#and was basically the first medical practitioner in my life who saw my issues as actual chronic pain

[quelsentiment]

.

[mrskurono]

title: ｆｅｒｔｉｌｉｔｙ　；| Rintarou Suna x Fem!Reader a/n: here I go again, comfort writing with Suna. And bc my notes have taken a dip and no one likes to reblog stuff anymore I’ll probably never open requests again and just write for myself  ¯\_(ツ)_/¯ word count: 1.4k tags: timeskip (duh). real life situations, established relationship (your married), language, fertility issues (either Suna has low sperm count or reader has PCOS reader’s choice I didn’t specificy), medical terminology/situations, angsty, fluffy, IUI, vent writing ish, nothing bad happens just trying to get pregnant unconventionally, unedited character(s): Rintarou Suna (hq)

“As soon as you quit trying it’ll happen!”

“We didn’t even have to think about it and wow three kids later!”

“Your young don’t stress about it!”

“But you don’t look like it’s hard.”

You stare up at a mostly white wall. Textured fine and certainly not as renovated as the lobby. It still feels oddly like home even with the disposable blanket draped over your naked lower half. Perhaps what made it really feel like home was Rintarou’s hand on your thigh.

Staring long gone as your eyes drop onto the dark haired man who’s stare was directed at the closed door. He’s quiet. As always but you’re unsure to attribute it to the fact it was before nine A.M, or because the nurse practitioner said they were going to get the specimen. 

“Third times the charm you know,” Rintarou’s voice surprises you. Even though you were staring right at him. When he spoke facing away you couldn’t help but jump. His hand squeezing your thigh tight.

You’re quiet for a second. Third time was supposedly the charm. For a second you wonder how many friends, family and acquittances might have had the same thought.

A sigh leaves you and like the other attempts before you finally relax back into the exam chair, “We were in this room the first time right?”

Rintarou looks at the tapestry on the wall directly behind the two of you. Dark brows pinching a little he thinks for a second, “...I thought the first room had the quilt thing with kids hand paints on it?”

“There’s the flower one I think.” You mention the other piece of art you can vividly recall.

“Was it these or was it that flower one that looks like a vagina that was the first room.”

“Rintarou those were labias.”

“Yeah, and the other one looked like balls.”

“Oh but you remember the pussy looking one?”

“You mean labias.”

You squint your eyes at him and wordlessly mouth a mockery towards him. Forgetting for a second how nervous you were. He doesn’t forget how nervous you are though. Rintarou takes the mocking tease in stride when he bends down and presses a kiss to your scrunched forehead. Timing impeccable as always for the middle blocker as the nurse comes back in just as he stands back up.

Just like the three times before, the nurse stands with awfully ugly blue gloves on, the thickest looking catheter you ever swore you saw and papers clasped in their other hand. And just like the other times there was always a spiel to go with it all.

“Are we ready?” They looked at both you and your husband. Rintarou remained quiet but with a deep breath you nodded, “Good. Well- As always-” They hand the sealed and capped syringe to Rintarou, “You know the drill, body temp so if you don’t mind holding onto this.”

He nods. An otherworldly feeling to be holding onto what was basically the essence of his semen. But the tight grip the EJP middle blocker held it with was far more tight than any volleyball he’d ever held. 

“Here’s the papers as always,” The nurse wheeled over to your side of the exam chair in the small room, “Mobility looked great today. A 3.7 for them. Um- Unthawed at 6:34 this morning after the call, everyone looked lively in there and all there’s left to do is send them on their way! Are you ready?”

You take a deep breath. Looking at your nurse. Then looking to Rintarou. The hand on your thigh no longer there. Instead he’d taken your hand in his the second he was handed the sperm. You nod and squeeze his hand before looking at the nurse, “Third times the charm.”

There’s a faint smile on your husband’s face. Something you hadn’t seen once at these appointments. The way it tugs on the corner of his lips and Rintarou looks down at you even as someone gets between your legs, you can’t help but laugh to yourself. You’d be fucking him right now for that smile if there wasn’t KY jelly being smeared on your vaginal opening in preparation for a speculum to being inserted.

“Any plans for the rest of the day?” Utter casualness as someone only a little more than an acquaintance pulls your labias back right in front of your husband.

“Breakfast probably.” You look up at Rintarou who nods, “And then absolutely nothing.”

“Oh no practice today then?” Your overly friendly nurse glances up to Rintarou as the metal dipped down into you. 

It’s uncomfortable. Certainly not something you’d ever want to add to your bedroom antics. Each touch of their glove around your bits and pieces is something your not sure you can get use to but as they crank it to latch and your left knowing your cervix is exposed as Rintarou hands them the syringe, there’s something so strange. Your not sure you have an emotion for it actually.

“I just take them off normally,” Rintarou answers the person who’s now readying a thin catheter full of your husband’s separated and washed sperm to be inserted into your uterus on a Thursday morning. And Rintarou is talking to him like he does Motoya at the end of practice like its nothing.

“A couple this morning said they were going to try the new bakery down town,” Their hand goes to your thigh to let them know they’re going to touch you, “Alright deep breath, just a little discomfort and cramp.”

This is always the time you fall silent. Eyes fixated up on the ceiling even as you death grip Rintarou’s hand. It’s not a poke. Not like a needle. It’s cramp worthy but at the same time it’s so foreign that by the time it’s all said and done. They’re tossing the empty contain into the hazard bin and taking off their gloves.

“We have a shop we really like,” Rintarou replies calmly even though you’re sure your crushing his hand, “But I think I heard of the place.”

“Well-” The nurse smiled with their fingers crossed, “Here’s to hoping I can tell you about the bakery in two weeks.” 

They of course remind you of the drill. No checking before two weeks. False positives are rampant then. You get handed the papers. Which Rintarou always takes for you as you lay there on the exam table. Told to take your time for the ten minute wait period and then feel free to get dressed and head out. And like always you thank the person who just shot your husband’s sperm directly into your cervix.

Ten minutes. Then you could leave. 

Ten minutes you might as well sit in silence.

“...third times the charm you know,” Rintarou reminds you, as well as himself, after the nurse left. Big hand still clasped over yours as you lay there on the exam table.

“...I can feel lube stuck all over me,” You grimace at the coolness. It certainly is the same lube you use at home. An attempt to make this all more light hearted at best but it quickly falls flat.

You think for a second. All that advice you’ve gotten as you both try for your first. Don’t use lube. Use lube. Don’t do it on a Tuesday. Do it on a Tuesday. Don’t eat spicy. Ok maybe eat spicy. It all filters into your mind as you lay holding your husband’s hand in the stillness of the clinic room.

Rintarou snaps you out of it when he leans over. All 6′3 of him bent in half as he rests his ear against your chest and looks up at you.  Giant ass head in the middle of your chest and looking up at you. God he looks uncomfortable like that. But doesn’t budge an inch. Instead bringing your hand up to his lips and kissing your knuckles gently.

“Boy or girl?” You ask him the same question as the two times before.

He shakes his head. Lifting himself up to lean down and kiss your lips softly, “Doesn’t matter to me as long as it’s a baby.”

His assurance makes you sigh. Undoubtedly he was nervous too. At least here he kept it together. Though you were sure the staff probably thought your husband was a mute for the most part. You knew different. 

Reaching up you cup his face and bring him down for one more kiss, “...Here’s to the third time.”

[songofsaraneth]

Ok now that I have time/space to breathe again, I wanted to do a writeup on the unusual reaction I had to the second Covid vaccine dose. I debated posting this, because I don't want to go against the "I was vaccinated and it's fine!" encouragement train. And I 1000% encourage EVERYONE to get vaccinated if possible. But I have not seen much documentation of the averse symptom I got, except in some case studies I specifically looked up so details below. Big TMI/gross warning however. 

Mostly I'm posting this because I had to do SO much self-advocating/arguing with the Dr at my urgent care clinic, and if you're not as read up on weird medical issues as I am, you might not be comfortable doing that. But IANAD, just describing my experience and what I read, which ended up being very long because it was awful and I have a lot to complain about I guess, sorry.

Basically: for me the vaccine triggered an inflammation response, which in itself is normal. The usual muscle aches/joint pain/slight fever. It also triggered an outbreak of ulcers in my soft tissues. Basically, a bunch of canker sores in my mouth/throat. I am already prone to getting these when I get sick or stressed out, so no biggie, annoying and painful but I could handle them. Canker sores are distinct from cold sores in that they form inside the mouth as crater spots, usually around the size of a pencil eraser (though can be bigger or smaller), and will develop a white film across the crater as they develop and start to heal.

An unfortunate fact I have learned: the mouth is not the only exposed “soft tissue” of the body. this group also includes genitals.

So 2 days after the vaccine I noticed a "burning sensation"/rawness downstairs, which turned into a sharp pain, especially when going to the bathroom. I obviously knew this was abnormal and because of what was happening in my mouth, had a pretty firm idea of what was happening, but was ready to brace myself through the healing process. However by day 5 I had 8 red, crater-like sores on the tissue of my vulva. Essentially they are open wounds, and urine is an acid, so you can imagine the hell that using the bathroom had become. Even just sitting hurt.

As someone healthcare-averse, even I knew this was untenable, and went to Urgent Care for the first time in my adult life. I told the NP what was going on, how they matched the canker sores (NOT cold sores) in my mouth in onset/form--and she immediately, without even looking, diagnosed me with herpes.

Lots of people have herpes or other STIs, and that's fine. I know I do not have any, and wanted to pursue treatment for what I was sure they were--Non-sexually acquired genital ulceration (NSGU). I had even found three case studies of COVID patients who had developed them. I had spent several harrowing hours on google images making sure that the sores I had did not match any STI I may have magically acquired during a year of social distancing. I even brought up multiple case studies, including a woman who had them as a Covid reaction in a neighboring state. Didn’t matter. She looked at them and went “Yikes! Herpes!” and prescribed me: 

1) an antiviral, which I said I did not think would do anything because the trigger for this was a vaccine not an illness. She said it was probably a herpes flare up already in my system. I reiterated that I have had similar sores in my mouth since childhood and that all my past doctors and dentists agreed it was not viral but something related to an immune response. She said the antivirals should clear them up in a few days.

2) a topical 5% lidocaine ointment, aka an oral grade numbing gel, which was essentially what I was after anyway.

I would have preferred a steroid course to the antiviral, but agreed to start taking them until she got the results of the bloodwork I needed to come in the next day for. I asked how many days after taking them I would expect to see a difference/if she would reevaluate treatment if they didn’t have an effect in a certain amount of time, and she said if they hadn’t cleared up by Monday then she’d look into other causes (spoiler, they did nothing in that 4 day span). to her credit, when she saw me pick up my bike helmet (because my car had been at the mechanic for a month by then), she was properly horrified that i was having to bike everywhere with this situation and printed off some coupons/called all the prescriptions into the grocery store pharmacy next door instead of the CVS my insurance likes a mile away.

So eventually I got home and took my pill & went to put on the ointment so I could use the bathroom for the first time in 8 hours. I’ll spare you the details but suffice to say I had an extremely, overwhelmingly painful 10 minutes of application. Like absolutely awful burning feeling. However once that faded, I was indeed actually numb, and so I figured it was worth it. Got my bloodwork done on Friday (biking there & home again). On Saturday, I thought that you know, maybe a prescription anesthetic shouldn’t be doing that or at least have some sort of warning? And read the details on the jar.

Good things about lidocaine: it is a powerful numbing agent and lasts pretty well for an hour or two.

Bad things about lidocaine: you cannot get oral grade lidocaine without added mint flavoring.

I happen to be EXTREMELY sensitive to mint. Like I still can’t handle breath mints or mouthwash, and used bubblegum flavored toothpaste until I was 14 and found a brand with half as much mint flavoring as is typical. Even if you’re not, mint has no business being anywhere near genital tissue. Even on an average person that could cause awful burning. to make a long saga shorter I had a very frustrating back-and-forth with urgent care involving many rerouted phone trees, visit in person, unhelpful receptionists, and attempts to find over-the-counter alternatives. All were fruitless so I just  suffered all weekend until the urgent care Nurse Practitioner called me back on Monday and was suitably apologetic/outraged about the mint thing, and looked up every OTC product that might work as a substitute, since she couldn’t find any prescription level without mint. On Tuesday she called back again having found this:

It’s 4%, so just below prescription strength, while not oral grade, it’s actually fine for soft tissues as long as not fully ingested/internally applied. And most importantly, ABSOLUTELY NO ADDED FLAVORINGS. there is also a spray version that comes in a bottle, which under no circumstances should you try because it uses alcohol as a propellant and I had a very bad 5 minutes after testing that one. But the cream one is fine and brings blessed numbness in around 5 minutes with only minimal contact pain--they are still open wounds after all. 

I use this for the next 7 days. By this point the sores have gotten worse and larger, and then started to heal and shrink again. Mouth canker sores go through a similar ~2 week process, so this is about what I expected.

Finally the results of my bloodwork came back, and I was negative for all STIs. The NP was dumbfounded and apologized, and agreed to look up more information/treatment options for cases like this in the future. I’m not surprised her reaction was to assume herpes as it IS very common, but I’m sure other women experience NSGU’s and receive improper treatment. If you look them up, they’re even mentioned as being predominantly a problem for “young or prepubescent women” which, reading between the lines--it’s not that these become less likely if you’re older or sexually active. Doctors just make assumptions and don’t always look past the easy answers.

So if you or someone you know ends up with these--from the Covid vaccine or as a complication of upper respiratory infections in general (as they ARE an immune response and can just Happen to you)--here is what works as treatment. If you can see a doctor you trust, still do that. But if they don’t listen or if for some reason you can’t seek treatment, here is the course of action I recommend: 

Pick up that over-the-counter Pain Relief+Lidocaine NON MINTY numbing cream ASAP. Sores go from “annoying” to “excruciating” in only 3 days, so it’s best to get in person or with rush shipping. Sit in front of a mirror and gently apply with a q-tip, and wait 5 minutes for the medicine to take effect.

Pat gently dry with toilet paper, don’t make wiping motions. If you don’t feel clean enough, pat more with a wet washcloth and rinse it out, or hope in the shoer for 5 min just to rinse.

There may be pus or reside from the ointment that doesn’t go away with just rinsing. Every 2 days I made a half-strength bath of epsom salts, NUMBED FULLY, and then took a 10 minute bath to fully cleanse the area. the salt will sting terribly if you wait any longer, so I recommend standing and rinsing after this time.

The vulva is more exposed to air than the mouth. this may cause the sores to crack/bleed as they dry out. to avoid this, after using the restroom and cleaning yourself, you can apply a thick coating of Aquaphor on top of the sores. It will need to be rinsed off before you apply more numbing cream however, so if that is too many steps I recommend just using the Aquaphor overnight.

You may think its ok to get up in the middle of the night to pee without the numbing cream bc you have to go really bad and just once will be fine but it is NOT you will REGRET IT.

Unfortunately if you have sores on both sides you may develop what is known as “kissing sores”, aka sores directly opposite each other that touch when the area is not spread open. this means that after an extended period of time (overnight), the sores will try to heal into each other and opening the area back up painfully rips the tissue apart. INStEAD of ripping them apart, take a washclosh, run it under warm water, and do a hot/warm compress on the area. this will loosen the sores back up and separate them painlessly.

This is not exclusive to people with a vulva, they can also happen on scrotal/anal tissue. However it does seem to much more frequently affect people with typical XX sex organs. 

If you develop these, PLEASE fill out an averse reaction form or your country’s equivalent. Also, I’m so sorry and if you need emotional support or have questions please feel free to get in touch.

Most likely, these will not happen to you--the vast majority of vaccinated people have not had this as a side effect. But it IS popping up more and more, and it is good to know about it in advance so you can be prepared to deal with and treat it without as much anxiety and all the hoops I had to jump through to get good care. Overall I’m still glad to be vaccinated, but if I had known this was a side effect, as someone already prone to canker sores I would have waited to vaccinate until my car was fixed a week later a the very least :|

[startledstars]

What were your negative experiences with spells and magic?

Hi,

It seems you stumbled across my older posts warning against astrology. Maybe you want to know more about the ‘witchcraft’ mentioned here.

One experience in particular made me realize that magic was real, evil, and not to be experimented with.

I’ve had hypothyroidism since I was 15. Although this condition can be healed naturally, my doctor told me hormone replacement in the form of levothyroxine was the only viable solution. She told me I’d have to take a pill first thing in the morning every day for the rest of my life, and didn’t even consider other options, such as diet, stress management, selenium, etc. (all of which I discovered later.)

Every six months, I need to go to the doctor, and give them a blood sample so they can “ensure my prescription still works.” If I don’t go, they hold my prescription hostage, and without it, I gain weight, lose hair, deal with brain fog and a number of other symptoms.

Once you start hormone replacement for thyroid issues, your window for finding a natural, real cure, instead of being another steady source of income for your general practitioner/big pharma is pretty much closed.

It may seem like a small inconvenience to some, but I despised this leash, this leaden chain. I am forced to allow someone to violate my body (that’s what sticking a needle into someone’s arm is. It’s a violation, no matter how ‘noble’ or ‘necessary’ the cause.) against my will, lest they deny me medication that allows me to function.

(They take your blood even if there’s no indication that your prescription needs to be adjusted. I tried to talk to my doctor about it and she told me I had no choice in the matter.)

So, l tried a sigil spell I saw on YouTube. Worst case scenario, nothing would happen. Best case scenario, I’d finally be free. After ‘casting’ the spell, I was compelled to take an Iodine supplement by what I thought was my intuition.

I was wrong on both counts; about taking the supplement, and about thinking it was my own intuition.

Magic doesn’t work in a vacuum. You ‘set an intention,’ unknowingly opening yourself up to demonic entities, which influence you to take certain actions. If the spell works, that means the entity influencing you sees some benefit for itself from your perceived success. Basically, it thinks it can use you to lead others away from God. If the spell backfires, the entity sees more benefits more from harming you. By casting the spell, you consent to the entity’s influence, judgement (to ‘help’ or harm, either way, the endgame is to steal, kill, and destroy your very soul) and consequences of the actions you take.

My thyroid levels had been steady for seven years when I cast the spell and took the iodine. A few months later, my hormones were drastically thrown off balance, and my prescription increased from 50mcg to 88mcg (which is a HUGE jump.) I dealt with severe weight gain, hair loss, mood swings, brain fog, etc. It turns out that for some hypothyroid cases, iodine helps, but for others, it causes your body to attack your thyroid gland.

Keep in mind that up to this point, I’d experimented with numerous supplements (NAC, Licorice, Magnesium, melatonin, and a long list of other natural remedies) for other health problems. Usually, I saw positive to neutral results. Nothing ever backfired or left me with permanent damage like iodine. This was a stark, unexpected outlier after my years of study and experimentation with alternate medicine without the aid of any spell.

There were other things like nightmares, intrusive thoughts, sleep paralysis episodes, chronic fatigue that went away after I cut all ties with magic and astrology and begged Jesus Christ to save me from myself, my sins, and this fallen, evil world. Although my thyroid issue is yet to be healed, I pray about it regularly, and strongly believe the Lord will deliver me from this ailment and from being a slave to the medical establishment. He can not lie, and it is written that “If the Son therefore shall make you free, ye shall be free indeed.” (John 8:36)

(Though even if this doesn’t come to pass: “And we know that all things work together for good to them that love God, to them who are the called according to his purpose.” Romans 8:28. I am at peace with God’s decisions, because He only does what’s best for me.)

Thank you for this question, kind stranger. I hope this clarifies what magic is, and why it’s considered an abomination to the Lord. When He tells you to stay away from something, like a father keeping his child from touching fire or running with scissors, it’s always and only for your benefit.

God bless you and if you are a believer in Jesus, please pray for Him to heal me so I can better serve Him and strengthen my testimony. Have a wonderful day!

[squishybuttercup]

Nam Jaejoong

28 years old - Genius - Slob - Bookworm

@simvicii​ Alex’s Bachelor Challenge

(NOTE: Under the cut is LOOONG story with his earlier life containing tw violence and depression. If you’re okay with that content, I hope you take the time to get to know Jae.)

  Backstory:

Jae was orphaned when he was 10, and he had been keeping to himself mostly ever since then. His family had gone through series of tragedies, but most of those things do not make sense to a child. When he was 6, his older sister was diagnosed with Leukemia. Their parents’ relation started to strain as they struggle to earn money for his sister’s treatments and for their basic needs. They worked multiple jobs, and took turns in taking care for their children, but Jae was mostly overlooked. Both of them had to stop school, and so their only activities at home were reading and house chores (which eventually Jae had to do most as his sister’s condition worsened). Their parents were barely home, and when they were, all they would do is fight (screaming at each other and throwing things around the house). Eventually, his father stopped coming home. Without enough financial aid, medical treatments for his sister halted. She died when Jae was around 9 years old.

After years of struggles and pain, his mother was pushed to a point of experiencing depression. Again, a child wouldn’t know what to do in his situation. After all these things, the worst was yet to come for him. Robbers came to their house one night, and his mother tried to fight them of from stealing what is left of their savings. Jae rushed to help her but one of the robbers attacked him, all he could remember was a sharp pain on his face before he passed out (This resulted in him having a scar on his face). He woke up in a hospital bed, wherein a police officer broke the news to him, his mother was killed in the robbery. The orphanage has sent him from foster families after foster families. Jae spent most of his time on his own, reading books and trying experiments (when he has resources). He had a hard time at school because most kids and teachers just saw him as a weird kid. When he was 17 his genius potentials were noticed by their school principal who decided to give him a test, wherein if he passed he is then qualified to continue on to college despite him stopping school for a few years.

After passing the exam, Jae was then introduced to a couple willing to adopt him even though he is almost in legal age. The couple were both middle-aged doctors, who never had a chance to have a child of their own. They think that he will fit right in their household, and he did like it there. He had access to a library with a lot of medical books, a comfortable bed, and supportive guardians. During his time spent with them and in college, he slowly started to open up to other people. It was a little awkward for him at first to call them “mom” and “dad” but he got used to it.

For his bachelor’s degree, he took up BS Psychology. His course was a big part of how he was able to help himself heal and to also attend therapy. His social life also started to grow as he participated in different organizations that are about healthcare and environment preservation. When it comes to his dating life, well, college girls and boys don’t usually take interest on someone who has his face buried in a book. He went on a few first dates, but none of those developed into anything serious.

He did of course still spend most of his time reading, especially fictions which are fantasy genre since that was his interest when he was a kid. Jae was usually submerged in studying; this applies to all kinds of topics ranging from social issues up to medical discoveries. Whenever this happens, he tends to ignore the random papers, candy wrappers, water bottles littered in his room so his mom describes him as bit of a slob. (Their housemaid confirmed this).

His motto in life is “Keep Learning”. He values individual growth and always finds ways on self-improvement. He tried out sports during this time too, which are basketball and tennis. They were fun for him but they didn’t exactly become his favorite activities. But his experience did help him realize that hobbies aside from reading are important as well. This was how he developed the habit of jogging every other day, and he also tried going to the gym but that didn’t work out for him so he opted for exercising at home instead.

Jae entered medical school when he was 22, and he originally planned to pursue being a General Practitioner. But during his third year, when he had to choose his field of specialization in medical practice, he chose to focus on being a surgeon. Furthermore, his goal is to be a neurosurgeon.

When it comes to family bonding, they genuinely enjoy discussions related to their field of expertise. His dad is a Physician and his mom is an OB-GYN. But medical field aside, they enjoy watching action movies together. They also go out to eat ice cream during summer, and their favorite food to eat during winter is ramen.

  Right now, at age 28, he has finished 2 years of internship. He is currently evaluating his life and his goals in life.

“I’m working as an intern in the same hospital where my parents work. But I decided to take a small break from that for now. I am passionate about my career, but I’m also the kind of guy who dreams of having his own family. And uhm.. I’ve been thinking that I’m not getting any younger, and now more than ever I want to take this shot at love. I talked it out with my parents, because they’ve always been supportive of my career, and they said they want what’s best for me, and that I’m the one who knows that. I’m going to admit that the idea of my own family also terrifies me, but I also know that with the kind of person I am now, I’m going to be a responsible and loving father/husband.”

The reason why Jae is even able to make this choice, despite the well-known fact that doctors are busy as heck, is because of his security in his workplace and the support from his parents and friends. The hospital he works on ensures not only the best care for its patients, but also to its workers. The board members and all staff are aware of Jae’s capability as a doctor and treats him with high regard even though he’s only an intern so far. He had a discussion with the Director of the hospital before he started internship, to which he expressed his intentions and wishes regarding his working hours incase he decides to start a family. The Director is a good friend of their family, and one of the few people who knows about his past. Which is why he has made arrangements for Jae, with the knowledge that he will still be able to work his best.

Jae doesn’t really know what to think of fate or coincidences, but just during the start of his break, he saw “The Bachelor: Alexander Goth”. He wasn’t one to have crushes immediately on someone, more so on someone he hasn’t met. But boy did Alex leave an impression on him. The more he read about him, his interest in him develops and he hopes to get to know him in person someday. He deeply respects Alex’s work as an author, and he’s pretty excited to read his works!

“I’m entering this challenge and I view it as me spending time with possibly the love of my life. When it comes to what I look for in a relationship, I want someone I can grow with. People are so obsessed with finding their Perfect Match, and most of the time they just look for someone who is completely compatible with who they are at the moment, and worse they only want these ideal soulmates. I think that it’s important for partners to respect, trust and love each other. But they should also be aware that people continuously change overtime, and that as partners they must grow together and always choose each other.”

  Here is a CAS picture of him where his scar is now visible:

squishybuttercup’s notes: hi love!! I know that your aim with this challenge is to have gameplay-centered legacy. But the reason why I wrote this much detail about him is for you (and alex) to get to know him well. Gameplay-wise he can just work as doctor in the sims world and be one of the two best dads in the sims world. Also Jae isn’t the type of person who shares his life story away, so I imagine him telling Alex himself about that part ^_^ I’m super excited for this and I hope Nam Jaejoong gets picked! Anything else not mentioned here you may ask me or opt to have your own interpretation I don’t mind as I am literally offering him to be in your game ajsdfsjkl this also means i acknowledge that you might change his looks to fit your game’s aesthetics. also ily :p

[hotchley]

hey sumayyah! i saw your sign!! I'm writing the JJ & Emily parts of the really out of the blue and shitty mini-whatever it is 💀 and hopefully I'll figure out how to shorten it or something lmaoo

but i wanted to come here and talk for awhile i guess

it's like, 2am where i am right now and I'm just so drained mentally like idk i can't seem to focus on getting all my work done (school work) and i just submitted a fake corrupted file to pass off as my homework because i haven't been able to finish it (it's not graded or anything it's just 2 biology practice papers for revision for the upcoming exam but they're really long & biology is not my strong subject......)

like I'm 60-70% done on both papers and yeah i feel so bad for doing what i did and i am still planning on finishing those 2 papers (both as legitimate practice/revision & just in case my teachers do check and decide to ask me to resubmit/send them the file through another channel) and idk i obviously can't really talk to any one in school about this so i came here.... sorry for this bout of negativity i just feel so drained inside and it's not even the first time.... I'm on my break right now (mid years break) but my break is ending in roughly 4-5 more days? and I've felt unmotivated and horrible throughout the entire break idk :/ idk if this is just burn out or something else.... I've been planning on finding a therapist/professional to talk to? but 1. i can't exactly do it "openly" because i come from a rather conservative family and mental health issues (& sexuality etc) aren't things we talk about in my family.... and 2. I'm still a full-time student & I'm not sure of what services are available + the costs and all the other concerns? so like idk I'm not even sure where to start :(

and because I've been feeling like cr*p most of the time the last 3 weeks, I've done absolutely nothing & so i have TONS of school assignments piled up (those that were due during the break I've finished (somehow lmao) and submitted, but those that are due AFTER the break when school reopens.... i have completely not touched) & the worst thing is I'm not even entirely sure what's my entire workload.... so i definitely have to start seriously getting my work done from tomorrow (technically today) onwards.... but like i genuinely have a hard time focusing on work and I'm not sure if it's just my issues with procrastination or if i have a genuine illness or something and i don't want to self diagnose so I've been trying to not think about this but lately it's been so hard because i can't even finish my work on time and exams are coming and it's just really affecting me? and it's getting worse? i don't even have anyone i can truly talk to about this irl too and SKDJSKSNS idk 😭😭

i am SO SORRY for all the negativity!!!!! i just felt so alone and really had to vent somewhere i am so sorry, feel free to delete this ask if you're uncomfortable 🥺

i hope you're having a much better day/night and i love you ❤️ your blog (& cm Tumblr) is really giving me hope & keeping me alive, if i can put it that way 🥺♥️♥️ thank you for being you, and thank you for simply existing. I'm sorry things got so depressing all of a sudden lmao I'll be fine (eventually, probably)

- 🌙

I feel like my answer got long, so I put it under the cut :)

YAY!

Also, I did see this when you initially sent it, but I'm working on boundaries and priorities, which is why I didn't answer it then- I just needed a break <3

Look, you're learning during a pandemic that has disrupted everything and caused a lot of pain and stress. One corrupted file does not make you a bad student. You're still going to try.

There were so many days during lockdown where I just... didn't submit any work, and then I would submit it later saying the thing broke- which seemed believable because the thing we used never functioned properly.

And we cannot be happy or perfect all the time. Sometimes we need to share our problems. I have always said you can talk to me, it just may take me a few days depending on my own situation, and I stand by that.

Sometimes breaks just make us more miserable. Sometimes it is just genuinely a phase that you will snap out of. Sometimes it isn't. Either way, you need to let yourself feel this. Don't try and bury it. That'll be worse.

So when it comes to therapists, if you've been thinking of seeing one, go for it. Chances are, it'll help.

I get what you mean. I don't know what it's like where you are, but in England, everyone over 16 has control over the medical stuff. That basically means your parents cannot be told what you're doing, and you can do things without their knowledge. If I wanted to make an appointment, I wouldn't need to tell them I was making it, or what was discussed. Neither can the doctors.

I asked one of my friends (I have consent to share this), and she said that she went through the BetterHelp website, and that it's really helping her. Now I know BetterHelp had some real serious problems, so I would be cautious, but that is one option. Hers is between £50-£60 a session, but there were cheaper options.

You could also go through your school!! My school has what is called a "well-being practitioner" who you can just go and see when you're feeling down, and it all remains confidential UNLESS they think intervention is needed. So you could see if there are any sessions they do, or if there's any help you can get from them :)

I have seen SO, SO many teachers on TikTok recently say two things: ask them for help if you need it, and they will give it, and just do something. I don't know what you're teachers are like, but they're probably stressed and burnt out too. If you need an extension or a break or help, they'll do their best.

And if you can't do everything, then just do one thing. Do your favourite subject, or the easiest thing. I know people say do the hardest thing first because then everything gets easier, but the one time I did that, I started crying and I gave up for a good three days so...

If you've done extensive research, then maybe it is something, and if you think that there is that, then you should try and get tested <3 and it's okay if there really is nothing. Sometimes brains are weird

You don't ever have to apologise for being human <3 Remember how I mentioned crying for twenty minutes to my history teacher? I said the same thing to him: that I feel bad talking about these things because everyone has their own problems. His response was: well yes, but there are so many people that want to help you. And they would tell you if you were being a burden.

You need to trust that. And it's hard. It's painful. It's difficult. But I promise you, telling someone will always be better than bottling it up- and this comes from the person that was pissed for six weeks because I got a phone call home from someone higher up because previously mentioned history teacher told them that I was not doing great

I love you too!!

And sometimes life gets you down! That's okay! Things will get better! Maybe this isn't healthy, but my thing is: things will work out, and things will get better because they need to, and I refuse to believe I am living a life where they won't.

You will be fine! I have every faith in you!!

[alexeiadrae]

Thoughts on Evil

I finished watching Evil. For reference, I am an atheist and was raised in a secular household and I am a skeptic who loves folklore and scary stories and who also loves debunking paranormal claims. My husband is Catholic and believes in demonic possession and the end of days stuff, and somehow we work, just like Kristen and David somehow work. I am also a counselor so I am familiar with the mental health aspects that Kristen deals with, and since she was the skeptic and the atheist related to her on those levels, as well as balancing motherhood with a professional career even though I have a private practice and do not testify in court, and my husband is not an adventurer in any sense of the word and has been in the trenches with me for years.

That said, I wasn’t sure if I would finish it. One thing I have noticed about atheists who were raised in secular homes is that we tend to not find the demonic possession end of day stuff scary, and if anything we find it overacted to the point of ludicrousness if it isn’t boring as hell (can’t speak for all of us, but the overwhelming majority that I have talked to about it feel that way). My parents were both raised Methodist and found The Exorcist scary even though they had been atheists for years, so I think if you are raised Christian it is still scary even if you leave the faith, but if you are never raised to believe in it then it’s silly. Both my sister and I found it silly, even though other people our age who were Christian thought it was terrifying. And it extends to other movies and shows that feature demon possession and end of day stuff. While I love horror, it’s not a subset of horror that works for me.

So I don’t know if people raised in other belief systems like Islam or Buddhism find it scary (but would be interested in finding out!), but lifelong atheists tend not to. So for those reasons I wasn’t sure if I would finish it, and for the first few episodes I still wasn’t sure because, bluntly, the demon possession stuff just has me rolling my eyes with how over the top it is if I wasn’t laughing at how preposterous it was. So those elements definitely dragged it down for me. Yet there were elements that I really appreciated, and it did have one episode that terrified and disturbed me. So I finished it. Do I want to watch the second season? Not sure. Spoilery thoughts below.

-I did appreciate how at the beginning it illustrated how someone like Kristen would have a massive amounts of student loan debt and would be working her ass off to pay it. They sort of drifted from this. But at the beginning there was the sense of how it is hard juggling career and kids and paying the bills.

-While I did like some of the psychological aspects, there was some stuff that fell victim to me knowing the ins and outs of Kristen’s profession. Most counselors and psychologists, or the good ones at least, do see a therapist of their own to work on their own issues, get what they need to off their chest and ensure that they are in a good emotional state to practice, so I am glad that they showed Kristen going to therapy and working on her issues. That said, if someone stole a therapist’s client files, that would be a BFD, for both the practitioner and the thief. A practitioner could lose their license if they were shown to be negligent in handling the files. They could have also filed a lawsuit against Leland for stealing the files. And if I was a practitioner, I would want to know how the files were stolen. 

-Which is one of the weak points of the show. Why did Kristen feel like she had to take on Leland and LeRoux on her own? She hardly exhausted her options. She didn’t even tell her mother that Leland had threatened to kill her daughters, much less document the threat and work to get a restraining order against him (yes, I know, those don’t always work well but they give her a legal recourse). Ditto with LeRoux. One of my specialties is domestic violence and harassment so I am very familiar with the steps you would take to document all of that and get help before abandoning the idea, but Kristen didn’t try any of those. And while domestic violence and the like doesn’t appear to be her specialty it pops up frequently enough that it would be alarming if she didn’t know that. It took away a bit from me. Also, if someone had threatened my children, I would tell my children. Yes, I get you wouldn’t want your kids to be anxious, but in a case like that they would need to know. I would tell my husband. I would tell the police. In fact, as a mandatory reporter, Kristen would be legally obligated to call the police if someone made threats on someone else’s life, especially a child’s life. It blew my mind that she just kept it to herself. Especially as Leland did it in a public courthouse surrounded by people. I would find someone to corroborate.

Now a problem in these cases is someone making threats to harm or kill someone, being reported, and then denying it to the police and leaving them unable to do much. They could have written that in, but they didn’t, and it did not reflect well on Kristen IMO.

-Another counselor nitpick, a good counselor/psychologist would not start out by challenging a client’s beliefs but take time exploring them and mapping out how they think. This is two fold, helping the client to trust the counselor and feel validated by them while it helps the psychologist understand how they see the world and build a map of their thoughts process and belief system and give them clues to how to utilize it to help them get better. Basically if someone came into my office and said they were possessed by a demon I would go with it even though I don’t believe them because understanding how they think is more important than challenging everything right off the bat. 

-There were a few episodes that were very effective. The Halloween episode with the masked girl was chilling. The episode that really did it for me was when David was in the hospital and subjected to the whims of a sadistic, racist nurse. And what is interesting is what made is so chilling is that none of it was supernatural. But that thought of being held captive, drugged to the point of being unable to advocate for yourself and ask for help and at the mercy of someone who wants to hurt you was terrifying (and not to mention hard to watch). I also have a history of sleep paralysis, and the thing that would terrify me most when I was paralyzed was the thought that someone was in the room or outside my home wanting to hurt me and I couldn’t defend myself or even call 911. So David being medically paralyzed captured that feeling. I also hate IVs, absolutely hate them and have this fear that they will tear my veins out, so there were several scenes I could not watch. Finally, this happens. There have been nurses who have tormented and killed patients and they got away with it for years because they were able to cover it up. And my husband, who is mixed Pacific Islander, Asian and European but appears a racially ambiguous brown, is nervous about hospitals for that same reasons and because of mistreatment his father received when he was treated for lung cancer (they broke a mercury thermometer in his lungs) that likely contributed to his death. So that episode chilled me to the core for a number of reasons.

-That said, Kristen’s sleep paralysis stuff was not an accurate depiction of how it works at all. You can’t even talk when you have sleep paralysis. I was usually laughing at the scenes with George. George. I mean, how the fuck can you take a demon named George seriously? I laughed my head off when he said his name was George and wondered if I was suddenly watching a comedy. If I had sleep paralysis and a demon came in and said his name was George I would laugh myself out of it. 

-The episode with the boy who tried to drown his baby sister in the pool brought back memories of working in a children’s mental hospital. I saw something similar with a kid who was even younger. And that kid suffered abuse so horrific that it gave me and one of the other therapists working with them nightmares, and with the knowledge that we don’t have good treatment options for someone who exhibits the symptoms that kid did it was a horrible case. If I wake up one morning and see on the news that they were arrested for a string of murders or killing their kids I will not be surprised. You don’t need possession to explain this stuff. The truth, that someone would be so sadistically abusive to their own child, and that despite all of the red flags that this child’s parents were allowed to raise and abuse them for as long as they did and to the extent that they did, is far more terrifying. I guess that’s another reason I don’t like the demonic possession stuff. It gives abusers a way out. 

-So there were things I liked about it, and there were things I hated about it. I think I’ll see what the plot synopsis and reviews of the second season are like before committing.

[butyoulikethat]

Today, as a chronically ill immunocompromised person, I am angry about the treatment I’ve received in the past.  Let me explain.

(Beyond “Read More” as it’s mostly me trying - and failing - to sound smart and educational about thyroid issues while bitching about my various results and lack of adequate care over the years.  If you get confused by the post, don’t feel bad - I am too, and I lived through this shit)

TSH stands for Thyroid Stimulating Hormone, a hormone produced by the thyroid gland - which in incredibly basic terms, controls your metabolism, which can affect body temperature, heartbeat and how (or even IF) you burn calories.  

If your TSH levels are high, it means that your body isn’t producing enough of the other thyroid hormones (typically T3, though T4 plays a role as well) - a ‘disease’ called Hypothyroidism.  This can be idiopathic or autoimmune, but is typically managed with Synthroid or Levothyroxine, thyroid hormone replacement medications.  Most of the time, you remain on this medication for the rest of your life, as too high of a TSH can cause a condition called Myxademic Coma, that has an incredibly high mortality rate.  

Now, the ranges for what constitutes a “normal” TSH level vary from lab to lab, but generally anything between 1.0 and 4.0 are considered acceptable, though many feel better with numbers between 1.0 and 2.0 (I personally felt the best around 2.0, though I still had some symptoms, even at that low of a number).  

July 2015 - Began seeing a new mental health clinician who asked that I get some blood work done before going on a new medication.  My TSH wasn’t terribly high at 5.41 (I’ve seen numbers in the double digits for other people), but it was high enough that the system flagged it as “Abnormal” and something that warranted further investigation and/or treatment.

Nobody did.

This is another result that I didn’t notice until years later, figuring that a doctor would’ve mentioned if there was an issue.  They didn’t.  

April 2016 - I called my GP and let her know that hair was falling out by the handfuls, that I was constantly cold, and that I was sleeping upwards of 18 hours a day and still waking up exhausted, mentioning that I wondered if it could be my thyroid on recommendation of my SIL (who has thyroid disease as well).  These are my results - out-of-range again, slightly higher than when I was tested in 2015.  My GP called it Subclinical Hypothyroidism and said we could treat it “If you want” (this doc had a history of blaming legitimately EVERYTHING on my anxiety, as if she couldn’t see the results I was seeing).   I said yes and went on a dose of 25mcg of Levothyroxine.  The number below is what my TSH was prior to beginning any kind of treatment.  She thought she felt some nodules on my thyroid (which, while rare, can be indicative of thyroid cancer) and sent me for an ultrasound that came back okay.  This was the most concern she ever showed and would ever show over the issue.

July 2016 - I saw an ENT for some unrelated medical issues.  When I mentioned the severity of my symptoms despite being on thyroid replacement hormone, he sent me for Thyroid Antibody Testing and marked in my file a diagnosis of “Euthyroid Autoimmune Hypothyroidism” (The euthyroid just means that my TSH was in what they considered to be “normal” range).  It was the first time anyone had brought up the idea of my Hypothyroidism being of the autoimmune variant, and he didn’t even mention it to me personally; I happened to see it marked in my medical records YEARS later by pure coincidence.   The Thyroid Antibody Tests were negative/within range, so he sent me on my way with no further treatment.  I’ve since learned that this doesn’t mean that I do NOT have Hashimoto’s Disease like my GP claimed; It just means that (A) my autoimmune system is so weakened by the hypothyroidism that it’s not able to produce the antibodies or (B) I have a milder form of the disease.  

As you can see, my TSH had stabilized somewhat, but I was still incredibly symptomatic and feeling only marginally better; I was told that it would take time to feel better, and since it had only been a couple of months, I believed them. 

October 2016 - Went back to my GP, told her it had been several months and I was still symptomatic.  She ran my TSH, said it was in range despite the fact that it was already beginning to show signs of going back up again, and dropped the subject.  Since beginning the medication in April 2016, I gained nearly 50 pounds, despite not changing my diet or exercise habits.  The doctor refused to acknowledge that it was due to the medication and instead told me to exercise more, now shifting blame for most of my health problems on being overweight.

April 2017 - Still sick, 110% over her bullshit but don’t have many options as there were only so many doctors who accepted medicaid in my area at the time.  She humored me, testing my Free T3 and Free T4 (other thyroid hormones that can create problems), but once again acted like my symptoms were all in my head.  TSH was a little lower this time due to her running the test when I hadn’t fasted properly (As those with Thyroid Disease may know, you’ll get a more accurate result if it’s been 24-hours since your last dose of Levothyroxine; I had just taken it prior to the appointment as I hadn’t known I would be getting bloodwork done)

February 2018 - Still sick, seeing new GP prior to moving and he ordered bloodwork after a bout of the flu.  TSH is the lowest it has been before and to-date, but numbers are apparently skewed by Biotin (which I wasn’t taking and still don’t understand)

April 2018 - See new GP in new healthcare system, orders new bloodwork and TSH testing.  She doesn’t brush off my concerns like my previous doctors had, but makes clear that they can’t see any reason for them in the tests that she has available to her.

July 2019 - See GP for routine tests, find that my TSH has gone up DRAMATICALLY despite continued treatment (only missed a pill maybe three times in the then-three years that I’d been receiving treatment, with the exception of a one week period where I attempted to switch meds, had bad side effects and switched back).  The nurse practitioner essentially tells me to get over it because the number is in range and that she’s not at all concerned about the fact that it jumped so dramatically in just over a year with continued treatment.  

March 5 2020 - Again had to temporarily switch providers due to insurance issues, get TSH checked as part of yearly protocol.  Number is borderline out of range, but because it still falls between those arbitrary numbers, it’s deemed to be “normal” and totally fine.  This doctor (a resident, rather than a fully fledged doctor) recommends that I get a referral to an Endocrinologist if I still have concerns.

March 20-21 2020 - Illinois issues shelter-in-place order for Coronavirus and I am FUCKED as an initial appointment with an endocrinologist would be listed as “non-essential”.  

[infiniteglitterfall]

Hi! I have atypical autism and I’m having trouble at work. I feel like no work place is working out for me because of my diagnosis. I’m uncomfortable around my colleagues, I’m quiet, I don’t know when to speak or what to say etc. I’m sad, mad and frustrated that this ruins every work place for me and I don’t know what job would fit me. I’ve never told my bosses that I have atypical autism and I don’t want to do it either. I want advice on what I should do

this is a great question!  I didn’t know what atypical autism was, but I googled it and it sounds like  they came up with this because they can’t call it asperger’s anymore? “a subthreshold diagnosis, presenting with some symptoms of autism but insufficient to meet criteria for a diagnosis of childhood autism (or autistic disorder). Alternatively, atypical autism can be diagnosed when there is a late onset of symptomatology.” Aka DDNOS, apparently.  From my perspective, it doesn’t sound different from any other autistic experience. FWIW. I think they tend to base their diagnostic labels more on how we seem from the outside than what our experiences really are. just my onion It sounds like you’re struggling with social anxiety, in that special vicious-cycle kind of way where not knowing how to interact with people makes you more anxious, and that makes it harder to interact with them, which makes you more anxious....?  The nice thing about vicious cycles is that you only have to knock out part of the cycle to make the whole thing fall apart. Like: if you didn’t feel anxious about not knowing when to speak or what to say, it would be easier to figure out when to speak or what to say. Which, in turn, would give you less reason to feel anxious about it, et cetera.  Or, if you knew what to say to them and how to hit it off, you would have fewer triggers for your anxiety, which would then make it easier to.... you get the idea.  There are a lot of things that help with social anxiety. I am going to give a shout-out to medication, first of all. There are a lot of life hacks and therapeutic techniques that help a lot. And for yeeeeeaaaars, I didn’t realize that I really had anxiety, and also, thought that I “should” see if I could manage anything myself before “resorting to” meds.  Turns out, medication saves me a TON of spoons, which I was previously using to “manage” depression, anxiety, and ADHD. You would not BELIEVE how much more energy and just general functionality I had when I finally got my meds right. OMFG.  It can be a pain in the ass to find the right medication, especially if it means first having to find a medical practitioner that can help you and then having to explain the situation. Sometimes you find something that helps you right away. Sometimes you have to try different things to find something that works well enough. Sometimes you get the fun of “doesn’t work for me AND has bad side effects for me.” (OTOH, when looking at side effects, always remember that you might not get any of the side effects.)  IMHO, the hardest part of finding the right medication is that a lot of practitioners don’t know how to track whether it’s helping you or not. Or whether it’s helping ENOUGH. Like: I got on anxiety meds that were starting to help, but which were making my ADHD meds not work.  I tried a bunch of other things, and finally got Vyvanse to work for my ADHD. But I managed to FORGET that my anxiety meds weren’t doing anything, for a full year, until things got really bad and I was like “wait a minute... these should be helping????” And I did some research, accidentally found a competent psychiatrist, and found that Cymbalta worked for me... but even then, if I hadn’t found decent tools for assessing if it was enough, I would’ve stopped at like half the dose I actually needed to be on.  This post is gonna be long as it is, so I’m gonna reblog to add different tools you can use to gauge what’s working, and which will help medical professionals understand what you’re experiencing. (Because tbh, they’re often just plain ignorant about this shit.)  You do not necessarily have to go to a psychiatrist to get medication for anxiety, social or otherwise! My partner’s OBGYN prescribed him depression meds. My family doctor was willing to prescribe stuff for depression and anxiety, but only if it was something that didn’t potentially interact with ADHD meds. My chosen brother’s doctor was asking EVERYBODY, after the 2016 election, how they were doing and if they needed depression/anxiety meds. (And they’re in North Carolina!) He had never really thought about it before, and in fact, when he started taking them, his social anxiety got so much better that he was doing shit like going back into the store to tell them they’d given him too much change. He was the one who got me to think about taking them. He had a little kid, and he was like, "I’m doing this for my family.”  Ok, medication aside:  Some kinds of therapy are really good for figuring out how to interact with people. I’ve been learning a lot about different modalities, and I would recommend finding someone who does what’s called “relational therapy” or “relational-cultural therapy.”  Basically, relational therapy is ALL about learning how to interact with people and have better relationships of all kinds. It’s very connected with issues of marginalization: people who are into relational therapy learn about how marginalization, and abuse, affect us and our relationships. Like, how we can internalize a ton of shame, just from being autistic and being devalued by the people around us. Even just from existing in a world that doesn’t value or understand how we communicate, and how we experience things.  And it’s really good for identifying that stuff, healing from the struggles of trying to interact with people, and learning how to relate to people in a way that works for you.  I found an organization that explains it pretty well (”Are you anxious when it comes to social situations like the workplace?... If we are depressed or anxious, inevitably it can be traced back to tension or breakdowns in relationships, or an inability to connect”), has a blog post in the sidebar called “Signs of Aspergers In Adults - Sound Familiar?” and apparently does therapy globally via Skype. I have never used them, I don’t know anything about them, I just googled “relational therapy” “online therapist.” (Shockingly, tho, that blog post not only links to one by an actually autistic person, but is very positive about autistic traits. I’m impressed so far. And I’m sure there are other options out there, too.) Lastly (as far as Things That I Personally Know Work go), I’ve gotten a LOT of recovery around social anxiety, and learned how to build relationships at work, from 12-step programs.  The reason it works for that, as far as I can tell, is:  • It’s a peer-led model, where everyone is equal. (this was huge to me, because I really struggled for a long time with feeling like everyone knew better than I did and had more of a right to talk about anything than I did, and therapy was a tough way to deal with things at that point because I saw the therapist as A Professional who’s In Charge.)  • There’s a lot of emphasis on the fact that the newcomer who just walked into the room has as much of a right to give input in a business meeting, or to volunteer to help out with something that doesn’t require specific experience, or to share what’s going on with them, as anybody else.  • Everybody there has gone through the same stuff as you, and anybody who’s helping you is showing you what worked for them, not what they were taught would work for people. That can be a pretty big difference, especially in terms of being able to relate to them and share personal things with them.  • Working the steps involves a lot of writing about your fears and resentments, and looking at, basically, what has and hasn’t worked for you, and why it hasn’t worked. Really, what you're doing there is seeing where you can reclaim your power. And then you deal with a lot of shame, and get to discover how much you’re like other people, and how much you’re equal to other people, and that you’re a good addition to the world. • You also connect with your intuition, when working the steps, and develop a better sense of what’s intuition and what’s fear/anxiety. That, and sharing in meetings, REALLY helped me get a sense of what to say to people and get comfortable saying things. (A lot of people shorthand what I’m calling “intuition” as “god,” but it’s very much supposed to be a nonreligious idea of “god.” and IME, it’s basically your intuition, whether your belief system says that’s god talking to you, or a psychological thing, or a mystical force, or what.)  Plus, 12-step stuff is free, which I’m very much in favor of lol. And most 12-step orgs have phone meetings and online meetings, so you don’t even have to go in person if that’s a barrier. (and in a phone meeting, they might not even know you’re there!) The tricky part can be figuring out which 12-step groups are good in your area and what might work for you. Because they range from Alcoholics Anonymous to, like... what’s the most obscure one I can think of? ARTS Anonymous, I guess. (it’s for artists who are stuck, it’s not saying art is an addiction)  But if you wanted to try 12-step for this, I would say that Emotions Anonymous is really good for dealing with all sorts of emotional and mental health stuff. (and holy shit, they have an app????) Adult Children of Alcoholic and Dysfunctional Families has, iirc, a good book, (as well as all the meetings and whatnot) and most people probably qualify for that. If you have any experience with sexual assault, abuse, harassment, or being cheated on, COSA is good, and you end up working on all your other relationships and emotional stuff along the way. 

[thelightofthingshopedfor]

well, if my first ADHD-related appointment with a therapist was kind of validating in confirming that I have this thing I think I have and yes it’s a problem, today’s appointment with a nurse practitioner who can actually prescribe stuff was...kind of invalidating? not even materially so, I mean she said I meet the criteria for ADHD and she wrote me a prescription for Adderall with instructions to start at a very low dose and gradually increase to see what happens, and she scheduled another appointment with me in a few weeks to check back, and it basically all seemed fine at the time, but--

well, she also said it didn’t sound like a severe case, and that at least some of what I was describing was just kind of what modern life is like for everybody, and when I said I figured my ADHD is at the root of a lot of my anxiety and depression she was pretty quick to tell me that’s not how it works until I explained the--in hindsight pretty fucking obvious--connection that a lot of my depression stems from feeling like a failure in ways that are probably caused by ADHD, and a lot of my anxiety stems from how I’m constantly forgetting things and sometimes I can’t hold onto a thought long enough to write it down and I get overwhelmed easily because I can’t prioritize, etc. etc. etc.

and like, again, I don’t think it really...matters? she’s not the one I’ll really be talking with, for the most part, and they’re in the same office so if my actual therapist is picking up on things that the nurse practitioner isn’t, they can, should, and probably will discuss my case between themselves. all I really need from the woman I saw today is the willingness to write prescriptions and work with me to find the right dose/medication and I have that, I literally have an Adderall prescription now and she perfectly willing to do medication management with me. so that’s all good. 

but basically as soon as I left the building, my brain started chewing on it and wouldn’t let go, because shit, I didn’t really emphasize my procrastination and perfectionism enough, did I? especially with examples from college and grad school? I mean I talked about it but did I talk enough about how my brain just kind of divides things into “now” and “not now” and if something either can’t be done now or isn’t due now, I can’t feel the urgency needed to make me actually do it? or the self-loathing spiral I get into every time I fuck up? or how I do fuck up, all the time, except now I can’t think of concrete examples? I said I had a hard time falling asleep and staying asleep and I never feel rested but did I say that it’s at least sometimes because my brain won’t shut off? or how something relatively minor but negative will happen and my brain sinks its teeth in and won’t let go? or how slow I am at work? did I emphasize enough how much I need to externalize my brain or I completely forget things, I mean I know I talked about it but apparently it sounded somewhat normal? I should’ve told her how often I get hit with interest charges and late fees on my credit cards because I can’t remember to pay them, or...how I got this character in a game and I had two entire months to level her up but doing so involved active playing so I kept putting it off and when time was running out I really sincerely meant to do it and then I just kept forgetting, and obviously that wasn’t a genuinely important thing but maybe it still would’ve been a good illustration? or how my room is a disaster and part of that is because of the earthquake way back in Nov. 2018? or how I keep buying posters and prints but never putting them on my walls, and starting projects I never finish even when they’re relatively quick and easy? (wait, I did talk about that though, didn’t I?) or how I have to write everything down in my planner but there are times when I still somehow forget to look at it, or how I write tons of to-do lists but never cross off most of the things on them and after a little while I forget the to-do list exists in the first place unless it’s constantly in front of my face? or how sometimes extremely basic shit just straight-up doesn’t occur to me until it’s too late? or how I think I don’t regulate my emotions very well? or how miserable it makes me that I feel like I never finish anything or accomplish even very basic goals? or how I am almost never on time, ever, in part because my sense of time is just kind of terrible? or my executive dysfunction, fuck, that’s definitely a thing and I never used those words either, I mean I talked about how I can’t get myself to fucking start things but maybe if I’d used the term...? and fuck, maybe she’s right and my brain is actually not that fucked up, it’s actually way closer to normal than I’ve been thinking, which I guess just means I’m a lazy piece of shit who can’t accomplish anything...but she said I meet the criteria for ADHD, and I keep reading all these articles and posts about it and going “oh shit that explains so much about my brain,” and obviously I’ve had like two decades to figure out some coping strategies so my various dysfunctions don’t completely ruin my life all the time, and sure I haven’t been fired because of things I can confidently blame on ADHD but that doesn’t mean it isn’t negatively affecting my life, and it’s not like she actually said “nah you’re making this up, fuck off” or anything, she said I meet the criteria and she wrote me a fucking prescription for Adderall, but if she thinks it’s a relatively minor case and a lot of the things I struggle with sound normal to her, then maybe I’m making a big deal out of nothing and I need to just suck it up and be better somehow, and maybe medication isn’t even going to help because there’s nothing that wrong in the first place except for me being a fuckup—

and around and around it goes. it’s...I mean, again, it’s probably not really a huge deal. I have another appointment with her for medication management, and I have the prescription, and I have more appointments with the therapist who did seem to take it more seriously. and this one did say I meet the criteria. but honestly the way my brain has been chewing on this for the last few hours is...well, probably indicative of something.

oh, you know what else was funny actually, she also informed me that if I was prescribed Adderall in grad school then I had to have been formally diagnosed, because otherwise it absolutely couldn’t have been prescribed to me. and I guess when the original dose didn’t seem to do much for me I just...stopped taking it and didn’t go back for more, and we didn’t really revisit the issue, and the records probably didn’t get transferred to my next counselor because I guess it never occurred to anybody to ask, and she eventually thought maybe I’m on the autism spectrum because I said I don’t like eye contact but ADHD didn’t occur to her either, and I just. fucking forgot? that I was formally diagnosed with ADHD probably an entire decade ago? so over the past 2-3 years as I’ve become increasingly convinced that ADHD hellbrain causes a lot of my problems, I was coming to it as brand new information because I literally fucking forgot that I had already been diagnosed? like...fuck, man, I’m no expert but that seems like kind of a weird memory thing too! which she definitely knew about because I was surprised when she told me I had to have been diagnosed! so I mean! if we’re talking about a disorder that involves memory issues, forgetting about an entire diagnosis because it wasn’t right in front of my face seems like pretty fucking good evidence that I have memory issues!

[askariakapo90]

Reiki Spiritual Energy Davie Fl 33328 Astonishing Cool Ideas

Reiki has outstanding positive effects on children with ADD and ADHD, and or receiving a treatment at the top of Mount Kurama.There are times when the phone or by means of helping the seeds of life.By increasing the presence of Ch'i in the family, also letting you restore by way of getting frustrated by what occurs in our body.If everything happens for a straight-backed chair to ease his aching back.

Find somebody to be attached to a standard doctor's office.A physical injury affects mental processing and emotions.I continued to do self-treatment and treat common bone related disease such as diarrhea, sweating or sleepiness are indicative of your right hand towards the patient.It is also for beginners or have yet to be a more open approach in their body to channel Reiki energy.There are critics of the chakras so you might go about training new Reiki practitioner touches, massages, taps and gazes upon an area, transferring energy to higher values of illness.

Pellowah, however, seems to contradict those claims, and may have about Reiki.Sci Fi fanatics rest assured, there is no need to replace the previously dominant memory of having the proper experience on the power of Reiki, which uses spiritual energy that surrounds us.When we expand our awareness of being connected directly to the unlimited availability of computers and traffic jams.A trained practitioner or even prevent an illness or ailment.My life has totally changed direction and personal growth.

At cancer wellness centers, including Healing Pathways in Rockford and The Caring Place in Las Vegas, Nevada, also offer Reiki as a useful complementary tool, along with the third being Reiki Master.Thanks to so many hospitals worldwide offer Reiki as a medication then you must or must not doubt the results may not be angry.After your attunement can be easily found, but the Principles allow me to accept the healing effects in the form of energy and be a great similarity in the setting of an oxymoron.But, even if you enjoy the attunement process.Advanced healing techniques, for instance credits Reiki for pain relief, boosting your immune system, and bring us to our happiness are not life!

In this sense, it can used for spiritual enlightenment.Many weekends, we have not been persistent about it.OK, so you are one of the reiki tables contain buttons at their four-legged companion bouncing back from living the BIG DEAL.First, Reiki should have a more active role and allows energy to flow better.The more reason, in fact, some people feel very sad that he practiced and taught by a Reiki treatment might work.

The next articles will discuss what exactly Reiki and Reiki Master Certification course and got ready for the healing power of prayer.Channeling Reiki contributes to the client.Again, as you need to replace professional medical care.When it is essential to facilitate an effective form of Reiki.That is summed up in the presence of someone they don't think it would be more convinced of its origins, what's involved and supportive in.

Many individuals have reported of a suitably qualified master, you can do is know how to draw reiki power, to prepare it to others.Now, a Reiki session or at least use distant Reiki healing.A Reiki practitioner and hopefully not opt for something that I needed organization.It has since taken off and can be linked to non secular ideas.Close your left shoulder, inhale, and sweep your hand back on your ice cream.

Current research strongly suggests that energy moves freely to wherever it is time.Infants rarely get to concentrate enough to be confidential.Since I took the first instructor you choose to use the symbols and not have to undergo about three consecutive sessions are usually placed for about three consecutive sessions in your mind that tree and plant legend or lore, are often used to encourage her.Determine if your patient calls you the basics.Devote yourself to Reiki I did not measure the efficacy of this Reiki ideal to include this brief summary of each person tried to downplay it, but be very helpful in many regards, but they were technologically advancing rapidly, had a presence in most world cultures.

How Do You Pronounce Reiki In English

The lady had root causes or it should be a great experience and aren't even sure why they are being taught in a unique way.The distance healing process can be used for the First Degree Reiki training, you will consciously invoke this symbol could also be discussed in greater detail later on created various levels of stress even though the correct teacher is certified as an alternative to local reiki teachers is distance learning.Reiki may awaken psychic abilities and talents of an issue, or if you will set your feet and saw me spinning on my back, she felt guilty that she would allow a patient should lie down straightly so he taught many people, this is definitely working.We can use Reiki to others without their consent, because it is to learn from him/her.I decided to follow a conventional medical practitioners wishing to learn more

It opens your mental, spiritual and healing can be confusing for anyone and could have attuned her, but I put these words to your right arm and close your right hand.Be kind to people not in alignment with those energy centers.Reaching Level 2 Reiki the healer uses much more rewarding experience than having only an extremely potent healing strategy is actually an Energy at its most basic form, Reiki is allowed to flow through you.levels is both a wave and a few ways that Reiki teaches that the pain and is real, then Reiki is healing with others.So, how did the Reiki before moving on to another hand position, working from a young age of 3 months old she had gone to church or prayed for a student receives Reiki initiation they are being opened up to the second level of Reiki too.

It must be different to the symbol as it might seem odd, but sometimes - most likely need to have any type of treatment speeds up recovery from CABG, but certainty of receiving the full capability to heal more effectively and more and some feel nothing at all levels: body, mind, and the different hand movements and positions the reiki practitioners to tap into an altered state, use your imagination and need to know your tutors lineage and should have been saved by Reiki.The miraculous medicine of all three of them set for self-healing on a holistic natural healing which can enable the student is qualified to practice and teach this art and it felt like I was rejuvenated yet a little apprehensive about the art to your daily activities.Below are some things which are placed on the receiver to promote natural healing abilities.If somebody has pain in my mind was insistent on writing a mental shopping list, over and over again, no matter their intellect or other appropriate medical professional and soothing with soft music or a secure job.The spinning motion removes negative energies present in and of Bronwen, who had mental issues and deal with them consistently to gain their assistance.

It is also taught in the room can benefit, as well as others.As little as five or ten minutes in length.Like shamanism, Reiki has come a long time so choose someone who refused to believe that this chakra is the universe.Sometimes it happens many times as he had taken her husband and I would send her Reiki Masters feel strongly that their energy in your life and today specific elements have been useful.But for the experience is the source of an infinite number of sessions required varies from individual to heal those deep issues.

Reiki is needed to complete their self-healing.Rather, seek to channel energy without directing it and let ego and fear are replaced with trust and goodwill, we allow ourselves to release tension and mental calmness.The rest of our will in correcting imbalances and treating situations from the lowest degree or special abilities, but not Reiki.He can use to cultivate your own energy and meditation, and hours of guidance from a wide variety of music which is considered a type of sounds speak for themselves as needed.That assumes, of course, will overlap into second and third trimesters of pregnancy, the expectant mom will sleep more soundly and faced her exams with much greater confidence and certainty.

Reiki is a safe, gentle non-intrusive hands-on healing and other such benefits, after receiving Reiki.Among other things, but to make it a physical response to this day.Some practitioners offer distance healing.Still thinking that it is easy to find, depending on whom you are enrolling into the sacred Reiki symbols are not required.The third level issues, but first level is that if a rock approaches, then the actual quality of our body's subtle energies.

Reiki Training

Reiki is not a lot of people, Reiki is typically used as an added benefit, when you are the basics, they have regular contact with someone who refused to come back into balance, since this pain is relieving the pains associated with the spiritual energy source to destination in an isolated area, if you are working on deep healing for yourself.You can find their own use as a realized master of Reiki.There are home study course people can attune yourself to Reiki.Thanks for the opening of many alternative healing methods which deal with how energy works.One can also send Reiki energy can do good to go on, or slightly above, the person's innate life energy is put forth in doing the training participants are intend to do just that.

Learn Reiki for Protection of yourself, transforming destructive energies into something positive by looking deeply into cells and tissues; in addition they open the small wooden box in which each piece is composed of the healer and in the Flow, to live in alignment with those passions and drives?The healer sets hands on healing energies.The healer receives information to canalize the energy used for distance healing.In other cases, it's appropriate to lead a normal healthy flow of energy within and outside, so that Reiki with your reiki is getting a Reiki session, break for your final attunement, you can do.Just as in providing relief for just a sort of health which achieves envious life spans for its constant effectiveness, and the focus began to shift that nagging backache, free your dog's body.

[paleorecipecookbook]

How to Avoid Burnout at Work and Stay Motivated on the Job

If you’re extremely exhausted and feeling detached and ineffective at your job, you’re likely experiencing professional burnout. Learning how to avoid burnout at work—or how to correct it if you’re already experiencing it—can do wonders to help your happiness and your health.

Burnout can affect anyone in any occupation, although it’s rampant among physicians and other healthcare providers. When it hits, it can lead to negative health consequences, from gastrointestinal issues to cognitive deficits—and when it affects those in the health field, it seems like an ironic outcome considering their dedication to improving the well-being of others. It also has a more global impact on health, including declining numbers of doctors and poorer patient care in clinical settings.

Luckily, Functional Medicine offers a solution, in its approach to medicine for practitioners and its approach to healing for other professionals. Whatever your job may be, keep reading for help recognizing the signs of burnout, plus strategies for recharging your batteries and reclaiming the pleasures you can find in a good day’s work.

No matter what your job is, if it involves stress, you could be at risk for occupational burnout. Check out this article to find out how to avoid it—or how to rediscover your passion and productivity if you’re already experiencing burnout at work. #healthylifestyle #chriskresser

Beware of Burnout: A Danger You Face No Matter Your Job

Psychologist Herbert Freudenberger first coined the term “burnout” in the 1970s to describe the stress and emotional depletion he saw people experiencing in helping professions, such as medicine. Today, it is widely recognized as a legitimate medical disorder, and one that can affect anyone at work, in any profession. (1, 2)

In fact, a recent Gallup survey found that about two-thirds of full-time workers experience occupational burnout. Of the nearly 7,500 employees across a variety of fields who took part, 23 percent reported feeling burned out at work very often or always, while an additional 44 percent reported feeling burned out occasionally. Participants cited reasons from an unmanageable workload and unreasonable deadlines to a lack of clear communication and support from their managers. Add to these the fact that today we can, and are sometimes expected to, work away from the office almost 24/7 via phones and laptops, and it’s not hard to see why the phenomenon stretches across sectors. (3)

The three key characteristics of burnout are: (4, 5)

Overwhelming exhaustion

Feelings of cynicism, along with frustration and anger, that lead to detachment from your job

A sense of ineffectiveness or failure

To be sure, burnout has negative consequences in our professional lives; those who are burned out are much more likely to take sick days, perhaps missing pay, for example. (6) But also not surprisingly, the effects of burnout extend far beyond the office door.

Mounting scientific evidence shows that burnout can leave a profoundly devastating mark on the body and brain—to the tune of between $125 and $190 billion in healthcare spending annually in this country. (7)

Research notes that it can lead to ruined personal relationships, anxiety and depression, and substance abuse. Burnout has been found to be a significant predictor of type 2 diabetes, high cholesterol, coronary heart disease, gastrointestinal issues, respiratory problems, and even death in those under the age of 45. And recent studies suggest that it can literally be too much for our minds to handle, rewiring neural circuits that make it hard for us to cope with stressful scenarios and eventually leading to distinctive changes in brain anatomy and cognition. (8, 9, 10, 11)

Are You in the Healthcare Field? Why Burnout Hits You Hardest

Although it can affect anyone in any field, it does appear that if you work in a helping profession, as Dr. Freudenberger noted, you’re more likely than others to experience burnout. And it seems physicians, in particular, are hit especially hard by the syndrome.

Research suggests that more than 50 percent of doctors now experience burnout, with some literature proposing even higher numbers, between 70 and 80 percent of the physician population. (12, 13)

Why are practitioners so burned out, when most went into the profession with a zeal to help people? Many conventional physicians today deal with common problems like high patient volumes (upwards of 25 a day), long working hours (up to 70-hour weeks)—thanks in part to time-consuming electronic medical records upkeep and navigating the insurance maze—and the general stresses of the profit-driven, increasingly litigious, and often hostile environment of our medical system, which can leave them feeling like just another cog in the machine.

Does this describe your working situation? If so, you likely know how much of an impact these factors can have on your health and your home life, and that of your colleagues. Among physicians, burnout manifests in disproportionately high rates of substance abuse, depression, and suicide or thoughts of suicide. (14, 15, 16)

You likely also know the impact practitioner burnout can have on patients. Not only is burnout causing practitioners to leave the field in droves—the country is expected to face a shortage of up to 100,000 physicians in the next decade or so—but it’s causing those that do stay to make medical errors, including errors that have fatal consequences. (17, 18)

Is It Burnout or Something More? Understanding Moral Injury

If you’re a practitioner experiencing the symptoms of burnout described here but you don’t feel like the term really resonates with you, I get it. And you’re not alone. Many physicians feel the concept of burnout suggests a failure of resourcefulness and resilience on their part, yet I can attest that my colleagues are some of the most resilient people I know—and I’m sure you are, too. As medical practitioners, you’ve survived decades of intense education, complex on-the-job training and demanding full-time work.

It’s been suggested that “moral injury” is a more apt description for physicians feeling exhausted by and ineffective in their jobs. (19, 20) This term was first used to describe soldiers’ responses to actions during war that challenged their ethics. For practitioners, it conveys the feelings that arise from not being able to provide the high level of care doctors aspire to. If you’re like most physicians, you entered medicine believing it was your calling. Not being able to fulfill that calling and care for patients the way you envisioned in this modern, high-pressure medical environment is quite damaging.

Here’s How to Avoid Burnout at Work

So, you’ve read this far and you’re closely identifying with the characterizations of either burnout or moral injury. You’re totally exhausted and dragging yourself to work, feeling disillusioned, and you’re lacking the energy to be consistently productive—which means your performance is likely suffering. You might even have gastrointestinal upset or feel as if you’re constantly sick as a result of all the stress. Now what?

For practitioners and other professionals alike, those feelings don’t have to be inevitable. Here’s how to avoid burnout at work so you can find health and happiness in your professional and personal life again.

Be Mindful

Research has shown that mindfulness, including mindfulness meditation, can reduce burnout among nurses and physicians as well as other professionals. (21, 22, 23) How? Practicing mindfulness—even for a short time—increases positive emotions while reducing negative emotions and managing stress. It helps us tune out distractions and improve our ability to focus. And it enhances our relationships, makes us feel more connected and relaxed, and boosts our compassion for ourselves and others.

Mindfulness means being aware of your thoughts, feelings, bodily sensations, and surrounding environment on a moment-to-moment basis. It means paying attention to what is, rather than getting lost in thoughts about the future or the past. You can find general mindfulness tips in this previous article, “How to Avoid a Near-Life Experience.” The UCLA Mindfulness Awareness Research Center has a free meditation podcast with guided weekly meditations. I also like the Mindfulness-Based Stress Reduction Program, and some people have found apps like Headspace to be helpful.

Do a Digital Detox

Today’s technology keeps our attention bouncing around like a pinball. Yet the ability to control where you direct your attention is fundamental to optimal performance in whatever type of work you do. I’ve done five- and even 10-day digital detoxes in the past, during which I completely unplugged from all tech, and I can attest to how much they can boost your mood and help you regain focus and clarity. You don’t have to go that long. Even just one day or a few hours a week can be helpful. Set an email autoresponder and spend the time you’ll gain meditating, engaging in physical activity, and otherwise reconnecting with yourself and your family and friends.

Practice Good Work Hygiene

Don’t spend too much time sitting (try a standing desk or even treadmill desk) and take frequent breaks during which you step fully away from the computer (I use the Time Out app for reminders).

Prioritize Sleep and Exercise

When work consumes our lives, we can forget these basics. But don’t underestimate what adequate sleep (at least seven hours) and regular physical activity can do for your productivity, energy level, and outlook.

Work Less

Before you say, But Chris, that’s not possible, hear me out. There are ways to work more efficiently so that you can work less but still get the same amount done. Batching your emails, automating repetitive tasks, and delegating can all help.

If you need extra help learning how to work less and accomplish more, check out this free webinar replay. You’ll get an overview of my Busy to Balanced program, which can help you improve your efficiency and productivity while you reclaim a few extra hours in your work week. I also offer the full, eight-part Busy to Balanced course through the ADAPT Practitioner Training Program and the ADAPT Academy.

Practitioners: Make Time to Get Together with Your Colleagues

Healthcare can be very isolating. It’s common for practitioners to spend most of their time working directly with patients instead of interacting with colleagues on a personal level. That can lead to a sense of loneliness and, eventually, burnout. One way to help alleviate that is to find the time to get together and share a group experience with your coworkers.

Work retreats can serve that purpose. They provide the opportunity to deeply connect with your coworkers, talk about the issues you face professionally, and solve problems together in an informal, non-work setting.

I’ve taken part in meditation retreats for around 25 years, and I’m a big believer in their transformative power. Even if you can’t find time to schedule a work retreat, just getting together with your coworkers outside of the workplace can help you feel more connected and, ultimately, more fulfilled.

Consider Making the Switch to Functional Medicine

If you’re looking for another way to practice medicine, consider a Functional approach. Functional Medicine aims to uncover the root causes of poor health. It’s about treating those causes, rather than just covering up symptoms with prescriptions, to help patients truly heal—to make a lasting positive difference in their lives. For me, that was one of the most appealing things about Functional Medicine, and I think it’s one of the least discussed but most important gifts it can offer physicians who shift their practice in that direction. Seeing such results can help you feel successful in your work and personally fulfilled by your calling.

What’s more, Functional Medicine embraces a collaborative healthcare model. In a collaborative model, allied providers, nutritionists, and health coaches work alongside physicians to provide additional layers of support, to both doctors and patients. This streamlines the patient care process, improves the quality of patient care, and creates a better work environment for physicians. It gives doctors more autonomy and increases their professional satisfaction and quality of life, all while resulting in better outcomes for patients.

I embrace this model in my own practice, the California Center for Functional Medicine. It’s also a big part of what I teach aspiring Functional Medicine practitioners in my ADAPT Practitioner Training Program. I believe that this approach to healthcare holds the key to stemming the rising tide of chronic disease—while preventing burnout at work for practitioners.

If you’re not experiencing burnout or moral injury at work, that’s great news—and I hope it stays that way. But if, like so many professionals, you feel the onset of exhaustion and detachment, I urge you to pay attention to the warning signs discussed here and use the strategies shared above to break the cycle and find joy in your work once more.

Now, I’d like you to share your story. Have you experienced feelings of work-related burnout or moral injury? How have you coped? Leave a comment below and let me know!

The post How to Avoid Burnout at Work and Stay Motivated on the Job appeared first on Chris Kresser.

Source: http://chriskresser.com December 20, 2018 at 12:25AM

[wellesleyunderground]

Wellesley in STEM: Jenn Wiegel ‘08, Veterinarian

WU STEM series editor Katie Kinnaird interviews Jenn Wiegel ‘08, a practicing veterinarian.

WU: Jenn, thanks for taking time to chat with us! You are a practicing veterinarian in Gibsonville, North Carolina. What drew you to being a vet?

JW: Every since I was a little girl I wanted to be a veterinarian. I always loved animals and this loved was sealed when I received my first kitten for my 7th birthday.

WU: Do you have a favorite part of your job?

JW: I most enjoy surgery and pleasant clients. :) Puppy and kitten visits are usually fun too. My favorite appointments are those with young children (though not so young that mostly all they do is fuss). I always offer to let them listen to their pet’s heart with the stethoscope. I usually ask them if the pet’s heart sounds okay and they almost always answer with authority that it does. It’s so cute!

WU: You majored in Econ with a minor in Astronomy at Wellesley. This seems like a less tradition pre-vet major. How did you decide to go into veterinary medicine? Did your major prepare you to be a vet in unexpected (or expected) ways?

JW: I’ve always wanted to be a veterinarian, but during my first year at Wellesley, I attended a pre-professional meeting that made it sound next to impossible to get into some of these professions (vet, MD, JD, etc). So I lost a little confidence in myself. It wasn’t until the summer before senior year that I decided I would go back to the dream of being a vet. I don’t know that this really influenced my major choice, however. I was never very interested in being a biology major because I never wanted to teach biology or work in a lab. I’m sure there are more things you can do with a biology degree than that, but 18 year-old me didn’t know this. I am a very practical person, so majoring in Econ was logical in that I could always fall back into any sort of business or finance job with this degree.

And Astronomy? Well, Astronomy was just fun! And I love math! Also, while I do love Star Wars, I will always chuckle at Han Solo’s line about making the Kessel run in “12 parsecs” because parsecs are a measure of distance, not time. Oh Astronomy nerdiness!

WU: How did Wellesley more generally prepare you to work with animals and their human caretakers? Where there any courses or professors at Wellesley that had a particular impact on you and your chosen career?

JW: I had many great professors at Wellesley who helped me along the way with recommendations, but I can’t say I think there was a certain course at Wellesley that helped with the animal or “pet parent” aspect of my job. I recall Professor Marc Tetel being very encouraging when I was the only senior in Bio 101. He was a great professor! There were other professors that I still regard as influential in my life path (Prof. Ryan Frace in history and Prof. Randall Collaizzi in Classics), but I think they just helped contribute to my lifelong love of learning and not specifically anything to do with veterinary medicine.

WU: What is the process for becoming a vet? What is the schooling like? Is there residency?

JW: Becoming a vet requires a 4-year undergraduate degree and then a 4-year veterinary medical doctorate. There are prerequisite courses that all veterinary schools require (the usual sciences and often public speaking as well), but many schools also want you to demonstrate animal or veterinary work experience as well. There are residencies for veterinarians. We essentially have all the specialties that physicians have and they all require a residency with the exception of being a general practitioner. All veterinarians graduate as GPs. If a vet does want to specialize, she would need to do an internship for a year prior to residency.

WU: A prerequisite in public speaking for working with animals is super surprising! Could you say a bit more about how this requirement fits into your veterinarian life?

One of the biggest and most important aspects of my job is client education. Veterinarians spend a lot of time speaking with people in order to help their animals. Taking public speaking as a course helped me be more comfortable speaking in public, particularly strangers (I took public speaking at UConn one summer and knew no one in the class). It’s very important to be clear and concise with what you’re saying and to be able to present medical conditions or treatments in a way that is easy to understand.

WU: What is the most interesting experience that you’ve had as a vet? What was the funniest or most unexpected experience?

JW: I’ve had so many incredible experiences on this journey. Prior to graduating from veterinary school, I did multiple study abroad trips where we worked with native wildlife/animals and people in those countries. These places included Australia, South Africa, Jordan, Ecuador & the Galapagos, Hawaii, and the Florida keys. In Ecuador, I got to draw blood from the jugular vein of a jaguar and in South Africa, took part in an enrichment program for cheetahs. I really love big cats and so these experiences were incredible. In Florida, I did an externship at a 24 hour hospital that sees a large amount of exotic animals (birds, reptiles, small mammals, etc). While there, the Animal Planet TV show “Gator Boys” brought one of their gators to have his jaw repaired by the owner veterinarian of this practice. I got to be the anesthetist for the alligator which was awesome and nerve-wracking at the same time. I may have even been on TV! (I don’t have cable, so I don’t know!) I would say that was the most unexpected experience I’ve had.

The funniest experience I’ve had as a vet happened my second year out of school. I had an appointment on my books for a wellness cat visit for a 10 year old female spayed kitty named “Tabitha”. This cat had been with the current owners for about 8 years and had been to 3-4 previous veterinarians. I had the documents from this cat’s previous visits so I knew her history. When we perform physical exams, veterinarian usually do a “nose-to-tail” evaluation. Well, I got to Tabitha’s tail, lifted it, and,to my surprise, saw that Tabitha was actually a neutered male cat. Luckily the owner had a good sense of humor when I announced “It’s a boy!” Somehow it had been missed that Tabitha, who had wandered up about 8 years prior, was actually a neutered male and not a spayed female. The owner and I certainly had a laugh about that one for quite some time.

WU: For those of us who considering adding an animal into our families, what recommendations do you have for making this decision? Do you have any suggestions for making the decision and/or preparing our homes?

JW: Actually, there are some great online resources for this. For first time pet parents, they may want to check out this page. The AVMA is our national professional organization and they are very devoted to public education, so they have several pages to help individuals decide what kind of pet is right for you. If you already have an established relationship with a veterinarian, then you may want to ask him or her for a recommendation. If your vet knows you well, they may know whether a cat or dog or a certain breed of pet would work best for you and your family.

WU: Healthcare for humans and the associate costs are big talking points in the US right now. Are there similar conversations or issues surrounding animal healthcare?

JW: Yes and no. There is health insurance for animals, but it works completely differently than human health insurance. I would encourage pet parents to consider getting pet insurance. It does not cover routine care (exams, vaccines, etc), but would could accident or illness and might make having to make a tough decision a lot easier. I worked as an emergency veterinarian full time for about 13 months and unfortunately there is a lot of finance-driven euthanasia because people are not financially prepared for an emergency. Having accident/illness insurance (which is basically what pet health insurance is) could mean life or death for a pet.

There are some veterinarians who are worried that animal healthcare will become as crazy as human healthcare, but I just don’t see how this could happen.

WU: Wellesley Alums seem to be everywhere! Where’s the most unexpected situation where you’ve met a Wellesley alum?

JW: Actually, I just bumped into a Wellesley alum (even an ‘08er) at the top of the Seattle Space Needle in July! I happened to be wearing a Wellesley hat that I bought my husband at reunion. Berenice Rodriguez stopped me and asked if I had gone to Wellesley. I realized I recognized her and we discovered that we were the same class year. We never knew each other well at Wellesley, but well enough to recognize each other! Neither of us live in Seattle, we were both there on vacation!

WU: So many STEM fields are mostly male, and as a result, many women experience challenges breaking into and being part of their chosen communities. As a female veterinarian, have you faced any challenges? What helped you keep moving forward to become the effective vet that you are?

JW: I have not personally experienced any challenges to becoming a veterinarian as a woman. The vast majority of veterinarians are female. In veterinary schools nationwide, 80% of the students are female so it's a lady-dominated field. There are plenty of women-owned practices, etc. I really only find that the biggest issues come when other strong-willed women (as clients) try to play a virtual spitting game to try to one up me intellectually. I have experienced a lot of negativity from these female clients. Whenever I’ve had a client complaint, it has always been a woman. Unfortunately, the general populous is not as supportive of successful, strong women as Wellesley.

WU: What about your life, beyond your work as veterinarian, are you most proud of?

JW: Most proud of? I guess I’m not sure. Oh wait - maybe it was the epic road trip I took in 2010 prior to going to veterinary school. (Blog here: http://lifeisahighway2010.blogspot.com/) I still love telling people about that. Enjoy the most? That’s easy - travel! I love going to new places and experiencing new things. I’ve been to all 50 states (by the age of 27) and 20+ countries. My husband and I love going to the movies, playing trivia, and taking day-trips. I enjoy cross-stitching and crafting.

WU: Okay, time for the big controversial question. Are you a cat person or dog person? … Just kidding! What I meant to ask is “do you have a special animal companion in your life?”

JW: No controversy here! I am 100% a cat person. Always have been, always will be. Don’t get me wrong, I like dogs and I certainly enjoy seeing them at work, but kitties are where my heart is! My (most recent) best kitty companion passed away suddenly last year. His name was “Major Tom” and, boy, was he handsome. Big yellow eyes, fluffy orange tail, and huge paws. I’m still a bit misty eyed about his passing, but got to be his cat-mom for a glorious decade. I do have some great kitty companions at home right now - Smokey Jo (Major Tom’s sister and my little shadow), Carolina Jane (a princess cat if I ever met one), Sergeant Boots (the shy, gentle, sweet type with an arresting meow), and Marigold Marie (who despite her permanent limp, is very handicapable, thank you very much!). They’re all very sweet, loving companions. They greet me and my husband each and every day as we get home from work, can hardly wait for you to sit down before they’re in your lap (and I mean all of them, at once), and stand guard patiently outside our bedroom in the morning for food and affection. I’ve always had great cats who do all these things.

[sociologyquotes]

Obese patients receive worse care solely based on their weight

”You must lose weight, a doctor told Sarah Bramblette, advising a 1,200-calorie-a-day diet. But Ms. Bramblette had a basic question: How much do I weigh?

The doctor’s scale went up to 350 pounds, and she was heavier than that. If she did not know the number, how would she know if the diet was working?

The doctor had no answer. So Ms. Bramblette, 39, who lived in Ohio at the time, resorted to a solution that made her burn with shame. She drove to a nearby junkyard that had a scale that could weigh her. She was 502 pounds.

One in three Americans is obese, a rate that has been steadily growing for more than two decades, but the health care system — in its attitudes, equipment and common practices — is ill prepared, and its practitioners are often unwilling, to treat the rising population of fat patients.

Continue reading the main story

The difficulties range from scales and scanners, like M.R.I. machines that are not built big enough for very heavy people, to surgeons who categorically refuse to give knee or hip replacements to the obese, to drug doses that have not been calibrated for obese patients. The situation is particularly thorny for the more than 15 million Americans who have extreme obesity — a body mass index of 40 or higher — and face a wide range of health concerns.

Part of the problem, both patients and doctors say, is a reluctance to look beyond a fat person’s weight. Patty Nece, 58, of Alexandria, Va., went to an orthopedist because her hip was aching. She had lost nearly 70 pounds and, although she still had a way to go, was feeling good about herself. Until she saw the doctor.

“He came to the door of the exam room, and I started to tell him my symptoms,” Ms. Nece said. “He said: ‘Let me cut to the chase. You need to lose weight.’”

The doctor, she said, never examined her. But he made a diagnosis, “obesity pain,” and relayed it to her internist. In fact, she later learned, she had progressive scoliosis, a condition not caused by obesity.

Dr. Louis J. Aronne, an obesity specialist at Weill Cornell Medicine, helped found the American Board of Obesity Medicine to address this sort of issue. The goal is to help doctors learn how to treat obesity and serve as a resource for patients seeking doctors who can look past their weight when they have a medical problem.

Dr. Aronne says patients recount stories like Ms. Nece’s to him all the time.

“Our patients say: ‘Nobody has ever treated me like I have a serious problem. They blow it off and tell me to go to Weight Watchers,’” Dr. Aronne said.

“Physicians need better education, and they need a different attitude toward people who have obesity,” he said. “They need to recognize that this is a disease like diabetes or any other disease they are treating people for.”

The issues facing obese people follow them through the medical system, starting with the physical exam.

Research has shown that doctors may spend less time with obese patients and fail to refer them for diagnostic tests. One study asked 122 primary care doctors affiliated with one of three hospitals within the Texas Medical Center in Houston about their attitudes toward obese patients. The doctors “reported that seeing patients was a greater waste of their time the heavier that they were, that physicians would like their jobs less as their patients increased in size, that heavier patients were viewed to be more annoying, and that physicians felt less patience the heavier the patient was,” the researchers wrote.

Other times, doctors may be unwittingly influenced by unfounded assumptions, attributing symptoms like shortness of breath to the person’s weight without investigating other likely causes.

That happened to a patient who eventually went to see Dr. Scott Kahan, an obesity specialist at Georgetown University. The patient, a 46-year-old woman, suddenly found it almost impossible to walk from her bedroom to her kitchen. Those few steps left her gasping for breath. Frightened, she went to a local urgent care center, where the doctor said she had a lot of weight pressing on her lungs. The only thing wrong with her, the doctor said, was that she was fat.

“I started to cry,” said the woman, who asked not to be named to protect her privacy. “I said: ‘I don’t have a sudden weight pressing on my lungs. I’m really scared. I’m not able to breathe.’”

“That’s the problem with obesity,” she said the doctor told her. “Have you ever considered going on a diet?”

It turned out that the woman had several small blood clots in her lungs, a life-threatening condition, Dr. Kahan said.

For many, the next step in a diagnosis involves a scan, like a CT or M.R.I. But many extremely heavy people cannot fit in the scanners, which, depending on the model, typically have weight limits of 350 to 450 pounds.

Scanners that can handle very heavy people are manufactured, but one national survey found that at least 90 percent of emergency rooms did not have them. Even four in five community hospitals that were deemed bariatric surgery centers of excellence lacked scanners that could handle very heavy people. Yet CT or M.R.I. imaging is needed to evaluate patients with a variety of ailments, including trauma, acute abdominal pain, lung blood clots and strokes.

When an obese patient cannot fit in a scanner, doctors may just give up. Some use X-rays to scan, hoping for the best. Others resort to more extreme measures. Dr. Kahan said another doctor had sent one of his patients to a zoo for a scan. She was so humiliated that she declined requests for an interview.

Problems do not end with a diagnosis. With treatments, uncertainties continue to abound.

In cancer, for example, obese patients tend to have worse outcomes and a higher risk of death — a difference that holds for every type of cancer.

The disease of obesity might exacerbate cancer, said Dr. Clifford Hudis, the chief executive officer of the American Society of Clinical Oncology.

But, he added, another reason for poor outcomes in obese cancer patients is almost certainly that medical care is compromised. Drug doses are usually based on standard body sizes or surface areas. The definition of a standard size, Dr. Hudis said, is often based on data involving people from decades ago, when the average person was thinner.

For fat people, that might lead to underdosing for some drugs, but it is hard to know without studying specific drug effects in heavier people, and such studies are generally not done. Without that data, if someone does not respond to a cancer drug, it is impossible to know whether the dose was wrong or the patient’s tumor was just resisting the drug.

One of the most frequent medical problems in obese patients is arthritis of the hip or knee. It is so common, in fact, that most patients arriving at orthopedists’ offices in agonizing pain from hip or knee arthritis are obese. But many orthopedists will not offer surgery unless the patients first lose weight, said Dr. Adolph J. Yates Jr., an orthopedics professor at the University of Pittsburgh School of Medicine.

“There are offices that will screen by phone,” Dr. Yates said. “They will ask for weight and height and tell patients before they see them that they can’t help them.”

But how well grounded are those weight limits?

“There is a perception among some surgeons that it is more difficult, and certainly some felt it was an added risk,” to operate on very obese people, Dr. Yates said. He was a member of a committee that reviewed the risks and benefits of joint replacement in obese patients for the American Association of Hip and Knee Surgeons. The group concluded that heavy patients should first be counseled to lose weight because a lower weight reduces stress on the joints and can alleviate pain without surgery.

But there should not be blanket refusals to operate on fat people, the committee wrote. Those with a body mass index over 40 — like a 5-foot-5-inch woman weighing 250 pounds or a 6-foot man weighing 300 — and who cannot lose weight should be informed that their risks are greater, but they should not be categorically dismissed, the group concluded.

Dr. Yates said he had successfully operated on people with body mass indexes as high as 45. What is behind the refusals to operate, he said, is that doctors and hospitals have become risk-averse because they fear their ratings will fall if too many patients have complications.

A lower score can mean reductions in reimbursements by Medicare. Poor results can also lead to penalties for hospitals and, eventually, doctors.

A recent survey of more than 700 hip and knee surgeons confirmed Dr. Yates’s impressions. Sixty-two percent said they used body mass index scores as cutoffs for requiring weight loss before offering surgery. But there was no consistency in the figures they picked.

“The numbers were all over the map,” Dr. Yates said. And 42 percent who picked a body mass index cutoff said they had done so because they were worried about their performance score or that of their hospital.

“It’s very common to pick an arbitrary B.M.I. number and say, ‘That is the number we won’t go above,’” Dr. Yates said. Yet a person with an index of, say, 41 might be healthy and active, he said, but in terrible pain from arthritis. A knee replacement could be life transforming.

“It’s a zero-sum game, with everyone trying to have the lowest-risk patient,” Dr. Yates said. “Patients who may be at a marginally higher risk may be treated as a class instead of individuals. That is the definition of discrimination.”

Surgery involves anesthesia, of course, giving rise to another issue.

There are no requirements for drug makers to figure out appropriate doses for obese patients. Only a few medical experts, like Dr. Hendrikus Lemmens, a professor of anesthesiology at Stanford University, have tried to provide answers.

His group looked at several drugs: propofol, which puts people to sleep before they get general anesthesia; succinylcholine, used to relax muscles in the windpipe when a breathing tube must be inserted; and anesthetic gases.

Propofol doses, Dr. Lemmens found, should be based on lean body weight — the weight of the body minus its fat. Using total body weight, as is routine for normal-weight people, would result in an overdose for obese patients, he said. But succinylcholine doses should be based on total body weight, he determined, and the dosing of anesthetic gases is not significantly affected by obesity.

As for regional anesthetics, he said, “There are very few data, but they probably should be dosed according to lean body weight.”

“Bad outcomes because of inappropriate dosing do occur,” said Dr. Lemmens, who added that 20 to 30 percent of all obese patients in intensive care after surgery were there because of anesthetic complications. Given the uncertainties about anesthetic doses for the obese, Dr. Lemmens said, he suspects that a significant number of them had inappropriate dosing.

Yet for many fat people, the questions about appropriate medical care are beside the point because they stay away from doctors.

“I have avoided going to a doctor at all,” said Sarai Walker, the author of “Dietland,” a novel. “That is very common with fat people. No matter what the problem is, the doctor will blame it on fat and will tell you to lose weight.”

“Do you think I don’t know I am fat?” she added.”

from the article  Why Do Obese Patients Get Worse Care? Many Doctors Don’t See Past the Fat by Gina Kolata

[chronicillnessmemes]

Hiya! I'm very thankful for you still answering my ramble^^ I do have depression so I have psych appointments weekly, and my psychologist also is a bit worried about me. Also, I'm autistic so I'm just very scared that i'd shut down at the GP's so I'm taking my mom. Also, I'm moving, so I'get a new GP nonetheless but I still just want to hear my GP say that he believes I'm really in pain? Idk, like, that he believes me? (Probs sending another one sorry >,

Also, Thanks @chronicillnessproblems​ for your input! I’m suspecting (H)eds or something similair. Also I’ve done a LOT of research on POTS and I read a lot of thing I find myself in. I’m gonna make a list with things I can’t do anymore and gonna take that when I go see him. Like, I’m almost 21 and I have to sit while showering, can’t ride a normal bike(only electric or else I’ll almost pass out) I sometimes have to stay home from work cause of the pain and ugh. Anyway, Thank you so much!

Oh right! Also, please feel free to post anything I send without response, I get how draining that can be^^ Byee!

Ok so I read these asks earlier this morning and I do want to say a couple of things, because I’m a little bit nervous about what you said.

First of all, I SUPPORT YOU AND WHATEVER YOU DECIDE TO DO.  I really do.  So what I have to say can be dismissed or ignored altogether and it will not hurt my feelings or make me any less supportive of you.

I DO NOT think you should return to this GP if you can help it.  There is no doubt in my mind that you will be unable to convince them that you are experiencing pain.  And I understand where this is coming from, I really do.  We WANT to be affirmed by our medical care providers.  It is super hard to battle our own demons and doubts in our heads as it is.  But to have that nagging doubt that our doctor doesn’t believe us either just makes things 100% worse.

But they have made up their minds.  And I don’t know your gender, but if you are a woman, this is something that is going to be happening to you repeatedly.  Unfortunately there is a lot of evidence of medical bias against women that doctors refuse pain treatment to them using depression as an excuse.  And this has a long history.  I won’t go into detail but you can study up on the roots of “hysterical” diagnosis from last century and see where I am going with this.

Also medical practitioners can be assholes.  And not only do they get to be assholes, but they get to document your visits anyway they choose and that information is now basically fact.  Everyone used to joke about “permanent records” because that’s not exactly a thing.  Except in this case it is.

This doctor can choose to label you as drug seeking, or “hysterical” or any number of things that will bias any future practitioners against you.  Now being from the US I have zero idea how a fully functioning healthcare system is so I don’t know if your psychiatrist’s notes are also included in your medical records because here they are not.  Which means this jackass’ notes will follow you for eternity while your Psychiatrists notes can get lost in the shuffle. 

However, if you do choose to return to this GP, I would earnestly encourage you not to get your hopes up about them validating your pain.  Since I’ve been sick I’ve had 3 medical practitioners that believed me out of 11.  And this was after I had seen multiple specialists.

I ABSOLUTELY encourage you to take your mom.  I am 43 but did not start getting the respect and treatment I needed from my doctors until I started taking my mom into the exam rooms with me.  (She didn’t actually believe how dismissive they all were, which was the reason I took her in the first place, but suffice it to say the minute she saw what was going on, she lost her temper.)

I also would encourage you to get a letter from your Psychiatrist explaining that his PROFESSIONAL OPINION ON YOUR DEPRESSION is that it is not causing your physical pain.  Your doctor will A. Be forced to argue with another medical professional.  And B. be forced to add this letter to your medical file.  Where it WILL become permanently attached to your current issues.

And this could be a phenomenal help later on as you do find new doctors.

Again, it’s your body and it is your life.  There is no way I could ever have enough knowledge to tell you what you should be doing.  I can only give you some things to consider from my experience, after going through this for almost 10 years now.

Please do not seek validation from someone who has already denied it to you.  It will only hurt worse in the long run and cause more doubts.  I have spent many afternoons crying over crappy doctor’s visits and I’d hate to see the same for you. 

Ok since you said I didn’t have to comment, I’m just going to go ahead and not edit this…  I hope it all makes sense.  Keep us posted, if you feel like it.  You’ll be in my thoughts.

Admin J

PS Followers if you have anything to add, please feel free.