#had the opportunity to get diagnosed at 15 (which is late already but it Was 2005) because her family is rich and her father’s

[hsslilly-blog]

also i think this might be obvious by now but blair is on the spectrum. as most my characters are

[lady-foxfire]

General Headcanons for the Heros/Partners of MD! (long)

Rescue Team

Hero: M!Eevee named Lunit, age 17. Despite appearing cold and calculating, he tends to drop this facade as someone with a very juvenile sense of humor.

Although he has earned this appearance for a reason, during rescues he hardly reacts to even the most dire of circumstances.

During his early days at Pokemon Square, many of the civilians had some misgivings of Lunit due to this cold disposition. But he slowly but surely won them over. Not that he was ever trying.

Partner: M!Chikorita named Aeroc, Age 20. Compared to his cold and calculating comrade, Aeroc's high octane nature causes him to stand out

While Lunit could be considered the brains, Aeroc is without a doubt, the brawns.

Outside of rescues, Aeroc has a strange tendency to wander into the Square in the middle of the night, drop several apples, and walk away. He denies these occurrences.

Explorers

Hero: F!Vulpix named Myth, probably aged 14-16. Fairly quiet outside of guild affairs, it can be hard to get her talking. Once she gets talking though, her brain to mouth filter has a tendency to get turned off, leaving the other people open to her, at times, scathing criticisim.

But overall, shes very kind and willing to risk life and limb for pokemon she never met.

She has severe thalassophobia. Shes fine with water in general, but deep water, especially oceans, leaves her recoiling with fear.

When she was found by Renn, she had a shard of a fire stone attatched to her neck, and scars around said neck.

Her thalassophobia combined with her general recklessness draws the concern of her guildmates and Treasure Town has a whole.

Has undiagnosed autisim.

Partner: MtF!Shinx named Renn, aged 15. To say shes timid would be rather an understatement.

Her parents were very... questionable pokemon at best, suddenly abandoning Renn not withstanding.

After her parents left, her already timid disposition was turned up to a unhealthy degree. Her rare visits to Treasure Town with her parents stopped, drawing the concerns of the residents, especially Kangaskhan.

Kangaskhan later found her on the streets, attempting to steal from the Kelceon brothers to get by. Kangaskhan ended up as Renn's adoptive mother.

Kangaskhan's late wife ended up being the primary inspiriation for Renn to become a explorer.

Diagnosed with social anxiety disorder.

Gates (i have not played so please bare with me)

Hero: M!Snivy named Erwin, aged 21. Erwin led a fairly aimless life as a freelance construction worker prior going to the pokemon world.

Hes a jokester at heart, never missing an opportunity for a lame pun.

Despite this, Erwin does stop the joking when its in poor taste.

Has a flirtatious streak, which comes out fullblast towards Umbreon and eventually Keldeo, Espeon finds this amusing.

Partner: M!Axew named Marthis, Age 24.

Never really had friends growing up and generally lived in poverty.

His poverty ridden early years was a major inspiration to build paradise.

He was also never very good at managing funds, often giving the last of it to people who he deems needs it more. He gets better at this after meeting Erwin.

Super

Hero: FtM!Fennekin named Eberen, aged 14. Despite his sharp tongue he has a heart of gold deep down.

He's not shy to criticize others, but also is equally blunt with his praises.

He has a general thirst for learning, due to his lack of knowledge.

(SPOILERS) He doesnt think of himself as a child due to fighting the war against Dark Matter. This carried over when he lost his memories.

Partner:M!Treeko named Markos. aged 13. Despite their hyperactivity, they actually are very level headed, and can develop strategies on the fly.

Took awhile to be diagnosed with autisim and ADHD.

If you asked him, if he stands still at all he will spontaneously combust and die instantly.

After becoming friends with Eberen, he became far more thoughtful, although still immensely hyperactive.

[dramione-tea]

recommendations & little snippets of myself

by Cassiopeia Candles ( Instagram: @casseopya.candles )

note: click the title in order to be directed to the desired fan fiction.

- for the dramione shippers, I wish you luck! 

Unrequited Love  [ casspiane ]

“Darling, I wished you knew,” 

Draco Malfoy x Original Characters (OC)

1. Love Never Dies. [ rosebuds_ ]

Rachel Farrell, pure blood witch, family of Gryffindors. First year is not the best for Rachel. She struggles trying to fit in and be accepted by those around her. Falling for Draco Malfoy, Rachel has to overcome a wave of obstacles. She finds it difficult to be accepted by her family and turns to the Malfoys... Which was undoubtedly one of the biggest mistakes she made. Find out what happens to Rachel and what truly changes her life.

- Literally binge read the whole book during my 6th grade examination. ( I know it was bad for me ) But hey I didn’t fail.  

P.S. Don’t be like me. 

2. midnight of the masquerade [ seraphilims ]

a story in which two people realize masks only hide the appearance - not the heart. 

- Love the story plot.  I’ve read this thrice in different years. 

3. Imperio [ pansyparks ]

The younger sister of Cedric Diggory, Arden, is a Slytherin who doesn't fit in. Draco Malfoy, a wealthy Slytherin bully. The two come together, and Arden realises that being a Slytherin isn't so bad after all; but with a few bumps in the road for Draco, can they stay together?

4. Dear Draco [ malfoyuh ]

❛stay a little longer❜

- 15 year old me were in tears, so was my heart.  Rate it as 5/5.

5. Let’s Kill Tonight  [ Bambey ]

Rebecca Rosewood's life is dramatically changed when she becomes a Death Eater. With blood on her hands, she is summoned by Voldemort to go to Hogwarts and extract information from the famous Harry Potter, finding herself hopelessly attracted to Draco Malfoy at the same time. But it all gets a little too much when her past finally catches up with her...

- One of the first fan-fictions I’ve read about Draco.

6. if looks could kill [ WhenInDoubtSleep ]

In times like this, the truth can rewrite the past and alter the future. In an attempt to find herself amidst the deceptive lies and horrible truths, she finds Draco Malfoy instead. She honestly just wants to make it out of the year alive...and maybe with a few less kisses from the blond git. Love story set during the sixth year at Hogwarts.

7. Always Had A Thing For Bad Boys [ oxNeverShoutNeverxo ]

8. Who Are You?  [ TheBlondeAdventurer ]

Draco Malfoy. One of the most arrogant teenage boys in Slytherin's house. He struts through the school and doesn't miss an opportunity to cut someone down, just as he has been by his father his entire life. Now enter Elena Crowe. A quiet girl who tries her hardest to stay out of trouble, and one of Ravenclaw's best students. She always has the best answers and never fails to help someone in need, even if they may not deserve it. In their sixth year at Hogwarts, Draco finally runs into Elena, whom he has never seemed to notice before. Elena does her absolute best to stay away from him, because all he can be is trouble, but Draco finds amusement by forcing himself into her life. For what reason, he doesn't know; but what he does know is that he enjoys bantering with this quiet girl, because even she can get riled up and fight back. But Draco will see that Elena is a lot more than what she may seem. Soon he will be battling morales, his past, his family, and both of them may end up facing off in the final battle not with Lord Voldemort, but each other.

- To be completely honest, read this one more than 3 times. 

9. Unwanted Legacy [ writtenbyciara ]

" admit it, you care about me. "

- Recently read this months ago and found it quite interesting. The author’s writing style is different from the rest as her words make you visualize more on what is happening. 

- Book 1 & 2 is complete, while book 3 is still on its way. 

Draco Malfoy x Hermione Granger (Dramione)

1. We Learned The Sea [ floorcoaster ]

Draco Malfoy turns himself in after a very successful career as a Death Eater, then enlists Harry and Hermione to help him in a scheme to bring down the Dark Lord.

- This gave me the feels.  Draco’s personality in this is far most different from the books and other fan fictions.

2. The Bachelor  [ Fluff ]

Hermione's mother is pressuring her into finding a boyfriend. On a whim, she applies and is accepted into the wizard version of The Bachelor. But what happens when The Bachelor is none other than Draco Malfoy himself?

3. Defending The Dark  [ Cece Louise ]

Almost three years after Voldemort's defeat, Hermione Granger is a Ministry-appointed Defense Inquisitor. Her next assignment: defend Draco Malfoy. She's sure there must be some mistake. Confronted with mysterious memories, candid conversations, and confusing feelings, she is plagued with uncertainty. Just who is Draco Malfoy? And does he deserve a second chance?

4. Graveyard Valentine  [ Bex-chan ]

Hermione thought she was the only person in the world who would spend Valentine's Day in a Graveyard, but she was wrong. He's there. Every single year, with his gloves, roses, and answers. Dramione Valentine's Day one-shot. Post-Hogwarts. 

- All time favorite.

5. Eighteen Months  [ Istalindar ]

When Hermione is diagnosed with a magic allergy and kidney failure during the summer, everything changes for her, friends, enemies..life.

6. Love Me Twice [ Bex-chan ]

'"They tore her apart and then wiped me out of her mind to send me a message. To mess up my life. To break..." he trailed off. Blaise nodded his head with understanding. "To break your heart," he finished for him.' Dramione. One-shot.

7. The Wrong Strain [ Colubrina ]

Everyone knew what veela were. Veela were magical creatures, breathtakingly beautiful, who captivated men with a single look. It would have been nice to have been that strain. Instead, Hermione Granger was infected by another. Instead of captivating all men, she was captivated by one. She'd die without him. She was already in almost constant pain. 

8. Entwined In Time  [ TheSummerNightingale ]

When Hermione and Draco get put into detention together, a potion mishaps throws them back in time: into the Marauders' era. As they begin to adjust to life twenty years into the past, the two become drawn together, sharing the bond of the future as they are forced to work together to return to their own time.

9. Destiny [ Annie Lockwood ]

Hermione's wedding night is everything but perfect for the young witch. Her new husband and long-time friend, Ronald, is passed out drunk and she thinks upon her life leading up to that night. Hermione falls asleep, despondent and alone. When she wakes up the following morning, she is still in bed with her husband. But it isn't Ronald Weasley.

10. Silencio [ AkashatheKitty ] 

One late night, hate turns to lust.

11. Clean [ Olivie Blake ]

Malfoy's handsome face was contoured into a condescending smirk. "No faith in that giant brain of yours, Granger?" She looked up at him defiantly. "Maybe I don't have faith in you!" she said, raising her voice. Malfoy only looked at her. "You'll find I'm very surprising."

12. Marked  [ Olivie Blake ]

Two dead. Three missing. The Order is down a leader and another innocent takes the Mark. Where is the Chosen One, and who killed Draco Malfoy?

13. The Fallout [ everythursday ] 

Hermione learns about growing up through the redemption of Draco Malfoy.

14. Every Day, a Little Death [ LovesBitca8 ]

It has become common knowledge that Hermione Granger cannot have an orgasm. Many have tried, none have succeeded. Can Draco Malfoy offer his assistance?

15. familiar faces, worn out places [ LovesBitca8 ]

“You are at St. Mungo’s. You were in a coma.” He looks me over again, taking a pause. “I am a Healer here now,” he says, like it explains something. My fingers stretch, drifting across his sleeve. He looks down, like I’ve thrown mud at him.

Forcing my vocal chords together for the first time, I whisper, “What’s your name?”

16. Kiss Me, Haunt Me, Kill Me [ LovesBitca8 ]

"So," she said, and her voice was just as he'd remembered it, "you've chosen to haunt the castle as well?" She lifted her brows. "I'm dead. What's your excuse?" ~*~ Draco Malfoy returns to Hogwarts as Potions Master to find the ghost of Hermione Granger floating through the halls.

17. Ribbons Down Her Back [ LovesBitca8 ]

The unintentional annual seduction of Draco Malfoy through a series of ribbons and bows - or - Christmas Fluff with a dash of Secret Santa.

18. Manacled  [ SenLinYu ] 

Harry Potter is dead. In the aftermath of the war, in order to strengthen the might of the magical world, Voldemort enacts a repopulation effort. Hermione Granger has an Order secret, lost but hidden in her mind, so she is sent as an enslaved surrogate to the High Reeve until her mind can be cracked.

19. The Library of Alexandria  [ SenLinYu ] 

 The Library of Alexandria is not for just any witch or wizard. Many bookworms may try but few are permitted to pass through its doors. The books residing there are ancient and powerful and, if one happens to make a mistake, the consequences can be rather—novel.

20. A Slow Cruel Descent + A Fragile Ascent  [ SenLinYu ]

A Slow Cruel Descent

The war grinds on and Hermione Granger, the lead intelligence for the Order of the Pheonix, is captured. Unable to crack her through interrogation without risking her mind, Voldemort conceives a cruel method of breaking her that involves a reluctant Draco Malfoy.“He stared at her in disgust.She looked—broken.The fire she’d still had when she was dragged in was now extinguished. Her eyes were locked on his face like she were memorizing him.“Stop staring at me.” He snarled. “You stupid bint. You’re supposed to be so clever. They can’t break you with torture but a fucking potion reduces you to a sniveling traitor.”

A Fragile Ascent

The War is over. Voldemort is dead. And Hermione Granger is broken.

21. Sweetly Broken [ LadyKenz347 ] 

As the dust settles following the Battle of Hogwarts, Draco’s confidence, belief system, and world are shattered.In an attempt to mend his broken pieces, he turns to vials that take the pain away. But once the high’s are no longer so high and the lows get so much lower, Draco has to start a journey of healing and redemption that often hurts more than it helps.

22. Truth, Lies, and Storytelling  [ BreathOfThePhoenix ]

“Hermione,” Harry took a deep breath and flipped the book over to see the back cover, “why is my name on this?”“Like I said, someone is writing about us. The film we just saw was based on that book,” Hermione tapped the cover of the book on the top of the stack, “and it was incredibly accurate.”Harry passed the stack of books over to Ginny, holding on to the first one. He turned the title of the book over in his head, mumbling the words quietly to himself.“Harry Potter… me… Harry Potter and the Philosopher’s Stone. Philosopher’s stone. Hermione, this feels weird. Am I the narrator?”When Hermione and Draco uncover a familiar new film called “Harry Potter and the Philosopher’s Stone” they learn that the wizarding world may not be as well hidden as they thought.

23. DIVINATION FOR SKEPTICS  [ OLIVIEBLAKE ]

The latest in magical advancements is an enchantment that reveals the bearer’s romantic compatibility with another person. Effectively eliminating uncertainty from dating, the charm can tell you whether or not you’ve found The One with a precise, Hermione Granger-approved calculation of traits and preferences. It’s a foolproof method of predicting relationship happiness. It’s also, for Hermione, positively dreadful news.

24. Isolation [ Bex-chan ]

He can't leave the room. Her room. And it's all the Order's fault. Confined to a small space with only the Mudblood for company, something's going to give. Maybe his sanity. Maybe not. "There," she spat. "Now your Blood's filthy too!"

25. Hunted [ Bex-chan ]

Forced to work together when their old schoolmates start dying, Hermione & Draco must overcome their differences to solve the mysterious deaths. The tension in the office is getting rather...heated.

If you reached to this part. 

HEY THERE! 

Feel free to message me on instagram if you ever feel the need to fan girl, I do too most of the time. 

[cakesexuality]

no offence but how the FUCK do multiple psychs not believe you?? like you are a grown adult who knows their shit and they're not believing you?? that you could be schizophrenic even though it's common and affects 1% of people in the world!! i thought no one believed me cuz i'm like 17 and a "female" or whatever ....i'm really worried i'll never get diagnosed now

Idk!!!

I mean, before I was 20 it wasn't very clear what I was experiencing, my hallucinations and delusions have never been super prominent and I was only experiencing dissociation and memory problems occasionally

I'm assuming you're an anon who came from Alex's blog and maybe don't really know me, so I've gotta explain a lil bit of stuff!!

When I was 19/20 (2016) I had my own apartment for a year. I moved in in January but in?? July?? I was having trouble focusing and being motivated on things and I originally thought I was becoming tolerant of my Ritalin but after a while it became very clear it was something else!! My social anxiety was really bad and my anorexia had relapsed and my mom was having to come over once a week to help me do the dishes, take out the garbage, and clean the litter box (she was already coming over twice a week to pick up and drop off my laundry bc it cost like $6/load to do it at my building)

I moved back in with my mom in December bc I wasn't able to be independent anymore but somehow I was still able to go to school!!! Despite all the shit in my brain!!! And my college had their own psychiatrist who only saw students, but she was re-training after not practicing for a while and she was young so I don't think she had much experience before that, but she really listened to me and she was trying!!!! And I remember one appointment where she said she had asked me the same questions a couple months before but I was hard to understand when I first started seeing her (which was around finals FUCK how did I manage that)

I ended up having to leave her after a few months bc I transferred to a school in another city, so the psych from my original college referred me to the psychosis program at a hospital in the same city as my new college, however the doctor there didn't seem interest in helping me??? She seemed to think I just had MDD with psychotic features and I'd come in like "Hey I'm hardly eating bc of my ED and I'm sleeping way too much and I've been doing [redacted maladaptive behaviour]" and she was like "Okay :^) Come back in 4 months :^)" without any plans for how to move forward

So I've seen 2 psychiatrists since moving back, once each, one at the local hospital who was quite late to the appointment and seemed like he wanted me out of there ASAP, and then one from CAMH (the big psych hospital in Toronto) over a video call 14 days ago who I talked to for 2.5 hours and she still didn't seem to listen to me!! I talked to my nurse practitioner yesterday and she told me about the psych's report and apparently the doctor recommended multiple antidepressants that involve serotonin after I explicitly said I don't want to take them bc I don't have a good history with antidepressants that involve serotonin, plus she suggested Abilify and Cipralex which I said I've tried and didn't do well with, so only 3 out of 7 of her medication suggestions feel like viable options, being to try risperdone or lithium and to increase my Wellbutrin. And the CAMH doctor said what I have is either mini-psychosis caused by BPD or MDD with psychotic features, even thought I tried to make it clear it's not part of a mood disorder (I do see where she's coming from with the BPD suggestion though)

So that's the shitshow of me talking to doctors about my psychosis!!!

And I know you feel like you may never get a diagnosis but it can happen even if you have to fight for a while!! I've had MDD and anorexia since I was 15 which weren't diagnosed until 17 and 18 respectively, and I've always had anxiety but that wasn't diagnosed until 17. Hell, my ADHD wasn't diagnosed until I was 18 even though there were multiple opportunities for me to be tested starting at age 7. I'm also currently trying to get diagnoses for some immune and ocular problems (which may actually be just one combined problem) which is adding onto the pile of feeling AWFUL so the last few days I've been working to put together a list of places I could consult for help/directions to help (e.g. Arthritis Society, GoodHope Clinic, Victorian Order of Nurses) and I'm trying to make a binder of all my health issues, including a reference section so if a doctor suggests a treatment or diagnosis that I can't remember off the top of my head I can be all 📖🔍👀 to have my info right there and I'm just generally putting my energy from being angry into getting shit together to be prepared for medical situations

[witchdreamcolors]

Helora’s Biography

•Around midday on Admirestar 1st of 874, Queen Aurora Butterfly and Pine Forest had their first and only daughter. With green hair, periwinkle/blue eyes (it depends on who you ask), with her mother's skin and two hearts in the shape of infinity on her cheeks. Her name had come from the union of the name Helia (“The Sun” in High Mewnian) and Flora (“Flower” in Low Mewnian). But just before registering, they decided to shorten Heliaflora to just Helora.

 •Helora had a huge love for her family, and Helora refused to leave Aurora for many times, and liked to play with her, especially to fix her hair and make up. They were very close, and Aurora was the first to notice some strange symptoms in her daughter: frequent coughing, malnutrition and shortness of breath. She and Pine took her for a check up at Cross Clinic, and the diagnosis made her nervous: a genetic disease caused some problems, like making her body produce much thicker mucus than it should be and causing breathing problems.

 •Aurora and Pine turned all their concern to their little daughter. Some time later, Aurora ended up dying from her hybrid condition. Helora cried and refused to eat for some time, until Pine convinced her.

 •The first hospitalization occurred at six years of age, three years after diagnosis. She was scared, but Pine made sure to be in good hands. She spent a week in the hospital and, after returning home, slept for a week in her father's bed. She couldn't get used to being away from her father, so Alice Cross, one of Helora's caregivers, and Gareth McKnight, Alice's husband, had an idea: they introduced her to her adopted son, Boriond Cross, a boy three years older, with violet eyes and blue hair. In time, Helora no longer felt so uncomfortable when she was hospitalized, nor did she cry any more when she had to leave her father. A curiosity is that, even though she was small because of her condition, Helora was taller than Boriond.

 •When she started reading at the age of seven, she liked fairy tales, especially those who saw her grandfather Marco Diaz's native dimension. She found stories interesting and enjoyed reading and / or listening to stories told by her father, Boriond, or Lacey, a good nurse who befriended the princess shortly after Boriond. It was at this age that she started her famous bad jokes, which were later known as "Helora Jokes", that the princess considered one of her greatest achievements.

 •Some time later, a new patient began to attend that wing of the hospital. Tall, dark skin, short blond hair and blue eyes. Her name was Bonnie, who came from the Smith Kingdom, where she acquired some lung problems, and would become very close to the princess of Mewni.

 •Helora, like the other princesses of the Butterfly Kingdom, received a Loney Star Ball, which was organized by her grandfather, Marco Diaz. The princess was delighted with how he managed to bring elements of stories she loved to her party. Unfortunately, the party ended shortly after they ate the cake, because the princess was not feeling very well. It was nothing related to her lung disease, it was just her lactose intolerance attacking.

 •At the age of 12, she started reading to the children in the hospital, and after a few months, she started reading in schools as a volunteer. This brought together two of the things she liked most: children and storybooks. Helora would do this until the end of her life, even when she was not in the kingdom.

 •It was 888 a. M when they presented her with the royal magic wand, on her 14th birthday, which the princess ended up forgetting and almost received the wand in pajamas. Many hoped that she would soon inherit the throne, but a statement from the royal family made it clear that her reign would not come soon (so much so that she became queen just 3 years later.). Until that time came, Helora began to dedicate herself to her magical studies. She created some spells, like "Aurora Borealis Colors Paint", "Sunflower Glitter Cataclysm","Rainbow Glitter River", and "Glitter Smoke Bomb".

 •One of the chapters that most interested her was Soupina, The Strange. She studied many of her soups, and tried to use some so that her illness could be cured of her illness, but several things went wrong. After trying the soups, she tried potions. After a small accident that almost killed Boriond, Helora tried a strange combination of spell and potions.

•All Boriond and Helora remember after that was waking up in a snow-white room (and as cold as, according to the princess herself), surrounded by humanoid with marks on their skin, with stars on their skin, eyes and hair. After making sure that they were well, they were taken to the monarch of that place. In appearance described as brilliant, the queen was introduced as Pervinca, the queen of the Faerist Kingdom, of the fairies of the night.

 •Helora explained how they got there, and who they were. When she introduced Boriond to Pervinca, she started to cry. After a glass of bright, colorful liquid, the queen calmed down. And then she explained that he reminded her of her late son. She asked to spend time with him, and in return, offered them both everything a member of the royal family could have, in addition to a treatment for Helora's illness. It was not a cure, it was just something to prolong the princess's life. Seeing the opportunity, Helora contacted her father, and after a while, she managed to convince him to allow her to stay.

 •Helora received a room next to that of Pervinca's heir, Petal, a girl with a delicate appearance and a cold personality. Petal did not like the presence of the two Mewnians, and thinking about it, Pervinca spread the story that Helora was a fairy who had lost most of her powers, and what was left had earned her marks similar to two hearts. Helora knew about some fairy hatred for mewnimans, but she thought it best to keep her mouth shut, at least for now. She received everything that Petal also received, both in education and in gifts that Pervinca gave to both. They even wore practically identical tiaras, the difference being the jewel, with Helora having a butterfly made of angelite and Petal, a crescent moon made of moon crystal. Helora received literature classes, Faeri dialects, and after a certain time, skills training.

 •At the same time, she spent some time in her treatment. Despite being much more effective in fairies, Helora noticed that her health was at least a little better. In her diary, she says that despite her improvement, she had no hope of being cured.

 •Her mewberty would arrive soon, but unlike her ancestors, she didn't chase anyone, except for Boriond Cross (and having asked Bonnie about some people). While she flew around, she acted normally with other people. A few weeks after her mewberty, Boriond asked the princess about it. It was there that Helora confessed that she was not attracted to people she didn't know well, and not by looks or other things.

 •In the time that Helora and Boriond stayed in the kingdom, they returned home only once: on the Princess Song Day of Helora. They arrived 15 days earlier, and took the time to spend with their family. Pervinca and Petal were invited, but only the queen attended the event.

 •Helora, like all training fairies, when she reached 15 years old, which is the majority in the Faerist kingdom, went through the Real Test, which consisted of a demonstration of the powers of each fairy, who discover their “special ability” that day, and then there would be duels determined by lot, where depending on their actions, they could be approved or go through another year of training. As she could not use her wand, Helora secretlytrained to be able to do magic without a wand. She worked very hard, and she did it, although she couldn't control it very well.

 •During the Test, Helora did well. Their special ability was just called "witchcraft", and there were a few other fairies with that ability present there, as it was a relatively common skill. She had to fight a girl with red hair and blue eyes named Robin Nightplume, which Helora had not said much contact with, whose ability was to control the elements. The fight between them resulted, because of the amount of points for her actions, in a victory for Robin, but Helora also had enough points to pass. They became friends after the Real Test, and she became one of the few people who knew Helora's secret.

 •By this time, she already knew the reason for fairy dislike for Mewnians: a kingdom that had already disappeared had come into conflict with the fairies a long time ago, and more recently, some who had entered the kingdom murdered the husband and eldest son of Pervinca. She swore to herself that she would try her best to fix things.

 •Helora and Boriond returned to their birth kingdom in 890 a.M, when Helora was 16, the age at which she began to look more like her father. After a while, it was almost common knowledge that the princess was dating with Boriond.

 •A year after Helora's arrival, she was crowned. Pervinca, Petal and Robin attended the event as guests of honor, who stayed in the kingdom for 15 days. Both received a tour of the kingdom, courtesy of Helora. It was part of her plan to fix past mistakes. Her first real act was to try to do that, through diplomatic visits. Obviously, there were negative repercussions on both the fact that they were deceived and the fact that Helora was a Mewnian queen. Some more conservatives were slow to accept both facts, but most forgot after a while.

 •Helora also had the idea of creating the Moon Fair, where mewnians and fairies got together and shared their different cultures. It occurred when the moon Bellanoche of the Faerist Kingdom and the moon Diana of the Butterfly Kingdom were in the phase of the new moon.

 •A law created by Helora determined that all children should be examined at birth, in case there were any diseases like hers, to be diagnosed earlier and to receive treatment. She invested a lot in the areas of health and culture, always encouraging reading and writing. Great writers emerged at that time, such as Genevive G., Eloise LeCroise and Jacos Golden, among others, who were also guests of honor to the queen whenever she gave a party.

 •She was named “fairy of honor” in a ceremony in 893, making her the first mewniman to be called a fairy, and that's where her title came from, although Bonnie and Robin (mainly by Robin).

 •That year, too, Helora sought information about Boriond's parents, after he confessed to her that he was curious about it. She discovered that Boriond's father, a guy named Stephen, lost his paternal rights after he was unable to raise his son, and his mother ended up dying in childbirth, and Helora was unable to find out anything about her other than the name Morgan Morning, who probably was a fairy. Boriond thanked her very much for finding out about his parents, although Helora thought she could have found more information.

 •She had a great love for children, and wanted to give them better opportunities, so a major act of the queen was the creation of a home for orphaned children, the Royal Orphanage, a large wing of the castle that could house more than 100 orphaned children until they were adopted.

 •In 894, Helora proposed marriage to Boriond after a four-year relationship. The ceremony was held the following year in an extremely closed ceremony for a few people. A place was left reserved for the bride's mother, the late Queen Aurora, and one for Morgan too. They didn't have a honeymoon because Helora ended up getting pneumonia and stayed in bed for a long time.

 •After some time with treatments, she got what she most wanted at that moment: a daughter. She gave birth to a little girl named Bellanoche Butterfly, named after the moon Faerist, because of the fairy appearance she had. But the happiness that the child gave her was replaced by the emptiness she felt after losing her, because at one month of age, the princess would be kidnapped during the night.

 •After more attempts, she became pregnant again, but from a boy with the appearance of Aurora, which she named Boreal Butterfly.

 •A few days after the birth of Boreal, her aunt Moon Butterfly died, and Helora decided to adopt as her daughter and heiress her only daughter, Thea.

 •Helora was sorry for the loss of her daughter, and she had become overprotective with her children now. They had limited freedom, always accompanied by at least two guards since they learned to crawl. At this point, she was hopeless, but she did not stop her husband from creating a team with spies to find the princess.

 •A girl with brand marks was spotted with a fairy in the Forest of Right Death, and many thought she was the lost princess, and probably her kidnapper, which resulted in small tensions between the fairies and the Mewnians, as the evidence indicated that a fairy who had kidnapped the heiress.

 •But her hopes were dashed when a corpse of a little girl with painted cheeks was found next to a fairy corpse, none of which was identified. They were buried in shallow ditches like destitute.

 •Despite his wife's lack of faith, Boriond remained firm: he still had some hope within him, despite six years since he last saw his daughter. Once again, the spies saw a fairy with a girl with marks on her cheek. Instead of warning the queen, they acted quickly: they arrested the two and were taken to the throne room. After a period of revelation, it was discovered that they were Petal and the missing princess, Bellanoche Butterfly.

 •Helora's heart filled again, but it broke when she realized that Bella didn't recognize her. Despite just wanting to be cuddled with her, she had to lead her to a room where her siblings were, and took Petal to the dungeons.

 •The trial lasted about a week, where the princess admitted to kidnapping Bellanoche, murdering her father, brother and two peasants, and after asking each person in the court what would be the appropriate punishment for Petal, she was sentenced to 5 arrests perpetual.

 •She tried to get Bellanoche to get used to her new life, and after her return, she gave her children a little more freedom. When Bellanoche showed interest in poems and literature, she placed her under the tutelage of Libra Firefly, who also taught her nephews, Auriga and Vulpeculo Firefly.

 •It was shortly after that she also talked to Bellanoche and Thea, and explained to them that, although she loves them both equally, Bella was still the heir to the throne. Both understood the situation.

 •In the year 906, two things happened. The first was Boreal's departure for the Silvan Kingdom to study the culture of that place. Helora was reluctant to allow him to go, but in the end she allowed.

 •The second was Petal's escape from prison, and he organized a small rebellion with conservative people who did not support Queen Helora's initiative. Bellanoche was startled, and upon seeing her daughter's reaction, Helora swore that she would not let that woman hurt any of the people she loved again.

 •Helora prefers not to talk about what became known as “The Rebellion of the Fairies”, but I will write here everything she revealed about it. She put the spies who found Bellanoche and Robin to infiltrate the site. They provided for the invasion of Pervinca and Helora, which ended that rebellion by bloody means. Helora never forgot the sight of the corpses. The fact that Robin went blind in one eye, Bonnie was killed, and Lady Peregrine lost her family and became Lady "Black Widow" made her feel guilty, despite the fact that Robin assured her that was her fault.In 909, Helora Butterfly passed her wand to Bellanoche, and left it under the care of another literature professor, Julian Blackhole, an old friend of hers whom she had met during her stay in the Faerist kingdom.

 •Two years later, she also passed her crown, due to her health at the time. She did not attend Bellanoche's wedding to Vulpeculo Firefly due to another pneumonia, but gave her a gift before leaving for their honeymoon, where Bellanoche became pregnant.

 •She saw the birth of all the children of Bellanoche: Vialaxia, Lunarius, Lumos and Noturna, and each child left a gift for when he was older, he remembered his grandmother fondly. She also wrote letters to each of them, which would become one of Noturna's treasures.

 •In 916, at the age of 42, Helora died of her illness and, on her deathbed, left Bella a book written by her. She was buried in the crypts and immortalized as the queen who united the fairies and the mewmans. But how long would the peace she created last? ________________________________________________________________ by Sirrrrrrrrr Glossaryck ... of Terms!In my old DeviantArt account of the same name, I had already posted an old version of this, but here's an updateExtra information: - Her disease is based on Cystic Fibrosis -Robin started to live in the Butterfly kingdom shortly after Helora's coronation. - It is unknown who killed Petal. -The gifts left for her grandchildren were: a violin, a painting kit, a sewing kit and a movie projector. Aurora and Pine by jgss0109 (DeviantArt) por Sirrrrrrrrr Glossaryck... dos Termos!Na minha antiga conta do DeviantArt de mesmo nome, eu já havia postado uma versão antiga disso, mas aqui está uma atualizaçãoInformações extras: - A doença dela é baseada em Fibrose Cística -Robin passou a morar no reino Butterfly pouco tempo depois da coroação da Helora. -É desconhecido quem matou Petal. -Os presentes deixados para os netos dela foram: um violino, um kit de pintura, um kit de costura e um projetor de filmes.

[reeceabi-blog]

There must be something in the genes

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[verdiprati]

Looking Ahead

[NOTE: this post is now out of date. Check the schedule tag on my blog for the most recent version of this list.]

Hello, Tumblr friends. 

I have been, for a while now, hesitating to continue my customary series of posts chronicling the future public performance plans of my favorite singer, Dame Sarah Connolly. 

I have decided to keep compiling and updating the list, but I also want to share some of my thoughts on the matter. Discussion, followed by list of performances, after the jump.

As you will probably have heard by now, Dame Sarah announced in July that she had been diagnosed with breast cancer and would have to withdraw from certain performances while undergoing treatment. She also expressed at the time a hope to fulfill all her other concert and recording commitments.

In the weeks since that announcement, Dame Sarah has made a few further alterations to her performing schedule while also maintaining some scheduled appearances: I myself heard her sing beautifully at concerts in Exeter and London earlier this month. A recent blog post by Jessica Duchen, written after that London concert, mentions that Dame Sarah now faces “a new journey, through chemotherapy.” Chemo protocols and how well individuals tolerate them can be really variable; the soprano Erin Wall has written about how she managed to keep performing between chemo treatments, but chemo can bring on a host of side effects that can make it extremely difficult to carry on one’s normal activities for the duration of treatment, which may take months. (Frankly, just reading that list from the American Cancer Society makes me feel sympathetically ill.)

I am sure you can see the delicacy of maintaining a public list of Dame Sarah’s scheduled performances. There is a lot that Dame Sarah herself probably does not know yet about her own treatment experience and how it will affect her availability (and desire) for work, and we the public may not know whether she is going ahead with any given engagement until relatively late. 

I do not want to prematurely write off the next several months of Dame Sarah’s work, and I would still encourage anyone who lives near one of her performance venues to consider buying a ticket. It is a bit of a gamble, but if you can afford the risk of disappointment, go ahead and give yourself the possibility of hearing this wonderful singer. 

At the same time, I think ticket buyers for whom Dame Sarah’s participation would be essential to the enjoyment of a concert should be aware that the likelihood of her withdrawal for health reasons is higher than usual in the next several months. What I provide below is the best information available through public channels; I’ll make an effort to update the list if and when I learn of any changes, but editing this list is not exactly my full-time job, and if there is a performance date that you care about, I would urge you to monitor the sponsor’s website and social media feeds for yourself.

Finally, and most delicately, although I consider this blog to be a fairly obscure corner of the internet, I would not want to embarrass Dame Sarah or damage her future employability by chronicling cancellations that might arise from her illness. No singer really wants to be associated with a record of frequent cancellations, however good the reasons for them might be. This consideration has been my greatest point of hesitation. I have, however, concluded that: (a) the circumstance of her illness is already well known in the industry, by her choice; (b) I really hope prospective employers will be understanding of her current circumstances and optimistic about her post-treatment future onstage; ( c ) I am only compiling information that is publicly available elsewhere; and (d) the intended audience for this list is fellow fans who, like me, want to keep tabs on possible opportunities to hear Dame Sarah perform live. 

So. Here is the latest edition of my list: 

Upcoming Performances by Dame Sarah Connolly 

Those of you in Britain might catch a performance in London, Cheltenham, Chipping Campden, or Buxton. Those on the Continent might see Dame Sarah in Madrid, Barcelona, Paris, Amsterdam, Vienna, Hamburg, Köln, Rotterdam, Basel, or Vilabertran. An as-yet-unconfirmed performance may be on the horizon in New York.

The usual disclaimers:

This is not an authoritative list. These are the upcoming performances by Dame Sarah Connolly that I have been able to learn about from Dame Sarah’s new website, Dame Sarah’s agent's website (Askonas Holt), Operabase, Bachtrack, Dame Sarah's Twitter, and generally ferreting around the web.

I sometimes list concerts that are not yet officially confirmed; you should of course check official sources before making plans and be aware that cast changes and cancellations can happen at any time.

I have added links to venue, ticketing, and broadcast information where available. Tips on new information are always welcome! Please contact me via email (verdiprati [at] selveamene [dot] com), Tumblr messaging, or ask box (plain prose only in the ask box; anything with links or an email address will get eaten by Tumblr filters) with corrections or additions.

Recital with Julius Drake at Temple Church, London, November 25, 2019. The repertoire includes Robert Schumann’s Frauenliebe und -leben, Gedichte der Königin Maria Stuart, Judith Bingham’s Adieu Solace, and “songs by Alma and Gustav Mahler.” The Judith Bingham piece is apparently based on the life of Mary Queen of Scots, as are Schumann’s Gedichte.

Elgar, Sea Pictures with the London Symphony Orchestra at the Barbican, London, December 12, 2019. In a concert conducted by Sir Antonio Pappano that also includes instrumental works by Tippett and Vaughn Williams. UPDATE: as explained in a note on the LSO’s website, Dame Sarah has had to withdraw from the concert due to her treatment for breast cancer. Karen Cargill is scheduled to sing Sea Pictures instead.

[New! Deferred broadcast] Bob Chilcott, A Christmas Oratorio (Mary), on BBC Radio 3, December 19, 2019. World premiere performance recorded live during the Three Choirs Festival on August 1 of this year, at Gloucester Cathedral. The other vocal soloists include Nick Pritchard (Evangelist) and Neal Davies (Simeon). The Philharmonia Players are conducted by Adrian Partington, and the combined cathedral choirs that give the festival its name also participate. The recording should be available for listening on demand for about a month after the broadcast.

Wagner, Die Walküre (Fricka) at the Teatro Real, Madrid, February 12, 16, 21, 23, 25, and 28, 2020. Co-stars include Tomasz Konieczny (Wotan), Ricarda Merbeth (Brünnhilde), and Stuart Skelton (Siegmund). (James Rutherford, Ingela Brimberg, and Christopher Ventris appear in the roles respectively on the 23rd.) Pablo Heras-Casado conducts; the production by Robert Carsen is a revival from Oper Köln. Single tickets go on sale November 4, 2019 if I read the Teatro Real website correctly. UPDATE: Although Dame Sarah’s name still appeared on the Teatro Real website well into December 2019, she replied to a fan on Twitter on November 3, “sadly I won’t be singing Fricka in Madrid this time. Waltraute in [Autumn] 2020, Paris is still on!” (Note that as of February 21, 2020, this is no longer the case: Dame Sarah has been replaced by Michaela Schuster in the Paris cast.) In late December, the Teatro Real announced that Dame Sarah had canceled her participation and Daniela Sindram would sing the role of Fricka

Oskar Fried, Verklärte Nacht with the BBC Symphony Orchestra at the Barbican, London, March 13, 2020. From the Barbican website: “Dame Sarah Connolly is currently undergoing treatment for breast cancer and regrets that she must withdraw from this performance. BBC SO are grateful to Christine Rice for replacing her and wish Dame Sarah well in her recovery.”

Recital at Wigmore Hall, London, March 19, 2020. From the Wigmore Hall website: "As Dame Sarah Connolly continues a period of treatment and recovery following her breast cancer diagnosis, she needs to limit her schedule and therefore has had to withdraw from the above concert. We are grateful to Fatma Said (soprano) for taking her place.”

Conversation with Mahan Esfahani at Sir John Lyon’s Theatre, London, March 20, 2020. Per the RPS: "With regret, Dame Sarah has had to withdraw from the event and we wish her all the very best at the current time.” Esfahani is still booked for the event; he will engage in conversation with the conductor François-Xavier Roth.

Appearance at “Bringing the House Down” charity concert at Glyndebourne, Lewes, April 5, 2020. Update: Dame Sarah’s name has been quietly removed from the list. 

Mahler, Symphony No. 2, Resurrection, with the Sinfonieorchester Basel, Basel Minster, April 22, 2020. Update: Catriona Morrison is now the listed mezzo soloist.

Mahler, Das Lied von der Erde with the Philharmonia Orchestra, Royal Festival Hall, London, April 30, 2020. Update: a statement on the Philharmonia’s website reads, “Dame Sarah Connolly has had to withdraw from this performance due to ongoing treatment for breast cancer. We are grateful to Claudia Mahnke for stepping in. Dame Sarah intends to return to performing later this year.”

[Canceled] Mahler, Symphony No. 2, Resurrection with the Rotterdams Philharmonisch Orkest, De Doelen, Rotterdam, May 14, 15, and 17, 2020. Chen Reiss sings the soprano part; Lahav Shani conducts. UPDATE: As of this writing on April 6, the orchestra’s website now explains that “Following the government decision regarding COVID-19, this concert cannot take place on the planned dates.” 

[Canceled] Recital with Ashley Riches, Joseph Middleton, and Tony Robb at the Chipping Campden International Music Festival, May 22, 2020. The recital was originally billed as a collaboration between Connolly and Middleton only, with repertoire TBA. Now that Riches and Robb have been added to the group, the program has been listed with repertoire by Duparc, Debussy, Ravel, Saint-Saëns, Caplet, and Fauré. The Festival website explains, “Following treatment for breast cancer Dame Sarah has made changes to this programme to reduce her workload while her recovery continues. She hopes very much the audience will enjoy the variety these changes afford.” UPDATE: As of March 23, the entire festival has been canceled due to the COVID-19 pandemic. 

[Canceled] Mahler, Symphony No. 2, Resurrection with the Rotterdams Philharmonisch Orkest, Köln Philharmonie, May 27, 2020. Chen Reiss sings the soprano part; Lahav Shani conducts. (A repeat of the program from Rotterdam, above.) UPDATE: See the note on the May 14-17 concerts, above.

[Canceled] Recital at the Musée d’Orsay, Paris, June 6, 2020. With Malcolm Martineau. The program includes Ravel’s Shéhérazade, Elgar’s Sea Pictures, Debussy’s Trois chansons de Bilitis, and various works by Hugo Wolff, Alexander von Zemlinsky, Charles Villiers Stanford, and Cecile Chaminade. UPDATE: as of this writing on April 14, I am now observing the word “Annulé” at the bottom of the concert information page (below the word “Tarifs”), which I take to mean that the concert has been canceled.

[Canceled] Mahler, Symphony No. 8, Symphony of a Thousand with the Wiener Symphoniker at the Musikverein, Vienna, June 12 and 13, 2020. Three Vienna choirs add their forces; Philippe Jordan conducts. The other scheduled vocal soloists are Camilla Nylund, Irène Theorin, Martina Janková, Michaela Schuster, Burkhard Fritz, Iain Paterson, and John Relyea. UPDATE: Although the informational pages for these concerts do not mention their cancellation, the Wiener Symphoniker website has a news post explaining that the Austrian government has canceled all indoor events with more than 100 participants through the end of June, and thus the orchestra’s public performances will not take place during this time period.

[Canceled] Duruflé, Requiem with the Choir of St Catharine’s College, Cambridge, at Ferrandou Musique in Beaulieau-sur-Dordogne, Turenne, and Carennac, France, June 20-22, 2020. UPDATE: this series of concerts is now marked with a “CANCELED” banner on the Ferrandou Musique website.

[Canceled] Mahler, Das Lied von der Erde (in a chamber arrangement) at the Proms at St Jude’s, Hampstead Garden Suburb, July 2, 2020. With Andrew Staples and the Aurora Chamber Orchestra conducted by Nicholas Collon. The orchestra played the same arrangement, with the same vocalists, in 2017; here’s the (very positive) Bachtrack review. UPDATE: Although, oddly, I can find no direct reference to the cancellation of this concert or of the whole festival on the Proms’ website, a tweet from the Proms at St Judes on March 24 announced the cancellation of the 2020 festival.

[Canceled] Mahler, Das Lied von der Erde (in a chamber arrangement) at the Cheltenham Music Festival, July 3, 2020. With Andrew Staples and the Aurora Chamber Orchestra conducted by Nicholas Collon. UPDATE: On April 7, the Senior Management Board of the Cheltenham Festivals announced that the 2020 Cheltenham Music Festival is canceled (along with its sister Jazz and Science Festivals). 

[Canceled] Recital at the Buxton International Festival, July 11, 2020. With Joseph Middleton. Songs by Poulenc, Duparc, Mahler, and Schumann. Note the noon hour and the short duration of this performance. UPDATE: Although I am late to pick up the news, cancellation of the Buxton International Festival was apparently announced on March 18.

[Canceled] Mahler, Das Lied von der Erde (in a chamber arrangement) at Wigmore Hall, London, July 17, 2020. With Andrew Staples and the Aurora Chamber orchestra conducted by Nicholas Collon. UPDATE: On March 30, Wigmore Hall announced that it would close for the remainder of the ’19- ’20 season and all performances through July 31 would be canceled.

[Canceled] Recital at Schubertíada Vilabertran, August 21, 2020. With Malcolm Martineau. Songs by Mendelssohn, Liszt, Elgar, Debussy, Ravel, and Chaminade. UPDATE: Although the Schubertíada announced on June 10 that it would go ahead with a schedule of live concerts, Dame Sarah’s has been eliminated. The Spanish newspaper La Vanguardia reports that “[el] concierto con Sarah Connolly ha caído por cuestiones de salud de la mezzo británica” (the concert with Sarah Connolly has fallen due to the British mezzo’s health concerns). 

[Canceled] Mahler, Symphony No. 2, Resurrection, with the MDR Rundfunkchor and Sinfonieorchester Basel, in Basel, August 26, 2020. Christina Landshamer sings the soprano solo and Yoel Levi conducts. Part of a concert with a work called “Epitaph” by Andrea Lorenzo Scartazzini. UPDATE: I am not sure on what date the concert was deep-sixed, but the MDR website now marks it as “abgesagt” (canceled).

[New details!] Recital at Wigmore Hall, London, September 30, 2020. With Roderick Williams and Julius Drake; the first concert of the Wigmore’s Mendelssohn and Liszt series. 

Recital at Sant Pau Recinte Modernista, Barcelona, October 2, 2020. With Julius Drake. Part of the LIFE Victoria series of recitals; originally announced for November 27, 2019, but postponed due to Dame Sarah’s treatment for breast cancer. Songs by Brahms, Wolf, Debussy, Alma Mahler, Gustav Mahler, and Zemlinsky. As of April 30, LIFE Victoria has issued a press release indicating that they still plan to go ahead with recitals scheduled for the fall of 2020.

Wagner, Götterdämmerung (Waltraute, Zweite Norn) at the Opéra national de Paris, November 13, 17, 21, and 28, and December 6, 2020. Update: the roles of Waltraute and Zweite Norn are now assigned to Michaela Schuster, one of a handful of casting changes reported by OperaWire on February 21, 2020.

[New details!] Handel, Agrippina (title role) at the Dutch National Opera, January 17-27, 2021. Finally, a year and a half after the news started leaking on Twitter, we get the official announcement, complete with a bizarre (even by DNO marketing department standards) video of a rubber-covered woman dancing in a ball pit. The production is Barrie Kosky’s (previously seen at the Bayerische Staatsoper and the ROH, and later moving on to the Staatsoper Hamburg). Ottavio Dantone conducts; co-stars include Ying Fang (Poppea), Franco Fagioli (Nerone), Gianlucca Buratto (Claudio), and Tim Mead (Ottone). If I read the DNO website correctly, tickets go on sale June 3, 2020.

[New!] Stravinsky, Oedipus Rex (Jocaste) at the Dutch National Opera, March 10-27, 2021. In a double bill with the new commission From ‘Antigone’ by Samy Moussa. Other singers in the Oedipus cast include Sean Panikkar (Oedipus), Bastiaan Everink (Creon), Rafał Siwek (Tiresias), and Ramsey Nasr (Speaker). Erik Nielsen conducts; Wayne McGregor directs. If I read the DNO website correctly, tickets go on sale November 17, 2020.

[New!] Stravinsky, Oedipus Rex (Jocaste) with the NDR Elbphilharmonie Orchester, Hamburg, April 10 and 11, 2021. Even though these concert performances follow on the heels of Dame Sarah’s engagement for the same opera in Amsterdam, the two gigs appear to be administratively and artistically unrelated. Her co-stars in Hamburg include Brenden Gunnell (Oedipus), Tomasz Konieczny (Creon), and Sir John Tomlinson (Tiresias); the MDR Rundfunkchor Leipzig supplies the men’s chorus. Alan Gilbert conducts. The program also includes Le sacre du printemps. Tickets can be ordered starting May 26, 2020, with payment due six weeks before the concert. There’s some background information on the NDR website.

[New!] Recital at the Concertgebouw, Amsterdam, May 18, 2021. With Julius Drake. Songs by Mendelssohn, Liszt, Elgar, Debussy, Ravel, and Chaminade. Tickets go on sale June 1, 2020. 

[New!] Elgar, The Dream of Gerontius with the Berliner Philharmoniker, Berlin, May 27, 28, and 29, 2021. With Allan Clayton and Roderick Williams, as well as the Rundfunkchor Berlin; Simon Rattle conducts.

[Livestream] The concert on the 29th will be livestreamed on the Berliner Philharmoniker’s Digital Concert Hall platform.

[Unconfirmed / details TBA] Brett Dean, Hamlet (Gertrude) at the Metropolitan Opera, New York, sometime in 2021-22. Allan Clayton, who starred in the title role of Brett Dean’s Hamlet at Glyndebourne in 2017, mentioned in an interview with the Telegraph that he would be reprising the role at an unspecified date and venue in the US. When prompted on Twitter, Dame Sarah indicated that she would be participating in the revival, too (“I shall be misunderstanding my confused boy again”). In a later interview with Opera News, Clayton reportedly specified that he would reprise Hamlet at the Met. The Future Met Wiki places the production at the Met in the 2021-2022 season (as does this New York Times article). Hat tip to Christopher Lowrey, who sang Guildenstern in the original production at Glyndebourne, whose tweet praising Allan Clayton brought the Telegraph interview to my attention. (No indication whether Lowrey will also be cast in the American revival.) Additional hat tip to the Tumblrer who submitted information on this topic via the ask box.

Previous versions of this list can be found under the schedule tag on this blog. This list published October 29, 2019. Updated November 2 to reflect Dame Sarah’s withdrawal from the LSO Sea Pictures. Updated November 3 to reflect her self-declared withdrawal from the Teatro Real Walküre. Edited November 21 to add Das Lied at Cheltenham. Edited November 23 to add the radio broadcast of Chilcott’s Christmas Oratorio. Edited December 15 to add Das Lied at Wigmore Hall. Edited December 20 to update the casting information for the Teatro Real Walküre. Edited December 15 to add the Proms at St Jude’s performance of Das Lied. Edited January 24 to reflect Dame Sarah’s withdrawal from concerts on March 13 and 19 due to ongoing cancer treatment. Edited January 28 to add the Wigmore Hall recital in September 2020. Edited February 10 to cross off the “Bringing the House Down” charity concert. Edited February 22 to reflect Dame Sarah’s withdrawal from the Royal Philharmonic Society event, the Basel Mahler 2 in April, and the Paris Götterdämmerung. I also updated the link for the Philharmonia Das Lied von der Erde / Song of the Earth and added newly-available details for the Chipping Campden recital, the Proms at St Jude’s performance of Das Lied von der Erde, and the Schubertíada Vilabertran recital. Edited February 29, 2020 to add the two Dutch National Opera engagements, the Concertgebouw recital, and the Buxton recital. Edited March 10 to reflect Dame Sarah’s withdrawal from Das Lied von der Erde with the Philharmonia Orchestra. Edited March 23 to add the Ferrandou Musique dates, to reflect the first round of COVID-19 cancellations, and to add cautionary notes for concerts up through July 11. Edited April 6 to reflect the cancellation of the Wiener Symphoniker’s Mahler 8 as well as the Proms at St Jude’s and Wigmore Hall performances of Das Lied von der Erde; to add a link to the Cheltenham Music Festival’s announcement changing its ticket sale dates; and to confirm and clarify the cancellation of the Rotterdam Phil’s Mahler 2 concerts. Updated April 7 with the cancellation of the Cheltenham Music Festival and the Buxton International Festival, and to update the link to the Wigmore recital on September 30, 2020. Edited April 14 to indicate the cancellation of the Musée d’Orsay recital. Edited April 22 to add the Berlin Gerontius. Edited May 6 to update repertoire details for the LIFE Victoria recital and add the Hamburg Stravinsky concerts and the Basel Mahler 2 in August. Edited May 8 to reflect the cancellation of the Ferrandou Musique concerts. Edited June 19 to reflect the cancellation of Dame Sarah’s recital at the Schubertíada Vilabertran and the second (August) Basel Resurrection. I may continue to edit this list as I receive new information.

[outrotearbias]

@mccnhild tagged me in a few tags and 1) thank you!!! 2) since i’m apparently incapable of not talking abt myself on all platforms including what was meant to be a thirst blog for bts, but i haven’t actually like. said any concrete facts about myself lmao i figured i should actually talk about myself on here?? so this is a good opportunity to do that

uh well the first one is the bias selfie tag and everyone else might be cute enough to do that but i would honestly rather swallow a bee whole than directly compare myself to yoongi LIKE. i just. no. so i’ll just post a selfie. i almost never take pictures of myself so i really did not have much to choose from, ignore the janky lipstick and extremely yellow light lmao. i took these on the night that i went to go see burn the stage and YES i looked and felt extremely out of place #armysneedgothrepresentation

hate that these are so large but idk how to work tumblr despite having it since 2010

“get to know me” tag:

Nicknames/Pet names:  literally so boring lmfao, just em or emmy (although if you do call me emmy and you’re not a close family member i will be legally obliged to murder you). my grandma calls me milunia sometimes which is like a polish nickname for emily i think? that’s probably my only nickname that i actually like the sound of

Zodiac: this might get me killed for admitting this on tumblr dot com but i could literally care less about astrology. i’m a taurus but i don’t rly identify w it or care

Height: like 5′3.75 and yes i’m pretentious for not just saying 5′4 but that’s my truth

Last Movie: i literally never watch movies uhhh i think the last one was venom? i hate marvel movies normally but i will literally endure anything for tom hardy

Last Thing I Googled: "movies 2018″ bc i knew the last movie i watched was pretty recent but i couldn’t remember it lmfao

Favorite musician: radiohead, city and colour, alexisonfire, daughter, and this group that’s called bts i think??? 

Songs Stuck In My Head: desire by ateez, their new album BANGS and this song in particularly is so catchy 

Other Blogs: @thedalishelves is my main and @calebandnott is my semi/mostly-inactive critical role blog. i’ve had like a billion others but those are the ones that are (ostensibly) active

Do I Get Asks?: i used to a lot but all of the blogs i got a lot of asks on are either deleted or i don’t use them much anymore. i do kinda miss it sometimes but also now no one asks me to diagnose them or tells me their trauma in detail so it’s a toss up really

Dream Trip: i have a phobia of traveling lmfao so it’s more about who i’m with rather than the destination? like i don’t really care at all about seeing new places, more about just being with someone that i like away from daily life for a bit. that being said i do wanna go to paris before i die. also italy and poland to like. connect w my ancestry or w/e lmfao

Amount of Sleep: when i just let my body do its thing (which has been almost all the time lately as i don’t have classes any more and my job has irregular hours) i naturally sleep for abt 9-10 hours. and yes that’s a lot and YES it sucks

Lucky Number: i mean it’s not lucky but i have a Thing abt the number 3 in certain situations

What I’m Wearing: sweats and hoodie bc i’m at home and if u wear anything other than comfy clothes at home. i have nothing to say to u

Favorite food: don’t rly have one atm

Dream job: english professor!!! i’m nearly half way through my phd so. almost there! (if any jobs ever open up 💀💀💀 might get to fulfill this dream in about 40 years or so)

Play any instruments:  i used to play the piano and the baritone (lmfao) but i’ve long abandoned them

Languages: obvs english, EXTREMELY bad french that i can passably read, sort of write, almost completely cannot speak and definitely cannot understand. also i took a year of arabic during my undergrad but i only remember how to kind of read the alphabet. and i have a pretty sizable polish vocabulary (considering i don’t speak it) but absolutely do not know ANY grammar, so the best i could do is throwing random polish words into english sentences. so. basically just english and reading in french

Random fact: *vegan voice* HI I’M A VEGAN

15 questions tag:

Are You Named After Someone: yeah emily brontë bc my mom loved wuthering heights lmfao. in hindsight.. really indicative of how my life would turn out (both in the whole ‘i love reading and i’m doing an english phd’ thing and also the gothic tragic horror lmfao)

When was the last time you cried: yesterday about 461 times. sometimes it be like that

Do You Have Kids: yes one beautiful little tabby cat named faye, i adopted her in august and she’s 3 years old now and extremely annoying and also perfect

Do You Use Sarcasm A Lot: i used to a lot more but now i’m too paranoid abt people hating me and thinking i’m negative so i try not to

What’s the First Thing You Notice About Someone: if they’re a threat or not (either in the immediate physical sense, like seeing someone walking down the street towards me, or in the more complicated sense that i can’t be bothered getting into now and yes i’m aware this is a depressing answer)

Eye Color: dark green

Scary Movie or Happy Ending:  what a weird thing to juxtapose lmfao ig i’m a bit too much of a wimp to watch scary movies often so happy ending? i’m really not one to need happy endings in a movie/story though

Any Special Talents: I Cannot Stress Enough How Untalented I Am. anything that i’m good at is due to dedicating A LOT of time and practice to it.

Where Were You Born: toronto

Hobbies: video games are definitely my main hobby. other than like, listening to music and indulging in whatever obsession i currently have (like bts for instance) all i do is play video games. reading isn’t a hobby anymore, bc even though it occupies most of my time, it’s all for school

Pets: seems pretty redundant to ask about children and pets in one tag. but in addition to my own cat, my family also has a cat named chloe who is super gross but also i love her to death and i think she might actually be an angel. if you could not tell i am completely a cat person and plan on adopting 300

How Tall Are You: let’s go w the less pretentious answer of 5′4 this time even if it’s 0.25″ short of the truth

What Sports Do You Play/Have You Played: LMMMMAAAAOOOOOOOOOO DO I LOOK LIKE

Favorite Subject: i mean. english. obviously

Dream Job: since i already answered this let’s really get wild w the “dream” part of dream job. i would absolutely love to somehow become extremely rich through no work of my own, move to an isolated castle w a really big library, wifi, and like. idk an archery range and some stables w horses and a lot of cats and an incredibly hot gameskeeper that i have a passionate but somewhat detached love affair with. like i’m tryna live like a combination of enya and lady chatterley from lady chatterley’s lover except w/out the shitty husband and class critiques and soul-destroying ennui

HOO BOY i really wrote way too much huh. i’m too avoidant to tag ppl but if u read that whole mess i owe u my whole life thank u

[atlas-of-a-human-soul]

Sleeping at last (E.D.)

Summary: Ethan learns the hard way that not every story has a happy ending.

A/N: Ethan is older in this one.

Warnings: angst, sad, maybe one swear word

Word count: 2750

Sleeping At Last - Saturn (the song that inspired me to write this one)

The first time I ever saw her was on a rainy Monday at exactly 3 pm. After spending the past 8 hours in surgery I finally got a little lunch break and I was waiting for Grayson because he wanted to talk to me about how to propose to his girlfriend and since I was on call, this lunch break was the only time I had to give him. He was running late and I got annoyed, deciding to get something from the vending machine in the lobby because it was the only one that had gummy worms.

I remember thinking about waiting for him in the lobby since I was already there and I’m really glad I did because that’s when faith stepped in.

Instead of Grayson, she walked in and I swear my heart skipped a beat. She was one of those people that emit a certain type of aura that just draws you in.

I was standing there with my mouth open, eyes following her slowly disappearing figure, but I couldn’t move. I stared at the stairs thinking I should probably follow her, introduce myself, get her number…something! Anything! But my feet were glued to the ground.

I missed my chance.

The second time I saw her was only two days later, on a Wednesday morning at 8:15 am. I was standing a bit closer to her thinking maybe I could just accidentally run into her, apologize and use it as an opportunity to introduce myself. It didn’t happen because I got paged and by the time I looked up, she was gone.

Every break I had during that week was spent in the lobby, just hoping I’d see her again.

It didn’t happen...at least not while I was awake.

I dreamed of her every night since Monday but her face was blurry and it frustrated me. Sure, I never saw her up close, however I could easily tell how beautiful she is.

I saw her again next week. This time I just chickened out and didn’t approach her.

Why was she here so often? Did she work in the hospital? Was she visiting someone? If she was, was it her boyfriend?

The thought of her with someone made me depressed and I was losing hope I’d ever get to speak to her.

I watched her come and go like that for three weeks. Then all of a sudden, she stopped showing up. She was just gone. She wasn’t there the fourth week...nor the fifth...and by the sixth I realized she wasn’t returning.

Why did it hurt so much? I never even met her…Why did I miss someone I’ve never met?

I just got off a 48 hour shift but I knew I wouldn’t be able to sleep. Plagued by the thought of her I decided to visit my favorite cafe right by the beach.

The sun was just coming up, even when I was drowning in my own frustrations and hardship, the sky remained beautiful. Sunlight filled the sky, pure scattered light illuminating each crevice of the land and in the distance I could hear seagulls waking up as well.

I love this time of the day. The town is just waking up, there aren’t as many people walking around. It was perfect for lonely dreamers like me.

Just when I thought I was never going to feel happiness again I saw her again.

She was sitting at the cafe with a milkshake in her hand. She was facing the sun, eyes closed with a gentle smile on her lips, letting the soft amber glow of the sunrise caress her beautiful face

With breath paused in my lungs, I wished time would halt.

She opened her (Y/E/C) eyes and noticed me staring immediately. She blinked and the beauty of her eyes was momentarily covered by the shield of her eyelashes; naturally long and soft looking without a trace of make up.

I walk right up to her and sit at the table in the chair across from her. I wasn’t afraid of approaching her anymore. I was a lot more afraid of never seeing her again. This girl felt like a dash of spring in my dark days and I needed to know her.

At any cost.

She didn’t react when she saw me take a seat but I could tell she was curious.

“Hi.” I manage to say. I hide my shaking hands under the table. I don’t want her to know how nervous I truly am.

“Hi” she responds, that beautiful smile graces her lips once more.

“I know this is weird, me just walking up to you at 6 am on this beautiful sunny day, but I had to meet you.” I blurt out.

Shit, she’s probably going to think I’m a crazy stalker now.

Thankfully, she gives me a smile that seems so genuinely sweet with just the right touch of shyness that unexpected warmth rushes through me.

“That’s okay. I like weird people. Usually they’re the one with the most interesting stories to tell.” I return her smile and decide this was probably a good time to tell her my name.

“I’m Ethan.”

“Y/N.” Wow, even her name was beautiful.

We started talking and never stopped. I was so comfortable around her which never happened with other people. She was the type that made you feel like you were the only person in the world that mattered.

I was flying high, living on cloud nine.

That day was only the beginning. We’d talk all the time. I used every chance I could to see her. I was addicted. It was like she was my own personal brand of heroin and no matter how much I take, it was never nearly enough. The chemistry between us was amazing.

Whenever we got together and talked it was as if we had a language of our own. It felt as if she spoke the same language as I, yet no other was able. I didn’t feel alone anymore as  before. I always had a feeling of being isolated, in a windowless room, in a door-less room… and then suddenly she walked in as if strolling over a summer meadow. She became my sunshine, a breath of life, my medicine.

Three months later, I still didn’t make my move. I didn’t mind, mostly because I didn’t want to scare her off or overwhelm her. We were supposed to go out tonight but she called and said she wasn’t feeling well.

I might not be her boyfriend (YET) but I was her friend. I bought some chicken soup and a lemonade and headed to her place.

I knocked three times and the door swung open. I expected to see her beautiful face, but I was met with a middle-aged woman’s face instead. Just by looking at her I knew she was related to her. Probably her mother.

I tried explaining who I was to her and gave her the things I bought. I begged to see her daughter, even for a minute, but she turned me away.

I was so worried about her that night. I called and texted, but she never responded.

In the morning I got a text:

I don’t want to see you or hear from you. We’re no longer friends. Forget this number.

Where did this come from? Where did I go wrong?

I tried visiting every day for two weeks but I was sent packing each time. She never took my calls, never replied to my messages.This loneliness was a vice on my heart, squeezing with just enough pressure to be a constant pain. It killed me every day just a little bit more, taking what was once my inner light, my sun and replacing it with a darkness that overshadows each moment.

I needed an explanation! Anything!

I went to her place and her mother opened the door again. She sighed and shook her head slowly. I could tell she felt sorry for me. It was written all over her face.

“I’m sorry Ethan, she doesn’t want to see you. I think it’s time for you to move on. This isn’t healthy.” She says gently almost as if she saw just how broken I already was and didn’t want to add onto the damage.

“I can’t move on ‘till she talks to me. I need a reason! Tell her I’m not leaving until she gives me an explanation. I’m going to sit here, right at your doorstep until she comes out. If she really doesn’t want me here, I need to hear it from her.” I insisted, no longer willing to play by her rules.

I stayed true to my word. I didn’t leave. Not when the rain started. Not when I had to pee. Not when I got hungry. Not even when the darkness of the night engulfed me.

Somewhere around 3 am the door finally opened. I jumped up like an eager dog when their owner cane home.

There she was.

My beautiful Y/N.

Just by looking at her I could tell why she refused to see me. I was a doctor, I’d know something was up immediately. She was pale, her eyes sunken without their usual glow. She was skinny...too skinny. She looked fragile, like a gush of wind could cause her to crumble.

“Hi”, she says, her voice weak and hoarse.

“Hi” I respond quietly. I was still shocked to see her like that. She was a shadow of her former self.

Without a second though I take a step forward and engulf her in my arms causing her to break down. I pick her up like she was a little child and use my foot to shut the front door. Sitting on the red couch, she wrapped herself around me and cried. I cried with her the entire night till she exhausted herself and fell asleep in my arms. Soon I followed suit.

In the morning she finally opened up to me. It was excruciating, but I need to hear it.

“It’s cancer. Stage four. It started in my thyroid and spread everywhere. They can’t do much.”

She starts, her breathing shallow and fast…I knew it was a sign her lungs were affected as well.

“They diagnosed me almost 5 months ago in the same hospital you work at. I spent a few weeks doing tests only to get a terminal diagnosis. I don’t have long...the past month...it really started to take its toll on me.”

“You knew about it when we met and yet you kept it from me? ” I murmur trying not to sound too offended but probably failing completely.

“Just a moment before we met, before I opened my eyes and saw you, I wished for something good to happen to me. One last good thing. I opened my eyes and there you were.” She answers with a small smile and a twinkle in her eyes.

“I didn’t want to ruin everything by telling you. I didn’t want you to treat me any differently or pity me. I wouldn’t be able to handle that. I wanted to be happy and make you happy as well.”

“I wouldn’t treat you differently”, I start but she cuts me off.

“That’s a lie and you know it Ethan. I see it in your eyes. You’re afraid to even yell at me for cutting you out of my life when you and I both know you’d be screaming at me if I was healthy!” She raises her voice a bit but it caused her to cough.

“Why did you cut me out? Do you know how much pain you’ve put me through?” I question, my hands weaving into her hair.

“We got close. Too close. I was getting worse and I’m definitely not going to get better...ever. It would hurt you a lot more to watch me wither away, bit by bit. So I let you go, but you’re too stubborn to leave.”

“Hell yeah we got close! I fell for you even before we met. I saw you at the hospital and my life hasn’t been the same since. You weren’t doing me any favors by disappearing on me! Why did you let me In last night?” I was yelling now. I know I shouldn’t, but it’s inevitable.

She just smiled and took my hand in hers. “Now you sound like a creepy stalker…just a bit.”

I shake my head. “Why did you let me in?”

“Because I’m weak and selfish. I missed you. I needed you.” She shrugs.

“Contrary to what you think, I just wanted to protect you. I’m a grenade Ethan. I’m going to blow any day now and when that happens, everything in my proximity will be annihilated. You’re the closest one to the blast zone and I had to get you out. I didn’t want you to suffer.” She says and wipes away tears that started to spill from her eyes.

“You do realize that no matter what you say or do it does not in any way, shape or form, lessen what I feel for you. I love you (Y/N) (Y/M/N) (Y/L/N). I’ve loved you from the start and I’ll love you for as long as I live.” I confess.

“I’ll be with you till the end and no matter what you say or do, I’m not going to leave you. Ever.”

“I love you too Ethan Grant Dolan, so damn much.” She says and moves closer to me.

I couldn’t wait any longer so I cupped her face and connected my lips with hers in a kiss that would be our beginning and my ultimate doom.

It was four months since our first kiss. In my mind I knew she was getting progressively worse, but my heart still had so much stubborn hope.

I’ll always remember the day I lost her.

We were dancing in the kitchen. I put her feet on my own and held her in my arms because I knew she was too weak to do it herself. Her exact last words to me were: „This is perfect…You are perfect.“

I remember her laughing in spite the pain she felt, her kiss that held so much love I have never felt before. I remember her hair that smelled like lilies and I remember the moment she started to suffocate when her lungs finally gave out.

I raced her to the E.R. and they intubated her. Soon after her body gave out completely and the only thing that kept her alive were all the tubes and wires and machines. I knew her choice was never to be left on life support and she left a DNR. They turned the machines off and I held her in my arms.

I stayed true to my world. I stayed with her till the very last breath she took, until the very last beat of her heart, and the very last synapse in her brain died. I kept repeating ‘I love you’ to make sure the last thing she heard is how much love she evoked in the world she’s leaving behind.

She’s been gone for ten years now, but I’ve never felt alone.

In a way she’s still here with me. I see her in every sunrise and every sunset, in every star and every flower. I feel her in every raindrop and hear her whispers in every gust of wind.

She’s still in my dreams from time to time as well.

“Sunshine, I still love you. Till my last breath, remember?” I carefully put a white lily on her grave with a heavy heart and walk away.

Grayson is waiting by the car with his wife and the moment I got there they both hug me tightly.

I look back at her grave underneath a willow tree and smile.

She taught me how to love and showed me what it truly means to be loved. She taught me the meaning of life, gave me hope, faith and above all...happiness.

Life is an unwritten book. You get to be the star of your own story, crafting it day by day, interacting with loved ones who are the stars of their own stories too. As we all travel the pages, it is our connections that make the tale worth telling.

I made a connection with a real life angel and I’ve never had any regrets. I got to spend 9 and a half months of utter happiness with her and it was worth all the pain that came right after. I know I’ll see her again.

Till death do us apart doesn’t apply to us.

Soulmates always find their way back to each other.

[phawareglobal]

Doug Evans - phaware® interview 362

Doug Evans is a Pulmonary Hypertension patient from Florida.

In this episode, Doug discusses his time in the military as a bomb loader, why he had to move from Colorado to lower altitude due to his PH, and how his treadmill and passion for Team PHenomenal Hope helped him lose over 80 pounds by simply walking.

My name is Doug Evans. I'm a 20-year veteran of the United States Air Force and retired from Comcast as an engineer. In late 2014, I was diagnosed with pulmonary hypertension. Now I’m living in Florida where I no longer have to wear oxygen, which if your doctor says to move to a lower altitude, by all means, if you can do it, go. It was a lifesaver.

I'm originally from western New York near Buffalo. In the mid-'70s, there was actually no jobs in the western New York area. So myself and almost all my buddies from high school enlisted in the military. I enlisted in the Air Force and ended up loading bombs for a living. It's one of those jobs that very few people volunteer for. You end up getting assigned to it, because of a lack of manning. I ended up actually enjoying the job once I learned it. I spent 20 years loading bombs. I was in Germany, Italy, Spain, Turkey, stationed in North Dakota on B-52s for quite a long time. Korea, Guam, Hawaii, New Mexico, where I finally retired.

Imagine my shock when I discovered that there were very few airlines hiring bomb loaders. So I had retired and rejoined my family in North Dakota, and it was getting near Christmas time and there was an opportunity to work for Fisher-Price toys as a computer technician. They were going to provide all the training that you would need since Fisher-Price is originally from my hometown area, I said, "What the heck, I’ll give it a try." It was some interesting computer products for little kids, and I was doing phone support for them. They were really good products. We got very few calls. So I hung out with other contracts that were in the same building, the same call center, and one of them was Gateway computers.

I would sit in on their training, and I probably got more training on Gateway than the Gateway technicians. I ended up working there and ended up a senior lead, and it just kept compiling. I would move to a different contract, and eventually when that call center closed, I ended up moving back to the western New York area and ended up working for Adelphia cable. After Adelphia cable went bankrupt one winter, we had seven feet of snow in one storm, and I was really not happy with all that shoveling. A friend called up from Denver and said, "Hey, do you want a job with Comcast here in Denver? They'll move you." I was there before she could hang up the phone. I remained in Denver for close to 15 years until I got laid off, and I had enough time in to convert that to retirement. By that time, I had already contracted pulmonary hypertension.

I was stationed in Denver in the early part of my career in the Air Force. I noticed the altitude did affect the human body, because the altitude in Buffalo is like a hundred feet and you'd go up to 50 to 80 feet, you've run out of breath really quickly. In the Air Force they would... For the first two weeks when you stationed there, you'd just do a lot of marching and walking to get used to the altitude. I eventually did get used to it. So when I moved back, I expected that, and it was just a lot harder to get used to it.

By this time, my folks had moved to Florida. Whenever I would go visit them, of course, in Florida, I'd feel great. Then going back to Denver after a week or two vacation, it was really, really tough to get used to it. I lived on the second floor of an apartment building and climbing those stairs was just awful, and it just slowly got worse. One day I had to move a server in my workspace from a cubicle to the warehouse. It wasn't a big distance and it wasn't real heavy servers, so I just picked it up and carried it. By the time I got to the storage area, I couldn't breathe. Well, I could breathe physically. I could feel the air going in and out of my lungs, but it was like it wasn't doing any good. I remember my boss just staring at me saying, "What's wrong with you?" I said, "I don't know. I'm just not breathing right. Something's wrong." Eventually, one day not long after that, we had a big family occasion at the house for the holidays. I moved from the kitchen, walked through the house to the living room, and I almost didn't make it. I was so out of breath. When I got to my recliner and I sat down and I bent over and I'm trying to get my breath. I was almost ready to faint. My wife says, "You okay? Do you want to go to a hospital?" And I said, "Yes." And she thought I was going to die because I never want to go see a doctor. So yeah, she really freaked out. She almost called an ambulance. That's the day I found out I had pulmonary hypertension.

I ended up in the emergency room at the local hospital, and they also found a congestive heart failure, which has never reoccurred. That was like a one-time thing. I went through all kinds of stress tests. Boy, I never want to do some of those again. They punch you full of chemicals and you just suddenly feel like you've ran a dozen miles. All kinds of CT scans. They said, "Yeah, you got pulmonary hypertension." I said, "What's that?" "Ah, it's a condition." That's about it. At the same time, my wife was going to National Jewish Health, one of the top respiratory hospitals in the nation. She has asthma. So she set me up with an appointment with her doctor, Dr. Amy Olson. Went to see her for what they suspected was sleep apnea. I also signed up for their pulmonary hypertension clinic. When Dr. M. Patricia George took over, that's when I finally started to understand what was going on. She really took a lot of time to sit down and explain to me exactly what was happening. She was really a blessing to have in my life.

My recovery, if we want to call that, really started when we got a treadmill for Christmas. I had more fun putting it together than I really thought I'd ever have fun with a model kit. It was a really nice treadmill, and you could program a route anywhere in the world, and it would show you through Google Street View where you're walking. I just started walking. I programmed my old route I walked to school, and I was really upset that I couldn't do that. So I kept practicing over and over until I could walk that three-quarters of a mile to school. I had a high output oxygen concentrator, and I turned it up higher than my prescription said, and that really helped. I'm going longer and longer routes.

At this time, it was only a year ago that the real estate market in Colorado was just going crazy. People were buying houses as fast as they could get them. The equity in my house shot up through the roof. I remember at one time, Dr. George said, "It would be good if you move to a lower altitude." My wife and I talked about it, and the friend who got me the job in Colorado was now living in Florida. She and my wife were very good friends, and we decided let's move to that area. We ended up finding a real nice house in Hilliard, Florida.

The whole time I'm on the treadmill. I'm keeping track of every workout, and I was over 300 miles total. That was only about five months. I just started out just a little bit every day, and just tried to add a little bit more with every workout, if I only added five minutes. In pulmonary hypertension, we have these bad days where we we're just exhausted, and they just come out of the blue. I did everything I could to work on those days. I call them crash days. We eventually just said, "The heck with it." We got a good price on our house. We packed up and moved. We couldn't take the treadmill with, so I got down to Florida and I just started walking on the streets, and it's so much easier to breathe down here.

I went to a local pulmonologist. She said, "Yeah, you don't need to wear oxygen in the daytime. You're responding so well to the lower altitude." So I started walking maybe a mile a day outside. It's so much different than a treadmill. I just kept increasing every day, a little bit more, a little bit more. I found that those crash days come further and further apart, and sometimes they're not as bad as others. So that's a big plus. When I got moving, I found that I didn't have those days where the exhaustion just overwhelmed me. I track every step I take. I got a smartwatch and a smartphone, and that does a great job tracking your activities and stuff like that. For 2020, including the time on the treadmill and everything, I logged 1,141 miles. In 2021, I'm still going. I'm up to five miles a day.

Now, I do have back issues and hip issues from my service. That really kind of limits me to five miles. The arthritis starts kicking in. So I will try to walk a second walk in the evening, to extend that five miles daily. As the weather gets better down here, I'll be doing that more often. The one thing I'd say is just get up and move. I know it's difficult, especially on those exhausting days, but get a phone or something where you can play music, put on your headsets and just go for relaxing walk. For me, it was the best thing I can do, and I hope everyone can give it a try. If you can't go outside, if you're stuck up in the north, see if you can find a treadmill. Don't set out to walk a thousand miles. Set out to walk a mile. Set out to walk a half mile, and then tomorrow just do an extra 20 feet.

But yeah, it really helps. I've lost 80 pounds just walking, no real major change in my diet other than I'm doing a lot better on portion control now. When you get pulmonary hypertension and you get those days you're so exhausted, the only thing you can do is watch TV and eat, at least for me. I gained a lot of weight and I'm sure a lot of folks in my position do. It not only helped me, it helped my dogs. My dogs were getting really chubby too. So I walked them with me. I was walking every day, a little bit more each day. I never really concentrated on doing it faster, but I did concentrate on doing it better, trying to keep the cadence the same and always talking to my doctor about what I'm up to. Not only am I talking to my doctors, I'm talking to my past doctors.

I'm always in contact with Dr. George back in Denver. I mentioned to her what I was up to, and she said, "Well, the Team PHenomenal Hope is having a Tour of PHenomenal Hope. It's going to be like a bicycle race. It's set up in stages, but you can walk, you can ride a bike, you can swim. You just track all your activities on this free application called Strava. I joined up as an athlete. I didn't really tell anybody except Dr. George that I was a PH patient. Being retired, I could put in as much time as I wanted. That was one of the things that we're measuring was total time. I was putting in about almost 15 hours a week, just walking, occasionally riding a bike, not too often, because it is getting to be winter down here. That put me in the lead, and I wonderful for the total time invested. Then, that's when I told the organizer that I was a PH patient, and she was just ecstatic. And next thing I know I'm doing a podcast.

My plan for 2021 is to try to get as many of my brothers and sisters doing this. I would like to see the number of patients outnumber the number of doctors in 2021's Tour of PHenomenal Hope. We don't have to win. We just have to be there. Go for a walk, 20 minutes a day. Just let them know that we are trying. In my personal life, my wife has been injured, her mom has been injured, so I am now the caregiver in the house. That's going to eat up a lot of time, but I'm going to continue to walk. I want to spend more time on my bike, and I want to spend as much time as I can encouraging my PH brothers and sisters that we don't have to sit down and take this. We can actually physically do something.

My name is Doug Evans, and I'm aware that I'm rare.

Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Never miss an episode with the phaware® podcast app. Follow us @phaware on Facebook, Twitter, Instagram, YouTube & Linkedin Engage for a cure: www.phaware.global/donate #phaware #ClinicalTrials

Listen and View more on the official phaware™ podcast site

[juniperpublisherscasestudies]

Juniper Publishers- Open Access Journal of Case Studies

Capacity of Shear Wave Elastography in Diffuse Liver Diseases in Children

Authored by N E Kuzmina

Abstract

Two hundred and thirty children aged 3 to 18 years were included in the study, among them 200 were practically healthy (control group) and 30 patients aged 2 to 17 years had chronic liver diseases (study group). All patients underwent standard liver tests and two-dimensional shear wave elastography (Aixplorer device (Supersonic Imagine, France, convex sensor acting within the medium-frequency range of 1-6MHz). Ten measurements of Young modulus (Emean) were made in different segments of the right and left liver lobes with subsequent data averaging. In patients with chronic liver disease Young modulus values were significantly higher than in patients of the control group (Emean median was 7.05kPa and 5.00 kPa, interquartile range was 6.40-9-18 and 4.70-5.38kPa correspondingly) (p<0.001).

Ultrasound elastometry can be successfully used in complex assessment of liver diseases in children for dynamic monitoring in the group of patients with chronic liver diseases. Young modulus value of 6.35kPa will enable to reveal children who need additional examination when healthy children undergo screening evaluation by means of 80% sensitivity and 100% specificity tests.

Keywords: Ultrasound elastography; Shear wave elastography; Stiffness; Young modulus; Chronic liver disease; Fibrosis; Liver; Children

Introduction

Chronic diffuse liver diseases are an urgent issue in present children gastroenterology. The interest to this group of liver diseases is due to their increasing incidence, frequent severe course, tendency to progression and unfavorable outcomes. This problem requires great attention as the course of the diseases is often insufficiently symptomatic because of the great compensatory capacities of the organ. Clinical manifestations and patient presentation often take place when severe morphological changes have occurred, and adaptation and compensatory mechanisms have already been wasted [1]. Regardless of the etiology, cirrhosis is the cause of fatal outcome in patients due to the development of complications, i.e. hemorrhage from the esophageal varices, ascites, encephalopathy, hemorrhagic syndrome, transformation to hepatocellular carcinoma.

Various infectious agents such as hepatitis B, C, D, G viruses, cytomegalovirus, Epstein-Barr virus as well as autoimmune liver diseases, cystic fibrosis, metabolism diseases, etc. may act as etiologic factors causing liver fibrosis and cirrhosis in children. There is a direct correlation between the intensity of cirrhotic changes in the liver and the degree of cytolytic enzymes activity in viral hepatitis in children. In children with liver cirrhosis developing due to the conditions not related to the viral hepatitis pathologic process activity may be contemplated as a factor contributing to the progression of liver affection to cirrhosis. Thus, cirrhotic changes which are observed in diseases with high activity (autoimmune hepatitis, biliary atresia) develop within a short period. While diseases occurring with normal activity (congenital hepatic fibrosis) and insignificantly increased activity (cystic fibrosis) progression to liver cirrhosis occurs much slower. Long term catamnesis observations of liver cirrhosis and chronic viral hepatitis course have shown that cirrhosis occurs sufficiently early from the moment of its identification and is not the outcome of chronic viral hepatitis [2]. In spite of the increased experience in the study of viral liver diseases, characteristics of clinical manifestations, diagnosis, treatment and prevention of viral hepatitis A, B, C, D, E as well as metabolic, hereditary liver diseases i.e., galactosemia, α-1-antitripcin, Wilson-Konovalov disease, Alagil syndrome, Goshe disease, etc. still present some difficulties. They require technically and methodically complex approaches and committed pathogenetic therapy. Late diagnosis of many diseases results in unfavorable outcome so that there remains the only option i.e. orthotopic hepatic transplantation. It is practically impossible to extrapolate the study results obtained from adult patients because of the anatomico-physiological characteristics of a child because of his development rates, formation of all organs and systems [3].

Liver biopsy is still the basic diagnostic and predictive procedure in evaluation of liver diseases in children. Specific histological characteristics are important to diagnose hepatitis, cholestatic liver affections, steatosis, vascular conditions, storage diseases [4,5].

Biopsy is of utmost importance in case of crossed syndromes or non-typical clinical manifestation when only histologic sample can help solving diagnostic dilemma and give a chance of timely adequate therapy. Indications to perform liver biopsy are numerous and they increase in number when the current knowledge of etiology, molecular basis and therapy options of liver diseases in children increase. Development of alternative diagnostic methods and improvement of liver visualization techniques change the role of biopsy. The biopsy procedure is often complicated by technical difficulties connected with anesthesia, availability of trained staff and equipment, smaller sizes of the organ and a smaller sample. It may cause such complications as pain syndrome, profuse hemorrhage, formation of subcapsular liver hematomas, development of biliary peritonitis, etc. [6]. Standard liver biopsy averages 1/50.000 of the whole liver that is why the sampling error of 20- 30% is significant. It is necessary for the clinicians to cooperate with pathology doctors who have a clear picture of hepatobiliary problems in children. Diagnostic errors made by unexperienced specialists were registered in more than 25% of patients. Biliary atresia is a challenge for clinicians and pathology doctors because a missed opportunity of early diagnosis results in a missed opportunity of surgical correction. The feasibility of intra- and inter-observational study of biopsy samples is well known and can be the main factor limiting liver biopsy capacity [7].

That is why considering all difficulties of histologic verification specialists are motivated to search for noninvasive techniques which will enable not only to reveal changes in the liver but also to carry on dynamic observation of fibrosis process.

That is why considering all difficulties of histologic verification specialists are motivated to search for noninvasive techniques which will enable not only to reveal changes in the liver but also to carry on dynamic observation of fibrosis process. information in the form of digital data of the shear wave velocity (or Young modulus) in the area of interest (light window) is obtained. Areas with different velocity values of shear wave (or various values of Young modulus) are mapped by different colors. It is the digital values of these parameters that determine the color in the area of interest [8].

Shear wave elastography can be successfully used in the complex evaluation of liver parenchyma when it is affected and differentiation of diffuse pathology in B-mode is problematic. This ultrasound approach is intensively studied, but not in pediatrics [9-12]. Diagnostic efficiency of two-dimensional shear wave elastography was proved by the studies performed in the adult population. As a result, the threshold elastometry values for each stage of fibrosis were established [13-15].

The purpose of our investigation has been to study the values of liver stiffness in children with liver chronic diseases and performing a routine ultrasound exam to establish the values of Young modulus which will enable to reveal patients with uncertain chronic liver conditions requiring additional complex examination.

Material and Methods

Two hundred and thirty children aged 3 to 17 years were included in the study. Among them there were 200 practically healthy children aged 3 to 18 years (control group) and 30 patients aged 2 to 17 years with chronic liver diseases (study group).

In the group of children with hepatitis the patients were distributed in the following way: cryptogenic hepatitis – 10, autoimmune hepatitis – 4, hepatitis of unspecified genesis - 3, liver cirrhosis - 3, hepatitis of cytomegaloviral etiology – 2, storage disease – 2, unspecified liver fibrosis, primary sclerosing cholangitis – 2, virus C hepatitis – 1, herpes-viral hepatitis – 1 (Figure 1).

All children underwent standard ultrasound study of abdominal organs in the grey scale mode supplemented by two-dimensional shear wave elastography on Aixplorer device (Supersonic Imagine, France) by broadband convex sensor acting within frequency range of 1-6MHz. Elastometry was made when a patient was fasting, breathing normally, in elder children during breath-holding for not more than 10sec, patients were in a supine position. There were subcostal, intercostal and epigastric accesses. The sensor was placed perpendicularly to the body surface with minimal pressure. Measurements were taken in the areas free from the vascular structures, fixing the zone of scanning at the depth of 3-5cm from the capsule, in different segments of the right and left hepatic lobes, taking into account literature data testifying absence of significant differences between stiffness in the right and left lobe. The investigation was completed after getting 10 informative measurements with average values of Young modulus (kPa) – Emean, at stabilization of the image to get a homogeneous coloring of the light window and color filling for more than 90%. By the results of the measurements arithmetic mean value of Young modulus characterizing liver stiffness was calculated.

Informed consent was obtained from the legal representatives of all patients. The study was approved by the Ethics committee FGBOU DPO “Russian Medical Academy of Postgraduate Professional Education” of Health Ministry of the Russian Federation and local Ethics committee of GBUZ “Chelyabinsk Regional Children Clinical Hospital”.

Statistical analysis of data was performed by IBM SPSS Statistics 19 pack. Most of the quantitative values did not follow normal distribution, that is why methods of nonparametric statistics were used. All quantitative values were presented as M (mean value), σ (standard deviation), median (50th percentile), 25th-75th percentiles of both minimal and maximal values. Comparison of quantitative parameters was performed using Mann-Whitney test, qualitative ones were compared by Fisher criterion of accuracy. Differences (p>0.0)5 were considered significant.

Results

During the investigation of the study group of children hepatomegaly was revealed in 28 patients (93,3%), splenomegaly in 17 (56.7%), signs of portal hypertension were found in 7 children (23.3%). Twenty-three children (76.7%) were ill not more than 3 years, one child was ill up to 5 years (3.3%), in the rest of the children (6 patients) the duration of the disease was more than 5 years (20%). All the patients of the study group underwent examination in Chelyabinsk Regional Clinical Hospital. They were admitted to the hospital during the development of symptoms (abdominal, dyspeptic, asthenia -vegetative syndrome, complaints of malaise and fatigue, abdominal pain, vomiting, skin and sclera icterus combined with increased transaminase in the biochemical blood analysis), they were also examined for isolated increase of liver enzymes resulting in cholestasis and cytolysis syndrome. Histological verification was done in 18 patients of the study group. During this verification we faced the absence of unanimous consent on the pathomorphological evaluation of biopsy samples: evaluation of fibrosis stage according to different scales Knodell, Metavir, Desmet included just descriptive picture of the sample without any conclusion of fibrosis stage. Autoimmune hepatitis was found in 4 children based on presence of ANA- and SMAantibodies. Nine patients underwent CT and MRI, 3 patients had radioisotope imaging.

Elastography characteristics of changes in the liver in all patients with hepatitis showed the presence of heterogeneous elastometry picture: from homogenous coloring in dark blue and light blue tones and absence of areas of increased stiffness (i.e. qualitative characteristics (range of colors) were not practically different from the control group to yellow-orange and red coloring in the area of interest (Figure 2 & 3).

Earlier we studied liver stiffness in 200 practically healthy children aged 3 to 18 years. Young modulus values were considered as standard [9]. Young modulus values in the study and control groups are presented Table 1. Comparing groups of patients with chronic liver diseases and those from the group of practically healthy children significant differences of Young modulus values were obtained (Emean) (p<0.000).

Considering insufficient number of patients in the age subgroups it is impossible to perform statistical analysis of gender – age characteristics of liver stiffness in children with hepatitis. Then sensitivity and specificity of diagnostic tests and threshold value of stiffness in patients with hepatitis were determined.

ROC-analysis of Young modulus value was done. This analysis enabled to determine the threshold value of interval variable of a predictor. The more convex is the ROC curve, the more accurate are the prognostic test results. The indicator of this feature is the area under the ROC curve (AUC) which equals 0.5 for zero degree of prognosis and for maximal prognosis it equals 1.

ROC analysis results are presented in Figure 4 and Table 2. In our study while building the ROC curve of Young modulus the area was 0.934 (corresponding to a good model of classifier), the confidence interval was 0.874-0.994;

a) Sensitivity.

b) Specificity.

c) Diagonal segments are formed by coincidences.

Table 3 shows data of sensitivity and specificity of threshold values of Young modulus values in patients with hepatitis in optimal combination of sensitivity and specificity predicative significance of threshold value of 5.9-6.35kPa seems optimal.

Discussion

According to literature data several research teams studied liver stiffness values in patients with hepatitis. Young modulus values in adult patients with hepatitis C were studied by G Ferraioli et al. [13]. The study group included 121 patients, accuracy of two-dimensional shear wave elastography (SWE) compared to transient elastography (TE) was evaluated, liver biopsy served as a reference standard. The study was done by two doctors by convex sensor SC6-1 and probe M3 in the right liver lobe through the intercostal space with a patient in the supine position. Evaluation of reproducibility was studied simultaneously. It was established that liver stiffness values increased simultaneously with fibrosis degree when assessed on different devices. Median of Young modulus for F1 fibrosis was 6.2kPa (interquartile range 5.1 - 6.8), for F2 - 7.6kPa (7.2-8.3), for F3 - 10.0kPa (9.2-10.1), for F4 - 15.6kPa (12.8-18.8). Taking into consideration histologic verification fibrosis evaluation accuracy by SWE technique was 83.1%, while by TE technique – 66.7%. Diagnostic accuracy for fibrosis differentiation of F0-F1 from F2-F4 with AUC was 0.92 (CI 95%, 0.85-0.96) for SWE and 0.84 (CI95% 0.76-0.90) for TE (p=0.002); for differentiation of F0-F2 from F3-F4 – 0.98 (CI 95% 0.94-1.00) for SWE and 0.96 (CI 95% 0.90-0.99) for TE (p=0.14) for differentiation F0-F3 from F4 – 0.98 (CI 95% 0.93-1.00) for SWE and 0.96 (CI 95% 0.91- 0.99) for TE (p=048). The study results showed that SWE in the real-time mode is more accurate than TE to evaluate significant fibrosis (> F2). Evaluating the results consistency obtained by the first and second research teams the value range of correlation coefficient was 0.95 (CI 0.93-0.98) and 0.93 (CI 0.90-0.96) for the first operator and the second operator correspondingly. Inter – observational consistency was 0.88 (CI 95% 0.82-0.94) which proved the technique to have good reproducibility when it is used both by one and different operators [13].

Similar study design was carried out by a research team in hepatology of A Guibal et al [14]. Diagnostic capacity of twodimensional shear wave elastography was compared to transient elastography, histomorphology analysis served as a reference standard. The study showed high accuracy of two-dimensional shear wave elastography in evaluating liver fibrosis in 149 adult patients with chronic liver disease. Five measurements in liver segment V with patient in a supine position, holding breath for 5sec and using convex sensor SC6-1 were made. Median of five successful measurements was recorded, when the light box was filled by 2/3 and stiffness values were higher than 0.2kPa. In the subgroup of random patients five additional measurements of stiffness were also made by the third physician to study the inter – observational reproducibility. All patients had liver biopsy in segment V under ultrasound control, the results were evaluated in accordance with METAVIR system. In the subgroup of 55 patient’s stiffness correlation measured by SWE and TE and fibrosis degree were compared by means of Spirmen ranging coefficient.

The average liver stiffness in the study group was 7.0kPa (IQR: 6.0; 8.3) for F0-F1; 9.5kPa (IQR: 7.8; 11.4) for F2; 13.0kPa (IQR: 10.4; 16.7 for F3 and 25.8kPa (IQR: 21.7; 34.5) for F4. Twenty-five patients were included in a subgroup to study reproducibility. ICC composed 0.92 (CI 95% 0.81-0.96). Young modulus threshold value for fibrosis F> 2 was established as 8.8 kPa for SWE and 7.7kPa for TE with sensitivity 90.5 (69.9- 98.8) and 85.7 (63.7-97.0) and specificity 79.4 (62.1-91.3) and 88.2 (72.5-96.7) correspondingly. For F >3 it was established as 11.5kPa for SWE and 8.6 kPa for TE with sensitivity 78.6 (49.2- 95.3) and 85.7 (57.2-98.2), specificity 97.6 (87.1-99.9) and 90.2 (76.9-97.3) correspondingly. For fibrosis F=4 it was established as 15.8kPa for SWE and 11.8kPa for TE with sensitivity 100 (54.1-100) and 100 (54.1-100), specificity 98.0 (89.1-99.9) and 87.8 (75.2-95.4) correspondingly. Two-dimensional shear wave elastography showed high diagnostic accuracy for fibrosis F >2 with AUC 0.904 (CI 95% 0.845-0.946); 0.958 (CI 95% 0.912-0.984) for fibrosis F > 3 and 0.988 (CI 95% 0.955-0.999 for fibrosis = F4. There was established significant correlation between fibrosis stage and stiffness by SWE (r = 0.77; CI 95% 0.63-0.86; p<0.0001) and TE (r = 0.65; CI 95% 0.47-0.78; p<0.01) in this subgroup [14].

Two hundred and twenty-six adult patients with hepatitis B included in V Y Leung et al. [15] underwent liver biopsy. The stiffness values were compared to those in 171 healthy volunteers from the control group. Measurements were made by a convex sensor in segment VIII of the right liver lobe by three operators with different work experience, patients holding breath for a short time. Reproducibility and degree of values consistency were evaluated. Inconsistency of elastometry results and histologic evaluation was 10.2% (23 of 226 patients). Threshold value for fibrosis > F1 was determined as 6.5kPa with AUC 0.86; for > F2 as 7.1kPa with AUC 0.88; for > F3 as 7.9kPa with AUC 0.93; for F4 as 10.1kPa with AUC 0.98. The range of values of correlation coefficient for three operators measuring stiffness in three different hepatic areas was from 0.86 to 0.98, CI 95% 0.71 to 0.99. Good reproducibility was noted among the three operators (ICC 0.85; confidence interval 95% 0.70, 0.94 [15]. Comparison of results of shear wave elastography and transient elastography in the diagnosis of diffuse liver diseases was carried out in the group of 128 patients in the study performed by Diomidova VN & Petrova OV [16]. Liver stiffness was studied in 60 practically healthy people and 68 patients with chronic liver diseases. Stiffness values (Emean) in segment VIII projection were significantly higher (p < 0.05) when comparing with other segments. In transient elastography stiffness values in patients with chronic viral hepatitis B and C were 7.2kPa, liver cirrhosis – 43.8kPa; in shear wave elastometry (Emean) – 8.3 and 55.3kPa correspondingly (p< 0.05 comparing to the control group). Efficiency rate of measurements by transient elastography was 84.4% of cases, shear wave elastometry – 100.0% [16].

It is known from the literature data that O Belei et al. research team [11] carried out the study of the feasibility of liver stiffness measurement in children with CLD by means of point shear wave elastography (ARFI) and two-dimensional elastography (SWE) compared to transient elastography (TE) as a reference standard. Liver biopsy in children was not performed. The group of children with liver diseases (n 54) included: children with chronic hepatitis B, unspecified chronic hepatitis, autoimmune hepatitis, nonalcoholic steatohepatitis, Wilson disease and hemochromatosis. Ten liver stiffness measurements were made. SWE was made by Aixplorer device (Supersonic Imagine, Aixen- Provence, France) using a convex sensor, a mean value of 5 measurements was determined. The mean value of Young modulus in the children studied by two- dimensional shear wave elastography SWE was (7.76±2.46) kPa (CI 95% 7.07-8.46), which is sufficiently close to our study.

Using the technique of two-dimensional shear wave elastography (Aixplorer, Supersonic Imagine, France) in patients with chronic liver diseases (76 children) O Tutar et al. [12] also established that the mean value of liver stiffness in children with fibrosis changes of F1, F2, F3 and F4 degrees according to Brunt was significantly higher than in the control group (p<0.001 for all comparisons) [12].

The analysis of the data obtained in our study as well as that of other research teams has revealed that values of hepatic tissue stiffness in patients with chronic liver diseases are significantly higher than those in healthy volunteers. Young modulus values in the study group are significantly higher than those of the children in the control group (Emean median – 7.05 and 5.00kPa, interquartile range – 6.40-9.18 and 4.70- 5.38kPa correspondingly) (p < 0.001). In children with chronic liver diseases the mean value of Young modulus of 7.89 ± 0.43kPa coincides with the data of O Belei et al. [11] research team – 7.76±2.46kPa and close to the results of A Guibal et al. [14] - 7.0kPa. Young modulus value of 5.9-6.35kPa used as a test (close to the results of V Y Leung et al. [15] study) will enable to reveal children who need additional 80% sensitivity and 95% specificity examination. Taking into consideration the noninvasive feature of this technique ultrasound elastometry can be used both in complex evaluation of liver lesions and for dynamic monitoring purposes.

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[morningnews24h]

Pennsylvania governor says hospitalizations are reaching critical level

Hospitalizations are reaching critical levels in Pennsylvania because of COVID.

Overwhelmed hospitals would be dangerous for everyone — people who need care for COVID and for any other medical emergency. pic.twitter.com/qVlmytM9P3

— Governor Tom Wolf (@GovernorTomWolf) December 8, 2020

Alexander Smith

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A vaccine front-runner developed by Oxford University and AstraZeneca became the first to have its Phase 3 trial published in a peer-reviewed paper, the Lancet medical journal, which confirmed its shots have an average efficacy of 70.4 percent.

There were no hospitalizations or cases of severe Covid-19 three weeks after the first dose taken by around 11,600 volunteers in the U.K. and Brazil, it said.

Peer-reviewed data is something that experts have been desperate to see, given most of the positive Covid-19 vaccine news has been communicated in press releases.

Click here to read the full story.

The Associated Press and Denise Chow

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Dr. Scott Gottlieb told CNBC that the White House declined “multiple” offers from Pfizer to strike a deal on more vaccines for the second quarter of 2021. Gottlieb’s statements came after The New York Times and The Associated Press reported that the Trump administration months ago did not lock in the chance to purchase millions of additional doses of Pfizer’s vaccine, which has shown to be highly effective against Covid-19.

That decision could delay the delivery of a second batch of doses until Pfizer fulfills other international contracts.

“Pfizer has gone ahead and entered into agreement with other countries to sell them some of that vaccine in the second quarter of 2021,” Gottlieb told CNBC.

Click here to read the full story.

David K. Li

5h ago / 3:19 PM UTC

Oklahoma school district apologizes for controversial football picture

Jenks Public Schools in Oklahoma apologized on Dec 6, 2020, after posting this photo on Facebook of a crowded, mostly maskless student section at the high school football team's state championship game.Jenks Public Schools

An apologetic Oklahoma school district said it “acknowledges and accepts” harsh criticism sparked by a viral photo showing mask-less, shoulder-to-shoulder students celebrating a big football win.

Jenks High School, from an affluent suburb of Tulsa, won the state football title over the weekend and a widely circulated picture showed players, cheerleaders, students and fans celebrating in the stands with hardly anyone wearing a mask.

"The photo of the Jenks High School student section included in a post on Saturday from the state championship football game has been widely criticized. Jenks Public Schools acknowledges and accepts this criticism," Jenks Public Schools said in a lengthy apology. "There were too many high school students without masks and too many high school students in close contact with one another. This is not the kind of safe environment JPS seeks to create for students and staff members. JPS understands the importance of social distancing."

The district added: "At future secondary events, Jenks Public Schools pledges to do more to maintain stricter safety protocols. This was not up to the standard that is expected. Jenks Public Schools and Jenks High School sincerely apologizes for this mistake." 

Like much of America, Tulsa County, Oklahoma, has been struggling to contain coronavirus. There were 4,994 active cases there as of Tuesday morning with 289 deaths during this pandemic, according to county records. 

Erika Edwards

6h ago / 2:37 PM UTC

FDA: Pfizer's Covid-19 vaccine safe and effective after one dose

Pfizer's Covid-19 vaccine candidate offers protection after the first dose, according to documents released by the Food and Drug Administration Tuesday morning.

The information was made public ahead of a Thursday meeting of the Vaccines and Related Biological Products Advisory Committee, or VRBPAC — an advisory group to the FDA, which will vote on whether to advise the agency to grant emergency use authorization of the vaccine in the U.S.

The 53-page document contains analysis from both federal regulators and Pfizer on the latest data from the company's Phase 3 clinical trial on its Covid-19 vaccine. It will be used to help guide the advisory group in its decision making.

Click here to read the full story.

Laura Strickler and Kit Ramgopal

6h ago / 2:17 PM UTC

Trump admin has yet to launch promised effort to get Americans to trust Covid-19 vaccines

WASHINGTON — In late July, officials with the administration’s Operation Warp Speed said when Covid-19 vaccines were imminent there would be a tightly targeted four to six week national campaign to encourage Americans to get the shots. Now, with multiple vaccines finally on the horizon, state health officials tell NBC News they have not yet seen materials from the federal government.

Data shows there’s reason to be concerned about the American public’s willingness to sign up for shots. While recent polls indicate an increasing number of Americans willing to take the vaccine, the latest STAT/Harris poll shows at least 42 percent are still reluctant.

The federal government recently shifted its public health education strategy, amid media and congressional scrutiny related to alleged politicization of the message. Following a review ordered by the secretary of the Department of Health and Human Services, the department canceled a $15.1 million contract that included work with members of the entertainment industry.

Click here to read the full story.

Joe Murphy

7h ago / 2:06 PM UTC

California reports its 20,000th Covid death

California reported its 20,000th Covid-19 death Tuesday morning, part of a surge across the state that has set record case numbers and seen an uptick in deaths.

While California's 20,057 deaths is the third-highest among any state, its per-capita deaths are among the lowest in the country. More than 1.4 million cases of the coronavirus have been confirmed in the state. In the U.S., more than 15 million have had the disease.

Monday, Tennessee reported its 5,000th Covid-19 death. More than 400,000 have been diagnosed there.

Several states reported Covid-19 records Monday:

Connecticut, 8,129 cases. The state had reported zero the previous two days.

Iowa, 215 deaths

Nevada, 4,959 cases

New Hampshire, 1,045 cases

New Jersey, 6,944 cases

Rhode Island, 3,681 cases. The state had reported zero the previous two days.

Tennessee, 8,136 cases

Rebecca Shabad

7h ago / 1:18 PM UTC

Operation Warp Speed chief says he doesn't know what Trump's order on vaccines is about

The Trump administration's adviser overseeing Operation Warp Speed, which is tasked with developing and distributing a Covid-19 vaccine, said Tuesday that he doesn't know the purpose of President Donald Trump's expected executive order on the vaccines. 

"Frankly, I don't know, and frankly, I'm staying out of this. I can't comment," said chief science adviser Dr. Moncef Slaoui in an interview on ABC's "Good Morning America." 

Pressed further, Slaoui said, "Our work is rolling. We have plans. We feel that we can deliver the vaccines as needed, so I don't know exactly what this order is about."

A senior administration official told reporters Monday that Trump is "going to be signing an executive order on ensuring access to U.S. government Covid-19 vaccines. This is a reaffirmation of the president's commitment to America first, to ensure the health and safety of our citizens, the viability of our economy, the security of our nation, and ensure that Americans are able to resume normal life. That's the first and most directive thing the executive order does."

Alexander Smith

8h ago / 12:33 PM UTC

William Shakespeare becomes second person to receive approved Covid-19 vaccine

In a turn of events that's already spawned a thousand Twitter puns, the second person to receive the clinically approved Covid-19 vaccine Tuesday was a man named William Shakespeare.

Bill, 81, as he's known to friends, got the shot at a hospital in the English city of Coventry, as the United Kingdom kicks off its largest public vaccination campaign in its history.

For a country recently accused of turning its world-first vaccinations into nationalistic point-scoring opportunities, it was a detail that might have been tossed from a writers' room for being too on-the-nose.

"William Shakespeare" quickly became the number one trending topic on British Twitter, where people responded with wordplays such as "The Taming of the Flu," "The Two Gentlemen of Verona" and "a plague on none of your houses."

Wilson Wong

9h ago / 11:43 AM UTC

The U.S. tops 15 million Covid cases, its second million-milestone in December

The United States surpassed 15 million Covid-19 cases Monday only a few days after setting its first million-milestone this month, according to an NBC News tally.

The U.S. recorded 1,789 deaths related to coronavirus on Monday, bringing the total death count close to 285,000 people, according to the tally. The country logged nearly 187,000 new cases of Covid-19 on the same day.

The country also registered more hospitalizations on Monday since the pandemic began, with almost 102,000 people who were hospitalized across the country, according to The Covid Tracking Project.

https://albahuth.info/wp-content/uploads/2020/12/2128-pennsylvania-governor-says-hospitalizations-are-reaching-critical-level.jpg https://albahuth.info/?p=2128&feed_id=1173 #technology

[duncepatrick92]

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[memorylang]

23rd Birthday~ Roses and Rosaries | #39 | July 2020

I’ve focused on being present for others while even taking to new projects, as I continue to wrestle with the time COVID-19 in America has given me. 

With July 6, 2020, I’ve turned 23, hooray! Hard to say whether I feel young or old. 

Just after my birthday, my half-brother, his wife and my baby nephew visited for the first time since Christmas, too! Now their adorably big 15-month-old baby babbles and crawls. He’s so squishy. Just before I returned to Reno and they returned to Ohio, we also saw “Hamilton” (2020), which felt grand as well. 

Also included, tales from the 4th of July, American Independence Day. But before I go any further, though, I need to share news that’s been hanging on me all month, no matter my activity. 

Sensing the Soul’s Hourglass

A dear friend said he’s been diagnosed with brain cancer. He said he’s heard he won’t have long to live. 

About a month ago on June 10, I learned this. Just two weeks earlier, my friend and I were chatting, and he shared how excited he felt to have finished undergrad at the top of his class like me. He’d asked for leadership advice, too, on a new role he was taking on. Unfortunately, he’s since had to step down. 

My friend and I have kept in close communication ever since his news I received on my stateside Week 14. Our first couple weeks, we mostly talked through the shock. As topics started to thin, we’d begun talking about movies. This led me to take up his offer to see the films he’d recommended most. More on this later. 

Memento mori

The Knights of Columbus, like many Christian organizations, invites its members to reflect on the Latin phrase, “Memento mori,” which people often translate to, “Remember you must die.” To have a fellow brother knight undergoing the challenge he faces now, this phrase matters especially. 

Our Knights of Columbus College Council, of which he is a part, began praying weekly rosaries for him and his family. We asked others to pray for him as well. Meanwhile, he appeared on a podcast hosted by a fellow knight, the same one I appeared on a couple weeks later. 

Terror Road

The day after I learned my dear friend’s news, June 11 at 1:34 a.m., Dad and I had what Dad calls a “Thank you, Jesus” moment. 

Dad was driving. It was pitch-black off the highway, judging from how well I could see the stars. We rode a two-lane road, heading back to Reno from Vegas. I was talking to Dad a bit, and he mentioned planning to stop in Beatty, Nev. 

In the oncoming traffic, I saw what seemed the semi-driver ahead had his or her brights still on. Then it looked like another car was passing. Dad slid our car right, into the shoulder, as not one but two vehicles zoomed by. 

Three cars just passed each other on a two-lane road. 

Not long after, we drove over a large animal's carcass, which didn’t quell my morbid thoughts much. 

Sure 2 a.m. neared, but I felt way too rattled to rest. Every passing headlight for a while made me flinch. But then we reached Beatty, got our rest and continued, ending Week 14 (June 5–11). 

Ancient Skies

June 22, a separate drive up to Reno, Week 16 (June 19–25), around the same dark hour, a more peaceful moment happened. While Dad napped at the rest stop in Luning, Nev. from 1:47 a.m., I went forth and stargazed. 

I felt enamored to see the Milky Way. This was the rest stop where Boys’ State often stopped, on my trips with them years ago. I searched for the Big Dipper and Cassiopeia, my usuals. I tried to find Orion, too, but had trouble. There was one area I thought might have been it, though. So, I Googled star charts. I felt that childhood song, “Twinkle, Twinkle, Little Star” made far more sense while stargazing. 

First I found Vega and Hercules from Big Dipper, then Deneb and Cygnus, followed by Delphinus. What I thought might have been the Little Dipper was part of Sagittarius. Turns out what I thought was Orion was part of it, too. Then I went back and found Altair and Aquila, after zooming out my perspective. Pegasus looked so big! What I thought may have been Cassiopeia, I doubted. Then I found Polaris, solving that mystery. 

I paused and saw a couple shooting stars. I reflected on the seeming perfection of ancient star charts, ancients’ stories they wove with the patterns in the sky and the dome creation mythos in the Hebrew Bible that piercing lights there. Some even liken stars to souls of those passed. 

Lastly, I found Draco, Lacerta, Cepheus and Ursa Major, followed by Perseus and what looked like Camelopardalis. What I thought might have been Cassiopeia I realized was Ursa Minor. 

My Milky Way quest this night reminded me of my Memorial Day Great Basin quest, Week 12 (May 22–28), but better. I felt awed how a quest to find Orion instead opened me to the rest of the summer sky. If I ever visit the Southern Hemisphere I better stargaze. 

After I returned to the car at 3 a.m., Dad said he’d seen the stars when he was little. What a memorable night. 

Science in a Lifetime

Curiously, ‘Philosophy of Science’ has been among the most impactful courses I took for compulsory credits in late undergrad. I met a friend who’s eagerly engaged in space politics, especially with how that historic Dragon launch (my family watched) changes opportunities. Likewise, that class exposed me in greater depth to gene-editing, beyond the CRISPR-Cas9 I first learned about on a trip with Boys’ State staff. 

On one of these Nevada rides with Dad, I asked about his med school experiences. He shared how some professors and students lost their lives to cancers. Leukemia had even taken the life of my father’s brother when the brother was in the 1st grade. 

I felt awed then to realize in our world, science has given us potential to reverse cancers that once so mercilessly claimed lives within still living people’s lifetimes. My dear friend and I had hope, and that’s all we needed beyond prayer. 

Birdwatching

One day in the backyard during a return to Vegas, I decided my new favorite animal has changed from mantis shrimp to the elusive, hoving hummingbird. 

Furthermore, I just thought about how awesome birds are in general. 

I met an Irish priest in Taiwan who even watched birds for fun. He had such excitement in his eyes. I vaguely recalled a poem I encountered, sometime after I came back from Mongolia. The poet compared herself to the birds. In fact, Mongolian hunters use eagles, falcons and other birds of prey. But I felt even the normal birds sounded different in Mongolia. Birds can be so colorful.

God bless the hummingbirds. 

July 4, 2020, and an Eclipse

This was my first time back in America for July 4 since 2016. 

Down in Vegas on American Independence Day, my youngest brother and I drove to our stepmother's, where two of her daughters and Dad were. My older brother would come later. I helped a little in the kitchen. Mostly, I worked on my writing while chatting with my youngest stepsister before she left for work. 

I had no idea I missed the taste of an American-style burger on the 4th of July. It's truly been four years since my last. 

Dad had felt glad I saw “What’s Up, Doc?” recently, so he had his wife, my youngest brother, and my older (not oldest) stepsister see it. My stepsister and my brother left, though. I enjoyed seeing it again. 

Then I went out on the back porch, as fireworks began downtown and around the neighborhood. Being there, feeling the warm breeze, reminded of Panamá, seeing on my host family’s front porch the lunar eclipse during January 2019. 

Here in the States for the 4th felt good—a taste of home again. The United States is a young nation, one I hope that continues to revel in its history, remembering its roots. Its roots run all throughout the earth. Unless we are indigenous peoples, we and our ancestors came from elsewhere. And as citizens of the States now, let us continue to honor those who gave of themselves to make possible the democratic experiment on which the United States was founded. 

God bless!

23rd Birthday—Online, Anywhere

“It's a funny thing about coming home. [...] You realize what's changed is you.” —The Curious Case of Benjamin Button (2008)

When I was a schoolkid, I used to enjoy sleepovers for my birthdays. I'd at least have get-togethers at my house so friends and I could see each other halfway through summer. 

In recent past summers, though, studying abroad in China then serving with Peace Corps Mongolia, I hadn't been stateside for my birthdays! This changed due to the COVID-19 pandemic, making this my first summer home a birthday since 2016. Even online, I could read what people wrote me! 

About a week before my birthday, I had the pleasure of visiting to pray a rosary with Evan, an older fellow Knight of Columbus who has been homebound due to limited mobility among other conditions. He felt thrilled by my commitment to see him and keep the faith, and he asked me to join him daily in rosaries over the phone. We began at once. We even started praying two a day, at his request. He deeply believed in continued prayer and suggested what many need is a night entirely in prayer. Unfortunately, he lacked the health to do this. 

Understanding a physically distant birthday would be best amid this pandemic, I'd already planned to restrict my birthday functions to online only. I realized my day would mark a perfect occasion for the vigil! Reaching out to fellow knights, I received rapid support for the vigil idea. I and those who join me would pray for peace, preservation and intercession amid the pandemic for all who suffer illness, especially our dear friend. 

Realizing, too, late nights in the States could be more pleasant times for Catholics elsewhere in the world, I reached out to pilgrim friends I met during World Youth Day 2019 pilgrimage in Panamá. Since rosaries contain a sequence of repeated call-and-response prayers, I felt we could share our native languages and still understand the meaning, just as we’d done at World Youth Day. Salvadoran, Mongolian and Malaysian friends helped me translate my invitation to Spanish, Mongolian and Mandarin Chinese. I hoped by having fellow Americans alongside pilgrim friends pray together with me, we could share in the universality of the faith in peace and solidarity during this pandemic. 

Birthday Vigil Begins

We began 23:00 Pacific time on Sunday, July 5, praying until we completed all 23 rosaries. We finished at noon on my birthday July 6. When some friends had to retire for the night or to leave for work in their timezones, I'd pray alone until a new friend appeared. At most, only an hour would pass between others' arrival to join me in prayer, which felt great. 

At kick-off, I was joined by fellow two fellow knights—Javier, who had begun our council’s weekly rosaries, and my dear friend. I felt so elated on video to see him again for the first time in ages! Additionally, two pilgrim friends join us—Andrea in El Salvador joined us and Marie in the Czech Republic. 

We began with Latin, the Church’s universal language, which might have been a laughable start. We followed it with an easier rosary, Spanish, which was Andrea’s native language. We tried another hard one for us, next. Javi taught us responses for Tagalog, then we gave it a shot. I really enjoyed praying in Tagalog, as many of my middle and high school friends know the language. 

For our fourth rosary, we tried to do French since our dear friend knows it, but because the language’s pronunciation rules aren’t straightforward, we bailed after the “Our Father” and switched to English. I felt impressed we prayed the first three in non-English languages, though! 

Most had to go around 1–2 a.m. Around that time, Marie, who had been without a camera and microphone, realized she could try using her sister’s laptop. Thus, right after everyone else left, she was able to speak! She taught me enough Czech that I could read the responses. I found it a beautiful language. Then I taught her enough Mandarin Chinese so she could read the responses in Mandarin. Marie might have set the record for being online longest with me—about four hours! 

Birthday Vigil and Daybreak

My most difficult hour was between about 3–4 a.m. Alone, I completed three rosaries but felt increasingly lethargic. 

Thankfully, when I felt totally drained, my fellow knight Marco bailed me out! For the next hour or so, we said one in English then another in Latin, which helped me find my groove. 

After Marco left for work, two unexpected guests popped in. My Mongolian friend Angelica, whom I met during Peace Corps, visited briefly as well as my Panamanian host mother, who housed me for World Youth Day. Although neither could stay long, I appreciated their presence. They wished such kind blessings! Meanwhile, I said rosaries in Latin and Mongolian. 

My fellow knight Evan joined our rosaries for an hour and a half around 6:30 a.m., our usual time we prayed together. Our Grand Knight Thomas joined that morning, as well. Evan enjoyed hearing us in Latin. 

My Mexican pilgrim friend Ricardo came in about when Tom left, so after Latin with Evan, I prayed in Spanish with Ricardo. He said great blessings, too! Then I said a quick rosary alone in English. 

Then came more Salvadoran pilgrim friends! Josselyn dropped by around 9 a.m. Just after she left came Rosibel around 10. I enjoyed how they added litanies, which I hadn’t done on previous rosaries. With them, I spoke and prayed in Spanish, which gave me lots of practice. They felt relieved they didn’t need to speak English to join me, and they thought I spoke well, too! 

Just after Rosibel left and shortly after 11, my Salvadoran friend Andrea, who joined me at the vigil’s very beginning, returned! I practiced a lot of Spanish that morning. Thankfully, Andrea knew English and indulged me to pray the final, 23rd rosary in my native tongue. 

Vigil’s Aftermath

In total, I with friends prayed six Joyful, five Luminous, six Sorrowful and six Glorious Mysteries. Of these, we prayed most in non-English languages, primarily Spanish and Latin, but also Tagalog, Czech, Mandarin Chinese and Mongolian. I really enjoyed honoring prayer in others' native languages. Beyond the States, we were joined by friends in Latin America, Europe and Asia, including El Salvador, Panamá, México, the Czech Republic and Mongolia. 

I'm touched and honored by those who came to support our efforts. Got to finally put to the test my months of restarting Spanish! Those who participated shared their joy and commendations, too. My homebound knight even requested I do another in August. (My late mother’s birthday is in early August, so we’ll see.)

Mere days after the vigil, my dear friend shared doctors said he’s in recovery! That raised our spirits. 

Mere days after, my dear friend received opposite news that the cancer spread. Days later, he reported rough days and said he could practically sense his hourglass of life. Doctors said in three months, he would lose function in his legs. Still, our correspondences continue. 

On the bright side, “glioblastoma” makes a great Scrabble word, he added.

Rose Thorns of Life

Felt a little choked up clipping the dead rose blooms yesterday morning. I thought they were still alive, but they weren't. So I needed to prune them. For, the whole life of the bush looks better when it's free of its once alive-and-beautiful, now finished-and-dead parts. Its life thrives by focusing on the living pieces when they live and removing the dead when they’re dead. Such are our lives. 

My stepmom likes roses. 

When I was little, I disliked roses because of their thorns. I bled whenever I grabbed them. I realize now that if I don't get close, I don't get hurt. But to care for them better, I must get closer. Such is life. 

I was praying over the phone my daily rosaries with fellow knight Evan while pruning the rose bushes yesterday. It was Thursday, so we prayed the Luminous and Sorrowful Mysteries—fitting. They meditate on acceptance, suffering and letting go. 

I don’t find rosaries all that fun, to be honest. But people say they’re important. And they feel like a nice way to get in the right spirit, even outside places of worship. In the clipping of roses, they remind me of the beauty and tragedies natural to our lives on Earth. 

More to Come

When it comes to my Latin and Spanish studies, I took a pause to refocus on my writing. Though, I still do a Duolingo Latin lesson a day to keep up that 75-day streak. I’ve plenty to share on languages next month. 

For my four months of labor, I wanted my own camera for my birthday. But ultimately, I found those a bit too large for my needs. Dad purchased me a new mid-range smartphone with a great camera instead. It felt odd compensation for 20 weeks’ work, but, still, I don’t have to cover rent, food nor transportation while home... Plus, the device still beats the older used phone I’d been on through the back half of my undergrad, especially on Google suite and apps. Feels Sci-Fi! 

By the way, do you play Pokémon GO? If so, you can add me at 2070 8544 5874. I recently rejoined after having stopped four years ago. Just one more way to get me and my face mask out and about while physically distancing! 

My younger sister also spoofed an old story I wrote when I was little and gave that as a birthday gift. I found it hilarious. My day marked the third of my siblings’ quarantine birthdays! 

Up next, I’m working on blog stories from last July in Mongolia. So, in a sequel to my previous throwback, get ready for adventures back to that Mongolian summer with me! We’re going rural, too, so the countryside is coming back. 

I’ll update you in August on exciting projects I’ve taken on, too. Please keep my dear friend in your thoughts and prayers, also. 

Till then, take great care, my friend. 

You can read more from me here at DanielLang.me :)

[dailydosefact-blog]

Ranveer Allahbadia aka Beer Biceps transformation from being overweight to becoming health & fitness icon.

By Dailydose.fact Staff

02 November 2019

I’m like those who simply Google everyday “how to lose weight” and there are those, like Ranveer Allahbadia, who become a YouTube sensation and make a career out of being fit. If you are active on social platforms you may already know Allahbadia by his YouTube handle, Beer Biceps. The channel has over 2.35 Mn subscribers and his Insta following stands at 672k. Beer Biceps is one of India's first fitness YouTube channels that caters to the unique fitness needs of Indian men. However, you should know that Ranveer Allahbadia wasn't always ripped; Should I say he wasn't even fit. So how did aka Beer Biceps go from fat to fit and go on to become one of India's best-known fitness icon?

Ranveer was 15 when he was diagnosed with a gall bladder stone. "It's what happens to people in their late 40s or 50s," he says. "This came as a rude wake-up call and was also a major indication for future health complications. I was told to get my ducks in line, but due to my engineering entrance exams taking up all my time, I remained out of shape for the next two years. When I was 18, I finally decided to do something about my situation and start leading a healthier life before things got worse."

 It didn't take him long to figure out that engineering was not his cup of tea. "It wasn't that I was bad at studies but I didn't enjoy the subject. I realized that at the end of my course, I would only have three options: do an MBA, go abroad or get a job. I couldn't see myself being happy doing any of these three things but I also wasn't sure of what I wanted to do."

 By now, Ranveer had already begun asking himself how to lose weight before it got too late. Before long, he got interested in fitness and completed a certificate course from Peak Performance, a fitness academy that his coach, Binny Sreedharan, runs. Soon after he graduated, Ranveer and his coach tried their hand at launching a start-up that, as he describes it, was an Uber for fitness and yoga coaches. "When we took the idea to an investor, he bluntly said that one of us would need to get famous for something like this to pick up and that would be a good marketing strategy," he recalls.

 "So, I took a chance and started putting out videos on YouTube to get the word out. Back then I didn't even know that YouTube pays for content. While I was trying to get fit, I watched a lot of foreign fitness channels, but I felt like they didn't answer the questions I had as an Indian. That's when I realized there was an opportunity and grabbed it with both hands."

When time came to name his channel, Ranveer called it Beer Biceps "because I believe in having fun and staying fit at the same time."

How do i lose weight, get ripped according to someone who's done it “I asked”

Ranveer says he lost his first 10 kg simply by doing cardio. "But that was the wrong way," he says, "Because when you're only doing cardio, along with the fat, you're also losing a lot of muscle weight and your health almost always ends up going for a toss.

"This is a common mistake a lot of people make. A lot of teenagers tell me that they only eat 1,000 calories a day, which is a bad thing because it ends up stunting their height and doesn't give the body the required amount of nutrition. Just doing cardio is not the answer to lose weight."

Ranveer learnt this lesson early on when his coach explained the science behind it. "He suggested that if I wanted to know how to lose weight, I should combine weight training with cardio so that I build muscle while burning fat at the same time." Hmm Interesting.

Can I lose weight by eating right?

Ranveer says that the key to weight loss is by focusing on consuming protein. "Ever since I started my weight-loss journey, I've maintained a portion of 150 gm of protein in my diet daily. I usually have five portions of 30 gm each, but it also depends on how the day goes. Sometimes if I've not eaten much all day, I eat 3-4 heavy meals. Otherwise I try splitting it up.

"Generally, breakfast comprises an omelet with multigrain toast or a fruit. I usually have a big serving of chicken or fish with brown rice, curry and vegetables for lunch. A little later in the day I have some protein shake with a lot with some nuts.

"Then I go to the gym and again follow it up with another protein shake. Dinner is just like lunch and if I get hungry again at night, I'd whip up some eggs or have some more protein shake." Isn’t that healthy and yummy.

What are the worst foods for weight loss?

"If you want to know how to lose weight, just go slow on sugar," he says. "It might seem like common sense but it's amazing how little we pay attention it. Sugar is the culprit behind any fatal disease, be it heart-attack or diabetes or even joint problems. Directly or indirectly sugar intake is the key root of most health problems. Even deep-fried food is not as bad as it. Generally, you consume a lot of sugar when you have some dessert and along with that, you're also consuming a lot of dirty fats.

"At the end of it, sugar is an addictive substance and that pastry will lead to you injecting all those dirty fats and clogging up your arteries. This is something people really need to know about. Talking about eating the right kind of food is one of the main goals of my channel."

How to maintain the weight loss

Ranveer says he spends about an hour at the gym. This is over and above the time he spends shooting videos for his channel. "Being a YouTuber is a stressful job, because you're working for yourself and it's seven days a week. At the end of it, when I hit the gym, it's like I'm disconnecting and unwinding. For days that I can't make it to the gym, I've got an exercise bike at home and make it a point to spend at least 30 minutes on it so that my body gets the movement it needs."

When he started out on his weight loss programme, Ranveer went from 92 kg to 68 kg. But as he started to bulk up, he went back up to 90 kg before settling at 70 kg. His body fat percentage now stands at 13.

Water intake forms a major part of Ranveer's diet. "Since I follow a high-protein diet, I take my water intake very seriously. Generally, protein can act as a catalyst to escalate health problems if your body is not hydrated at all times. Not drinking enough water would generally create problems like kidney-stone and uric acid. But I make sure to have at least four-five liters of water a day and I keep a track of my urine. If your urine is yellow in color, your body is telling you that it's dehydrated," he says.

So, what does a day in the life of a fitness vlogger look like?

"I have the liberty to start my mornings a little late because we generally work the nights," he says. "I wake up around 11 and prep for the day: meditate, get freshened up have breakfast. We then kick off the day by shooting or writing or conceptualizing, whatever is the need of the hour.

"Then from 4-6, I help my team edit videos and from 7 pm to 8 pm we brainstorm on how to take the business forward. I hit the gym by 8 pm or 9 pm and come back and unwind for a bit. I am usually up until 3 am writing or scripting videos."

Growing his YouTube channel was a major challenge. "The initial growth to 10,000 subscribers is very difficult and slow. It's a really testing and demotivating at times because nobody is watching your videos. But being consistent is key. Once we got past that, even the older videos that no one watched started getting a lot of hits."

For someone who comes from a family of doctors, making such an unconventional career choice was a bold move. Ranveer says that while his mother had some reservations in the beginning, his father was always supportive of him. "There was a period when things weren't picking up and that was worrisome for my parents. But later, when their patients came and spoke about my work, they were relieved and started getting an idea of what I was doing. Until then, they didn't really understand how YouTube works. But now, that we've picked up and even opened up offices, they see the work happening and the money raking in and are now happy."

2020 will hopefully see Ranveer working on an original web-content series. But for now, he's focusing on “The Ranveer Show” (TRS) Interviewing successful role models and inspirational figures.

[thysurveys]

730.

1: How tall or short do you wish you were? I’m fine. 2: What’s your dream pet? I don’t really have one.

3: Do you have a favorite clothing style? This may sound lame, but I really enjoy a chic “smart casual” look. 4: What was your favorite video game growing up? Sims. Always has been, always will be. 5: What three things/people do you think of most each day: Kevin, my future and . . . I don’t know.

6: If you had a warning label, what would yours say? "May freak out unexpectedly.”  7: What is your Greek personality type (Sanguine, Phlegmatic, Choleric, or Melancholic)? I don’t know. 8: Are you ticklish? I am. 9: Are you allergic to anything? I am not. 10: What’s your sexuality? Heterosexual.  11: Do you prefer tea, coffee, or cocoa? Cocoa more than any of the other two. Tea before coffee. 12: Are you a cat or dog person? I’ll say cats. 13: Would you rather be a vampire, elf, or merperson? Merperson, if I had to choose? I don’t know. 14: Do you have a favorite Youtuber? I have plenty of. 15: How tall are you? 5′2″. 16: If you had to change your name, what would you change it to? I don’t know if I would. 17: How much do you weigh? Next question. 18: Do you believe in ghosts/spirits? I do. 19: Do you like space or the ocean more? They’re both fascinating.  20: Are you religious? No. 21: Pet peeves? I have misophonia, so. There you go. 22: Would you rather be nocturnal or diurnal (opposite of nocturnal)? Diurnal. My anxiety is at its worse at night. 23: Favorite constellation? Aries, only because it’s my star sign?  24: Favorite star? The sun? I don’t really have a favourite star though it would be interesting to have one other than the “sun” lol. 25: Do you like ball-jointed dolls? I don’t really care for them? 26: Any phobias or fears? The unknown. I also have Trypophobia, feeling out of control of my own body and death.  27: Do you think global warming is real? Yeah. 28: Do you believe in reincarnation? I don’t know if I do or if I don’t, though I have watched interesting documentaries on reincarnation. Story time: my dad once told me when he was younger, my Pop and Nan were in the car with my dad, and they were driving to a place they hadn’t been to before and they were lost. My dad said to my Pop (who was driving) to turn at the end of the street and there’d be a bridge. They did, and there was a bridge. My dad knew the place, but he had never been there before in his entire life, so. I don’t know. It’s kind of crazy. 29: Favorite movie? I never know. I have way too many. 30: Do you get scared easily? Yeah, definitely. 31: How many pets have you own in your lifetime? I have had plenty of “family” pets growing up, but myself and Kevin have had two. A dog and a cat. 32: What is a color that calms you? Blue. 33: Where would you like to travel and/or live? America (which I am in March) and the UK. I mean, I would happily travel just about anywhere and everywhere given the opportunity.  34: Where were you born? Australia. 35: What is your eye color? Green. 36: Introvert or extrovert? Introvert, one-hundred percent. 37: Do you believe in horoscopes and zodiacs? No. 38: Hugs or kisses? Both. 39: Who is someone you would like to see/visit right now? I am with him right now, so no one. 40: Who is someone you love deeply? Kevin. 41: Any piercings you want? I’m okay for now. 42: Do you like tattoos and piercings? Yes, I do. 43: Do you smoke or have you ever done so? I was, once upon a time, a smoker. 44: Talk about your crush, if you have one! More than a crush. He’s my boyfriend. 45: What is a sound you really hate? I am not great with very “loud” sounds.  46: A sound you really love? Rain! I was actually talking about this the other night with Kevin. 47: Can you do a backflip? Nope. 48: Can you do the splits? Nope. 49: Favorite actor and/or actress? I really fancy Drew Barrymore. I don’t know why. I think she’s pretty badass. 50: Favorite book? Too many to choose from. 51: How are you feeling right now? Anxious. 52: What color would you like your hair to be right now? I need to recolour it again (I had a blonde balayage, but it’s quickly fading) 53: When did you feel happiest? I don’t know. I haven’t felt too “happy” recently. 54: Something that calms you down? Rain. 55: Have any mental disorders? Clinical depression, Depersonalisation Disorder, PTSD (though, this has subsided a lot), Social Anxiety, GAD. These are all diagnosed. I also think I have BPD (undiagnosied).  56: What does your URL mean? My survey Tumblr is self-explanatory, my main Tumblr is solefulness. And I don’t know. It’s inspired by the word “soulful”  57: What three words describe you the most? Creative, anxious and . . . I asked Kevin for help and he said “beautiful”, but you know. Lol. 58: Do you believe in evolution? I guess I do, yes. 59: What makes you unfollow a blog? They haven’t updated in forever or they say some stupid offensive bullshit (e.g. racism, classism, homophobia, etc.). < What they said. 60: What makes you follow a blog? Aesthetics? Lol 61: Favorite kind of person: An INFJ lol or similar. Basically, someone who has an advanced bout of empathy, understanding.  62: Favorite animal(s): Pandas and cats. 63: Name three of your favorite blogs. No, I can’t be bothered and I don’t even know if I do have a favourite right now. 64: Favorite emoticon: The “hang loose” emoticon was the first that came to mind, though I can’t say it’s my fave. Maybe a leaf (I am so lame) 65: Favorite meme: I use a lot of Full House memes. 66: What is your MBTI personality type? INFJ. < me too! 67: What is your star sign? Aries. 68: Can your dog roll over on command, if you have a dog? My dog’s dead and she never obeyed commands. She was way too hyper. < Literally my same answer.  69: What outfit out of all your clothes do you like to wear the most? A cardigan as of late. 70: Post a selfie or two? I ain’t ready for a face reveal.  71: Do you have platform shoes? Nope. 72: What is one random but interesting fact about yourself? I would say I am an INFJ considering they take up only one percent of the population, but you already know that. Let me ask Kevin. He said: “you were the first to graduate in your family. I think. I don’t know. Is that a good one?” 

There you have it, folks.  73: Can you do a front flip? No. 74: Do you like birds? No. I do not like birds. They freak me out. 75: Do you like to swim? I am not crazy about it. 76: Is swimming or ice skating more fun to you? Swimming > ice skating any time. 77: Something you wish didn’t exist: Homophobia. 78: Some thing you wish did exist: Fifty large sacks of money right in front of me. > ngl. Me too. 79: Piercings you have? My ears. 80: Something you really enjoy doing: I like to watch a lot of YouTube and a lot of Netflix (or any film, really).  81: Favorite person to talk to: Kev. 82: What was your first impression of Tumblr? I don’t know. 83: How many followers do you have? Enough. 84: Can you run a mile within ten minutes? I asked Kevin and he laughed. So, I guess not. 85: Do your socks always match? I barely wear socks. 86: Can you touch your toes and keep your legs straight completely? I can do. 87: What are your birthstones? Aquamarine.  88: If you were an animal, which one would you be? I don’t know tbh. A panda or a cat. Maybe a cat. 89: If a flower could aesthetically represent you, what kind would it be? Good question. Um, a baby breath bc they’re small and simple. 90: A store you hate? I don’t know nor care. Maybe Gloria Jeans bc I once found out they don’t support gay marriage. 91: How many cups of coffee can you drink in one day? None. I can’t drink it without freaking out. 92: Would you rather be able to fly or read minds? Both scare me. Can I choose to read minds? 93: Do you like to wear camo? Not my style. 94: Winter or summer? I do love winter, but lately I’ve needed summer. 95: How long can you hold your breath for? I don’t know. 96: Least favorite person? Any evil dictator. < True. 97: Someone you look up to: Kevin at the moment. 98: A store you love? Kmart if I had to choose. Any homeware shop too.  99: Favorite type of shoes My Nike runners are my fave right now. 100: Where do you live? Aus. 101: Are you a vegetarian or vegan? If so, why? No, just because I’m not. 102: What is your favorite mineral or gem? Never really thought about it. 103: Do you drink milk? I do sometimes. 104: Do you like bugs? I don’t hate them, but I don’t go out collecting them either. 105: Do you like spiders? I am not a great fan but again, I don’t collect them. 106: Something you get paranoid about? Every thing. 107: Can you draw?: No. Unfortunately not. 108: Nosiest question you have ever been asked? I don’t know. It’s funny because via a survey, I am open to any question. But if it’s someone face to face, or away from Tumblr, I freak out and think anything is a nosy question. 109: A question you hate being asked? "Why are you quiet?” Like, I don’t know? Maybe because I am. 110: Ever been bitten by a spider? No. 111: Do you like the sound of waves at the beach? My favourtie. 112: Do you prefer cloudy or sunny days? Sunny. 113: Someone you’d like to kiss or cuddle right now: Kevin. 114: Favorite cloud type: A cumulonimbus cloud because they’re big and they look fluffy. 115: What color do you wish the sky was? Pink. You know, like when the sun sets? Or blue. Blue is calming to me. 116: Do you have freckles? I wish! 117: Favorite thing about a person: I think people in general are interesting so. 118: Fruits or vegetables? Fruits. 119: Something you want to do right now: Eat. 120: Is the ocean or sky prettier? The ocean. 121: Sweet or sour foods? Sweet. 122: Bright or dim lights? In between. 123: Do you believe in a certain magical creature? No. I don’t know. 124: Something you hate about Tumblr: I don’t really think about that to be honest. 125: Something you love about Tumblr: I find it relaxing. 126: What do you think about the least? I don’t know. 127: What would you want written on your tombstone? No idea. 128: Who would you like to punch in the face right now? No one. 129: What is something you love but also hate about yourself? Hm… Maybe how much I care about certain people/things. < Truth. 130: Do you smile with your teeth showing for pictures? Rarely. 131: Computer or TV? Computer. 132: Do you like roller coasters? They’re alright. 133: Do you get motion sickness or seasickness? Yeah, a bit. 134: Are your ears free or attached? I think they’re attached? What. 135: Do you believe in karma? Yes. 136: On a scale of 1-10, how attractive would you say you are? Mm, 3. 137: What nicknames do you have/have had? Many. 138: Did you have any pretend or imaginary friends? I did. 139: Have you ever seen a therapist/shrink? Yeah. 140: Would you say you are a good or bad influence to others? Good. 141: Do you prefer giving or receiving gifts/help? Giving. 142: What makes you angry?: People can make me angry. 143: How many languages do you speak fluently? Just English. 144: Do you prefer boys, girls, and/or non-binaries? Boys. 145: Are you androgynous? No. I don’t think I am, anyway.  146: Favorite physical thing about yourself: I don’t know. I don’t really have a lot to like about myself. 147: Favorite thing about your personality: My willingness to understand, respect and empathise.  148: Name three people you would like to talk to right now in person. No one in particular. My family, if anyone. 149: If you could go back into time and live in one era, which would you choose? I don’t know. The 50s or 60s, maybe. 150: Do you like BuzzFeed? Yeah, I do. 151: How did you meet your spouse/girlfriend/boyfriend/partner? Through friends, at a “gathering”. 152: Do you like to kiss others’ foreheads or hands for platonic reasons? No. I don’t. 153: Do you like to play with others’ hair? Not really. 154: What embarrasses you? Because I empathise a lot, I get secondhand embarrassment a lot too. So, there you go. 155: Something that makes you nervous/anxious: Every fucking thing. 156: Biggest lie you have ever told: I can’t think of anything right now. 157: How many people are you following? Not many. 158: How many posts do you have on your blog(s)? This blog? 730 when I post this one. 159: How many drafts do you have on your blog(s)? None. 160: How many likes do you have on your blog(s)? I don’t know. 161: Last time you cried and why: A few days ago. I don’t want to go into it. 162: Do you have long or short hair? Long-ish. 163: Longest your hair has ever been: Up to my bottom. 164: Why do you like, dislike, or have neutral feelings about religion? I don’t really have an opinion at all, I guess. Um. I don’t know. I just don’t care nor think about it. 165: Do you really care how the universe and world was created? I mean. It would be interesting to know, but... I don’t care. 166: Do you like to wear makeup? Yes, I do. 167: Can you stand on your hands or head for more than thirty seconds? No. 168: Did you answer the questions you were asked truthfully? Yes, sir.