#Hospitals Accepting Health Insurance

[advancedneuro0121]

best neurology doctor in Patna

Managing Chronic Pain with Physiotherapy: Techniques and Strategies"

"Managing Chronic Pain with Physiotherapy: Techniques and Strategies" is an insightful blog that explores the effective utilization of physiotherapy in the management of chronic pain (Neurologist near me).

[freebooter4ever]

i think the toughest part for me during all this is how fast it's been. going from being totally normal but with gas/bloating/farting....to suddenly having no gas/bloating/farting but experiencing difficulty breathing and high heartrate one time when i ate too much. then during the week having that happen more and more every time i ate. and then having it happen even if i ate hardly anything. and then starting the probiotics the next week and having that solve the difficulty breathing issue but introduce other side effects. and eventually getting to the point where that nerve pain and extreme reduced ability to move my legs/arms and mental confusion was a constant rather than just when i ate. i have felt so helpless through this whole thing and the doctors kept saying 'wait a week for your appointment and get a referral' while the ER was saying 'you need to see a specialist NOW'. and every day i was waiting it got worse. its just so frustrating because if i had been able to see a real doctor on the 27th of july when i ended up in the ER the first time, so much of this pain might have been slowed or prevented. im sitting here being dizzy and unable to do basic things like clean my house or move around much and am looking forward to spending the next four days just trying to survive till i can see a doctor.

my lovely neighbor went out and bought me these drinks called 'orgain' so im drinking that now and just hoping desperately its not going to trigger anything

[perfektblau]

If 🔪 all those politicians, ceos, and those who perpetuate the nightmare American healthcare system that only exists to prey and profit off from human lives would stop it, I'd do it even if it means cutting down half of my lifespan or going to purgatory. If it means people won't have to suffer anymore, I would.

[medicinemane]

I still wonder about the people who double down on communism... and not even like me when I was younger where I got (not the full extent, but got) that the soviet union and such were awful, but just thought that maybe with less terrible people at the helm it could work (later realizing that these kind of things always have power hungry people rise to the top) Anyway, no I just don't get the "well see, you've admitted your great grandpa owned a chicken, sounds like he deserved to die" people... like the fuck is there even to gain here about being smug while dying on a particularly stupid hill?

[specialgradefckr]

Heatwave: Day 7

tw: explicit content, mentions of past abuse. 6k+ words. Toji/Reader. beta!reader, alpha!toji. hurt/comfort, whump, fluff, toji is kinda pathetic. top!toji, size kink, surprisingly soft sex, extremely domestic.

Prompt: Not everyone has secondary genders, but those who do are considered less than human.

You find him on the streets. A lonely stray, beaten and bruised.

Hair all mussed up, face dirtied, a scar on his lip too poorly healed to be anything but a punishment.

He’s on the floor, propped against the wall in some filthy, dingy alleyway. Covered in dirt, himself.

Eyes half-closed and slowly flitting over his surroundings, like he’s tired but expecting to get hit the instant he tries to sleep.

It’s not uncommon for parents to throw out an alpha or omega teenager as soon as they turn eighteen, if they even waited that long.

Many hospitals didn’t do secondary gender confirmation for minors because the parents would just… leave. Most orphanages were filled primarily with newly-presented alpha and omega teenagers.

And those were the lucky ones. Unlucky alphas and omegas got into worse places. Much worse places. A lot of them stayed around even after adulthood, because what other way was there to work for a living?

Even if they tried to pretend to be a beta, their heat or rut would give them away. Betas didn’t need to go on leave for a week every month or so. Health insurance didn’t cover suppressants if you were registered as a beta, and only betas could get jobs that provided health insurance.

And betas didn’t have the innate urge to mate like omegas or alphas did. Didn’t have the same sense of possession, loyalty, the addiction to their partner’s scent and pheromones that made abandonment impossible.

What they did have was money. All the money, power, and prestige in the world was in the hands of betas.

And if you were an alpha or omega, the best you could do was use your secondary sex to provide the rest of society with entertainment, and maybe get a meal somehow along the way. If you were young and pretty, you might get to live a decent life as some rich beta’s pet.

The stray in the alleyway is a lot older than eighteen. He looks like he’s been eaten alive. Chewed up and spat out once he lost his flavor.

You step up to him and he doesn’t even react to the noise. He’s just sitting there, against the wall, eyes half-lidded and glazed over like he’s waiting to die but still can’t quite sit back and accept it just yet.

That’s the worst part about it all, probably. Because when he was born, he would have looked like a beta, like any other ordinary kid.

Probably to parents who were happy to have him. He might have even had a good life, a happy childhood, a life full of love with a real future in front of him. Until he presented.

He’s a stray, not a wild animal. He had a home, once. Knew what it was like to have a warm bed and a full belly every night. A place to come back to. People who loved him.

A life. A real life, with dreams and aspiration like any normal person – all yanked out from under him in an instant.

An alpha, it looks like. You bend down, sitting on your heels in front of him, waiting for him to notice you. His eyes are narrow, and it’s hard to tell the color –

And then he looks up at you, and you see it. Dark and muddled but the color’s still there. Emerald glittering at you, pick me up, a treasure obscured so only you can see it.

When you reach your hand out, it’s gently, as if not to startle. He just eyes you, wryly, as if he’s too exhausted to be curious about what you’ll do.

You smile. “Hey, stranger.”

Eyes close. Not a threat. “Mmm.”

“Need a hand?”

“If you’re offerin…” He lets his head fall to the side. Not worth the effort to watch you. Some beta lady with a soft heart.

You don’t smell like anything much, not to his burned-out nose, but he can feel your warmth when you lean in closer.

“You got a name?”

Once upon a time, he did. A big name, real important-like, one you might even recognize. Now? Now he’s got nothing.

“Toji,” He gives you, before letting out a hiss as you pull on his bruised hand.

“Sorry,” You murmur, “Let me help you up. Here, like this…”

An arm wraps around his shoulders, tugs him up. It’s impressive that you try at all – Toji heaves his tired, agonized muscles into holding himself up, stumbling along with your support.

You’re doing a pretty good job as a crutch, but there’s no way you can stand his weight for long.

That’s fine. You don’t need to. All he needs is a few days off the streets.

Looks like his luck hasn’t run out completely. Not yet.

-

When you help him in through the doorway, closing it behind you, he slips his shoes off and sets them beside the door, right where yours are.

A stray, not a wild animal. He’s been in homes before, maybe even recently. Just not one he could call his own.

It hurts to think. Almost hurts to look at him, but there’s something achingly handsome about his face.

That half-sly, half-defeated look he’s always got. Those lowered brows and hooded eyes, the cut on his lip that should be mean but just looks scrappy.

He’s an alpha and he’s built like it, but there’s still an unmistakable proudness to his features. A well-defined jawline, strong chin, eyes sharp and fierce.

You’re a little embarrassed at the state of your home. Even in the best of times, you hated doing dishes, and you hadn’t exactly been expecting company. Still, it’s nothing to be terribly ashamed of, even if you apologize for the mess. He doesn’t seem to mind.

“You want to go to a clinic?” You’ve got some pills in hand – some over-the-counter generics, he’s sure – and a glass of water to go with it. “I can take you, don’t worry about the bill.”

Aren’t you just a doll? “Nah. I’ll be fine. Had worse.”

He can see it, too, transparently, how his words pull at your heartstrings. If he plays this right maybe he can get a whole week. Maybe two.

Toji’s always been the gambling sort. You look like a good bet.

“Well…” You think to yourself for a moment, “I think I have a shirt that would fit you, but not much else. I have a bathrobe, too, if you want to take a shower.”

A shower would be perfect, especially if he was going to fuck his way into your good graces. Beta ladies love alpha cock.

“Mhm.” He hums, following you to the hallway and waiting patiently for you to gesture him into the bathroom.

You hand him a robe – probably large enough for him, but extremely fluffy – and a shirt that would probably be a little small on him, but far too large to be a woman’s.

“I, uh, I don’t have separate stuff for guests – feel free to use my shampoo, conditioner, body wash, whatever, I buy it in bulk anyways.” How nice of you to offer.

He was going to anyways, of course. As sexy as the whole wounded filthy beast thing was, women didn’t like letting a dirty guy sleep in their bed.

Even if you were annoyed by it, it’d be a while before that pissed you enough to kick him to the curb. When you did, that wouldn’t be what did it.

A quick once-over confirms he’s pretty bruised and beaten up, but no broken bones. A few cuts here and there that have already stopped bleeding. Every muscle in his body is screaming for him to lie down, hard enough that he almost passes out in the shower, but other than that, he’s all right.

There’s bandaids beneath the sink. It’s more than he usually gets.

When he comes out, clad in the robe and nothing else, he’s kind of ready to collapse.

But what kind of man whore would he be if he didn’t at least give you a glance at the goods? He saunters into your living room, sliding into a plush chair beside the couch you’re currently on.

Your eyes widen gratifyingly at the sight of him, glancing away for a moment in an attempt to stay casual. It’s a little cute, but hopefully you’re not some kind of prude; that’d make things significantly harder.

“Did you find everything okay?” You say, and he notices for the first time a cat curled up next to you as you stroke it gently. It’s bright white and long-haired.

He nods. You notice his gaze, and smile.

“This is Catoru! He’s a huge diva and he loves attention.” A white tail curls around your arm as you pet, swaying gently.

Great. Competition. “Any roommates?” He asks.

To his relief, you shake your head. “I have a guest bedroom, though, you’re free to stay there for as long as you need.”

As long as you need. He’s heard that one before.

It’s all right, though. You’re just a naïve, sheltered beta; you’ve probably never even met someone who would take advantage of your kindness to the absolute fullest extent.

Toji supposes he should be honored to pop your cherry. Right now, he’s not anything but exhausted.

You set a cup of tea in front of him, “You want a snack? I have some protein bars – ”

Sounds perfect, “If you don’t mind.”

He scarfs down everything you offer him, sighing in relief when you bring him a couple more. Sips at the tea, requests a cup of water, drowns several of them before he’s really dead on his feet.

Ah. Clean. Some food in him, some water. This is what heaven must be like.

“My room is just across the hall,” You smile, “I leave my door cracked so Catoru doesn’t freak out. Just let me know if you need anything.”

And Toji feels your smile, all the way deep into his tired bones. Can’t wait to gnaw on it, suck at it, devour every last bit of it until there’s nothing left. He’s always had shit luck but it looks like it hasn’t abandoned him just yet.

He thanks you. The cat at your side winks open an eye to look at him, bright blue and startling against his white fur.

-

He’s left the door open a crack, just in case you’re bolder than you appear.

One of the particularly shit things about being an alpha or an omega is the pack behavior crap. They weren’t meant to be alone, especially while they slept. Made them nervous.

Some kind of pack-bonding stuff. It was hard to sleep without someone next to him. Made him antsy, twitchy, whenever he did sleep he woke up after an hour or so.

Meant a lot of sleepless, painful nights at the Zenin complex. He’d taking to sprinting around the complex, push ups, squats, whatever he could do to exhaust himself so much that he could just lie down and pass out until one of his cousins kicked him awake.

It usually bought him only a few hours, but combined with his alpha genes it meant he grew up built; lean and mean and strong enough to take hits that would kill lesser men.

Lucky him. After they kicked him out he was approached by some tall, scrawny looking omega called Shiu who had a job or two for a strong man with nothing to lose. Money he could blow on food or gambling while he went from one hookup to the next.

He hadn’t heard from Shiu since the last job. Not surprising, since it went worse than expected. In retrospect, if you hadn’t found him in that alley, someone elsewould have.

The thought doesn’t bother him much. Had to end sometime. Every dog has his day, and for a mangy mutt like him, he’d already gotten way more than he deserved. Even life on the streets was better than living with the fucks he shared blood ties with.

Still, as long as he’s in the game, he’s pushing his luck. If he can get you to fuck him, you’ll let him stick around longer, and he’ll get a full night of sleep.

There’s a noise at the door and his excitement rises a touch. He didn’t think you’d be willing to do it this early –

A gentle weight on the bed. Too gentle.

For fuck’s sake!

“Hey, Catoru,” He grumbles, “You’re lucky I even remember a guy’s name. Don’t make a habit of it.”

Catoru, of course, simply curls up next to him, obnoxiously close. His fur is impossibly soft. He should have been named Cloud or Snow or something.

Toji reaches, stroking the bundle of warmth and softness with short, lazy movements. His hands are rough, calloused, but it doesn’t seem to bother the cat any. He just snuggles up and purrs. It soothes his instincts to a degree he finds utterly uncomfortable.

God, fuck, he hadn’t been competition for the cat. The cat was taking pity on him.

Normally he wasn’t so picky about where the pity came from. He was way more popular with the ladies but there was a guy here and there who wanted to try him out.

Those were usually much shorter affairs, though. Women were way better. Took a certain kind of guy to want to fuck an alpha male. A lot of them got off on making him their ‘bitch’, fucking him hard and rough because he had to take it for a place to sleep.

He had enough of that shit at the Zenin complex. This is worlds better.

It’s too good for trash like him, but he’ll take it as long as it lasts.

He wakes up a few times in the middle of the night, but that’s normal enough. The cat’s insufferable, but he’s warm, and soft, and cuddly, which he’s never seen before.

It helps, until the traitor wanders off into your room, probably to snuggle until he decides to wake you up for food.

Bastard. Toji watches him stalk into your room like he owns this whole damn place. Probably jumping right into your arms.

He wonders where the shirt is from. An ex-lover? A male relative? It doesn’t smell like anyone else, but it would probably have belonged to a beta.

You’re living alone, though, which is enough for him. He’s gotten plenty of beta ladies to sleep with him despite having other lovers currently, that’s not a problem.

It’s not like he has to worry about your lover showing up and beating the shit out of him (or you) either – little perks of being an alpha. As long as you paid the bills and wanted him around, that was enough.

There’s a little part of him that always takes an intense pleasure at the thought. Protecting his mate and all that garbage.

Doesn’t matter. He’s just hanging on for now.

-

You’re not sure what food your guest would like, but it’s a good excuse to cook a big breakfast for him and you.

Lord knows, the poor man had an appetite, so you doubt even your mediocre cooking would go to waste. It’s a little embarrassing to have dishes still in the sink, but you’ll do them all at once after you’ve eaten. For sure this time.

Besides, not a lot of ways you could screw up eggs, French toast, bacon, all that stuff. It’s a few minutes of shuffling through things, putting down pans and containers, before you’re ready to get cooking.

You open the fridge, and it hits you. Eugh. Something’s gone off.

Living alone, it happens sometimes. You buy something then forget to eat it before it goes bad. But your fridge is pretty full already…

You look through the shelves, the cases, trying to find what’s gone bad. It’s weird, it’s like the rotten smell just hits you at random times, you can’t seem to find where it’s coming from.

There’s a sudden warmth behind you, like a wall of muscle, as Toji leans over your shoulder, lazily scanning the fridge. He takes one sniff, then reaches deep past a couple jars of condiments and a stick of butter to pull out some cheese.

It’s a soft Havarti, sliced, and you can see the green creeping through it. Bleh.

Toji rolls his eyes as he opens the package up, “It’s cheese, you can eat around it – ”

Oh hell no. You snatch it back and toss it in the trash. The way he’s eyeing it fills you with incredulity.

“It’s not like – it’s not parmesan or whatever fancy cheese that gets mold on it. We can just get more next time.”

“Mmmhmm.” He nods.

He wouldn’t dig through your trash, right? Right??

“Seriously, thank you for picking it out. I was looking for whatever smelled so off.”

Toji was absolutely planning on digging through your trash. Hell if he’d let good food go to waste, but your house, your rules.

“Really? What are you, nose blind?” Beta, he remembers. Not a great sense of smell.

Toji’s always had a great nose. His shitty uncles would hide rotting food around the backyard, and if he was lucky, he could get to it before it was all eaten by bugs or animals.

His cousins would play with him sometimes. Bloodhound. He can still feel the makeshift collar and leash of rope wrapped around his neck. Promises of extra food or clothes if he hunted down a misplaced possession of theirs.

What a chump he was. Took him years to stop falling for it. Ancient history. He watches you shrug.

“Guess so.” Your hand comes up to him, and he doesn’t flinch, but the strike never lands.

Instead, he feels fingers, ruffling through his hair. Softer than usual, since you made him use your fancy shower crap. You have to reach up to get to his head, and you look silly, all stretched like that, but it feels like something in his chest is stretching alongside you.

“I appreciate it.” He almost whines when your hand goes away. “Thanks, Toji.”

That shitty name doesn’t sound so bad coming from your voice. “Anytime.” The words come out softer than he expected them to.

Toji watches for about five minutes while you get ready before he quietly stalks up to the stove and starts the heat on one of the pans. God, he loved some good bacon.

Was a good day when he could snatch some from the family breakfast, even if he got beat for it. Most of the women he stayed with weren’t really the cooking type.

You don’t seem that domestic, either, but with all the food in your fridge it’s obvious you’re trying. You give him a look while you whisk together some eggs, sugar – French toast, he thinks.

“I can get the bacon,” He mutters, waiting for the pan to heat up so he can start laying strips down. “You take the other side.”

“Oh. Oh, sure!” You brighten, smiling at him – what, you’re feeding him for free, but you’re happy he’s helping?

You’re a good person, he supposes. Really good, down to the core, in a way none of those Zenin fucks ever were.

The normal, upstanding sort who went to their jobs and lived their lives without ever knowing what omega brothels were or how alphas were treated as expendable muscle.

You live in a completely different world, one that has barely, briefly intersected his. But he’ll greedily gulp down every breath of fresh air he can get here, even if that means ruining it. Not like he’s ever done anything else.

-

It’s funny, living with you. The funniest part is that it doesn’t seem to stop. It takes him some time to realize that you really meant what you said – as long as you need.

What a chump. A bleeding heart. He’s chomping at the bit to eat it all up.

He learns that you’re a teacher – a professor – at a nearby community college. The pay can’t be that good but the hours are easy, and you don’t need a car – you’re living in some nearby campus-sponsored housing as a part of your employment package. There’s grocery stores close enough to walk to, and a bus for when you need it.

You teach math, or some other nerdy shit. It’s hard not to zone out when you start explaining in depth, especially since you get that excited look in your eyes, and your voice just flows out of you like you’re on a roll.

Before you leave for classes you make yourself a coffee, and you make him one, too. It’s funny, having someone hand him a warm drink without him paying for it first. Funny, seeing you smile and say good morning at the start of the day.

Usually he tried to slink around, stay out of sight unless he knew he could turn things into sex, but you’re not expecting that so he just… lingers.

He used to peek through cracked doors or barely high enough windows to watch TV. Darting out of the way whenever someone glanced outside.

They locked him out, sometimes, like an unruly dog. Can’t have some ugly alpha mutt dirtying their doorways, pissing on the carpet or some shit.

Now, you hand him the remote and show him the channels before you leave.

He watches whatever, until you come home and he bears through your dumb TV shows (Sorcerers? Cursed spirits? Who watches this shit?) and nags you afterwards about your favorite characters, jokes and laughs about them and the plot.

So he catches up when you’re at work, too, just so he can tell you how dumb this Satoru dude is.

God, the guy’s hair is so stupid. And he’s got next to no fashion sense, Toji can already tell (never mind that he is not, by any stretch of the imagination, a stylish man). What a damn tool. Why the hell do you like this stupid beanpole so much?

He tries not to think about why your preferences bother him so much. No use thinking about stuff he can’t change.

The kids are fun, though. Megumi’s smart, even if he’s a bit rough around the edges, Yuji’s too nice for his own good, Nobara is a riot. The Sukuna guy looks like he’s gonna be a blast.

Maybe the show isn't completely irredeemable. You don’t seem to mind his slander of one of your favorite characters, giggling, teasing him, arguing playfully.

It’s fun. It’s fun, and weird, the kind of conversation he’s never had before. Mostly he flirts with women – he does with you, but you brush it off or it flies right over your head – and half-threatens guys. Or he rolls over like a dog to get what he wants.

Doesn’t get to tease people much unless he’s planning on killing them, so it’s a nice change of pace.

He hasn’t gotten his ass handed to him since before you took him in, too. Gets to eat three times a day, or more, even, when you remember to get snacks. He doesn’t ask you but when you see them start to go missing, you start to buy more, ask him what kind he likes best, and it makes him feel funny things.

Lots of things you do make him feel funny. The dumb smiles, for one. The warm meals and carefully made drinks, tea or coffee with cream but no sugar, even though you like yours half-diabetic.

You hate doing dishes, he learns, and quietly he starts picking it up himself. And there’s that smile you make, when you come back home, that look of delighted surprise on your face when the kitchen’s all clean. It’s painfully gratifying.

Same with the litter box for the stupid beast. You’re supposed to change it every day, but you sort of scrape by every other day – with his sensitive nose, he finds it easier to just scoop it every day.

He’s not even trying to help you. Barely sees why you don’t like to do it – Toji’s never minded getting his hands dirty.

He’s been filth his whole life. What’s a little more? This was pristine, compared to sleeping out in the dirt. Compared to getting pissed on, having knives or garbage thrown at him, bruised and bloodied face rubbed in the floor while somebody held him down.

It goes on for so long he wonders if he’s going to lose his edge, starts doing laps around your apartment block. One day you casually hand him a card and ask him to come with you – you’ve gotten a household membership at a local gym.

You don’t visit as often as you should (your words, not his). But you must have noticed him, seen him.

He goes during the day, having nothing better to do, and knowing it’s best to stay in shape for whatever work he may be able to scrounge up someday. He goes to the gym and it’s as weird as living with you.

Punching things, lifting things, stretching and running without his muscles screaming in agony from start to finish, without adrenaline fueling his every motion.

He goes until he’s tired and other folks at the gym give him looks, but they don’t want to fuck him or beat him up. A couple guys glance at him and whoop when he does a deadlift, and he’s really not sure why.

But it’s fun. It’s worth his time. It feels fucking amazing after – he’s all tired out but in a good way, a nice soreness that goes down to his bones and makes him look forward to the hot meal waiting for him at home.

He’s started to cook some, too. Wordlessly helping out alongside you, and then silently prepping things while you’re out.

You hate doing dishes anyways, and it feels good to see how grateful you are to come home to food and a clean home. He doesn’t mind doing it. Doesn’t mind doing any of it, when you look at him like that.

There’s a bit of cleaning to do usually, thanks to some white furry bastard leaving his hair everywhere.

The fuckin cat. What’s with that stupid thing?

He’s never had a pet before, obviously, even scrapped with a few mutts on the streets sometimes digging through the trash.

Once or twice he’d fucked someone who had a pet, and usually it growled at him, if it didn’t cower or ignore him completely. Just alpha shit.

Catoru (god, was he named after that guy in the show?) has a fucking crush on him or some shit. Fucking weirdo.

He walks up to him, rubbing against his leg, purring and meowing to be pet. Likes to be held, too, chirps happily when Toji lifts him up. Lounging in his arms like a little prince-beast he is. Making a home of Toji’s lap whenever he’s on the couch, meowing indignantly whenever he so much a shifts.

The cat meows constantly when you’re gone and Toji wondered at first if you forgot to feed the damn nuisance. But no, you’d never do that to your BABY. Stupid cat.

(God damn. He’s jealous of the fucking cat.)

Nah, the thing is meowing for attention. Wants it bad. Wants his soft pretty fur to get pet, and doesn’t care if it’s some dirty alpha whore doing it.

Eh. Takes one to know one. You did say Catoru was an attention whore.

If he’s got a few treats on hand, if he indulges the stupid animal just to keep it from whining… well, whatever.

-

And then his rut is coming up. Not surprising, since he’s healthy again and fucking lives with you, all domestic-like and shit, like you’re his mate. If anything, he’s surprised it took this long.

Normally when he feels his rut coming up he just finds the first broad he can. He’s got a handsome enough face, a more than impressive form, all he needs is a warm and willing partner.

He doesn’t usually have a problem finding an adventurous beta lady all excited to take a big alpha cock – it’s what comes after that get dicey.

You can’t knot betas, even in the midst of his rut he’s not dumb enough to try it. But his dick is big and he’s been with enough women to know that’s not actually a good thing, at least, not the night after all the “fun”. And ruts last a few days.

His dick’s been bothering him for a while, too, even before his rut. You’re just so fucking hot all the time, so nice to him, so smiley and friendly and you laugh and make jokes with him and shit.

It’s just so easy. He thinks he should feel bad about it, about using you like this, but you’re so utterly unbothered he starts to wonder who’s really winning.

You’re so fucking smart, you and your classes and your routines and your crafts and hobbies and projects. You notice details and act all considerate and shit. Pet him on the head even though he’s taller. Makes him all gooey on the inside and shit.

Blue balls fucking suck when you’re an alpha, and the cock doesn’t help. It’s a disgusting thing, big and swollen and aching, something his cousins and uncles jeered at.

A humiliating handicap that sent him humping and rutting against things like an animal, helpless to do anything but whine and moan and maybe lash out when they tossed rocks or shit at him.

One of his younger cousins liked to kick him in the dick, and another thought of a fun little game where they tied a rope between his legs, and, well –

Shit’s in the past, now. His cock works fine, he’s lucky enough for that. Made him strong, in a way. All those hits, anything could put him on his ass, and he’d get right back up.

It taught him that no comfort was coming, no mate, no home, no warmth, he had to curl up and bear through it, find a way to fuck it out and to not to expect anything but malice on the way out.

It’s not like he’s ashamed of it.

Shame is for people who have the luxury of pride. Toji knows what he is, what he's good for.

But a deep, tiny, stupid part of him is quaking in fear at the thought of rejection. A larger part of him, the practical side, doesn’t want to piss you off and get tossed out.

It’s nice here, too nice, he’s got to keep it going as long as he can, even though he knows your endless patience will run out on him someday.

You’ll look at him and see him for the garbage he is. An alpha, a beast, a dirty animal you’ve taken into your home and fed and pampered until he wouldn’t go away anymore. Garbage to toss out on the street, where he belongs.

One day even the image of you smiling at him will be a distant memory of the days when he had it good.

-

Toji’s gonna lose his fucking mind at this rate.

It’s not like he’s ugly. He knows he’s not ugly. He could accept maybe that he’s not your type, but from the way you have to avert your gaze whenever he walks around post-shower with a towel around his waist, you’re not at all indifferent to his body.

So why the hell won’t you fuck him?

He’s made it pretty obvious that he’s available. Not shy in his body at all. He’s grateful to you, always obedient, never denying any of your request. He’s an alpha, and you know that, you must know that, what he’s good for.

You won’t even ask. Won’t make any kind of mood, send out any signal.

He starts to wonder if you’ve got a partner waiting for you somewhere after all, just far away, and something terrible twists in his chest.

But he’s never had any patience for mixed signals. And this is going to happen no matter what he does, so he might as well say it.

“I’m going into rut,” He says, just to put it out there.

Right away, he sees your body language, little scent indicators that even betas give off. Flustered. Aroused?

“Oh – oh, well. Is there anything I can do to help? To make it easier, I mean…” You trail off, but he doesn’t give you time to be mortified by your own words.

“Unless you want to have sex with me, not much. Just let me get some food and water to wait it out in my bedroom with.”

Honestly, more than he was used to back at the compound. Nothing beat a good fuck, though. And it doesn’t help that you’re pretty attractive, too.

“Oh. Uhm.” He holds back a chuckle at your expression. Too cute. “I – I thought alphas and betas couldn’t really…”

“Oh yeah, you can’t knot a beta,” Toji shrugs, “But having someone with you is the most important part. None of the other betas I fucked have complained.” He was good for one thing, at least.

You look like you want to sink into the ground. “Do you – do you have someone – ”

He raises a brow at you, “If I did, they were a pretty shit partner, yeah? You were the one who dragged me out of that alley.”

“Well, that was just – ” You pause, and god, what he would do to find out what was going on in that little head of yours, “Basic compassion, you know?”

This time, he does laugh. “For an alpha?”

“Well, yeah! You’re human too, right?” You both know that’s not how it works. “And – and still. It’s not like you would have died, right? I was just helping you out.”

He gives you a wry smile. “Right. Anyways, there’s no one else. You’re all I’ve got.”

Oh, he knows what he’s saying. What he’s doing. He’s done it a million times before, but he’s never quite wanted it to work this bad.

Usually women fuck him and then they pity him. You haven’t fucked him yet, and you’re pitying him more than anyone ever has in his entire life.

A better man might be bothered by that. Toji? He can’t get enough.

Watching you stumble for words and stammer and avoid his gaze like prey. It strokes every last instinct he has and then some. He swears he can hear your heart racing, and his knot is starting to pulse in time with it.

There’s a whiff in the air. Tickling his senses. You’re a beta, and it’s faint, but he grins to himself over your stammered answer.

Jackpot.

-

You’re not as shy as he thought you’d be, is his first thought, when he takes you to bed.

You’re smaller than him – most people are – and delicate, breakable, he’s got to be careful. Normally he tries to feel a woman out, see if they like it hard and fast and he can go rough, but somehow, for all his desperate urges, his alpha instincts lock him up when he’s looking down at you.

It’s weird, how strong it is. How compelling. How much he wants to go along with it.

He’s got to do right by you. Treat you nice, make you feel good. Can’t fuck this up when it’s the very first time.

There’s a reason alphas are stereotyped as aggressive, and it’s biting at him now, pulsing in between his legs so painfully he thinks he could die, but Toji’s been on the verge of death before and that doesn’t scare him.

You looking at him with fear in your eyes? Flinching away or crying out? That’s fucking terrifying.

So he kisses you on the lips, works his hands down your body, against your shoulders like a massage. Enough that he can touch you hard but still be tender, still be good to you like every fiber of his being is screaming for him to be.

He’s never been this gentle in his life. Toji is all muscle, all lean performance like a panther, built to kill, but he’s so careful with you, touches ghosting along your skin until you’re humming and pressing back into him.

Taking a large, calloused hand in your own and bracing it over your breast with a bashful look.

And shit, when has he ever laughed during sex? You whine back at him, meeting his eyes as he squeezes and nips – not even hard enough to leave a mark – and something deep inside him trills at how it makes you squirm. How it makes you smell.

He kisses you again. God, he could kiss you forever. The taste of your tongue on his is the best thing he’s ever tried –

But he knows, when he spreads your legs, it’s about to be the second best.

Your hands bury themselves in hair that’s now soft and well-conditioned.

He feels like a beast, licking between your legs, drinking in your moans and wails as he laves over your clit. He feels like he could devour you forever and not be full. Like he’s going to start drooling any time he ever smells you.

A trained dog, with you clasping his hair like a short leash that he never wants you to let go of. You took him in, you fed him and kept him and cared for him, and now he’s yours.

Since he’s yours, you have to have him. It’s only right, only fair.

He makes you cum once on his tongue, then he fingers you, spreading you open with care and diligence, like any loyal hound would.

Your cunt is the purpose of his existence, the vessel for the knot that throbs agonizingly between his legs, and his pain is the evidence of his complete and utter devotion.

When you cum around four of his fingers, he pulls himself up to rub his cock against you. Spreading your slickness carefully along him. You’re not an omega, but he’s made you wet, his spit and your cum slick against him as he spreads it on himself.

Toji doesn’t think he’d mind being your dog. The thought comes to him as he buries himself deep inside you.

It feels like nothing he’s ever had before, like he’s melting, like the whole world disintegrates until all he’s got left is the wet heat of your cunt sucking him it.

He’d gladly be on collar and leash for you. Be your bloodhound, hunt down anything you wanted. Kill, bite, attack, heel.

He’d learn all your commands and jump to obey them like a trained animal. As long as you’d have him. As long as you’ll let him in.

His knot pulses and throbs just outside your entrance. He doesn’t mind if you can’t let him, in, if you never do, as long as he gets to feel this warmth.

Your arms reaching around him, holding him against you. Little noises you make while he drives into you with religious precision, hitting the best spot. Reaching with his thumb to rub over your clit. Kissing your lips, your cheek, your neck as you babble and moan when you get close.

He cums when you do. Nothing feels better than knowing he made you feel good. Every fiber of his body – muscled, powerful, built to rip and crush, kill and fuck – it trembles at the sight of you. Shivering at a bone-deep pleasure that dissipates throughout his entire form.

Alpha instincts scream at him to dig his teeth into your neck. Soft, unmarked, bared for him. It sings to him. He’s never wanted anything more.

But you’re a beta, and it would hurt you. So he lays kisses where he wants to bite. Suckles gently while you laugh at how it tickles, and smiles and kisses your lips like he can devour the sound of your joy, eat it, keep it inside himself like a light that never goes out.

You hold onto him, too. Like he’s something precious, like you want him here with you. He falls asleep like that, half-buried inside you, head buried between your breasts. He’s bigger than you, but he buries himself inside you, hides away in this cavern of warmth and softness like nothing he’s ever known.

He waits for you to pull away, but you don’t. You never do. He wakes up with you still against him, still snuggling up – the annoying bastard of a cat curled up at both your feet.

Maybe… Toji knows he’s living garbage, disposable, good for a fight or a fuck and then to be thrown away.

But he’d been good to you, hadn’t he? You liked him, for some reason he can’t understand.

Maybe – maybe if he can do just this one part good enough –

Maybe you’ll keep him, anyways.

[mostlysignssomeportents]

The health industry’s invisible hand is a fist

On June 21, I'm doing an ONLINE READING for the LOCUS AWARDS at 16hPT. On June 22, I'll be in OAKLAND, CA for a panel and a keynote at the LOCUS AWARDS.

The US has the rich world's most expensive health care system, and that system delivers the worst health outcomes of any country in the rich world. Also, the US is unique in relying on market forces as the primary regulator of its health care system. All of these facts are related!

Capitalism's most dogmatic zealots have a mystical belief in the power of markets to "efficiently allocate" goods and services. For them, the process by which goods and services are offered and purchased performs a kind of vast, distributed computation that "discovers the price" of everything. Our decisions to accept or refuse prices are the data that feeds this distributed computer, and the signals these decisions send about our desires triggers investment decisions by sellers, which guides the whole system to "equilibrium" in which we are all better off.

There's some truth to this: when demand for something exceeds the supply, prices tend to go up. These higher prices tempt new sellers into the market, until demand is met and prices fall and production is stabilized at the level that meets demand.

But this elegant, self-regulating system rarely survives contact with reality. It's the kind of simplified model that works when we're hypothesizing about perfectly spherical cows of uniform density on a frictionless surface, but ceases to be useful when it encounters a messy world of imperfect rationality, imperfect information, monopolization, regulatory capture, and other unavoidable properties of reality.

For members of the "efficient market" cult, reality's stubborn refusal to behave the way it does in their thought experiments is a personal affront. Panged by cognitive dissonance, the cult members insist that any market failures in the real world are illusions caused by not doing capitalism hard enough. When deregulation and markets fail, the answer is always more deregulation and more markets.

That's the story of the American health industry in a nutshell. Rather than accepting that people won't shop for the best emergency room while unconscious in an ambulance, or that the "clearing price" of "not dying of cancer" is "infinity," the cult insists that America's worst-in-class, most expensive health system just needs more capitalism to turn it into a world leader.

In the 1980s, Reagan's court sorcerers decreed that they could fix health care with something called "Prospective Payment Systems," which would pay hospitals a lump sum for treating conditions, rather than reimbursing them for each procedure, using competition and profit motives to drive "efficiency." The hospital system responded by "upcoding' patients: if you showed up with a broken leg and a history of coronary disease, they would code you as a heart patient and someone who needed a cast. They'd collect both lump sums, slap a cast on you, and wheel you out the door:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195137/

As Robert Kuttner writes for The American Prospect, this kind of abuse was predictable from the outset, especially since Health and Human Services is starved of budget for auditors and can only hand out "slaps on the wrist" when they catch a hospital ripping off the system:

https://prospect.org/economy/2024-06-13-fantasyland-general/

Upcoding isn't limited to Medicare fraud, either. Hospitals and insurers are locked in a death-battle over payments, and hospitals' favorite scam is sending everyone to the ER, even when they don't have emergencies (some hospitals literally lock all the doors except for the ER entrance). That way, a normal, uncomplicated childbirth can be transformed into a "Level 5" emergency treatment (the highest severity of emergency) and generate a surprise bill of over $2,700:

https://pluralistic.net/2021/10/27/crossing-a-line/#zero-fucks-given

The US health industry is bad enough to generate a constant degree of political will for change, but the industry (and its captured politicians and regulators) is also canny enough to dream up an endless procession of useless gimmicks designed to temporarily bleed off the pressure for change. In 2018, HHS passed a rule requiring hospitals to publish their prices.

Hospitals responded to this with a shrewd gambit: they simply ignored the rule. So in 2021, HHS made another rule, creating penalties for ignoring the first rule:

https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/hospitals

The theory here was that publishing prices would create "market discipline." Again, this isn't wholly nonsensical. To the extent that patients have nonurgent conditions and the free time to shop around, being able to access prices will help them. Indeed, if the prices are in a standards-defined, machine-readable form, patients and their advocates could automatically import them, create price-comparison sites, leaderboards, etc. None of this addresses the core problem that health-care is a) a human right and b) not a discretionary expense, but it could help at the margins.

But there's another wrinkle here. The same people who claim that prices can solve all of our problems also insist that monopolies are impossible. They've presided over a decades-long assault on antitrust law that has seen hospitals, pharma companies, insurers, and a menagerie of obscure middlemen merge into gigantic companies that are too big to fail and too big to jail. When a single hospital system is responsible for the majority of care in a city or even a county, how much punishment can regulators realistically subject it to?

Not much, as it turns out. Kuttner describes how Mass Gen Brigham cornered the market on health-care in Boston, allowing it to flout the rules on pricing. In addition to standard tricks – like charging self-pay patients vastly more than insured payments (because individuals don't have the bargaining power of insurers), Mass Gen Brigham's price data is a sick joke.

See for yourself! The portal will send you giant, unstructured, ZIPped text files filled with cryptic garbage like:

ADJUSTABLE C TAPER NECK PLUS|1|UNITED HEALTHCARE [1016]|HB CH UNITED HMO / PPO / INDEMNITY [34]|UNITED HEALTHCARE HMO [101604]|75|Inv Loc: 1004203; from OR location 1004203|52.02|Inpatient PAF; 69.36% Billed|75|Inv Loc: 1004203; from OR location 1004203|56.87|Outpatient PAF; 75.83% Billed

https://www.massgeneralbrigham.org/en/patient-care/patient-visitor-information/billing/cms-required-hospital-charge-data

These files have tens of thousands of rows. As a patient, you are meant to parse through these in order to decide whether you're getting ripped off on that HIP STEM 16X203MM SIZE 4 FEMORAL PRESS FIT NEUTRAL REVISION TITANIUM you're in the market for (as it happens, I have two of these in my body).

Kuttner describes the surreal lengths he had to go through to prevent his mother from getting ripped off by Mass Gen through an upcoding hustle. By coding her as "admitted for observation," Mass Gen was able to turn her into an outpatient, with a 20% co-pay (this is down to a GW Bush policy that punishes hospitals that charge Medicare for inpatient care when they could be treated as outpatients – hospitals reflexively game the system to make every patient an outpatient, even if they have overnight hospital stays).

Kuttner's an expert on this: he was national policy correspondent for the New England Journal of Medicine and covers the health beat for the Prospect. Even so, it took him ten hours of phone calls to two doctors' offices and Blue Cross to resolve the discrepancy. The average person is not qualified to do this – indeed, the average person won't even know they've been upcoded.

Needless to say that people in other countries – countries where health care is cheaper and the outcomes are better – are baffled by this. Canadians, Britons, Australians, Germans, Finns, etc do not have to price-shop for their care. They don't have to hawkishly monitor their admission paperwork for sneaky upcodes. They don't have to spend ten hours on the phone arguing about esoteric billing practices.

In a rational world, we'd compare the American system to the rest of the world and say, "Well, they've figured it out, we should do what they're doing." But in good old U-S-A! U-S-A! U-S-A!, the answer to this is more prices, more commercialization, more market forces. Just rub some capitalism on it!

That's where companies like Multiplan come in: this is a middleman that serves other middlemen. Multiplan negotiates prices on behalf of insurers, and splits the difference between the list price and the negotiated price with them:

https://www.nytimes.com/2024/04/07/us/health-insurance-medical-bills.html

But – as the Arm and a Leg podcast points out – this provides the perverse incentive for Multiplan to drive list prices up. If the list price quintuples, and then Multiplan drives it back down to, say, double the old price, they collect more money. Meanwhile, your insurer sticks you with the bill, over and above your deductible and co-pay:

https://armandalegshow.com/episode/multiplan/

The Multiplan layer doesn't just allow insurers to rip you off (though boy does it allow insurers to rip you off), it also makes it literally impossible to know what the price is going to be before you get your procedure. As with any proposition bet, the added complexity is there to make it impossible for you to calculate the odds and figure out if you're getting robbed:

https://pluralistic.net/2022/05/04/house-always-wins/#are-you-on-drugs

Multiplan is the purest expression of market dynamics brainworms I've yet encountered: solving the inefficiencies created by the complexity of a system with too many middlemen by adding another middle-man who is even more complex.

No matter what the problem is with America's health industry, the answer is always the same: more markets! Are older voters getting pissed off at politicians for slashing Medicare? No problem: just create Medicare Advantage, where old people can surrender their right to government care and place themselves in the loving hands of a giant corporation that makes more money by denying them care.

The US health industry is a perfect parable about the dangers of trusting shareholder accountable markets to do the work of democratically accountable governments. Shareholders love monopolies, so they drove monopolization throughout the health supply chain. As David Dayen writes in his 2020 book Monopolized the pharma industry monopolized first, and put the screws to hospitals:

https://pluralistic.net/2021/01/29/fractal-bullshit/#dayenu

Hospitals formed regional monopolies to counter the seller power of consolidated Big Pharma. That's Mass Gen's story: tapping the capital markets to buy other hospitals in the region until it became too big to fail and too big to jail (and too big to care). Consolidated hospitals, in turn, put the screws to insurers, so they also consolidated, fighting Big Hospital's pricing power.

Monopoly at any point in a supply chain leads to monopoly throughout the supply chain. But patients can't consolidate (that's what governments are for – representing the diffuse interests of people). Neither can health workers (that's what unions are for). So the system screwed everyone: patients paid more for worse care. Health workers put in longer hours under worse conditions and got paid less.

Kuttner describes how his eye doctor races from patient to patient "as if he was on roller skates." When Kuttner wrote him a letter questioning the quality of care, the eye doctor answered that he understood that he was giving his patients short shrift, but explained that he had to, because his pay was half what he needed, relegating him to a small apartment and an old car. The hospital – which skims the payments he gets for care – sets his caseload, and he can't turn down patients.

The answers to this are obvious: get markets out of health care. Unionize health workers. Give regulators the budgets and power to hold health corporations to account.

But for market cultists, all of that can't work. Instead, we have to create more esoteric middlemen like "pharmacy benefit managers" and Multiplan. We need more prices to shovel into the market computer's data-hopper. If we just capitalism hard enough, surely the system will finally work…someday.

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/2024/06/13/a-punch-in-the-guts/#hayek-pilled

[kvothbloodless]

Looking into the business side of the UHC shooting has really shifted my perspective on how to approach the practicalities of "greedy" businesses and similar things. To be clear, it hasn't in any way affected (and thus I'm not at all talking about) the purely moral side of things.

Disclaimers: Obviously for profit healthcare is morally repugnant, etc. etc. Please do not yell at me about the morality of private healthcare or how this entire post is evil because I'm discussing the situation at hand rather than the ideal world where we have public healthcare. Also, while I've done a decent amount of research over the past few days, I am still the furthest thing from an expert here, so please take everything I say with a heaping handful of salt, and feel encouraged to correct me if I make any dumb mistakes. Also also, most of this was realized by talking with friends, I did not just have an epiphany on my own.

That aside though, I've been looking at profit margins, and what contributes to costs. Mostly for the healthcare industry (insurance, hospitals, pharma, etc.) but I think this applies to most businesses (at least in America; this entire post is from a very American perspective). To vastly oversimplify, there are two types of corporate "greed", and the general categories of possible solutions look different.

The first is the one that Tumblr seems to treat as the only category, the one that we’re all thinking of when we say "corporate greed". This is where companies fuck over their customers/public to make big numbers even bigger, so they can keep expanding, make shareholders absurd amounts of money, etc (even this isn't actually that simple, but it is relatively kinda simple). This kind of greed can be affected/"fixed" by public pushback, government regulations, etc. Pharma companies fall into this category. The industry average for profit margins for pharma corps is in the large double digits, somewhere upwards of 50% (and to be clear that's taking into account the genuinely massive amounts of money they're investing into research and development, just to head off that line of argument). If a drug company is price gouging on a medication and it becomes a public scandal, they can easily afford to cut the price by A Lot, and still make a profit overall. If you pass laws that simply impose stricter regulations on production, or that cap prices, the companies will object and grumble and try to get around them, because that's what companies do. But at the end of the day, it's theoretically possible to just tell them to cut that shit out, and they Can do it.

Critically though, at least in healthcare, this is Not the category health insurance falls into. Nor most healthcare! This category only applies to businesses with a decent profit margin; the industry average for profit margins for both health insurance and hospitals is in the low single digits (and even though the executives are obviously insanely overpaid and ridiculously greedy, they still account for only a tiny fraction of these companies' budgets! Slashing the pay and bonuses of execs is not going to solve this problem)! Yes they're making Billions of dollars, but they're also spending billions. “Necessary” spending. We can discuss and debate Why this is the case (though it seems clear to me that the main culprits are massive inefficiency due to lack of centralization and the artificial, imposed scarcity on the number of new doctors and medical facilities), but I'm not interested in that here.

My point here is that, while obviously the execs of United Healthcare are greedy bastards willing to screw people over to make an extra .1% profit, the current system is set up such that they sort of have to be (again, this is not a moral justification). Like, the money has to come from somewhere! In the absence of government subsidies, a private insurance company is operating pretty close to the razors edge; if UHC wants to accept more claims, they've got to have higher premiums, or screw over their own employees across the board, or make up the money somewhere else (and again, slashing exec salaries and bonuses will not make a big dent here). This means that they are Not going to be nearly as amenable to public pushback, and even simple government regulations won't really work. If the government told UHC that they needed to accept more claims without raising premiums a corresponding amount (or slash all employees' salaries, etc.), then either UHC will find a way around those new regulations, or they will go bankrupt, and everyone they insured will have to go buy insurance from another company that did one of those other things.

While you Can rightfully still call this behavior greedy, it seems to me an obviously different Type of greed compared to the first category. It's a sort of systemically Enforced greed, rather than one owing to any given board's choices. Like, in the absence of single payer healthcare (obviously a better option), insurance companies Must be horrible and greedy because if they are not they will stop being a functioning company. And you can't really pass the buck! The profit margins for medical facilities and specialists and such are all equally small. This isn't a situation where you can say "well the insurance companies are unnecessary", because healthcare (in its current form, in the USA) itself is pretty expensive to pay for!

Prices are negotiated between a healthcare facility and each insurance corporation, so it gets a bit more complicated, but at the end of the day, these businesses rely on both the reliable but individually lower income from insurance companies, and the sporadic but insane price gouging they charge for people without insurance. And this sucks! But that doesn't change the fact that if you tell a hospital or whatever that they must significantly reduce how much they charge for, say, an MRI, or even an annual checkup, then they must either find a way to charge more elsewhere and make it up; they must fire employees or lower wages, lowering the quality of care; or they will go out of business. They just don't have a large enough profit margin to handle any sort of significant reduction in income.

Aha! I hear you say. While slashing executives salaries and bonuses wouldn't put a dent in expenses, slashing doctor's salaries would! And you'd be correct, to a degree. However, doctors have massive amounts of medical debt, and also regularly work 12+ hour shifts. Until that changes, significantly reducing their salaries (and it would need to be a Large reduction to make a useful dent in costs) is an extremely thorny issue.

So where am I going with this? No idea, to be honest. Except to say that, issues with murder and such aside, putting the fear of god into insurance CEOs quite literally Cannot make a major difference long or even medium-term. They simply do not have enough profit margin to play around with. As I said way earlier, this is not the sort of corporate greed that can be significantly "fixed" by public action or simple government regulations; without a major change in the entire system, private insurance companies are fairly essential to people getting decent healthcare, and those companies are obligated to be awful and greedy, or they will go bankrupt. I know I'm coming dangerously close to mentioning game theory and summoning Moloch, though this is really a couple levels below that, so I'll stop here.

Oh, except to say that, if you're dead set on shooting a CEO, go for a pharma corp one rather than health insurance.

[coral-skeleton]

Help me afford top surgery

Hi y'all, for those who don't know me, I'm a disbled, neurodivergent, trans man living in Cape Town, South Africa. I'm also a gradstudent in Astronomy currently finishing up my MSc, an artist and a poet.

In South Africa we don't really have many options to pursue transition, our private medical aids and insurance don't cover any of it, not even hospital costs as they classify gender affirming care as a cosmetic process instead of the life saving medical care we all know it is. Going through the public health sector is also not really an option as the waitlist is over 26 years long due to our national government again seeing gender affirming care as purely cosmetic and only giving one spot for any gender affirming surgery per year.

In South Africa there's also still alot of stigma around being trans and trans people face violence and discrimination on a daily basis, so in addition to the usual benefits of getting top surgery, it will also greatly improve my safety

This is however very expensive, being a student I am on a very tight budget, living paycheck to paycheck already, trying to save up for a procedure that costs nearly my entire yearly income is next to impossible, I also can't turn to my family in this instance as they are extremely transphobic

So the only option I have left is to try and crowdfund it. As I am South African I unfortunately can't use go fund me, so I'm using the South African croudfunding service, backabuddy, it does accept paypall and I-Pay

Any and all help will be greatly appreciated

So far I have raised:

R11 111.00/R120 000.00

$590.13/$6 374.00

(usd for convenience, conversion rate on 6 march 2024, $1 = R18.83)

[imaginedreamwrite]

Like No One Does

Part 3: Take Me By The Hand

The pitiful image was burned into your mind, the statement that was such an anxiety producing point in your life. The account number that was on the top of the statement might have well been ash and dust—there was no need for it to be as mocking as it was. The bare bones of your bank account had rendered a familiar feeling of you struggling to comprehend and take care of your parent's house.

At least when you weren’t in the hospital, or when you weren’t in Danah’s house pretending like you weren’t one additional bill away from being flat broke. Your parent’s terminal sickness had already been the starting point of anxiety for you, but then to add insult to injury was your extended family’s inability to care.

If it wasn’t for the Levinson’s you would’ve been homeless at 16. You were already an orphan at 16, with no extended family who cared. And adding homelessness to your decrepit standing wouldn’t have been a far fetch. But the Levinson’s, they saved your life. Danah was your best friend, Mrs. Levinson was your second mother, Mr. Levinson your second father.

And Ari…

Ari Levinson was a stronghold you didn’t know you needed, he was a stalwart support system that you didn’t deserve but received anyway.

Maybe that’s why you were so nervous as you waited for him to pick you up. You’d accepted a job offer from him to become his new assistant/secretary, and you had quit your jobs like he wanted you to. You had completely freed yourself to be his assistant and accepted a job that paid enough for you to not just survive, but thrive. This job would give you incredible benefits and health insurance that you wouldn’t have been able to afford otherwise.

Of course, Ari insisted that you required more or better clothes for this job. And you couldn’t have even pretended to argue with him because you knew it was true. You had no appropriate clothes for this job, even if you hadn’t been struggling as you were, there was a certain expectation he had. Or likely had.

“Empty bank account would be better than this.” You crumbled the paper in your hands and tossed it aside, the wrinkled and discarded statement landing somewhere in your dismal place.

With it departing you by your hand, you had turned your attention to the window on your right. You had been watching the window for Ari’s vehicle, not only not wanting to keep him waiting, but knowing that this neighbourhood wasn’t the greatest. And Ari’s didn’t deserve to spend more time in this hellhole than necessary.

“You should move in with my sister, princess. Or move in with me, I’d be a good roommate.” Ari had brought up that particular argument many times over when you would talk, and every time you would let your stubbornness get in the way.

“Danah has her dance studio, and even if she didn't, I’ll be fine.” You denied Ari and you denied Danah, as often as you could.

Your bank account may have been in the red, but at least you had paid rent, insurance, and utilities for your apartment. You might not have had any money, currently, to your name, but you had necessities in your place to eat and not go hungry. However, there was the increasing desire to want more, and that desire pushed you to accept Ari’s offer.

At the very least, you would be able to pay off your parent’s medical bills easier, you’d have good health insurance, and you could save enough to move to a new place. You could potentially afford to get a newer car that didn’t seem like it was running on it’s last rusted bolts. At the very least, this job would be able to give you more of a financial pillow.

“Princess, let’s get going!” Ari’s voice filtered from the street below, and it was a look out the thin glass that made your heart race at the sight of him.

Wearing a plain white v-neck shirt with a leather jacket and a pair of dark wash jeans, he looked like a massive yet ethereally gorgeous runway model. It was unjust how attractive Ari Levinson was, and how easy you could get irritated at him—for seemingly just being beautiful.

“Don’t make me come up there!” He had leaned against the side of his car, something sleek and black, with his arms crossed over his chest. Covering his eyes was a pair of mirrored aviators, which you wouldn’t have liked on anyone else, but on him, they looked good.

Through the thin glass you waved, once, and then stepped back. You grabbed your cheap second hand purse and your phone, on the verge of breaking and couldn’t hold a charge. Once you had your things, you slipped your shoes on and left your apartment, locking the door behind you, before you headed down the stairs.

You pushed on the main door to the building and stepped onto the sidewalk, watching him watching you from across the street. Your feet carried you with purpose, and your fingers tapped against your palm in a rhythmic dance to quell your nerves.

“Baby,” Ari spoke to you, his voice deep and husky, and his blue eyes fixated on you with wholehearted anticipation, “I was about to come up and grab you. Get in the car, hertzeleh.”

You paused and looked at Ari when you were just a foot away, your neck craned to be able to look into his eyes. With his casual yet striking clothing choice and his endearing smile, it was almost impossible to understand why he was currently single. The women he had spent time with and slept with in the past had all been flings, by his account and his claims, yet none had managed to win the bachelor over.

“What does that mean?” You asked him with a soft voice, walking around the front of the vehicle to the other side and as you got into the passenger seat, you took notice of the box on the centre console.

The food distracts you from Ari not telling you what he called you, although given his track record, it must be something sweet.

“Food, sweetheart. For you.” Ari climbed into the driver’s seat and lifted the glasses from his face to set them on the dashboard. “Ma sent your favourite and I picked up coffee for you.”

“Ari, you didn’t have to.” The iced coffee sitting in the cupholder came from one of his parent’s Jewish bakeries, and it was your absolute favourite combination.

The hazelnut blend mixed with a dash of cinnamon and whipped cream was your go-to whenever you and Danah went. And as for the breakfast, you could only imagine what food Mrs. Levinson made Ari bring you.

“We have a full day ahead of us.” His cordial smile and pleasant tone were nothing new to you, nothing you hadn’t expected from him. It was only natural for Ari to be the kind of man who was firm and levelheaded, yet tough when it came to business, and a giant teddy bear when it came to family and friends.

“A full day? How long can it take to go clothes shopping?” You scoff and turn away, biting into the delicious flaky Jewish pastry. As you get a few pieces of the sugared crispy top stuck to your lips, Ari’s laugh fills the void—and his thumb brushing the pieces off sends shivers down your spine.

“Princess, your ass is mine from right now until I drop you off at your new apartment.” The sudden bombshell announcement nearly makes you choke on your food, and you find yourself sputtering to catch your breath.

You turn your head and stare at him, eyes wide and lips parted in shock. You seemed completely mind blown by this revelation, although to your shock, Ari simply cups your chin and closes your mouth.

“Buckle up, hertzeleh. I mean it.” He leans away from you and his broad shoulders touch the driver's seat, and then he winks at you. “Your sass-pot ass isn’t dying today.”

“You don’t get to slide by the fact that you said new apartment, Ari Levinson.” You set the pastry down and wipe your hands, steeling your gaze.

He’s ignorant to you, or maybe just ignoring your stare and your tone. Whatever he’s doing, it doesn’t bother him and more than that he seems to smirk. Even though he’s not looking at you, and he's slipping a pair of aviator sunglasses on, you can tell he’s rather pleased with himself.

“Ari Levinson—“

“Cut the attitude, baby girl.” His smirk only grows, and he reaches out to tap your knee. “You eat first, and then we’ll talk.”

“No, we’ll talk now.” You shift in the seat to face him more head on, as far as the buckle allows, and then you tuck your chin to your chest. “What the hell are you talking about? New apartment?”

He doesn’t answer you immediately, though you doubt he’s at a loss for words. Rather, it's all part of his ploy, of his plan to control the conversation, simply because he can. After a moment, Ari finally speaks and when he does, he tips his head, conveniently stopped at a red light.

“It’s part of the contract, sweetheart.” He flashes you a grin, one that’s convinced countless women to fall into his bed—but it just annoys you.

“I didn’t sign a contract, Ari.” You enunciate his name with force, your jaw ticking as you briefly grind your teeth. “And I don’t need a new apartment.”

“It’s part of your benefits, Y/N. You don’t need to be so stubborn all the time, little bug.” Damn him and damn the way his voice eases you, regardless of how much you want to smack him. “It’s got everything you want.”

“Oh yeah? Like what? What does this new apartment have that mine doesn’t?” You want to challenge him, you want to fight with him because if he thinks he can tell you what to do with your place…

“For one, honey….” Ari’s hand reaches for yours, and he squeezes lightly, drawing out a soft huff from you. “…no one’s been shot in the building. Or stabbed.”

You roll your eyes and almost wish you could have defended the building, but you couldn’t. Truthfully, it felt like every time you went into that place, or even near it, you were risking something. You knew it yourself that you needed a new apartment, but the fact that you couldn’t afford one was holding you back.

“Ari—“ you start to protest again, finding yourself unable to raise much of an argument when his hand touches your leg. His fingers spread above your knee as he squeezes lightly—telling you nonverbally that you don’t need to be so stubborn and let him do this for you.

After a minute of silence, he speaks, like what he says would be the final nail in the coffin. “It’s in the Lexington, sweetheart.”

And you suppose it is. The Lexington was a building you’d always wanted to live in, a place inside the city that seemed to be so improper. The building itself was brick and mortar, but there were these marble-esque pillars that stood outside the front entrance. They were like guards over the building, and it had given it such an aged yet fresh feel to the place.

The apartments inside were just as beautiful as the exterior with rich dark hardwood floors, private balconies that overlooked the park. Each apartment had onsite laundry, which would’ve been a selling point on its own; however, the bathroom would’ve been your convincer.

You’d seen pictures of the bathrooms on the rental site, and you’d been amazed from the beginning. Each apartment had a large two-person soaker tub with clawfoot details and had a seamless view to the outside world. The window let in natural light that made the whole room seem otherworldly. It was a big draw to why you’d only wished to live there, meanwhile the causality of being unable to always boiled down to money.

The rent alone was more than you’d make in 6 months, and it never seemed to be in the realm of possibilities for you. The Lexington was always unreachable, it felt as far from you as the castle you’d dreamed of as a child. It was a noble or even tender dream, but it was never within any realm of reality.

“Ari, you can’t just get me an apartment, or pay for an entire new wardrobe. Or…” you wanted to continue listing off reasons why he didn’t have to spend all this money on you, or why he didn’t have to put in the effort.

You were a grown woman, and he was your best friend’s brother. He didn’t owe you anything, and you weren’t going to take advantage of his time or money. You knew the entire Levinson family was generous, they’d taken you in when you had nothing, when you had nowhere to go. But that was over now, yes Ari had offered you a job, but he didn’t owe you more.

The job was enough. The job would make you capable of paying off the debts from your parents' hospital bills and funerals. You’d be able to pay it off on your own, you didn’t need him to do anything for you.

“Ketzeleh,” he squeezes your knee again, briefly splitting his attention between the road and yourself, “I’m not asking, I’m telling.”

“I’m not sleeping with you.” It slips from your mouth before you can stop it, the irrevocable sentence unable to be retracted. You feel stupid for a minute, like a fool for saying what you had. At least until you hear Ari’s deep rumble, the husky laugh that fills any minute slip of silence.

“Ari, I mean it, I’m not sleeping with you.” You cross your arms over your chest, your lips pressed firmly together. “I’m not going to be one of those girls that falls into your bed.”

“Of course not, baby.” He removes his hand from your knee and rests it on your cheek. “You’re too strong for that, right?”

You roll your eyes and smack his hand away, huffing poignantly. You retain the silence and draw your attention back toward the pastry Ari’s mother sent for you. It remained half-unfinished during the conversation, and you pick it up again to finish it. You shift away from him back to your original position and sink your teeth into the flaky dessert, ripping a piece off.

Ari has leagues of women falling at his feet. He’s Boston’s most eligible bachelor, and no one woman has been able to hold him down. Although they’ve tried, all he seems to want to do is sleep around and have everything be temporary. You’d seen some of the women he’s messed around with, all of them beautiful and striking and modelesque.

You, on the other hand, had few relationships. You didn’t have an opportunity to have relationships, not when you were made an orphan. Not when you were saddled with a suffocating amount of debt that you had to pay off.

“Ketzeleh, look at me.” Ari had finally stopped the car, parking in a private and gated lot for a series of expensive boutiques he was taking you to. “Ketzeleh…”

You raised your head and looked his way, your eyes searching his blues. He had unbuckled and turned to face you, the car still running and the faint sound of the radio in the background. Once you had faced him, Ari had reached out and brushed a piece of the fine sugar from the pastry off your cheek. His thumb grazed your skin and his eyes were solely on you. His voice was quieter than expected yet no less husky.

“You don’t need to ask, you don’t need to feel like this is an IOU situation. This is a gift, there is nothing you have to pay back.” His husky Boston accent had drawn an illicit shiver down your spine as he slowly leaned in and kissed your forehead. The moment was tender, and you were easily distracted by the feel of his plush lips on your skin.

It felt like you were 16 again, sitting in your dark room with nothing but candlelight. It was as if Ari were comforting you again, whispering to you that everything would be okay. You felt like that 16-year-old, scared and frightened for the future.

“You’re okay,” one hand wove into your hair at your nape while the other cupped your cheek, “you’ll be okay.”

[spacelazarwolf]

i think you’re absolutely right about the cuntboys/make trans guys pregnant shit. it made me so uncomfortable too.

pregnancy has always been a giant fear of mine, and there are people out there who genuinely think forcing trans men to get pregnant will ‘fix’ us or some shit. like, sure, it’s fine to joke abt stuff that affects you, but that post didn’t read all that jokey to me tbh.

and the cuntboy thinf. seriously? that’s essentially just pushing us- (sorry can’t remember the right word for it lol) but it’s just pushing us down to labeling us by what we were born with and differentiating us from cis men

it's just blowing my fucking mind to watch them try to backtrack and claim it was "just joking about kinks between friends" because that is literally not what happened. they were talking specifically about a group of "cuntboys" they don't like, said that they should make those "cuntboys" they don't like "fat and pregnant" and then joked about making them "breeders." if they were joking about a kink between friends, they'd have made a separate post and used language that made it clear they were talking about themselves. they didn't though bc they were literally talking specifically about a group of people they don't like and specifically weaponizing a terrifying and traumatizing experience a lot of trans ppl who can get pregnant never ever want to experience.

and i put this in the tags of my other answer, but like. when roe v wade fell, i waited on the phone for 4 hours with the "women's health clinic", the only clinic in my area that took medicaid, to try to get an appointment to get sterilized and it took another two weeks just to get it confirmed. i remember the guy i was hooking up with texted me the day the news broke and asked if i wanted to stop hooking up because he knew how huge a fear pregnancy is for me. i had been trying to get sterilization surgery for years but kept getting sent away, and finally i had to just tell the doctor i had my appointment with "listen dude i am almost 30 i know what i want if i get pregnant and i can't get an abortion my only option will be to kill myself and i really want to fucking live so please give me this surgery." insurance ended up not even covering a hysterectomy so i had to opt for tubal removal. because even being on hormones and having a clear record of asking over and over again for sterilization wasn't enough to grant me bodily autonomy, i had to give them no other option. i got misgendered the entire time i was at the hospital and don't even remember how i got home because i was barely out of anesthesia and conscious when they loaded me in my sister's car.

a pregnancy is a death sentence for so many trans people. and for those that end up going through it, or even for those who want to go through it, pregnant trans people are treated horrifically. if your kid comes out with birth defects, you can be prosecuted for child endangerment because testosterone can cause birth defects.

you do not fucking make jokes like that about other people. and you do not turn around and tell the people you made rape/forced pregnancy jokes about that they're being too sensitive or that they're somehow making you uncomfortable for calling you out on your disgusting and misogynistic joke. this is not fucking 2016 reddit you do not have to be an edgelord to be accepted as one of the guys. making literal rape jokes is not protecting trans women. it's you being a misogynist. i am not changing my mind on this.

[advancedneuro0121]

best neurology doctor in Patna

Managing Chronic Pain with Physiotherapy: Techniques and Strategies"

"Managing Chronic Pain with Physiotherapy: Techniques and Strategies" is an insightful blog that explores the effective utilization of physiotherapy in the management of chronic pain (Neurologist near me).

This informative guide delves into various techniques and strategies employed by physiotherapists to alleviate pain and improve quality of life (Neurologist In Patna).

[bebsibby]

The Top Surgery Log

Hello! I got top surgery yesterday! I want to catalogue my experience so I can remember it and provide some insight for people who want it but haven't gotten it yet. I will continue to update this post as my healing goes on. Everything under the read more!

Leading Up

My insurance is with Kaiser which has been an AWESOME experience so far. They do require a therapist letter, so no informed consent, but the process was very simple and there were a lot of people dedicated to getting me what I needed.

I had about 3 therapist meetings where she just asked me questions about my experience with gender and how my transition has gone so far, my support network, can I afford it, etc. Then she wrote my letter, sent it off to the surgical team, and I was approved within a few days!

After that I had my very first consult with the surgeon. He took pictures, did a breast exam, asked about general health and family health history, then gave me a little presentation of the process. It had post up photos of prior patients, a lot of explanations of the types of surgeries available that he does, and a lot of good information in general. He answered a lot of my questions and made me feel fully confident and prepared for the experience.

Also important to note: I told him the surgery I had been wanting ever since I started doing top surgery research was Inverted-T and I was curious of he knew of it/why that WASN'T an option they offered. He explained everything to me and showed me what he expected my results to look like if I DID want to go to a different surgeon outside of Kaiser. Said surgeon does NOT accept insurance, but would work with the insurance side of things to make sure they would reimburse for the expenses. I really appreciate that because it showed me they wanted to do get exactly what I wanted.

Based on all of that, I decided to just opt for Double Incision both to save me time and get a result that was aesthetically more pleasing to me. Loss of nipple sensation is unfortunate, but apparently IT only has the potential to bring a little sensation back, which wasn't worth all the extra hoop jumping for me.

After this consult, my surgeon told me to think about everything then email him a few days later with my decision. I did and then a few days later got my call to schedule. I got to pick my date but not the time of day, as I would later learn that's decided by the hospital and not me. Once my surgery was scheduled, another pre-op appointment was scheduled about a month before the surgery date. That appointment was very short, as it was just signing consent forms and confirming everything I wanted. He also gave me a packet of supplies I needed to get before the surgery.

After that, I'd occasionally receive emails with more pre-op instructions, like when to stop eating and drinking, showering instructions, when to stop certain medication, and how to care for my drains.

The Surgery

The day before surgery I had initially planned to do all of the last minute housework and leave for the surgery the next morning. HOWEVER, when I got my call to tell me the time, it turns I had to be there by 6 AM! The surgery center is over an hour away from me and the bus my wife and I were going to take didn't run that early, so we had to scramble to make other plans. Luckily the friend who was going to drive us back home was cool with us crashing on his floor for the night, so we were able to do the most important things at home then take the bus down the day before.

Once we were all set up for the night, I did the first cleaning routine that I was required to do, set my alarm, then tried to sleep. I didn't get much due to Hard Floor and also excited but that wasn't a biggie because I'd be sleeping again soon LOL.

Next morning I woke up, did my second skin cleansing, and we headed out! I checked in, waited a little in the waiting room, then got called back to start.

Everyone who was working with me was SUPER funny and kind. I got asked more questions, signed another form, took some pre-med tylenol, them stripped to switch into my gown, bonnet, and grippy socks (Got to keep those btw :>) My IV got put in my wrist which REALLY fucking hurt!!!!!! It never stopped aching. After that, the surgeon popped in to check on me and see if I had any questions, then they wheeled me in to the operating room.

I had gotten another premed via IV that was already making me tired, and I remember the last thing being the surgeon saying what to do with my removed tissue once he was done and I was gone!

The surgery itself lasted around four hours, but all I remember is waking up and seeing my wife and friend sitting at the foot of the bed. I said hi to them and that was apparently third time I had said it. I had been up and talking to them for awhile all loopy but also becoming suddenly very serious when talking with the nurses. I've had a few surgeries but I've NEVER been this way after so that was funny. The nurse had also been giving ME all of the postop discharge info and I don't remember it so thats unfortunate! I only remember her talking about the drains. I had to read it all again when I got home but it was all good.

Once I was awake enough, they wheel-chaired me down to my friends car, packed us all up and we headed back home. I napped about half the time but still kept my eyes closed when i was awake and talking bc my vision was still FUCKED and it was so bright out. We got home, I was lead inside, and that was that pretty much! I napped several more times, nibbled on some roast beef, emptied my drains (which made me very woozy, mostly due to the standing) and went to bed!

After Surgery

Day one! I woke up a few times in the night mainly to go to the bathroom, but slept REAL deep otherwise. It rained all night which was awesome. I woke up feeling very achy but not painful except for my throat. Those ET tubes are NOT easy on your body. Took all my meds, got out of bed eventually, and had cup ramen for breakfast. Now I'm just sitting on the couch with all my computer stuff moved from my desk to where I'm sitting. I got a long hdmi cable so I can just watch stuff on the big TV so I'm pretty set up!

My wife just brought me some cookies and overall I'm just feeling really good. Not really excited or emotional about it. Its just a very warm contented feeling.

I don't know what my chest looks like yet since my post-op binder got put on while i was still out, but everything gets removed next week! I'll probably update again after that appointment.

Feel free to ask specific questions! I'll be resting most of the time so I'll just be around!

[orange-foxes]

Marriage Proposal

💍Who's Gonna Hold You Like Me? by lilac_and_ravens (5k)

“Minyard, who the fuck did you murder this time?” David Wymack grumbled through the phone. “I lost Neil,” was all Andrew said in response. There was silence for a second before Wymack replied, “What, like lost him in the grocery store?” “No, like he left for a run and never came home.” (OR: a very unconventional Andriel marriage proposal <3)

💍 It's the Thought that Counts by gluupor (2k)

Andrew and Neil's relationship has many facets that are confusing to outsiders. The strangest may be their habit of giving each other the contents of their pockets and calling it a gift.

💍 For Better Or For Worse by gluupor (15k)

Marrying your best friend who you've secretly been in love with for years because you need health insurance is a good idea, right? ...Right?

💍 Fool for You by conniptionns (1k)

Andrew and Neil get married on April Fools' Day. No one believes them.

💍 The Pinterest Wedding Board by jingerhead (4,5k)

“Do you want to see my Pinterest wedding board?” Andrew asked, already pulling it up. Aaron, who’s arms had been crossed in what could only be him trying to be intimidating, completely lost his composure. “Your what?” “My Pinterest wedding board,” Andrew repeated. He patted the cushion next to him in invitation that Aaron hesitantly accepted, sitting down so slowly and gingerly it was comical. “Here.” He turned the computer towards Aaron, who gave Andrew a concerned look before finally looking at what was there. “You’re serious,” he stated.

💍 Who's Gonna Hold You Like Me? by lilac_and_ravens (5k)

“Minyard, who the fuck did you murder this time?” David Wymack grumbled through the phone. “I lost Neil,” was all Andrew said in response. There was silence for a second before Wymack replied, “What, like lost him in the grocery store?” “No, like he left for a run and never came home.”

💍 Eight Paws and a Roof by JuiceGremlin (10k)

Five times the cats were part of something important, and one time they weren't.

💍 I can't make you love me (if you don't) by djhedy (5k)

Andrew realises he’s faced with two choices: hold onto this or let it go forever. And he hates that. Almost as much as he hates Neil. He watches as Neil turns away, walks up the length of the room once, stops, looks back. “It’s ok,” he says, his voice drained of any emotion, face set. Sure. Resigned. “You always said this was nothing.” Andrew nods. Remembers there’s a cigarette dangling between his fingers, so brings it back up to his lips, holds it there, doesn’t even bother breathing in. “Ok,” Neil says again, and leaves the room. --- before andrew graduates, neil asks him to make a choice.

💍 Say I Do by gluupor (1k)

Neil’s not sure how this happened. Well, okay, that’s blatantly false. This happened because he’s a competitive asshole and so is Andrew, although he hides it behind his general apathy. They wouldn’t both be professional athletes if they didn’t have healthy competitive streaks. But what that means is that sometimes neither of them will back down when issued a challenge. Like right now. When they’re locked in a game of engagement chicken.

💍 i'm a tourist making stops (i'll never leave without you) by Talls (3k)

Andrew is unreasonably on top of this, and should have expected Neil to not be any good at relationships. Or, in which Andrew proposes, and Neil confronts the reality that is his life. (ft. Kevin as a perceptive asshole who Neil couldn't live without)

💍 Neil Josten Is a Lucky Man by irls_goaway (11k)

5 times Neil ends up in the hospital and nobody tells Andrew+The 1 time someone has the common sense to tell Andrew and Andrew decides, fuck, he has to marry Neil.

💍 The Sock Drawer by Paradoxolotl (2k)

Andrew refuses to ask, but he's not unwilling. His solution is simple: put the ring where Neil will find it. Hell, Andrew will even make it obvious where to look. Easy. Simple. He just didn't expect it to take this long.

💍 I'll Race You There by jingerhead (5k)

“Excuse you,” Neil grumbled, nudging his nose against Andrew’s head, “it’s about to be Neil Josten-Minyard.” “I don’t want your stupid last name.” “But I want YOUR stupid last name.” ~*~ Wedding days aren't always picture perfect. Sometimes things go wrong, but if the day ends with you walking down the aisle with your husband, could it really be so bad? Andrew doesn't think so. He thinks that's as perfect as he and Neil are going to get, and it's exactly what he wants, too.

💍 january 19th by crystalcrow (2k)

“Yes or no?” “To kissing?” Andrew puts his hand down, grabbing what he stuck between the wall and the headrest and drops it on Neil’s chest. “To marrying me.”

💍 you ought to give me wedding rings by absolutelithops (11k)

Andrew has the damn thing for a year before he makes any use of it. or Three times Andrew almost asks a very dangerous question, and the one time he does.

[elvenmoans]

For 7 years I have been fucking fighting with insurance, with the help of several doctors, to cover a geneticist. I have Ehlers Danlos. Most forms don't effect life span. The ones that do, have organ involvement.

I already had two issues with my organs by the age of 20. I had to be hospitalized with sepsis for one of them. My liver is weirdly structured to the point they thought I had a fatal disease, before they realized it just has strictures and odd shapes, and a more benign disorder which doesn't explain why it's shaped like that.

I've had several doctors think I had a decent chance of having vascular subtype and that I NEEDED to get it tested NOW

But over and over and over insurance says no. They say only 5% of eds patients have this subtype so it's not worth looking into

I was hospitalized with sepsis bc of organ issues the week after my 18th birthday.

Vascular eds has a median life expectancy of 48. Meaning half don't make it that far. Patient survival was 99.3% at year 1, 89.9% at year 5, and 83.4% at year 10 of follow-up.

Yet insurance wants me to just shrug and accept that a single fall could have my veins or organs burst and kill me. Without any opportunity to be prepared for it or take meds to soften the risk. Because geneticists are too expensive to justify. Even with my symptoms, even with teams of doctors working years to get me in. insurance won't budge.

The billionaires running this wouldn't accept this level of lethal risk for their own health. But I'm supposed to sympathize? I'm supposed to give a fuck about their chance of death and the fear they may feel?

This isn't even counting that they took my mother away from me when I was 8 years old, because she couldn't get cancer treatment covered until it was stage 4. It doesn't count the sheer agony I have gone through when eds led into a preventable spinal cord injury, and many more smaller spinal complications. I had to threaten to fucking kill myself over the pain to get any pain relief. Even with my scans. And it's still not enough. I'm still in enough pain that it affects every single moment of my life. Even the best ones.

I have no empathy for them, or the people who are morally corrupt enough to love monsters like them.

[justinspoliticalcorner]

Andrew Perez at Rolling Stone:

EARLIER THIS WEEK, two Democratic senators announced they have requested a criminal investigation into Supreme Court Justice Clarence Thomas — regarding, in part, a loan for a luxury RV provided by a longtime executive at UnitedHealth Group, one of America’s largest health insurers. Thomas apparently recused himself in at least two cases involving UnitedHealth when the loan was active, according to a Rolling Stone review. Yet, he separately chose to participate in another health insurance case and authored the court’s unanimous opinion in 2004. The ruling broadly benefited the industry — shielding employer-sponsored health insurers from damages if they refuse to cover certain services and patients are harmed. Thomas’ advice to patients facing such denials? Pull out your checkbook.

While UnitedHealth was not a party to the case, the company belonged to two trade associations that filed a brief urging the Supreme Court to side with the insurers.  “As we saw so starkly this term, Supreme Court decisions can have sweeping collateral implications: If the court rules in favor of one insurance giant, for instance, it tends to be a boon for all the other insurance giants, too,” says Alex Aronson, executive director at the judicial reform group Court Accountability. “That was the case here, and it’s a perfect example of why justices shouldn’t accept gifts — especially secret ones — from industry titans whose interests are implicated, whether directly or indirectly, by their rulings.” The public had no way of knowing about Thomas’ RV loan at the time of the decision: The loan was only exposed by The New York Times last year. Senate Democrats investigating Thomas believe that much or all of the loan, for a $267,230 motor coach, was ultimately forgiven. Sens. Sheldon Whitehouse (D-R.I.) and Ron Wyden (D-Ore.) recently requested the Justice Department investigate whether Thomas reported the forgiven portion of the loan on his tax filings, after he failed to disclose it in ethics forms.

Meanwhile, Thomas’ health insurance opinion has had wide-ranging, long-lasting ramifications, according to Mark DeBofsky, an employee benefits lawyer and former law professor.  “It hasn’t been rectified. The repercussions continue,” DeBofsky tells Rolling Stone. “People who are in dire need of specific medical care, and [their] insurance company turns around and says, ‘That care is not medically necessary,’ and there’s an adverse outcome as a result of the denial of the treatment, or hospitalization, or service — there’s no recompense for what could have been an unnecessary death or serious injury.” Since last year, the Supreme Court has faced an unprecedented ethics crisis, with much of the focus aimed squarely at Thomas. ProPublica reported that Thomas received and failed to disclose two decades worth of luxury gifts from a conservative billionaire, Harlan Crow, who allegedly provided free private jet and superyacht trips to Thomas and his wife; bought a house from Thomas and allowed the justice’s elderly mother to live there for free; and paid for at least two years of boarding school tuition for Thomas’ grandnephew.

[...] Federal law requires Supreme Court justices to recuse themselves in any case where their “impartiality might reasonably be questioned.” The justices decide for themselves when such a move is necessary — and when they do withdraw from a case, they rarely say why. Thomas does not appear to have explained his decision to withdraw from the two matters that directly involved UnitedHealth. Thomas did not take similar steps in Aetna Health Inc. v. Davila, a case that broadly affected the health insurance industry. He instead authored the court’s opinion, which expanded insurers’ favorite tool for limiting liability: ERISA. Congress passed the Employee Retirement Income Security Act, commonly known as ERISA, in 1974 to protect employee benefits. The law is relatively vague when it comes to “welfare benefits,” and contains a broad preemption clause. The courts have filled in the blanks — including in the Aetna Health case — with distressing results for patients. Half of Americans have employer-sponsored health insurance coverage; nearly all of these plans are governed by ERISA.

Rolling Stone exposes how SCOTUS Justice Clarence Thomas received a $267K RV from a health insurance executive.

[nando161mando]

"Joking about the murder of a human being - a husband and father - is deeply insensitive." - from WSJ oped

Seriously, doesn't that depend upon who the human being is? Plenty of husbands, fathers, mothers, brothers have been murdered throughout human history, but for those who were evil or hated, there are jokes galore.

On the other hand, denying as many health insurance claims as necessary in order to raise profits is not insensitive, it's just business, I guess, and totally acceptable.

>But in the wake of the fatal shooting of a UnitedHealth Group executive, there has been an outpouring of negative public sentiment toward private insurers. “Remembering the day United Healthcare denied a one-night hospital stay for my 12yo child as ‘medically unnecessary’ following ASD heart repair surgery,” wrote one user on X. Another shared this: “Today I’m thinking about the time United Healthcare suddenly decided to stop paying for my chemotherapy and didn’t bother telling me.” A Facebook post from the company expressing sorrow over the killing of Brian Thompson, chief executive of the insurance unit, prompted more than 70,000 laugh emojis. “Thoughts and prior authorizations,” went a typical comment.

>Joking about the murder of a human being—a husband and father—is deeply insensitive. The claims made about UnitedHealthcare by individuals on X haven’t been independently verified. And it should be needless to say that no one should face threats or violence, no matter how contentious the debate over health policy might be.

https://www.wsj.com/health/healthcare/unitedhealth-insurance-negative-public-sentiment