#and not about... the healthcare

[colorisbyshe]

I do think it's interesting (yet extremely predictable) that the meme-ification of and conspiratorial thinking around Luigi has 100% smothered the embers of intentional movement. If you spend all of your time talking about how he didn't do it, someone else did, he's totally been framed you end up spending no time on actually talking about... what to do next?

A movement where no one actually did anything and nothing actually happens will always be a movement where no one does anything and nothing actually happens.

But it was always obvious it was going to go this way and it's gonna keep going this way because people are more interested in seeming smart and seeing the truth and jokes where no one else sees them than they are in like... figuring out what to do next

And I'm not above that, I don't know what to do next besides things so abstract they're meaningless but like... if there was a communal interest in doing this, it'd be much easier to figure this shit out together instead of just all of us, separately, spewing things so abstract they're meaningless

But tbh this post is a week late, everyone has moved on because no one has the attention span for a movement anyways

[gingersnapwolves]

So today I want to talk about puberty blockers for transgender kids, because despite being cisgender, this is a subject I’m actually well-versed in. Specifically, I want to talk about how far backwards things have gone.

This story starts almost 20 years ago, and it’s kind of long, but I think it’s important to give you the full history. At the time, I was working as an administrative assistant for a pediatric endocrinologist in a red state. Not a deep deep red state like Alabama, we had a little bit of a purple trend, but still very much red. (I don’t want to say the state at the risk of doxxing myself.) And I took a phone call from a woman who said, “My son is transgender. Does your doctor do hormone therapy?”

I said, “Good question! Let me find out.”

I went into the back and found the doctor playing Solitaire on his computer and said, “Do you do hormone therapy for transgender kids?” It had literally never come up before. He had opened his practice there in the early 2000s. This was roughly 2006, and the first time someone asked. Without looking up from his game of Solitaire, the doctor said, “I’ve never done it before, but I know how it works, so sure.”

I got back on the phone and told the mom, who was overjoyed, and scheduled an appointment for her son. He was the first transgender child we treated with puberty blockers. But not, by far, the first child we treated with puberty blockers, period. Because puberty blockers are used very commonly for children with precocious puberty (early-onset puberty). I would say about twenty percent of the kids our doctor treated were for precocious puberty and were on puberty blockers. They have been well studied and are widely used, safe, and effective.

Well. It turned out, the doctor I worked for was the only doctor in the state who was willing to do this. And word spread pretty fast in the tight-knit community of ‘parents of transgender children in a red state’. We started seeing more kids. A better drug came out. We saw some kids who were at the age where they were past puberty, and prescribed them estrogen or testosterone. Our doctor became, I’m fairly sure, a small folk hero to this community. 

Insurance coverage was a struggle. I remember copying articles and pages out of the Endocrine Society Manual to submit with prior authorization requests for the medications. Insurance coverage was a struggle for a lot of what we did, though. Growth hormone for kids with severe idiopathic short stature. Insulin pumps, which weren’t as common at the time, and then continuous glucose monitoring, when that came out. Insurance struggles were just part and parcel of the job.

I remember vividly when CVS Caremark, a pharmaceutical management company, changed their criteria and included gender dysphoria as a covered diagnosis for puberty blockers. I thought they had put the option on the questionnaire to trigger an automatic denial. But no - it triggered an approval. Medicaid started to cover it. I got so good at getting approvals with my by then tidy packet of articles and documentation that I actually had people in other states calling me to see what I was submitting (the pharmaceutical rep gave them my number because they wanted more people on their drug, which, shady, but sure. He did ask me if it was okay first).

And here’s the key point of this story:

At no point, during any of this, did it ever even occur to any of us that we might have to worry about whether or not what we were doing was legal.

It just never even came up. It was the medically recommended treatment so we did it. And seeing what’s happening in the UK and certain states in America is both terrifying and genuinely shocking to me, as someone who did this for almost fifteen years, without ever even wondering about the legality of it.

The doctor retired some years ago, at which point there were two other doctors in the state who were willing to prescribe the medications for transgender kids. I truly think that he would still be working if nobody else had been willing to take those kids on as patients. He was, by the way, a white cisgender heterosexual Boomer. I remember when he was introduced to the concept of ‘genderfluid’ because one of our patients on HRT wanted to go off. He said ‘that’s so interesting!’ and immediately went to Google to learn more about it. 

I watched these kids transform. I saw them come into the office the first time, sometimes anxious and uncertain, sometimes sullen and angry. I saw them come in the subsequent times, once they were on hormone therapy, how they gradually became happy and confident in themselves. I saw the smiles on their faces when I gave them a gender marker letter for the DMV. I heard them cheer when I called to tell them I’d gotten HRT approved by insurance and we were calling in a prescription. It was honestly amazing and I will always consider the work I did in that red state with those kids to be something I am incredibly proud of. I was honored to be a part of it.

When I see all this transgender backlash, it’s horrifying, because it was well on the way to become standard and accepted treatment. Insurances started to cover it. Other doctors were learning to prescribe it. And now … it’s fucking illegal? Like what the actual fuck. We have gone so far backwards that it makes me want to cry. I don’t know how to stop this slide. But I wrote this so people would understand exactly how steep the slide is.

[bluesky-out-of-context]

[theabigailthorn]

"trans people deserve love respect and dignity" - sweet nothing, pablum, easy to co-opt into nonperformative statements, it's giving Labour Party

"Public Official X's specific decision to Y is completely unevidenced and is harming trans people. Public Official X should resign or face consequences." - unco-optable, focused on justice, deliciously angry

[reasonsforhope]

A new treatment combining ReCET and semaglutide could eliminate the need for insulin in type 2 diabetes, with 86% of participants in a study no longer requiring insulin therapy. The treatment was safe and well-tolerated, and further trials are planned to confirm these results.

Groundbreaking research presented at UEG Week 2024 introduces a promising new treatment approach for type 2 diabetes (T2D) that has the potential to greatly reduce or even eliminate the need for insulin therapy.

This innovative approach, which combines a novel procedure known as ReCET (Re-Cellularization via Electroporation Therapy) with semaglutide, resulted in the elimination of insulin therapy for 86% of patients.

Globally, T2D affects 422 million people... While insulin therapy is commonly used to manage blood sugar levels in T2D patients, it can result in side effects... and further complicate diabetes management. [Note: Also very importantly it's fucking bankrupting people who need it!!] A need therefore exists for alternative treatment strategies.

Study Design and Outcomes

The first-in-human study included 14 participants aged 28 to 75 years, with body mass indices ranging from 24 to 40 kg/m². Each participant underwent the ReCET procedure under deep sedation, a treatment intended to improve the body’s sensitivity to its own insulin. Following the procedure, participants adhered to a two-week isocaloric liquid diet, after which semaglutide was gradually titrated up to 1mg/week.

Remarkably, at the 6- and 12-month follow-up, 86% of participants (12 out of 14) no longer required insulin therapy, and this success continued through the 24-month follow-up. In these cases, all patients maintained glycaemic control, with HbA1c levels remaining below 7.5%.

Tolerability and Safety

The maximum dose of semaglutide was well-tolerated by 93% of participants, one individual could not increase to the maximum dose due to nausea. All patients successfully completed the ReCET procedure, and no serious adverse effects were reported.

Dr Celine Busch, lead author of the study, commented, “These findings are very encouraging, suggesting that ReCET is a safe and feasible procedure that, when combined with semaglutide, can effectively eliminate the need for insulin therapy.”

“Unlike drug therapy, which requires daily medication adherence, ReCET is compliance-free [meaning: you don't have to take it every day], addressing the critical issue of ongoing patient adherence in the management of T2D. In addition, the treatment is disease-modifying: it improves the patient’s sensitivity to their own (endogenous) insulin, tackling the root cause of the disease, as opposed to currently available drug therapies, that are at best disease-controlling.”

Looking ahead, the researchers plan to conduct larger randomized controlled trials to further validate these findings. Dr. Busch added, “We are currently conducting the EMINENT-2 trial with the same inclusion and exclusion criteria and administration of semaglutide, but with either a sham procedure or ReCET. This study will also include mechanistic assessments to evaluate the underlying mechanism of ReCET.”

-via SciTechDaily, October 17, 2024

--

Note: If it works even half as well as suggested, this could free so many people from the burden of the ongoing ridiculous cost of insulin. Pharma companies that make insulin can go choke (hopefully).

[gmaybe666]

free luigi the new italian american folk hero

[wilwheaton]

[arch-aeology]

Merry Christmas! Here’s a Jayvik au where they’re college students in 80s New York

[irlcupcake]

10 of my favorite easy glow up tips! 𐙚 ‧₊˚ ⋅

get a gua sha!! not expensive at all and made such a difference in my face shape and carving out my cheek bones and jawline. there’s lots of good tutorials on tiktok or youtube!

tea in the morning/night! there’s so many teas to help with different things but my favorite’s are spearmint tea for clearing skin and green tea for reducing bloating.

ice your face! helps SO much with de-puffing and closing up your pores! dipping your face in a bowl with ice water can reduce inflammation, help with acne and reduce oily skin!

make sure to get enough sleep! It’s so easy to stay up scrolling on tumblr until the sun comes up but getting enough sleep is so important mentally and physically!

find a skincare routine that works for you and remember too much skincare can be bad for your skin! my skin was breaking out the worst when i was using a bunch of skincare and It’s cleared so much since i simplified my routine.

use a lash/brow serum! my favorite brand is grande lash and it’s a little pricey but using castor oil works as well and it’s super affordable.

going on walks! I’ve never been a fan of intense exercises and I’m a chronic bed rotter but putting on my favorite hot girl playlist and strutting on the treadmill/sidewalk is genuinely so fun!

rosemary oil for hair growth! my holy grail of hair growth products along with a scalp massager. my whole life my hair grew so slow and since using rosemary oil i have to trim my bangs twice a month sometimes!

i cannot stress this one enough..wear what YOU want! don’t let new trends or judgment from others stop you from embracing your true style. we look our best when we feel most confident!

most importantly ~ take care of yourself! make sure you’re eating enough, drinking water, listening to your body and being gentle with yourself always. improving ourselves can be so fun but make sure it’s not at the expense of your mental health <3

[charl0ttan]

whats really really scary that i think abt a lot is how many people lived their entire lives not knowing it could be better and what are the odds that i was born into a life that breaks that cycle. what am i missing out on

[gingersnapwolves]

You know what since I’ve got a ton of new followers because my post on puberty blockers took off and people apparently want to see me rant, I’m gonna get up on my soapbox for a PSA for tumblr’s aging userbase.

Do not! Get! A Medicare Advantage plan!

Tell your parents not to get one. Tell your aunts and uncles not to get one. Tell your friends not to get one.

Why is that, you might say? Kouri, what is a Medicare Advantage plan, you might say?

tl;dr Medicare is the government healthcare plan for Americans of a certain age or with certain disabilities. It is owned, administered, and operated by the government. You are entitled, if you wish, to outsource your Medicare and have your policy run by a commercial group, such as United HealthCare, Cigna, Aetna, et cetera.

Here’s how it works: For everyone who signs up for, say, a plan that rhymes with Figna Medicare Advantage, Medicare gives Figna a certain amount of money and says ‘use this to take care of this patient’.

You can see where this is going, right? Figna says ‘sure boss! *wink nudge*’ and then shoves as much of that money into their own pockets as possible, and they do that by finding excuses to NOT pay for your medical care.

Medicare Advantage plans are pushed and marketed heavily. They’ll call you. They’ll set up stands in your PCP office to try to encourage you to buy in. They will say things like ‘with Medicare, you have to pay a 20% coinsurance, but with us you only have a 10% coinsurance’ and completely neglect to tell you that having a smaller coinsurance only matters if they approve the fucking care that you need, which often they won’t (while Medicare would have) and if your doctors are willing to accept it, which often they don’t (while they do accept Medicare).

Is Medicare perfect? Absolutely not! I've got my share of bones to pick with them. But simply put:

Medicare is government administered. It is a service. It costs the government money, which is why the GOP is always trying to cut funding to it. Medicare Advantage is corporately administered. It is supposed to make money. Which gives them incentives to deny your care and fuck you over that Medicare simply does not have.

Do not. Get. A Medicare Advantage Plan.

[haberdashing]

Musings on the "depose" part of "deny, defend, depose":

When I first read those words, my mind, like most people's I think, read "depose" in the sense of "overthrow". Like how you'd depose a king, kicking him out of his position of authority, in a way that may or may not involve him losing his life as well as his power over others.

But when I mentioned it to a friend, that friend brought up that the word has a second meaning that might be relevant here as well.

In the legal field, "depose" is the verb form of "deposition". Deposition itself is one of the ways you can go about getting evidence from somebody. A deposition is when you get someone to swear that they're telling the truth, and you ask them questions, or ask them for explanations, and they have to answer truthfully. Documents might be part of a deposition, but it's not about the documents themselves, exactly; it's about what they mean, the essential truth behind what the documents describe.

(In my line of work, this might be something like, "Does that income amount listed on your court filing include this bonus listed in your bank statements?" but with a lot of questions leading up to that one to establish things like the bonus being from their employer and deposited into their bank account.)

In a way, it's like the cross-examination part of a trial isolated. (Assuming that it's the other side being deposed; it could also be a witness or third party, but almost by definition you only do depositions on a party that isn't your own client in the case.) One side asks the hard questions, and unless those questions break rules, the other side has to answer them. And like cross-examination, if someone's not truthful in a deposition, that can cause them to face all sorts of sanctions for perjury.

Now, it's very probable that the assassin in this case meant the word only in the more commonplace sense of the word, comparing the CEO to a ruler that needs to be removed from power. But when you consider the legal definition of the word, it seems almost like an ultimatum:

Tell the truth about your unjust business practices, or else lose your power to enact them.

Be deposed, or else be deposed.

[faerygardenparty]

Idk it just annoys me as someone who was heavily affected by a mass shooting and had to suffer through a media parade of “he was just a poor bullied mentally ill kid who sat alone at lunch 😢” nonstop right after not knowing if I’ll ever see my friends again, only for THIS to be the fucking case where all of a sudden everyone grows a conscious and decides we’re not allowed to sympathize with the killer, like fuck right off, I spent the latter half of high school wondering if I was going to be next, there are still days where I can barely stand to be out in public places, I don’t actually give a shit that billionaire CEOs with their private security teams are crying about how scary it is and they don’t know if they’re going to be next and how we should all feel so so bad for them, that same sympathy was never extended to me or my loved ones so why should I give it to them?

[andhumanslovedstories]

I went to the emergency room the other day to get an MRI after I tripped over my own feet and fell face-first three feet down into a window well. Crazy that didn’t kill me. Anyway, I’m in the ER getting an IV put in by this nurse, and he’s joking with me, I’m joking back, it’s lighthearted, fine time, etc. I go back to the waiting room, then about 20 mins later, I get called back to the same booth where I got my IV so I can get some Ativan prior to the MRI.

(Even they were explaining I was gonna get an MRI, they were like “are you claustrophobic?” And I was like “in some circumstances yes, and in others no. Let’s not roll the dice on which circumstance an MRI would fall under. It went fine, no worries, definitely could have gone without the Ativan, but I can get why going headfirst into the screaming tube that thumps like a dryer with a shoe inside could stress some people out.)

Anyway, I’m back there, and the same nurse comes over, confused to see me, and goes, “huh did I forget something?”

And me, thinking he’s joking around again and knows that I’m here to get a medication, go “haha I guess there’s something else you gotta stick in me.”

Then he didnt say anything, and I played back what I said, just as another nurse came over and told him, “oh she’s here to get the Ativan,” so he gave me Ativan, and I smiled and thanked him, and the second he left, I grabbed Katie’s arm and hissed in complete mortification, “I guess there’s something else you gotta stick in me????” And she was like, yeah. You did a very bad job talking.

Anyway at least medically my brain is fine

[can-we-be-kind]

I genuinely wonder if this is going to start something

Will more people start killing CEOs?

Are there more people willing to potentially give up their freedom for the ‘greater good’?

How many people are in the position to actually access a weapon and be within proximity to a billionaire?

Will there actually be a revolution?

Are people too scared to actually start something?

Are the people who want to, too young, too weak, too ill, ect. to actually be able to do something?

Are you able to actively do something?

Are you able to go outside right now and kill a CEO?

Are the charities working? Are the protests working? Are the movements working?

Is it really getting better?

Maybe if you don’t like something, you should do something.

I dunno man, maybe 1700s France was onto something

[erinwantstowrite]

i am absolutely baffled by the amount of people who keep calling the CEO killer "just like Batman" because I thought it was common fucking knowledge that that man does not use guns??? and does not kill???? before I even got into Batman that was very much something that I knew. just because he is a vigilante does not mean that he's like Batman. I've even seen people call him the Joker???? what planet are you fucking living on??? if you want to compare him to a Batman character look at literally half of his kids when they're having a bad day. I'm more inclined to believe that this is something Jason Todd would do, if he somehow was like "I need to be discreet about it" for the first time in his life. honestly I can see Tim doing it. I know they keep saying that Tim did not kill anybody when he blew up all of the League bases... but let's be real for two seconds. Tim Drake has an alternate future where he becomes Gun Batman. he knows how to create multiple fake identities for himself and rarely gets caught. in a timeline where he wasn't losing his shit and was planning out a murder meticulously for a reason and a message it'd be like this. Jason and Tim both have the dramatics to put the Monopoly money in a backpack. Actually they'd consider this a bonding exercise and do it together