Doreen Traylor has been mod since May 2020 when I took over a very dead sub with 9 members. In the course of growing it, I've tried a few different things, learned a lot and started over fresh in 2023 with a new focus.
Beautiful city tucked in between Pennsylvania and West Virginia. Small town charm, excellent eateries, world class shopping.
The whirring blades of my MD-902 throbbed against the warm evening air, and I smiled.
From 5,000 feet, the ground flew by in a carpet of dark forests and kelly-green fields. The sun hung low on the horizon in a picturesque array of dazzling orange and gold, and I could make out the narrow strip of the Ohio River to my left, glistening in the fading daylight. This time of year, the trees would be full of the sweet aroma of fresh blossoms, and the frequent rains kept small pockets of fluffy white mist hanging in the treetops. It was a beautiful view, one that reminded me of why being a helicopter pilot trumped flying in a jumbo jet far above the clouds every day of the week. Fourteen more days, and I’m debt free.
That made me grin even more. I’d been working as a charter pilot ever since I obtained my license at age 19, and after years of keeping my nose to the grindstone, I was closing on the final payment for real-estate in western Pennsylvania. With no debt, a fixer-upper house on 30 rural acres all to myself, and a respectable wage for a 26-year-old pilot, I looked forward to the financial freedom I could now enjoy. Maybe I’d take a vacation, somewhere exotic like Venice Italy, or the Dominican Republic. Or perhaps I’d sock the money back for the day I started a family. “Remember kleineun, a real man looks after his own.”
My elderly ouma’s
voice came back from the depths of my memories, her proud, sun-tanned face rising from the darkness. She and my Rhodesian grandfather had emigrated to the US when they were newlyweds, as the violence against white Boer descendants in South Africa spiraled out of control. My mother and father both died in a car crash when I was six, and it had been my grandparents who raised me. Due to this, I’d grown up with a slight accent that many of my classmates found amusing, and I could speak both English, and Afrikaans, the Boer tongue of our former home.
I shifted in my seat, stretched my back muscles, and glanced at the picture taped to my console. Both my parents flanked a grinning, gap-toothed six-year-old me, at the last Christmas we’d spent together. My mother beamed, her dark hair and Italian features a sharp contrast to my father’s sandy blonde hair and blue eyes. Sometimes, I liked to imagine they were smiling at me with pride at how well I flew the old silver-colored bird my company had assigned to me, and that made the long, lonely flights easier to bear.
A flicker caught my eye, and I broke my gaze away from the photograph.
Perched in its small cradle above the controls, my little black Garmin fuzzed over for a few seconds, its screen shifting from brightly colored maps to a barrage of grey static. Did the power chord come loose?
I checked, ensuring the power-cable for the unit’s battery was plugged into the port on the control panel. It was a brand-new GPS unit, and I’d used it a few times already, so I knew it wasn’t defective. Granted, I could fly and navigate without it, but the Garmin made my time as a pilot so much easier that the thought of going blind was dreadful.
My fuel gauge danced, clicked to empty, then to full, in a bizarre jolt.
More of the gauges began to stutter, the entire panel seeming to develop terrets all at once, and my pulse began to race. Something was wrong, very wrong, and the sludge inside my bowels churned with sour fear.
“Come on, come on.” I flicked switches, turned dials, punched buttons, but nothing seemed to fix the spasming electronics. Every gauge failed, and without warning, I found myself plunged into inky darkness.
Outside, the sun surrendered to the pull of night, the sky darker than usual. A distant rumble of thunder reverberated above the roar of my helicopter’s engine, and I thought I glimpsed a streak of yellowish lightning on the far horizon to my left. Calm down Chris. We’re still flying, so it must just be a blown fuse. Stay in control and find a place to set her down.
My sweaty palm slid on the cyclic stick, and both feet weighed heavy on the yaw pedals. The collective stuck to my other hand with a nervous vibration, and I squinted against the abyss outside. Beep.
I jumped despite myself, as the little Garmin on my panel flared back to life, the static pulling aside to reveal a twitching display. Each time the screen glitched, it showed the colorful map detailing my flight path over the ground below, but I noticed that some of the lines changed, the names shifting, as if the device couldn’t decide between two different versions of the world.
One name jutted out at me, slate gray like most of the major county names, appearing with ghostly flickers from between two neighboring ones. Barron County.
I stared, confused. I’d flown over this section of southeastern Ohio plenty of times, and I knew the counties by heart. At this point, I should have been over the southern end of Noble County, and maybe dipping lower into Washington. There was no Barron County
Ohio. I was sure of it.
And yet it shown back at me from the digital landscape, a strange, almost cigar-shaped chunk of terrain carved from the surrounding counties like a tumor, sometimes there, sometimes not, as my little Garmin struggled to find the correct map. Rain began to patter against my cockpit window, and the entire aircraft rattled from a strong gust of wind. Thick clouds closed over my field of vision like a sea of gray cotton.
The blood in my veins turned to ice, and I sucked in a nervous breath.
Land. I had to land. There was nothing else to do, my flight controls weren’t responding, and only my Garmin had managed to come back to life. Perhaps I’d been hit by lightning, and the electronics had been fried? Either way, it was too dark to tell, but a storm seemed to be brewing, and if I didn’t get my feet on the ground soon, I could be in real trouble.
“Better safe than sorry.” I pushed down on the collective to start my slow descent and clicked the talking button for my headset. “Any station, this is Douglass Three-One-Four-Foxtrot, over.”
“Any station, this is Douglass Three-One-Four-Foxtrot, requesting emergency assistance, over.”
Still nothing. If the radio’s dead, I’m really up a creek.
With my hand shaking, I clicked on the mic one more time. “Any station, this is—”
Like a curtain pulling back, the fog cleared from around my window, and the words stuck in my throat.
Without my gauges, I couldn’t tell just how far I’d descended, but I was definitely very low. Thick trees poked up from the ground, and the hills rolled into high ridges with flat valley floors, fields and pastures pockmarking them. Rain fell all around in cold, silvery sheets, a normal feature for the mid spring in this part of Ohio.
What wasn’t normal, were the fires.
At first, I thought they were forest fires for the amount of smoke and flames that bellowed from each spot, but as I swooped lower, my eyes widened in horror.
They were houses.
Farms, cottages, little clusters that barely constituted villages, all of them belched orange flames and black pillars of sooty smoke. I couldn’t hear above the helicopter blades, but I could see the flashes on the ground, along the road, in between the trees, and even coming from the burning buildings, little jets of golden light that spat into the darkness with anger. Gunfire. That’s rifle fire, a whole lot of it.
Tiny black figures darted through the shadows, barely discernable from where I sat, several hundred feet up. I couldn’t see much, but some were definitely running away, the streaks of yellow gunfire chasing them. A few dark gray vehicles rumbled down one of the gravel roads, and sprayed fire into the houses as it went. They were fighting, I realized, the people in the trucks and the locals. It was horrific, like something out of war-torn Afghanistan, but worse.
Then, I caught a glimpse of the others
They didn’t move like the rest, who either fled from the dark vehicles, or fired back from behind cover. These skinny figures loped along with haphazard gaits, many running on all fours like animals, swarming from the trees by the dozens. They threw themselves into the gales of bullets without flinching, attacking anyone within range, and something about the way they moved, so fluid, so fearless, made my heart skip a beat. What is that? “Echo Four Actual to unknown caller, please respond, over.”
Choking back a cry of shock, I fumbled at the control panel with clumsy fingers, the man’s voice sharp and stern. I hadn’t realized that I’d let go of the talking button and clicked it down again. “Hello? Hello, this is Douglass Three-One-Four-Foxtrot out of Pittsburgh, over.”
An excruciating moment passed, and I continued to zoom over the trees, the fires falling away behind me as more silent forest took over. “Roger that Douglass Three-One-Four-Foxtrot, we read you loud and clear. Please identify yourself and any passengers or cargo you might be carrying, over.”
Swallowing hard, I eyed the treetops, which looked much closer than they should have been. How far had I descended? “Echo Four Actual, my name is Christopher Dekker, and I am alone. I’m a charter flight from PA, carrying medical equipment for OSU in Columbus. My controls have been damaged, and I am unable to safely carry on due to the storm. Requesting permission to land, over.”
I watched the landscape slide by underneath me, once catching sight of what looked like a little white church
surrounded by smaller huts, dozens of figures in the yard staring up at me as I flew over a towering ridgeline. “Solid copy on that Douglass Three-One-Four-Foxtrot. Be advised, your transponder shows you to be inside a restricted zone. Please cease all radio traffic, reduce your speed, climb to 3,000 feet and proceed north. We’ll talk you in from there. How copy, over?”
My heart jumped, and I let out a sigh of relief. “Roger that Echo Four Actual, my altimeter is down, but I’ll do my best to eyeball the altitude, over.”
With that, I pulled the collective upward, and tried my best to gauge how far I was by eyesight in the gathering night, rain still coming down all around me. This had to be some kind of disaster or riot, I decided. After all, the voice over the radio sounded like military, and those vehicles seemed to have heavy weapons. Maybe there was some kind of unrest going on here that I hadn’t heard about yet? Kind of weird for it to happen in rural areas though. Spoiled college kids I get, but never saw farmers get so worked up before. They usually love the military.
Something moved in the corner of my eye, and I turned out of reflex.
My mouth fell open, and I froze, unable to scream.
In the sky beside me, a huge shadow glided along, and its leathery wings effortlessly carved through the gloom, flapping only on occasion to keep it aloft. It was too dark for me to see what color it was, but from the way it moved, I knew it wasn’t another helicopter. No, this thing was alive, easily the size of a small plane, and more than twice the length of my little McDonald Douglass. A long tail trailed behind it, and bore a distinct arrow-shaped snout, with twig-like spines fanned out around the back of its head. Whatever legs it had were drawn up under it like a bird, yet its skin appeared rough and knobby, almost resembling tree bark. Without pause, the gigantic bat-winged entity flew along beside me, as if my presence was on par with an annoying fly buzzing about its head.
Gripping the microphone switch so tight, I thought I’d crack the plastic, I whispered into my headset, forgetting all radio protocol. “T-There’s something up here.”
Static crackled. “Douglas Three-One-Four-Foxtrot, say again your last, you’re coming in weak and unreadable, over.”
“There’s something up here.” I snarled into the headset, still glued to the controls of the helicopter, afraid to deviate even an inch from my course in case the monstrosity decided to turn on me. “A freaking huge thing, right beside me. I swear, it looks like a bat or . . . I don’t know.” “Calm down.”
The man on the other end of the radio broke his rigorous discipline as well, his voice deep, but level. “It won’t attack if you don’t move too fast. Slowly ease away from it and follow that course until you’re out of sight.”
I didn’t have time to think about how wrong that sounded, how the man’s strict tone had changed to one of knowledge, how he hadn’t been the least surprised by what I’d said. Instead, I slowly turned the helicopter away from the huge menace and edged the speed higher in tiny increments.
As soon as I was roughly two football fields away, I let myself relax, and clicked the mic switch. “It’s not following.” “You’re sure?”
Eyeing the huge flapping wings, I nodded, then remembered he couldn’t see me. “Yeah, I’m well clear.” “Good. Thank you, Mr. Dekker.”
Then, the radio went dead.
Something in my chest dropped, a weight that made my stomach roil. This wasn’t right, none of it. Who was that man? Why did he know about the thing I’d just seen? What was I supposed to—
A flash of light exploded from the trees to my right and shot into the air with a long finger of smoke. What the . . .
On instinct, I jerked the cyclic stick to one side, and the helicopter swung to avoid the rocket. Boom.
My world shook, metal screeched, and a dozen alarms began to go off inside the cockpit in a cacophony of beeps and sirens. Orange and red flames lit up the night sky just behind me, and the horizon started to spin wildly outside. Heat gushed from the cockpit door, and I smelled the greasy stench of burning oil. The safety belts dug into my shoulders, and with a final slip, the radio headset ripped free from my scalp. I’m hit.
Desperate, I yanked on the controls, fought the bird even as she spun toward the ground in a wreath of flames, the inky black trees hurtling up to meet me. The helicopter went into full auto-rotation, the sky blurring past outside, and the alarms blared in a screech of doom. Panic slammed through my temples, I screamed at the top of my lungs, and for one brief second, my eyes locked on the little black Garmin still perched atop my control panel.
Its screen stopped twitching and settled on a map of the mysterious Barron County, with a little red arrow at the center of the screen, a few words popping up underneath it. You are here
Trees stabbed up into the sky, the belts crushed at my torso, glass shattered all around me, and the world went dark.
Copper, thick, warm, and tangy.
It filled my mouth, stank metallic in my nose, clogged my throat, choking me. In the murkiness, I fought for a surface, for a way out, blind and numb in the dark. This way, kleineun.
voice echoed from somewhere in the shadows. This way.
Both eyes flew open, and I gagged, spitting out a stream of red.
Pain throbbed in my ribs, and a heavy pressure sent a tingling numbness through my shoulders. Blood roared inside my temples, and stars danced before my eyes with a dizzying array. Humid night air kissed my skin, and something sticky coated my face, neck, and arms that hung straight up toward the ceiling.
Wait. Not up. Down
I blinked at the wrinkled, torn ceiling of the cockpit, the glass all gone, the gray aluminum shredded like tissue paper. Just outside the broken windows, thick Appalachian bluegrass and stemmy underbrush swished in a feeble breeze, backlit by flashes of lightning from the thunderstorm overhead. Green and brown leaves covered everything in a wet carpet of triangles, and somewhere nearby, a cricket chirped.
Turning my head from side to side, I realized that I hung upside down inside the ruined helicopter, the top half burrowed into the mud. I could hear the hissing and crackling of flames, the pattering of rain falling on the hot aluminum, and the smaller brush fires around the downed aircraft sizzling out in the damp long grass. Charred steel and burning oil tainted the air, almost as strong as the metallic, coppery stench in my aching nose. They shot me down. That military dude shot me out of the sky.
It didn’t make sense. I’d followed their orders, done everything they’d said, and yet the instant I veered safely away from whatever that thing in the sky had been, they’d fired, not at it, but at me.
Looking down (or rather, up) at my chest, I sucked in a gasp, which was harder to do that before.
The navy-blue shirt stuck to my torso with several big splotches of dark, rusty red. Most were clean slashes, but two held bits of glass sticking out of them, one alarmingly bigger than the other. They dripped cherry red blood onto my upturned face, and a wave of nausea hit me. I gotta get down.
I flexed my arms to try and work some feeling back into them, praying nothing was broken. Half-numb from hanging so long, I palmed along my aching body until I felt the buckled for the seat belts.
“Okay.” I hissed between gritted teeth, in an effort to stave off my panic. “You can do this. Just hold on tight. Nice and tight. Here we go . . .” Click.
Everything seemed to lurch, and I slid off the seat to plummet towards the muck-filled hole in the cockpit ceiling. My fingers were slick with blood and slipped over the smooth faux-leather pilot’s seat with ease. The shoulder belt snagged on the bits of glass that lay just under the left lowest rib, and a flare of white-hot pain ripped through me. Wham.
I screamed, my right knee caught the edge of the aluminum ceiling, and both hands dove into a mound of leaf-covered glass shards on the opposite side of the hole. My head swam, being right-side-up again enough to make shadows gnaw at the corner of my eyes.
Forcing myself to breath slowly, I fought the urge to faint and slid back to sit on the smooth ceiling. I turned my hands over to see half a dozen bits of clear glass burrowed into my skin like greedy parasites, red blood weeping around the new cuts.
“Screw you.” I spat at the rubbish with angry tears in my eyes. “Screw you, screw you, screw you.”
The shards came out easy enough, and the cuts weren’t that deep, but that wasn’t what worried me. On my chest, the single piece of cockpit glass that remined was almost as big as my palm, and it really
hurt. Just touching it felt like self-inflicted torture, but I knew it had to come out sooner or later. Please don’t nick a vein.
Wiping my hands dry on my jeans, I gripped the shard with both hands, and jerked.
Fire roared over my ribs, and hot blood tickled my already grimy pale skin. I clapped a hand over the wound, pressing down hard, and grunted out a string of hateful expletives that my ouma
would have slapped me for.
Lying on my back, I stared around me at the messy cargo compartment of the MD-902. Most of the medical supplies had been in cardboard boxes strapped down with heavy nylon tow-straps, but several cases had ruptured with the force of the impact, spraying bandages, syringes, and pill bottles all over the cluttered interior. Orange flames chewed at the crate furthest to the rear, the tail section long gone, but the foremost part of the hold was intact. Easily a million-dollar mess, it would have made me faint on any other trip, but today it was a godsend.
Half-blind in the darkness, I crawled along with only the firelight and lightning bolts to guide me, my right knee aching. Like a crippled raccoon, I collected things as I went, conscious of the two pallets of intact supplies weighing right over my head. I’d taken several different first-aid courses with some hunting buddies of mine, and the mental reflexes kicked in to help soothe my frazzled mind. Check for bleeds, stop the worst, then move on.
Aside from my battered chest and stomach, the rest of me remained mostly unharmed. I had nasty bruises from the seatbelts, my right knee swelled, my nose slightly crooked and crusted in blood, but otherwise I was intact. Dowsing every scratch and cut with a bottle of isopropyl alcohol I found, I used butterfly closures on the smaller lacerations that peppered my skin. I wrapped soft white gauze over my abused palms and probed at the big cut where the last shard had been, only stopping when I was sure there were no pieces of glass wedged inside my flesh.
“Not too bad.” I grunted to myself, trying to sound impassive like a doctor might. “Rib must have stopped it. Gonna need stitches though. That’ll be fun.
Pawing through the broken cases, I couldn’t find any suture chord, but just as I was about to give up, I noticed a small box that read ‘medical skin stapler’. Bingo.
I tore the small white plastic stapler free from its packaging and eyeballed the device. I’d never done this before, only seen it in movies, and even though the cut in my skin hurt, I wondered if this wouldn’t be worse. You’ve gotta do it. That bleeding needs to stop. Besides, no one’s coming to rescue you, not with those rocket-launching psychos out there.
Taking a deep breath, I pinched the skin around the gash together, and pressed the mouth of the stapler to it. Click.
A sharp sting, like that of a needle bit at the skin, but it didn’t hurt nearly as bad as the cut itself. I worked my way across the two-inch laceration and gave out a sigh of relief when it was done.
“Not going to bleed to death today.” I daubed ointment around the staples before winding more bandages over the wound.
Popping a few low-grade painkillers that tumbled from the cargo, I crawled wriggled through the nearest shattered window into the wet grass.
Raindrops kissed my face, clean and cool on my sweaty skin. Despite the thick cloud cover, there was enough constant lightning strikes within the storm to let me get glimpses of the world around me. My helicopter lay on its back, the blades snapped like pencils, with bits and pieces of it burning in chunks all around the small break in the trees. Chest-high scrub brush grew all around the low-lying ground, with pockets of standing water in places. My ears still rang from the impact of the crash, but I could start to pick up more crickets, frogs, and even some nocturnal birds singing into the darkness, like they didn’t notice the huge the hulk of flaming metal that had fallen from the sky. Overhead, the thunder rumbled onward, the feeble wind whistling, and there were other flashes on the horizon, orange and red ones, with crackles that didn’t sound quite like lightning. The guns. They’re still fighting.
Instinctively, I pulled out my cellphone, and tapped the screen.
It fluttered to life, but no matter how I tried, I couldn’t get through to anyone, not even with the emergency function designed to work around having no service. The complicated wonder of our modern world was little better than a glorified paperweight.
Stunned, I sat down with my back to the helicopter and rested my head against the aluminum skin of the craft. How I’d gone from a regular medical supply run to being marooned in this hellish parody of rural America, I didn’t know, but one thig was certain; I needed a plan. Whoever fired the missile could have already contacted my charter company and made up some excuse to keep them from coming to look for me. No one else knew I was here, and even though I now had six staples holding the worst of my injuries shut, I knew I needed proper medical attention. If I wanted to live, I’d have to rescue myself. My bag. I need to get my go-bag, grab some gear and then . . . head somewhere else.
It took me a while to gather my green canvas paratrooper bag from its place behind the pilot’s seat and fill it with whatever supplies I could scrounge. My knee didn’t seem to be broken, but man did it hurt, and I dreaded the thought of walking on it for miles on end. I focused instead on inventorying my gear and trying to come up with a halfway intelligent plan of action.
I had a stainless-steel canteen with one of those detachable cups on the bottom, a little fishing kit, some duct tape, a lighter, a black LED flashlight with three spare batteries, a few tattered road maps with a compass, a spare pair of socks, medical supplies from the cargo, and a simple forest green plastic rain poncho. I also managed to unearth a functioning digital camcorder my ouma
had gotten me for Christmas a few years back, though I wasn’t sure I wanted to do any filming in such a miserable state. Lastly, since it was a private supply run from a warehouse area near Pittsburgh to a direct hospital pad in Ohio, I’d been able to bring my K-Bar, a sturdy, and brutally simple knife designed for the Marine Corps that I used every time I went camping. It was pitiful in comparison to the rifle I wished I had with me, but that didn’t matter now. I had what I had, and I doubted my trusty Armalite would have alleviated my sore knee anyway.
Clicking on my flashlight, I huddled with the poncho around my shoulders inside the wreck of the chopper and peered at the dusty roadmaps. A small part of me hoped that a solution would jump out from the faded paper, but none came. These were all maps of western PA and eastern Ohio. None of them had a Barron County on them anywhere. The man on the radio said to head north, right before they shot me down. That means they must be camped out to the north of here. South had that convoy and those burning houses, so that’s a no-go. Maybe I can backtrack eastward the way I came.
As if on cue, a soft pop
echoed from over the eastern horizon, and I craned to look out the helicopter window, spotting more man-made flashes over the tree tops.
“Great.” I hissed between clenched teeth, aware of how the temperature dipped to a chilly 60 degrees, and how despite the conditions, my stomach had begun to growl. “Not going that way, are we? Westward it is.”
Walking away from my poor 902 proved to be harder than I’d anticipated. Despite the glass, the fizzling fires, and the darkness, it still held a familiar, human essence to it. Sitting inside it made me feel secure, safe, even calm about the situation. In any other circumstance, I would have just stayed with the downed aircraft to wait for help, but I knew the men who shot me down would likely find my crash site, and I didn’t want to be around when they did.
Unlike much of central and western Ohio, southeastern Ohio is hilly, brushy, and clogged with thick forests. Thorns snagged at my thin poncho and sliced at my pant legs. My knee throbbed, every step a form of self-inflicted torture. The rain never stopped, a steady drizzle from above just cold enough to be problematic as time went on, making me shiver. Mud slid under my tennis shoes, and every tree looked ten times bigger in the flickering beam of my cheap flashlight. Icy fear prickled at the back of my neck at some of the sounds that greeted me through the gloom. I’d been camping loads of times, both in Pennsylvania and elsewhere, but these noises were something otherworldly to me.
Strange howls, screeches, and calls permeated the rain-soaked sky, some almost roars, while others bordered on human in their intonation. The more I walked, the softer the distant gunfire became, and the more prevalent the odd sounds, until the shadows seemed to fill with them. I didn’t dare turn off my flashlight, or I’d been completely blind in the dark, but a little voice in the back of my head screamed that I was too visible, crunching through the gloomy forest with my long beam of light stabbing into the abyss. It felt as though a million eyes were on me, studying me, hunting me from the surrounding brush, and I bitterly recalled how much I’d loved the old Survivor Man
TV series as a kid. Not so fun being out in the woods at night. Especially alone.
A twig snapped somewhere behind me, and I whirled on the spot, one trembling hand resting on the hilt of my K-Bar.
Nothing. Nothing but trees, bushes, and rain dripping down in the darkness.
“This is stupid.” I whispered to myself to keep my nerves in check as I slowly spun on the spot. “I should have went eastward anyway. God knows how long I’m going to have to—” Creak.
A groan of metal-on-metal echoed from somewhere to my right, and I spun to face it, yanking the knife on my belt free from its scabbard. It felt so small and useless in my hand, and I choked down a wave of nauseas fear. Ka-whump. Creak. K-whump. Creak.
Underbrush cracked and crunched, a few smaller saplings thrashed, and from deep within the gloom, two yellow orbs flared to life. They poked through the mist in the trees, forming into slender fingers of golden light that swept back and forth in the dark. The soldiers . . . they must be looking for me.
I swallowed hard and turned to slink away.
Ice jammed through my blood, and I froze on the spot, biting my tongue to stop the scream.
It stood not yards away, a huge form that towered a good twelve feet tall in the swirling shadows. Unpolished chrome blended with flash-rusted spots in the faded red paint, and grime-smeared glass shone with dull hues in the flashes of lightning. Where the wheels should have been, the rounded steel axels curved like some enormous hand had bent them, and the tires lay face-down on the muddy ground like big round feet, their hubcaps buried in the dirt. Dents, scrapes, and chips covered the battered thing, and its crooked little radio antenna pointed straight up from the old metal fender like a mast. I could barely make out the mud-coated VW
on the rounded hood, and my mind reeled in shock. Is . . . is that a car?
Both yellow headlights bathed me in a circle of bright, blinding light, and neither I nor the strange vehicle moved.
Seconds ticked by, the screech-thumping in the background only growing closer. I realized that I couldn’t hear any engine noises and had yet to see any soldiers or guns pointed my way. This car looked old, really old, like one of those classic Volkswagen Beetles that collectors fought over at auctions. Try as I might, I couldn’t see a driver inside the murky, mold-smeared windows.
Because there wasn’t one.
Lightning arched across the sky overhead, and the car standing in front of me blinked.
Its headlights slid shut, as if little metal shades had crawled over the bulbs for a moment and flicked open again. Something about that movement was so primal, so real, so lifelike,
that every ounce of self-control I had melted in an instant.
Cursing under my breath, I lunged into the shrubs, and the world erupted around me.
Under my shoes, the ground shook, and the car surged after me in a cacophony of ka-thumps
that made my already racing heart skip several beats. A weather-beaten brown tow truck from the 50’s charged through the thorns to my left, it’s headlights ablaze, and a dilapidated yellow school bus rose from its hiding place in the weeds to stand tall on four down-turned axel-legs. They all flicked their headlights on like giants waking from their slumber, and as I dodged past them, they each blared their horn into the night in alarm.
My breaths came short and tight, my knee burned, and I crashed through thorns and briars without thought to how badly I was getting cut up.
The cheap poncho tore, and I ripped it away as it caught on a tree branch.
A purple 70’s Mustang shook off its blanket of creeping vines and bounded from a stand of trees just ahead, forcing me to swerve to avoid being run over, my adrenaline at all-time highs. This can’t be happening, this can’t be happening, this can’t be happening.
Slipping and sliding, I pushed through a stand of multiflora rose, and stumbled out into a flat, dark expanse.
I almost skidded to a stop.
What had once been a rather large field stood no taller than my shoestrings, the grass charred, and burnt. The storm above illuminated huge pieces of wreckage that lay scattered over the nearly 40-acre plot, and I could just make out the fire-blackened hulk of a fuselage resting a hundred yards away. The plane had been brought down a while ago it seemed, as there weren’t any flames left burning, and I threw myself toward it in frenzied desperation.
Burned grass and greasy brown topsoil slushed underfoot, and I could hear the squelching of the cars pursing me. Rain soaked me to the bone, and my lungs ached from sucking down the damp night air. A painful stich crept into my side, and I cursed myself for not putting in more time for cardio at the gym.
Something caught my left shoelace, and I hurtled to the ground, tasting mud and blood in between my teeth. They’ve got me now.
I clawed at the mud, rolled, and watched a tire slam down mere inches from where my head had been. The Mustang loomed over me and jostled for position with the red Volkswagen and brown tow truck, the school bus still a few yards behind them. They couldn’t seem to decide who would get the pleasure of stomping me to death, and like a herd of stampeding wildebeest, they locked bumpers in an epic shoving match.
On all fours, I scampered out from under the sparring brutes, and dashed for the crumpled airplane, a white-painted DC-3 that looked like it had been cut in half by a gargantuan knife blade. I passed a snapped wing section, the oily remains of a turbo-prop engine, and a mutilated wheel from the landing gear. Climbing over a heap of mud, I squeezed into the back of the ruined flight cabin and dropped down into the dark cargo hold. Wham.
No sooner had my sneakers hit the cold metal floor, and the entire plane rocked from the impact of something heavy ramming it just outside. I tumbled to my knees, screaming in pain as, once again, I managed to bash the sore one off a bracket in the wall.
My hand smeared in something gooey, and I scrabbled for my flashlight.
It clicked on, a wavering ball of white light in the pitch darkness, and I fought the urge to gag. “Oh man . . .”
Three people, or what was left of them, lay strewn over the narrow cargo area. Claret red blood coated the walls, caked on the floor, and clotted under my mud-spattered shoes. Bits of flesh and viscera were stuck to everything, and tatters of cloth hung from exposed sections of broken bone. An eerie set of bloody handprints adorned the walls, and the only reason I could tell it had been three
people were the shoes; all of them bore anklebones sticking out above blood-soaked socks. It smelled sickly sweet, a strange, nauseas odor that crept into my nose and settled on the back of my tongue like an alien parasite.
Something glinted in the beam of my flashlight, and my pulse quickened as I pried the object loose from the severed arm that still clung to it.
“Hail Mary full of Grace.” I would have grinned if it weren’t for the fact that the plane continued to buck and roll under the assault from the cars outside.
The pistol looked old, but well-maintained, aside from the light coating of dark blood that stained its round wooden handle. It felt heavy, but good in my hand, and I turned it over to read the words, Waffenfabrik Mauser
stenciled into the frame, with a large red 9 carved into the grip. For some reason, it vaguely reminded me of the blasters from Star Wars.
I fumbled with a little switch that looked like a safety on the back of the gun and stumbled toward a gap in the plane’s dented fuselage to aim out at the surrounding headlights. Bang.
The old gun bucked reliably in my hand, its long barrel spitting a little jet of flame into the night. I had no idea if I hit anything, but the attacking cars recoiled, their horns blaring in confusion.
They turned, and scuttled for the tree line as fast as their mechanical legs could go, the entire ordeal over as fast as it had begun. Did I do that?
Perplexed, I stared down at the pistol in my hand. Whoosh.
A large, inky black shadow glided down from the clouds, and the yellow school bus moved too slow to react in time.
With a crash, the kicking nightmarish vehicle was thrown onto its side, spraying glass and chrome trim across the muddy field. Its electro-synth horn blared with wails of mechanical agony, as two huge talon-like feet clamped down on it, and the enormous head of the flying creature lowered to rip open its engine compartment.
The horn cut out, and the enormous flying entity jerked its head back to gulp down a mass of what looked like sticky black vines from the interior of the shattered bus.
At this range, I could see now that the flying creature bore two legs and had its wings half-tucked like a vulture that had descended to feed on roadkill. Its head turned slightly, and in the glow of another lightning bolt, my jaw went slack at the realization of what it was. A tree trunk. It’s a rotted tree trunk.
I couldn’t tell where the reptilian beast began, and where the organic tree components ended, the upper part of the head shaped like a log, while the lower jaw resembled something out of a dinosaur movie. Its skin looked identical to the outside of a shagbark hickory but flexed with a supple featheriness that denoted something closer to skin. Sharp branch-like spines ranged down its back, and out to the end of its tail, which bore a massive round club shaped like a diseased tree-knot. Crouched on both hind legs, it braced the hooked ends of its folded wings against the ground like a bat, towering higher than a semi-truck. Under the folds of its armored head, a bulging pair of chameleon-like eyes constantly spun in their sockets, probing the dark for threats while it ate.
One black pupil locked onto the window I peered through, and my heart stopped.
The beast regarded me for a moment, with a curious, sideways sniff.
With a proud, contemptful head-toss, the shadow from the sky parted rows of razor-sharp teeth to let out a roar
that shook the earth beneath my feet. It was the triumphant war cry of a creature that sat at the very top of the food chain, one that felt no threat from the fragile two-legged beings that walked the earth all around it. It hunted whenever it wanted, ate whatever it wanted, and flew wherever it wanted. It didn’t need to rip the plane apart to devour me.
Like my hunter-gatherer ancestors from thousands of years ago, I wasn’t even worth the energy it would take to pounce.
I’m hiding in the remains of the cockpit now, which is half-buried under the mud of the field, enough to shield the light from my screen so that thing
doesn’t see it. My service only now came back, and it’s been over an hour since the winged beast started in on the dead bus. I don’t know when, or how I’m going to get out of here. I don’t know when anyone will even see this post, or if it will upload at all. My phone battery is almost dead, and at this point, I’m probably going to have to sleep among the corpses until daylight comes.
A dead man sleeping amongst friends.
If you live in the Noble County area in southeastern Ohio, be careful where you drive, fly, and boat. I don’t know if it’s possible to stumble into this strange place by ground, but if so, then these things are definitely headed your way.
If that happens . . . pray that they don’t find you.
I am at a crossroads in my life and I need to make a final decision on where I should raise my son. It’s hard to plan for the long term future when I don’t know where we will physically be. The issue is, I don’t really have a “home”.
Backstory: I was born in Virginia, and moved to California with my Mom at 13. The rest of my family remained on the east coast. I “came of age” in California and loved living there. I moved away due to being priced out (Bay Area 2014 was the last time I lived in CA).
I have moved nearly 40 times in my life, and I’m currently in Texas, which is the 8th state I have lived. My child was born here but I really don’t foresee staying here forever. I moved here on a whim in 2020, I have no friends or family close by, I’m not a fan of the weather and I’m worried it’s not the best place for my kid to grow up.
My family is scattered all over the east coast- VA, MD, FL… and my son’s father’s family is in Southern California. So Texas is a good central location between extended family.
Here are more details: I don’t think we could afford to live in California, but we have family and friends there. My kid’s dad doesn’t want us to go to the east coast because it’s so far away from his family.
I lived in Oregon for years, have strong friendships there, and loved it, but it’s so far from both families.
If we live away from a coast, I would prefer to live closer to a large city, if I’m on a coast, City proximity doesn’t matter.
I have thought about staying somewhere in the central US but with different weather and more left leaning policies(let’s not get into why). A city I have highly considered is Ft. Collins, CO.
My job is remote and very secure, I make over 70k, and I don’t plan to buy a home in the immediate future or maybe at all. So I make a decent income and I am looking to rent long term.
If you have any advice or recommendations of where I should bring my family, I appreciate the input.
Ok so— got rejected/waitlist by all of my reaches, thought I would have a miserable time at my cheap state flagship (Rutgers-a strike, a missing kid, and a repeat of high school?) Got accepted off the waitlist to a T3 LAC across the country. Didn’t put some documents into my Non-Custodial parent’s CSS (makes >$125k but pays child support.) Mentally prepared to go to the LAC, put in the info in my NPC and resulted in $9k after aid. (FAFSA EFC is 0)
Just got my official financial aid letter today, and it’s $36k.
They gave me like 24 hours to pay the $500 deposit after receiving my package, but nevertheless I will try and appeal my offer. For a really nice school that demonstrates 100% financial need, has a very high med school acceptance, and good weather all the time (it’s Pomona lol), I didn’t expect it to be so expensive. As stated, I want to go into medical or dental school, and I want Pomona’s accessibility to their pre-health resources, grade inflation, as well as its ability to explore the 5cs and become independent. I dislike how large Rutgers is, asbestos in the dorms, and not much interaction with other professors. But it is the cheaper option after all…
Pomona also has the prestige (in terms of grad school), and I want to pursue an MD/PhD path. Not sure if Pomona is known to be good with appealing financial aid. It’s the better opportunity overall, unless someone says that it is not.
Have not decommitted to Rutgers, said that I will accept my offer to Pomona but have not paid the fee waiver. Scared to let the best opportunity fly by.
What’s my best bet? Do off campus dorming? Loan options?
he International Scoliosis Research Society defines early onset scoliosis (EOS) as the various types of scoliosis that occur within 10 years of age (1). EOS leads to distortion of body appearance and reduced heart and lung function, which often limits the development of the chest and even oppresses the spinal cord, resulting in paralysis (2). A large-scale demographic study showed that an increase in altitude negatively correlated with newborn birth weight. Moreover, neonatal body weight shows obvious changes when the altitude exceeds 2500 m (3, 4). Based on relevant studies, we defined an area with an altitude above 3000 m as a high-altitude area and an area with an altitude below 500 m as a plain area (5). High-altitude environments consists of low air pressure, hypoxia, and cold weather, all of which impact the cardiopulmonary function and structure of the human body. Such high-altitude environments increase cardiac output, pulmonary ventilation, pulmonary capillary hyperplasia, and other compensatory reactions (6, 7). However, there are limited studies on the effects of high-altitude environments on cardiopulmonary function in patients with EOS. Therefore, this study aimed to determine the effects of high altitude on the respiratory and circulatory systems of patients with EOS by comparing blood gas analysis results and cardiopulmonary function between the high-altitude and plain area groups. In addition, we explored how scoliosis affected patients' cardiopulmonary function by analyzing the correlations between scoliosis imaging parameters and cardiopulmonary function measures. We aimed to provide an improved preoperative evaluation and postoperative rehabilitation for EOS patients living in high-altitude areas.
Inclusion and exclusion criteria A retrospective cohort study was conducted to identify patients with EOS between June 2013 and June 2021. The inclusion criteria were: (1) EOS patients with a long-term living altitude >3000 m or living area altitude <500 m; (2) full-length anteroposterior and lateral radiographs of the spine showing scoliosis of mainly the thoracic curvature type; (3) patients with an aggravated Cobb's angle >45°; (4) no treatment with braces or growth rods before evaluation; and (5) all patients knew of the study procedures and agreed to participate. The exclusion criteria were: (1) incomplete spinal radiography data; (2) patients who could not cooperate with the completion of pulmonary function examination, blood gas analysis, and cardiac color ultrasound; and (3) patients with congenital cardio-cerebrovascular diseases, syndrome scoliosis, and previous spinal surgery. Evaluation methods Patient records and relevant data were collected retrospectively. All patients underwent full-length anteroposterior and lateral spine radiographs, blood gas analysis, lung function examination, and heart color ultrasound examination. Imaging parameters Preoperatively, whole-body and lateral spinal X-rays were performed on all patients, and both shoulders were flexed anteriorly during X-ray examination to ensure the most natural state of lumbar lordosis. The imaging parameters were as follows: (1) kyphosis angle of the thoracic (kypho), (2) upper thoracic curve (UT), and (3) main thoracic curve (MT). MT measures the Cobb angle from the head side of the T3 upper endplate to the T12 lower endplate. The UT measures the Cobb angle from the T1 upper endplate to the T3 lower endplate on the cephalic side. Kypho measures the Cobb angle from the upper endplate of the cephalic T2 vertebral body to the lower endplate of the caudal T5 vertebral body. All measurements used the Cobb method. The picture archiving and communication system was used by two independent observers. To test agreement among the observers, two orthopedic spine surgeons measured the imaging parameters twice independently, and the intraclass correlation coefficient was analyzed. Doppler echocardiography Color Doppler echocardiography indices were collected and recorded, including those of the pulmonary artery internal diameter (PAID), left ventricular end-systolic dimension (LVISD), ascendant aorta inner diameter, right ventricular basal diameter (RVBD), left atrium left-right diameter (LALRD), right atrium left-right diameter, left atrium longitudinal diameter, left atrium vertical diameter, peak late diastolic flow velocity (A peak), left ventricular early diastolic peak flow velocity (E peak), interventricular septum extent (IVSE), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), right atrium vertical diameter, and interventricular septum thickness. A color Doppler ultrasound instrument (Vivid E95, GE Healthcare) with an m5S probe was used. Patients were positioned in the left lateral decubitus position, and their electrocardiograms were recorded synchronously to obtain apical four-, 2 three-, and two-chamber heart section images for three consecutive cardiac cycles and acquire spectral Doppler images of the mitral and aortic valves. Routine parameter measurements were performed according to the American Society of Echocardiography guidelines, and the LVEF was determined using the biplane Simpson method. The patients’ imaging results were jointly rated by two experts in ultrasound imaging. Pulmonary function examination The indices of pulmonary function examination included forced vital capacity (FVC), forced expiratory flow in 1s (FEV1), percentage of predicted value, vital capacity (VC), and maximum ventilation (MVV). Preoperative pulmonary function examination was performed using the JAEGER Oxycon Pro with a unified baseline (CareFusion Germany 234 GmbH, Hochberg, Germany). A lung function detector (JAEGER Master Screen PFT, CareFusion Germany 234 GmbH, Hochberg, Germany) was used for measurement. A lung function detector was used for measurement, and the measurement module included pulse oscillation lung function, conventional lung capacity, velocity loop, residual gas function, dispersion function, and MVV rate. Lung function test results were obtained using JLab 5.7 software (CareFusion Germany 234 GmbH, Hochberg, Germany). Blood gas analysis Blood gas analysis indices included blood oxygen saturation (SO2%), hematocrit (Hct), partial pressure of oxygen (pO2), total hemoglobin (Hb), and partial pressure of carbon dioxide (pCO2). Two independent observers recorded these indices. To test for inter-rater agreement, the reported outcomes were recorded twice independently by two orthopedic surgeons, and the recorded data were reconciled. Statistical methods The data were analyzed using SPSS 23.0 software, and the data were expressed as`x±s, where`x and s stand for the mean and standard deviation, respectively. An independent sample t-test was used to compare the measurement data between the two groups, and the χ2 test was used for counting data. Differences were considered statistically significant at P<0.05. The correlation among the parameters was determined using Spearman’s correlation coefficient and analyzed using Origin 2021 software. General data Based on the inclusion and exclusion criteria, 38 and 66 EOS patients were enrolled in the high-altitude and plain area groups, respectively. The high-altitude group comprised 20 boys and 18 girls, with a mean age of 8.42 years (range, 6–10 years). The plain area group comprised 26 boys and 40 girls, with a mean age of 8.77 years (range, 4–11 years). The average age of the high-altitude group was not significantly different from that of the plain area group (P>0.05). The body weight and height of the high-altitude group were significantly lower than that of the plain area group; however, there was no significant difference in the body mass index between the two groups. The average Cobb’s angle was 79.65°, and the average thoracic kypho was 60.16°. There was no significant difference in the degree of other spinal deformities between the two groups. The thoracic spine curves of both the groups were mainly on the right side, and the proportion of right kyphosis in the high-altitude and plain area groups was 63.16 and 66.67%, respectively, with no significant difference (P>0.05). There were 48 cases of idiopathic scoliosis, 16 of congenital scoliosis, two of 3 neuromuscular scoliosis, and 24 cases of idiopathic scoliosis in the plain area group; there were 14 cases of congenital scoliosis in the high-altitude group. There was no significant difference in the proportion of patients diagnosed with idiopathic scoliosis between both groups (P>0.05). Color Doppler echocardiography examination The PAID, LVEDD, and IVST in the high-altitude group were significantly lower than those in the plain area group (P<0.05). There were no significant differences in the other cardiac color ultrasound indices, and were within the normal range. Pulmonary function examination The results of the pulmonary function examination showed that the FVC, VC, and MVV in the high-altitude group were significantly lower than those in the plain area group (P<0.05). The average predicted FVC% values in the high-altitude and plain area groups were 77.81 and 73.77%, respectively, and the average predicted FEV1% values were 78.65 and 73.05%, respectively (P>0.05), showing mild restrictive and obstructive ventilatory dysfunction. Blood gas analysis The Hct levels of the plain area group (38.49±2.89%) were significantly lower than those of the high-altitude group (40.85±4.47%; P<0.05). Hb levels in the high-altitude group (13.67 ± 1.46 g/L) were significantly higher than those in the plain group (12.85±0.94 g/L; P<0.05). The pCO2 levels of the high-altitude group (33.44±4.7 mmHg) were significantly lower than those of the plain area group (35.92±4.66 mmHg; P<0.05); however, there was no significant between-group difference in pO2 and SO2% levels (P>0.05). Correlations of parameters The correlation analysis between the spinal parameters and cardiopulmonary function measures in the high-altitude group is significant. In the high-altitude group, there was a significant correlation between the angle of the main thoracic curvature, the angle of the upper thoracic curvature, and kyphosis (rho=0.692, rho=0.484). There was a significant correlation between the kypho and upper chest curvature angles (rho=0.519). There was a significant correlation between LVISD, IVSE, RVBD, LALRD, and the MT (rho=-0.399, rho=0.565, rho=-0.358, rho=-0.371); however, there was no significant correlation between the angle of kyphosis and echocardiography index. PO2 and SO2% levels correlated with the angle of the MT (rho=-0.400, rho=-0.406). The upper chest bend angle was significantly correlated with VC, MVV, FVC, and FEV1 (rho=-0.498, rho=-0.451, rho=-0.513, rho=-0.588), while the upper chest bend angle and kyphosis bend were not significantly correlated with the pulmonary function index. There was a significant linear correlation between the UT and FEV1, FVC, and MVV in the high-altitude group. FEV1=1.623-0.011*UT, FVC=1.858-0.012*UT, MVV=54.646-0.286*UT. The results of the correlation analysis between imaging indices and cardiopulmonary function indices indicated that in the high-altitude group, UT showed a clear negative correlation with VC, FEV1, FVC, and MVV. In contrast, UT showed a clear positive correlation with these indices in the plain area group. In the high-altitude group, MT showed no obvious correlation with lung function indexes, whereas in the plain area group, MT showed a negative correlation with lung function indices. Scoliosis is a complex three-dimensional deformity that leads to distortion of body 4 appearance and reduced organ function, often causing irreversible damage to cardiopulmonary function (8, 9). Scoliosis due to rotation and thoracic scoliosis leads to a decrease in thoracic volume and asymmetry between the left and right thorax, which seriously affects the normal development of cardiopulmonary function in patients. The thoracic volume is vital for the development of cardiopulmonary function in children. Studies have shown that the critical period of alveolar and thoracic development in children occurs before the age of 10 years. Alveolar development in children approximately 10 years old is as prevalent as in adults, and the thoracic volume can reach half of that in adults (10, 11). Therefore, alveolar and thoracic development in EOS patients is critical since scoliosis and thoracic deformities can lead to pulmonary dysplasia. Most researchers believe that poor cardiopulmonary function in patients with scoliosis is caused by mechanical compression of bone tissue (12). Tsiligiannis et al. (13) showed that scoliosis changes the position of thoracic organs and affects normal respiratory movement, resulting in restrictive ventilation disorders. Campbell et al. (2) indicated that congenital scoliosis in patients with rib deformities could cause thoracic deformities, affects the normal development of heart and lung function and often leads to thoracic insufficiency syndrome. However, other studies have suggested that lung function is mainly affected by the limited development of the heart and lung caused by scoliosis rather than the mechanical compression caused by simple thoracic deformities (14). Davies et al. and Berend et al. (12, 15, 16) performed autopsy studies on EOS patients. They showed no obvious abnormality in the shape of alveoli, a decreased total number of alveoli, and no decrease in the size of alveoli due to thoracic compression and no decrease in the size of alveoli due to thoracic compression (the size was found to be compensated). Koumbourlis (17) et al. studied the relationship between scoliosis and patients’ circulatory and respiratory functions. They discovered that scoliosis-related deformities prevent patients from exercising like their normal peers, which reduces the number of chest breaths and compensates for the number of abdominal breaths. Regarding the thoracic structure, scoliosis limits the normal development of the chest, causing deformation of the important cardiovascular compression, leading to cardiopulmonary dysfunction. High-altitude areas exhibit a unique geographical environment comprising factors such as low pressure, low PO2, and low air content. Living in low-oxygen and thin-air environments over a long period impacts the development of cardiopulmonary function. An independent risk factor for low birth weight in newborns is the high-altitude environment, which leads to fetal growth restriction and affects the function of the respiratory and cardiovascular systems (5, 18). When the altitude increases by 100 m, the ambient atmospheric pressure decreases by 5 mmHg. Because the oxygen concentration in the atmosphere is constant, the oxygen partial pressure will decrease by approximately 1 mmHg. At sea level, the average pO2 is 150 mmHg. When the altitude is between 3000 and 5500 m, the PO2 decreases between 80 and 100 mmHg. When exposed to hypoxia and a hypobaric environment, people living in a plateau environment will have compensatory regulatory responses to restore the body's internal homeostasis. Over the course of natural selection, this compensatory response may be passed on to offspring through genetic material. The compensatory responses of people at high altitudes to hypoxia and hypobaric environments include increased pulmonary blood perfusion, erythrocytosis, blood viscosity, lung tissue compliance, and a slight increase in 5 pulmonary artery pressure. Studies have shown that people in high-altitude environments have symptoms of right ventricular hypertrophy and pulmonary hypertension, and elevated Hb levels in the body (19-21). In this study, the chest curve was the main bend in EOS patients in plain and high-altitude areas, with Cobb's angle of the main bend >45° in all patients. There was no significant between-group difference in the direction and severity of scoliosis and kyphosis. Idiopathic scoliosis is the primary classification of scoliosis. Excluding congenital cardiac developmental abnormalities, pulmonary artery diameter, LVEDD, and inter-ventricular septum thickness in the high-altitude group were smaller than that in the plain area group. This may be due to structural abnormalities of the heart and lungs caused by long-term low pressure and lack of oxygen in high-altitude areas. To explore the relationship between scoliosis, cardiopulmonary function, and the effect of high altitude on cardiopulmonary function, a correlation analysis was performed. The UT angle in the high-altitude group was correlated with the pulmonary function examination indexes (VC, MVV, FVC, and FEV1), while the UT angle in the plain area group was not significantly correlated with these indexes. Long-term exposure to high and cold climates, low pressure, and low oxygen environments impact the cardiopulmonary structure of patients in high-altitude areas. Therefore, the reduction in thoracic space caused by changes in spinal structure will cause more serious damage to the cardiopulmonary function of patients in high-altitude areas compared to patients in plain areas (22). Therefore, patients with severe scoliosis in high-altitude areas require active surgical intervention to reduce cardiorespiratory impairment associated with scoliosis. The results of pulmonary function tests showed that the average values of FEV1% and FVC% in both groups were < 80%, and there were mild restrictive and obstructive ventilation disorders, indicating that scoliosis and thoracic deformities limited the normal respiratory function of patients. The FVC, VC, and MVV indices of the high-altitude group were significantly lower than those of the plain area group. This could be due to the following: the low temperature at high altitudes contracts the small airways of the lungs and increases ventilatory resistance; the hypobaric and hypoxic environment forces the patients to breathe more times per unit time, increasing the load of respiratory muscles and causing respiratory muscle fatigue; the nutritional status of patients in high-altitude areas is worse than that of patients in plain areas; and the thoracic volume is smaller in patients in high-altitude areas than that of patients in plain areas. Scoliosis with thoracic deformity is often accompanied by limited diaphragm function and decreased chest volume, which leads to a decrease in lung tissue pressure and compliance, pulmonary hypertension, and even serious diseases such as cor pulmonale and respiratory failure (23). Studies have shown that pulmonary dysfunction before surgical treatment increases perioperative respiratory complications such as respiratory insufficiency, atelectasis, and pneumonia (24). Therefore, during clinical treatment, more attention should be paid to evaluating pulmonary function in EOS patients before surgery. For patients at high altitudes or other EOS patients with significantly impaired pulmonary function, it is necessary to carry out preoperative respiratory function training to improve respiratory function (25) and surgical safety and reduce postoperative complications; the comprehensive evaluation of pulmonary function in combination with other disciplines is also possible. 6 Because of the lack of studies comparing lung function between EOS patients in high-altitude and plain areas that are similar to our patient population, it cannot be ruled out whether the decline in lung function indices is affected by spinal deformities. In this study, the number of patients in high-altitude areas was less than that of patients in plain areas. Our results may not be comprehensive enough as there were only a few categories of imaging parameters; therefore, it was difficult to analyze the correlation between other imaging parameters and cardiopulmonary function. Conclusion EOS patients in high-altitude areas had poorer cardiac and pulmonary functions than those who live in plain areas. Cardiopulmonary function and the degree of scoliosis interact with each other. We should pay more attention to preoperative evaluation and postoperative rehabilitation for EOS patients living in high-altitude areas. References: 1.Fletcher ND, Bruce RW. Early onset scoliosis: current concepts and controversies. Curr Rev Musculoskelet Med.(2012)5: 102-10. doi:10.1007/s12178-012-9116-0 2.Campbell RJ, Smith MD, Mayes TC, Mangos JA, Willey-Courand DB, Kose N, Pinero RF, Alder ME, Duong HL, Surber JL. The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J BONE JOINT SURG AM.(2003)85: 399-408. doi:10.2106/00004623-200303000-00001 3.Mortola JP, Frappell PB, Aguero L, Armstrong K. Birth weight and altitude: a study in Peruvian communities. J Pediatr.(2000)136: 324-9. doi:10.1067/mpd.2000.103507 4.Zhou L, Yang H, Hai Y, Hai JJ, Cheng Y, Yin P, Yang J, Zhang Y, Wang Y, Zhang Y, Han B. Scoliosis among children in Qinghai-Tibetan Plateau of China: A cross-sectional epidemiological study. Front Public Health.(2022)10: 983095. doi:10.3389/fpubh.2022.983095 5.Jensen GM, Moore LG. The effect of high altitude and other risk factors on birthweight: independent or interactive effects? AM J PUBLIC HEALTH.(1997)87: 1003-7. doi:10.2105/ajph.87.6.1003 6.Ostadal B, Kolar F. Cardiac adaptation to chronic high-altitude hypoxia: beneficial and adverse effects. Respir Physiol Neurobiol.(2007)158: 224-36. doi:10.1016/j.resp.2007.03.005 7.Maggiorini M. Cardio-pulmonary interactions at high altitude. Pulmonary hypertension as a common denominator. ADV EXP MED BIOL.(2003)543: 177-89. doi:10.1007/978- 1-4419-8997-0_13 8.Kadoury S, Shen J, Parent S. Global geometric torsion estimation in adolescent idiopathic scoliosis. 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I wanted to have a control deck I could play on ladder sometimes, was wondering if there were any suggestions. I have been trying to do research into control decks but been having a hard time finding a nice list of all the ones I can play in MD. Altergeist and Weather painters seemed pretty neat but I found both rarely mentioned on control lists, so I was just wondering if there are any I am missing out on as well that are fun.
Tldr looking for a fun control deck