#ITS MY LAST WEEK OF CLINICAL POSTING THE FREEDOM IS SO CLOSE YET SO FAR

[collecting--stardust]

My roommate hasn't sleep yet so I continue to play on my phone with no guilt until I realised that tomorrow is Monday and I'm on am shift while she's on pm shift 💀

[kaitkerrigan]

Happy Father’s Day

My 2 1/2 year old daughter is sick this weekend. All last night and all day today, she's needed my husband and me to come to her side and tell her that we’re here - not that we can stop her from being sick but to acknowledge that she IS sick and that it's ok and that it will pass. We take shifts at night. I took the early shift - 8 til 12 and my husband took the later shift. I went in every 45 minutes for a while, finding her in a cold sweat, confused by the cough she has never experienced before. We’re lucky. I can count on one hand the number of times she’s been sick but every time it happens, she’s stunned that her body could rebel against her. She cries, blubbering “I don’t feel well today.” in her eerily accurate grammar. We’re lucky.

There are 2000 children who were on the most harrowing journey of their lives, fleeing their countries because their parents feared for their lives, and at the end of that journey, they were ripped away from the only people they had who could tell them that as hard as this is, it will pass. 

Now they're alone. They're being treated like prisoners. And some of them are sick and all of them are scared and there's no one there to tell them that it's going to be ok. There's no way to know that it will be ok. 

We wouldn't treat a stray nursing dog and her puppies like this. But we have done this to mothers and their babies. WE have done this.

We have the luxury of pressing our children against us and knowing that their cold will pass and then they’ll get to go out and play without repercussions. But such freedoms are on a slippery slope. The moment we start seeing “others” as more of a pestilence and less of our sisters and brothers, our democracy begins to decay. Our moral highground is eroded. “It can’t happen here” is the biggest lie that anyone can tell you. Anything can happen anywhere. We alone are responsible for what happens on our watch. And so we are responsible for the children who have been ripped away from their parents this month. 2000 children in one month. Project forward a year and that’s 24,000 children. We cannot allow that. 

How can you help? SEND MONEY TO FIGHT FOR THE RIGHTS OF THESE HUMAN BEINGS - mother, father, and child. 

RAICES bond fund (https://actionnetwork.org/fundraising/bondfund…) gives 100% of your donation will help pay to get a parent out of detention so they can claim their own child.

VOTE. VOTE. VOTE. Are you not registered yet??? CLICK TO VOTE.

Please read the whole post below that (among all the chilling articles I’ve read in the past 24 hours, in the past week, in the past month) but especially this: 

"There is a fundamental principal of international law which arose after World War II: the concept of a refugee – a person deserving of protection because she is unsafe in her country due to persecution in her country based on her race, religion, nationality, political opinion, or membership in a particular social group. The United States Government has recognized its responsibility in protecting refugees for almost seventy years – in international treaties and in our own laws. Whatever your politics, it is an absolute and undeniable fact that the US must protect asylum seekers under its international treaty and internal legal obligations."

From FACEBOOK - Kate Lincoln-Goldfinch on June 8 at 4:03pm

Yesterday, I met with a mother whose 5-year-old son was literally pulled out of her arms by a Border Patrol Officer while she and her son cried and begged for him not to be taken. She is an asylum seeker who fled death threats in her country. She has not seen or spoken to her son in weeks. This mother recounted the story of her son being taken, stone faced, clearly unable to begin to access the emotions under the surface. It was the lowest, saddest, most distressing moment of my career as an immigration lawyer.

I chose to be an immigration attorney after my first experience as a law student in the immigration clinic. I was asked to do an intake with a family of Iraqi asylum seekers who were being detained with their 5-month-old daughter. The baby was wearing a prison-issued onesie. Her mother asked me to hold her, because I smelled like the outside world. All along, that moment has been my marker of the lowest moment, the catalyst for my career. Yet that was nothing compared to what is happening today.

I am writing to share with you what I am seeing so that you can be informed and take action. I want to help you know the background and combat the arguments that these parents chose this for their children, that they brought it on themselves. And to combat the lies coming from the Administration, claiming there is no choice in whether to enact the policy of separation.

There is a fundamental principal of international law which arose after World War II: the concept of a refugee – a person deserving of protection because she is unsafe in her country due to persecution in her country based on her race, religion, nationality, political opinion, or membership in a particular social group. The United States Government has recognized its responsibility in protecting refugees for almost seventy years – in international treaties and in our own laws. Whatever your politics, it is an absolute and undeniable fact that the US must protect asylum seekers under its international treaty and internal legal obligations. (I am avoiding citations and legalese in this article because I want it to be readable, but I can easily provide citations for anything written here.)

In the last decade, the political situation in Central America has deteriorated. Gangs and drug cartels have taken power and the governments of Central America, particularly in the northern triangle of Guatemala, El Salvador, and Honduras, are unable to protect their citizens. People are being extorted and required to make regular payments to gang members. If they refuse, they or their family members are murdered. Boys as young as eight years old are forced into the gangs. If they or their parents refuse, they are murdered. Young girls are forced to become the property of gang members and treated as sex slaves. If they or their families refuse, they are murdered. The police are unable to help, and in many cases have themselves been infiltrated with gang members, so that making a police report brings more danger. Parents are fleeing and bringing their children here to rescue them from rape and murder.

When an asylum seeker wants to come to the United States, she has two choices: come to the bridge to ask for asylum, or sneak into the country. Why sneak in? Well, because border patrol officers often don’t permit people to seek asylum. They tell them to turnaround, we aren’t accepting asylum seekers. In fact, now border patrol officers are patrolling the Mexican territory in front of the borders to keep asylum seekers from even crossing the bridge. This leaves option two: the only way to get in. Historically, asylum seekers who crossed over got immediately apprehended (we don’t have the porous borders the Administration claims we do), then were placed in family detention centers and put through the credible fear interview process. If they passed, they got out of detention and finished out the asylum process in court. If they failed, they were sent back. This was far from a tolerable solution, but it has “worked” this way for over a decade, with subtle shifts in policies and practices.

What changed? The Trump Administration decided in May to enact a “zero tolerance” policy against people crossing the border. This means everyone, regardless of cause or circumstance of entry, gets prosecuted for illegal entry. Parents of children, including infants, are being taken to federal court and their children are being placed in custody of the Office of Refugee Resettlement. There is NO agency responsible for facilitating communication or reunification of these families. Parents are getting deported without their kids, and shelters are filling up. These families are being transferred and taken all around the US depending on where there is space for them. Parents are not told where they are going, where their kids are, or whether they are okay. If this does not horrify you, check your pulse.

What can you do? Here is the hard part. And I promise to keep working on this. Immigration attorneys can help – that’s easy. You can travel to detention centers and help parents pass their credible fear interviews and get out on bond. A volunteer sheet will be circulating within the next week. Nonimmigration lawyers can partner with an immigration attorney or attend a training (Mark your calendars for an opportunity for Austin Bar Association members the afternoon of June 25.) Nonlawyers – there are the obvious options: contact your legislators and demand an end to family separation. Form mom groups, dad groups, psychologist groups, contact the media, and get loud. Give money. I personally think money is best spent on the RAICES bond fund (https://actionnetwork.org/fundraising/bondfund…) where 100% of your donation will help pay to get a parent out of detention so they can claim their own child.

What you should not do, in my opinion: anything to support or legitimize what is happening. This includes offering to foster these kids and take them off the hands of the agency, donate supplies, or assist the Department of Homeland Security in any way. I know your hearts are in the right place, and you want to help the kids. But if the shelters are at capacity and no one is offering to take the kids, maybe the administration will stop taking them from their parents. Maybe they need to feel the pain of what it is to care for so many distraught babies, so they stop the horror show.

Thank you for reading this far, for letting me get this off my chest, and for caring. The only positive that comes out of moments like these is the groundswell of goodness.

In solidarity, Kate

Finally, happy father’s day. Hug your babies close. Hug your fathers tight. Celebrate your connection and your liberties and find a moment in your day to  talk as a family about what it would be like if you had to flee your country. What would you need? What can you as a family sacrifice to help?��

[thejakeformerlyknownasprince]

Modern Animorphs AU (part 2)

@jollysunflora : The second half of my complete list of modern AU Animorphs headcanons, approximately one per book.  

28. “Ax,” Marco says, “How come you can roll out ‘venti dulce de leche dark-chocolate frappuchino extra whip’ without batting an eye, but you giggle every time you have to say the word ‘soy’?”

“It has so many vowel��owl?—sounds, in so little space,” Ax says.  “That long sssssssssss, so pleasant on the tongue, but then that odd oooyyy ooy-yah?  All in the back of the mouth.  Very strange.  Sssoooy.  Ssususs-oooyaaa.”

“Also, he’s moved on from the frappuchinos,” Tobias adds.  “Now he keeps spending all our hard-stolen bitcoins on espresso mack... mach...”

“Espresso macchiato con panna,” Ax explains.  “Doppio.”

29. Cassie feels herself sweating as she props the laptop across the room from her, tools laid out and Ax unconscious on the table.  She never expected to find a YouTube video on how to perform brain surgery—and to be honest, it’s actually about “how neurosurgeons perform an orbitozygomatic craniotomy,” not intended to be a how-to manual—but it’s the best she can do under the circumstances, and so she’ll follow along for now.  

MM3.  “That’s the kind of strong leadership we need.”  Jake gestures to the full-color television (this year’s latest model) where a program of their current leader plays on a loop.  “Keeping the wrong kind of people out of this country, saving America for the right kind of Americans.”

“Yeah, yeah, whatever,” Rachel says.  She and Tobias and Jake are the only three Animorphs, except when Melissa joins them sometimes, and listening to their “Supreme Leader” blather on gets old sometimes.  “All I want to know is whether it’s true that within a few years people will really have phones that plug into their cars.  That’d be cool.”

Tobias rubs his eyes against the silk of his wing feathers.  They itch constantly, since he doesn’t have a gas mask to wear every time he goes out into the pollution-opaque air outside the way that his human friends do.  Jake and Rachel take bets sometimes, idly, brutally, about whether he’s the last raptor left on the face of the planet.

“Magnificent!”  Drode appears in their midst, and both the Berensons immediately point guns at his head.

30. Marco is lying on his bed the day after watching Eva fall, staring at a patch of wall above his dresser, when he registers that his phone has been buzzing for a while now.  It goes off so many times he assumes he has to be getting a call, but when he checks his notifications he just discovers he’s gotten seventeen text messages in the last hour.  

The first is from “Smurfette,” and says “Did you know that there is a type of food that involves baking a cinnamon bun inside of a donut?  We must secure as many of these as it is possible for a human to consume, as soon as possible!”

The next one, from “Hawkgirl,” reads: “found out recently that apparently ax still thinks you invented flea powder.  i told him that if youd invented flea powder wed all be a lot richer right now.”

“Team Dad” (not to be confused with “Real Dad,” which is how Marco lists Peter) sent along several invitations to team missions on League of Legends this afternoon, along with a threat to have Cassie play Marco’s avatar if Marco doesn’t join in.  “we both know that by the time you get back you’ll have only healing attacks and she’ll have trained it to apologize automatically for stabbing people,” Jake adds.

One of the many texts from “Julia Butterfly Hill” suggests that Jake has underestimated Cassie’s diabolical streak, because it’s a screenshot of a clone of his account which has had its name changed to HarambeWasFramed.

The real surprise, however, is the single text from “Xena: Warrior Princess.”  It’s a link to an article about a disaster in the local national park and the efforts to clean up the wreckage of an as-yet-unidentified craft which went down in the canyon.  Marco has to read it a few times to understand the point she’s making, because it’s all about what’s not there: the article makes no mention of any human bodies being found among the wreckage.  

Marco gets halfway through typing a reply to them all which informs them in no uncertain terms that he sees through their transparent attempts to cheer him up and doesn’t appreciate it, but he deletes without sending.  He can practically hear his mom’s voice saying it: he can focus on the fact that he’s still surrounded by people who love him, or he can focus on the negative side of everything.  And being constantly negative is no way to live.  

31. “Sharing this again, because its been 3 months,” Jake’s cousin Brooke posts on Facebook.  “Anyone who has any news at all about Saddler, no matter what it is, PLEASE contact my family.  Big brother, I dont know if youre still out there, but I miss you.  I miss you like crazy.”

Jake turns up his Spotify’s Offspring channel a little louder to drown out the sounds of Tom and his dad shouting at each other downstairs.  His eyes flinch past Brooke’s post, but they can’t move fast enough to prevent the thought that flashes across the surface of his mind: Is this going to be me a year from now?

32. Tobias texts Rachel and Jake an article from Audubon.Org, where several birdwatchers are going into ecstasies of scientific fascination at the bald eagle and peregrine falcon seen flying in close formation in a cell-phone video taken near a highway overpass downtown.  His only comment is, “Told you so.”

33.  In the aftermath, Rachel does a Google search: “PTSD treatment symptoms outcomes.”  She reads through the WebMD site, the NIMH page, the Wikipedia link to a DSM-5 entry.  She thinks of Tobias’s withdrawn silences, his antipathy toward so much they used to enjoy, but she thinks of other things as well.  How exhausted Jake seems any time they’re not on-mission.  How badly Cassie flinches when the school bell rings and doors slam.  How Ax seems to be gradually losing interest in the things—cooking shows, new condiments, human history trivia, These Messages—that once drew his fascination.  How last week Marco flicked an ant off the back of his hand and then went white like he’d just kicked a puppy.  How good it had felt when she’d hurt David, spreading the pain around, giving it back.

She catches an Uber to the clinic downtown, filling out forms in the waiting room based on the checklist written on her phone for “how to get tobias an ssri”: Yes, she often feels tense and worried.  Yes, her heart often races for no reason.  No, she hasn’t thought of ending her life.  No, she doesn’t feel out of control when she eats.  

She gets as far as developing a cover story—it’s about how she’s never felt the same since her parents’ divorce—but in the hallway to the office she panics and calls Cassie.  “Am I doing the right thing?” she asks, after she’s explained.

Cassie is silent for a long time, never a good sign.  “I’m not sure an SSRI would work on a bird,” she says at last, “and that’s even if we could figure out a dose that would work without killing him.  I know you want to help, and I think you should, but...”

Rachel hears what she’s not saying: but what if her mom asks too many questions?  But is this risk really worth it?  But what if the psychiatrist (the receptionist, the pharmacist) is a controller?  But isn’t it them, and only them, against the world, and isn’t that just how it has to be?

“The war won’t last forever,” Cassie says weakly, and Rachel hates her a little for it.  “When it’s over, when we get to tell everyone what’s happening...”

Rachel hangs up.  She goes home, morphs, and flies out to the woods.  

«You know I love you, right?» she asks Tobias later that evening.

«Of course I do.»  He sounds exhausted.  She’s never felt more helpless in her life.

34. The Yeerk Peace Movement, as it comes out, has a Twitter feed.  It is rather painfully obvious that it has been set up and run entirely by aliens who are doing their very best to communicate with humans, and not quite succeeding. Most of the posts are couplets, for some reason that none of the Animorphs can fathom.  

“Want to be On Fleek? When you see someone’s rights threatened, speak!”

“Don’t be a Belieber anymore - end slavery and even the score.”

“#tbt: Remember when we were symbiotes?  Give taxxon freedom your sympathy votes!”

“Nickelback is super lame, and keeping involuntary hosts is just the same.”

“Respect your host’s rights today, and make your human into your bae!”

35. It’s Marco who comes up with the idea for how to take down William Roger Tennant.  This is a guy, after all, whose cockatiels have their own Instagram account: he runs his fame on the internet.  

“It's simple,�� Marco explains. “We start a hashtag—#notsonicetennant—and we make it go viral.  All we have to do is film this guy everywhere he goes, and eventually the yeerk will slip up.”

It proves not to be simple after all.  Their gif of Tennant twitching madly mid-EPA speech gets overshadowed by the news story about One Direction nearly getting poisoned with spiders at the same banquet. Ax does not understand the concept of hashtag, and keeps adding #notsonicetennant to his retweets of what Marco calls “food porn.” They train one of Tobias’s repurposed GoPros to follow poodle-Marco, but that becomes a meme mocking the world's most obnoxious stray dog rather than Tennant himself.

The plan finally, finally comes off when they pull out all the stops and just confront him in morph.  The smartphones that Rachel rigged up in the surrounding buildings don't pick up the thought speak, but the audio of Tennant screaming at the aliens to leave him alone comes through just fine.

When the scandal breaks, the internet (in truly predictable fashion) drops #notsonicetennant and starts using #tennantgate instead.  

Ax reposts an old photo of Tennant eating a quinoa salad—zoomed in on the salad—and tags it #tennantgate.  All of his teammates assure him they appreciate the attempt.

36. “All right, that’s just weird,” Marco says, looking at the final entry in the underwater creepshow they’ve been walking through for the past hour.  “All the other ships have been getting more modern as we’ve gone, but this one?  Looks like it was made in the sixties, at the latest.”

«The world’s creepiest museum curators are getting sloppy with the placement of bodies as well,» Tobias points out.  «There’s no way that many people could fit on a boat that small.  They’re practically falling over the sides.»

Jake and Cassie look at each other, seeing the same realization reflected in each other’s eyes.  Neither one of them wants to say it out loud.

Jake becomes the one to bite the bullet.  “Don’t you get it?”  He points to the ragged clothes, the emaciated bodies, the modern smartphone tucked in among the antiquated radio equipment.  “They were refugees.”

37. Rachel shuts the window on the library computer as soon as she hears someone walk into the room, but she can tell she was too late by the look on Jake’s face when she turns around.  

“Roy Ludvig, huh?” Jake says.  “Heck of a name.”

“He was at the T.V. studio when we attacked.”  Rachel looks down, picking at her nail polish.  “No civilians were supposed to be in danger.”

Jake’s expression softens, as much as it ever does.  “And now you’re scrolling through his Facebook, looking for something that’ll let you sleep at night.”  

“He’s got a grandson,” Rachel blurts.  “Jordan’s age.  He...”  She shrugs.  He’s dead, and it’s more or less her fault.

“Shouldn’t be looking on Facebook.”  Jake sets his phone on the library table next to her, taps the screen to bring up an official-looking report.  “You should be, say, borrowing my dad’s computer.  Sending an email from his account to ask for the guy’s medical records.  If you had, you’d know that Mr. Roy Ludvig had a heart condition.  That he had maybe a year to live, at most, and doctors said he might die at any old time.”

Rachel looks down at the report for a long time, and eventually looks up at Jake.  “Doesn’t make it okay, what I did,” she says.  “He’s still dead.”

Jake shrugs.  “You don’t have to forget it ever happened, but you do have to live with it.  Live, and fight another day.”

38. In the aftermath of Estrid's visit, Tobias is flying over the boardwalk when he sees a henna artist who clearly smokes way too much pot to be a Yeerk. He gets Ax, they morph human, and both get henna tattoos of Elfangor's name. (Ax had previously expressed an admiration for the human tradition of commemorating a lost loved one by making markings on one's body.) They know the tats will disappear when they demorph, but they're both glad they did it. The artist asks how long they've been together, and Tobias says in a scandalized voice, “he's my UNCLE!” Thus, Tobias succeeds in both of his goals: making Ax laugh, and reminding him he has family here on Earth. Honestly, the reminder doesn't hurt Tobias either.

39. “You know, not all squirrels are like that,” Marco is fond of saying after a morph goes wrong.  “Not all termites are horrifying worker drones.”  Sometimes it’s, “You know, some of my best friends are fleas.”

It’s Cassie, however, who gets the last laugh out of that one.  «You know, Marco,» she says as they swim away from the wreckage of the helicopter, «Not all ants are like that, right?  I shouldn’t say that all ants are killers, right?»

Marco stares at her in silence while the others snicker, watching him war between the two impulses: to keep the joke going forever, and to express his honest hatred of ants.  

«Come on.»  And now Rachel has joined in on the teasing.  «You’re just going to let that kind of besmirching of the ant community stand?»  

«Okay, okay!»  Marco gives in.  «Ants suck.  Yes, all ants!»

40. “Our experts have examined the video extensively, and near as we can conclude, this footage is genuine and unedited,” the newscaster says.  “Given how viral this video has proven to be, with over two million views since it was posted to YouTube on Wednesday, everyone wants to know: is this footage proof that aliens exist?  Is this a publicity stunt for the upcoming Fantastic Beasts sequel?  Or, as one YouTube commenter asks, did a Smurf just have sex with a centaur?”

«Potential new ally?» Tobias suggests.  He’s already tapping out a search for the original video in his modified tablet.

Ax laughs.  «Of course not.  He’s crippled.  A vecol.  Useless.  We must respect the privacy of his isolation.»

“You know what?  Fuck that,” Marco snaps.  He shoves to his feet, posture tight with anger.  “Just... Fuck that,” he tells Ax.  “I have ADHD.  Attention Deficit whateverthefuck.  I take a pill every morning to help me function because my brain isn’t good enough to filter stimuli all by itself.  I got a fucking 135 on the world’s most boring IQ test and I’m still failing half my classes.  I’m a vecol.  You think I’m useless, huh?  You gonna start refusing to talk to me because of some bullshit about ‘respecting’ my ‘privacy’?  Huh?”

«That’s different,» Ax says.  «You’re not...»  He doesn’t seem to know how to finish that sentence.  

«If he’s an exception, I hope I am too,» Tobias says more gently.  «I got screened for anxiety disorders as a kid, and I guess we’ll never know if I qualify or not, ‘cause my aunt decided that doctors cost money and if the test said I needed one then she didn’t want to know about it.»

Ax doesn’t answer for a long time.  He doesn’t seem to know where to look.  

«Let’s go tell the others what we found.»  Tobias taps a button to send the video to himself.  «We can talk more about this later.»

MM4. Tobias flinches when his phone makes the small ping sound that means he has an alert.  The new kid is the easy target in every school on the planet.  He wonders what it’ll be this time: another Facebook post where the semi-anonymous account Toby IsALoser tags him in another meme about how he has to pay people for sex because the sight of his body would make any normal girl run away screaming, another unnamed Instagram ping telling him he should kill himself so that no one has to look at his stupid fat face anymore, another Snapchat image of a puddle of vomit with the caption “me when I think of you,” an email with the most disgusting gif anyone could find after a quick search...

It’s not, though.  It’s an invite to join a private Facebook group, called The Sharing, with several hundred local members.  Most of the names Tobias recognizes are cool older kids from the high school.  Intrigued, willing to trust for the moment that this isn’t some ridiculously elaborate prank, Tobias clicks “join.”  

41. Jake looks around at the enormous open field, concrete pitted with openings and low hovels of corrugated steel and rebar.  He can see for nearly half a mile in every direction before the smog makes it impossible, and the tallest things around are the hunched hork-bajir.  “Where are we?” he asks.

Cassie frowns.  “This?  Jake, this is downtown Manhattan.”

He gapes at her.  “What happened to it?”

“Tall buildings are targets for drone strikes,” she says casually, turning away.  “The only way to be safe was to go underground.”

42. Marco doesn’t bother going to the house of the guy who photographed them, nor does he try to catch the kid before he uploads the video anywhere.  Instead he waits for the image to appear on YouTube, then becomes the first commenter.  “Sweet manip!” he says.  “Is that Photoshop, or can you do that in free programs like Gimp?”

43.  “EarthIsOurs-dot-tumblr-dot-com?” Marco says incredulously.  “What does Taylor do there, post pictures of her pet taxxon?  Reblog plans for planetary domination?”

«Judging from her archive history, she’s had this blog for many years,» Ax says.  «She recently changed the domain name, but some of the content on here is from as early as 2008.»

Jake and Marco get caught up in debating with Cassie about what exactly to send to her, but Tobias just scrolls quietly through Taylor’s old posts.  She didn’t lie about being beautiful, he realizes, or about being popular.  There’s a long blank period in her tumblr account in mid-2014.  And then she posted one selfie—just one—after the fire.  

He can’t bring himself to read the names that the trolls call her, or the discussions about how much money they’d have to be paid to have sex with her.  But there’s no overlooking the suggestions that she kill herself.  The posts are too numerous, too vitriolic.  

“Every chick ever to wander onto the internet has gotten that crap,” Rachel says; clearly she’s been reading over his shoulder.  “She should’ve developed thick skin, not joined the Sharing.”

Tobias thinks of the Facebook page made at his old school just to discuss the fact that he’s a chubby zit-face, of the posts which eventually overwhelmed his Instagram with death threats.  «Yeah, I guess,» he says.

44.  It takes a long time for Cassie to get home from Australia, but at least they’re not too worried for most of that time; she texts them her location and a brief description of the insanity that landed her in the Outback as soon as she gets in contact with Yami’s family.

45.  “None of this makes any sense,” Peter says.  “I’m hallucinating, or you’re delusional, or else—”

Marco sets his phone in Peter’s lap. “Check the timestamp, Dad.  I took that six months ago.”

Peter stares at the phone for a long minute, and then slowly looks up at Marco.  At a clear loss for words, he tilts his head back toward the screen.

“I know.”  Marco laughs, the sound wet with tears.  “That blond wig looks terrible on her.  But it’s really her, Dad.  I swear.”

46. “So they’re going to get the U.S. embroiled in another war,” Marco says.  “And this one with a country that can actually fight back.”

«Seems like,» Tobias says.  «Only why bother with all the secrecy and political wrangling?  Why not just send a couple mean tweets to Donald Trump and Kim Jong-Un?  That’d probably do the job just as well.»

“No, it wouldn’t.”  Jake runs a hand through his hair, looking around at them all.  “The yeerks need a total war.  Everything the U.S. and its allies can pull out, against everything China and its allies can muster.  Our military has gotten too used to sending drones to fight its wars, to ‘tactical strikes’ against insurgents.  If the yeerks want half the species annihilated, they have to do a lot more than poke a couple of egos.”

47. “News flash,” Marco says.  “Your average suburbanite ain’t gonna accept a seven-foot-tall alien for a neighbor.  You know the number of times my mom’s been asked for proof of citizenship before she was allowed to vote or cash a paycheck or buy a car?  How many times she’s been pulled over by cops while driving the speed limit with her seatbelt on?  And she’s a regular old human being.  Toby’s right—the hork-bajir have a whole other fight coming if we ever win the war.”  

48. Rachel feels the blood drain from her face when she opens the Facebook message and sees the name attached.  David’s Facebook account has been defunct for almost two years now; there’s no one left who would want or even be able to access it from the outside.  Should be no one.

Miss me? the message from David’s account says.

Who are you? she types with shaking fingers.  What do you want?

I know what you did.  I’m coming for you.  I’ve got friends all over the place and they’ll find you.  They’ll kill you.  Amazing the allies you can get, when you know where the bodies are kept.  On the internet, no one knows you’re a—

Rachel hits “block.”  She tells herself that the screaming nightmares she has all that night and into the next are the product of having a stressful life, she’s an Animorph for pete’s sake.

She doesn’t stop shuddering every time she gets a message for the next two weeks, but she never hears from whoever (It wasn’t David. It couldn’t have been.) it was ever again.

49.  They stagger away from yet another hopeless fight, all of them injured, half of them missing limbs or bleeding to death.  Dragging their damaged bodies behind the first dumpster they find, they demorph, remorph, and force their minds to focus long enough for the long flight home.  It’s only when Rachel is in owl morph, staring around the dimly lit alleyway, that she sees the security camera pointed directly at their location.  

«They must not check it that often,» Marco says without much hope.  «Or else they’d be out here already to come looking for us.»

«Doesn’t matter,» Tobias says harshly.  «It had a perfectly clear view of all your human faces.  And that building is owned by the yeerks.»

They all stare at each other in dull shock as the realization sinks in.  They always knew this moment was coming—they could only be so careful for so long—and yet, on some level each of them hoped it never would.  

«Take one more night to be with your families,» Jake says at last.  «We evacuate everyone in the morning.»

Jake loses his phone, again, somewhere amidst all the chaos.  This time around he doesn’t bother to replace it.  It’s not like his mom is going to be wondering where he is, not anymore.  

50.  “So,” Jake says, “this is going to sound crazy, but—”

“Aliens are invading the planet, and you’re the only kid terrorist who can stop them?” James suggests.  “We do have wifi up here, you know.  You’re Jake Berenson, right?  You’re all over the conspiracy theorists’ forums right now.”

“Um.”  Jake runs a hand through his hair, starts again.  “Yeah, pretty much.”

James nods.  “In that case, you’ve got thirty seconds to convince me your story’s not a load of crap before I call security.”  

51. Ax secures their wifi in something a billion times better-hidden than Tor.  With that reassurance, they all end up starting blogs.

Marco’s is a rambling string of wry comments about everything from the invasion to his parents’ science projects.  Sample post: “Insider source (aka my mom): Visser Three has morphed human and eaten AN ENTIRE BAG OF MARSHMALLOWS in one sitting, ON MORE THAN ONE OCCASION.  Pass it on!”

Jake’s is the place that people go to find out how they can help, and to get his reassurance that the help means something.  Sample post: “As Barack Obama says, ‘We the people recognize that we have responsibilities as well as rights; that our destinies are bound together; that a freedom without a commitment to others is unworthy of our founding ideals, and those who died in their defense.’  This fight will never be over just as long as we keep supporting each other.  I can’t tell you how grateful I am to you all for the KickStarter donations.”

Rachel’s has beauty tips for the American girl on the run, light and self-deprecating enough that you often don’t notice the undercurrent of desperation.  Sample post: “If you want to be able to look at yourself in the mirror, try fixing your hair using reflective surfaces such as pots, ponds, or pieces of Bug fighter wreckage.  Alternately, just say ‘fuck it’ and never look at yourself again.”

Cassie’s tells people how to stay safe, and how to keep their environments safe as well.  Sample post: “Everyone please remember, it’s important to stock enough food and water for family pets as well as humans when retreating to an apocalypse bunker!”

Tobias’s has a lot of good-natured grumbling about everyday life in the valley.  Sample post: “In other news, my girlfriend’s mom is currently arguing with the smartest being on the face of the planet about where to put the new latrine facilities.  Sorry Naomi, but my money’s on Toby.”

Ax’s has a lot of food reviews, of course, but again there’s that undercurrent of desperation, almost like he’s trying to convince someone else (or maybe even himself) that humans are worth saving.  Sample post: “Marco assures me that there are no less than 23 distinct flavors contained within every sip of Dr. Pepper.  Just think of the years of experimentation and innovation it must have required to produce a drink which can inspire 23 different reactions from human taste buds, all at the same time.  Truly inspired genius.”

52. They run drills upon drills for what to do in case of a drone strike.  Using any morphs they have that can dig or build—mole, taxxon, elephant, beaver—the Animorphs create an extensive network of tunnels and shelters, posting guards at all times to keep their eyes on the sky.  The hork-bajir valley doesn’t show up on satellite imagery, which they only know thanks to Peter’s definitely-illegal fact-gathering missions on the darkweb, but they don’t know for sure whether an overhead camera would be subject to the same strange perceptual distortions they all experience when flying there as birds.  They nearly lose their precious secrecy when Naomi sends several emails from her work account, claiming she’s being held hostage and asking anyone who will listen to come rescue her.  Eva generates a hasty follow-up from the same account asking people to ignore “the prank that I now realize was in poor taste,” but none of them are sure it worked for the next several days.  

53. Rachel makes one last post on her nearly-extinct Instagram account.  This time the scrap of paper she uses appears to be torn from the back of a food label, but the penciled script is as intricate as ever.  It reads “Who wants to live forever? —Freddie Mercury, 1986”  

54. After it’s all over, Tobias retreats, he hides, but he keeps a thread of communication open.  Cassie shoots him an email with the subject line “Hawk patient with intermittent aggression and lethargy—any idea what could be causing it?”  Marco sends him idiotic memes that now feature the Animorphs’ names and faces.  Ax asks for constant updates on the new wing of Taco Bell being built downtown, and repays the favor by leaking confidential information about the search for the Blade ship.

And then he gets one of the stranger emails he’s ever received.  It’s an offer of a full legacy scholarship to Harvard University (which has just found the means to explain some inconsistencies in the records of one “Alan Fangor,” who graduated in the ‘80s) in exchange for Tobias teaching one class per semester on any subject of his choice.  He agrees, with the stipulation that all his classes be online.

The resultant course (Ornithology 442: An Insider’s Perspective) is like nothing the students who participate have ever seen before.  Tobias will write out rambling treatises on Why Blue Jays Suck or All the Ways Hawks Are Superior to Eagles with a thought-speak-to-text recorder.  He’ll deliver online lectures from a shaky webcam pointed into a nonspecific tree, occasionally wandering off for hours at a time to go hunting.  Students who ask him personal questions about Rachel get regurgitated mouse skeletons Fed-Exed to their campus mailboxes.  Essays that don’t demonstrate much effort get feedback such as “even I can tell this sucks and I have a seventh-grade education” or “my grandmother could make better sentences than this AND SHE’S AN ANDALITE WHO DOESN’T SPEAK ENGLISH.”  Assignments include “find one bird fact in a textbook and explain why it’s a load of crap” or “go film a Boston pigeon until it does something interesting, I dare you.”

Nevertheless, enrollment is so popular that Harvard has a three-year waiting list and charges students an extra $500 just to sign up.  When Tobias finds out about the extra fee, he promptly video-calls the Intrepid, gives Ax remote access to his computer, and explains why he needs Ax to convert the course illegally to a MOOC.  Harvard University fires him for breach of contract; Yale hires him on that very same afternoon.  

part 1 here 

[thisdaynews]

Even if Roe is upheld, abortion opponents are winning

New Post has been published on https://thebiafrastar.com/even-if-roe-is-upheld-abortion-opponents-are-winning/

Even if Roe is upheld, abortion opponents are winning

Demonstrators gather during a protest vigil outside of the Planned Parenthood of Metropolitan Washington, D.C., Carol Whitehill Moses Center in January. | Zach Gibson/Getty Images

health care

A drip, drip, drip of state restrictions has made abortion harder to obtain.

Abortion is still legal in the United States, but for women in vast swaths of the country it’s a right in name only.

Six states are down to only one abortion clinic; by the end of this week, Missouri could have zero. Some women seeking abortions have to travel long distances, and face mandatory waiting periods or examinations. On top of that, a new wave of restrictive laws, or outright bans, is rippling across GOP-led states like Alabama and Georgia.

Story Continued Below

Both sides of the abortion battle are focused on the future ofRoe v. Wade,but opponents have already won the ground game over the past decade, chipping away at abortion access.

The Supreme Court’s new conservative majority, about to wrap up its first term, has not yet taken up a case challengingRoe.Just this week it declined to reinstate an Indiana law, signed by Mike Pence when he was governor, that would have banned abortion on the basis of gender, race or fetal disability. But that’s no guarantee the court won’t take another look at the landmark 1973 abortion rights ruling.

But even without the high court, GOP-backed laws have added restrictions and obstacles, whittling away access. Since the start of the Trump administration, hostility to abortion in general and Planned Parenthood in particular has only intensified in statehouses around the country.

“We celebrate freedom in America. But I believe that my choice ends when another life begins,” Louisiana state Rep. Valarie Hodges said just before a fetal “heartbeat” abortion bill passed there.

Years of piecemeal state laws have left their mark. Mandatory waiting periods, travel, missed work and lost wages all make getting an abortion more expensive and more difficult, particularly for low-income women. Doctors and clinic staff have to face protesters, threats, proliferating regulations and draining legal challenges; clinics have closed. In remote parts of the midwest and south, women may have to travel more than 300 miles to end a pregnancy.

“This is a moment of seeing how all of these laws fly in the face of medicine and science and go against what we in the medical profession know, which is that any restriction on medical care by politicians will endanger people’s health,” Planned Parenthood President Leana Wen, a physician herself, said in an interview.

It’s intensified of late. Republicans in Alabama and other states have raced to enact laws that would almost completely ban abortion, sometimes without exceptions for pregnancies that result from rape or incest. Eight states have enacted laws which, if allowed to go into effect, would ban abortion once a fetal heartbeat can be detected, as early as the sixth week of pregnancy, when many women don’t even know they are pregnant. (Missouri’s variant is eight weeks.) Alabama has gone even further, granting “personhood” and legal rights from conception.

Those laws may eventually reach the Supreme Court and testRoe,the 1973 decision that recognized women’s right to abortion. But those statutes aren’t what’s crimping access nationwide right now. That’s happened through a drip, drip, drip of lower-profile efforts that have created obstacles for pregnant women and led to a dwindling supply of doctors trained and willing to perform abortions.

Many of those laws were promoted as attempts to make abortion safer — though courts often disagreed and threw them out as unconstitutional barriers. Now, abortion opponents are openly talking about ending the practice altogether.

“The strategy used to be death by a thousand cuts,” said Colleen McNicholas, a physician based in St. Louis who also provides abortions in Kansas and Oklahoma. “They’re no longer pretending things are to promote the health and well-being of women, which is what we used to hear all the time. Now they’re being very bold and upfront.”

“It doesn’t change the fact that for many Americans, particularly for women in the middle [of the country] and the South, abortion is inaccessible,” she added.

Data from the Guttmacher Institute, a research organization that supports abortion rights, shows that 788 clinics in the U.S. provided abortion services in 2014 — a drop of 51 clinics over three years. Since 2013about 20 clinics have closed just in Texas.

Further, one in five women would have to travel at least 43 miles to get to a clinic, according to a Guttmacher analysis from October 2017. In North Dakota, South Dakota and Wyoming, at least half of the women between 15 and 44 years old lived more than 90 miles from a clinic.

Six states — Kentucky, Missouri, Mississippi, North Dakota, South Dakota and West Virginia — have only one clinic left that performs abortions, according to a recent analysis from Planned Parenthood and Guttmacher. Lawmakers in many of those states have pursued limits in when abortion can be allowed — such as fetal heartbeat laws or 15-week bans, though the laws have been blocked in court. Four of those states have also passed so-called trigger laws that would ban abortion immediately should the Supreme Court overturnRoe.

In Missouri, the sole clinic, which is in St. Louis, could close this week. On the surface, it’s a dispute with the state health department over licensing, safety and regulation, but the showdown comes just days after state lawmakers passed a ban on abortion after eight weeks of pregnancy, with no exceptions for rape or incest.

“States have been marching down this path for a number of years. The restrictions that have passed previously have set the stage for the bans this year,” said Elizabeth Nash, Guttmacher’s senior state issues manager. “It’s counseling, it’s waiting periods, it’s abortion coverage in your health plan. It’s limits on abortion providers, such as unnecessary clinic regulations.”

“Missouri is the first and other states could be next,” Planned Parenthood’s Wen said on a recent call with reporters.

The ramifications of the anti-abortion movement’s sustained assault against Planned Parenthood are perhaps no clearer than in Texas, where lawmakers have passed dozens of restrictive laws, including mandatory ultrasounds, waiting periods and state funding restrictions.

The Supreme Court overturned another set of Texas restrictions in 2016 — but not before about 20 clinics shut down, many of which were never able to reopen. Providers retired, staff found other jobs and clinics had to start from scratch to get licensed and staff up. “All of those things take time and a significant amount of money,” said Kari White, an associate professor in Health Care Organization and Policy at the University of Alabama at Birmingham and an investigator with the Texas Policy Evaluation Project.

Even though Texas permits abortions until 20 weeks — itself a cut-off point that conflicts withRoe v. Wade, although it hasn’t yet come to the Supreme Court — abortion access has sharply declined. That scenario is likely to play out in other conservative states, even if they don’t go as far as Georgia or Alabama.

More than half of Texas’ 41 abortion clinics closed or stopped performing abortions after the state passed legislation, TX HB2 (132), in 2013 that bundled several onerous restrictions, according to research from the Texas Policy Evaluation Project. The average distance a woman had to travel one way for an abortion jumped to 35 miles from 15 miles. In rural parts of the state, drives of 100 miles or more to access care are not uncommon, according to the group.

The evaluation project found that while the number of abortions overall declined after the Texas law went into effect, the number of second-trimester abortions rose as women were forced to wait and travel longer distances. Currently only about 22 abortion providers, mostly in urban areas, are operating in Texas, a state with roughly 6.3 million women of reproductive age.

Low-income women are disproportionately affected by abortion restrictions, said Kamyon Conner, executive director of the Texas Equal Access Fund, which helps women who can’t afford an abortion, which costs between $500 and $10,000 dollars depending on the point in pregnancy. The nonprofit was part of a group that challenged dozens of Texas abortion restrictions in court.

Calls to the group’s hotline have tripled over the past few years to 6,000 in 2018, but it only funded about 1,000 women last year, she said. Some of those women are undocumented immigrants, some are incarcerated and others have children but cannot afford to raise more.

Other costs mount — both in money and time, Conner said. Because Texas has a 24-hour waiting period between an initial consult and the abortion, women miss work and may have to pay for hotel rooms.

“There are fewer clinics to provide the services,” said Conner. “The few clinics that are left are in very high demand.”

Telemedicine could plug some gaps in care for women seeking abortion medication, instead of a surgical abortion. But there too access varies widely by geography. Some states ban telemedicine-facilitated abortions. Elsewhere, providers are using video-chat technology to dispense the medication. Seventeen states require licensed abortion providers to be physically present when administering abortion medication, which effectively is a ban on telemedicine, according to the Guttmacher Institute. Abortion medication is approved for use up to ten weeks into pregnancy, but under current FDA rules can only be dispensed at certain medical facilities, including abortion clinics.

Alternatives are being tested. In one FDA-reviewed study, clinicians can mail abortion medication directly to patients after a video chat. Study participants can go to any clinic for their screening and ultrasound, send the results to a participating abortion provider, and then video chat with that provider. If appropriate, the provider can decide to dispense the medication to the patient’s address, and the patient can take it at home.

Under this system, women don’t have to travel several hours just to pick up the abortion pills, Erica Chong, director of Gynuity Health Projects, told POLITICO. The Gynuity study has enrolled about 360 people across eight states since 2016; it builds on recent research concluding that telemedicine-facilitated medical abortions are just as safe for patients as the ones administered in-person.

Because it’s been reviewed by the FDA, the Gynuity trial is exempt from the dispensation limitation. The study operates in Maine, New York, New Mexico, Hawaii, Colorado, Oregon, Washington and Georgia. Gynuity’s trial in Georgia began a few weeks ago, shortly before the state passed its “fetal heartbeat” law.

“With a lot of these bans, there’s going to be a long legal battle,” Chong said, explaining that she didn’t expect the new Georgia law, which bans abortion after a fetal heartbeat is detected at about six weeks, to affect the study in that state just yet. But she noted that the recent spate of early abortion bans have alarmed patients, who are unsure whether their appointments are still legal.

Gynuity’s goal is to convince the FDA that dispensing abortion medication directly to women’s homes, or even to retail pharmacies, is safe and effective, and that restrictions on its dispensation should be eased, Chong said.

Outside the Gynuity trial, some providers across the country let patients drive to the facility closest to them and video chat a clinician located at another site. Planned Parenthood, for instance, lets patients in 14 states virtually consult with clinicians based elsewhere. Yet in many cases, the clinician must watch the patient ingest the pill on screen to comply with federal restrictions limiting where the medication can be dispensed. Women might still have to travel across state lines to access these services — and many don’t even realize these options exist.

“How’s a woman in Alabama going to know to go to a Georgia clinic to find services?” Chong said.

Read More

[type2diabetestreatments-blog]

The Scoop on Novo's New Faster-Acting FIASP Insulin

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/the-scoop-on-novos-new-faster-acting-fiasp-insulin/

The Scoop on Novo's New Faster-Acting FIASP Insulin

There's a new ultra fast-acting insulin on the market internationally, and hopefully before long it will become available to us here in the U.S. too.

You may have heard mention of FIASP, or Faster-Acting Insulin Aspart, that recently hit the market overseas and in Canada -- and been wondering what the deal is with this new super-fasting insulin. We put our ears to the ground to learn more about it, what PWDs (people with diabetes) who've started on this med are saying online, as well as what its manufacturer Novo Nordisk has to say about this new product that was just recently re-submitted to the FDA for consideration as a new type of medication.

Here's what we've heard:

Getting to Know FIASP

What exactly is Faster-Acting Insulin Aspart? Remember, insulin aspart is the official scientific name for the synthetic insulin analog that sells under the brand Novolog here in the States and NovoRapid internationally.

What's in a Name? OK, so maybe FIASP is not the most creative branding (sounds like a variety of wasps?), but the name certainly fits. Whether it will carry a new brand name here States when launched remains TBD.

By Vial or Pen? Internationally, FIASP is available by vial, Penfill, and FlexTouch insulin pen. Interestingly, we see that in Europe it's approved for insulin pumps but it's not pump-approved in Canada. Hmm. Here in the U.S., Novo tells us FIASP will only be available in pen form.

Timing Flexibility: FIASP can be taken anywhere from 2 minutes before a meal or up to 20 minutes after the start of a meal, and apparently works just as well as NovoRapid/NovoLog that is taken before mealtime. While Novo officially still recommends taking FIASP before the meal, overall they're touting more flexible dosing, mentioning “earlier, greater and faster absorption, thereby providing earlier insulin action." This something that Novo has also pushed with its new Tresiba basal insulin that can last as long as 42 hours.

Faster Absorption: It's twice as fast as regular NovoLog or NovoRapid. Getting into the science, that's because two "excipients" have been added to FIASP’s formulation -- Vitamin B3 (niacinamide) to increase the speed of absorption, and a naturally occurring Amino Acid (L-Arginine) for stability.

Better Post-Meal BGs: Clinical trial data in which more than 2,000 PWDs with type 1 and type 2 were tested using FIASP showed the new insulin was linked to a lower spike in post-meal BGs and was determined to be just as safe as NovoLog.

More Hypos?! However, data also shows patients had more hypos in the first two hours after eating a meal -- most likely, as the result of not being used to the quicker action.

A1C Effect: Yes, data also show that patients lowered their A1C levels. This remains important, despite the fact that PWDs have been saying for years (and the FDA has recently acknowledged) that A1C is not the end-all, be-all guage for diabetes care. So it will be interesting to watch how FIASP proves itself with other measures like time in range.

The FDA actually sidelined FIASP in Fall 2016, asking the company for more detailed information about the "assay for the immunogenicity and clinical pharmacology data." On March 29, Novo just re-submitted their FDA application for review, so it's TBD how quickly it moves from there. The company expects to hear back from regulators by year's end.

Real-Life Feedback on FIASP

How are patients liking FIASP? It's pretty early to tell still. And of course "fast-acting" is often a subjective term just like everything else in this pancreatically-challenged universe of ours; Your Diabetes May Vary.

One of the best visual explanations we've seen on FIASP to date comes from diabetes nurse specialist in London, UK, Ines Parro, who created this infographic for her informational site Daybetes:

And here's a sampling of some of the online feedback we've seen around the global Diabetes Online Community (shared with their permission, where applicable):

"I have been using FIASP for 30 days. I was using NovoRapid/NovoLog before. FIASP doses the same for me. I find that it starts to work faster than NovoRapid and it stops working a little faster as well around the 3-hour mark. It is too early to see results in my A1C. I did find some injection site discomfort the first few days, nothing serious. That has subsided now and I don't feel a thing with a bolus. I have tight control, 5.8% A1C last time. I think it will make a difference as I can stop a rising high post-meal BG much more effectively than with NovoRapid. I do notice that when I bolus there is a sensation similar to what I felt when injecting Lantus before I switched to the pump."

-- Steve, a Canadian in an OmniPod group on Facebook, who also mentions that insulin is available over the counter in his country.

"Have been on FIASP for a week now, and holy smokes -- what a difference that has made for my blood sugars and overall control. I barely have words to describe my gratitude. For my fellow pancreatically-challenged friends, cannot say enough about how much this has helped with meal-time dosing and corrections. Game-changer!! #fiasp #gamechanger #insulin"

- Sandy Struss in Canada

"Someone who has tried it said the initial drop is fast, so make sure you are eating and the tail is shorter... so far she likes it but she is also using it with a closed loop system."

-- from the Women with Diabetes group on Facebook

- Liz in Europe, discussing FIASP on Diabetes UK forums

"I've got some in my Omnipod right now. I don't find it works any faster or shorter acting than the Apidra that I had been using before (but Apidra was a lot faster and shorter-acting for me than Humalog and Novolog). What it did do though, was drop my BG way more than I expected, so I guess it is more effective. My very first meal with it I bolused the same 4 units that I normally would for the lunch I eat everyday, and my BG fell to 2.9 mmol/L (52 mg/dl) around 90 minutes after eating, where as normally, from the 6.5 I started at, Apidra or Humalog would have brought be down to 5.5 or 6.0 after eating. I've had to lower my basal rate as well, because I woke up three times last night to the low alarm from my Dexcom. I am using fewer units per day, but I find its effects less predictable than Apidra for me. There is probably going to be a descent length adjustment period to learn the idiosyncrasies of it."

- Vicka Plume in Canada, as posted on the TuDiabetes forums

We're also following our UK D-friend Tim Street over at DiabetTech, who's been experimenting and chronicling his FIASP experience since starting on it in March -- from his first 48 hours and initial impressions, to wondering if "this is, in fact, the next-gen insulin we've been waiting for?" He was initially enthusiastic, but ran into some snags later, as noted in his latest Further FIASP Insight blog post:

"At first it was a joy, with massively reduced bolusing time and huge efficiencies, however as the month has progressed, our friendship has soured somewhat. I’ve been needing more and more of it and it’s not been much fun trying to work out what’s been going on."

Specifically, Tim notes that while FIASP appears to work faster, it has also increased his insulin sensitivity and he's observing that it seems less effective per unit as time goes on. He wonders whether that could be a long-term issue for this product across the board, or maybe just an effect personal to him.

He also notes: "For meals with a slow absorption profile, there is a real risk of hypoing here if the upfront bolus is too high. It looks like it will be beneficial in the use of a square wave or dual wave/combi bolus though. I think these factors will need to be considered in changing to this insulin. People may need to re-learn their bolusing strategy dependent on the foods that they eat. Something for both PWDs and HCPs to be aware of when looking at changing."

We're happy to see Tim inviting others from around the D-Community to share their own experiences with FIASP, to help everyone better understand how it works in real life. Great idea, Tim!

Access and Affordability?

Of course, any new insulin product these days brings critical questions of access and affordability.

No matter how great the innovation, it doesn't much matter if people can't afford it or get access through their insurance plans. So what's the status of cost and coverage for FIASP?

We're told that in the EU and Canada, FIASP carries the same cost as existing Novolog insulin, whereas U.S. pricing has not yet been finalized, according to Novo.

That's a little unnerving given the complicated drug pricing and insurance coverage system we're faced with here in the States, where insurance plans have no real incentive to let patients change to newer or different medication varieties if they cost more. In fact, the payers are notoriously pushing patients to cheaper alternatives these days (i.e. non-medical switching), which gave birth to the #PrescriberPrevails advocacy campaign calling for physicians (and patients) to have the freedom to select the best treatment for the individual.

At the moment, we can only cross our fingers that PWDs will have reasonable access to any insulin they need, up to and including exciting faster-acting varieties that could improve results.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

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