#having some moderate mental and physical problems flare up

[variantoutcast]

Anybody have any like withdrawal esque experiences after stopping estrogen based birth control?

[cyanomys]

The Misery Loop

I have a potentially unpopular take. Disclaimer: IANAD, I'm just a person with moderately severe chronic illness and an entirely useless psych degree.

Part of the burden of every illness is psychological. The way you think about your illness, your pain, your agency, and yourself all has an impact on how you feel physically, and even sometimes what is happening inside you biochemically. Always. This is actually true for every single sick person out there, unless they are literally comatose -- because everything you experience has to pass through your brain, which is where you have thoughts and feelings and psychology. This is even true for people who have illnesses we think of as "purely" biological, like a broken leg, or stomach cancer.

But vise versa, how you feel physically (and what is happening to you biochemically) has an impact on your psychology, too. This is because your brain is actually just 3 pounds of meat in your head, just like the other roughly 177 lbs of meat that makes up the rest of you. So your emotions and thoughts, which you think of as entirely within your control (or at least entirely in your head), are actually also moving at the whims of your gut biome or bad joints or whatever. Unfortunately.

People living with chronic illness and chronic pain can be really, really resistant to and defensive against the idea that any part of their illness is psychological. I have been one of these people. This feeling is pretty reasonable, because doctors and family members have used "it's all in your head" as an excuse to refuse us the treatments, accommodations, mobility aids, disability payments, or even just common decency that we need for the biological reality of our illness.

But staying blind to the psychological aspects of our illness shuts us off from knowledge that could help us suffer less. It's impossible to think or will or manifest yourself out of any illness (even psychiatric illness), like ableist people might imagine. However it is possible to learn about how your body and mind interact, and practice thinking in a way that will not increase your suffering.

When I've been at my sickest and most miserable, I always got stuck in a self-reinforcing thought loop about it, which I call The Misery Loop. The loop is never the cause of my illness, but it always makes me more miserable and I genuinely believe it elongates the flare. It goes like this:

Physical pain or misery -> mental anguish and feeling helpless -> physical misery heightened because of the mental misery -> avoiding a lot of things to try to be less miserable -> having no distraction and thinking about the misery more, or avoiding doing stuff that would over time make me feel better -> more misery -> repeat.

I never really saw this cycle clearly until I worked at a physical therapy clinic. Even though I just worked the front desk, I talked to many patients, saw their medical records, and learned from the PTs. For many chronic illness patients, like 60% of the effectiveness of PT was just giving them hope, a feeling of agency, and and human connection. This kicked them out of the Misery Loop enough that they could start feeling better, and benefit from that other 40% of physical exercise.

For the chronic illness patients that didn't respond to PT, sometimes the problem was that they needed some other therapy first to make it viable (like medication) -- but a lot of the time the problem was in the "avoiding things that would over time make [them] feel better" part of the Misery Loop. They were so hypervigilant about not increasing The Misery that they were unable to do the PT that would potentially help in the long run.

And can you blame them? The Misery is really horrible. If they weren't in a chronic pain/illness context, all of this would probably be good and protective right? So this is probably just how the brain is designed to keep them alive but it doesn't understand what to do with long term misery.

And by "they" I mean "I". I was literally working at a PT office, receiving free PT, and struggling with this exact problem. I said I saw the cycle while I worked there. But I was so resistant to the idea that any of this was "in my head" that I was always really anxious and full of cognitive dissonance about what I observed and my own inability to do the exercises. I didn't finish fully unpicking the emotional mess I felt about this until like this week. And it took a lot of journaling.

How do you get out of the Misery Loop? Idk all the answers man, I'm new at this. Just paying attention to how my thoughts and body react to each other is helping me catch when they're in the cycle. Distracting myself instead of dwelling on the Misery helps, or telling my brain when it tries to say "ugh my head hurts" for the 50th time to "shut up, I am fucking AWARE that our head hurts." Acceptance (in the "accepting what I can't change" sense, not the "giving up" sense) also seems to help stave off the Misery Loop.

And I've been keeping a careful health journal but trying to remember to frame what I learn as "this is what I CAN do" instead of "this is what I can't do". Which maybe sounds pollyanna, but it works. Instead of constantly searching for what makes me worse so that I can avoid it, I can search for new things (or old things in new ways) that are tolerable. Instead of my world getting smaller and smaller, it gets bigger and bigger, a teeny tiny bit at a time. I'm going to talk to my therapist about this more soon too, once we get done with the main part of OCD therapy.

Realizing all this makes me extremely angry actually. This is one more avenue that bad doctors and shitty family and medical trauma took from me, for many many years. If "it's all in your head" hadn't been weaponized against me, I think I would have naturally come to believe I had some control over my thoughts about my illness. And I would have been less miserable. But I was clutching desperately onto the thought that "this must be 1000% out of my control in every way" because I had been beaten into believing that otherwise I didn't deserve treatment -- which actually took my agency away and made me more likely to enter the Misery Loop. Fuck ableism.

Not to mention the ableist idea at the core of the whole "all in your head" garbage -- that things in your head are under your control, and therefore moral failings.

When googling around my Misery Loop sounds a lot like the "Pain-Thought-Pain Cycle". Plus there's something very Buddhist about the whole "don't add to your suffering with mental suffering" angle. Considering that I've been wading around in the waters of psychology (as both a patient and a student) and secular buddhism for a while I probably picked it up from there. I think "Misery Loop" is way more catchy though. And sometimes, you have to simmer something around in your brain soup for a while, and then pour it back out as something new, in order to make sense of it.

I have a very unscientifically validated theory that different people (even at different times in their lives) have a different amount that the misery loop contributes to their suffering. So like, one person might be 90% misery loop and 10% literal something-mechanically-wrong-in-body, while another person might be 90% something-mechanically-wrong-in-body and 10% misery loop. That's probably why some people are like "Therapy cured my chronic pain!" or whatever, whereas some people find a medication that cures them.

I imagine that for the vast majority of us, it is an inconveniently sticky mixture of the two in closer proportion. It is cruelly ironic, but it is much more difficult to figure out your Misery Loop (and Misery Trauma) when you're also dealing with The Misery. Falling into the Misery Loop is a perfectly valid thing to do, and you shouldn't beat yourself up for it. I will probably do it again myself. Hell, I'll probably do it tomorrow.

But maybe eventually we can claw ourselves out, inch by inch, thought by thought. And suffer a little less than we would otherwise.

[justadragonn]

tw mental health - need to put some words to things

this med was supposed to make things better. caplyta, if anyone is curious. all it does so far is wreck my sleep schedule, triggering depersonalization and derealization. i can barely form coherent thoughts - this post alone is taking everything i have to write. im spending the majority of my time unable to process the fact that i have a physical body, and once i do start to process it i have a breakdown about the burden that it is. i wish dysphoria was my only problem. moderate to severe joint pain, nerve pain, and connective tissue pain. flare ups as a result of some unknown illness. i have to dissociate from my body or ill go insane, yet doing so is having the same effect. i look at the world around me and realize its all animated. at least inside my home things feel comfortable, but the moment i step outside everything feels wrong, the colors are off, the framerate stutters. the people all lie, not an ounce of truth to their interactions, all pretending to be people, but im the only one who can see through it. outside of my bubble, nothing feels real, and i fear how i will react when the bubble pops and it too becomes foreign. maybe one day ill wake up to find the past few weeks never happened, i cant ever be sure anymore. i dont even know what day it is most of the time. and it wont ever get better, not really, not permanently. it always comes back, and its worse every time, and i have long since lost the will to keep going. i dont know how much longer i will last.

[arcane-sync]

I'm just... not in a good way. Kind of in a very bad way, actually.

Still dragging my way through school. Which is fine at this point. No new struggles there. Just... several house problems have come up as well, and my husband has done fuck all to address them. I am moderately germaphobic, so it is very literally difficult to do certain tasks. Yet I find myself doing the litter, cleaning the dishes, and hell, even some plumbing. The sinks have been draining slowly, and cleaning the drain traps has been an actual nightmare. I asked him to at least clean out the bucket I used and put on the back porch. He emptied it, but he didn't rinse them out with the hose. I've had to do construction and handyman work. I need to figure out how to drain the hot water heater. Plus normal stuff like cleaning the counters, the floors, the toilet. I CAN do these things, even with the phobia, but it is so, so mentally taxing. Plus the litter and dishes are supposed to be his chores, and he complains about them not getting done. He just... doesn't do it. Says he doesn't have time, doesn't fit into his schedule.

The cat has been misbehaving as well. She has decided my husband's clothes are a good place to go bathroom. And my husband is loosing his temper over it, which is... very literally triggering me. My dad would lose his temper with our cats growing up and kick them across the room. My husband isn't hurting our cat, but it still triggers me that he is getting angry with the cat for doing cat things. It's not her fault. It's our fault for not training her properly and/or not seeing to her medical needs. He has been complaining about this for weeks, but he hasn't fixed anything. I finally decided to just schedule the vet appointment myself. He bought cleaning supplies to deodorize her messes, but he hasn't used them properly. He just throws the clothes in the washer without running it, making the washer smell. I should mention I am ALLERGIC to cat urine. He KNOWS this. I have asked him to clean these things. But again... doesn't fit his schedule. He just gets mad about it instead. I am just trying to keep up with the problem as best I can.

My physical health is struggling, mostly because the air quality is terrible where I live. It is causing several different health issues to flare.

Counseling has been... hard. Good progress. Amazing progress. I have met a few new parts. But with that comes... well... difficult memories. Difficult emotions. New things I do not know how to deal with. New parts to take care of. I need to publicly state I am not ashamed of them or what they've been through, because I know they fear that. It is just... hard. For me and them.

Since my mental AND physical health is flagging, older mental health issues are beginning to rear their heads again. Stuff that I usually have a handle on. Self harm just to make everything... stop... slow down for a while. I have an old eating disorder rearing its head too. I've never known exactly what it is, never been diagnosed. I'll go days at a time without eating. And when I do, there's a 50/50 chance I'll keep the food down. Sometimes I'll throw it up due to disgust with myself for eating, and sometimes its due to distrusting the food, that it is somehow contaminated (and that is 100% a trauma thing, growing up in a house with food that was frequently infested. Don't know if those instances count as flashbacks or not).

I am... scared to admit to struggling. Not with my relationship with my school now. It's pretty clear that any signs of mental health struggles will be confronted with great bias. Hell, even my marriage problems. That is one of the areas they drilled me on, saying that a poor marriage was a sign that I was unfit for the program.

I find myself missing the psych ward. The permission to just... focus on myself and my own recovery.

I am... not okay.

[dermac1]

The Connection Between Stress and Skin Conditions: Managing stress for better skin

The Connection Between Stress and Skin Conditions: Managing stress for better skin

Maintaining both physical and mental wellness requires an understanding of the relationship between stress and skin disorders. Stress can cause a range of skin problems, from acne to early aging, as we at Dermac Clinic in Model Town, New Delhi understand. This blog examines the effects of stress on the skin and provides practical coping mechanisms.

The Science Behind Stress and Skin

When faced with stress, the body releases hormones such as cortisol, which can have several negative effects on the skin:

Increased Oil Production: Sebaceous gland stimulation brought on by high cortisol levels results in clogged pores and excess oil, which can lead to acne outbreaks.

Inflammation: Stress causes the body to react inflammatory, which exacerbates diseases like rosacea, psoriasis, and eczema. Irritation, flare-ups, and redness can result from this inflammation.

Premature Aging: Prolonged stress speeds up the skin's elastin and collagen breakdown, causing wrinkles and a lack of elasticity. You can look older than you actually are because of this.

Impaired Healing: Stress can interfere with your skin's normal healing process, leaving it more susceptible to infections and other problems.

Common Skin Conditions Linked to Stress

Several skin conditions are particularly sensitive to stress:

Stress-induced hormonal shifts can exacerbate acne problems by increasing inflammation and oil production.

Because eczema and psoriasis impair skin barriers and increase inflammation, these chronic illnesses frequently flare up during stressful times.

Rosacea: The condition's symptoms, which include visible blood vessels and a persistent redness, can be brought on by or made worse by stress.

Effective Stress Management Techniques

While it’s impossible to eliminate stress entirely, there are practical strategies you can implement to manage it effectively:

1. Mindfulness and Relaxation Techniques

Meditation: Practicing mindfulness or meditation for just ten to fifteen minutes each day can greatly lower stress levels. To relax, pay attention to your breathing.

Deep Breathing Exercises: Easy breathing methods can rapidly reduce stress. Try taking four deep breaths, holding them for four counts, and then letting them out for four counts.

2. Regular Exercise

Engaging in physical activity releases endorphins—natural mood lifters that help alleviate stress. Aim for at least 30 minutes of moderate exercise most days of the week. Activities like yoga not only promote physical health but also enhance mental well-being by reducing anxiety.

3. Healthy Diet

Your body's capacity to cope with stress is enhanced by a well-balanced diet full of fruits, vegetables, lean meats, and healthy fats. Maintaining proper hydration is equally crucial because water is essential for healthy skin.

4. Adequate Sleep

Try to get between seven and nine hours of good sleep every night. Sleep is essential for the renewal and healing of skin. Create a relaxing nighttime ritual; to encourage relaxation, think about reading or having a warm bath before bed.

5. Skincare Adjustments

Hydration: To preserve your skin's barrier function, use a high-quality moisturizer that is appropriate for your skin type.

Gentle Products: Choose skincare products that won't aggravate stress-induced sensitivity. Seek out components like chamomile or aloe vera that have anti-inflammatory qualities.

6. Seek Professional Help

Consult a therapist or counselor if stress seems overpowering or ongoing. Getting professional advice can give you the skills you need to properly manage stress.

Creating a Supportive Environment

Including these methods in your daily routine can greatly enhance both the appearance of your skin and your mental well-being. Whether it's engaging in a hobby, spending time with loved ones, or just taking in some quiet time, schedule time for the things that make you happy.

Conclusion

You can take proactive measures to improve the health of your skin by being aware of the significant effects that stress has on it. You can keep your skin looking its best even during difficult times by engaging in mindfulness exercises, leading a healthy lifestyle, modifying your skincare regimen, and getting help when you need it.

With individualized skincare guidance and treatments catered to your particular requirements, we at Dermac Clinic in Model Townl are here to help you overcome these obstacles. Never be afraid to seek expert advice on how to properly manage your stress levels and skin health. This is the beginning of your path to a better complexion and a more tranquil mind.

[alazyparallelworld]

battlestation bed

i ramble ★ frequenters and those who have read my extended about page may know that - i'm, bedbound - i eat, drink, play, and work in my bed. i live in my bed; my anatomy has bled into my bed.

this sounds... very edgy...! and tragic. but, this is, an 'informative' kind of post... i wouldn't talk abt it as oft as i do, if it brought me despair.

i don't mind questions, concerns, w/e about this - i don't plan to 'edit' this post whatsoever. this is to serve as a... 'quick reference' or summary.

content warning: detail of chronic pain, implications of neglect, severe health problems.

if you'd like to skip over the explanation, of the Why am i bedbound, start at: bc. Every Step. is Agony. i... LIVE IN BED...!! WE ARE HERE NOW.

so--! my physical ailment is, you know. Chronic Pain. i have an underdevelopment disorder both physically n mentally... as a result, some bones in both of my knees, 'grind' together. i've lost a moderate amount of cartilage in my left leg, and less so in my right.

there is no 'fixing' nor 'preventing' my problem. eventually, my right leg will catch up to my left. my medication deals to lessen the symptoms, as physical therapy, medications, injections, surgery, have been ineffective. furthermore, i have the slightest flat feet - which, ah, doesn't help matters.

walking brings me pain. throughout my life, i have had these... Pangs, burning sensations. my childhood was very anti-medicine; i never saw the doctor, for a Regular Checkup, until i was 21. until i was - 19 - i believed this agony was... normal!

the reveal came as, a nonquestion to my friends. in context of sleep. "well, you know, your body tells you when you're tired... when your legs flare up and even standing hurts, it's, 'time for bed,' you know?"

their reaction was unexpected. because, for me, that 'time for bed' pain was daily.

i had no reason to suspect this was abnormal. and i enjoyed - very, very much so - running, i loved the feeling of it. i ran every day, for hours on end. and this... obsession, is what kept my legs from fully atrophying. i saved myself thru such rigorous exercise, while in a double-edged sword way, making them worsen earlier, as i was busying the bones that grind against themselves.

upon intake, examinations... in gentle words, i was told, "expect to never run again." and - i was 21. i knew then my pain was bad, but the emotional pain of... Giving Up, my primary coping mechanism, was worse. even typing this near brings me to tears, ah. anyways...!

i began, an antiflam, and then a knee brace, and then physical therapy... and then injections... then Creams... further physical therapy... strengthened pain medication. a Surgery. Water and regular physical therapy. to this day, the only thing that brings me 'relief,' is thru numbness via marji.

my insurance won't approve of - a replacement - per my age. even then, the likelihood of success is low. it's estimated that sometime in my 30s, i'll be dependent on a wheelchair.

bc. Every Step. is Agony. i... LIVE IN BED...!! WE ARE HERE NOW.

i live alone, with no friends or family to speak of. as i have no support system, am unemployable, and have state insurance - i have a medical caregiver. she is here 5 days out of the week, and approved for nearly 100 hours of the month...

she is the one who takes care of my - food and water. most of my meals are either prepped, needing only reheating or hands-off frying and such, or cooked for me the day of.

my activities of daily living (ADLs) are helped by her - food making, housework, hygiene, medications, and the like. she is my transport to necessary in-person appointments - and, well, keeps me from going mad due to my total isolation otherwise.

but! she is not live-in, and there are days of - incidents! she can't come...! so-and-so emergency, or mix-up, and the like. i am VERY dependent on my caregiver, but not totally... so, how do i function, alone?!

food and water - aforementioned, most of my meals are prepped. otherwise, i do 'low effort,' things like microwavable meals... and, you know, the odd delivery. >>;; re water (soda, lol), i have beside table, where there's a mini fridge. i make sure to keep a good stock of it in both of my fridges. n there is a bedside trashcan, where i dispose of any waste.

hygiene - ...i am not the best at this... i have to be helped into showering, specifically. i have a shower chair, as i cannot stand under such water pressure. i've considered dry shampoo for my hair, and i give myself the occasional wet-wipe bath. better than nothing, after all.

i have spare clothing - my robe, extra pants, etc always in my bed so in hot/cold flashes, i can redress easily.

a tv tray is slipped between my bed and the wall, which i have an organizer on - inside, it holds my medicine, glasses, wet wipes, etc.

locomotion - for when i have NO CHOICE, but to walk, i keep it scheduled. feeding the cats is conjoined with, 'food time,' or, bathroom trip. i also have a roller chair nearby - so, when necessary.. whhheee...! my apartment is small, w/ wooden floors, so i can foot-drag my way around. I Don't Like Doing This.

when outside, i am supported by my knee brace. it lessens the pain in the moment, but only enough to function for short-term and infrequent outsides. for grocery store trips, i tend to use mobility scooters... smth i, again, Dislike. i am considering inquiring about a power scooter, post my next procedure, so i can go outside more regularly. in my particular case, a cane would not be of much help and would cause further dependency on my right leg.

pet care - Water fountain! re: food, as aforementioned, i make it a 'two birds, one stone,' affair... and play - they have e/o, and Believe Me that they make their own fun - but automatic toys, too. nozomi-tan (alias) has been taught to bring toys into bed, so i can play with him there. hikaru (also alias) has learned to turn on the automatic toys by herself... many times, i am awoken, to the sound of it buzzing. Smart girl.

furthermore.. it's more that nozomi-tan takes care of ME... he is insistent, knowing of when tot ell me. Wake up - time to get up - so I don't depress in bed forever. My bathroom anxiety, he follows me there... and the like. this was his purpose.... soiled by, mm, someone else treating him more like a pet. But he is still very good at grounding me in bouts of depression, PTSD, and the like.

i believe that is most of the. 'how do you live/function?' questions...?

now. For optimization. two years ago, i was in good fortune enough to buy a relatively good Gaming Laptop, and have upgraded its RAM and storage since. thanks to public assistance, i can afford wifi... so, i, have internet. This is my base entertainment.

...as i, dont leave the house sans medical appointments, i am... Always online. Keyboard warrior. anyways -

i watch things, game, read things, write things, so on and so forth. I have consoles, but they need setup - as i stream/record things - so I game largely from here... bc of my hands, i use a controller so they do not. Claw Up. i have usb 2 and usb c cords running to my bed (as of today, w/ help, they're now snaked to my bed from the extension cord behind it), which is how i charge.. phone, headphones, tablet, controller, etc.

right in front of my bed, there is a large slab of a desk. this is where my TV is! very few things in my apartment need batteries. but, i have those - fancy - rechargeable batteries... so no worries about, replacing batteries in the tv remotes and the like. BUT! my tv here is a smart tv...! so i control it from my phone.

the tv tray - stated earlier - has an organizer wherein it holds the very basics. my meds, pens, the remote for my lamp, etc. my mood light is sat right atop of it, and it's where i rest my headphones as they're too bulky to fit inside the organizer itself.

the lap desk is where, i guess, the magic happens... as i would be chugging my laptop against the bedsheets, otherwise. it means i don't pain my legs from its weight, and i only have to rest my external keyboard on myself...

so. this is how. I Live from my Bed.

[surveys-at-your-service]

Survey #303

“if i can’t be loved, then i’ll be hated”

What color are your glasses, if applicable? Black. Candy corn or conversation hearts? They're both gross, don't make me pick between garbage. Do you own a lot of earrings? Not really after I weeded them out before moving. What did your backpack in high school look like? I dare say I had the dopest backpack of them all. It looked like a massive Ouija board, and the zipper was the planchet (sp?). Have you ever been to a rave? Nah. What is your favorite art medium? I have a particular fondness of oil paintings. They tend to look so smooth, and you can achieve incredible realism with them. How far away is the nearest hospital from you? Not even five minutes, I think. Who was the last person you visited in a hospital? My mom. What is your favorite car color? Pink, duh. How did you learn to type? We actually had a class specifically for typing in middle school. What style of wedding dress do you want? I don't have that set in stone yet, but I really do love ballgown dresses with long trains as well as a-lines with a moderate train. I love a lot, except really for mermaid dresses. Do you fit into any stereotype, or are you non-stereotypical? I don't know if I fit perfectly into any and really don't care. Would you want your first child to have your hair color? ???? I don't care about their hair lol?????? It would depend on the hypothetical father, in which case I'd probably find it cute, but this is so, so unimportant. Do you enjoy writing in cursive? Yeah, it just feels good and flowy to me. What is your favorite hair color? Natural? Probably blonde with natural darker undertones throughout. I like blonde hair because it's far easier to dye, haha. Now, if we're including DYED hair, rose gold or pastel pink is *chefs kiss* What is your favorite eye color? Sapphire blue, probz. Would you put your birthday on a different day if you could? Nah, it's fine where it is. What holiday is your birthday closest to? Valentine's. Do you vent on social media a lot? NOOOOOOOO. I barely post ANYTHING about myself on social media because I feel like I'm being annoying, self-absorbed, find anything I do actually interesting, or don't want people to think I'm a whiner. All I ever really do on social media is share or reblog funny shit, things I love, stuff I find relatable or inspirational, educational, important for whatever reason, etc... Do you have abusive parents? I am very thankful to say no. Is your house haunted? Doesn't seem like it. What's your favorite thing to watch on YouTube? I'm in a real WoW-related phase lately... Watching my favorite streamers, gold farming guides, and other various aspects of the game. What are five health problems that you have? I talk about the mental issues enough, so I guess I'll talk about physical stuff here. Uhhh I have very low blood pressure (it's a med side effect), I have extremely weak legs following muscle atrophy, I have bad tremors, especially in my hands (amplified by medication once again), maybe TMI but we're adults here and it's a legit issue that I have chronic and severe conspitation, aaaand then of course I have hyperhidrosis (excessive sweating) to a fucking outrageous and also humiliating degree. Ooooonce again as a prescription side effect. This answer made meds sound kinda bad, I know, but really, I'd rather have the will to live and just have to deal with these than want to die everyday and not. Do you have surgery coming up? No, let's keep it that way until I lose enough weight and when I am 110% getting loose skin removal. Which family member(s) do you look the most like? My sisters, ig. People say my mom also, but I honestly don't see it. Have you ever cried while watching a YouTube video? Yeah, usually just in let's plays, but it's happened for other reasons. Are you missing a website that just shut down? Nah, none that I know of. NO. FUCKING WAIT. So, when my laptop was fixed, a LOT of shit was wiped from it, and that included all of my goddamn Lightroom editing presets. The site they were from no longer exists, so I had to use a different, pretty sub-par one to install at least a few because it helps me get a start on editing the photograph and leaning towards the "vibe" I want before spending like 15+ minutes tuning it myself. Would you be a barefoot bride? No. Which would you rather name your daughter: Eliana, Echo, Emerald, or Ellery? Ohhh, I like these. I think I prefer "Eliana," but "Echo" is a close second. "Ellery" is nice, but it sounds too much like "celery" to name my kid that lmao. Which would you rather name your son: Maverick, Matthew, or Moses? Ugh, none, honestly. But "Matthew" wins. When was the last time you gave a speech? Like a *legit" speech? Probably not since uhhh... I guess when I argued my disability case at court? Does that even count? Have you ever been in a stampede? Well, never seen this'n in a survey before, so good job, lol. No. If you were a fairy, what color would you like your wings to be? It would depend on what I wore, really. And my hair. But probably light pink. Would you rather name your son Storm, Skylar, Sorin, or Solomon? "Sorin." "Skylar" is SO Southern, and "Solomon" sounds like the creepy kid all his classmates avoid and I ain't putting my kid through that. Did you read a devotional this morning? Not my jam. Would you rather be named Arizona, Alaska, Cali, or Georgia? Hm... "Alaska" is actually kinda cool???? And I'm white as fuck so lol????? I wouldn't mind to nickname of "Ally," anyway. Are you repulsed by ugly reptiles? lololol bro get out Did all your friends know about your first crush or was it a secret? I was definitely secretive and shy about it when I first started getting crushes. Do you ever feel insecure about going out without makeup? I feel insecure either way, so... How many different natural hair colors are there in your immediate family? So, this is a hard question to answer. My mom was born with brown hair, but it darkened to almost black; only her daughter Katie inherited that. By some genetic magic, Dad had blond hair as a kid, but it also turned black. Like... how?????? I was born with dirty blonde hair like him, and mine turned an average brown with age. My immediate sisters have always had brown hair. What is your favorite online game? World of Warcraft is ballin'. Would you ever want to be famous and sign autographs? Ha, the idea of signing autographs is awful... I can't physically write very long without my carpal tunnel flaring up. Do you like your shirt to be loose or tight? LOOSE. Especially as a bigger person, tight shirts are just really uncomfortable. What is your favorite Spanish name? I don't know nearly enough to answer this. Would you rather visit Asia or Europe? I think Asia is, in general, more interesting and prettier as a whole, but I guess I'm drawn to European culture being more like my own and there are specific locations I'm interested in, like Germany or Scotland. So to answer the question, I guess Europe wins. Are there any Asians in your family? I don't believe so. Have you ever had colored braces? Haha yeah, I did that when I had them. Do you take birth control pills? Yes, just for period cramps. Without them, they can be immobilizing for me. If you live in the USA: do you feel free and safe? Ha, no. Well, not *entirely*. Have you ever been sick on your birthday? I was recovering from the stomach virus, if that counts. As in I still got sick the day before and felt iffy on my actual bday. 17th, I think? Is talking about your past painful for you? Yes. Are you a member of any support groups online? I'm a member of The Mighty site, if that counts. When I'm feeling very, very sound of mind and helpful without all the negativity being a detriment to myself, I do like going on there and trying to help or comfort people. Have you ever called a suicide hotline? Yes, and the line was busy, and that's when I decided I was a goner. Do you ever fantasize about revenge? I uhhhhh... sometimes. What's a movie you would recommend to someone who never watches movies? Ohhh, that's hard. I don't really watch movies either, and I'm trying to think of one that essentially anyone would like, so hm. Oh, Coco is absolutely a possibility. That movie touched me so, so deeply and is high on my favorites list. It's impossible to not feel the emotions. Do you want to have grandkids? Hell, I don't want kids. Do you want to be an aunt or uncle? I already am one, and I love being an aunt. Who was your favorite Spice Girl? I don't remember their names or characters in general. Did you make a lot of home videos growing up? I mean *I* didn't, but Mom filmed quite a few. Do you enjoy babysitting? NO. What's an unpopular opinion that you have? Avoiding some political ones, uhhhh. OH. HERE'S ONE. THE SCENE AESTHETIC IS FUCKING CUTE AND NOT CRINGEY AND YOU CAN FIGHT ME ABOUT IT. Are you attracted to the opposite gender, same gender, or both? Both are A+. Was your first crush on someone of the same gender or opposite? Opposite. As a kid, I didn't even fathom the concept that women could date women. What is something you'll never eat again? Why? Brussel sprouts. Fucking disgusting. What is currently happening that is scaring you? Besides the very obvious answer of "Covid," I worry about my mom a lot. She's so weakened after all the chemo and meds and can do literally less than I can without heavily breathing and sweating. I just worry a lot that cancer will return sooner than we hope; I don't want it to EVER come back, but doctors say it is very, very likely at one point or another because she was so very close to Stage 4. What would be your personal hell? Being completely and entirely isolated forever while somewhere hot and humid, lol. And play one of my trigger songs on repeat eternally. What made the "weird kid" at your school weird? There was this poor guy named Alfred that was VERY clearly depressed out of his mind, and I heard him speak maybe once through all of high school, and the entire class couldn't believe it. He always sat way in the back and never smiled. I wonder how he is nowadays. What is a word you personally find offensive? "Retarded" personally offends me the most when misused and spoken as an insult. What instantly puts you to sleep? Now that is HARD to do; I have a ridiculously hard time going to sleep. The easiest way though would probably be me being drained from an emotional breakdown. That is so exhausting that I'm capable of crashing pretty fast and hard. What song is in a language you don't speak, but you love it anyway? I adore Rammstein, so there's plenty. I'll probably say "Donaukinder" is their best. What is something you would like to do if you weren’t judged for doing it? I keep that I RP a complete secret in my "real" life for this reason unless it's like, pried out of me. What's a movie you think everyone should watch? Why that one? Johnny Got His Gun. See how goddamn disgusting war is. What was the most unexpected good thing that's ever happened to you? Ha, realizing I was bisexual after once being homophobic. What is the funniest fact you know? Oh man, I know a lot of random trivia shit, really, so it's hard to say. Maybe that quokkas throw their offspring at predators to distract and escape from them... As awful as that is, c'mon, you gotta admit it's funny and shocking with just how adorable they are. What was your 'mic drop' moment? Oh, I don't know. Possibly when I publicly came out as bi on Facebook and made it abundantly clear that I gave no shits about some homophobic friends and family & I was beyond willing to let anyone's ass go over it. What's the kindest way a stranger has treated you? I remember as a kid at McDonald's, the woman in front of our car paid for our food; apparently seeing a mom, dad, and three kids in a van was enough that she wanted to just be kind and give us a smile. We have no idea who she was, never saw her face or anything, she was just a sweet woman. What is the biggest design flaw of your body? Okay, I'm going to let go of all hatred for my body weight-wise and just think of this as from a strictly natural design perspective, in which case I'd say my toes are too small. What age are you afraid of turning and why? 30, because I'm terrified of getting there and seeing I've possibly gone nowhere. What is the strangest thing you have ever felt? I'm keeping this question in just because I think there could be some interesting answers for others, but I'm witholding my answer because nobody wants or needs to know lmao. What makes someone immediately unlikable? Acting better than others and belittling. Who's a villain you sympathize with and why? D A R K I P L I E R because of his origins and overall purpose and just simply existing. What is something you regret to NOT have done? I have this oddly weird regret of not going like, all-all the way with He Who Shall Not Be Named????? Idk why though????? Considering I loved him way too much and I was a reckless and impulsive person who probably at some point would have wound up accidentally pregs????? What a fuckin trip that woulda been. What movie changed your life for the better? None have really "changed my life." What book you think should be directed as a film? Oh, idk. Most I can think of have been. Of all the decades you've lived in, which one have you liked best? The 2000s, probably. A carefree kid. How are you doing today? I'm exhausted. While out with Mom and my sisters yesterday, we got behind a van whose driver was obviously drunk or high off his goddamn ass, and he was swerving EVERYWHERE, nearly shoving so many cars off the road. Mom called 911 to get in contact with highway patrol to report his dumb fucking ass in. I was having an absolute panic attack and cried quietly like the entire 45 or so minute drive home. I was just so, so upset because this is why I don't fucking drive, and I felt like I'd made my sister (who was driving) mad because she had to firmly tell me I had to calm down (I was hyperventilating and talking to myself to try to calm down) if she was going to focus and keep us safe. She later ensured me she wasn't mad, but I still wasn't the same the entire rest of the day. Anyway, I slept hard last night but had two nightmares, so I'm still really tired today. I'm trying to keep myself really distracted. What's something your relatives don't know about you? A whole lot really, considering beyond my very immediate family, I see almost nobody because they live many states away. What's something your parents did, which you have sworn never to do? Mom would spank us or slap an arm pretty hard if my sisters or I misbehaved or "disrespected" her by "talking back." I'm not having kids, but I would never, ever, ever, put my hands on them in any way that isn't loving. You do not teach children via inflicting fear. I also have this probably overly strong aversion to beer because that's what Dad always drank as an alcoholic. I'll probably never try it, not that I really want to because it smells awful. What's the most annoying thing your pet does? I feel like "annoying" is the wrong word for this, but Roman (my cat) can be incredibly demanding of attention and to lie on me when I'm on the laptop in bed, and sometimes I just want space and be able to clearly see the screen, haha. He will legit meow like a baby and gently swat my arm sometimes if I try to keep him back. Heeee usually gets his way. As for Venus (snek), she does nothing "annoying" either, but rather a bit concerning to a snake mom: she is usually very slow to find and strike her food. I feed her frozen/thawed mice, and she will first slither around her entire cage, tongue flicking and clearly looking for her food, even though I always place it atop the same spot on her hide, and she can have her head RIGHT beside it and still do nothing. She ultimately generally eats (as a ball python though, she's a picky eater and will occasionally reject a meal), but I of course wonder why she's odd about dinnertime... As a champagne, she does have the notorious "spider gene" in her, which can cause neurological issues, but idk if something like this could be related.

[wtfzodiacsigns]

Health Advice for the Signs

**Check your Sun sign, your Sun sign’s polarity, and your Ascendant

Aries: The head is ruled by Aries. They are susceptible to a lot of headaches, migraines, and sinus issues, and could be susceptible to minor head and facial injuries, too. Arians are also prone to eye strain and problems with the teeth, and they have a tendency to overwork themselves. Arians easily get red in the face when they’re excited or angry, and when they have a fever, it often becomes very high in a very short amount of time.

Advice: Use protective headgear if you’re participating in strenuous sports. Be sure to take breaks when working, and don’t try to take on more than you can handle. Eat meals in a serene atmosphere. Drink plenty of water and rest often.

Taurus: The throat and neck are ruled by Taurus. Taureans may be subject to a sore throats, colds, laryngitis, thyroid problems, swollen glands, stiff necks (especially when they’re stressed) and other minor afflictions. They’re also prone to tonsillitis and ear aches. Taureans’ keen taste buds lead to a love of food, and that, paired with possible problems with the Thyroid gland, which is also ruled by Taurus, as well as a generally sedentary lifestyle, can cause weight gain. Because they are ruled by Venus, Taureans may also have back strain.

Advice: Bundle up during the winter to avoid getting sick. Be careful of your eating habits. Remember everything should be done in moderation. Take walks outside to keep yourself active. Take the time to give yourself a quick massage or do some stretches if you’re experiencing neck or back pain.

Gemini: The hands, arms, shoulders and lungs are ruled by Gemini. Geminis may have problems with respiratory disease and may be prone to bronchitis and asthma, as well as difficulty breathing when stressed. They’re susceptible to accidents involving the hands such as sprained wrists, jammed fingers, and broken bones, as well as minor bruises, scrapes and cuts. Gemini is ruled by Mercury, which rules the brain and nervous system, so Geminis may also be prone to anxiety and nervousness, which can make them physically sick.

Advice: Because your ruling planet, Mercury, is associated with the brain and nervous system, your mental health is tied to your physical health. Meditation, yoga, or even some simple breathing exercises would be beneficial to your overall health. Smoking tobacco is especially detrimental to Geminis, so avoid that. Playing sports such as tennis or ping pong will help strengthen the arms.

Cancer: The breasts and stomach are ruled by Cancer. Cancerians could be susceptible to weight gain in later years, and it may be hard for them to lose that excess weight. They are prone to stomach and digestive problems such as ulcers, gallbladder issues, and nausea. Cancerians are likely to overindulge in wine and alcohol, which causes further stomach problems as well weight gain and water retention. Tension, anxiety, and high emotions are likely to cause illness in those born under this sign.

Advice: Eat your meals in pleasant surroundings—no arguing at the table. Take a walk afterwards to aid in digestion. Walking in a warm rain or by the sea will soothe the lungs, as the air is moist.

Leo: Leo rules the back, spine, and heart, and those born under this sign may have problems with the back and spine due to physical and emotional strain as well as overexertion. They’re especially susceptible to upper back pain and pressures and pains around the heart. They may have heart problems later in their lives.

Advice: Avoiding lifting heavy objects and doing stretches for the back would be beneficial. Try and maintain good posture as well, and make sure to get enough rest and relaxation. Sunbathing is a good way to do so.

Virgo: Virgo rules the nervous system and intestines. Virgoans are worriers, and their nervous tension, anxiety, and emotional stress easily become physical ailments, usually intestinal, as they have sensitive stomachs and are prone to ulcers, indigestion, liver and bowel problems.  

Advice: Herbal tea eases the stomach. Light but regular exercise, periods of relaxation, and sunshine are helpful in getting Virgoans to stop worrying and destress, at least for a little while.

Libra: The lower back, butt, and kidneys are ruled by Libra, and Venus, Libra’s ruler, rules the throat, skin, hair, and veins along with those regions as well. Librans are prone to lower back pain (especially when they’re stressed) as well as kidney problems, such as infections, and sensitive skin, along with breakouts. Librans may have delicate immune systems as children, but it usually evens out as they age.

Advice: Drink lots of water and avoid excessive alcohol and carbonated drinks as they are bad for both the skin and the kidneys. Mild exercise, back stretches, and good posture are all beneficial for Librans, and you should try to keep both your surroundings and your company pleasant and harmonious.

Scorpio: Scorpio rules the genitals, and Scorpios may have problems with urinary tract infections and genital infections—skin flare ups, cystitis, and other ailments. They may also experience exhaustion and ill health due to their own volatile emotions and inability to rest and relax, and suppression of those emotions as well as sexual frustration can lead to cruel and erratic behavior.

Advice: Take time to relax and process your emotions. Don’t bottle your feelings up; take time to exercise, and keep your surroundings peaceful. As you are one of water signs, you Scorpios benefit from taking trips to the sea, soaking in the bath, and drinking spring water opposed to tap water.

Sagittarius: Sagittarius rules the liver, hips, and thighs. Sagittarians have sensitive livers, and they may be susceptible to overuse of alcohol and to hepatitis, since their ruling planet, Jupiter, governs the liver. They also may be susceptible to gaining weight in their later years, especially around the hips and thighs. They also are prone to chronic aches, fractures, sprains, and bruising in this area.

Advice: You Sagittarians absolutely need exercise, fresh air, and sunshine daily, and you benefit from being around nature, but beware of the effect of the sun and wind, and be careful when walking, riding, or playing sports that you don’t injure your hips and thighs.

Capricorn: The bones, joints, and knees are ruled by Capricorn. They may be prone to knee injuries and pains, stiff joints, arthritis, rheumatism, and orthopedic problems. Capricorn’s ruler, Saturn, governs the gallbladder, spleen, bones, skin and teeth. Capricorns’ teeth tends to need a lot of care, and their skin tends to be dry. Their own pessimism and worrying can cause body aches and drained energy.

Advice: Be careful in the sun to avoid skin damage, and be sure to keep warm during cold or wet weather. Try to keep good posture, but don’t walk too stiffly. Colorful surroundings, flowers, good friends, and good music are sure to lighten your mood when you’re feeling low.

Aquarius: Aquarius rules the circulatory system, shins, calves, and ankles. The lower part of the leg is more susceptible to cuts, bruises, sprains, and fractures than any other part of the body, and the ankles may be prone to swelling. Aquarians may suffer circulatory problems, low blood pressure, anemia, and hardening of the arteries, and cold weather is particularly hard on them.

Advice: You Aquarians need fresh air and exercise to release tension and increase energy. Brisk walks are good for circulation, but avoid running, as you’re likely to trip and fall. Elevate legs to counteract puffiness. Afternoon naps are good for vitality, but avoid drinking excessive amounts of coffee as it makes you nervous.

Pisces: The feet are ruled by Pisces. They may be prone to aches, bunions, corns, and callouses, as well as athlete’s foot and other fungal infections. Pisceans often afflicted by bruised, stubbed, or broken toes, and are prone to gout too. Pisceans find it hard to stand for long periods of time, and they have problems with ill fitting shoes. They also experience emotion related illnesses as they are one of the water signs. Pisceans may be more likely than others to fall prey to alcohol and drugs.

Advice: You Pisceans should keep a well balanced diet, a mild exercise regime, and be sure to get enough rest so that you can keep up your vitality. Dancing and swimming are good exercises for those of you born under this sign. Be sure to take care of your feet and wear comfortable shoes. A warm footbath before bed aids in relaxation and a good night’s sleep.  

Source: divinezodiac

[creativity-is-rebellion]

Life on Intermission

So, for mental health reasons, I have decided to put my law studies on hold for six months while I gather myself. The thing I am supposed to be mostly doing is resting (which is the hardest thing in the world for me - I always need something to do). I think the main reason why it is difficult is because for the majority of my life I have had too much cortisol running through my body. When I was a kid (and teenager), I grew up in a tumultuous household with a narcissistic mother and an enabler for a father. I had to parent and counsel my mother day and night for her unresolved issues surrounding her own traumatic upbringing and stressful early life, which led to a transference of generational trauma from herself to me. I was both psychologically, (and one time) sexually abused by her. Adding to this, there was a constant money shortage, sometimes to the point of relying on food stamps, and I was bullied terribly at school. At 16 years of age, I was raped by a guy who had been my boyfriend of 3 months, and unceremoniously dumped shortly afterwards. I had to see him every day at school for the rest of my time there. The loneliness I felt, with both what was going on at home and what was going on at school, led me to try to take my own life with pills, but obviously, this was unsuccessful, because my parents came home early and I was rushed to the hospital unconscious and had my stomach pumped. My mother refused me a counselor and medication, so my depression (which was later diagnosed as Bipolar I) just got worse. and unceremoniously dumped shortly afterwards. I had to see him every day at school for the rest of my time there. The loneliness I felt, with both what was going on at home and what was going on at school, led me to try to take my own life with pills, but obviously, this was unsuccessful, because my parents came home early and I was rushed to the hospital unconscious and had my stomach pumped. My mother refused me a counselor and medication, so my depression (which was later diagnosed as Bipolar I) just got worse. and unceremoniously dumped shortly afterwards. I had to see him every day at school for the rest of my time there. The loneliness I felt, with both what was going on at home and what was going on at school, led me to try to take my own life with pills, but obviously, this was unsuccessful, because my parents came home early and I was rushed to the hospital unconscious and had my stomach pumped. My mother refused me a counselor and medication, so my depression (which was later diagnosed as Bipolar I) just got worse. because my parents came home early and I was rushed to the hospital unconscious and had my stomach pumped. My mother refused me a counselor and medication, so my depression (which was later diagnosed as Bipolar I) just got worse. because my parents came home early and I was rushed to the hospital unconscious and had my stomach pumped. My mother refused me a counselor and medication, so my depression (which was later diagnosed as Bipolar I) just got worse.

I graduated from school with a relatively good result, and thus was able to gain entry into the university program of my choice. Or rather, it was my parent's choice. I had won a few poetry competitions which had been published in some anthologies. I wanted to study creative writing, but my parents thought it would be better I learned something "more stable" (which is ironic), so I "decided" to study psychology, my third choice. Regardless, I thought this would be a way to start over, and leave the horrors of high school behind me. But because of my family's lack of money, it was impossible to move out on just the income I was getting from the casual job I had whilst supporting myself at university. And then, along came my first love, who I had a tumultuous relationship with. We were on again, off again for many months, in fact, many years. We first met in 2003, and parted ways for the last time at the beginning of 2006. In hindsight, I think he loved me, but just couldn't say it. At the time though, it was devastating. I moved states and universities to get away from the situation, first to Canberra (but I have followed me there), and then to Brisbane (but I have kind of followed me there too). 

I was able to make a life for myself in Brisbane for a time, despite still living with my parents (who had followed me up there), but then the loneliness I felt, mixed with being given the wrong meds, led to my first full -blown manic episode. I was spending money I didn't have, and wracking up a debt on 3 credit cards and 2 personal loans. In 2005, I tried to take my life again, which (again) was unsuccessful. Towards the tail end of this spending spree, I met my future husband. This was a brief reprieve. I decided to take a year off uni and work full-time to pay my debt back, and my future husband and I moved in together. Within 7 months, I was pregnant with our first son, and, even though I went back to university, I kept having to defer because of money issues. After giving birth, I went though a pretty bad bout of postpartum depression, 

In 2010, we got married, and things went well for a couple of months, until the financial situation became critical. We decided to move back to Norway, my husband's home country, despite me never even visiting, as he could get a better job there. I graduated with just one half of my double-degree, and off we went. Initially, things were good when we moved; I worked toward my master, learned the language, got a few jobs which allowed me to focus on practicing the language, and was of the impression that I would be able to study psychology in Bergen once I finished my language courses. But then, in 2012, I found out that I had been given the wrong information about this, and it was no longer an option. I wanted to leave, as there were no jobs available in my specialized area. I was hospitalized for suicidal thoughts for the first time ever in 2012, but there would be another 3 times after that over my time in Norway. In 2013, I gave birth to my second son, which was truly a joy, and for which I didn't get any postpartum depression, but, at that time, my actual Bipolar was bad enough. My husband's career was taking off, and I felt my problems were ignored, and that he was leaving me behind. We didn't move back to Australia (my home country) until 2017. Again, there was another promise of a fresh start.

After working with my degree for a few months, I decided to do my PhD, which was awful (I covered that in a previous post). I loved teaching and participating in conducting research, though. With my income from these gigs, and my husband's income, we were living the high life. Until the teaching dried up and my husband's company folded at the beginning of 2019. The pressure of all of this led me to be hospitalized again in the psychiatric ward 2019 for 3 months. Afterwards, as soon as I came out, I had to look for work, due to our dire financial situation. We had been in the throes of building a new house when times were good, and now we were in more debt than we had ever been. My husband found work, but was now earning half of what he was earning before. I've applied for 600 jobs before I've got to his first job interview. I ended up getting casual work, but couldn't find anything permanent, and it didn't pay enough. I started my law degree, which got off to a prosperous start, but I was also diagnosed with Lupus, which would explain why I not only felt mentally shit, but also physically shit. And that takes my biography more or less up to the present (with some stuff most likely left out).

But now, I am taking a break. I am, for the first time, deciphering what happened to me, trying to process all of the trauma, in order to become a better version of myself. Here are just some of the things I am doing during this coronavirus lockdown to self-improve:

^ Here is book I need to read whilst in the throes of finally finishing my first novel. It's only taken me 13 years. Not biggie. I need to procrastinate less. But also be less harsh on myself. I've had some really dark periods in-between that have lasted years. Sometimes, I just feel like I lose so much time when the depression is particularly bad. It makes me overdo myself when I actually feel OK for once.

^ This is a picture of my jewelery projects and couch-side workroom for when I am on hiatus. I'm going to try to get my jewelry business in order during my time off, but it's all about moderation, as my jewelry-making sometimes becomes obsessive because I get a rush of ideas. For example, yesterday I made 3 necklaces and 4 bracelets in a trance-like state. It might be impending mania, and I have to try to keep track of it, and approach it in a healthy way.

^ My fitness and health has been a personal concern of mine for a while now. Due to being diagnosed with Lupus last year, the sedentary life of being a student, and having to take mood stabilizers and anti-psychotics for my Bipolar, I have put on a little bit of weight that I want to shed, but because of the physical pain I experience due to the flares, sometimes it's difficult to do anything but light exercise. It's all about baby steps. Daily walks are also good for boosting my mood.

There is also a number of boxes awaiting my attention in the garage, which I suppose could be seen as symbolic of me unloading both emotional and literal unwanted baggage / rubbish. Its a long road, but at least I am finally taking the necessary steps for dealing with unresolved trauma and ridding myself of painful secrets that have haunted me for the longest time. All I have to do now is to remind myself to breathe.

[godkilller]

How does Gin cope with the loss of his arm in your failure verse? Has he had episodes of phantom limb in Rangiku's presence? Did he ever snap at her while trying to complete basic tasks, spurring any arguments or fights between them? How receptive is Gin of her assistance in the very beginning of his recovery?

          Coping??? That’s a funny joke——no but really, Gin mainly views the loss of his arm as a reminder, a punishment, for the fact that he failed to achieve what he essentially ruined his life to do. Whenever he runs into a frustrating moment involving his injury, the anger that follows typically melts away to avoid any instances of self-pity or outright wallowing, as he feels he doesn’t deserve to sulk about the state of himself—-because he inflicted it upon himself. So he quells those knee-jerk reactions in favor of biting his tongue, hiding his pains and frustrations, to bow his head and not make a fuss to draw further attention to himself. Gin is, after all, amazingly sharp at disguising and otherwise masking his personal emotions. He’s falling apart, sure, but he intends to do so with some form of composure. Not so much out of any whisper of pride, but really just due to the habit of maintaining a facade.

          Phantom limb pain, a phenomenon that occurs to amputees in which the, for lack of better wording, ‘ghost’ sensations of the lost limb spark discomfort and pain (mild, moderate, or even severe) as the brain and nerves relive a whiplash reminder that the limb is, in fact, gone. It can hit at random, but instances in which, for example, the dominant hand is gone—-and someone tosses a ball over for them to catch? The instinctual desire to grab with the missing hand will cause an odd and uncomfortable echoing feeling of an outstretched palm, usually painfully and not really right feeling, and the brain / muscle memory, in its confusion and rebounding, will try to make sense of that missing data. The nerve-endings detached from the body will, after their attempt to establish contact with the limb, declare that something is wrong, and the immediate response is typically a shoot of pain. The brain sends its regards, and decides that oh, oh my, that entire arm’s gone, that must have hurt ! The body’s way of dealing with trauma of that extent differs from person to person, but with Gin it’s more likely to strike him at night, right after waking up, or during a dream.

          Rangiku has yet to see Gin succumb to more flaring episodes, though they can become quite painful for him with the additional element of Aizen’s reiatsu lacing the wounds throughout his recovery—-something discussed in Bleach canon as an often side-effect of being cut by an overpowering reiatsu. Eventually, it’ll fade, but phantom limb pain does not disappear fully; victims of trauma very rarely 100% remove the experience from their lives, they simply learn to lessen the instances via removing triggers, using certain physical therapy practices to better align their mind and body to be on the same page (and therefore avoid the likelihood of such clashes) and other techniques that assist in the calming of their frantic nerves. A man that lost his legs 30 years ago may still experience these pains, the duration of their physical recovery, unfortunately, doesn’t play much of a part—-the problem is also rooted in the mind, and often shares those roots with PTSD.

          Gin is careful to not get outwardly angry with Rangiku, specifically at her, too—-especially when the issue at hand is absolutely not her fault. If anything, he’s more likely to become openly frustrated with himself, and by extension possibly snap at her—-but the feelings would fade fast in light of such a slip-up, and he’d immediately divert any possible implications of blame back towards himself, and it’d more than likely just cause him to become more upset and less angry, namely at his lack of overall control and composure at the moment. Gin knows Rangiku wants to help him, knows she feels probably just as helpless as he does, if not more, and he knows that everything they’re currently struggling with falls onto his shoulders. He’s tired, he’s war-torn and irreparably broken to the soul, so he won’t be perfect and his attempt to consume all blame, all negativity he cast across them both throughout the betrayal and the Winter War, will undoubtedly slip—-he wants to fall on the grenade and take the hit by himself, but it’s impossible to do so when so terribly wounded physically, mentally, and emotionally. It’d be unrealistic, then, to say that he wouldn’t start a fight between them. Probably over something trivial, like adjusting his sandals and not being able to properly tie them without a struggle.

          Gin is most likely to express his frustrations in private, though given Rangiku’s dislike of leaving him to his own devices (rightfully so, for many reasons beyond her abandonment issues) it’s also likely that she’d at least walk in on him being frustrated with himself at least once. He wouldn’t break anything—-I mean, no matter how hard you throw straw sandals, they’re pretty sturdy. Annoyingly so, Gin would think.

          That would lead to the main subject of their argument; Gin is terrible at accepting help—-not because of any amount of stubbornness, though he certainly has a fair dose of that—-rather, he absolutely doesn’t believe himself worthy of it, but simultaneously doesn’t want to openly wallow in the undeserving rut. He wants to serve his punishment on his own, he doesn’t want to further burden her, but he also has to come to accept that pushing her away will only result in more hurt—-but he doesn’t know how to accept her help. Even before his betrayal, before the whole act began, Gin always kept his struggles private. So now, the mere concept of accepting her help astounds him. How could he expect her to just pick him up when she’s in pain, too? He’s near a breakdown, he can feel it every sleepless night laying next to her, and he’s wearing thin more and more each day in this sort of numb trance—-standing at the edge of a cliff, and he doesn’t want to bring her with him when he inevitably falls. Or perhaps he’s already falling.

          He’s not very receptive to getting help, but he also is too tired to put up much resistance in light of any persisting on Rangiku’s part.

          Rangiku’s luck in being able to help Gin via his relenting would directly coincide with how worn out he is on any given day. If he’s got enough fight in him to deny her extended hand, to keep trying to accomplish the task on his own, then he will. But Gin doesn’t have much fight left in him to spare, so it’d become a case of him choosing which battles to take on his own, and which to lean onto her during. He wouldn’t like it, but he also understands that Rangiku has more stubborn fight left in her than he does, and his disadvantage would leave him to a low-energy damage control setting—-manage what he can, and pick the lesser evils for her to help him with. In the beginning, this list of difficulties would be lengthy not only due to him being at the mere start of his recovery, but because he’d be absolutely too devastated to even try to remotely care for himself.

          Adjustment to physical trauma takes time, too. Rangiku would have to help him with quite a lot in the beginning, and she’d notice a grand withdrawing the moment Gin considers himself “capable enough” to do so. Recoiling, Gin would attempt to do everything by himself initially, before learning in privacy his new limits. It’d take Rangiku approaching him first, however, for him to eventually realize that he needs to accept her help, still, in those areas. Gin was not ambidextrous. Losing his dominant hand, he Gin would have to relearn (in particular) how to write, hold chopsticks, wield a blade, and overall sharpen his remaining hand-eye coordination. It would be extremely difficult for him to tie knots without using (and having a reasonable reach to) his mouth, and therefore shihakusho would be an endeavor–Gin may still dress himself, with extra time and effort, but obi, in particular, would be extremely difficult towards impossible to properly tie with a single hand. Rangiku would need to assist him in those areas.

          Gin is not ashamed of asking for help, but more so ashamed of himself and the fact that he must rely on Rangiku after so thoroughly damaging her. It will take him longer than a few weeks to heal from that sort of shame, guilt, and deep dejection. 

[mhmulticarehomeopathy]

All You Need To Know About Ankylosing Spondylitis Ankylosing spondylitis is a long-term disease that causes inflammation of the joints between the spinal bones, and the joints between the spine and pelvis. It eventually causes the affected spinal bones to join together. The cause of ankylosing spondylitis is unknown, but genes seem to play a role. The disease most often begins between ages 20 and 40, but may begin before age 10. It affects more males than females.

Exercise is one of the best ways to ease the pain and maintain flexibility. Pain relievers and other medications also help. Ankylosing spondylitis is a chronic inflammatory disease that attacks the spine and the sacroiliac joints, causing arthritis. This can also cause inflammation of the eyes, bowels and other joints, and may induce fatigue, weight loss, and photosensitivity.

In the latter case, new bones may develop in an effort to treat the inflammations, hardening the joints and the spine rigidly. Ankylosing spondylitis affects three times as many men as women, while it takes women longer to receive a diagnosis. However, it can also affect younger people, affecting those as young as 15 years old and displaying some symptoms as early as age 10. In actuality, this kind of illness is less likely to develop in adults beyond the age of 40. What are the symptoms of ankylosing spondylitis (AS)?

Although symptoms can occur in younger children or older adults, they often start to show between the ages of 17 and 45. While some people experience severe symptoms, others just endure lesser discomfort. Symptoms may flare up (worsen) and improve (go into remission) off and on. If you have ankylosing spondylitis, you may experience: Common symptoms:

• The feeling of stiffness and pain. • Severe pain in the tendons and ligaments. • Back pain. • Loss of flexibility in the spine. • Hip pain • joint pain • neck pain • Difficulty breathing. • skin rash • Vision problems • Abdominal pain and diarrhea • fatigue How Homeopathy helps to cure Ankylosing spondylitis? Homoeopathy treats the person as whole. It focuses on patient as a person as well as pathological condition. A Remedy is selected after full indivualizing examination and case anaylsis which includes medical history of patient, physical and mental constitution etc. Homeopathic medicines along with regular physiotherapy can help manage the symptoms of ankylosing spondylitis. Homeopathic medicines majorly provide symptomatic management of pain and stiffness and work well in cases where the inflammation is detected in its early stages. Homeopathic remedy for ankylosing spondylitis can help moderate the immune system to halt the progress of the disease in the initial stages, and also help manage pain and movement. Know more: https://www.multicarehomeopathy.com/diseases/homeopathic-medicines-for-ankylosing-spondylitis-treatment

[styleatacertainage]

FASTER WAY TO FAT LOSS | PELOTON

all right, gang here’s a quick fitness update. and i’ll share what i eat on a typical day later in the post. but first things first. this girl has a BIG birthday coming up as in the big 6-0 in three short weeks. and with birthday gifts on my mind, i went ahead and splurged on a Peloton. actually, way back in January when i started my fitness journey i had my eye on this spin bike and the on-demand or live classes that come along with it. if you have never taken a spin class let me assure you it is one of the best forms of high-intensity exercise out there. it works your heart, quadriceps, hamstrings, lower legs, glutes, back and upper body. and it’s easy on your joints. most spin classes add a section of weight training where you work your arms while seated on the bike. it’s a crazy hard section even though you are working with lighter weights. maybe because you’re exhausted from the high-intensity intervals doled out throughout the class and then you work your arms. when i was in my forties i was introduced to spinning and immediately fell in love. well, it’s more like a love/hate relationship because any spin class on any given day will kick your butt to the door and back again. but you will leave class feeling as if you’ve accomplished something. it goes without saying you’ll be dripping in sweat so stay hydrated by drinking plenty of water. and i have to say i am impressed with the Peloton instructors and the variety of classes offered. there are floor exercise sessions, cool down stretches, and of course, spin classes that can be selected by length, music genre, instructor, live, on-demand, lot’s of options and endless choices. truly one of the best birthday gifts ever!

this month was the perfect month to exchange my Orange Theory workouts for Peloton as i’ve been gimping around the past few weeks. an old knee injury from college flared up and i’ve had to curtail my workouts while it’s on the mend. so i can’t say i made great progress this past month but i’m slowly ramping up my exercise routine thanks to spinning. this week will be the first time i’ve hit my goal of five workouts for quite some time and it feels good to be operating at full capacity! and, yes, five workouts are optimal three workouts are minimal to see real results. and another resounding yes it takes longer for a fifty-nine-year-old to get into shape as opposed to a thirty-nine-year-old. but it can and should be done. scientists have proven that those who exercise regularly are younger on a cellular level than those who lead sedentary or moderately active lifestyles. the good news is it’s never too late to incorporate exercise into your lifestyle. you’ll immediately start reaping the benefits. regular physical activity helps you look and feel younger and stay independent longer. it lowers your risk for a variety of conditions, including Alzheimer’s and dementia, heart disease, diabetes, certain cancers, high blood pressure, and obesity. and your mood improves too. it’s those endorphins!

what do i eat on a typical day? since i’ve joined FASTer Way to Fat Loss, i use My Fitness Pal app which tracks macros (proteins, fats, and carbs). i aim to keep all three balanced on any given day. since FASTer Way to Fat loss incorporates intermittent fasting (an eight-hour feeding window) i don’t eat my first meal until noon, right after my morning workout, which consists of a banana, kiwi, and almonds. my second meal of the day is typically my largest, and i love a chef salad that includes a hard-boiled egg, salmon or chicken, and avocados. plus a light dressing of olive oil and lemon juice. then at night, i’ll eat something light – yogurt, apple slices, edamame, sweet potatoes, or lentil salad. on the weekends i splurge a bit by adding a cafe mocha, class of wine, and consume heavier meals. all-in-all i try to keep a balanced perspective when it comes to meals and lifestyle. if i truly wanted to lose more weight all that’s necessary is to adjust my macros and keep my workouts to five or six days a week. but my goal is to be fit not to wear a specific size.

this is a photo taken right after my first workout back in January.

this is me today. Faster Way To Fat Loss Sign up

what is FASTer Way to Fat Loss? it’s an easy program to follow that lays everything out step by step. during the six-week program, you receive a full program guide complete with daily workouts, nutritional guidelines, webinars, meal plan information and access to a Facebook group to get all of your questions answered.

spin shoes are a must. guess who couldn’t resist a pop of pink?

| tank | spin shoes

this is what the Peloton monitor looks like from my perspective. you actually feel as if you’re in class. but i love the fact i can work out according to my schedule, not the gym’s schedule.

Helpful Links:

Faster Way To Fat Loss Sign up // Faster Way To Fat Loss Cookbook // Faster Way To Fat Loss Cookbook Bundle // Vegan Cookbook //

three reasons i love this program:

ONE – every detail is planned out for you. the online workouts have exact directions and links to watch the moves. but if you love working out at The Barre, or have another workout routine, you’re used to like Spin Class no problem. there are options, ladies, options. my workout routine consists of two sessions per week at Orange Theory the other three are spent in my home gym with Amanda (the mastermind behind FWTFL). the great thing about FASTer Way To Fat Loss is you can make it work with your lifestyle!

TWO – this is a lifestyle, not a diet. we use My Fitness Pal app to track calories and macros, but the mentality is progress, not perfection. the goal is to eat dairy free, grain free and gluten free as much as possible but again, there’s flexibility. do i have a cocktail or glass of wine on occasion? absolutely! did i enjoy chocolate chip cookies last weekend when one of my kiddos was home? well, i couldn’t let him eat the whole batch by himself! as i mentioned, FASTerWayToFatLoss is a lifestyle change, not a diet. this program teaches how to cut fat and gain lean muscle while still living life to its fullest.

THREE – it is a proven system that helps women and men (yes, there is a program for men) lose fat. and there’s no age limit! actually, you’ve heard me talk about the importance of exercise as we age. the amount of muscle we lose each year is alarming. you’ve heard it said “use it or lose it.” it’s true! my goal is to live the best life possible at any age. and exercise is key.

[dxmedstudent]

Hey dx. Hope you're well. I don't know if you remember this ask, but I'm the anon who asked a few months ago about supporting a friend in med school with depression and finding it a bit much. A lot has happened since then. She's sadly left med school and has been diagnosed with bipolar disorder. Currently she doesn't really have stable periods and is either high or low. I got kind of ok with having boundaries with texting etc/meet-ups only when actually able to. Part 1

Part 2. Anon supporting friend here. Recently she’s been high and has been messaging me nearly all day every day/asking if I’m there if I take time to reply/constantly updating me on what she’s doing/sending me all her family pictures. I’m finding it really stressful and overwhelming, tried turning off my notifications yesterday but still keeps going. My own anxiety is flaring up and I’m stressed hugely with workload.

Part 3. Anon supporting friend. I’ve told her I take time to reply because I’m stressed/overwhelmed and yet the messages keep coming. I know she’s hypomanic/manic so she probably sees things in a different perspective atm and forgets that it’s too much. I’m wondering whether it’s worth asking her to please message a little less as I find it overwhelming to get so many messages each day, or whether it will just not work as she isn’t in her right mind. Part 4. She has got professional help in place. She’s fallen out with her other friends because they don’t message her when she’s low etc/her best friend has distanced herself from her because she doesn’t know what to say. I don’t want to not be friends but I need to work something out! I’m trying to remember she’s ill but I’m starting to feel unwell too. Any advice?! PS. I know this is an extremely long ask and that you’re very busy, so please take your time if you need            

Hey, I’m glad to hear from you again. I’m so sorry for my late reply; I rread your ask at the time, and thought about it a lot. But I had to take some time to process my own life problems and mental health, and I couldn’t really give most of my asks the time or energy they deserved, so I had to leave them until they could. Which is kind of the theme of this ask, ironically. But I hope late is better than never.  Thank you for your message at the end of your ask, it’s very much appreciated :) I’m so sorry that your friend’s going through a rough time, and that you are, too. I’m so sorry to hear that she left med school; bipolar is a truly difficult illness, she has been on a really tough journey.  I’m glad she has professional support; that’s always a huge deal because the right treatment and support can revolutionise people’s lives. I’ve seen it, and though I don’t think the way we treat mental health is perfect, I do think we can do so much good by acknowledging mental illness and treating it properly. And taking people seriously. I’m glad to hear you started to work out some boundaries that worked for you; it’s tough, but it’s good to hear that you made some progress, even if it doesn’t always work out as  well as you hope, it’s still progress. You’re right to put your own wellbeing first; it’s hard for us to support others if we’re being brought to a mental breakdown ourselves. It’s a hard lesson for us to learn, but you can’t serve others with a broken/empty cup. I think it’s a really fair idea to turn off notifications to avoid overloading yourself. She can keep going; thats OK. You can’t control your friend’s mania, or how ‘full on’ they are; perhaps not even they can. Unfortunately, that’s part of the illness. And it seems you understand that well, deep inside. She might process things differently, and I think you’re an excellent friend for doing your best to support them, and understand what they are going through. I’m putting this under a cut because it’s long.

Everyone reacts differently to being told the truth, so only you will know how they might respond. Sometimes we can just tell people ‘sorry, I’m not feeling well so I might not respond much’. Sometimes we invent excused to be kind or because we aren’t ready to talk about the entire story; in my view, in personal* settings, it’s OK to tell white lies not to hurt people sometimes. I’ve told friends I’ve been sick or oncall when I couldn’t attend events because I was physically exhausted or not feeling well, because I really cared about seeing them but didn’t want them to think I was not coming because I was not bothered. However, with close friends I’m honest, and the vast majority of the time, if I say I’m oncall, it’s because I’m actually oncall. I don’t like fibbing, and I don’t like hurting people’s feelings, so it’s a fine line, but I’d rather feel a bit guilty than make others feel bad. It might be OK if you tell her that you sometimes need time to reply because you are overwhelmed; have you ever discussed your own mental health issues with them? Do they get that you get really anxious or overwhelmed? It might depend on how much insight they have into their own state right now, and perhaps it’d be difficult for them to moderate how they act, or how they feel about it.  However, if you find yourself having to take quite a bit of time to yourself, don’t feel shy to just tell them “I’m not ignoring, you, I just wasn’t feeling well and had to take a break, I’m listening now”. Or you could say “I care about all your messages, and I always read them all, but sometimes I can’t reply to them all at once because I’m busy/overwhelmed/tired/unable to process it all”. If they get upset because you haven’t replied, it might help to reassure them that you do care (because this is, deep down, what they fear”, and that you care about their wellbeing, but that other issues in your life have been stressing you out, too. And that you just didn’t want to bother them with your stress, so needed to take some time out. There are ways of discussing it that don’t outright lay the blame on them, or make out that they are the cause of your problems, when it’s not true, and therefore avoids making them feel guilty for things outside of their control. Something can be not the cause of our problems/stress and still be overwhelming, and if you’re able to be honest with them, I think that’s a good way to put it across.  As well as the idea that in order to be truly there for them, and have enough energy and time to be able to support them, sometiems you need to take time out to process the other things in your life. Work, uni, family, love life, etc, whatever it is. Telling someone “I have a lot of thigns in life that are stressing me out, and draining my energy, and sometimes I need to take some time out to process/fix them, and rest before I can chill with you and help you, and be happy with you, because otherwise I’d spend my time with you stressed and miserable and might make you feel worse” makes sense. I can’t say if that would work for your friend, but I feel a lot of people would understand that. In the end, I am sure they care about you, too. But because of their own illness and issues, deep down they are probably terrified of losing you too. They know that their illness can make things harder for them, harder for those around them, and they probably feel really bad about that; we all beat ourselves up over stuff like that. Reminding them that you care, and want to be there, and want to be strong and rested so you don’t bring them down with your own problems is actually a kindness to them. I remember publishing a similar ask/anwer/post by someone else who answered a similar question, because it reminded me of you and your ask. I hope you saw that, it might be tagged under my #mental health and medicine tag. You come across as a supportive, loving friend who is doing their best, please don’t feel guilty if you have to put yourself first. I hope you and your friend take the time you need to heal. * In professional settings, we’re bound by the rules of probity. We don’t lie in medicine. TBH my parents raised us to NEVER LIE, which makes working in medicine easier because I’m a terrible gulty fibber who likes to follow all the rules and who doesn’t even like parking in the wrong place, much less anything exciting.            

[spectrumpsp]

WHAT IS SUBSTANCE ABUSE AND HOW DOES IT RELATE TO OPIOID USE DISORDER?

Substance abuse is characterized as a substance or drug used to support temperament, modify or oversee social changes, and keep psychological circumstances stable. Substance misuse will in general change unexpected emotional episodes, yet in a way that isn’t lawfully worthy; additionally, utilizing these meds brings about trading off well being or destructive to oneself or others. Substance misuse related with narcotics use, notwithstanding, can prompt narcotic use issue, manifestations of an illness at any rate two of the accompanying in a time of a year:

Narcotics utilize inordinate sums or for a more broadened period than at first planned.

Determined wish to lower, or pointless endeavors to scale back

Essential, span is spent procuring or taking the narcotic or returning from its belongings.

Serious needing, or overwhelming longing or firm impulse to utilize

Intercedes with duty

Use in spite of information on having steady or insecure physical or mental issues probably delivered or compounded by the narcotic.

Social and expert life, work, or sporting exercises are dismissed or less due to narcotic use.

Narcotics are taken in circumstances where use is truly hazardous.

Withstand to narcotics, characterized by the wish for perceptibly upgrade amount to accomplish inebriation or requested impact or moderately lessened impact with customary take a similar sum

Note: This model isn’t considered for patients utilizing narcotics solely under reasonable medication.

Withdrawal, as appearing by certain side effects

Tension

Anxiety

Rhinorrhea

Lacrimation

Widened students

Queasiness

Spewing

Looseness of the bowels

Stomach cramps

Narcotics are utilized to part with solace or keep from withdrawal side effects

Note – Should keep in thought that this rule may not be taken as indications of maltreatment in all patients, notwithstanding, aside from an indication of actual reliance and may not be proper for patients utilizing narcotics only under reasonable clinical management.

The United States is over the span of a disturbing general well being flare-up of narcotic use DISORDER. The 2015 National Survey on Drug Use and Health review shows that 3.8 million Americans take narcotics for non-clinical reasons occasionally. Medication abuse is the essential driver of unexpected passing. In 2015, 63.1% of medication glut passings required a narcotic.

Controlling agony in patients with a new or previous history of a narcotic use issue (OUD) is troublesome. Patients disappearing are frequently terrified of taking narcotics, in any event, when they had horrifying agony close to the most recent long periods of life. Then again, patients continually condemning narcotics are trying to assess appropriately and may not utilize enough suggested narcotics or different prescriptions. Patients with dynamic OUD ought to be demonstrated to a proper enslavement treatment facility. It isn’t proposed to begin narcotic treatment for a patient ingesting medications to keep an OUD rather than a controlled guess or an intense torment issue (for example broken bone).

Prescriptions That Approved For Opioid Use Disorder And Their Comparision

Patient JB’s drug, Butrans, comprises of buprenorphine, a blended agonist-adversary opiate. When blended in with naloxone, an opiate adversary, the medication is proposed for patients with a background marked by substance maltreatment to debilitate habit and narcotic use abuse. It ought to be focused on that items with opiate rivals, similar to naloxone, are NOT suggested for torment. Buprenorphine without anyone else is fitting for both narcotic agonist reliance AND agony. As opposed to full narcotic agonists (for example methadone, morphine, oxycodone), buprenorphine’s restricted movement at the narcotic receptors predicts a roof to its pharmacological impacts – this implies that the danger of excess, misuse, and poisonousness from buprenorphine is low when contrasted with full narcotic agonists (something positive for narcotic reliance) anyway it isn’t useful for advance degrees of agony requiring > 80mg of oral Morphine identical to soothe.

Buprenorphine

Sign 1 – Pain – Transdermal (TD) fix (Butrans®), transmucosal (Belbuca®), IM/IV (Buprenex®)

Suggestion 2 – Opioid agonist reliance – TD fix, the subdural embed (Probuphine®), sublingual tablet (Subutex®)

The manner in which it works – Mixed narcotic agonist-rival

Advantage(s) – Easier to restrict potential and tighten than methadone; powerful in pregnancy differentiation to blend buprenorphine-naloxone

Drawback – Can welcome on withdrawal; More maltreatment probability contrasted with mix buprenorphine-naloxone

Changing from OME to Buprenorphine transdermal fix (Butrans) – A buprenorphine to OME (in mg) modifying proportion of 1:75 has been suggested by well-qualified assessment late years, writing has elevated reaches from 1:70 to 1:100.7 make utilize a transformation proportion ought not substitute clinical judgment. Keep note that the TD fix is in “mcg/hr,” and the equilibrium is in “mg/day.” Butrans recommending data for sign,

Changing From OME To Buprenorphine buccal film (Belbuca) – Belbuca proposing subtleties for suggestions

Changing over from OME to Buprenorphine sublingual tablet (Subutex) – Off-mark take as this dose structure isn’t officially suggested for torment, and information is tight on this sign. A buprenorphine to OME (in mg) change proportion of 0.4:30 has been suggested by well-qualified assessment in the documentation. In any case, it ought not supplant clinical judgment. There is no writing on a progress From SL buprenorphine To other narcotics. Attempting to change over SL buprenorphine to substitute narcotics utilizing the proportion above isn’t recognized as it generally yields a bigger than anticipated narcotic portion/day.

Methadone (Dolophine, Methadone)

Suggested – (1) Pain (2) Opioid agonist fixation

Working strategy – Opioid agonist; impolite narcotic over-energized impact because of uninvolved beginning and removed eventual fate of activity; smother withdrawal and longing for

Advantages – Most sensible; medication of decision in pregnancy

Drawback – The more critical chance of CNS and respiratory inconvenience and QTC delaying; Abuse potential; Drug collaborations

Switching back and forth between oral morphine counterparts (OME) – The transformation proportion From OME To methadone is changing and depend on a few components dependent on the picked technique/model for changing and suggesting for use

Buprenorphine-naloxone (Suboxone, Zubsolv, Bunavail)

Proposal – Opioid agonist depend upon

Working example – Buprenorphine is a blend narcotic agonist-rival; Naloxone is a narcotic adversary

Utilizations – Conveniently to assess and tighten than methadone – When to take sublingually or buccally, naloxone result is less because of low assimilation; If not use as expected by infusion, naloxone may gag the result of buprenorphine which improve the likelihood for withdrawal.

Disadvantages – Can achieve withdrawal; matter that naloxone may reason withdrawal in hatchling for pregnant patients; NOT prudent for torment

Changing between oral morphine counterparts (OME)

Naltrexone (ReVia , Vivitrol)

Suggestion – Opioid agonist reliance

The manner in which it works – Opioid rival

Utilizations – Cannot be abused; reasonable choice for incredibly stimulus patients

Disadvantage – Can assist withdrawal in patients who have not been landmass from fast acting narcotics for at any rate seven days and at any rate ten days from gradually powerful narcotics; NOT recommended for torment

The change between oral morphine counterparts (OME)

What is some standard misconception for patients with torment and narcotic use abuse?

Misguided judgment – The continuation of narcotic agonist (methadone or buprenorphine) is providing absense of pain

Realities – For patients being assessed completely for narcotic use abuse, meds are exhorted at less portions just to put down withdrawal, not for absense of pain

Misinterpretation – use of narcotics for absense of pain may cause reliance backslide

Realities – There is no sign to encourage that revelation to narcotic analgesics for serious torment upgrades the pace of backslide. Then again, hypotheses suggest that pressing factor related with total agony is likely to set off backslide.

Confusion – The extra impacts of narcotic analgesics and medicine for narcotic use may bring about serious CNS and respiratory inconvenience

Realities – For patients being considered for narcotic use problem on a save portion, strength to CNS and respiratory impacts for safeguarding amount has so far occurred. The utilization of brief narcotic analgesics under clinical watch (notwithstanding the save portion) has not been clinically uncovered to achieve intense medication poisonousness.

Misguided judgment – Pain disappointment is drug-chasing conduct

Realities – Pain is surprisingly natural. A cautious clinical appraisal of target affirmation for agony will be expected to assess the difference among torment and medication looking for conduct.

How Might Pain Be Treated In Patients Using Burenophine For Opioid Use Disorder?

Torment Evaluation

Execute a record of over a wide span of time, alongside sum utilized, of tobacco, liquor, remedy, and sporting medication misuse AND utilize a validate screening instrument to assess the danger of narcotic abuse (for example Screener and Opioid Evaluation for Pain Patients (SOAPP) and the Opioid Risk Tool (ORT)

Separate dynamic substance use, in danger practices, recuperation, and enlistment in a treatment program.

Evaluate for fretfulness and tension, or other likely reasonable mental confusion, which is generally both in serious torment and those with SUDs

Assess for ongoing utilization of tranquilizers (like muscle relaxants and benzodiazepines)

Essential Management

Delineate treatment supposition

Reference to a consolidate trained professional/facility, it is feasible to supply a multi-disciplinary point of view. On the off chance that the patient is so far under expert practice, ask the group’s recommendation on the consideration plan.

Continue with narcotic use problem treatment portion or portion identical to upgrade withdrawal

Utilize a composed narcotic understanding that comprises of safe application and impacts. This may concede force people a feeling of command over their SUD. A constituent of a narcotic arrangement comprises of: Start a solitary narcotic prescriber, utilizing a solitary drug store, utilizing pill checks and occasional pee drug testing.

Consider checking your state’s physician recommended drug observing system to ensure that the patient isn’t getting idea from other prescribers

Respect non-pharmacologic and non-narcotic treatments (i.e., active recuperation, needle therapy, skin cures, NSAIDs) first.

Treatment

At the point when placed in narcotics for painkilling, cross-resistance most likely required raised dosages for satisfactory help with discomfort.

Effective narcotics are recommended on a booked premise (not depending on the situation), explicitly for patients with nervousness about torment.

On the off chance that the patient is hospitalized with extreme agony, his or smooth out narcotic need can be controlled, and narcotic withdrawal can be halted by changing over buprenorphine to methadone at 30 to 40 mg/day. On the off chance that narcotic withdrawal proceeds with standard day by day methadone portions can be extended in 5 to 10mg augmentations—this strategy grant titration of the narcotic pain relieving for torment control in the absence of narcotic withdrawal.

Observing

For patients with substance misuse confusion in suspension, the objective (similarly as with some other patient in torment) is to supply sufficient relief from discomfort and spotlight on turning away backslide. Backslide is had an impact in intrapersonal and relational stressors (for example torment related diminished personal satisfaction, overlooked melancholy, enthusiastic and social nervousness) and the failure to utilize a beneficial adapting reaction.

Ceaselessly ask about different substances or utilize their agony medicine to secure high or adapt to stressors – remember them that these are questions requested from all patients.

Ordinary contact or visits license for close tolerant assessment and proposal of restricted amounts of narcotics.

Reexamine narcotic arrangement

To perceive backslide, screening devices, for example, pee drug screenings and proposal checking projects can be utilized. On the off chance that degeneration is perceived and narcotic detoxification is attempted, gradually tighten narcotic portion (generally close to 20-25% like clockwork) to lessen withdrawal manifestations and afterward quit utilizing. It is difficult to keep support endeavors towards recuperation and keep oversee narcotic access. Backslide ought not be respected a treatment disappointment however is a piece of the interaction of progress from an addictive infection to oversee torment the executives.

Consider that impulse is a persistent, backsliding sickness – and react with rising construction and sympathy.

Evaluation and Management – Patient Case

Assessment of JB utilizing the Opioid Risk Tool shows that the danger of abuse is low. JB was analyzed for uneasiness and sorrow upon entrance and is dealt with well on bupropion and as of late isn’t exhorted anxiolytics or muscle-relaxants. Non-narcotic torment treatments have been tried comprising of naproxen and now dexamethasone however are not completely satisfactory “old” serious back torment, “new” bone agony, nor dyspnea.

The hospice talk with JB and her guardian that narcotic treatment seemed the worthwhile alternative to decrease both her old and new side effects. The Butrans 15mcg/hr fix is limited for the agony she is confronting, and torment may torment, further narrowing its utilization. JB acquiesce to narcotic treatment. Suppositions of JB and her parental figure are then assessed, and bearings on legitimate removal of undesired prescriptions. A patient-supplier concession to narcotic safe practices and results is applied. Drug direction is as per the following:

Day 1 – Drop Burtons to 10mcg/hr with beginning of Morphine (Roxanol) 20mg/mL oral aggregate at a portion of 0.25mL (5mg) PO at regular intervals needed for torment.

Days 4-7 – Reduce Butrans to 5mcg/hr and assess the utilization of advancement morphine and direct portion/routine correspondingly.

Day 8 or Later Unfasten – Butrans fix and start booked utilization of Morphine. Thought can be made as of now for beginning methadone planned treatment for torment or another long-acting narcotic. Methadone is practical as it controls blended kinds of agony, is associated with less maltreatment probably contrasted with other narcotics, and JB isn’t a threat for drug-illness connections. Bupropion represents a normal medication drug trade bringing about expanded degrees of methadone; by and by, a methadone portion equilibrium can be made to represent this communication at the hour of portion change.

[divinezodiac]

Health Advice for the Signs

**Check your Sun sign, your Sun sign’s polarity, and your Ascendant

Aries: The head is ruled by Aries. They are susceptible to a lot of headaches, migraines, and sinus issues, and could be susceptible to minor head and facial injuries, too. Arians are also prone to eye strain and problems with the teeth, and they have a tendency to overwork themselves. Arians easily get red in the face when they’re excited or angry, and when they have a fever, it often becomes very high in a very short amount of time. 

Advice: Use protective headgear if you’re participating in strenuous sports. Be sure to take breaks when working, and don’t try to take on more than you can handle. Eat meals in a serene atmosphere. Drink plenty of water and rest often. 

Taurus: The throat and neck are ruled by Taurus. Taureans may be subject to a sore throats, colds, laryngitis, thyroid problems, swollen glands, stiff necks (especially when they’re stressed) and other minor afflictions. They’re also prone to tonsillitis and ear aches. Taureans’ keen taste buds lead to a love of food, and that, paired with possible problems with the Thyroid gland, which is also ruled by Taurus, as well as a generally sedentary lifestyle, can cause weight gain. Because they are ruled by Venus, Taureans may also have back strain. 

Advice: Bundle up during the winter to avoid getting sick. Be careful of your eating habits. Remember everything should be done in moderation. Take walks outside to keep yourself active. Take the time to give yourself a quick massage or do some stretches if you’re experiencing neck or back pain. 

Gemini: The hands, arms, shoulders and lungs are ruled by Gemini. Geminis may have problems with respiratory disease and may be prone to bronchitis and asthma, as well as difficulty breathing when stressed. They’re susceptible to accidents involving the hands such as sprained wrists, jammed fingers, and broken bones, as well as minor bruises, scrapes and cuts. Gemini is ruled by Mercury, which rules the brain and nervous system, so Geminis may also be prone to anxiety and nervousness, which can make them physically sick. 

Advice: Because your ruling planet, Mercury, is associated with the brain and nervous system, your mental health is tied to your physical health. Meditation, yoga, or even some simple breathing exercises would be beneficial to your overall health. Smoking tobacco is especially detrimental to Geminis, so avoid that. Playing sports such as tennis or ping pong will help strengthen the arms. 

Cancer: The breasts and stomach are ruled by Cancer. Cancerians could be susceptible to weight gain in later years, and it may be hard for them to lose that excess weight. They are prone to stomach and digestive problems such as ulcers, gallbladder issues, and nausea. Cancerians are likely to overindulge in wine and alcohol, which causes further stomach problems as well weight gain and water retention. Tension, anxiety, and high emotions are likely to cause illness in those born under this sign. 

Advice: Eat your meals in pleasant surroundings—no arguing at the table. Take a walk afterwards to aid in digestion. Walking in a warm rain or by the sea will soothe the lungs, as the air is moist.

Leo: Leo rules the back, spine, and heart, and those born under this sign may have problems with the back and spine due to physical and emotional strain as well as overexertion. They’re especially susceptible to upper back pain and pressures and pains around the heart. They may have heart problems later in their lives. 

Advice: Avoiding lifting heavy objects and doing stretches for the back would be beneficial. Try and maintain good posture as well, and make sure to get enough rest and relaxation. Sunbathing is a good way to do so. 

Virgo: Virgo rules the nervous system and intestines. Virgoans are worriers, and their nervous tension, anxiety, and emotional stress easily become physical ailments, usually intestinal, as they have sensitive stomachs and are prone to ulcers, indigestion, liver and bowel problems.  

Advice: Herbal tea eases the stomach. Light but regular exercise, periods of relaxation, and sunshine are helpful in getting Virgoans to stop worrying and destress, at least for a little while.

Libra: The lower back, butt, and kidneys are ruled by Libra, and Venus, Libra’s ruler, rules the throat, skin, hair, and veins along with those regions as well. Librans are prone to lower back pain (especially when they’re stressed) as well as kidney problems, such as infections, and sensitive skin, along with breakouts. Librans may have delicate immune systems as children, but it usually evens out as they age. 

Advice: Drink lots of water and avoid excessive alcohol and carbonated drinks as they are bad for both the skin and the kidneys. Mild exercise, back stretches, and good posture are all beneficial for Librans, and you should try to keep both your surroundings and your company pleasant and harmonious.

Scorpio: Scorpio rules the genitals, and Scorpios may have problems with urinary tract infections and genital infections—skin flare ups, cystitis, and other ailments. They may also experience exhaustion and ill health due to their own volatile emotions and inability to rest and relax, and suppression of those emotions as well as sexual frustration can lead to cruel and erratic behavior.

Advice: Take time to relax and process your emotions. Don’t bottle your feelings up; take time to exercise, and keep your surroundings peaceful. As you are one of water signs, you Scorpios benefit from taking trips to the sea, soaking in the bath, and drinking spring water opposed to tap water. 

Sagittarius: Sagittarius rules the liver, hips, and thighs. Sagittarians have sensitive livers, and they may be susceptible to overuse of alcohol and to hepatitis, since their ruling planet, Jupiter, governs the liver. They also may be susceptible to gaining weight in their later years, especially around the hips and thighs. They also are prone to chronic aches, fractures, sprains, and bruising in this area. 

Advice: You Sagittarians absolutely need exercise, fresh air, and sunshine daily, and you benefit from being around nature, but beware of the effect of the sun and wind, and be careful when walking, riding, or playing sports that you don’t injure your hips and thighs. 

Capricorn: The bones, joints, and knees are ruled by Capricorn. They may be prone to knee injuries and pains, stiff joints, arthritis, rheumatism, and orthopedic problems. Capricorn’s ruler, Saturn, governs the gallbladder, spleen, bones, skin and teeth. Capricorns’ teeth tends to need a lot of care, and their skin tends to be dry. Their own pessimism and worrying can cause body aches and drained energy. 

Advice: Be careful in the sun to avoid skin damage, and be sure to keep warm during cold or wet weather. Try to keep good posture, but don’t walk too stiffly. Colorful surroundings, flowers, good friends, and good music are sure to lighten your mood when you’re feeling low. 

Aquarius: Aquarius rules the circulatory system, shins, calves, and ankles. The lower part of the leg is more susceptible to cuts, bruises, sprains, and fractures than any other part of the body, and the ankles may be prone to swelling. Aquarians may suffer circulatory problems, low blood pressure, anemia, and hardening of the arteries, and cold weather is particularly hard on them. 

Advice: You Aquarians need fresh air and exercise to release tension and increase energy. Brisk walks are good for circulation, but avoid running, as you’re likely to trip and fall. Elevate legs to counteract puffiness. Afternoon naps are good for vitality, but avoid drinking excessive amounts of coffee as it makes you nervous. 

Pisces: The feet are ruled by Pisces. They may be prone to aches, bunions, corns, and callouses, as well as athlete’s foot and other fungal infections. Pisceans often afflicted by bruised, stubbed, or broken toes, and are prone to gout too. Pisceans find it hard to stand for long periods of time, and they have problems with ill fitting shoes. They also experience emotion related illnesses as they are one of the water signs. Pisceans may be more likely than others to fall prey to alcohol and drugs.

Advice: You Pisceans should keep a well balanced diet, a mild exercise regime, and be sure to get enough rest so that you can keep up your vitality. Dancing and swimming are good exercises for those of you born under this sign. Be sure to take care of your feet and wear comfortable shoes. A warm footbath before bed aids in relaxation and a good night’s sleep.  

[wtfzodiacsigns]

Health Advice for the Signs

**Check your Sun sign, your Sun sign’s polarity, and your Ascendant

Aries: The head is ruled by Aries. They are susceptible to a lot of headaches, migraines, and sinus issues, and could be susceptible to minor head and facial injuries, too. Arians are also prone to eye strain and problems with the teeth, and they have a tendency to overwork themselves. Arians easily get red in the face when they’re excited or angry, and when they have a fever, it often becomes very high in a very short amount of time.

Advice: Use protective headgear if you’re participating in strenuous sports. Be sure to take breaks when working, and don’t try to take on more than you can handle. Eat meals in a serene atmosphere. Drink plenty of water and rest often.

Taurus: The throat and neck are ruled by Taurus. Taureans may be subject to a sore throats, colds, laryngitis, thyroid problems, swollen glands, stiff necks (especially when they’re stressed) and other minor afflictions. They’re also prone to tonsillitis and ear aches. Taureans’ keen taste buds lead to a love of food, and that, paired with possible problems with the Thyroid gland, which is also ruled by Taurus, as well as a generally sedentary lifestyle, can cause weight gain. Because they are ruled by Venus, Taureans may also have back strain.

Advice: Bundle up during the winter to avoid getting sick. Be careful of your eating habits. Remember everything should be done in moderation. Take walks outside to keep yourself active. Take the time to give yourself a quick massage or do some stretches if you’re experiencing neck or back pain.

Gemini: The hands, arms, shoulders and lungs are ruled by Gemini. Geminis may have problems with respiratory disease and may be prone to bronchitis and asthma, as well as difficulty breathing when stressed. They’re susceptible to accidents involving the hands such as sprained wrists, jammed fingers, and broken bones, as well as minor bruises, scrapes and cuts. Gemini is ruled by Mercury, which rules the brain and nervous system, so Geminis may also be prone to anxiety and nervousness, which can make them physically sick.

Advice: Because your ruling planet, Mercury, is associated with the brain and nervous system, your mental health is tied to your physical health. Meditation, yoga, or even some simple breathing exercises would be beneficial to your overall health. Smoking tobacco is especially detrimental to Geminis, so avoid that. Playing sports such as tennis or ping pong will help strengthen the arms.

Cancer: The breasts and stomach are ruled by Cancer. Cancerians could be susceptible to weight gain in later years, and it may be hard for them to lose that excess weight. They are prone to stomach and digestive problems such as ulcers, gallbladder issues, and nausea. Cancerians are likely to overindulge in wine and alcohol, which causes further stomach problems as well weight gain and water retention. Tension, anxiety, and high emotions are likely to cause illness in those born under this sign.

Advice: Eat your meals in pleasant surroundings—no arguing at the table. Take a walk afterwards to aid in digestion. Walking in a warm rain or by the sea will soothe the lungs, as the air is moist.

Leo: Leo rules the back, spine, and heart, and those born under this sign may have problems with the back and spine due to physical and emotional strain as well as overexertion. They’re especially susceptible to upper back pain and pressures and pains around the heart. They may have heart problems later in their lives.

Advice: Avoiding lifting heavy objects and doing stretches for the back would be beneficial. Try and maintain good posture as well, and make sure to get enough rest and relaxation. Sunbathing is a good way to do so.

Virgo: Virgo rules the nervous system and intestines. Virgoans are worriers, and their nervous tension, anxiety, and emotional stress easily become physical ailments, usually intestinal, as they have sensitive stomachs and are prone to ulcers, indigestion, liver and bowel problems.  

Advice: Herbal tea eases the stomach. Light but regular exercise, periods of relaxation, and sunshine are helpful in getting Virgoans to stop worrying and destress, at least for a little while.

Libra: The lower back, butt, and kidneys are ruled by Libra, and Venus, Libra’s ruler, rules the throat, skin, hair, and veins along with those regions as well. Librans are prone to lower back pain (especially when they’re stressed) as well as kidney problems, such as infections, and sensitive skin, along with breakouts. Librans may have delicate immune systems as children, but it usually evens out as they age.

Advice: Drink lots of water and avoid excessive alcohol and carbonated drinks as they are bad for both the skin and the kidneys. Mild exercise, back stretches, and good posture are all beneficial for Librans, and you should try to keep both your surroundings and your company pleasant and harmonious.

Scorpio: Scorpio rules the genitals, and Scorpios may have problems with urinary tract infections and genital infections—skin flare ups, cystitis, and other ailments. They may also experience exhaustion and ill health due to their own volatile emotions and inability to rest and relax, and suppression of those emotions as well as sexual frustration can lead to cruel and erratic behavior.

Advice: Take time to relax and process your emotions. Don’t bottle your feelings up; take time to exercise, and keep your surroundings peaceful. As you are one of water signs, you Scorpios benefit from taking trips to the sea, soaking in the bath, and drinking spring water opposed to tap water.

Sagittarius: Sagittarius rules the liver, hips, and thighs. Sagittarians have sensitive livers, and they may be susceptible to overuse of alcohol and to hepatitis, since their ruling planet, Jupiter, governs the liver. They also may be susceptible to gaining weight in their later years, especially around the hips and thighs. They also are prone to chronic aches, fractures, sprains, and bruising in this area.

Advice: You Sagittarians absolutely need exercise, fresh air, and sunshine daily, and you benefit from being around nature, but beware of the effect of the sun and wind, and be careful when walking, riding, or playing sports that you don’t injure your hips and thighs.

Capricorn: The bones, joints, and knees are ruled by Capricorn. They may be prone to knee injuries and pains, stiff joints, arthritis, rheumatism, and orthopedic problems. Capricorn’s ruler, Saturn, governs the gallbladder, spleen, bones, skin and teeth. Capricorns’ teeth tends to need a lot of care, and their skin tends to be dry. Their own pessimism and worrying can cause body aches and drained energy.

Advice: Be careful in the sun to avoid skin damage, and be sure to keep warm during cold or wet weather. Try to keep good posture, but don’t walk too stiffly. Colorful surroundings, flowers, good friends, and good music are sure to lighten your mood when you’re feeling low.

Aquarius: Aquarius rules the circulatory system, shins, calves, and ankles. The lower part of the leg is more susceptible to cuts, bruises, sprains, and fractures than any other part of the body, and the ankles may be prone to swelling. Aquarians may suffer circulatory problems, low blood pressure, anemia, and hardening of the arteries, and cold weather is particularly hard on them.

Advice: You Aquarians need fresh air and exercise to release tension and increase energy. Brisk walks are good for circulation, but avoid running, as you’re likely to trip and fall. Elevate legs to counteract puffiness. Afternoon naps are good for vitality, but avoid drinking excessive amounts of coffee as it makes you nervous.

Pisces: The feet are ruled by Pisces. They may be prone to aches, bunions, corns, and callouses, as well as athlete’s foot and other fungal infections. Pisceans often afflicted by bruised, stubbed, or broken toes, and are prone to gout too. Pisceans find it hard to stand for long periods of time, and they have problems with ill fitting shoes. They also experience emotion related illnesses as they are one of the water signs. Pisceans may be more likely than others to fall prey to alcohol and drugs.

Advice: You Pisceans should keep a well balanced diet, a mild exercise regime, and be sure to get enough rest so that you can keep up your vitality. Dancing and swimming are good exercises for those of you born under this sign. Be sure to take care of your feet and wear comfortable shoes. A warm footbath before bed aids in relaxation and a good night’s sleep.  

Source: divinezodiac