a breathable bandaid or gauze.  Picking tends to increase the risk of infection and scarring. (from [personal profile] mashfanficchick)


Spectrum of Injury

Amount of blood and pain do not always correlate to severity, although they do give some idea. Most scrapes, unless deep, don't bleed much; but certain areas, such as the head, bleed more. Although typically shallow, scrapes tend to be quite painful because the wide surface area exposes many nerve endings. However, severe abrasions may destroy so many nerves that the injury doesn't register much pain. Assess the whole injury carefully before making a plan.

Abrasions are similar to burns in regard to some aspects of skin destruction, and in fact the two injury types can overlap in some cases such as road rash. Abrasions may be described as first, second, or third degree depending on how deeply they damage the skin. They may also be rated minor, moderate, or major based on size and other factors.


Here is a look at the range of damage commonly seen in abrasions:

* Clean scrapes that don't bleed, like when you bump your knee under long pants. The top layer of skin comes off but that's all. Rinse with water, soap if you want some, and put lotion or cream on it to soothe the skin. It typically doesn't need antibiotic or a bandage, unless you're prone to infections.

* Ordinary scrapes that ooze blood but have no visible debris and you didn't fall on anything filthy. Clean with water and mild soap, or a gentle wound rinse kind of antiseptic. I like Bactine, YMMV. Do check for grit that might have been hidden by blood at first. Top with your preferred first aid cream. I resent people dropping the original, which was a great product, and now there's nothing like it and ointments are NOT a synonym. Some people like triple-antibiotic ointments for scrapes, but I tend to reserve those for injuries that look prone to infection.

* Messy scrapes that bleed freely and have some debris. Wash thoroughly in stages, using water and mild soap or antiseptic. By this point I am usually using alcohol or surgical disinfectant, because if I don't, I find that this type of injury tends to get infected. Remove as much grit as you can gently, but if you can't get it out gently, either be more assertive yourself or seek expert help. Be really careful with these injuries because it is easy to miss grit, and if you do, infection is almost guaranteed. Top with a good antibiotic cream or ointment, or a dressing that has similar effect -- the hydrogels are very good at suppressing infections and aiding recovery.

* Really ugly abrasions like road rash and/or you fell on something filthy. Clean in stages as described above, but most people don't have the skill (or stomach) to handle these at home. A good first aid tent or emergency room comes with pain control for the unpleasant cleaning process! There they will use potent cleaners and scrub/pick vigorously, not just to remove debris but also skin damaged badly enough that it's going to die. This process is called debridement, and has various options. That means if you're doing this at home, you also need medical scissors to snip off ragged ends. 0_o Top with hydrogel if at all possible; that seems to be widely acclaimed as the current best practice for severe abrasions.

* Deep abrasions with traumatic tattooing drive particles far into the flesh.  If not removed, this debris not only causes infection but also leaves permanent tattoo-like marks in the skin.  Aggressive treatment by a professional is required for adequate cleaning.  That means numbing the skin and then scrubbing it vigorously with surgical brushes and surgical soap.  That will undoubtedly traumatize the flesh further, but gentle cleaning will not suffice for extreme cases and this is better than what happens if you leave a serious abrasion untreated.  Various aftercare options are available to help the skin heal, but this type of extreme damage sometimes requires surgical intervention.  If you cannot reach a medic quickly -- which often happens in wilderness injuries -- then clean as best you can using the steps described above for messy and ugly abrasions.


Time to see an expert if at all feasible:

* Any skin damage bigger than about hand size, which is roughly 1% of your body mass. If assessing someone else, their hand is more accurate as a gauge of their body surface area, but they may not be willing or able to loan it to you whereas your own hands are usually available. People who routinely scuff large parts of their bodies may wish to set their own threshold higher or lower than this after observing how well they heal.

* Abrasions on delicate areas like the face or genitals.

* Abrasions that cover enough of a joint so you are worried about impeding motion. This means a tiny but nasty scrape may impair your finger knuckle, while it would take considerably more to affect your knee.

* There is debris and you can't get it all out or aren't sure if you did. Any remaining particles may cause traumatic tattooing, which is worse with dark grit under pale skin.

* The abrasion doesn't hold its shape, related cuts won't stay closed, chunks of skin are actually missing, you can see fat or bone, bleeding won't stop after 10-20 minutes, any other sign the damage is deep or severe, etc.

* You fell on something filthy and haven't had a tetanus booster recently.

Balance the amount of damage against your personal first aid skills, how well your body heals, and the quality of available health care. Do you routinely collect scrapes, have complicating conditions, or treat someone else who does? If so, think about more advanced training than the rinse-and-wrap covered in basic first aid. Wilderness and sport classes are worth considering. Bikers (motorcycle or mountain/dirt bike) often have specialized training for crash care, which is an excellent place to learn about fixing bad abrasions such as road rash.


Medium of Skin Products

First aid supplies come in a variety of formats. There is some overlap in what they treat, but they are NOT all interchangeable. I wrote a whole article on this topic once. Here's a thumbnail:

Spray is a liquid, often based in alcohol or water. There are some oil-based sprays but that's usually for things like bug repellent rather than skin care. Many wound rinses have antiseptic and analgesic ingredients in a bottle meant for spritzing or squirting over injuries. Plain water or irrigation saline solution may also work.

Lotion has more water than fat. It is light and gentle, easily spreading a long way. It doesn't clog up the skin. You can find a few varieties with antiseptic or antibiotic ingredients; they're not common and not a great idea for routine use, but help some rashes. Lotion soaks in rapidly and shouldn't leave the skin sticky, so it doesn't require a bandage. Many tattoo artists therefore prefer lotion or very light cream to heavier products for tending fresh ink, and that makes tattoo lotion a good choice for minor abrasions. Some of my well-inked friends have abandoned other first aid creams in favor of whatever their artist got them hooked on, and now that's what they put in their first aid kits.

Cream may have slightly more water than fat or about the same, and this is where waxes begin to appear as stiffening agents. Cream can be quite soft, just thick enough to stick on your finger, or stiff enough to stand up a bit if swept into peaks. It is gentle and very nourishing to skin, yet it can carry a mild to moderate dose of medication. It tends not to clog skin too much, but be a little careful if yours is prone to that. Cream is great for most scrapes and other minor injuries. A little will soak in, but a lot needs a bandages. Unfortunately this has become difficult to find as the market switched to ointments.

Salve or ointment is a thick, greasy material with more fat than water and uses wax to moderate texture. These tend to get very stiff and cold weather and may get runny in hot weather. They're prone to clogging the skin, worst of all if based in mineral oil and/or petroleum jelly; natural bases aren't quite as bad. They're also more uncomfortable to rub over injured skin and don't spread as far. However, they can carry a high dose of antibiotics or other medications which will then stay exactly where it is put. Salve may be useful for messy or dirty injuries where less assertive treatments might not be enough. It requires a bandage because it doesn't soak in much, and in fact, a thick coating of ointment is often used to keep bandages from sticking to a wound.

Balm is a semisolid stick that uses a lot of fat and wax to hold its shape, and a good one won't melt on you in summer. They carry medication moderately well. The stiff texture means it will go a very long way over minimally broken skin, which makes it ideal for the shallowest scrapes or scratches that bleed little if any. The same features make it unfeasible for use on messy scrapes -- it hurts like hell and doesn't adhere properly. My go-to item for scratches is a balm stick with tea tree and lavender essential oils as the active ingredients, and it makes a downright dramatic difference in how well they heal. Plus a balm stick leaves a thin film that absorbs well and doesn't get gunk everywhere or require a bandage. Rinse, swipe, and ignore.

>>Strangely we've found that leaving wounds mostly alone, ie not covering them after a day or so, works a lot better for healing than the "keep covered until healed" advice that people've usually seen.<<

Always prioritize your lived experience over other people's advice. Advice is good, science is good, but bodies aren't identical. I don't cover my dings unless they are messy or in an area I'll bump or rub against things. But I definitely notice they heal better if cleaned and treated with something. My favorite for scratches and shallow scrapes is actually a balm stick with tea tree and lavender.
ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
A friend asked what to do with old socks. Here are some great ideas. Some of these will also work with other types of repurposed or scrap fabric. Yes, I have a ragbag that I actually use. My grandparents helped raise me, so I'm double-stamped on time period and have nearly Depression-caliber poorskills.

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ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
[personal profile] peoriapeoriawhereart tipped me to this video of karate in a Victorian dress.  Among the interesting points: skirts and corsets can cause problems, but apparently the sleeves are worse.
ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
There's a lovely little e-newsletter with links to new articles about gardening for wildlife

"Growing a Better Birdfeeder" discusses the importance of using native species of caterpillar host plants, not just to benefit the insects, but also to attract more birds.  Someone is building a database to list plants by the number of caterpillars they host. This is a level of sophistication that not even I had thought of, which doesn't happen much anymore, so I am really geeking out about it.  :D  I waaaaaant that list.  I looooove not having to make the damn thing myself.  And they're building to run on your zipcode so the plants will automatically be local-to-you.

EDIT 5/3/17: [personal profile] ari_the_dodecahedron found the image-hidden link to the plant database.  \o/  You can look up plants to see what butterflies and moths they host, or look up insects to see their host plants.

Be a Butterfly Hero!  Because butterflies need saving too.  And these ones don't sting.  ;)

"Weedy to Wonderful" has ideas for making a wildlife garden look nicer.  Yes, we bought a sign for exactly the reason listed.  Also my favorite tip is to put your caterpillar host plants in a less-visible spot if people will be annoyed rather than excited by holes in the leaves.  Me, I see chewed plants and think, "Aww baby butterflies!"  But then I am weird.  When planting herbs beloved of the winged peoples, I plant extra parsley or dill for them and just move the caterpillars there.
ysabetwordsmith: Text -- three weeks for dreamwidth, in pink (three weeks for dreamwidth)
Climbing trees is a fun activity, but not everyone knows how to do it. The two no-gear methods of climbing are scrambling and shinnying. Scrambling means using your hands and feet to go up a tree with branches. Shinnying involves wrapping your arms and legs around a narrow tree without branches, and ratcheting your way up. Of the two, scrambling is much easier, thus generally the best way to start. Climbing with gear tempts people to ascend to great heights, and you have to understand your equipment. It is therefore best left until after you have mastered the basics of freehand climbing of small trees.

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ysabetwordsmith: Text -- three weeks for dreamwidth, in pink (three weeks for dreamwidth)
Shock can take physical or emotional form. Both can pose significant dangers. Although physical shock tends to be more serious in the short term, emotional shock can easily turn into chronic conditions such as PTSD or depression which can kill later. Also, either version can feed into the other. Responses to trauma vary along a spectrum of severity. Acute stress reaction is a normal response to abnormal situations which exceed the victim's coping capacity. Symptoms typically subside within a few hours or days. This is best treated by Emotional First Aid unless symptoms pose a threat to self or others, or interfere with everyday life, in which case professional care may help. Acute stress disorder spans a period approximately two days to one month after trauma, with symptoms serious enough to upset ordinary functions that aren't healing or seem to be healing slower than expected. Treatment at this stage may reduce the chance of developing post-traumatic stress disorder, a chronic form of trauma reaction. It is important to distinguish between normal response (which heals on its own), disordered response (which may need a little extra support), and a disorder (which typically requires professional care). Just like physical injuries, mental injuries can be mild, moderate, or severe and need different levels of attention.

Local-American advice is not to seek hospital treatment for emotional shock; the facility is not equipped to provide the soothing atmosphere needed for trauma survivors or people with a loved one in the hospital. In many situations, little or no treatment is available for mental issues at mild or moderate levels. People can only get help for severe problems. Unfortunately this has much the same effect on mental injuries as on physical ones: ignoring them increases the chance they will not heal cleanly and that serious complications could develop.

Terramagne does have a Shock Room alongside the Emergency Room at most hospitals. The SR provides a clinical setting for Emotional Trauma Care, just as the ER treats physical trauma. They have an assortment of private and ward therapy rooms for techniques that help traumatized people feel safe or let them burn off excess energy after a trauma. Some are like industrial-strength quiet rooms; others are padded rumpus rooms. Therapeutic video games such as Tetris help process experiences into new memories in a healthy way. A small hospital might have only a few treatment options, while a large one has many, just as they expand support for more types of physical complaints. Specially trained therapists provide immediate comfort care, followed by assessment and then arrangements for long-term care if needed. (Doing the assessment first, while the person is still overwrought, can make matters worse.) They can also teach people about self-care following a trauma. This helps tremendously in preventing the initial upset from crystallizing into long-term damage. Sometimes it works amazingly fast, although most of the time it takes longer.

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ysabetwordsmith: Text -- three weeks for dreamwidth, in pink (three weeks for dreamwidth)
Emotional First Aid (also called Psychological First Aid) minimizes the lasting harm from traumatic events by treating it immediately. This is greatly preferable to ignoring the harm until it festers into a serious problem. Basic EFA may be taught in schools and community classes, with more advanced versions covering things like bereavement, sexual assault survivor assistance, etc. In Terramagne-America, an Emotional First Aide is roughly equivalent to an Emergency Medical Technician and they are often deployed in an ambulance, firetruck, or other first response vehicle. Many instutitions such as schools or malls also keep someone trained in EFA along with a nurse at the first aid station.

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ysabetwordsmith: Text -- three weeks for dreamwidth, in pink (three weeks for dreamwidth)
Slightly belated, I'm doing [community profile] three_weeks_for_dw again. I'm pulling together some useful resources. This one is a party monitor kit, inspired by several of my characters in Polychrome Heroics who are or have been party monitors.

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Bad things can cause the brain to start looping, endlessly repeating the same thought or memory. This is fundamentally a failure of the sorting-filing function of the memory processes. When it gets stuck long term, that's post-traumatic stress. So the way to fix that problem is to get the memory filed properly. Some things that people have found useful include...

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ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
I was talking with someone about hair as gender expression, and I happened to list a bunch of ways to explore this. I thought other folks might find this useful.

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There's a new Molly Beans strip, called "Mollyworld." What this really is: a discussion of who should pay the spoon for that conversation. Greg finds vocalization easier and more rewarding, while Molly prefers typing.

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ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
Someone asked me how to help an online friend through a difficult time. All the advice, of course, is aimed at helping friends in meatspace. Considering how many of us have online intimates, this is not helpful. Here is my effort to fill that gap.

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ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
One of the most famous psychological tests is the Rorschach or inkblot test.  It's very controversial, with some people arguing it's pseudoscience and others saying it gives valuable insights.  Actually, they're both right.  It has no objective basis in that different people will score the same response in different ways, and that's before  accounting for cultural differences. However, any kind of symbolic material can serve as inspiration for useful conversations.  The problem comes when someone makes binding decisions based on these test results -- that  is the pseudoscience.  It penalizes people for not doing what someone else wanted.

I've been watching this for a long time, and finally found where someone scanned the images online.  Previously you could only find vague replicas.  This page has the full-color cards along with instructions on what the tester wants to hear.  Some of its observations (sexual imagery will get you in trouble, positive interpretations score better than negative ones) apply across many psychological tests.  By memorizing these, you now have two options: tell a tester you're already familiar with the test, which invalidates this and most other psych tests; or cheat on it by telling them what the handbook says everyone should see (or whatever other image you may wish to project).  That's very useful if, as is often the case, the test is being used against you and against your will.  (It's commonly used in contentious legal cases such as divorce or abuse, and sometimes in employment.)  In particular, note that this article highlights the type of lying ubiquitous throughout psych tests: falsely telling someone they can "do anything" or "it doesn't matter" when in fact everything is being scored and difference from the center of the bell curve is heavily penalized.  You really can't rely on anything they say unless you have read the instructions and scoring rubric (if there even is one) for yourself.

However, if you have a psychotherapist you like -- and you really need someone with a high level of experience for this, most counselors won't be able to follow it -- then you can get into awesomely deep territory by discussing symbolism back and forth.  Rorschach cards are great for this kind of exercise.  But so are most types of abstract art, and any kind of symbolic art such as Tarot cards.  If you study the symbolism of colors, shapes, etc. across cultures then it becomes even more illuminating.  Dream dictionaries are great for this because they give you a ton of ideas what things could  mean. You just have to account for the fact that symbolism always includes both a universal and an individual aspect.  Butterflies always have an element of transformation due to their metamorphic biology, but to an individual they might be very sad due to seeing butterflies at a grandparent's funeral.  Plus when you look at the different possible meanings, you can gain insights into how other people think, or spot parallels among several related symbols.  One Tarot card may have 12 possible meanings, but if three other cards all have one overlapping interpretation, that's the one active in this reading. Some branches of psychotherapy are really into this symbolic stuff, and it's ideal for handling some types of problem that don't lend themselves well to logic.  Or just for fun.
ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
While talking with one of my readers, I got to wondering if there are any cookbooks for the blind. Ideally I'd want something with unique skills to overcome vision handicaps, not just a transliteration of a regular cookbook into Braille.  Turns out, there are both.

Regular Cookbooks in Braille
http://www.braillebookstore.com/Cookbooks

Stir It Up! Recipes for Young Blind Cooks -- probably a great place to start
http://www.nbp.org/ic/nbp/STIRITUP.html

In Touch -- a cookbook of easy-make foods with tips on cooking while blind
http://articles.latimes.com/1988-03-17/food/fo-2126_1_blind-people

Good Smells from the Kitchen -- Turkish cuisine with blind-aware descriptions
https://www.rotary.org/en/rotary-project-creates-cookbook-visually-impaired
ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
Someone asked me about emotional first aid for adults, so here are some ideas about increasing access to that ...

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ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
Occupational therapy is one of the very few branches of health care that I have frequently seen putting out fantastic material. Here is an example of things occupational therapists have thought of for conserving energy in self-care.  The whole point to this field is enabling people to do things, by finding new ways to do stuff when the old way doesn't work anymore.

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