A Drop In The Ocean

[Natasha Armitage]

Natasha took a seat at one of the only empty tables at the café in Diagon Alley waiting for her mocha while she fished a glossy portfolio from her massive purse. She opened it and removed a few different sketchs posted beside photographs of women and men in designer outfits, most of them dresses.

She leafed through the papers placing them in two piles, “Crap, crap, utter rubbish,” she made a face as she set a disturbingly bad piece of fashion into the ‘no’ pile which was significantly larger than the ‘yes’ pile. Natasha was supposed to be narrowing down the fashion pieces that would be displayed in the upcoming event in two weeks. Most of her options were terrible.

Turning the next page she smiled, “Brilliant!” she whispered to herself as she gazed at the glamorous dress. This would be the first event her boss had let her take lead on and she wanted it to be the most elegant and breathtaking fashion show anyone had ever seen. It was going to be spectacular, if Natasha had anything to say about it. It was then that she felt someone else’s presence standing over her, “What?” she asked in a haughty tone glaring up at the interloper on her thoughts completely forgetting about her order.

((ooc: Enter Kyle? Hope you don’t mind Emma that I started it, and that it’s rubbish but I was momentarily inspired hehe.))

[Kyle Michalka]

((ooc: Course I don't mind! Sorry he's not brilliant.))

"Hey Kyle, I need one mocha, two cappucinos, and an americano, mocha for table 3, others for table 6, please and thank you!" the server called to Kyle as he took orders from customers. Wiping his hands on his apron he nodded, "You got it," Kyle responded, deftly setting to work on multitasking the orders. Now he had well and truly settled into his place woraking in the small, but successful, café in Diagon Alley, he joked his calling was now coffee beans and steamed milk. No, not quite, but it paid the bills and he didn't hate the customer service world like most people so this kind of gig suited him quite well.

As he was preparing the drinks orders he noticed over the counter the blonde girl who'd ordered the mocha seemed quite preoccupied in sorting out papers into 'crap' and, presumably, 'not so crap' piles, though the former seemed much larger than the latter. A reprieve came as she seemed to be gazing delightedly down at one of the papers, obviously this was a breakthrough on whatever she was doing. Not that Kyle was being purposely nosy, he just needed entertainment - that tended to be the case when you were doing the same repetitive drinks orders 8 hours a day, 5 days a week. Watching customers and constructing their life stories in his head was one way of staving off any potential boredom.

Piling his orders onto the tray Kyle ducked under the counter and delivered table 6's cappucinos and americano with a smile before making his way over to table 3 where the girl seemed rather irritated to have another human being, god forbid, stand next to her. He looked down at her, having to suppress a smile of amusement at her haughty manner, "Your mocha," Kyle explained, setting down her coffee carefully alongside the glossy portfolio resting on the table and tucking the now-empty tray under his arm. Then, noticing a few papers must have fell out of the portfolio when she unpacked it he knelt down and picked them up, "I think you must have forgotten these," he pointed out, holding them out to her.

[Natasha Armitage]

Natasha’s gaze softened as she saw Kyle giving her the mocha she had ordered. She gave him a small smile feeling rather sheepish about it. “Oh, uh thanks,” she said taking the papers from the admittedly rather attractive blonde guy.

As he was about to leave she added, “Hey, uhh,” glancing at the pastries at the counter she asked, “Could I get a scone, or maybe a biscuit…” then, “What would you recommend?” she wasn’t really going to eat it she just wanted to see him again, and having hot guys wait on her was definitely a plus. Natasha was sure she should have been a princess in a past life.

((ooc: Kyle was lovely.))

[Kyle Michalka]

“No problem,” Kyle replied simply as he straightened up again. After he’d handed over the fallen papers he smiled politely but wordlessly nudged his head back to the counter as if to express ‘okay, I’ll leave you to it’, and turned on his heel only to be stopped in his tracks as the girl called out to him. Turning back to face her he looked a little confused at her question – asking for his recommendation seemed a little… off to him. The only time anyone had ever asked what he recommended was when they wanted an excuse to talk to him longer. He wondered if it would be arrogant to assume the same was happening now.

He pushed this out of his mind and instead smiled good-naturedly, “Depends on whether you are looking for something sweet or savoury today. Sweet then breaks down into chocolate, biscuit, cake or oat-based products. Personally I recommend the Millionaires' shortbread, it’s a layer of caramel, hardened chocolate topping, all on a shortbread base… what more could you want?” he asked hypothetically. Then, pausing he added in a lower voice, “Do you think I’m pulling off the whole customer-service, ‘trying to be genuinely helpful’ thing right now? My manager’s watching,” he explained quietly with a sly smile her way as his manager’s beady eyes suspiciously lingered over Kyle and Natasha.

[Natasha Armitage]

Natasha raised an eyebrow at him, “Do you need me to buy you one before you start drooling all over my work?” she asked sarcastically then smiled, “I’ll have one of those thanks, you’ve sold me on it.”

Propping her elbow up onto the table then she set her chin in her hand as she listened to him, “Hmm, well I’d say that you are pulling it off rather nicely,” she told him earnestly, but with something behind her tone that might have almost been teasing. Glancing over to the manager she bit her lip in thought. Then glancing back to Kyle she said holding out her hand for him to shake it, “Thank you very much for being so very helpful,” she said a little too loudly so his manager could hear her. “I’m Natasha by the way,” she introduced herself before returning to her work.

[Kyle Michalka]

Kyle smiled and shook his head, “You have no idea the amount of self-control it takes someone with a sweet-tooth to work here,” he joked, “Honeyduke’s would be worse of course.” Then, as she said she’d have a caramel shortbread he nodded, “Coming right up.”

Catching on to her teasing he chuckled, “Well thank you very much, I’ll choose to ignore the teasing tone,” he explained before taking her hand in his own, “You’re welcome, the customer’s needs are obviously paramount,” Kyle announced, loud enough for the manager to hear it and be satisfied enough to walk out, leaving the shop entirely as he was satisfied enough that his staff weren’t slacking off. Watching him go out of the corner of his eye he then turned back to Natasha, as she had just introduced herself, “I’ll just go get your order," he said, returning to the counter and plating up the shortbread. As he set the plate down alongside Natasha's mocha he added, "Oh and it's Kyle by the way," he smiled down at her.

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Pain Management: Treating Mind and Body



Scheman stresses the importance of approaching pain both physically and emotionally and addressing "people as entire human beings.” So while chronic pain medication can be effective and important for pain management for many people, it isn't the only tool available when it comes to pain treatment, and it shouldn't be the only tool that's used.



Medications. "There are a lot of medications that are prescribed for pain," says Scheman, although she notes that opioids (narcotics) and benzodiazepines may not be the best options. Those treatments "have their own problems, and there are no good studies on using opioids for long periods of time for the treatment of chronic pain."



Types of chronic pain medication used include:



NSAIDs (non-steroidal anti-inflammatory drugs), including ibuprofen, naproxen, and aspirin

Acetaminophen (Tylenol)

Antidepressants, which can improve sleep and alleviate pain

Anti-seizure medications, which can be effective in treating pain related to nerve damage or injury

Steroids, like dexamethasone and prednisone, to alleviate inflammation and pain

Therapy. Therapy can be aimed at both the mind and the body. Says Scheman, "I try to look at any of these therapies as not being purely physical or purely psychological — we are always a mixture of both of those things."



Physical therapy is a very important part of any pain management program. Pain can be worsened by exercise that isn't done correctly (or interpreted incorrectly as pain rather than overuse), and a physical therapist can tailor the right exercise regimen for you. Proper exercise slowly builds your tolerance and reduces your pain — you won’t end up overdoing it and giving up because it hurts.

Cognitive-behavioral therapy allows people to "learn and have a better understanding of what the pain is from, and what they can do about it," says Scheman. This therapy is really about understanding the role of pain in your life and what it actually means for you, add Scheman.

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Anti-inflammatory medications

Non-steroidal anti-inflammatory drugs (NSAIDs) can be taken to alleviate the pain caused by inflammation.

They counteract an enzyme that contributes to inflammation. This either prevents or reduces pain.

Examples of NSAIDs include naproxen, ibuprofen, and aspirin, which are available to purchase online.



Avoid the long-term use of NSAIDs unless advised by a doctor. They increase a person's risk of stomach ulcers, which can result in severe, life-threatening bleeding.

NSAIDs may also worsen asthma symptoms, cause kidney damage, and increase the risk of having a stroke or heart attack.

Acetaminophen, such as paracetamol or Tylenol, can reduce pain without affecting the inflammation. They may be ideal for those wishing to treat just the pain while allowing the healing factor of the inflammation to run its course.

Corticosteroids

Corticosteroids, such as cortisol, are a class of steroid hormones that prevent a number of mechanisms involved in inflammation.

There are two sets of corticosteroids:

Glucocorticoids: These are prescribed for a range of conditions, including:

Arthritis, temporal arteritis, dermatitis, inflammatory bowel disease (IBS), systemic lupus, hepatitis, asthma, allergic reactions, sarcoidosis

Creams and ointments may be prescribed for inflammation of the skin, eyes, lungs, bowels, and nose.

Mineralocorticoids: These are used to treat cerebral salt wasting, and to replace important hormones for patients with adrenal insufficiency.

The side effects of corticosteroids are more likely if taken by mouth. Taking them with inhalers or injections can reduce the risk.

Inhaled medications, such as those used long-term to treat asthma, raise the risk of developing oral thrush. Rinsing the mouth out with water after each use can help prevent oral thrush.

Glucocorticoids can also cause Cushing's syndrome, while mineralocorticoids can cause high blood pressure, low blood potassium levels, connective tissue weakness, and problems with the levels of acids and alkalis in body tissue.

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Pain Management Schemes for all

Pain is a very common condition and it is an unpleasant sensation caused by stimulation of fine nerve endings. The occurrence of pain rises as people get older, and women are more likely to experience pain than men. A pain management specialist is a doctor who evaluates your pain and treats a wide range of pain problems. A pain management doctor treats sudden pain problems such as headaches and many types of long-lasting, chronic, pain such as low back pain. Patients are seen in a pain clinic and can go home the same day. Pain management doctors offer a mix of medication-based treatments and procedures, that can stop the pain at its source.

Types of pain treated by a pain management doctor

The types of pain treated by a pain management doctor fall into three main groups. The first is pain due to direct tissue injury, such as arthritis. The second type of pain is due to nerve injury or a nervous system disease, such as a stroke. The third type of pain is a mix of tissue and nerve injury, such as back pain. However, pain fall into two major categories namely: acute and chronic pain. Acute pain is a normal response to tissue injury, which starts suddenly and is usually short-lived. Chronic (ongoing) pain persists beyond the normal time of healing and generally lasts for longer than three months.

Pain may be anything from a dull ache to a sharp stab, and can range from mild to extreme. Pain may be located in one part of the body or it may be widespread.

Studies suggest that a person’s outlook and the way they cope emotionally with long-term (chronic) pain can influence their quality of life. Counselling can help support you to manage the emotional and psychological effects of chronic pain. Understanding the causes of your pain can help reduce your fear and anxiety.

The pain management clinic

Pain patients are seen in an outpatient pain clinic that has procedure rooms, with ultrasound and X-ray imaging. Sometimes, the pain doctor performs the procedures in a nearby hospital. Some pain doctors may offer you sedation during the treatments. However, this is not needed in many cases.

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• pain-relieving medications

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• complementary therapies (such as acupuncture and massage)

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Causes of pain

The most common causes of pain in adults include:

• injury

• medical conditions (such as cancer, arthritis and back problems)

• surgery.

The most commonly reported pains are headache and back pain (although pain involving the limbs, shoulder, neck and head is also common).