#DM management
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mcatmemoranda · 1 year ago
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Diabetes Lecture
Dr. Samaan
8/23/23
HgbA1c 5.7%-6.4% is prediabetes
HgbA1c 6.5% is diabetic
Normal HgbA1c 4.8-5.6% is normal
DM: A1c 6.5%, BG 126, random BG >200 with symptoms
The A1c has to be a lab draw in order for you to use it to make the diagnosis. So a POC HgbA1c doesn’t count to make the diagnosis.
Screen everyone age 40-70 who are overweight or have risk factors; younger than 40 and obese with risk factor; screen q1-3 years. Risk factors: HDL<35, TG >250, depression, on atypical antipsychotics, high risk populations (non-white), OSA/sleep issues, HIV+ for 15+ years on meds. Old HIV meds caused endocrine issues. Newer HIV meds don’t unless they’ve been on them for a long time.
You don’t need to be fasting to check HgbA1c. Not covered as screening by CMS. A1c not accurate in GDM, renal failure, anemias, renal failure, liver disease.
Prediabetes: 5-7% weight loss will cut the risk of progressing to diabetes by 1/2! Moderate exercise: of 150 minutes a week (e.g., brisk walking 3+ mph), water aerobics, bicycling 10 mph or less, tennis (doubles), gardening—OR 75 minutes of vigorous intensity exercise a week.
Metformin started in prediabetics decreases progression by 31%! Shown to decrease CVD risk. Works best for BMI>35. Metformin can cause low B12. We should use “med monitoring” code annually in pts on metformin. Diarrhea is a common adverse effect. If pt can’t leave the house because of the diarrhea, try the extended release form.
GLP1 agonists and SGLT2 inhibitors could be used in prediabetics. It’s in the works.
If A1c of 9 and BG >200, you will have less fatigue, polyuria, blurred visions, skin infections.
A1c <7.5 à improved quality of life and increased productivity at work
Goal A1c is <7%
Tighter control in younger pts is ok.
Older pts can have A1c goal of 8.0%; avoid hypoglycemia and side effects of increased meds.
Metformin and lifestyle modifications are first line management.
You can start with something other than metformin, but insurance might not cover it.
DM education can help drop A1c by 0.6% or more. WDH and PRH have diabetes education classes.
Diabetic Benchmarks/Screenings:
Statins! All diabetics over 40 should be on moderate to high intensity statin. Under 40 if additional CVD risk factors.
Pts with DM have increased number of small LDL particles which tend to be more associated with ASCVD.
DM is the leading cause of CKD. Check urine microalbumin yearly. ACE/ARB is HTN and proteinuria, urine Cr >300. Go yearly for dilated eye exam. DM is the #1 cause of blindness in the US.
Nerve damage causes the fat pad on the sole of the foot to move, leaving decreased cushioning which predisposes to diabetic foot ulcers. Foot exam should be every visit if loss of sensation. Should do a foot exam annually. Check the skin, document hammer toe, charcot foot, bunion, pes planus.
Get an Ankle Brachial Index (ABI) if you cannot palpate a pulse. Get Toe Brachial Index (TBI) if ABI is not accurate.
Document presence of diabetic neuropathy. Assess for B12 deficiency, TSH, metals, etc.
Metformin, statin, annual vision screen and urine microalbumin, foot exams, diabetes education.
Sulfonylureas (e.g., glipizide) have no long-term benefits, cause hypoglycemia.
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savaralyn2 · 9 months ago
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A little peek at Ryoko Kui's illustrations for the upcoming Weekly Famitsu magazine
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mostlysignssomeportents · 5 months ago
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The reason you can’t buy a car is the same reason that your health insurer let hackers dox you
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On July 14, I'm giving the closing keynote for the fifteenth HACKERS ON PLANET EARTH, in QUEENS, NY. Happy Bastille Day! On July 20, I'm appearing in CHICAGO at Exile in Bookville.
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In 2017, Equifax suffered the worst data-breach in world history, leaking the deep, nonconsensual dossiers it had compiled on 148m Americans and 15m Britons, (and 19k Canadians) into the world, to form an immortal, undeletable reservoir of kompromat and premade identity-theft kits:
https://en.wikipedia.org/wiki/2017_Equifax_data_breach
Equifax knew the breach was coming. It wasn't just that their top execs liquidated their stock in Equifax before the announcement of the breach – it was also that they ignored years of increasingly urgent warnings from IT staff about the problems with their server security.
Things didn't improve after the breach. Indeed, the 2017 Equifax breach was the starting gun for a string of more breaches, because Equifax's servers didn't just have one fubared system – it was composed of pure, refined fubar. After one group of hackers breached the main Equifax system, other groups breached other Equifax systems, over and over, and over:
https://finance.yahoo.com/news/equifax-password-username-admin-lawsuit-201118316.html
Doesn't this remind you of Boeing? It reminds me of Boeing. The spectacular 737 Max failures in 2018 weren't the end of the scandal. They weren't even the scandal's start – they were the tipping point, the moment in which a long history of lethally defective planes "breached" from the world of aviation wonks and into the wider public consciousness:
https://en.wikipedia.org/wiki/List_of_accidents_and_incidents_involving_the_Boeing_737
Just like with Equifax, the 737 Max disasters tipped Boeing into a string of increasingly grim catastrophes. Each fresh disaster landed with the grim inevitability of your general contractor texting you that he's just opened up your ceiling and discovered that all your joists had rotted out – and that he won't be able to deal with that until he deals with the termites he found last week, and that they'll have to wait until he gets to the cracks in the foundation slab from the week before, and that those will have to wait until he gets to the asbestos he just discovered in the walls.
Drip, drip, drip, as you realize that the most expensive thing you own – which is also the thing you had hoped to shelter for the rest of your life – isn't even a teardown, it's just a pure liability. Even if you razed the structure, you couldn't start over, because the soil is full of PCBs. It's not a toxic asset, because it's not an asset. It's just toxic.
Equifax isn't just a company: it's infrastructure. It started out as an engine for racial, political and sexual discrimination, paying snoops to collect gossip from nosy neighbors, which was assembled into vast warehouses full of binders that told bank officers which loan applicants should be denied for being queer, or leftists, or, you know, Black:
https://jacobin.com/2017/09/equifax-retail-credit-company-discrimination-loans
This witch-hunts-as-a-service morphed into an official part of the economy, the backbone of the credit industry, with a license to secretly destroy your life with haphazardly assembled "facts" about your life that you had the most minimal, grudging right to appeal (or even see). Turns out there are a lot of customers for this kind of service, and the capital markets showered Equifax with the cash needed to buy almost all of its rivals, in mergers that were waved through by a generation of Reaganomics-sedated antitrust regulators.
There's a direct line from that acquisition spree to the Equifax breach(es). First of all, companies like Equifax were early adopters of technology. They're a database company, so they were the crash-test dummies for ever generation of database. These bug-riddled, heavily patched systems were overlaid with subsequent layers of new tech, with new defects to be patched and then overlaid with the next generation.
These systems are intrinsically fragile, because things fall apart at the seams, and these systems are all seams. They are tech-debt personified. Now, every kind of enterprise will eventually reach this state if it keeps going long enough, but the early digitizers are the bow-wave of that coming infopocalypse, both because they got there first and because the bottom tiers of their systems are composed of layers of punchcards and COBOL, crumbling under the geological stresses of seventy years of subsequent technology.
The single best account of this phenomenon is the British Library's postmortem of their ransomware attack, which is also in the running for "best hard-eyed assessment of how fucked things are":
https://www.bl.uk/home/british-library-cyber-incident-review-8-march-2024.pdf
There's a reason libraries, cities, insurance companies, and other giant institutions keep getting breached: they started accumulating tech debt before anyone else, so they've got more asbestos in the walls, more sagging joists, more foundation cracks and more termites.
That was the starting point for Equifax – a company with a massive tech debt that it would struggle to pay down under the most ideal circumstances.
Then, Equifax deliberately made this situation infinitely worse through a series of mergers in which it bought dozens of other companies that all had their own version of this problem, and duct-taped their failing, fucked up IT systems to its own. The more seams an IT system has, the more brittle and insecure it is. Equifax deliberately added so many seams that you need to be able to visualized additional spatial dimensions to grasp them – they had fractal seams.
But wait, there's more! The reason to merge with your competitors is to create a monopoly position, and the value of a monopoly position is that it makes a company too big to fail, which makes it too big to jail, which makes it too big to care. Each Equifax acquisition took a piece off the game board, making it that much harder to replace Equifax if it fucked up. That, in turn, made it harder to punish Equifax if it fucked up. And that meant that Equifax didn't have to care if it fucked up.
Which is why the increasingly desperate pleas for more resources to shore up Equifax's crumbling IT and security infrastructure went unheeded. Top management could see that they were steaming directly into an iceberg, but they also knew that they had a guaranteed spot on the lifeboats, and that someone else would be responsible for fishing the dead passengers out of the sea. Why turn the wheel?
That's what happened to Boeing, too: the company acquired new layers of technical complexity by merging with rivals (principally McDonnell-Douglas), and then starved the departments that would have to deal with that complexity because it was being managed by execs whose driving passion was to run a company that was too big to care. Those execs then added more complexity by chasing lower costs by firing unionized, competent, senior staff and replacing them with untrained scabs in jurisdictions chosen for their lax labor and environmental enforcement regimes.
(The biggest difference was that Boeing once had a useful, high-quality product, whereas Equifax started off as an irredeemably terrible, if efficient, discrimination machine, and grew to become an equally terrible, but also ferociously incompetent, enterprise.)
This is the American story of the past four decades: accumulate tech debt, merge to monopoly, exponentially compound your tech debt by combining barely functional IT systems. Every corporate behemoth is locked in a race between the eventual discovery of its irreparable structural defects and its ability to become so enmeshed in our lives that we have to assume the costs of fixing those defects. It's a contest between "too rotten to stand" and "too big to care."
Remember last February, when we all discovered that there was a company called Change Healthcare, and that they were key to processing virtually every prescription filled in America? Remember how we discovered this? Change was hacked, went down, ransomed, and no one could fill a scrip in America for more than a week, until they paid the hackers $22m in Bitcoin?
https://en.wikipedia.org/wiki/2024_Change_Healthcare_ransomware_attack
How did we end up with Change Healthcare as the linchpin of the entire American prescription system? Well, first Unitedhealthcare became the largest health insurer in America by buying all its competitors in a series of mergers that comatose antitrust regulators failed to block. Then it combined all those other companies' IT systems into a cosmic-scale dog's breakfast that barely ran. Then it bought Change and used its monopoly power to ensure that every Rx ran through Change's servers, which were part of that asbestos-filled, termite-infested, crack-foundationed, sag-joisted teardown. Then, it got hacked.
United's execs are the kind of execs on a relentless quest to be too big to care, and so they don't care. Which is why their they had to subsequently announce that they had suffered a breach that turned the complete medical histories of one third of Americans into immortal Darknet kompromat that is – even now – being combined with breach data from Equifax and force-fed to the slaves in Cambodia and Laos's pig-butchering factories:
https://www.cnn.com/2024/05/01/politics/data-stolen-healthcare-hack/index.html
Those slaves are beaten, tortured, and punitively raped in compounds to force them to drain the life's savings of everyone in Canada, Australia, Singapore, the UK and Europe. Remember that they are downstream of the forseeable, inevitable IT failures of companies that set out to be too big to care that this was going to happen.
Failures like Ticketmaster's, which flushed 500 million users' personal information into the identity-theft mills just last month. Ticketmaster, you'll recall, grew to its current scale through (you guessed it), a series of mergers en route to "too big to care" status, that resulted in its IT systems being combined with those of Ticketron, Live Nation, and dozens of others:
https://www.nytimes.com/2024/05/31/business/ticketmaster-hack-data-breach.html
But enough about that. Let's go car-shopping!
Good luck with that. There's a company you've never heard. It's called CDK Global. They provide "dealer management software." They are a monopolist. They got that way after being bought by a private equity fund called Brookfield. You can't complete a car purchase without their systems, and their systems have been hacked. No one can buy a car:
https://www.cnn.com/2024/06/27/business/cdk-global-cyber-attack-update/index.html
Writing for his BIG newsletter, Matt Stoller tells the all-too-familiar story of how CDK Global filled the walls of the nation's auto-dealers with the IT equivalent of termites and asbestos, and lays the blame where it belongs: with a legal and economics establishment that wanted it this way:
https://www.thebignewsletter.com/p/a-supreme-court-justice-is-why-you
The CDK story follows the Equifax/Boeing/Change Healthcare/Ticketmaster pattern, but with an important difference. As CDK was amassing its monopoly power, one of its execs, Dan McCray, told a competitor, Authenticom founder Steve Cottrell that if he didn't sell to CDK that he would "fucking destroy" Authenticom by illegally colluding with the number two dealer management company Reynolds.
Rather than selling out, Cottrell blew the whistle, using Cottrell's own words to convince a district court that CDK had violated antitrust law. The court agreed, and ordered CDK and Reynolds – who controlled 90% of the market – to continue to allow Authenticom to participate in the DMS market.
Dealers cheered this on: CDK/Reynolds had been steadily hiking prices, while ingesting dealer data and using it to gouge the dealers on additional services, while denying dealers access to their own data. The services that Authenticom provided for $35/month cost $735/month from CDK/Reynolds (they justified this price hike by saying they needed the additional funds to cover the costs of increased information security!).
CDK/Reynolds appealed the judgment to the 7th Circuit, where a panel of economists weighed in. As Stoller writes, this panel included monopoly's most notorious (and well-compensated) cheerleader, Frank Easterbrook, and the "legendary" Democrat Diane Wood. They argued for CDK/Reynolds, demanding that the court release them from their obligations to share the market with Authenticom:
https://caselaw.findlaw.com/court/us-7th-circuit/1879150.html
The 7th Circuit bought the argument, overturning the lower court and paving the way for the CDK/Reynolds monopoly, which is how we ended up with one company's objectively shitty IT systems interwoven into the sale of every car, which meant that when Russian hackers looked at that crosseyed, it split wide open, allowing them to halt auto sales nationwide. What happens next is a near-certainty: CDK will pay a multimillion dollar ransom, and the hackers will reward them by breaching the personal details of everyone who's ever bought a car, and the slaves in Cambodian pig-butchering compounds will get a fresh supply of kompromat.
But on the plus side, the need to pay these huge ransoms is key to ensuring liquidity in the cryptocurrency markets, because ransoms are now the only nondiscretionary liability that can only be settled in crypto:
https://locusmag.com/2022/09/cory-doctorow-moneylike/
When the 7th Circuit set up every American car owner to be pig-butchered, they cited one of the most important cases in antitrust history: the 2004 unanimous Supreme Court decision in Verizon v Trinko:
https://www.oyez.org/cases/2003/02-682
Trinko was a case about whether antitrust law could force Verizon, a telcoms monopolist, to share its lines with competitors, something it had been ordered to do and then cheated on. The decision was written by Antonin Scalia, and without it, Big Tech would never have been able to form. Scalia and Trinko gave us the modern, too-big-to-care versions of Google, Meta, Apple, Microsoft and the other tech baronies.
In his Trinko opinion, Scalia said that "possessing monopoly power" and "charging monopoly prices" was "not unlawful" – rather, it was "an important element of the free-market system." Scalia – writing on behalf of a unanimous court! – said that fighting monopolists "may lessen the incentive for the monopolist…to invest in those economically beneficial facilities."
In other words, in order to prevent monopolists from being too big to care, we have to let them have monopolies. No wonder Trinko is the Zelig of shitty antitrust rulings, from the decision to dismiss the antitrust case against Facebook and Apple's defense in its own ongoing case:
https://www.ftc.gov/system/files/documents/cases/073_2021.06.28_mtd_order_memo.pdf
Trinko is the origin node of too big to care. It's the reason that our whole economy is now composed of "infrastructure" that is made of splitting seams, asbestos, termites and dry rot. It's the reason that the entire automotive sector became dependent on companies like Reynolds, whose billionaire owner intentionally and illegally destroyed evidence of his company's crimes, before going on to commit the largest tax fraud in American history:
https://www.wsj.com/articles/billionaire-robert-brockman-accused-of-biggest-tax-fraud-in-u-s-history-dies-at-81-11660226505
Trinko begs companies to become too big to care. It ensures that they will exponentially increase their IT debt while becoming structurally important to whole swathes of the US economy. It guarantees that they will underinvest in IT security. It is the soil in which pig butchering grew.
It's why you can't buy a car.
Now, I am fond of quoting Stein's Law at moments like this: "anything that can't go on forever will eventually stop." As Stoller writes, after two decades of unchallenged rule, Trinko is looking awfully shaky. It was substantially narrowed in 2023 by the 10th Circuit, which had been briefed by Biden's antitrust division:
https://law.justia.com/cases/federal/appellate-courts/ca10/22-1164/22-1164-2023-08-21.html
And the cases of 2024 have something going for them that Trinko lacked in 2004: evidence of what a fucking disaster Trinko is. The wrongness of Trinko is so increasingly undeniable that there's a chance it will be overturned.
But it won't go down easy. As Stoller writes, Trinko didn't emerge from a vacuum: the economic theories that underpinned it come from some of the heroes of orthodox economics, like Joseph Schumpeter, who is positively worshipped. Schumpeter was antitrust's OG hater, who wrote extensively that antitrust law didn't need to exist because any harmful monopoly would be overturned by an inevitable market process dictated by iron laws of economics.
Schumpeter wrote that monopolies could only be sustained by "alertness and energy" – that there would never be a monopoly so secure that its owner became too big to care. But he went further, insisting that the promise of attaining a monopoly was key to investment in great new things, because monopolists had the economic power that let them plan and execute great feats of innovation.
The idea that monopolies are benevolent dictators has pervaded our economic tale for decades. Even today, critics who deplore Facebook and Google do so on the basis that they do not wield their power wisely (say, to stamp out harassment or disinformation). When confronted with the possibility of breaking up these companies or replacing them with smaller platforms, those critics recoil, insisting that without Big Tech's scale, no one will ever have the power to accomplish their goals:
https://pluralistic.net/2023/07/18/urban-wildlife-interface/#combustible-walled-gardens
But they misunderstand the relationship between corporate power and corporate conduct. The reason corporations accumulate power is so that they can be insulated from the consequences of the harms they wreak upon the rest of us. They don't inflict those harms out of sadism: rather, they do so in order to externalize the costs of running a good system, reaping the profits of scale while we pay its costs.
The only reason to accumulate corporate power is to grow too big to care. Any corporation that amasses enough power that it need not care about us will not care about it. You can't fix Facebook by replacing Zuck with a good unelected social media czar with total power over billions of peoples' lives. We need to abolish Zuck, not fix Zuck.
Zuck is not exceptional: there were a million sociopaths whom investors would have funded to monopolistic dominance if he had balked. A monopoly like Facebook has a Zuck-shaped hole at the top of its org chart, and only someone Zuck-shaped will ever fit through that hole.
Our whole economy is now composed of companies with sociopath-shaped holes at the tops of their org chart. The reason these companies can only be run by sociopaths is the same reason that they have become infrastructure that is crumbling due to sociopathic neglect. The reckless disregard for the risk of combining companies is the source of the market power these companies accumulated, and the market power let them neglect their systems to the point of collapse.
This is the system that Schumpeter, and Easterbrook, and Wood, and Scalia – and the entire Supreme Court of 2004 – set out to make. The fact that you can't buy a car is a feature, not a bug. The pig-butcherers, wallowing in an ocean of breach data, are a feature, not a bug. The point of the system was what it did: create unimaginable wealth for a tiny cohort of the worst people on Earth without regard to the collapse this would provoke, or the plight of those of us trapped and suffocating in the rubble.
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Support me this summer on the Clarion Write-A-Thon and help raise money for the Clarion Science Fiction and Fantasy Writers' Workshop!
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If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:
https://pluralistic.net/2024/06/28/dealer-management-software/#antonin-scalia-stole-your-car
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Image: Cryteria (modified) https://commons.wikimedia.org/wiki/File:HAL9000.svg
CC BY 3.0 https://creativecommons.org/licenses/by/3.0/deed.en
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hoofpeet · 3 months ago
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Look... kabru being genuine for once ever--> being instantly horrified/shocked that he let it slip because he can't comprehend being not instantly rejected for being himself.
Laios looking the most confused he ever has and instantly assuming kabru is lying--> he also can't comprehend someone wanting to be around him, which is likely why he tries to remove himself from people
I just feel like they're maybe each others first genuine friends... some laios/kabru focused posts are kinda sad sometimes because it acts like kabru doesn't like or care about him at all which like. Haha funny! But I think they do genuinely like each other !!
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windywriter · 3 months ago
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I feel like "dating" izana would probably feel more like taking care of a stray cat for the first few months. He's very aloof and probaby doesn't really enjoy physical contact unless he's the one initiating it. He also seems the type to just ghost you for days only to turn up in the middle of the night with bandages on him before he slumps into your arms, exhausted. Though if you point out the similarities hed probaby just scoff at you and call you weird or something.
He also has sharp senses so he'll notice if you smell different than usual or he'll hear your quiet sighs. Unwittingly he memorizes how gentle your touch feels and leans into it without realizing only for the spell to be broken and he once again retreats into his usual cold facade.
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eliotbaum · 1 year ago
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Them³. 
Some people expressed interest in the backstories & relationship between these characters so it’s under a cut. Beware, it’s full of Vallaki spoilers and. very long……. 
Lydia Petrovna/Fiona Wachter/my pc Father Dunant
Alright so, a not-so brief overview of each individual’s background and where their stories meet. Mind you, that is everything I currently know about the characters, and I'm pretty sure Lady W is still hiding something.
Lydia Petrovna has always been a frail, meek-hearted woman, but with a kind soul. For what she lacked, her best friend from ever since made up for it; Fiona Wachter was everything she ever wanted to be. Strong, assertive and with force of will. 
But Lydia also desired her in a different way, one that went beyond friendship and admiration. Fiona was not aware of those feelings and pursued Nikolai, while Lydia fell for Vargas, despite Fiona’s warnings and wishes for her not to do so. It fell on deaf ears, as Vargas seemed like a genuinely kind man. Suffice to say to those who played the game: the good qualities Lydia loved disappeared over time and he ended up emotionally abusing her, smothering her in a way where she completely lost who she was. Lydia was always desperate to help others despite her constitution and lack of powers or influence, so she thought putting on a bright face and encouraging the "all will be well" ideology would suffice. But she suffered greatly under it, too, coping with solitude and drug/alcohol abuse. Regardless, she kept holding onto hope, believing a better tomorrow will come one day. 
Vargas growing more paranoid of everyone ended up manipulating Lydia into believing Fiona and her husband were not to be trusted. And with Lydia’s facade steadily replacing what Fiona loved about her, ultimately drove the friendship to a breaking point after decades.
Fiona Wachter received a prophecy from an oracle (Madame Eva) while she was a young lady. The prophecy foretold of an outsider coming into Vallaki to bring great ruin, but his blood would also bring back sunlight to the town. She believed in this prophecy ever since, all the while pledging allegiance to Ravenloft as a family tradition, which earned her conflicting powers. On one hand, she could perform miracles and harm with radiance, on the other she received darker powers from her pledge. As such, she is also caught between two fronts — wishing for sunlight to shine upon the lands again while serving Ravenloft as is her family tradition. (This is something my PC challenges her with a lot)
This was all kept secret from her best friend as Fiona had always been a cautious woman. Fast forward to her strained relationship with Lydia that broke apart during Nikolai's early death. 2 years before the campaign starts, he died of an illness, and when Fiona turned to Lydia for comfort she didn't receive it. Lydia pretended like everything was fine still, and tried to deflect any mourning or sadness with Vargas’ messed up ideology. Suffice to say, Fiona felt betrayed, bereft, in more ways than one. And then, her daughter, who was to be betrothed to Viktor Vallakovich, Lydia's son, went mad after prolonged contact to Viktor. Fiona went scorched earth and planned an assassination on Vargas ever since.
In comes my lil guy! Father Kasper Dunant, a humanitarian priest always striving to be virtuous, to be of help, but who leaves calamity in his wake for whenever he tries to do good. Up to a point where experimentations with blood healings destroyed his hometown, (if this sounds like Bloodborne. big inspo haha) and he fled — only to get trapped in another ruinous and cursed place. In Vallaki, he helped with the St. Andral church and Father Lucian, Lydia's brother. Vargas also took a liking to him, which resulted to Kasper and Lydia growing closer. He was attracted to her gentle heart, her kindness he found beyond her facade. They became light in each other's darkness. 
Meanwhile, Fiona Wachter invited him & the party, intrigued by hearing of outsiders. She had hoped they could be part of her prophecy, and she intended to more or less rope them into her assassination plans. Now this being conflicting with many values and relationships our characters built, the party took a "safer" angle, in which we removed the biggest threat (general Strazni) from town and saved townspeople during riots following the assassination; Lydia being among those saved, who they hid away at the Martikov’s tavern. Lydia, who had fallen for Kasper early on, held onto him as she had lost almost everything (Vargas assassinated, Viktor teleported away) and they both found new hope, comfort and love in eath other. 
And in a way, Fiona also freed Lydia of the shackles of her abusive marriage.
Fiona would've taken charge of Vallaki had it not been for Kasper's suggestion to establish a council instead of a single ruler. Consisting of him, Fiona, Vasili (completely different character in our game and not secretly, yknow), a homebrew NPC and Ireena. Fiona and Kasper started to develop this dynamic of push and pull, feeling for how much they can trust and work each other with their opposing views in terms of politics and Ravenloft. But they had one moment where they forged a bond; Kasper, a blood cleric, summoned a mock sun through 'Daylight' for her (my flavor is that he spills blood for some spells). 
Voila, exactly what her prophecy foretold. She understood it wasn't real, but Kasper promised her to bring true sunlight back to Barovia. In a moment of fervor, Fiona suggested they could rule the town, the country together.
They are still very cautious but enjoy the tension and mystery they have about each other. Lydia, in the meantime, has been growing conflicting feelings about Fiona. While she was certain old feelings have been put to rest, the things Kasper tells her of Fiona seemingly awakened something again. There's a lot of guilt and hurt there, though, muddled with affection, and Lydia is sorting out her feelings still.
Meanwhile, Fiona still resents Lydia for her weakness. It was always clear how much Fiona cared for Lydia, repeatedly challenging her to put down this mask, to be herself again. And being hurt by seeing her friend lose herself so easily.  It's bitter, but Kasper has been meekly trying to calm the waves, to little avail so far. 
It is, A Mess to say the least, and Kasper together with Lydia have been growing concerns and worry for Fiona’s safety and ultimately, herself, since she changed so much, became so much darker since her husband’s death. But those two idealists hope there is still a chance to save her 🥺💦
tl;dr young outsider priest becomes entangled in noblewomen’s personal drama while both believe the gods and fate has sent him their way as he tries to mend a broken relationship 
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funeralprocessor · 11 months ago
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I really need to socialize with people more. Shame about the horrors though.
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doodlingwren · 8 months ago
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For scientific purposes I need to know what kind of rizz Deathmask has.
I drew some examples of what I believed would happen:
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...
Now, it's time for you to
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finemealprompt · 7 months ago
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DP x DC Prompt #32
When Danny had mentioned dungeons and dragons to his new family, he wasn't expecting all of them to latch on like they had. Hadn't realized they'd want him so desperately to DM for them.
But, Danny's in-between campaign's right now, so he agrees. Why not? Besides, it might be a good way to hint that he knows about their late night activities.
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onnoffwrites · 7 months ago
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After recent events, I ended up going back to the beginning to check things, because my first reaction will always be "wtf, this is shit, why would you do this" and my second reaction will always be "okay maybe that was a bit much, maybe he's not THAT bad, maybe has a good reason-
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Okay.. that doesn't rly mean anything, maybe she's just worried kaito found something he shouldn't-
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Okay.. okay this looks, well maybe he's just leaving some recordings in case kaito found something he shouldn't! It's not like they can hide it forever! The room is part of the house! Kaito lives in the house-
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Excuse me... What did .. what did you say...? Wha
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What do you mean "designed"?
What??? What do you MEAN "designed to open after 8 years"???
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I have been angry since April 12th and I've reached a point where I don't even know what to feel anymore I don't even know what to tell y'all.
Like, wow, omg, movie reveals. Other than family relations, the other thing isn't exactly anything new. We've all read Midnight Crow. We saw Kaitou Corbaeu. We've been in denial until finally reaching acceptance. For me at least. And then we spend a few years bargaining, bc surely there's a good reason kaitos not in the know. That kaito has to be KID. Surely there's a reason? Right?
Right???
At this point we don't even truly know if Jii is in the know and was acting as planned out by the parents or not. Or if he's just like kaito. Tricked, lied to, played for fools. At the very least ginzo doesn't know, so there's that. Not sure how much that would help kaito when he inevitably finds out. Because he will. The fact remains that it's quite suspicious that Jii just so happen to choose to don the KID outfit and become KID to draw out toichis murderers exactly 8 years after toichis death. EXACTLY the same amount of time that was set for that trap door portrait to open to kaito.
There's a lot of implications to think about
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bi-badass-geek · 7 months ago
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Hades 1 vs Hades 2 Designs
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● Hermes besides Hypnos was first character that made me think when i saw him oh some time has passed since Zag's escapes indeed, makes you feel that time skip. In this particular debate between those i'm really digging both but if needed to say which i prefer would go with second. I feel it should be said he sure rolls nicely with longer hair i would say darker outfit too but that's probably because pallet that's used for levels.
Ps. I saw post that mentioned how his ring is the same as ones Charon is wearing in first game and if it's a hint at something i'm here for it!
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● Zeus for this god specifically there is discourse about how his pose is less dynamic and oh boy if i don't agree with that so much. In first game you see him and his look makes you think yeah this is the king of gods while in second game man is just there with posture i take often because i'm useless gay that don't know what to do with my hands and feels like they took all this might and put it into chiseling his nipples & abs into his golden chestplate. Not to mention the detail of missing the iconic bolt! Don't think it needs to be said but 100% would pick Hades 1 design out of those options.
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● Poseidon the King of the Sea another example in my humble opinion where they went with flattening that dynamic looks exchanging it for man that just standing there chilling which is good for him but where first screams cool uncle second one goes uncle that wants retirement. I really like how we can see the trident now tho and need to point out his outfit sure got more print on it. When it comes down to pointing out which one is the winner in my eyes it would be 2020 one.
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● Aphrodite if she wasn't the one that got thrown into drama because people double standards and hypocrisy. Design from first game and the pose straight up makes you think of love, lust, seduction all the things that are associated with said goddess. As for Hades 2 version i have no clue why it feels like this considering it's actually the opposite because we can see armor on her legs now but she feels less covered for me, do i find it negative or in any way problematic? Not one bit let the woman show off all her assets all day long! Really love the adds of her weapon and shield makes you immerse in the store of oh fights are happening around these parts. From seduction to i stand here at the ready kinda vibe and i'm really digging it.
Ps. Another post i read was about fact that her war paint i will call it (not 100% sure if that is it or just line for the giggles) is reference to Ares and considering her myth i really like that touch!
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● Hypnos was the first OG i saw and was like man not only catching up on his sleep but also got such glow up i absolutely adore the design. Not to say he looked bad in Hades 1 but there it was like okay nice to Hades 2 like Damnnn and his lil helpers that keeps him up! Love the fact that of all things they made him be tucked into his cape like burrito.
Ps. I really do hope by the end of the game we get to wake him up so he can try out that nectar that we all leave there waiting.
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● Chaos so many things to say and at the same time silence says it all. Seen people focusing on fact some out there call them he or how it's a downgrade from previous but don't even elaborate why they think that because everyone has right to have their own preference but at least put it into words instead of going trash next..there was also notion how they resemble Meg and while i see where people get that idea from for sure before reading that my mind didn't went there at all. I think both designs really work with someone who is primordial originator and how time goes so can their form. I find it very fascinating that they put old skeleton with new one and adore galaxy under suit makes me think of Nyx right away and how they're connected. Can totally see how between those two gamers got major stance that left reminds them more of male and right of female beings but at the end of the it chaos is chaos. Gotta take chair routine from Meg while they at it! The face on the shoulder surely throws me in loop tho fits? Sure. Does it disturb me in micro scale? Yes. About frames and poses don't have much to say cause both caption the essence of i mind my business everything unrelevant until i say so.
Ps. I know it's about physical aspect but let me say Chaos roasting Mel about how her brother is amusing one out of two Hades spawns is living rent free in my brain.
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realpokemon · 1 year ago
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You must get a lot of asks, how do you decide which ones to answer?
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zzoupz · 2 months ago
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(Late) September commissions
1 slot open!
Artistree Link | Ko-fi Link
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cryptocism · 4 months ago
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changed my pf pic finally so if u dont recognize me yes you do just look into ur heart i am there waiting for u
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shitpostingkats · 1 year ago
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Jaden and Yuri is a killer Dark World Rulers combo because Jaden hates doing administrative work and Yuri not only has the training, this scrappy purple toothpick shouting down 12 foot tall hell monstrosities is good for his enrichment.
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sparklecarehospital · 6 months ago
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Sometimes I wonder how I'm ever gonna be able to work on the other Spinch stories I have, I have so many ideas for things but only so much fixation power
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