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Copy & Paste Diabetescore Emojis & Symbols 💉 Subcutaneous injections tend to be less painful

😷 If it’s a same day appointment without any preparation beforehand, still let them know any needs. Even if it’s not worth it to spend nearly an hour on preparing something especially for you, still let them know what might work best for you. If they need to use a speculum, ask for a small one! Even if they can’t use all their time convincing you of how convenient something might be, still tell them if you cannot do certain methods while feeling safe. Is there something on hand to relieve even a little pain? Can it be self administered at home? Can you sit in a different chair? If you cannot possibly resolve something as much as you’d like, ask for them to at least tell you what’s going on and ask how they might cope with similar sensations. Can an X-ray be done instead of a biopsy? If not, ask for them to take your concerns into account and go from there, such as a less invasive tool designed for the same purpose. Wear a long skirt or a dress so you can just pull it up rather than take your clothes off. You can also bring a jacket or different pants to change into. Take headphones and listen to music, explain you're nervous and would not like to hear much about what's going on but just to be told when they've started and when they've finished. Focus in on what you're listening to. Say if it’s your first time doing a certain procedure and mention your concerns. Acknowledge you understand people don’t necessarily enjoy it for fun. Knowing can make you less anxious. It’s definitely worth asking something like ‘I do find this procedure extremely painful, could you try with a X?’ The procedure is easier for them to perform if you’re not squirming around in pain so there’s no reason for them not to at least try. Pamper yourself. Count as you breathe. Breathe in 1-2-3-4. Breathe out 1-2-3-4. If the doctor's good, they'll keep you talking and talk to you for further distraction, and walk you through each step they take. Most of the time, certain tests don't take much longer than 30 seconds and afterwards they'll leave you alone so you can recover if you need it. Talk to them beforehand so they know you're anxious, and see what they can do to help you get through it. Knowing options are always open to you if you need it can help put you at ease. Knowing what certain tests feel like can make it go smoother and easier to manage. Mentally walk yourself through the procedure before it happens while doing slow breathing exercises - breath in for five counts and out for five (or longer) while walking yourself through what to expect with your eyes closed. If at any point you get nervous, keep breathing and open your eyes. Once comfortable, continue through the procedure and just keep breathing. Don’t dismiss true concerns so you can decide what might be best for you. Gather all available facts to make informed decisions with the medics. Discuss the procedure with the medic and what they will do and when it happens. While the procedure happens, ask them to explain what which thing it is they’re doing next and how it might feel. Tell them if at any point you express discomfort, they check in with you and do not proceed until you give them the green light. Make sure nothing is put in you if you have not consented to or understand the purpose of. It’ll help you stay in some control if you are allowed to say if you wanted to stop at any given time to get through it. Anyone could find any experience distressing, but one’s distress can be magnified by the facts of how they are autistic, traumatized, etc. Just like with any other condition, doctors should have to take into account a particular person in their office and adjust what they’re doing to meet the needs of said patient. Jot down in advance everything you want to discuss to know exactly why, when and how something is to be. Ask for details and mention anything. Think about the muscles in your legs as you close your eyes. Imagine you’re at home, or think of a show. Anything to make it seem less intimidating. Give them notes you’ve taken. Ask if you can pace. Even if you aren’t a child, you still may need the catering even if you understand what medics are for. Make kits. Ask them to listen to you and to take time with you to make it more comforting. Advocate as feedback. 😷
Tips 😷 Depending on the procedure, meet the one treating you to see if they are a good fit for you. If they seem nice and willing, find something where you can both agree to make it better for the both of you. If you can notify them ahead of time, mention your needs. “I have autism which might contribute to my discomfort. What can I bring to the clinic? Can I leave my pants on, or can I wear a skirt instead of having to undress? Can you prepare smaller medical tools? Do you have sedatives? Are numbing agents readily available? Do you have a room with an adjustable seat? What’s the best treatment for me? Are there other options to make it easier to get care?” Look up pictures of the place, visit it, read any rule policies and see if they can accommodate to getting special permission for certain aspects. Get a personalized treatment plan. Use telemedicine, an appointment over video, phone call or text chat, when available and appropriate. Ask about at home tests you can send. Tell your doctor about your worries. They might be able to help you address them.
💉 Subcutaneous injections tend to be less painful than intramuscular injections because the needles are smaller and do not have to push through as much tissue. 💉
Concerns to ask the doc if needed 😷 Although benefits can outweigh much, it’s still a worry. Even if it temporarily lasts a second, a person's pain should be taken into account. I’m not saying you should go under deep sedation just to get teeth cleaned, especially if you don’t need it. If you are having trouble tolerating certain exams, tell them to keep it in mind so the procedure can be easier on both of you. If you experience intense pain and find it hard to tolerate, request for ways to make it easier. Thank you for taking the time to care for me (be sure to show gratitude before, during and/or after) Can you explain the procedure to me? How long will it take? Can we count up or down to the number? Can you explain what you're doing as you begin to do it? Because it’s been hard in the past when X, so can we look at some techniques? Can I drink water before or during the procedure? Do you have a heat pack or ice pack nearby? I want to get it over with and I’d like it to be easy for both of us. If you have a distraction tool (like telling jokes) to use I’d still like to let you know about X knowing my concerns will still be taken into account. Can we talk beforehand and walk me through the procedure as it will happen, step by step? Do you have any non invasive ways to check for X? Can you do it another way instead? Do you have any smaller and/or softer instruments to get the job done? Can you apply something (like warmth, gel, etc.) to the instrument beforehand? Is there a way to get around it? Can I say if I wanted to stop (said procedure) during any time? Can I make informed decisions to decline X? When it comes to certain exams, I’ve sensory issues, trauma, etc. Do you know any breathing exercises or any methods to accommodate my specific needs? It’s not anything personal, it’s not distrust, but I want it to go easy for both of us. 😷
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Related Text & Emojis

🍑 https://www.mayoclinic.org/tests-procedures/pelvic-exam/about/pac-20385135 🍑
😷 https://lifehacker.com/what-your-pediatrician-should-and-shouldnt-do-during-a-1822524179 😷
😷 Wear a long skirt or a dress so you can just pull it up rather than taking your clothes. You can also bring a jacket or different pants to change into. 😷
😷 If it’s a same day appointment without any preparation beforehand, still let them know any needs. Even if it’s not worth it to spend nearly an hour on preparing something especially for you, still let them know what might work best. If they need to use a speculum, ask for a small one! Even if they can’t use all their time convincing you of how convenient something might be, still tell them if you cannot do certain methods while feeling safe. Is there something on hand to relieve even a little pain? Can it be self administered at home? Can you sit in a different chair? If you cannot possibly resolve something as much as you’d like, ask for them to at least tell you what’s going on and ask how they might cope with similar sensations. Can an X-ray be done instead of a biopsy? If not, ask for them to take your concerns into account and go from there, such as a less invasive tool designed for the same purpose. 😷
😷 Pamper yourself. Count as you breathe. Breathe in 1-2-3-4. Breathe out 1-2-3-4. If the doctor's good, they'll keep you talking and talk to you for further distraction walking you through each step they take. Most of the time, certain tests don't take much longer than 30 seconds and afterwards they'll leave you alone so you can recover if you need it. Talk to them beforehand so they know you're anxious and see what they can do to help you get through it. Knowing options are always open to you if you need them can help put you at ease.
😷 Take headphones and listen to music, explain you're nervous and would not like to hear much about what's going on but just to be told when they've started and when they've finished. Focus in on what you're listening to.
Say if it’s your first time doing a certain procedure and mention your concerns. Acknowledge you understand people don’t necessarily enjoy it for fun. Knowing can make you less anxious. 😷 It’s definitely worth asking something like ‘I do find this procedure extremely painful, could you try with a X?’ The procedure is easier for them to perform if you’re not squirming around in pain so there’s no reason for them not to at least try.
Skin 🧴 Skin protects the insides of the body. Human skin can range from light peachy cream colour to dark brown depending on the amount of melanin produced. Sun exposure and genetics can also play a role. 🧴
Tips 💉 Depending on the procedure meet the one treating you to see if they are a good fit for you. If they seem nice and willing, find something where you can both agree to make it better for the both of you. If you can notify them ahead of time, mention your needs. “I have autism which might contribute to my discomfort. What can I bring to the clinic? Can I leave my pants on, or can I wear a skirt instead of having to undress? Can you prepare smaller medical tools? Do you have sedatives? Are numbing agents readily available? Do you have a room with an adjustable seat? What’s the best treatment for me? Are there other options to make it easier to get care?” Look up pictures of the place, visit it, read any rule policies and see if they can accommodate to getting special permission for certain aspects. Get a personalized treatment plan. Mention you’ve special needs regarding X. Use telemedicine, an appointment over video, phone call or text chat, when available and appropriate. Ask about at home tests you can send. Tell your doctor about your worries. They might be able to help you address them.
😷 Before beginning trauma-focused therapy it is important to stabilise the individual with emotional coping strategies and creating feelings of safety. Support strategies that have been found to be helpful in the general population include: mindfulness and grounding in the present moment creating feelings of safety (for example an object/picture that symbolises safety) sensory soothing Autistic people may require: a greater number of sessions a longer or shorter duration to each session regular breaks. 😷
💙 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 💙
😷 Treatments should be appropriately adapted for autistic people and their individual needs. (Rumball et al. 2020) and Kerns et al. (2022) suggest a number of other events that autistic people found traumatic: abandonment by/loss of a loved one (for example a family member, pet or support staff) sensory experiences (for example fire alarms) transitions and change (for example school transitions, routine changes with the seasons, unpredictability in day to day life) social difficulties and confusion (for example difficulties interpreting social cues, misunderstandings and conflicts) events related to one’s own mental health difficulties (for example psychotic experiences). Autistic people may also be more likely to find these experiences traumatic due to autistic characteristics such as: sensory sensitivities communication and social interaction differences distress around changes to routines distress if prevented from taking part in repetitive and restricted behaviours such as stimming. Some theories suggest that other factors associated with being autistic, may mean an increased risk of developing or maintaining PTSD symptoms But just because symptoms aren’t crippling doesn’t mean you're not affected. 😷
🔪☆°・*:.。.☆💉 ☆.。.:*・°☆✂️
Knowing what certain tests feel like can make it go smoother and easier to manage. Mentally walk yourself through the procedure before it happens while doing slow breathing exercises - breath in for five counts and out for five (or longer) while walking yourself through what to expect with your eyes closed. If at any point you get nervous, keep breathing and open your eyes. Once comfortable, continue through the procedure and just keep breathing. 😷
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😷 https://about.kaiserpermanente.org/health-and-wellness/our-care/exploring-the-promise-of-at-home-cervical-cancer-screening 😷
😷 https://www.health.gov.au/ministers/the-hon-ged-kearney-mp/media/pap-smears-can-be-replaced-by-do-it-yourself-cervical-cancer-tests 😷
🍑 https://www.health.gov.au/self-collection-for-the-cervical-screening-test 🍑
🍑 https://www.healthdirect.gov.au/blog/self-test-makes-cervical-screening-pap-smear-even-easier 🍑
😷 https://neurodivergentinsights.com/misdiagnosis-monday/ptsd-and-autism 😷
💙 https://neurodivergentinsights.com/misdiagnosis-monday/ptsd-and-autism 💙
💉💉
⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠿⠿⠿⠿⠿⠿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⠀⠀⣿⣿⣿⡿⠛⠉⠀⠀⠀⠀⠀⠀⠀⠀⠀⠈⠙⠻⣿⣿⣿⡇⠀⠀⠀⠀⠀⠀⣿⣿⣿⣿⣿⠟⠀⠀⠀⠀⠀⠀⣴⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⠀⠀⣿⠟⠉⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠙⢿⡇⠀⠀⠀⠀⠀⠀⣿⣿⣿⣿⠋⠀⠀⠀⠀⠀⢀⣾⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⠀⠀⠋⠀⠀⠀⠀⠀⠀⠀⣀⣠⣤⣤⣀⡀⠀⠀⠀⠀⠀⠀⠈⠃⠀⠀⠀⠀⠀⠀⣿⣿⡿⠃⠀⠀⠀⠀⠀⢠⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⣴⣾⣿⣿⣿⣿⣿⣿⣶⡀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⣿⡿⠁⠀⠀⠀⠀⠀⣰⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⠀⡇⠀⠀⠀⠀⠀⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣤⣤⣤⣤⣤⡄⠃⠀⠀⠀⠀⠀⠟⠀⠀⠀⠀⠀⢀⣼⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⢸⡇⠀⠀⠀⠀⢰⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⢠⣾⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⢸⡇⠀⠀⠀⠀⠸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⠀⠁⠀⠀⠀⠀⠀⠈⢿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⠀⠀⠀⡇⠀⠀⠀⠀⠀⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠛⠛⠛⠛⠛⠃⡄⠀⠀⠀⠀⠀⣆⠀⠀⠀⠀⠀⠀⠻⣿⣿⣿⣿⣿⣿ ⡇⠀⠀⠀⠀⠀⠀⢻⣿⣿⡇⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠙⢿⣿⣿⣿⣿⣿⣿⠿⠁⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⣿⣦⠀⠀⠀⠀⠀⠀⠘⢿⣿⣿⣿⣿ ⣧⠀⠀⠀⠀⠀⠀⠈⠛⠋⠀⠀⠀⠀⠀⠀⣸⣄⠀⠀⠀⠀⠀⠀⠀⠉⠙⠛⠛⠉⠁⠀⠀⠀⠀⠀⠀⢀⡄⠀⠀⠀⠀⠀⠀⣿⣿⣷⡀⠀⠀⠀⠀⠀⠈⠻⣿⣿⣿ ⣿⣆⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⣠⣿⣿⣧⣀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⣠⣾⡇⠀⠀⠀⠀⠀⠀⣿⣿⣿⣷⡄⠀⠀⠀⠀⠀⠀⠙⣿⣿ ⣿⣿⣷⣄⡀⠀⠀⠀⠀⠀⠀⠀⢀⣠⣾⣿⣿⣿⣿⣿⣷⣤⣀⠀⠀⠀⠀⠀⠀⠀⠀⠀⢀⣠⣴⣿⣿⣿⡇⠀⠀⠀⠀⠀⠀⣿⣿⣿⣿⣿⣆⠀⠀⠀⠀⠀⠀⠈⢻ ⣿⣿⣿⣿⣿⣿⣶⣶⣶⣶⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣶⣶⣶⣶⣶⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿
😷 If you can, look for a trauma-informed healthcare provider, or a provider that has experience helping people who have experienced trauma. If your current provider doesn’t listen to your concerns or makes you uncomfortable, remember that you can absolutely seek out a different practitioner. 😷
😷 Remember that you are not alone and can discuss these issues with a trusted mental health provider. Exploring treatment options with a healthcare provider Exercising to reduce stress Setting realistic goals Breaking up large tasks into smaller ones Spending time with friends and family Confiding in trusted friends or relatives Seeking out comforting situations, places, and people Seeking out support from friends and family Finding a support group Learning to feel good about one’s actions in the face of danger Having a positive coping strategy Being able to act and respond effectively despite feeling fearful Medication and expectation management strategies may also be included in an overall treatment plan. 😷
😷 Keep a diary of the situations that make you feel anxious and note how you’ve reacted in each situation. This will help you identify potential triggers for your anxiety. 😷
😷 https://www.psychologytoday.com/us/blog/autism-and-anxiety/201904/medical-visits-and-autism-better-way 😷
😷 https://www.findatopdoc.com/Parenting/When-a-Child-with-Autism-Refuses-Treatment 😷
💙 An Autism Specific Care Plan helps families give hospital staff important information. It tells them how to communicate and interact with the child and keep them safe. Families who use Autism Specific Care Plans feel happier with their care and feel that health care providers are better at working with their child or teen with autism. Hospitals and emergency rooms can also think about making changes to help patients with autism. Small changes can all help lower anxiety for kids and adults with autism. Some of these changes include keeping wait times short, creating a calm space, and playing a movie in the waiting area. Making sure parents are part of all medical care and treated as experts on their child can help both families and staff. Finally, hospital staff can try communicating in the way the patient prefers (talking vs. typing, etc.). 💙
💉 https://news.vanderbilt.edu/2011/09/21/bloodwork-toolkit/ 💉
SPORTS OFFERED The Allen Delegation currently supports: Aquatics (swim) Athletics Basketball Bocce Bowling Flag Football (no skills level at this time) Golf Power Lifting (weights) Soccer (futbol) ​Tennis Volleyball ​Unified Sports (doubles) Allen Special Olympics Delegation (ASOD)
😷 https://kidsinpain.ca/wp-content/uploads/2021/11/Vaccine-Pain-Needle-Fear-Resources-v2-November-2021.pdf 😷
😷 https://theconversation.com/if-your-child-is-afraid-of-or-refusing-a-medical-procedure-heres-how-to-help-170923 😷
😷 https://www.statnews.com/2020/02/25/adults-dont-need-booster-vaccinations-for-tetanus-diphtheria-study/ 😷
😷 https://www.sensoryfriendly.net/how-to-create-a-sensory-friendly-ambulance/ 😷
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If feasible, other tests the patient fears might be performed while the patient is sedated. For example, before or after dental work, vaccines could be administered, blood could be drawn, and gynaecology or other physical exams could be done. This practise requires coordination and communication among providers. 💙 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708482/
💙 https://www.legalzoom.com/articles/what-is-medical-power-of-attorney 💙
💙 https://www.verywellhealth.com/guardianship-for-adults-with-autism-4165687 💙
💙 PFA TIPS: PAIN MANAGEMENT AND AUTISM By Alizah Patterson, MD, Pediatric Resident, PL-3 , The Herman & Walter Samuelson Children’s Hospital at Sinai Download a printable version of “Pain Management and Autism “ Sensory stimulation can be perceived very differently in people with autism spectrum disorder. It is common for children to be averse to certain types of taste, texture, and flavors. How they perceive pain, however, is not very well understood. Some people believe that people with autism may have a decreased sense of pain, but pain can manifest in different ways. Identifying and managing pain can be challenging for both healthcare providers and parents. Methods to assess pain Assessing pain in children can often be a challenge for providers and parents. For older children, the number pain scale is typically used with 0 representing no pain and 10 being the worst pain imaginable. The faces pain scale allows children to choose a face – images range from happy to crying – that shows how their pain is making them feel. For children who are nonverbal, the FLACC score is often utilized. This method looks at Facial expression, Leg positioning, Activity level, Crying and Consolability. This pain scale requires more time but can reliably assess pain responses in neurotypical individuals. People with ASD or intellectual disability, or any type of cognitive impairment may express pain in other ways and may require a customized FLACC scale. This would incorporate individualized pain behaviors which is more reliable in detecting pain in individuals with cognitive impairment. Again, this would require additional time and understanding of the scale. Research on autism and pain Not much research has been done on the topic of autism and pain, partly due to the challenges of assessing pain in children with communication difficulty and partly due to the common belief that people with autism have decreased sensitivity to pain or a high pain threshold. Studies conducted with people with high-functioning ASD tend to use a pain scale of 0-10. On this scale, patients tend to respond with lower numbers, but other methods of rating pain have shown varying results. Some studies have used observations of providers or parents, which also tended to show decreased sensitivity to pain in children with autism. Other studies have challenged the idea that people with autism experience less pain. These studies found that pain is expressed differently among those with autism. One study comparing children with autism, children with intellectual disabilities, and neurotypical children showed that both behavioral changes and physiologic changes (i.e. heart rate) were higher with pain, but face scores did not vary among the groups. Some case studies have found that when asked their pain score, verbal individuals with ASD respond with low scores, but when asked how much discomfort they have, the score tends to be higher. How does pain manifest in children with autism? Children with ASD may not express pain in typical ways – crying, moaning, or withdrawing from a painful stimulus – and therefore may often be labeled as less sensitive to pain. Several case studies have shown that though children may not show these typical signs or may not react to pain in the moment, they still have physiologic reactions and behavioral reactions. Even with no obvious reaction to a painful stimulus, they may start breathing fast or their heart rate may increase. They may have increased stimming behaviors, aggression, or anxiety after the painful incident. Individuals with ASD also tend to show behavior changes for longer after the painful incident than neurotypical children or children with intellectual disabilities. When assessing for pain in a nonverbal child with ASD, close attention should be paid to increased aggression, self-injurious behaviors, stimming, or any behavior that is not typical for that child. If they are acting unlike themselves, look for a possible source of discomfort or pain that may be present or was present in the near past. In a more verbal child, asking if they have pain or if something hurts may not accurately reflect what they are feeling. Using words such as “discomfort”, “uncomfortable”, or “anxiety” may better approximate the level of pain they are in. What can I do about my child’s pain? If a source of pain can be identified, treating that pain is of utmost importance. Treatment would be the same as for any other child—analgesics such as Tylenol or ibuprofen, ice, or heat (if tolerated), and rest. Parents and providers should be wary of hidden injuries that the patient may not be able to communicate about, such as a fracture or insect bite. If the source of pain cannot be identified or you are unsure of the severity of the injury/illness, always err on the side of caution and have a physician assess your child. They should do a full skin exam to look for scratches, bites, rashes, or other injuries. If an injury is suspected to a limb, x-rays may be needed to rule out a fracture. If no clear injury or illness can be identified, parents and providers should look for other possible medical causes for the behavior changes, like abdominal pain, headache, or urinary tract infection. For pain management during painful or stress-inducing medical procedures, like a blood draw, there are several techniques that can be used. Non-pharmacologic (medication) methods are preferred. Every child may respond differently to these techniques, so some trial and error may be necessary to determine the best method for your child. • Distraction: If your child has a preferred activity, engaging them in this activity during the procedure may significantly reduce their focus on pain. This could include watching a show, blowing bubbles, deep breaths, playing with a toy, or calming movements such as a parent rocking them. • Sensory distractions: There are several items that can be used to distract a child’s senses from the painful stimulus. A vibrating device or ice placed on the area of a blood draw or lumbar puncture can reduce the pain signal sent to the brain. • Topical pain control: There are a few topical medications that can be used to reduce pain sensation. A cooling spray at the site of the procedure is quick and easy. A numbing gel or cream can also be applied 20-30 minutes prior to the procedure, which has been shown to be an effective way to manage pain during IV sticks. However, this has not been shown to reduce anxiety or fear during procedures. • Deep pressure: Firm pressure, through squeezing or a tight hug, has been shown to significantly decrease anxiety and stress in individuals with autism. This method can also be used during medical procedures to decrease discomfort. Every child is different though, so deep pressure may be too much sensory stimulation for some. Medications can also be used to control pain, as well as anxiety, during medical procedures. Pre-medication with acetaminophen or ibuprofen may be helpful in reducing pain. For extremely painful procedures, an opioid may also be reasonable, per a physician’s assessment. Anti-anxiety medications may be helpful in reducing not only anxiety but also pain as they are typically slightly sedating. If you feel it is right for your child, discuss these options with your physician. When it comes to pain management in autism, remember these key points: • Always rule out pain when atypical behaviors occur or when certain behaviors increase. • Children are all different, whether in how their pain manifests or in what strategies work best to control their pain. • There are lots of non-medication options to help manage pain and anxiety during medical procedures. 💙
💙 https://www.spectrumnews.org/features/deep-dive/unseen-agony-dismantling-autisms-house-of-pain/ 💙
⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠿⠟⠛⢉⣉⣉⣉⣉⣉⣉⣉⠙⠛⠿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠿⠟⠛⠛⠛⠛⠛⠛⠛⠿⠿⢿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠟⠋⣁⣴⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⣶⣦⣄⡉⠻⢿⣿⣿⣿⡿⠟⠉⣠⣤⣶⣶⣿⣿⣿⣿⣿⣿⣷⣀⠐⠚⠻⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣁⡀⠈⢀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠖⠀⠙⠛⠉⣠⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣦⠄⠙⠻⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡟⢀⣴⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠿⠟⠛⠛⠛⠋⣠⣶⠿⠇⢀⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⠀⢤⣀⣹⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡏⢀⣾⣿⣿⣿⣿⣿⣿⣿⣿⡿⠋⣁⣤⣶⣶⣿⣿⡿⠀⣁⣤⣴⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⠈⢿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠀⣾⣿⣿⣿⣿⣿⣿⣿⣿⡟⢀⣼⣿⣿⣿⣿⣿⠋⢠⣾⣿⣿⣿⣿⣿⣿⣿⣿⠟⠛⠛⠻⠿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠸⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢸⣿⣿⣿⣿⣿⣿⣿⣿⡿⠀⣾⣿⣿⣿⣿⣿⠇⢰⣿⣿⣿⣿⣿⣿⣿⡿⠛⠿⠆⠸⣿⣶⣦⡤⠈⠛⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⠁⣼⣿⣿⣿⣿⣿⣿⣿⣿⠇⢸⣿⣿⣿⣿⣿⣿⠀⢻⣿⣿⣿⣿⣿⣿⣿⡇⠰⣦⣄⢀⣿⣿⣿⡇⠸⠃⠀⠙⢿⣿⣿⣿⣿⣿⣿⣿⡆⢸⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⠀⣾⣿⣿⣿⣿⣿⣿⣿⡇⢠⣿⣿⣿⣿⠟⢁⣤⣶⣶⣶⣦⡀⠻⣿⣿⣿⣿⣿⣿⡇⠸⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⡏⢠⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⡀⢻⣿⣿⣿⣿⣿⣿⣿⡇⢸⣿⣿⣿⡟⢠⣿⣿⣿⣿⣿⣿⣿⡄⠘⣿⣿⣿⣿⣿⣿⠀⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⠃⣸⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⣧⠈⢿⣿⣿⣿⣿⣿⣿⡇⢸⣿⣿⣿⣧⠈⣿⣿⣿⣿⣿⣇⣀⣽⣆⠘⢿⣿⣿⣿⣿⠀⢿⣿ ⣿⣿⣿⣿⣿⣿⣿⡟⢀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⣿⣧⡈⠛⣿⡿⠿⠟⢿⡇⢸⣿⣿⣿⣿⣦⡈⠻⢿⣿⣿⣿⣿⣿⡿⠆⠘⢿⣿⣿⣿⡆⢸⣿ ⣿⣿⣿⣿⣿⣿⣿⠃⣸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⣄⠙⠀⠀⢄⠀⠁⠘⣿⣿⣿⣿⣿⣿⣶⣤⣤⣤⣤⣤⣤⡄⢲⡆⠈⠛⠿⢿⣷⠀⢻ ⣿⣿⣿⣿⣿⡿⠃⣰⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡆⠸⡆⠀⢹⣷⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠉⠻⠇⢸⣿⠀⢶⣶⣤⣤⣤⣼ ⣿⣿⣿⠿⠋⢀⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠇⢰⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣄⡉⠉⢘⣿⣿⣿⣿⣿⣿⣿⣿⠟⠿⠛⠛⠛⠛⠶⠖⠚⠻⠇⢸⣿⣿⣿⣿⣿ ⣏⡁⠀⠴⣾⣿⣿⣿⣿⣿⣿⢿⣿⣿⣿⣿⡿⠋⣠⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡄⢹⣿⣿⣿⣿⣿⣿⣿⠃⠀⠀⠺⠿⠿⠶⠄⠒⠒⢀⣠⣾⣿⣿⣿⣿⣿ ⣿⣿⣶⣦⣤⣈⣉⣉⡉⠉⠀⠔⠿⠟⠛⢉⣠⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢸⣿⣿⣿⣿⣿⣿⣿⣿⣦⡈⠲⠶⡶⠖⠂⣠⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣶⣶⣶⣶⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢰⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣶⡆⢀⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠿⠿⠛⠃⠈⠙⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠈⢉⡉⠛⠻⢿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠋⢁⣤⣴⣶⣶⣆⠘⣄⠘⢿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠰⠀⢿⣿⣶⣄⠙⢿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠁⣴⣿⣿⣿⣿⣿⣿⣆⠘⣆⠈⢿⣿⣿⣿⣿⣿⣿⣿⣿⡀⢣⠘⣿⣿⣿⣧⠈⢿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠃⣸⣿⣿⣿⣿⣿⣿⣿⣿⡆⢸⣧⠈⢿⣿⣿⣿⣿⣿⣿⣿⡇⢸⡆⠸⣿⣿⣿⣧⠈⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣧⡈⠻⣿⣿⣿⠈⢿⣿⠇⢸⣿⡄⠙⣿⣿⣿⡄⢹⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢸⣿⣿⣿⣿⣿⣿⣿⣿⡟⢻⠀⣿⣿⣷⣤⣈⡙⠛⠃⠘⠋⣠⣿⣿⣿⡆⠘⣿⣿⡇⢸⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢸⣿⣿⣿⣿⣿⣿⣿⣿⡇⠸⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡄⢹⣿⡇⢸⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣾⣿⣿⣿⣿⣿⣿⣿⣿⡇⢀⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢸⣿⣷⠀⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠇⢸⣿⣿⡆⠸⣿⣿
https://www.forbes.com/sites/tarahaelle/2016/03/23/got-your-tetanus-shot-you-may-not-need-another-for-30-more-years/?sh=3b29aade6db3
https://www.spectrumnews.org/features/deep-dive/unseen-agony-dismantling-autisms-house-of-pain/
𝑇ℎ𝑒 𝑏𝑒𝑠𝑡 𝑎𝑛𝑑 𝑚𝑜𝑠𝑡 𝑏𝑒𝑎𝑢𝑡𝑖𝑓𝑢𝑙 𝑡ℎ𝑖𝑛𝑔𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑤𝑜𝑟𝑙𝑑 𝑐𝑎𝑛𝑛𝑜𝑡 𝑏𝑒 𝑠𝑒𝑒𝑛 𝑜𝑟 𝑒𝑣𝑒𝑛 𝑡𝑜𝑢𝑐ℎ𝑒𝑑 — 𝑡ℎ𝑒𝑦 𝑚𝑢𝑠𝑡 𝑏𝑒 𝑓𝑒𝑙𝑡 𝑤𝑖𝑡ℎ 𝑡ℎ𝑒 ℎ𝑒𝑎𝑟𝑡. -𝐻𝑒𝑙𝑒𝑛 𝐾𝑒𝑙𝑙𝑒𝑟
https://www.medicalnewstoday.com/articles/ableism
⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠿⠿⠿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠿⠛⠉⠀⠙⢛⣿⠟⠛⠃⠀⠀⠉⠙⠛⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣟⣿⣿⣿⣿⡿⠋⠀⠀⠀⠈⠉⠉⠻⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠟⠁⠀⠀⠀⠀⠀⠀⠂⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠉⠻⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⠿⠳⠛⠉⠉⠙⠛⠋⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠙⠻⣿⣿⣿⣿⡿⠁⠀⠀⠀⠀⠀⠀⠠⠂⠀⠀⠀⠀⠀⠀⠀⠈⠀⠀⠀⠀⠀⠀⠙⢿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⡿⠃⠀⠀⢀⣀⡤⠀⠀⠈⢳⡀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠐⣄⠈⢿⣿⡿⠀⠀⢀⡀⠀⠀⠀⠀⣿⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⢷⡆⠀⠀⠀⠀⠙⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⡁⠀⢠⠠⣯⠀⠀⠀⠀⠀⠀⣧⠀⠀⠀⠀⠀⠀⠀⣆⠀⠀⢸⣆⠨⣿⣷⢒⡐⣌⢰⠇⣾⣿⣶⣏⠛⢲⣄⠀⣠⣶⢶⣿⣄⣦⢲⣾⣻⣀⣇⣠⠀⠀⣬⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⡇⡄⢀⢌⠸⣿⢻⡄⠀⠀⠀⠀⢸⣆⣀⣠⣄⣄⣰⣦⡄⣿⢀⠸⣿⠀⢹⣿⣾⣛⣿⡘⢳⣿⣯⣹⣿⣵⣶⣿⣿⣯⣶⢬⣽⣿⣿⡴⢿⣈⣻⣹⡿⠀⣸⢣⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⠈⠁⣸⣿⣿⣟⣾⣿⢣⣴⣀⣤⣼⣷⡶⣿⡟⣿⣻⣿⣲⣿⠻⣿⣿⡀⢸⣿⣿⣟⣿⣙⣦⢬⣹⡿⣏⣬⣽⣻⣿⣿⢿⣿⡛⡏⣭⣿⣼⣟⣯⠿⠀⣴⢋⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣆⠀⠞⣿⢹⣿⣷⣘⣿⣽⣿⣿⣷⣾⣿⣿⣿⣞⢻⣻⣿⣿⡛⢿⣿⣿⣤⣿⣿⣿⣿⣿⣿⣥⣾⠿⣾⣿⣿⣿⣿⣿⣷⣞⡗⣛⣯⣿⣿⡟⠛⣤⠞⢡⣾⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣦⡀⠈⠘⠻⣿⣽⣶⣻⠿⣿⣛⡛⡏⣿⣿⣿⣿⣿⣿⣿⣿⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠘⢻⣿⣿⣿⣿⣿⣿⣿⡛⢾⣿⠟⢁⣤⣼⡃⣰⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣷⣤⣀⠀⠘⣿⣿⣿⣿⣿⣿⣿⣾⡼⢿⣿⣿⣿⣿⣿⣿⣿⡿⣿⠋⣹⢿⣿⣿⣿⣿⡯⢿⣶⣦⣨⣟⡿⠿⢿⠿⢋⡿⣿⠁⢂⢾⡟⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⣄⣹⣿⣿⣿⣿⣿⣿⣟⣀⡀⠻⢿⣿⣿⣿⣿⠿⠋⢫⣥⣿⢲⣯⣿⣿⠟⣿⣘⡿⠿⠟⢛⠿⢿⣭⣱⡼⢿⢛⣛⡿⢟⣥⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣏⠻⢿⣿⣿⣿⣋⣼⣿⣿⣷⡟⢷⣬⣙⠀⠤⣀⣤⣿⣿⣾⣻⣿⣿⣾⣿⣰⣄⣒⣒⣊⣠⣾⣿⡿⡩⢉⣽⣟⣽⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣄⢤⣻⣿⣽⡿⢿⣿⣞⠋⠀⠀⠀⣸⣿⣿⣿⡿⣿⣿⣿⣿⡽⣿⣿⣿⣿⣿⡿⠿⡛⠛⢋⠁⠩⡿⣴⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣾⡟⡹⣦⣰⣞⣚⣛⣡⣶⣾⣿⣿⡿⠋⢸⣷⣿⣿⣿⣿⣇⠸⢿⡶⠛⠛⠂⠁⠀⠀⣁⣤⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡜⣜⠿⠿⣿⣿⣿⡿⠿⠿⠋⠀⠀⣸⣿⣿⣿⣿⣿⣿⣿⣮⣤⣐⣀⣀⣤⡾⠯⢵⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣄⡀⠰⢳⡶⣶⠲⠙⠂⠁⣀⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⠞⠛⢛⣳⡿⠿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⣀⡹⢿⣿⣀⣠⡴⢟⣻⣼⣿⢿⣿⣿⣿⣿⣿⣿⣿⣟⣿⣿⣿⡿⠿⢿⢤⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣶⣟⢻⣾⢿⣟⣯⠶⠿⣿⣿⣿⣿⡯⠿⣿⡛⢉⣉⠉⡛⢻⣿⣻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣟⢿⣿⣭⠷⠖⢿⣿⣿⣿⣿⣿⣷⢾⣿⣿⣿⡿⠿⠿⠽⢟⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣯⡷⢖⡒⢛⣿⣼⠿⠿⡿⡿⠿⠛⠷⢷⣶⣶⠶⣦⣤⣭⣙⣛⣿⡛⢯⣻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠿⣋⣤⡴⣛⣟⣿⣟⣉⣿⣄⣀⣆⡀⠀⣒⣻⣇⣭⣭⣭⣥⣄⣉⣻⣾⣻⣿⣿⣎⡝⣷⣟⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣌⠋⣿⣯⣶⣾⣿⠿⠛⣩⣤⡶⠾⠿⢿⡺⡟⠻⣯⣼⣿⣿⣿⣯⣭⣉⣙⣫⣟⡛⢝⡳⣿⣿⣿⢻⣹⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣽⠻⣿⠿⣿⣿⠿⠴⢛⣥⣶⣿⠿⢶⣶⣽⣷⣀⣀⣭⠿⠻⣾⠧⣿⣿⣿⡛⠿⢯⣟⡻⣾⡽⢿⡘⠻⡖⢹⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣺⣶⣿⣿⢂⣴⢿⣷⣏⢁⣤⡾⠿⣻⣟⣻⣿⠿⢯⡀⡹⣷⣤⣭⡛⢿⣷⣬⡿⠿⣚⣷⣿⣿⠟⢿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣴⡟⣙⡗⢿⠫⠷⢚⢉⣴⣿⣿⣷⣾⠟⠛⠛⣷⣈⣿⣿⣾⣿⣯⡙⢿⣷⣦⣼⣷⣮⡿⢻⣿⣿⡎⣿⣺⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣯⠁⢸⣟⢛⣤⡾⠁⣾⡿⢫⣿⣿⣿⣷⣿⢿⣿⣷⣾⣫⣭⣭⣷⢻⣶⣬⡛⢿⡍⣈⡤⣿⣿⣿⣿⡿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡀⢸⣧⢟⠁⣠⡾⣋⣴⣿⣿⣿⡷⠛⡏⣉⠛⣿⣿⣩⣭⣭⣩⣿⢉⣿⣿⣿⠟⠛⠛⣼⣿⣿⣯⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠈⣿⡾⢶⣿⡿⣿⡽⣟⣿⣿⣿⠿⠟⣿⣿⣿⡿⢋⣉⣉⠉⣿⣯⠿⣿⣦⣸⢾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡄⢻⣡⡾⣫⡾⢋⣼⣿⣿⣷⣿⡿⡿⣿⠿⢿⣿⠛⠛⠛⢻⣿⡟⣷⣌⠚⠛⣿⣥⣿⣿⣿⡿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠘⣯⣾⠋⣴⡿⢋⣷⣿⣿⣿⣿⣷⣿⣿⣿⣿⠿⠛⢿⠾⢿⢦⣙⠿⣷⣦⣤⣼⣻⣿⣿⣧⡯⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠀⢿⣡⣾⣿⣿⣿⣿⣿⣿⣼⢿⣧⣀⣀⣼⣷⣼⣿⣿⣷⡷⠤⣿⣷⣾⣿⣿⣿⡅⣽⠇⠀⠍⡸⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡀⠂⢻⣿⣿⣿⣿⣿⣿⣿⣿⣶⣯⣿⠋⢛⣿⣥⣤⣤⣼⣤⡾⣿⣿⣿⣿⣿⣿⣷⣿⠀⠀⣴⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣁⠀⠀⣻⣿⣿⣿⣿⣿⣿⣯⣿⠶⠿⠿⣿⣿⣏⠉⠉⢹⣿⠉⣿⣿⣿⣿⣿⣿⣿⣿⣷⡚⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡏⠛⣿⣿⣿⣿⣿⣿⣿⣿⣧⣿⣲⣷⣶⣿⣿⠟⠛⡿⣟⢺⢾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⢄⣹⡻⣿⣿⣿⣿⣿⣿⡿⣿⣳⣾⣶⣾⣿⣿⡼⣷⣯⣿⣪⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢹⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡾⡞⣇⠹⣿⣿⣿⣿⣿⣿⠿⣋⣥⣴⣼⢿⣷⣶⣿⣧⣤⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠰⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⣹⡸⣆⢻⣿⡿⠛⠋⠉⢳⣿⣻⣭⣶⣾⣿⣿⣹⣹⡿⠛⠻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡤⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⣳⡹⣖⢻⡇⠀⠀⠛⢸⣿⣿⣏⣽⣿⣿⣿⣿⣏⠚⣧⠀⠨⣿⣿⣿⣿⣿⣿⣿⣿⡟⡗⢿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⢣⡽⣎⢧⠀⠀⠀⢠⣻⣿⣥⢾⣿⣿⣿⣿⣷⡾⢿⡆⠀⣿⣿⣿⣿⣿⣿⣿⣿⠁⣿⢸⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣎⠂⢹⣎⣧⡶⠂⠈⠱⣿⣷⣻⣿⣿⣯⣿⢿⣔⡀⣧⣶⣿⣿⣿⣿⣿⣿⣿⣟⣠⡿⠺⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣖⣀⣿⣊⣿⣿⣶⡟⢻⣾⣭⣿⣿⣿⢿⣿⣮⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡟⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡍⠛⣿⣿⣭⢸⣿⠄⠙⣯⣻⡿⢷⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡏⢡⢺⣽⡌⢿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣾⣿⣿⢯⣻⠿⣷⣦⣄⣁⣶⣿⣿⣿⣋⠙⢿⡿⣿⣿⣿⣿⣿⡟⢁⣿⣿⣾⣹⣆⠛⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢱⣿⣿⣿⣿⣳⣾⡛⣿⣿⣿⣿⣿⣷⠲⠓⢼⣷⣿⣿⣿⣿⣧⣤⣾⡛⡿⢃⣿⣿⣖⠙⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣾⣇⣿⣹⣎⠻⣿⣿⣾⣿⣿⣿⣿⣿⣷⠈⡟⢸⣿⣿⠟⣭⣿⣻⡿⢟⡷⢾⣿⣿⣿⡔⢹⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠋⣿⢻⡇⢻⣆⡙⢿⣿⣿⣿⣿⣿⣿⣿⣶⣏⣿⣿⣿⣿⡟⢣⣿⠁⣼⠃⣼⣿⣿⣿⣷⣾⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠨⣿⣧⣻⣬⢿⣧⠈⣿⣿⣿⣿⣿⣿⣿⡏⡏⣿⣿⣿⣿⣇⡿⢁⣼⡟⢰⣿⣿⣿⣿⣿⣿⣿⣿⣟⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢾⣿⡿⣇⣿⠘⣿⣷⣽⣿⣿⣿⣿⣿⣿⡏⡷⣾⣿⣿⣿⣿⣧⣾⣟⣠⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⢻⣿⣧⣸⣿⣿⣿⣿⣿⣿⣿⣿⡇⡇⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢣⢹⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢸⡄⠸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠞⠈⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠸⣇⠀⢿⣿⣿⣿⣿⣿⣿⣿⣿⠏⠀⠸⠂⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠙⠷⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⣱⣶⠿⠶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢛⡶⣜⢿⢤⣿⣿⣿⣿⣿⣿⣿⣿⠇⣶⣶⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⣡⣿⣶⣴⣿⣿⣿⣿⣿⣿⣿⣿⢸⣷⣌⣦⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡟⢭⣭⣍⣈⣾⣿⣿⣿⣿⣿⣿⣿⠘⠿⠛⡙⠁⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⣼⡯⢙⣿⣿⣿⣿⣿⣿⣿⣿⣿⣯⣤⡀⠳⠀⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⠀⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⡄⠀⠘⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡄⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⢹⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⢸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⠀⠸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⢨⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⣦⣠⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⠐⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⣸⢁⣹⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⡄⢀⡀⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣴⡟⢀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡙⣆⣹⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠛⣯⠙⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⣈⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠟⠁⠰⣏⣴⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢃⣷⡄⡘⠿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠟⠋⠡⠀⡶⠀⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣦⣷⣟⠀⢻⣦⠉⠉⠙⠛⠿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣯⣿⣀⣤⣦⣥⣤⣷⣿⣤⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣄⣘⣻⣆⣠⣦⣤⣄⣬⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿
Art by Joan G. Stark . |___________________________________ |-----|- - -|''''|''''|''''|''''|''''|'##\|__ |- - | cc 6 5 4 3 2 1 # # # __]==---------------------- |-----|________________________________ # # / | 'jgs |"""""""""""""""""""""""""""""""""""`
The following link https://www.nature.com/articles/d41586-018-05112-1 if read it shows Hans Asperger’s involvement w/ Nasi propaganda promoting problematic ideals calling autistics as psychopaths and deemed unfit in
https://psychcentral.com/autism/conditions-associated-with-autism
https://www.sheknows.com/health-and-wellness/articles/2148908/study-unnecessary-pap-smears-teens/
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⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯⣯ ⣯⣇⣇⣇⣇⣇⣇⣇⣯⠁⠀⠀⠀⠀⢻⣧⣏⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇ ⣏⣧⣇⣇⣇⣇⣇⣇⣯⠀⠀⠀⠀⠀⢠⣇⣧⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣯ ⣧⣏⣇⣇⣇⣧⣧⣯⣯⡀⠀⠀⣤⣶⣿⣧⣏⣏⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇ ⣯⣯⣇⣧⣯⠛⠉⣿⣇⣇⠀⠀⣯⣏⣇⣇⣧⣧⣇⣧⣇⣇⣇⣇⣇⣇⣇⣇⣇⣏ ⣯⣯⠟⠁⠀⠀⣤⣿⣧⣧⠀⠀⠀⠀⠀⠀⠀⠀⠀⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇⣇ ⣯⠋⠀⠀⣴⣿⣇⣧⣯⣯⠀⠀⢰⣶⣶⣶⣶⣶⣶⣇⣏⣏⣧⣇⣇⣇⣇⣇⣇⣇ ⡏⠀⠀⣾⣯⣯⣏⣧⣏⣯⠀⠀⠈⠋⠋⠋⠋⠋⠋⠋⠋⠋⣯⣧⣧⣇⣇⣇⣧⣇ ⡂⠀⠀⣇⣧⣯⣧⣇⣇⣯⣤⣤⣤⣤⣤⣤⣤⣤⣤⣤⣄⠀⠀⢫⣧⣏⣇⣇⣧⣇ ⣧⠀⠀⣿⣇⣯⣏⣯⣇⣇⣧⣏⣏⣇⣧⣧⣏⡏⠙⣧⣏⣦⠀⠀⠻⣧⣇⣇⣏⣇ ⣏⣄⠀⠈⢿⣧⣇⣇⣇⣇⣧⣏⣏⣏⣏⣯⠋⠀⠀⣼⣧⣯⣷⠀⠀⠙⣯⠏⢻⣏ ⣯⣏⣦⠀⠀⠈⠛⢿⣇⣧⣇⣧⣇⠟⠋⠀⠀⢀⣾⣇⣧⣇⣯⣿⡀⠀⠀⠀⣠⣿ ⣇⣇⣇⣏⣶⣤⣀⠀⠀⠀⠀⠀⠀⠀⣀⣤⣾⣯⣯⣯⣧⣧⣧⣇⣏⣦⣮⣮⣮⣮
⁉️*️꩜
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💟 WHAT MIGHT BE EASIER FOR YOU MIGHT NOT BE SO EASY FOR ME 💟
A quick look at the best at-home HPV tests Most affordable at-home HPV test: Everlywell HPV Test – Female Best HPV test with medical support: myLAB Box Home HPV Test Kit Best for women under 30: NURX Home HPV Test Kit Best for quick results: iDNA 🍑 However, some tests use a urine sample instead of a cervical
💙 ASD affects each person differently meaning that people with ASD have unique strengths and challenges and different treatment needs. Therefore, treatment plans usually involve multiple professionals and are catered toward the individual. 💙
𝑇ℎ𝑒 𝑏𝑒𝑠𝑡 𝑎𝑛𝑑 𝑚𝑜𝑠𝑡 𝑏𝑒𝑎𝑢𝑡𝑖𝑓𝑢𝑙 𝑡ℎ𝑖𝑛𝑔𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑤𝑜𝑟𝑙𝑑 𝑐𝑎𝑛𝑛𝑜𝑡 𝑏𝑒 𝑠𝑒𝑒𝑛 𝑜𝑟 𝑒𝑣𝑒𝑛 𝑡𝑜𝑢𝑐ℎ𝑒𝑑 - 𝑡ℎ𝑒𝑦 𝑚𝑢𝑠𝑡 𝑏𝑒 𝑓𝑒𝑙𝑡 𝑤𝑖𝑡ℎ 𝑡ℎ𝑒 ℎ𝑒𝑎𝑟𝑡. — 𝐻𝑒𝑙𝑒𝑛 𝐾𝑒𝑙𝑙𝑒𝑟
| | | | o o | | > | | \_/ | \___/ __| |__ / \ | | | | _________________| | | |_____________---__ / | |_____| | / / / /| mga / /_| _ |_\ / / / / | / / / / / / /__/ / /| /____________________/ / / /__________/___\_/_/ / | |____________________| |_| |__________________|/ | |____________________| |_| |__________________| / ____| | | | | | || | / | o o | o o || o o | / |______________|_____________||_______________|/ _______________________________________________________
🧂 Salt can be used in treating cavities because of its antibacterial and antiseptic properties. It reduces the inflammation, prevent the growth of bacteria in the mouth, draw out infections and ease the pain. -Take on tsp. of salt and dissolve it in one glass of warm water. Swish around in the mouth for one minute (concentrate on the tooth that is affected). Do the treatment three times daily until the symptoms subside. -Mix half tsp. of salt and lemon juice or mustard oil to make a paste and massage the gums with it for few minutes. After that, gargle with warm water. Do this treatment two times a day for few days in order to eliminate bacteria.
https://nickgram.com/mechanical-arm 🦿🦾😅 https://nickgram.com/mechanical-leg
💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜⃟💜
🍑 https://www.walgreens.com/store/c/walgreens-screening-kit-for-vaginal-health/ID=300424229-product 🍑
💙 https://www.cancer.gov/news-events/cancer-currents-blog/2020/cervical-cancer-screening-hpv-test-guideline 💙
🍑 what has been said about self collected samples for pap ‘After I made the choice, the only thing that worried me was that I wouldn’t do it properly,’ she recalls. ‘But the instructions were very clear and easy to follow, so that made me feel better about it. I’d say it was much quicker and more comfortable than doing the old Pap test, and I liked that I could do it in private.’ -Patient The Department of Health and Aged Care : (HPV) – a common infection that causes almost all cervical cancers. If you are eligible and want to collect your own sample, your healthcare provider can give you a swab and instructions. A self-collected sample is taken from there so you don’t need to worry about reaching the cervix or ‘getting the right spot’. All you need to do is insert a swab a few centimetres into and rotate it for 20 to 30 seconds. Yes, it’s accurate Evidence shows a Cervical Screening Test using a self-collected sample from there is just as accurate at detecting abnormalities such as HPV as a clinician-collected sample taken from there during a speculum examination. ‘Because my doctor was so reassuring about my ability to self-collect, and the quality of the results that will come back, I found the whole experience really positive. I will definitely choose to self-collect again.’ -patient 🍑
💉 I'll have it done under general anaesthetic. 💉
💉 https://www.forbes.com/sites/tarahaelle/2016/03/23/got-your-tetanus-shot-you-may-not-need-another-for-30-more-years/?sh=3b29aade6db3 💉
💉 https://news.ohsu.edu/2020/02/25/adults-dont-need-tetanus-diphtheria-boosters-if-fully-vaccinated-as-children-study-finds 💉
Adults who have never received a tetanus vaccination should get a Tdap shot. 💉 In general, the CDCTrusted Source recommend receiving tetanus vaccination every 10 years. 💉 However, research published in Clinical Infectious Diseases points to the possibility that these regular boosters may not be necessary for adults. 💉 A 2016 study that looked into tetanus immunity in 546 adults found that the vaccine provided at least 30 years of protection.
In general, the CDCTrusted Source recommend receiving tetanus vaccination every 10 years. However, research published in Clinical Infectious Diseases points to the possibility that these regular boosters may not be necessary for adults. 💉 A 2016 study that looked into tetanus immunity in 546 adults found that the vaccine provided at least 30 years of protection.
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