#and this is like. a patient with insurance and money at what is considered a very high-end facility!

[celiaelise]

I guess I already knew this, but it's always kind of astonishing how little medical providers seem to feel the need to communicate with their patients!

Like, my mom had surgery yesterday, and her doctor hasn't even committed to her getting to stay in the hospital again tonight. Even though she's expressed her desire to do so several times, and to several people, we're still not certain we won't have to take her home today. And it's almost 1pm!

Even disregarding the simple rudeness of that, and the stress the uncertainty could cause for the patient, (which, like. Shouldn't be disregarded.) there's also the logistical issues! Someone else has to take her home, and take care of her! People have jobs, and commitments!! Some people (though luckily neither I nor my brother) have children to take care of!! You can't just expect a whole family to be put on hold indefinitely, and if you DO expect that, you need to clearly communicate that expectation!! (I made sure my schedule was clear for 3 days, but it's the principle.)

And they don't tell her much about her schedule for the day, or anything. The nurses have mostly been very nice and polite, but it's difficult for her to get definitive answers to her questions from them. She hasn't even been told whether it's okay for her to use the shower in her room, even though she's expressed that not having showered is making her uncomfortable. They all act like the decisions are up to someone else, but no one seems to know who the "someone else" is. I mean, I guess it's the doctor, who spent maybe a total of five minutes talking to my mom early this morning. I'm told he mostly said, "we'll have to see how you do", which would be more understandable if he had actually made an appearance since. Like, how are you going to "see how she does" if you haven't even seen her??

I will grant, my mother is very passive and deferential and will not ask follow-up questions, but, like, so are many other people??? That doesn't mean they don't deserve information about their care! And communicating with patients who are reticent to communicate should be a skill and a priority to these providers, not something they can neglect.

Also, she specifically told us before her surgery, "was I nice? I want them to like me so that they are careful with me." She was scared!! They put her under and cut her leg open and apart, and she was nervous about that, and was aware that they would have all the power when it was happening!! She hasn't told anyone here that they're all mispronouncing her last name for the same reason. She doesn't want to ruffle any feathers, because she knows that these people are in a position to, very literally, hurt her if she does.

And, yeah, personally, I don't share these fears. I believe in advocating for myself, and, if I can't trust in my providers' compassion for me or their pride in their own work, I'm willing to put my faith in the power my money has over them, and the power I have to potentially make life more difficult for them in the future. But, like, my mother's not wrong, either!

[mostlysignssomeportents]

Conspiratorialism as a material phenomenon

I'll be in TUCSON, AZ from November 8-10: I'm the GUEST OF HONOR at the TUSCON SCIENCE FICTION CONVENTION.

I think it behooves us to be a little skeptical of stories about AI driving people to believe wrong things and commit ugly actions. Not that I like the AI slop that is filling up our social media, but when we look at the ways that AI is harming us, slop is pretty low on the list.

The real AI harms come from the actual things that AI companies sell AI to do. There's the AI gun-detector gadgets that the credulous Mayor Eric Adams put in NYC subways, which led to 2,749 invasive searches and turned up zero guns:

https://www.cbsnews.com/newyork/news/nycs-subway-weapons-detector-pilot-program-ends/

Any time AI is used to predict crime – predictive policing, bail determinations, Child Protective Services red flags – they magnify the biases already present in these systems, and, even worse, they give this bias the veneer of scientific neutrality. This process is called "empiricism-washing," and you know you're experiencing it when you hear some variation on "it's just math, math can't be racist":

https://pluralistic.net/2020/06/23/cryptocidal-maniacs/#phrenology

When AI is used to replace customer service representatives, it systematically defrauds customers, while providing an "accountability sink" that allows the company to disclaim responsibility for the thefts:

https://pluralistic.net/2024/04/23/maximal-plausibility/#reverse-centaurs

When AI is used to perform high-velocity "decision support" that is supposed to inform a "human in the loop," it quickly overwhelms its human overseer, who takes on the role of "moral crumple zone," pressing the "OK" button as fast as they can. This is bad enough when the sacrificial victim is a human overseeing, say, proctoring software that accuses remote students of cheating on their tests:

https://pluralistic.net/2022/02/16/unauthorized-paper/#cheating-anticheat

But it's potentially lethal when the AI is a transcription engine that doctors have to use to feed notes to a data-hungry electronic health record system that is optimized to commit health insurance fraud by seeking out pretenses to "upcode" a patient's treatment. Those AIs are prone to inventing things the doctor never said, inserting them into the record that the doctor is supposed to review, but remember, the only reason the AI is there at all is that the doctor is being asked to do so much paperwork that they don't have time to treat their patients:

https://apnews.com/article/ai-artificial-intelligence-health-business-90020cdf5fa16c79ca2e5b6c4c9bbb14

My point is that "worrying about AI" is a zero-sum game. When we train our fire on the stuff that isn't important to the AI stock swindlers' business-plans (like creating AI slop), we should remember that the AI companies could halt all of that activity and not lose a dime in revenue. By contrast, when we focus on AI applications that do the most direct harm – policing, health, security, customer service – we also focus on the AI applications that make the most money and drive the most investment.

AI hasn't attracted hundreds of billions in investment capital because investors love AI slop. All the money pouring into the system – from investors, from customers, from easily gulled big-city mayors – is chasing things that AI is objectively very bad at and those things also cause much more harm than AI slop. If you want to be a good AI critic, you should devote the majority of your focus to these applications. Sure, they're not as visually arresting, but discrediting them is financially arresting, and that's what really matters.

All that said: AI slop is real, there is a lot of it, and just because it doesn't warrant priority over the stuff AI companies actually sell, it still has cultural significance and is worth considering.

AI slop has turned Facebook into an anaerobic lagoon of botshit, just the laziest, grossest engagement bait, much of it the product of rise-and-grind spammers who avidly consume get rich quick "courses" and then churn out a torrent of "shrimp Jesus" and fake chainsaw sculptures:

https://www.404media.co/email/1cdf7620-2e2f-4450-9cd9-e041f4f0c27f/

For poor engagement farmers in the global south chasing the fractional pennies that Facebook shells out for successful clickbait, the actual content of the slop is beside the point. These spammers aren't necessarily tuned into the psyche of the wealthy-world Facebook users who represent Meta's top monetization subjects. They're just trying everything and doubling down on anything that moves the needle, A/B splitting their way into weird, hyper-optimized, grotesque crap:

https://www.404media.co/facebook-is-being-overrun-with-stolen-ai-generated-images-that-people-think-are-real/

In other words, Facebook's AI spammers are laying out a banquet of arbitrary possibilities, like the letters on a Ouija board, and the Facebook users' clicks and engagement are a collective ideomotor response, moving the algorithm's planchette to the options that tug hardest at our collective delights (or, more often, disgusts).

So, rather than thinking of AI spammers as creating the ideological and aesthetic trends that drive millions of confused Facebook users into condemning, praising, and arguing about surreal botshit, it's more true to say that spammers are discovering these trends within their subjects' collective yearnings and terrors, and then refining them by exploring endlessly ramified variations in search of unsuspected niches.

(If you know anything about AI, this may remind you of something: a Generative Adversarial Network, in which one bot creates variations on a theme, and another bot ranks how closely the variations approach some ideal. In this case, the spammers are the generators and the Facebook users they evince reactions from are the discriminators)

https://en.wikipedia.org/wiki/Generative_adversarial_network

I got to thinking about this today while reading User Mag, Taylor Lorenz's superb newsletter, and her reporting on a new AI slop trend, "My neighbor’s ridiculous reason for egging my car":

https://www.usermag.co/p/my-neighbors-ridiculous-reason-for

The "egging my car" slop consists of endless variations on a story in which the poster (generally a figure of sympathy, canonically a single mother of newborn twins) complains that her awful neighbor threw dozens of eggs at her car to punish her for parking in a way that blocked his elaborate Hallowe'en display. The text is accompanied by an AI-generated image showing a modest family car that has been absolutely plastered with broken eggs, dozens upon dozens of them.

According to Lorenz, variations on this slop are topping very large Facebook discussion forums totalling millions of users, like "Movie Character…,USA Story, Volleyball Women, Top Trends, Love Style, and God Bless." These posts link to SEO sites laden with programmatic advertising.

The funnel goes:

i. Create outrage and hence broad reach;

ii, A small percentage of those who see the post will click through to the SEO site;

iii. A small fraction of those users will click a low-quality ad;

iv. The ad will pay homeopathic sub-pennies to the spammer.

The revenue per user on this kind of scam is next to nothing, so it only works if it can get very broad reach, which is why the spam is so designed for engagement maximization. The more discussion a post generates, the more users Facebook recommends it to.

These are very effective engagement bait. Almost all AI slop gets some free engagement in the form of arguments between users who don't know they're commenting an AI scam and people hectoring them for falling for the scam. This is like the free square in the middle of a bingo card.

Beyond that, there's multivalent outrage: some users are furious about food wastage; others about the poor, victimized "mother" (some users are furious about both). Not only do users get to voice their fury at both of these imaginary sins, they can also argue with one another about whether, say, food wastage even matters when compared to the petty-minded aggression of the "perpetrator." These discussions also offer lots of opportunity for violent fantasies about the bad guy getting a comeuppance, offers to travel to the imaginary AI-generated suburb to dole out a beating, etc. All in all, the spammers behind this tedious fiction have really figured out how to rope in all kinds of users' attention.

Of course, the spammers don't get much from this. There isn't such a thing as an "attention economy." You can't use attention as a unit of account, a medium of exchange or a store of value. Attention – like everything else that you can't build an economy upon, such as cryptocurrency – must be converted to money before it has economic significance. Hence that tooth-achingly trite high-tech neologism, "monetization."

The monetization of attention is very poor, but AI is heavily subsidized or even free (for now), so the largest venture capital and private equity funds in the world are spending billions in public pension money and rich peoples' savings into CO2 plumes, GPUs, and botshit so that a bunch of hustle-culture weirdos in the Pacific Rim can make a few dollars by tricking people into clicking through engagement bait slop – twice.

The slop isn't the point of this, but the slop does have the useful function of making the collective ideomotor response visible and thus providing a peek into our hopes and fears. What does the "egging my car" slop say about the things that we're thinking about?

Lorenz cites Jamie Cohen, a media scholar at CUNY Queens, who points out that subtext of this slop is "fear and distrust in people about their neighbors." Cohen predicts that "the next trend, is going to be stranger and more violent.”

This feels right to me. The corollary of mistrusting your neighbors, of course, is trusting only yourself and your family. Or, as Margaret Thatcher liked to say, "There is no such thing as society. There are individual men and women and there are families."

We are living in the tail end of a 40 year experiment in structuring our world as though "there is no such thing as society." We've gutted our welfare net, shut down or privatized public services, all but abolished solidaristic institutions like unions.

This isn't mere aesthetics: an atomized society is far more hospitable to extreme wealth inequality than one in which we are all in it together. When your power comes from being a "wise consumer" who "votes with your wallet," then all you can do about the climate emergency is buy a different kind of car – you can't build the public transit system that will make cars obsolete.

When you "vote with your wallet" all you can do about animal cruelty and habitat loss is eat less meat. When you "vote with your wallet" all you can do about high drug prices is "shop around for a bargain." When you vote with your wallet, all you can do when your bank forecloses on your home is "choose your next lender more carefully."

Most importantly, when you vote with your wallet, you cast a ballot in an election that the people with the thickest wallets always win. No wonder those people have spent so long teaching us that we can't trust our neighbors, that there is no such thing as society, that we can't have nice things. That there is no alternative.

The commercial surveillance industry really wants you to believe that they're good at convincing people of things, because that's a good way to sell advertising. But claims of mind-control are pretty goddamned improbable – everyone who ever claimed to have managed the trick was lying, from Rasputin to MK-ULTRA:

https://pluralistic.net/HowToDestroySurveillanceCapitalism

Rather than seeing these platforms as convincing people of things, we should understand them as discovering and reinforcing the ideology that people have been driven to by material conditions. Platforms like Facebook show us to one another, let us form groups that can imperfectly fill in for the solidarity we're desperate for after 40 years of "no such thing as society."

The most interesting thing about "egging my car" slop is that it reveals that so many of us are convinced of two contradictory things: first, that everyone else is a monster who will turn on you for the pettiest of reasons; and second, that we're all the kind of people who would stick up for the victims of those monsters.

Tor Books as just published two new, free LITTLE BROTHER stories: VIGILANT, about creepy surveillance in distance education; and SPILL, about oil pipelines and indigenous landback.

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/2024/10/29/hobbesian-slop/#cui-bono

Image: Cryteria (modified) https://commons.wikimedia.org/wiki/File:HAL9000.svg

CC BY 3.0 https://creativecommons.org/licenses/by/3.0/deed.en

[preet-01]

K — Detective/Criminal for @witchywitchy19

It was a demotion. Lewis was absolutely sure of it.

How else would he go from undercover stings busting drug rings and mobs to investigating stolen art that he was 90 percent sure the museum was “losing” for the insurance claims? Though there were the benefits of being able to actually spend time with his husband now that he wasn’t always undercover for his job.

“It makes no sense, Seb,” Lewis groans as he rants about the latest developments in his case. The latest development being that there were no developments and Lewis was absolutely losing his mind having to deal with the museum’s art director — Nico Rosberg, a former friendship that had turned sour sometime during their college days.

He’d been able to avoid interactions with Nico and his petty remarks for so long, but with this case he had to deal with Nico everyday.

“Maybe take a step back and talk through the facts,” Sebastian advises. It’s a strategy Lewis knows that Seb loves to use with his patients. “What was stolen?”

“A rare Rembrandt painting that Nico so kindly has emphasized the importance of in every meeting we’ve had,” Lewis replies, cuddling closer to Seb.

“Anything else?” Seb inquires.

“Not according to the museum. Jenson is doing an audit with some of the museum guys to make sure nothing else was stolen,” Lewis says. To the naked eye, only the Rembrandt was missing. But the concern was that a reproduction had been hanging in the gallery as the actual painting was undergoing regularly scheduled maintenance inspections. So it was in the museum archive with a bunch of other stuff that wasn’t on display.

“Signs of breaking and entering?”

“That’s the thing, nothing is out of order. The cameras all worked with the exception of two — one that has been broken for the past three weeks and the one situated above the painting. The locks weren’t tampered with. And the reproduction wasn’t touched at all in the glass case. The thief knew to check the archive.” Lewis rants.

“Huh,” Seb says.

“Huh? What are you thinking of?” Lewis inquires.

“Well, you said the reproduction was hanging, right?” Seb asks as Lewis nods. “The only people who would know a reproduction is hanging in the museum while the original would be the museum staff, right?”

“They would know how to avoid the cameras, which ones worked, which one to tamper. They would have access to the building,” Lewis rambles off as pieces fall into place. There’s still more work to do, but things are starting to make sense and it’s a lead.

_______

“You’re late,” Mark says, “what took so long?”

“My husband was taken off of undercover and moved to robberies,” Sebastian answers with a sigh as he pulls out the Rembrandt that had driven Lewis crazy a month ago. “The Rembrandt robbery was his first case since that move. It requires caution when the detective trying to catch you is sleeping in your bed,” Sebastian adds.

“Considering you and the painting are here, I assume he didn’t crack the case,” Mark states as his guy checks the painting’s authenticity.

“He put away the museum’s art director,” Sebastian reveals.

“What did the art director do?” Mark’s guy — some pale twenty some year old with brown hair and an Australian accent just like Mark 1- asks.

“Nothing recently,” he answers, “years ago? Well that’s a different matter.”

“It’s a Rembrandt,” Mark’s guy tells them.

After making sure the wire transfer goes through, Sebastian returns home. A weight had been lifted from Lewis’ shoulders ever since the Rembrandt case had been closed which meant that Lewis could actually enjoy not being on the undercover unit.

And tonight was date night where he’s sure Lewis will bring up the idea of adopting. The Rembrandt money will help pay for a bigger home and the cost of raising a child. Not that Lewis would know it’s Rembrandt money, no as far as Lewis knew, Seb had a rich distant uncle in Germany that left his money to Seb.

He hadn’t intended for the blame to fall on Nico, but two birds one stone, gift horse, and all of that. The ghost of Nico and their college years couldn’t haunt them with the man locked away in a prison three hours away.

[fvckw4d]

In the US we have many types of doctors offices. If you have insurance, there's a Primary Care Doctor, who can't treat anything that isn't a cold. Their job for most people, especially the chronically ill, is to run blood tests and refer you to a specialist. A specialist is a doctor who went to extra school so they could only solve one specific issue at a time and their wait lists are usually months long because most people don't go to their doctors for colds or anything else you can solve in 15 minutes - the typical amount of time each patient is alloted with their doctor before they become "problem patients" - because doctors are expensive, so they get referred out. These doctors might be next door from your PCP or they might be hours long drives away.

If you don't have insurance or dont have months to wait, there's a Urgent Care, which is an oxymoron because you will not be seen urgently, but more like between 1 and 8 hours depending on your luck. They mostly exist to bridge the gap of PCPs and ERs, to make sure you can be medically neglected no matter what day of the week it is.* They can't prescribe most medications and don't have most equipment that a specialist or ER has, or even that your PCP has, because their real purpose is to prevent the poor or inconveintly-timed sick from clogging up the ER. There are versions of these in some of the bigger pharmacy franchises because making a lot of money selling drugs means you're basically qualified to be a doctors office.

(*most doctors offices are closed on the weekends and before 5pm.)

The ER, or emergency room, is a last resort doctor. Anyone will tell you that, it's for dying people didn't you know, which is why wait times are typically 8 hours. Yes we all know that it's the only place thats open all hours of the day and every day of the week, or has equipment that most doctors dont, or is legally required to see you no matter how insured you are. But if you go there without an emergency, it's because you're selfish and stealing time away from literal dying people, which will be the excuse used whenever you receive subpar care no matter why you went there or who is talking to you. The ER is a really good place to be diagnosed with anxiety and drug addiction by a doctor who isn't a psychiatrist or addiction specialist, no matter what your symptoms are. ERs also cost 10x the amount a PCP or Urgent Care does, but there's not much they can do to make you pay the bill, so this is a common choice for the absolutely destitute.

If you are poor, especially if you have "specialized needs" because you are queer or not white or homeless or have limited transportation, you might go to a wellness center or walk in clinic or what have you. They have a lot of names, but they're basically the same thing. This is the only publically funded healthcare in the US and the only place that will give you free or sliding scale healthcare, one of the only places you can go without needing an appointment (if you are fortunate), and one of the only places that you get care for things like HIV prevention or birth control or HRT. They don't have most of the equipment of even an Urgent Care. Every doctor there is severely overworked and most secretly think you're a junkie. It's a good place to get diagnosed with being high.

If all of this sounds bad to you, you might consider having enough money enough to afford a concierge doctor, which is a pet doctor rich people buy. They work much like how family doctors used to work about 50+ years ago, meaning they are on call at all times and will treat you at home. They're known for being willing to write any prescription you want, no more having to beg and plead and prove you aren't going to abuse your pills and aren't just a little anxious, which is how it works for everyone else.

And that's pretty much it. So many options, right? Tune in next week to hear about the state of mental healthcare in the good ol' US of A.

[shiraishi--kanade]

Wait so you have universal health care and also have huge medical bills??? I'm genuinely confused

Anon, you're probably American and you know what, I'm as confused about how American healthcare works and how therefore you guys imagine universal healthcare works as you are, so I'm not going to hold it against you.

But here's how it works in my country:

1. I have a heart disease. I go to a cardiologist in my city. My cardiologist takes one good look at me and says: "I'm sorry, we have nothing to help you here"- (because they lack the medical equipment, educated staff, or, in more cases than not, both). -"Here's reception contact for our state cardiology clinic, please go there."

2. So I go to the state clinic (that is located a fair distance away). They take a closer look at me, and they would treat about 60% cases that come to them, but then will also say "here's your meds and diagnosis but we don't have the equipment or staff to be 100% sure this is what's wrong. Have you considered..."

And then they refer me to a private hospital. Or a private clinic. Regardless, a private doctor, who charges their patients like everyone else does, and that pay goes up in thousands and tens of thousands for diagnostic processing or monitoring alone. And that's where I actually get my treatment. And my bills. Because regardless if you have universal healthcare or not, healthcare industry exists and will continue to exist.

State-funded healthcare (which we call free but it's not actually free, it's just paid for you by the state) will never be able to compete with the private healthcare industry because 1) the state doesn't receive any profit, and in fact only loses money on providing healthcare, 2) the state therefore does only the bare minimum to keep up with the demand, and usually doesn't necessitate enough funding to provide new technology and equipment or training, if any, 3) the medical staff, who have no equipment or training or pay, says "screw this, I'm out" and goes into the private field, where they actually have a shot at having a decent pay and working conditions.

Therefore the universal healthcare institution grows only weaker.

Is it fucked up? Yeah. Does it bring unnecessary suffering to anyone? Also yeah. But if you're any level of smart in this situation you'd just skip the first two steps and immediately go and pay to get treated properly instead of risk wasting PTO, gas and possibly your pre-existing condition flaring up to go through the routine.

And this is also why medical insurance is starting to get traction in my country with universal healthcare, because universal healthcare doesn't mean that you can get all the medical services free of charge but rather that there are options provided for you. No-one ever said these options have to not suck, especially for someone with a chronic condition. Fun!

Still better than the USA though I will admit to that.

[riverthebooknerd]

OPENING COMMISSIONS, BROKE QUEER 18 Y/O, PLEASE READ <3

Hey everyone!! For those who don't know, I finally got a decent job after months of searching! Unfortunately, I'm still dead broke, and in order to start my job, I need a bunch of training and verification. No biggie, except the verification is, in total, a few hundred dollars… plus I'm still having to pay for gas and phone bills and insurance…

I'm going to be completely transparent with y'all. I'm almost out of savings, and if I'm not able to get some kind of money, I'll have to ask my parents for help. They'd do it, and they've made it clear that they have no issues with lending me money if I need it, but I would REALLY rather not have to ask them. They've already given me way too much, and it's… embarrassing, for me, to be depending on them as much as I am.

Another thing is that I'm trying to save up enough money so that I start going on testosterone. It's basically my dream to start medically transitioning, but with my dwindling bank account, I don't really have the money to spare. This new job pays better than my last couple of ones, and if I budget right, I'll finally be able to afford t without asking my parents for help, since insurance won't cover it.

So, I'm gonna be opening commissions and accepting donations! If you happen to like my work on ao3 even a LITTLE bit, please consider commissioning me! I've never been paid for writing anything, this is a bit of a new experience, so please be patient! I'll have my kofi and my prices down below! I made the prices based off of what I've seen from other people who make similar work, and what I believe is fair for the amount of time it takes to write!

Anyways, don't feel obligated to help! If you can, even if it's just a couple of dollars, that would be AMAZING, but there's absolutely no pressure! Thank you all so much!! <3

kofi- ko-fi.com/riverthebooknerd

ao3- https://archiveofourown.org/users/riverthebooknerd

tiktok- https://www.tiktok.com/@someofusarealiens

(PS- if you can't donate, sharing and reblogging helps a TON <3333)

[financialzero5]

Why CometCare is the best ending (AKA why the public knowing about SparkleCare isn’t possible)

Let’s say, by some insane leak from a government official mad about their paycheck, the events of SparkleCare got leaked to the public, with enough evidence to back all of it up. Hooray right? Everyone knows what the patients and staff went through. Now this is the best ending! Here’s several reasons why this happening would be AWFUL for the Comet family (and nearfamily)

-Staff would be arrested | Imagine that you hear that the hospital you thought was safe and caring for their patients was actually torturing and killing them instead, while siphoning money out of their insurance. What would be your first reaction? The likely answer is get everyone involved imprisoned! And the government, now having to clean up their mess, would likely follow through with this in an attempt to show that they’re not incompetent. Now who do we know that was involved? This does include immoral characters like Sunny and Cuddles, but this also includes ALL the staff, like Boxa, Lovella, and most importantly for the Comets, DOOM, Mood, and Rem. I don’t think I need to explain why DOOM being arrested would be devastating for the Comets.

-EVERYONE finds out | The only person we see in CometCare that knows anything about SparkleCare outside of those involved with it, is Faerie. Faerie has a strained relationship with their parents, ESPECIALLY Boxa, due to him knowing what she did to people. Now imagine how characters like Marco or Cream would react to finding out one of their parents tortured and killed people. It’s stated in DOOM’s Toyhouse page that Marco’s respect means the world to him, and he does everything he can to make sure he doesn’t lose that respect. And Cream is noted for latching onto a bad thing about someone and never being able to move on from it. Needless to say, if DOOM somehow got out of being arrested, this would devastate him just as much. And this also affects the other parents, Uni, Polly, and Barry. A lot of their kids definitely wouldn’t understand why they were lying to them about all of this, and this would harm their relationship with their kids greatly. While this does mainly affect DOOM, I’m pretty sure finding out that their parents kept something like that hidden from them would sour their relationship quite a bit.

-Internet being the internet | Now this is mostly unsupported information, but considering that NO ONE believed the patients that broke into the music festival, covered in their own blood and wounds, it wouldn’t shock me if there were still some Bwitter users that think all of it is a government coverup for something else. Personally I would prefer everyone having mostly forgotten about SparkleCare’s existence, over having a bunch of True Crime podcasts talking about my trauma for money, and seeing a bunch of morons try to prove how all of it was a coverup to raise gas prices by 2%. This would be horrible for all the patients and staff, as well as their kids having to see that. Uni is also somewhat of an influencer online, so I’m sure that info coming out would be very traumatizing to both her and her fans on KneeTube.

While it sucks that all the atrocities that Cuddles committed are locked down in a government database somewhere, forever hidden from the public eye, this is just how it has to be. CometCare is the “best case scenario” for a reason. It’s simply impossible for that info to be public, AND have the victims live normal lives.

[brettdoesdiscourse]

There's so much to unpack here.

Let's knock out just the, "you most likely don't have BPD" thing.

Most likely based on what exactly?

It's estimated that at least 1.4%-1.6% of adult Americans have BPD. Although, researchers believe that number could be even higher. Assuming 1.4% of the adult American population have BPD, that itself is 3616200 people who have it.

That's not even counting how high the number might be. Anyone who is under 18 in America. And it's not even considering everyone else around the world.

Putting that aside, let's move onto the privilege comment.

It's ridiculously privileged to tell people to "just work" to make that money. And I don't know where you're from or what insurance you have, but most people are not going to get diagnosed with BPD for $75.

Even assuming it does cost $75, let's consider a few things.

People who are living literally paycheck to paycheck. At least 60% of Americans are living paycheck to paycheck. When every dollar has to go to something already, how are people meant to save? Being able to save money in itself is an incredibly privileged position.

People who live in areas that do not have mental health resources. In March of 2023 alone, 160 million Americans live in areas where they don't have enough mental health resources. Living in an area where mental health resources are available is an incredibly privileged position.

Assuming you have the money and professionals available to you, are any of those professionals qualified or willing to diagnose/treat BPD? BPD is still a highly stigmatized disorder and that is very prominent in the mental health field. Many professionals are not willing to deal with patients who have BPD or diagnose a patient with BPD. There's so much discrimination against BPD in the field.

Does this person have any trauma surrounding the mental health field or the medical industry in general? Tons of people have had extremely negative, even traumatizing experiences with medical settings. This can be even more increased if a person has BPD which can caused heightened paranoia. Seeking help can be an extremely daunting, even impossible thing, and I'd prefer to have someone self-diagnose rather than put themselves through a retraumatizing experience for....What exactly? What is actually changed by having an official diagnosis? What is the harm of someone self-diagnosing, even incorrectly?

[lesbianhalflifeposting]

Postponing the larger posts like CYIBC indefinitely because I'm feeling like complete shit lately. Girlfriend is leaving town and I won't see her until July, Dysphoria Fatigue is reaching an all-time high, and to top things off, I don't have the money to pay for my own HRT appointment since my insurance won't cover it out of network! Yippee!

Seriously though girls it's been bad out here lately. I'm having trouble even finding motivation to eat, let alone be horny enough to sit and write for hours at a time. What little posts I can muster both here and on my personal, I can promise you I am trying to give my all. I know it may not seem like it considering the volume of posts I used to make here but I am trying. Please be patient with me. I'm still taking asks about anything Half-Life/Portal related, so if you want to get me fired up about something, send an anon about your desires. Otherwise I'll keep posting when I feel up to it, or when this massive wave of despair passes. Pizza!

[mushroomwillow]

so I quit my job. Just texted and said nope. And even with the threat of not having a job in time to cover all my bills, 99.9% of my anxiety has gone away. Yes I’m still anxious. But I don’t feel sick to my stomach about going to work, and not knowing if tomorrow my entire schedule will change. That the “promised” hours will suddenly be gone.

So like, as much as I loved being a caregiver, being one on one with patients, I learned tbh the hard way that I cannot do it. September nailed the head on that coffin. So much was put on me, and no matter how much I asked for help, I was told “just deal with it he won’t be in our care by the end of the month anyway” and my mental health fucking tanked.

Him, his wife, and everyone I came into contact with expected me to find a solution. I had no power to do so. No recourses, and no way to convince them they needed a facility. That that’s all their insurance would cover. Even the nurses and shit expected me to be able to do this. One tried to convince me to start my own business so I could do it, even tho there’s no fucking way, I’m not a nurse, I have no formal education, how the fuck would I be able to do that.

And then talking to my therapist? Really thinking about how their children were boomers and all 3 of them went no contact? The likelyhood of a boomer doing that is slim to none. And it fucking hurts to do that, I’ve done it. So all 3? Something has to have happened that was serious and severe.

So idk. I like taking care of people. I enjoy helping people at the end of their lives. But I won’t ever be a caregiver again.

Now I’m looking for something where I can work with my hands. Something “mindless”. Something where the only thing I’m responsible for is getting one thing to another thing and making sure nothing gets broke or no one gets hurt. Just fuck it all for a while. Eventually I’d like to get into tattooing while I complete my degree, and maybe after the 4 years I’ll have had enough time to really consider what I want to do with it, but above all, I want my mental and physical health to be my priority.

I’ll find something to make extra cash in the meantime. Instacart, dog walking (I have to find the money for the background check first for that one), just something to make sure the bills are paid. We’re just going to have to eat a lot of rice and beans, pasta, and soup for a while. I can make my own bread too so that’s not much of an issue right now.

It sucks. And I’m kind of just venting and getting the thoughts out there. And coming to terms with a lot of stuff about myself. There’s so much right now that idk what’s going to happen. But the feeling of relief I have even with no idea when I’ll get a replacement job is honestly kind of sad. I knew it was messing with me but I didn’t realize how much.

[bisluthq]

How are you doing? Any updates you feel comfortable sharing?

lol okay so I did 5 days in patient and came home and promptly proceeded to like finish most of the Xanaxes I’d been prescribed outpatient (and when I tell you it wasn’t a suicide attempt I really do mean it and the psychs believe me lol because here’s the thing - I have done a bunch of these things so like if I were TRYING to kill myself I’d make more of an effort, it’s just that they had me on new meds and I had like 6 of those old ones left and I was like “wonder what six of these would be like 🤷🏻‍♀️” (ps for anyone considering trying it for science - it’s not worth it, exactly the same as like 3 but just knocks you out for longer). Anyway, the doctors have decided I’m not a danger to myself or others and I don’t have any physical addictions because I don’t exhibit any withdrawal symptoms. That said, obviously I’m not exactly the picture of mental health lol nor sobriety. So now my parents want to send me to this like rehab retreat thing where you live off the land in the mountains and work with the animals (I do like animals and horsies) and they do have wifi there and allow visitors so they think I could use the time to work on a book or a phd. My bf is pretty supportive of the horsie idea. There’s also a free version of that concept where you’re essentially just a farm hand but my problem with that one is it has no wifi and sorry but while the horsies and shit sound really good for me, two months with no wifi does not. My mom wants to try hypnotherapy but my dad and my bf both think that’s a waste of time and money (insurance doesn’t cover hypnotherapy) because the alcohol and the other stuff is a problem on occasion but I’ll find new things lol like I took up a 2 pack a day smoking habit while inpatient first time round so 🤷🏻‍♀️ My bf, in what can only be described as saintly behavior, has said he doesn’t want to break up and he’ll support me with this because well he knew I’m a troubled person going in like that’s what made it fun right at the beginning right is my nuttiness but he’s happy to make lifestyle changes to accommodate for it and if I need to go to live with the horsies for a while that’s fine. I said to him between his insane ass ex wife and me, he really needs to reconsider his taste in women though but yeah 😂🤷🏻‍♀️

[jupiterjames]

me, finding out they now have a genetic test for psychiatric drug tolerance from your post that just came up on my dash: technology is great but time is cruel. i went through The Trials for 4 years nearly 10 years ago and nearly died multiple times. only got approved for tms a couple years ago and luckily it worked Well Enough, but man. glad they have that for people now. hope you're doing well.

I'll tell you what. I was FURIOUS when I was told about it. But also informed it hasn't exactly been around here in the US, at least, for very long. I've been on and off meds for more than 25 years, and took 2 that gave me anaphylaxis, and one that made my mental illness so much worse, I ended up in an acute care psychiatric facility to detox off of them and find something else.

So now that there IS a way to mitigate that for some people, I'm more than happy to share it. Especially because, from what I've seen, it still isn't a very well-known thing among the doctor community.

And for many insurance carriers, it still does require Ye Olde "proof of failed first line treatments" before being covered, so most of us still had to play medication roulette for a year before receiving coverage for the test. It's still better than decades, but I think it will become far more common as a first line treatment as it gains recognition.

I advocate for it being part of psychiatric first line diagnotic criteria, like as part of the first or second patient establishment assessment. But that may be pie in the sky for now until more insurance companies learn how much money they're saving by not forcing patients to try a half dozen other meds for at least a month before even considering another way. It's all about the money in the world's most expensive fucking medical industry, after all.

Regardless, I hope all of us who HAVE suffered for it, and people who have the potential to, at least see SOME of the information I have and can advocate for themselves and spread awareness to their doctors and providers.

I've worked in insurance, and I grew up with a family of doctors and counselors, so I've learned a lot. And while change can be slow in the medical world, persistence can also pay off as an advocate for yourself or finding an advocate to help. Nobody likes mosquitoes buzzing in their ears all the time, do they? ;D

Anyway, I hope you stay as healthy as you can be!

[wolfiemcwolferson]

I love your ficlets from within the blue neighbourhood verse. I was thinking about Daniel, and the lasting effects he has mentally from Jules and driving. It would be amazing to see how he would react if one of the boys was in a small car accident (literally just a small bump) and how max and charles and the others would come together to make sure he was OK

Hi Anon! I’ve been sitting on this for so long. I reference this incident in the latest chapter of Galex that is literally just about to post. I had most of this ficlet written in my little secret Blue Neighbourhood ficlet file, but then I didn’t know if I was going to write the Galex chapter from Daniel’s POV, but decided to share something fresh and new for you. 

Thank you for being so patient!

CW: Car accident, mentions of death, minor injuries

Max had meant to buy a new car with the life insurance money, but every time he went to look, he couldn’t give it up, suddenly overly sentimental about it. At first, it was a practical I only ever drive to work and then it was a but I don’t know if I should replace it before it gives out and finally it was a too many good memories to replace.

Daniel understood, of course, because he had one single vehicle since he could drive. 

But, it becomes a fight when Max and Daniel move to Denver. 

“You cannot drive that in the winter.” Daniel says, arms crossed over his chest, pointing at it.

He knows they have a few months before it becomes an issue, but Max is stubborn and it might take him a few months to convince him to buy a new damn car. 

Max huffs out a laugh and waves him off. “We will see.”

Daniel lets it go because he has to pick his battles today and right now one of them is that they are not moving into the apartment building that’s literally down the road from his parents. If Daniel ever wants to see Max again, they’ll be moving into the one that’s 20 minutes away. Sure it’s a longer commute, but Daniel sees the writing on the wall there. Thanks.

.

Daniel is in DC meeting with Lance and Toto about some funding for a new shelter somewhere in the South - they’re still working out the details - the first time it goes icy back home and Daniel is pretty panicked about it, but Max assures him that he’s fine. He can get home just fine - it’s all main roads anyway. 

“Yes,” Daniel agrees, “But you are from Texas and Southern California, you don’t know how to drive in this.”

Max laughs and tells him he loves him and hangs up the phone. Daniel finishes getting ready to go to dinner with Lance and George - now that he’s back from New York - and he’s off. 

When he drunkenly tumbles back into his hotel room later that night, he responds to Max’s goodnight text with a half a dozen kissy face emoji’s and something that might be love u so much i miss you

His flight is at a criminal time in the morning. He’ll be back with him soon.

.

Not hearing from Max much this week isn’t particularly alarming considering the point in the semester and also, he has a deadline to make some edits on his latest book, but what is alarming is Grace waiting for him. 

“Max.” He knows it immediately, feeling like his whole world is dropping away, because -

“He’s fine,” Grace says, firm and unflinching, holding his chin in her hand. “He’s a bit bruised, but he’s fine.”

Daniel doesn’t believe it. If he was fine, he would have been here. He would know that Daniel wouldn’t - Daniel wouldn’t be fine, if he -

Grace is shoving a phone in his face and it’s probably Joe, but Daniel can see Max, laying on one side in Daniel’s bedroom, asleep. He doesn’t look bruised, but then all Daniel can see of him is his face - which is fine, nothing - the noise rushes in again. Daniel takes a deep breath and the noise rushes in again. 

“Danny,” Grace says, taking the phone from him. 

Danny’s chest is cracking open. “Ice?” 

Grace nods, looping their arms together. “Ice.”

“Well,” Daniel’s voice sounds brittle, “he’ll have to get a new car now.” Unless, god, unless it’s fixable. “Right?” He squeaks.

The grim set of her lips tells Daniel nothing.

.

Charles texts him and Daniel thinks he might be shit because he didn’t think to check on him, but Charles is concerned for Daniel and he knows that...well, of course Daniel wasn’t thinking about Charles - he’s not even thinking of himself - just Max. Just getting to Max. He needs to touch him, assure himself that he’s okay. 

And then the group chat messages start and Daniel knows that Charles has told everyone that they can check on him, but Daniel just puts his phone underneath his thigh, feeling it buzz as things roll in. He can’t - he can’t do it until he touches Max. 

“Mom -” he starts to ask her if he’s alright again, but he doesn’t because he knows that it won’t matter. He won’t believe it until he touches him. It’s like he’s on that plane again, feeling like he can’t do anything - desperate to touch him - to hold him - to feel him breathing. 

Grace reaches over and places her hand on his thigh. “I am sorry, my darling.”

Daniel squeezes the steering wheel until his knuckles go white. “I know.”

.

Max is awake and sitting on the couch downstairs when Daniel walks in the door, Grace trailing right behind. Daniel stands in the doorway for two long seconds. “Why didn’t you call me last night?”

Max shifts and then kind of winces and all of the anger and panic bleeds away in an instant. “Hi.”

Daniel moves, dropping to his knees before Max, putting his head on his knees. Max does his best to fold himself down on top of him as Daniel comes apart. 

Someday, he thinks, he will stop thinking everyone is going to die in a car.

“I’m ok, Danny.” Max whispers. “I’m ok.”

Daniel sits up, wiping furiously at his eyes. “You’re getting a car that’s meant for the snow. Don’t argue with me.”

Max pets a hand down his face. “Yes. I know. Joe has already given me the lecture.” He pulls his face up. “Now, please call some of our friends back before they start booking plane tickets.”

Daniel gives a bit of a wet sob. “Ok, I can do that.”

He tries to pull himself up, by using Max’s knees, but he barely keeps himself from audibly wincing, so Daniel uses the couch instead. “I think you’ll have to be gentle with me for a few days.” Max chuckles.

Daniel starts to say, “Oh, I’ll be gentle with -”

Grace clears her throat. “No.” She says firmly. “Daniel. Not in front of me, please.”

“Ow,” Max gasps, trying desperately to laugh. “Ow, ow ow ow, stop.”

Daniel stays on the ground for a little while longer, head on Max’s knee, laughing while Max runs a hand through Daniel’s hair. 

He’s alive. He’s laughing. 

[sonicenvy]

I think if there is something that I've learned this year having to deal with a lot of healthcare nonsense it's that many patients (myself included) need to learn our rights, and that there ARE options that we can take when we can't afford payment for drugs or care and when we get rejected by insurance for coverage for something. I wish to god we had a better healthcare system in this country; I do, but for now we have to live with the bullshit we have, and I think people would be served better by getting educated about their options and rights in the now to reduce harm in the now, while we fight for a better system. For now, here are some things that are of interest:

If you do not have health insurance at this time, you can get it through healthcare.gov. It doesn't matter where in the country you live, what your previous claims payment history is or what your current medical conditions are. You can pay for and get ANY plan that is offered on this site. This is defined through ACA Subtitle D, Part I.

When you look at the plans not signed in, they look SUPER expensive. They are not. Create an account and submit your tax information. Once your previous year's tax information is submitted, the site will tell you what your tax-credit reduction is for your monthly premiums. This is the amount of $ that the government will subsidize your premiums for. The less money you make, the more this amount will be. If your income was greater last year than it is this year, when you file your taxes you will get money back that you should have received in reductions on your premiums. If your income is greater, you owe. They give you the choice of how much of the credit to take in the now. If you choose not to use all of it, you get the unused amount back on your taxes.

If you have marketplace plan questions, call the healthcare dot gov help line (1-800-318-2596) and someone will help you. They will answer any questions you have, no matter how dumb they are. You can ask them simple stuff like "What is a premium?" and they helpfully explain it.

No insurance company can raise your premiums based on your claims payment history, your health conditions, your health history or any other form of "evidence of insurability". They cannot deny you a plan for any of these reasons or deny you renewal of a plan for them. You have rights, if your insurance is trying to do this, you can report them to the government. It is illegal for them to discriminate against YOU for any of these reasons. This is all defined either under ACA Subpart I: General Reform, sect 2702, sec 2703, and section 2705.

If you are over 65, you are eligible for medicare, and you should get it. If you have a serious disability, you can get medicare earlier. This will significantly reduce your healthcare costs. You have already paid into it if you have been paying taxes on a W2.

If you are poor, you may qualify for medicaid. If you are unemployed you probably qualify for medicaid. Eligibility requirements vary by state, but if you are below the federal poverty line and under 65, you are almost certainly eligible. Medicaid is low cost and covers most services. If you have children and are poor, you can get CHIP.

Certain services are considered "Essential Health Benefits" under the ACA and ALL plans are required to cover them. These EHBs include items and services in the following ten benefit categories: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services including behavioral health treatment; (6) prescription drugs; (7) rehabilitative and habilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and (10) pediatric services, including oral and vision care. If you plan refuses to provide ANY coverage for items and services under these categories, that is illegal and you can report them.

If you visit a non-for-profit hospital for emergency services, and are uninsured or poor, they must provide you with financial assistance, whether that is FREE care or significantly reduced care. This applies even for insured patients who are visiting an emergency room that is not in their network. Talk to their billing department and ask about financial assistance and charity care.

Under the No-Surprises Act, a subsection of the CAA 2021, a provider of emergency services cannot balance bill you (bill you money after you have paid your deductible, copay, coinsurance and your insurance pays out their obligation to make up for costs on the visit from their providers being not in your network). This is something new I didn't know about until my current situation lol.

Certain forms of medical debt CANNOT be reported on your credit report. Additionally, if you apply for an FHA mortgage to purchase a home, the FHA does not consider medical debt when assessing mortgage eligibility. For more information about new rules regarding medical debt as related to creditworthiness here is the general bulletin.

If you are denied coverage for a medically necessary drug or service, you have the right to appeal this. Call your insurance company and ask for an explanation for the denial of coverage. Sometimes, your doctor can provide a letter of medical necessity for the service to get you coverage. The same drugs and services can be billed under different classifications, which may affect coverage. Read through your plans benefits booklet to find if the service you are being denied is covered under a different billing classification (usually called a CPT #). If this is the case, you can work with your provider to reclassify the billing of the drug or service to get coverage. Arm yourself with all the right vocabulary and information by reading through your plan's benefits booklet and by requesting an extended EOB (explanation of benefits) for the claim in question. Note that you cannot get extended EOBs for medication claims, but you can for services. You may also want to enlist your provider in your fight against charges as there is certain information that they can more easily access than you can and that they can do on your behalf.

Many drugs have manufacturer coupons that you can use to reduce your copay. These coupons can be applied WITH your insurance. If a pharmacy employee tells you otherwise, they don't know what the fuck they're talking about. Ask to speak with the head pharmacist about this. You can find many kinds of drug coupons through sites like goodrx or the manufacturer of your drug's website. Sometimes your doctor may also have coupons; ask them. If you have an especially competent pharmacist, they can also help you find coupons or discounts.

Anyhow, I hope someone finds this helpful. Learn your rights and your terminology so that you can get the care you need and deserve!

[inscrutable-shadow]

Mediwhump May Day 8 - Scared of Blood

@mediwhumpmay

Cassiel belongs to @painful-pooch! Based on the fact that I broke my wrist in fifth grade, treated it as a sprain even though it def wasn't (no fracture on the x-ray so guessing it was a hairline) and then developed a ganglion cyst ten years later lol my wrist is still fucked up it's so fun (i went over my self-imposed word count on this one ack) Content Warnings: needles, minor surgical procedure

Another transfer case. The Doctor was considering making it look like they’d retired to avoid these. At this point, it was usually minor outpatient procedures that were incredibly annoying to perform and even though they could charge the insurance their usual “nameless doctor” rate (which was still less than other doctors would have), having to deal with legal processes at all made them want to spend an afternoon performing unsavoury experiments on a corpse. Not that they didn’t always want to do that. 

Between that and the fact that the espresso machine had broken down and they’d been forced to fuel their morning on drive-through coffee, they were already in quite a bad mood when their patient arrived, all shyness and deference and looking out of place, and they couldn’t bring themselves to demur back. 

“Mr Belanger, I presume? Do come in. I do not have all day to waste. The outreach programme has sent you over, no? I do wish that they would not send their excess to me…” “Oh, I can just… I dinnae have to…” Cassiel was slightly shorter than the Doctor, and despite his broad shoulders appeared to shrink back into the doorframe. They identified his accent as Scottish, though pulled at and smoothed over around the edges by proximity to other regions like the Doctor’s own mostly-English, sometimes-Swedish intonation.

They sighed. “My apologies. That was unprofessional of me. Just an annual physical, yes? Please, have a seat. I shall have you in and out in no time.” 

He hesitantly took his seat on the examination table while the Doctor pulled on a fresh pair of gloves. “It’s… you dinnae need money frae me, right?” Yes. He did not appear to be the sort of person who could afford them: his clothes were in tatters and his shoes full of holes. They were used to a clientele with large amounts of ill-gotten gains. 

They raised an eyebrow. “Correct, my compensation is covered by an agreement with the clinic you came from. Verify your name, date of birth, and medical history on that tablet over there, will you?” They rolled over the cart with the medical supplies on it while he did so, frowning and exchanging one tool for another just to kill the time. “Any particular complaints?”

Cassiel watched them warily as they brought their gloved hands up to check his lymph nodes. “Nay, nothin’ I can think of…”

Liar. “Oh? And does it hurt when I do this?” They bent his right wrist forward at a completely reasonable angle, which made him flinch and a spark of vindicated mischief flare in the Doctor’s chest. “That is what I expected. How long have you had the ganglion cyst?”

Cassiel blinked. “The what?”

“Ganglion cyst. A pocket of fluid found on the top or bottom of the wrist. Cause unknown, though they are common for patients who perform repeated wrist motions or have a history of wrist trauma.” They held up the hand, running a gloved finger down the scars on his arm. “You engage in some form of martial arts, no? I assume you fractured your wrist at some point in the past, perhaps a hairline, and you treated it as a sprain. This is quite a lot of fluid, I am sure it hinders your daily activities. How long have you had it?”

“Oh, er… Couple o’ years, I think… Is it dangerous? It does bother me a bit…”

“Not dangerous, no, but if it is impeding your activities, I do recommend aspiration, especially if it is multiple years old and has not gone down. It is a minor outpatient procedure, I could have the whole thing done for you before you leave today.” They rolled over to the supply cabinet to begin withdrawing the materials even before receiving an answer.

The colour had drained out of the man’s face by the time they turned around again. “H-hold on, wait… what’s… aspiration?”

The Doctor was too busy comparing needle gauges and deciding which one would be appropriate to really pay this any mind. “Quite simple, needle goes in, fluid comes out. Local anaesthetic is all that will be necessary. Just take care with the hand in question for a couple of days.”

“It… doesnae have to be a needle, do it? I, er…” Oh. Needle phobia. How annoying.

They tilted their head at him. “Well, I could excise instead. A bit more involved, I would need to use the scalpel, but should still have you in and out in an hour or so.”

He seemed to like that idea even less. “No, ah, it’s… all right, ye can, aspirate or wha’ever it is…”  

“Very good.” They began preparing the implements. “To reduce anxiety during the procedure, you can feel free to talk about whatever you would like. Keep your eyes on the chart on the back wall, yes?” 

The patient was silent for a moment as the Doctor began swabbing the site for the lidocaine injection, but eventually, he took a breath and blurted out, “I thought yer voice didnae match ye, when I walked in.”

“What?” The word came out strangely, as if their voice didn’t know how to behave when attention was called to it.

“Ye didnae seem like a purple person. I can… I see sounds.”

“Ah. Chromesthesia. Continue.”

Cassiel swallowed hard. “Is that… blood?” They tracked his eyes to the barrel of the syringe, which was now drawing up fluid.

“No. I told you to keep your eyes on the wall, did I not? If you stress yourself into syncope, I will not be pleased.”

He shifted uncomfortably, but relaxed after moving his attention. “See? That’s it. I thought ye’d be redder, but yer purple is very blue.” They didn’t really know how to respond to that. “Chromesthesia rarely has any tangible logic behind it, though I have been described as ‘cold’ and ‘rigid’ repeatedly by others in the past. I prefer to think of myself as efficient. There we are, all done. Not so bad, was it?” They’d done the steroid injection without him even noticing, and all that was needed now was the splint.

“That was… fast.”

“Like I said, I am efficient. Now, let us continue with the examination, yes?”

[aureutr]

My Mystery Pain in 2022, by Month

I feel trite being like “it’s been a journey!” but it kinda has.

Quick sum up, I have an acute pain roughly in the area of my right ovary. I used to think it was menstrual cramps because mine were horrible, but once I went on bc it persisted even though I wasn’t having periods anymore. So in roughly August 2021 I started trying to figure out wtf it actually is.

Also, all of this has been very expensive despite the fact that I have very good insurance through my husband’s job (I’m not asking for money, just a note).

2021

Thought it might be endometriosis, but OBGYN thought it was an ovarian cyst. Got ultrasounds, including a trans-vaginal ultrasound. It was not a cyst. OBGYN referred me to a GP.

GP thought it might be a hernia. Got a CT scan. Also had an MRI at some point but I honestly forget when in this span it was. The pain was not a hernia. GP referred me to a surgeon.

Surgeon poked at me and went “that’s probably endometriosis” and referred me back to the OBGYN

January

Had an exploratory laparoscopy to check for endo. They found some! ...on the wrong side. Nothing in the area of the pain that would explain it. Referred back to GP

February

GP referred me to a gastro NP (the wait to see the MD was months and months). She ordered a colonoscopy.

March

Colonoscopy comes back squeaky clean (literally, considering what you have to go through the day before 😂).

April

NP puts me on a couple of medications to see if they work (they don’t). At my request, refers me to a specialty clinic. I’m being vague on purpose, but think Mayo Clinic (it was not the Mayo Clinic)

Drive for hours (one way) to get to specialty clinic. They poke at me and go “umm this isn’t gastro related, go to pain clinic I guess?”

They say there’s not a huge difference between their pain clinic and what I’d find locally, so I ask for a referral I can take to a local place. It didn’t make sense to make the drive every time if I didn’t have to.

May

Check back in with GP. I have to say, I really like my GP. Just because she couldn’t find the answer and kept referring me to other doctors doesn’t mean she wasn’t doing her job. We had a lot of possibilities to eliminate!

Anyway, the pain clinic GP is associated with doesn’t have any appointments until September.

So I find another one!

New pain MD thinks it’s a nerve issue. Meralgia Paresthetica, he says. That covers a lot of possible specifics, but

I ask new pain MD about perhaps a TENS unit, because a friend of mine has one and I was curious as to if it would work for me. He literally screams at me about how it’s not a viable treatment. Sets up an appointment for a nerve block.

On my way out he hands me a printout about the condition so I can learn some more. Printout recommends TENS unit for mitigation.

Day of nerve block is weird af. There are a ton of people there, all patients. It’s run like an assembly line, almost. All of the nurses and assistants are great and kind and helpful. Pain MD is still a weird jerk.

I don’t know what he did, but all the nerve block accomplished was making the pain 100x worse (temporarily). When I mention this, he screams again about how he used imaging to find the nerve so what I was feeling wasn’t possible.

Follow-up was a phone call, during which I insisted my husband be present. Once again, Pain MD screamed at me for asking a question. He tells me that I can mitigate with lidocaine patches, but they probably won’t work so I should let him surgically implant an electrode instead.

I don’t want to do that, and even if it was the only answer I no longer trust Pain MD. Go back to GP and ask for a referral to the pain clinic I have to wait for.

In the meantime, start wearing lidocaine patches. It helps a little bit.

June

Waiting. Husband has knee surgery. It goes well and he heals quickly, and if I’m honest I’m relieved I can give some care back to him for a change. He doesn’t like to let people take care of him but I like to do it.

July

Waiting. But y’know, we can’t have socialized medicine in America because the wait times would be too long! 🙃

August

Still waiting! As a note, the pain is so bad that I regularly had to call out of work (generally half days, I always tried to push through until I couldn’t). I napped constantly, had almost no energy. I can’t use my home office because sitting upright in an office chair makes it worse. Nothing really makes it better other than sleep, but I found ways to prevent it from getting to the worst point.

September

After Pain MD, I now always have Husband go with me to initial doctor appointments so I can use his tall, white, cis dude powers to my advantage.

Fortunately, new Pain MD seems like a good guy and is very attentive. Has me do a pelvic X-ray because it was the only “easy” test that hadn’t been done. He didn’t think that it would be the answer, and was up front about that, but felt like it was due diligence. X-ray found nothing

He prescribes gabapentin, orders me a TENS unit, and puts me in physical therapy. He isn’t convinced physical therapy would help, but insurance will cover it and it’s something to try.

Gabapentin gives near-immediate relief. I drop from a daily 6 or 7 to a daily 2 or 3. It’s like I’m a person again.

Also refers me to a neurologist, whose first available appointment is December 30th.

October

Physical therapist is kind and helpful. Go 2x a week. It’s all individual exercises that aren’t hard on their own, but they add up.

I am still wearing lidocaine patches daily (I start cutting the big ones in half because I don’t like the material of the little ones), taking gabapentin, and regularly using the TENS unit. All together they help a lot, but nothing makes it completely go away.

November

Finish “evaluation period” of physical therapy. Pain has gotten worse since (not as bad as pre-mitigations, but still worse). Physical therapist and I agree that this is not a problem that PT can solve.

Have follow-up with new pain MD (actually with his PA). Gapabentin gets increased, no other changes.

December

Check in with pain PA again. She orders two separate nerve block tests, scheduled for January. They had been hesitant to do this because I had one done, but apparently the original pain MD I saw has a bad reputation. They didn’t dump on him, but professionally agreed when I did. There’s a suspicion that the first one was not done correctly.

Meet with neurologist (again, Husband comes to this first meeting). Mentions that this might possibly be a pinched nerve in my back, despite the core of the pain being in the front. Orders a nerve conduction study, not yet scheduled because insurance has to approve it first. Because American healthcare is hell. And I have good insurance!!

I also got laid off at the beginning of this month. Insurance is through my husband’s job, so fortunately that does not immediately affect my care.

Now

Three tests coming up (two nerve blocks, also nerve conduction study), then we’ll see. If it does turn out to be a pinched nerve in my back it might be fixable with surgery. But there’s a very good chance this is just something I live with and mitigate for the rest of my life. I don’t know yet.

Anyway, it’s kind of hard to feel creative on top of all of this so that’s why fics and art have kind of tapered off as the year wore on. I want to get back into it, but I try not to force hobbies. They should always be fun.

I don’t have a thesis statement to conclude. I wrote this out for me, really. I know this blog is mostly shitposts and fandom stuff, but it’s still a blog. Thanks for reading if you did, I hope you didn’t feel obligated to <3