#real information

[goodluckclove]

clove. I know that you're an expert on cars. What is the best car

I'm so glad you finally brought up my expertise on cars! No one's bothered to ask me yet, but I'm actually a car expert given that my dad is, in fact, Lightning McQueen. You might know him better as the car that voices actor Owen Wilson.

See the thing about cars is that they're delicious, but only if they're ripe. And people don't like to admit that because they're cowardly and hollow-boned, with their pants full of piss and shame. You want a car that prioritizes moisture, gaminess, and overall mouth-feel, and I found the secret to getting all your meds met is finding a model with the right angles (you fellas know what I'm talking about).

This isn't something I should be saying freely, but I know for a fact that the best and most delicious car is the Cybertruck Foundation Series. There's a pretty intense crust, but once you bite through the snap is fantastic and the inner meat is unbelievably tender. Think a creme brulee mixed with a waygu steak. It's incredible.

[blogparanormalexpresso2stuff]

The single PDF is at the link below:

That PDF can also be found at the bottom of the main page of the archive, i.e. at the bottom of: 

[mylovelyrainblog]

“disinformation containing violence”

This is suspicious. I have a right to suspect that real civilian reportings containing graphical information will also be removed under this flag. However, this is the digital age. Cover-ups don’t work that well. The world is also not actually flat.

Remember. Just a few years ago, a lot of major media outlets all called Covid a ‘misinformation’ at first. They also said masks aren’t effective quoting some medical experts. I remembered clearly how ridiculous it was until they took a U-turn. It all happened just three years ago. Do you think people have such short memory spans or that they all have a collective loss of memory?

This is why browsing “rumors” is important. You can equip yourself with strong suspicion and use abundant discretion towards any unreliable source, but you gotta browse them. To compensate for biased omittences. You can never trust one group of information outlets fully. This much I have learned.

[captainsaltypear]

IS ANYONE ELSE GONNA TALK ABOUT THIS OR

[sweetfeet87]

The best way to tell if a loaf of bread is done is to stick your dick in it

[chloesimaginationthings]

Michael Afton draws FNAF tape girl for Vanessa,,

[msilr]

Fascinating info about weight-loss medication.

Because my most popular post is about weight loss and how it's a crock, I get a lot of questions about various things, including bariatric surgery--just posted the link to the post I did about that--but also Ozempic/Wegovy, the once-weekly injectable semaglutide medication that was developed for diabetes but was found to have independent benefits on weight loss.

I always said that weight loss was like Viagra: when a medication came along that actually worked, it would explode. We'd all hear about it. Fen-phen in the 90s worked, but it was bad for your heart. Stimulants, like meth, may cause weight loss, but they do it at the cost of heart health, and raise your likelihood of dying young. Over the counter weight loss supplements often contain illegal and unlisted thyroid hormone, which is also dangerous for the heart if taken in the absence of a real deficiency. Orlistat, or "Alli," works the same way as the Olestra chips Lays made in the 1990s--it shuts off your ability to digest fats, and the problem with that is that fats irritate the gut, so then you end up with fatty diarrhea and probably sharts. Plus Alli only leads to 8-10lbs of weight loss in the best case scenario, and most people are not willing to endure sharts for the sake of 8lbs.

And then came the GLP-1 agonists. GLP stands for glucagon-like peptide. Your body uses insulin to make cells uptake sugar. You can't just have free-floating sugar and use it, it has to go into the cells to be used. So if your body sucks at moving sugar into the cells, you end up with a bunch of glucose hanging out in places where it shouldn't be, depositing on small vessels, damaging nerves and your retinas and kidneys and everywhere else that has a whole lot of sensitive small blood vessels, like your brain.

Glucagon makes your liver break down stored sugars and release them. You can think of it as part of insulin's supporting cast. If your body needs sugar and you aren't eating it, you aren't going to die of hypoglycemia, unless you've got some rare genetic conditions--your liver is going to go, whoops, here you go! and cough it up.

But glucagon-like peptide doesn't act quite the same way. What glucagon-like peptide does is actually stimulating your body to release insulin. It inhibits glucagon secretion. It says, we're okay, we're full, we just ate, we don't need more glucagon right now.

This has been enough for many people to both improve blood sugar and cause weight loss. Some patients find they think about food less, which can be a blessing if you have an abnormally active hunger drive, or if you have or had an eating disorder.

However, every patient I've started on semaglutide in any form (Ozempic, Wegovy, or Rybelsus) has had nausea to start with, probably because it slows the rate of stomach emptying. And that nausea sometimes improves, and sometimes it doesn't. There's some reports out now of possible gastroparesis associated with it, which is where the stomach just stops contracting in a way that lets it empty normally into the small intestine. That may not sound like a big deal, but it's a lifelong ticket to abdominal pain and nausea and vomiting, and we are not good at treating it. We're talking Reglan, a sedating anti-nausea but pro-motility agent, which makes many of my patients too sleepy to function, or a gastric pacemaker, which is a relatively new surgery. You can also try a macrolide antibiotic, like erythromycin, but I have had almost no success in getting insurance to cover those and also they have their own significant side effects.

Rapid weight loss from any cause, whether illness, medication, or surgery, comes with problems. Your skin is not able to contract quickly. It probably will, over long periods of time, but "Ozempic face" and "Ozempic butt" are not what people who want to lose weight are looking for. Your vision of your ideal body does not include loose, excess skin.

The data are also pretty clear that you can't "kick start" weight loss with Ozempic and then maintain it with behavioral mechanisms. If you want to maintain the weight loss, you need to stay on the medication. A dose that is high enough to cause weight loss is significantly higher than the minimum dose where we see improvements in blood sugar, and with a higher dose comes higher risk of side effects.

I would wait on semaglutide. I would wait because it's been out for a couple of years now but with the current explosion in popularity we're going to see more nuanced data on side effects emerging. When you go from Phase III human trials to actual use in the world, you get thousands or millions more data points, and rare side effects that weren't seen in the small human trials become apparent. It's why I always say my favorite things for a drug to be are old, safe, and cheap.

I also suspect the oral form, Rybelsus, is going to get more popular and be refined in some way. It's currently prohibitively expensive--all of these are; we're talking 1200 or so bucks a month before insurance, and insurance coverage varies widely. I have patients who pay anything from zero to thirty to three hundred bucks a month for injectable semaglutide. I don't think I currently have anyone whose insurance covers Rybelsus who could also tolerate the nausea. My panel right now is about a thousand patients.

There are also other GLP-1 agonists. Victoza, a twice-daily injection, and Trulicity, and anything else that ends in "-aglutide". But those aren't as popular, despite being cheaper, and they aren't specifically approved for weight loss.

Mounjaro is a newer one, tirzepatide, that acts on two receptors rather than one. In addition to stimulating GLP-1 receptors, it also stimulates glucose-dependent insulinotropic polypeptide (GIP) receptors. It may work better; I'm not sure whether that's going to come with a concomitantly increased risk of side effects. It's still only approved for diabetes treatment, but I suspect that will change soon and I suspect we'll see a lot of cross-over in terms of using it to treat obesity.

I don't think these medications are going away. I also don't think they're right for everyone. They can reactivate medullary thyroid carcinoma; they can fuck up digestion; they may lead to decreased quality of life. So while there may be people who do well with them, it is okay if those people are not you. You do not owe being thin to anyone. You most certainly do not owe being thin to the extent that you should risk your health for it. Being thin makes navigating a deeply fat-hating world easier, in many ways, so I never blame anyone for wanting to be thin; I just want to emphasize that it is okay if you stay fat forever.

[teaboot]

When I was a kid, I regularly lost reading privileges for "having an attitude" and "acting out".

It wasn't as simple as being told not to read during other activities- one of the first times it happened, I remember being six years old, watching my stepfather pull fistfuls of books off my bookshelf and throw them to the floor in a heaping mess while I cried and asked him to stop.

It was weird. Every other adult I knew described me as exceptionally well-behaved, but at home, it was the opposite, and it was blamed on "learning bad habits from that shit you're reading".

Because I couldn't read at home, I spent all my free time at school in the library, reading with my friends.

When I grew up and moved away, I realized that my family life was toxic and abusive, and the "attitudes" I was being punished for were standing up for myself, standing up for my younger siblings, and resisting actual, real-life psychological abuse. Because I'd learned from what I'd read that my family wasn't normal, not like my parents said it was, and in my stories, the heroes were the people who spoke out when it was hard to.

It is insane to me that there are students right now who can't access books. It is insane that books are being outlawed. It is perverse that we are stealing away an entire generation's ability to contextualize their lives, to learn about the world around them, to develop critical thinking skills and express themselves and feel connected to the world or escape from it, whatever and whenever and however they need.

That is not how you raise a compassionate, thoughtful, powerful society.

That's how you process cattle.

It's fucking disgusting.

[majunju]

olorun

[uncanny-tranny]

Learning to internalize the message above, but art is in all of our bones. If you feel afraid to create art because it won't be "good enough," it's worth it to explore why you feel that fear. Creating art is one of the basic impulses of people, and if you want to create art, then you absolutely must.

[goodluckclove]

do goose tongue teeth count as real teeth

I can't believe it's 2016 and I still have to say this.

If it's in. Your. Mouth. Then IT. IS. TEETH.

Teeth are teeth. Tongues are a sloppy tooth. Food is yummy teeth that gets mushy and then digested. And I don't care what fucking discourse it starts - all teeth are valid. Block me if you disagree but that says way more about yourself than it does about me.

[brbarou]

kisses

[tunapesto]

so when I die which I must do,

could it shine down here with you?

[endless-nightshift]

There's something so sad to me about the fact Lan Xichen goes from happily encouraging Lan Wangji to befriend Wei Wuxian to Considering Wei Wuxian to be Lan Wangjis 'only mistake'

Like... Imaging getting a miracle second chance not only at life but to have be loved by the man you've always admired only to find out that his family detests you because during the worst time in your life, physically and mentally you didn't take into account the idea that a man who'd always treated with cool acquaintance at best, active distaste at worst actually cared about you and that his constant reproach and effort get you do give up the one method you have to protect yourself while everyone was literally actually out for your head was honestly because he was badly wording his concern and not because he hated you and the methods you used to survive.

[yuviur]

[ABC by The Jackson 5 starts playing in the background]

[fun-k-boards]

I'm asexual

'But you can still like have sex right?'

I am fifteen. Why the fuck do you need to know.