Hi everyone, I (38F) had a spinal fusion in February (L4-L5 ALIF 360 with posterior screw placement). First of all, I was very nervous to have the surgery but I had done several years of physical therapy, numerous cortisone injections, and a rhizotomy, so I felt I exhausted all my non-surgical options. It’s been 12 weeks and I’m feeling really good - all the pain I had in my back when I was standing/laying flat is gone and it is a miracle! I’m still having a bit of nerve sensation in my leg every now and then and a glimmer in my back if I overdo it, but it’s not really pain. So i am PSYCHED to not be in constant pain!
With that said, I have had a couple of "weird" side effects happen since surgery and I’m curious if anyone else has had or heard of these things.
First, my hands have usually been cold my entire life, but since surgery if my hands happen to be cold, there have been 3 occasions when one of my fingers will turn completely white just in one or two knuckles - and it is numb and tingly. If I warm up my hands in warm water it’ll immediately look and feel normal again. When I’ve looked up Raynaud’s phenomenon it looks like that, but just one finger. My doctor said Raynaud’s usually affects more than one finger so I don’t know. Has anyone suddenly gotten Raynaud’s after having spine surgery or had one finger turn randomly white?
The second issue is that, like my hands, my feet have also always been cold for my entire life. After surgery however, they were immediately warm. I thought that surgery suddenly fixed my bad circulation and I was into it. But then it started feeling a bit too warm, and my feet were also suddenly very dry where they haven’t been before. The bottom of my feet also appears more red/white splotchy (see photo). Then my left one started cooling off, and now my left one is basically coldemore normal to what it was before surgery, but my right foot is still warm. I can warm up my left foot with my right foot and it kind of weirds me out that they are different. I had a vascular ultrasound on both legs - no blood clots or artery/vein issues that they can see. The only thing it said was my right foot had very mild hyperemia, or more blood in it (which I assumed since it is warmer). My surgeon told me initially to see my PCP, who ordered this ultrasound, and now my PCP is telling me that I need to go back to my surgeon about it, lol. The only other thing that popped up in my labs was a slightly elevated thyroid which I haven’t had previously.
Has anyone heard of this? Since my foot has changed temperature since surgery I’m hoping it will just continue to figure itself out as my nerves continue to heal, but the right foot has been consistently warm, regardless of my environment for the last 12 weeks which seems like a good amount of time. Am I just going to have one hot foot forever?
Thanks for reading! - Cold Hands, Hot Foot

• Age: 31 (at time of injury)
• Height & weight: 5ft5 70kg
• Gender: Female
• Medications: None prior to injury
• Smoking status: Never
• Alcohol and drugs: Drink occasionally (1-2 pints AVG a month at most), drugs dabbled with the odd joint at uni but not a drug user.
• Previous and current medical issues: Listed in post

My wife suffered a ruptured splenic aneurysm during labour. It was Asymptomatic until labour and where it first presented due to the rupture. My son passed away as a result but after a CT-A it was determined that she had a dozen aneurysms on her visceral arteries (only on Visceral arteries), the largest being a 5.8cm aneurysm on her Right hipatic artery and a ruptured splenic aneurysm which was life threatening.
They embolised the splenic and then stented the right Hipatic/coeliac arteries and saved her life after 4 surgeries and a total of 24hrs under GA and 40 units of blood. Very thankful as I was told 4 separate occasions that she wasn't going to make it. The surgeons were genuinely the nearest real life thing to Dr. house.
She currently has perfused visceral aneurysms (GDA, SMA and splenic hilum) which are unchanged in size since July 2023. Overall reassuring appearances.
We've been discharged by the Rheumatology and Lupus consultants, all infectious causes have been eliminated, and are currently in the care of the Genetics consultants. I can't name all the various teams we've met with but it's over 15 separate consults of various disciplines.
It's definitely a connective tissue disorder as my wife has many of the other 'soft' symptoms such has hyper mobility of the small joints (fingers, thumbs etc.), born with an esotropia (corrected at birth) which has started turning outwards as she's aged, hearing loss (originally diagnosed as bilateral otosclerosis but not sure now as has nerve involvement), bruises exceptionally easily (often has large purple brusies without reason or remembering how), thin skin on thighs and under arms/veins visible, relatively elastic skin, high myopia. There's more but I can't remember.
My son died at 40weeks+0 so carried to full term. Laboured to 9cm. No uterine tears, delivered through CS, stitched back no issues, healed no issues.
We have since had a full CTD Genetics panel (Something like 35 genes tested for different CTDs) all returned negative. We had been running on the presumption of VEDs up until this point but panel confirmed it was not VEDs as there's no spelling mistake on the COL3A1 gene. She does have a variation on the SKI gene but geneticist has ruled that out as the culprit as she shows no signs of any other symptoms of SKI.
No family history of anyone else having anything remotely similar. My wife is one of 4, her mum carried all to full term. Had a full post-mortem and nothing was found related. Father has had a CT-A and has no aneurysms. One sister has had an MRI and is ruled out, still waiting on her other sister and brother but none of them have any of the soft symptoms. Her maternal grandmother had 5 children no complications, her dad is one of 4 no complications either. Grandmother on the paternal side has hearing loss also.
Any ideas? We keep being told it's probably something that's not been discovered but I just don't see that being the case. Of all the possibilities VEDs seemed so likely but she still doesn't quite fit it. Really looking for absolutely any ideas we can push the geneticist for any other testing we could try?
Ultimately we want to determine the cause as we want to know the risks of another pregnancy with my wife's embryos. Another pregnancy has been ruled out but we're trying to find out the risks of using her embryos with a surrogate or if it's possible to do a PGT to make sure it isn't inherited.

Hi guys, so I just want to sort of get advice or other experience on this. I’ve had GERD for basically a year now and my symptoms are actually pretty manageable now. I’m assuming this is part of my GERD but it freaks me out a little every time. I get this stabbing pain below my left breast or like directly inside my left nipple. It also feels like it is directly where a vein/artery runs through. Just want to see if anyone has had this because it gives me anxiety about heart problems.

32, Female 5’2, 165
Issue:
I was diagnosed with a brain AVM in 2009 - 3 gamma knife treatments in 2019 to treat it once over & had a “blood brain barrier leak” (I think?) in February 2023.
I have never been prescribed a triptan until my new dr 2 months ago… when I asked if it was safe he asked me how “living in the box” was treating me. - I appreciated his confidence until I took my first dose because I felt like my head was going to explode.
He now wants me to get this “DHE” infusion that works similarly to a triptan with a black box warning of “fatal cerebral ischemia” 😳 when I KINDLY reminded him of my negative reaction to one dose of the triptan & asked him if he still thought it was a good idea he told me that it was good to do my research but that everything has a laundry list of side effects, even Tylenol & not to worry….
Is anyone able to offer a second opinion on this medication & Brain AVMs? I’m nervous 😥
BRAIN MRI NOTES:
Extensive abnormality in the posterior right temporal lobe, occipital lobe and parietal lobe. This is a combination of abnormal vasculature consistent with patent AVM/angiomatous transformation but also vasogenic edema and ill-defined white matter enhancement that is very likely radiation necrosis.
The FLAIR and T2 abnormality extends to involve the splenium of the corpus callosum. The enhancement is in the posterior most right temporal and inferior parietal/occipital region that is very likely radiation necrosis given appearance with ill-defined irregular primarily subcortical white matter enhancement. An additional similar globular irregular enhancement in the medial right parieto-occipital region medial to the occipital horn and atrium of lateral ventricle is also noted unchanged. In addition, there are enhancing vessels, angiomatous transformation and/or feeding arteries/veins related to the still patent AVM in the right hemisphere. These are most prominent in the high right parietal lobe. There is a single globular prominent cortical venous drainage in the right parietal region that extends to the sagittal sinus which appears patent. The extensive vasogenic edema and nonvascular enhancement likely radiation necrosis is stable.
The AVM is supplied by distal right MCA and PCA branches with dominant cortical venous drainage superiorly to the sagittal sinus. There are areas of substantial T2*hypointensity in the right parieto-occipital region in the deep white matter and in the subcortical region consistent with areas of hemosiderin staining or embolic material/calcification.
Medication: topamax 200mg 2x qulipta10mg , gabapentin 100mg 2x vyvanse 50 clonidine 0.1 vitamin d

My mother had a bilateral knee replacement done in Oct 2023 in a tier-2 city by Doctor A. Left one done first without any problems and right one done 5 days later with complains of tingling and burning sensation (at the foot) post the surgery. The discharge summary advised bed rest, normal diet and physiotherapy.
Two months later, the problem still persisted along with increased pain. Doctor A advised futher rest, and was told it would take time since she has diabetes and hypertension since 8 years.
With no relief after another month, she developed a small superficial bed sore at the ankle that was treated by doctor B in a different hospital in the same tier-2 city (Doctor A travels frequently and was unavailable most of thr time). Doppler scan indicated dilated veins and no deep or superficial vein thrombosis. Doctor C was instructed by Doctor B to do a pressure dressing every 3-4 days at her residence.
Three months later, the bed sore at the ankle increased to 2-3ins while Doctor C kept adding pressure bandages and peeling any black areas.
Tired of Doctor C, she visited Doctor B again at the hospital and he was shocked at the extent of damage. He did another doppler test and reported that there was no arterial flow in lower tibial artery and calcified plaques in lower limb arteries. Ignoring Doctor D's advice of conducting an angioplasty immediately, he went ahead with debriedment and advised further pressure bandage and bed rest.
After going through all this ordeal alone, my mother now revealed to me (I live in a different country) and our other relatives all of the pain she was going through alone.
I immediately took her to Doctor E in a tier-1 city who diagnosed that she has a gangrene heel and has severe calcification in her lower arteries and one blockage at the knee that was possibly caused/aggravated by the knee replacement surgery. She was at the risk of amputation if we had waited longer. Angioplasty was done immediately requiring 3 balloons and she is on vacuum dressing for the last 3 weeks
She is now heeling at the good care of doctor E requiring high doses of antibiotics and in the near future will need plastic surgery to close the open wound.
I think she is:
Wronged by doctor A for not evaluating her condition properly before conducting the knee replacement
Wronged by Doctor B for ignoring advice by Doctor D (to perform an angioplasty stat) and jumping to clean the wound without addressing the main problem and to make a quick and large amount of money
Wronged by Doctor C by primarily being incompetent and not updating status to Doctor B.
I want to know what legal actions I can take and also want to possibly file a PIL to make sure this kind of malpractice does not happen to anybody.
Please guide.

Bright illuminescant flashes bolted through the dark-lit sky, rushing and raging through clouds seemingly made of gossamer and finely woven felt. You could almost reach out and touch them if not for the raging storm ripping and hollering. It shone and splintered along the sky, splitting into a thousand arcs, each converging and convexing along the stars. Electrical currents spun like lavender spider webs along a farmhouse wall. The arcs traveled, painting a vibrant tapestry along its wake before reaching their climax and releasing a wicked KRAK as the lights slowly faded.
The gossamer clouds wept tears of dull acidic rain that fell, cascading downwards. Down to the swampy fetid fields below. Their droplets splashed and sizzled against the sand, slowly fizzing before hardening into a thin velvet glass before beginning all over again. A sad display of god’s fury laid bare and plain for all to see. The rain had begun just a week prior, but its assault had persisted in a constant pattern ever since. The swamp ached and squirmed in an agonizing way as the rain melted away any sign of basic life.
Puddles of the acidic deluge collected along a road leading to the once fertile silver mine, just three miles from the town of Crestfall. Near the edge of the road, a fork splits off into multiple directions. South of the fork leads to the entrance of Deep Rock Mine. The mine’s entrance stands agape, resting at the base of a mountain. The mine’s layout, a cavern of crisscrossing and haphazardly formed tunnels, awaited past the thick darkness entrapping the entrance. They curve and wind up the spine of the mountain, as well as descend deep into the now dead earth.
The face of the mountain was bare but rough. Rocks jutted and sloped along its curvature, forming a near mesmeric pattern of spiked granite. Towards the peak, a malicious and not all entirely natural pattern emerged. As the acidic rain fell, framing the mountainous backdrop, the pattern watched and waited. An almost human-like visage stretched along the face of the mountain like canvas pulled over a wooden frame. It’s design scorn into the rock itself as if meticulously laid out to warn any who dared breach the confines of the swamp.
Silence lingered amongst the misty atmospheric dredge, save for the muffled and subtle ambietic sounds of the rain. Through the dead foliage and gnarled remains of creatures recently passed, a sound rang forth. Distant exclamation and reverberated clanging rhythmically sounded from deep within the mine. Up and down the mine laid stalactites and stalagmites haphazardly stationed around every corner. Their abrupt positioning cast shadows wherever light felt unable to reach. The mine walls were smooth from years of work and toilage, along with the long uninterrupted tunnels, created an almost echo chamber for sound.
Abrupt crashes and distant thrashes echoed through the winding chamber. Its sounds detailed a fierce battle between clashing swords and fervent blows.
Or so it would seem.
A sword, emblazoned with the sigil of a raven, flew across the dimly lit room. Its body crashes and clings as it skips along the floor, its blade slashing and carving thin lines into the granite flooring as it makes contact with the ground. A fierce shadow sprawls along the cave walls, depicting a struggle between foes.
The wanderer-and recent owner of the raven crested blade-crashes to the floor. Leather straps firmly tied around his shoulder blades catch most of the weight of the fall, but pain still echoed through his nerves.
“Hells! You slimy bastard!” The wanderer winces and yells in a blinded fury. “You don’t play fair, and here I thought we were having a nice sport of it.”
No reply immediately came from his opponent, still standing off near a downed torch. Flame wisped and flicked along the ground, casting shadows and dreaded omens as if they were ripped directly from a child’s nightmare.
At once, the foe stepped forward. The shadows sprawled across the walls painted a disturbing picture of horror and grotesque form. Imaginative figures born from shadows were always so much more terrible than the beings that cast them, but in this case it was clearly the other way around. The foe opposite The Wanderer lurched forward, it's body a gnarled vestige of exoskeleton and mandibles. It almost resembled a large insect, like a praying mantis that decided its evolutionary cycle had not quite finished yet.
On multi-socketed legs, it snapped and convulsed along. Every movement of its body felt agonizing, as if the creature was hastily thrown together by a quite absent god. Various olive and violet fluids oozed and dripped from its husk like body as it vocalized terrible sounds. The creature-seemingly unable to speak-produced noises from its mouth that resembled a mix of gargles and marbles being tossed along a wooden floor. All the while, its grotesque pincer like appendage snapped and clicked almost involuntarily.
The wanderer-still recovering from his fall-slowly pushed his body along the cold rocky ground, his arm still pulsing with pain.
“Oh my, what big mouths you have.” The wanderer teased sounding much more worried than he intended. ‘Always good to keep in control of the situation. Confidence is key.’ As he was always want to say, but this wasn’t an ordinary situation.
His arm traced along the ground, reaching and prodding for his recently lost weapon. Daring not look away from the oncoming threat, he felt nothing. His sword was currently resting near the opposite side of the cave room, resting flat along the ground. Away from The Wanderer’s grasp, far away from being of any further use here it seemed.
Doubt surged through his mind, but only for a short time. ‘Doubt breeds more doubt, and further doubt breeds ruin’, another favorite.
Clenched palms moved along the granite flooring. Leather gloves scraped and bruised as The Wanderer lifted back to his feet, regaining balance and fervor. The arm that had broken his fall felt numb and altogether absent.
‘Dislocated most likely, not a big enough fall to break.’
The insect-like foe-still closing the distance between them-snapped and gurgled in an almost territorial display of aggression.
The Wanderer grinned, placing his uninjured arm against its opposite’s elbow, before violently, yet methodically, pushing it upwards. A clear snap, followed by a dull pop echoed through the room. Feeling began pouring back into his arm as the vibrating itch of numbness faded. Both arms began to raise, fists clenched, the leather gloves creased and squelched from the sheer pressure as his hands formed tightly wounded fists. Fists pointed squarely towards the all not entirely normal creature still gurgling and jerking along the shadow filled room.
“Oh...” The Wanderer began. “I’d be lying if I said I wouldn’t enjoy every second of this.” His fists raised up, reaching level with the bridge of his nose. “Come one now, give us yer best.”
As if understanding -and altogether disliking- the series of vulgar remarks thrusted toward it, the creature squealed through its deformed face. The jerking motion its movement seemed to have before was replaced with a fluid dash as it quickly closed the distance between the two adversaries. Arms outstretched as its gnarled and jagged hands opened and closed with violent snaps and twinges. Reaching out, grasping the air between them. The gap closed quickly, much quicker than he anticipated, but not enough to catch him entirely off guard as he shifts weight from right the left. The slender frame of his body flanking to the side of the creature.
Shadows arched and flailed with each movement, creating a strange optical illusion across the cave walls. The subtle shifting wind and osculation of the two fighters created an almost mural of events through the flames. Clashing swords, trumpeting horns and creatures that rivaled the tallest spires in Etheral began to converge into an unrecognizable painting of events. The fire loomed, gazing at the creature, at The Wanderer. Its gaze almost purposeful and full of intent. Neither the two beings made any note of the grand display unfolding around them. Fire is known to be a harsh mentor, and an even harsher ally. If one was to wander too deeply into its wounding gaze, one might find themselves trapped, forever living in the tapestry it painted.
The creature was fast, but nowhere as fast as him. Once useless, now repaired, the dislocated arm wrapped between the creatures glistening forearm, interlocking before weight shifted again. The creature stalled as if to reorient itself to face the man, but its movements were not its own. Quickly and deftly, The Wanderer placed immense weight on his forward foot, counterbalancing against the creature as their locked arms rotated and shifted sideways. Arching forward, the shift in balance quickly broke as the creature began to lift in the air as The Wanderer’s rear leg lifted to relegate pressure onward. Flailing and spewing its noxious fluid, the creature flipped entirely, finally crashing to the floor in a savage crunch. The Wanderer stands above, looking downward as it convulses in a fit of pain (could it even quantify pain) and anger.
A greyish foul-smelling slime coated The Wanderer’s chest and forearm. Small indentions formed along the hard leather surface of his jacket, most likely from the not entirely cosmetic spikes embedded into the creature.
“Alright, now I’d say we’re fairly close to a draw here.” The Wanderer began. “How’s say we handle the rest with a bit more diplomacy and grace? No point and making a bigger stink than we already got, but telling by the state of yourself, I’d say you know all about stink.”
The maddening gurgle of the creature slowed as its body began to calm. Its arms moving outward, sprawling along the hard granite rock as its legs raise along with the rest of it. Wet dew drips along the ground, rippling and casting weird reflections from all directions as the creature steps slowly along their puddles. Slow anxious steps it takes. Its demeanor changes from a wild and disturbed animal to a more methodic and wary being. Eyes of bluish gray sink into its head, pupils moving slowly, analyzing and taking in information. It stands straight, back locked into an opposing stance. God it was big. The man couldn’t much get a good measurement before with its body slouched over in a hermit like stance. It must be at least seven feet tall, equally proportioned from its legs to its torso. The head was rounded, almost human, with its bug-like mandibles protruding in a horrific fashion.
The Wanderer had dealt with creatures before. Along his travels he had come across a litany of monstrous beings; Wargs, Secrolants, Jittering Fiends, Goblins, Spiderlings. None of them quite matched the state of this one. Although he had heard of such beings, none had crossed paths before. The way it moved, the way it thought, it all was abnormal. It's quite simple to take a beast down, some you anger and gain the advantage, some you outsmart, others you can simply scare away. But this one.... oh, he was a different breed entirely. The way its mood could change mid-fight, or how it seemingly understood what was being said. And the way it stared. Thoughts were jutting along in the bug brain of its, and when monsters start thinking, all strategy and preparation goes out the window. Unpredictable is what they become, and prediction was The Wanderer’s bread and butter.
Wary now he waits, staring back at the creature. Locked eyes, they waited. Eyes filled with thought, filled with understanding and reasoning -but most egregiously- they were filled with malice. The fight was not over, they had just reached half-time.
“Let it not be stated that I did not strive for peace and harmony at every turn.” The Wanderer quipped, his hand raised once more, ready for another assault.
A flame flickers, casting shadows once again. Shadows of a man holding wolves at bay, hands outstretched to create a distance between them. The wolves circled and plotted, looking for weakness at every tune, but finding none. Leaves fell, becoming ash as they reached the ground. A fire spreads amongst the ash laden floor, consuming the visage, the man, the wolves. All in consumed in an immense concentrated heat, until the shadows fade to nothingness once more.
The creature meanders onward, just a few steps at a time; looking on as The Wanderer holds his footing, fists raised and ready. Each step of its hard glistening exoskeleton crunches against small rocks and debris sprawled along the cave floor, knocking them aside, producing echoed wails that seemingly bounced from surface to surface. After the third step it abruptly launches at the man, arms outstretched once more in a fit of animalistic fury. Thought seemingly left its eyes as they glazed over into a dull grey, the feeling and reasoning sinking further and further to the back of its mind. The Wanderer grinned, his stance loosening as the soles of his feet began to trace an outline of movement, preparing and readying for a counteroffensive. As its dripping breached the outline, The Wanderer shifted his weight once more, quickly flanking the creature to the side once again, but something was off. His eyes traced the movements of its body, of its arms, of its legs. The animosity in them seemed to almost shift mid attack, becoming lucid and methodical. As if the creature was dancing along with him. Even tracing down to the ground, the footing was wrong. Not his footing. He was always perfect. The dance was memorized, trained, honed to a sharp edge. No, it was the creature’s.
Abruptly the creature’s body shifted, its legs tracing backwards, its torso shifting to the side. A corrective action, a counterattack to his counterattack. Shadows of the pair danced along the cave wall, depicting a wickedly abstract waltz. The creature’s arm whipped outward, its claws barreling towards the thin leather separation between his elbow and forearm. God, it was fast. Faster than The Wanderer. Rip, flash, a bright light, then the crashing of feet as the two returned to their original standing.
It all happened so fast. Faster than he could articulate. He was used to speed, used to tracking and understanding battle situations, creating countermeasures, analyzing the most likely move and executing it within a fraction of a second. All of that was done, but it was all wrong. The creature moved in peculiar fashion, acted as if it were moving on instinct while simultaneously acting with thought and strategy. How could it possibly go both ways?
As he thought, mouth slightly open, breath pouring between his lips in a hot and heavy fashion, he hardly thought of anything else. They had made contact, but there was no feeling. Checking for wounds mid-encounter was generally out of the question with beasts. Often, they gave little time for thought or first aid, but the creature stood and waited. The dull grey look in its eyes were gone again, replaced with the methodical gaze of a strategist analyzing a battlefield. The Wanderer lowered his right arm and traced it along the path of his elbow, reaching his shoulder before he felt it. A definite gash traced about two inches wide, the depth of it couldn’t be guessed, but it had breached the leather. As his hand returned to a fist, warm fresh blood dripped between the fingers, falling and coagulating against the dust and pebbles along the ground. He had indeed been injured, but there was no feeling to it. All felt well, and that’s precisely why all was, in fact, not well.
“You’re a strange one. Not quite like anything I’ve seen before, but I’ll get to know you real well soon enough.”
His eyes moved from the creature, scanning along the ground. Before when this was a simple clean-up, a weapon would be handy, but hardly required of someone with his skills, but this was anything but simple. Parameters had changed, he’d very much like his sword back now.
It was nowhere to be seen initially. The room was dark, with little else than a soft glow from the fallen torch illuminating a small area and casting shadows that obscured others. Then it appeared. Near the feet of the creature, the raven crested blade sat where it had since the beginning of this strange dual. Thoughts echoed along in his head, casting suspicions and doubt in every facet of the encounter. Things were not as they appeared.
A slight grin crept along his face again, before quickly subsiding. “Think I have enough time for one more go of it. Care to lead?”
The creature stood, watching and plotting before the dull grey of its eyes appeared once again, launching it into another fury. It lunged, arms outstretched again, running full speed to the man. He simply stood, his hands loosening from tightly wound fists of rock to loosely packed fists of snow. His palms opened slightly; his footing loosened as the heels of his feet digging into the hard rocky floor. They began to move slightly, tracing a straight horizontal line where he stood as he slowly began to back away. The creature, still in a frenzy, closes the distance fast. Seemingly faster than any previous assault as The Wanderer ceased his slow backing retreat, his feet returning to a strong stance, soles digging deep into the earth. He takes in a breath, his heartrate slowing. The light sounds of the cave begin to grow, becoming more apparent and concentrated. Small droplets of dew falling from the ceiling, wind softly blowing along, echoing through the harrowed halls and the flickering of a flame slowly speaking its ancient language. They all converged, mirroring themselves as The Wanderer’s eyes closed. Time seemed to slow as the creature came closer, its steps further apart, its maddening gurgling seemingly floating away. It stepped, stepped and stepped along the ground, pushing pebbles and dust without thought.
Finally, it reached the line carved into the rock. Its foot crunched, making contact with the earth, and in an instant its eyes reverted again. The grey dullness seeping away to its methodically stategistic norm. In that instant, The Wanderers eyes erupted open. The chittering thing’s arms stretch out for his neck, hoping to seize his artery with its horrific claws. Quickly, quicker than anything that day, The Wanderer moved in a fast range of motions that all seemingly happened at once. His weight once again shifted, flanking the creature. His arms locked into a position of counterattack. The creature quickly issued its own countermeasure, once again whipping its body and throwing its claw outward, aiming higher than before, aiming for his neck.
A flame moved. Shadows formed along the walls once more, although they showed a different scene. A scene depicting two swordsman locked in deathly combat. Their swords swinging violently but with grace and purpose. They clashed a thousand times. Each time sending a spray of bright sparks that swelled through the air creating intricate patterns that lingered before slowly fading.
The creature was stuck, unable to move, unable to continue its assault and unable to return to its desired location. The Wanderer's palm grasped the creature's wrist tightly, locking it into a hold. The grey of the creature’s eyes were completely gone now as its pupils darted around in panic. His hand arched forward, his foot kicking –what would assumedly be- the creature’s calf, buckling its knees and forcing it to the ground. Cracking and popping erupted from the joints of its arm as his grip tightened. It’s gurgling became sporadic, as if pleading to be set free. He simply watched it, once against studying its behavior, its patterns, its mannerisms.
“You really are special. Not like anything in the world I imagine, but what makes you so special.” The Wanderer clenched his hold tighter, the creature falls lower, its face pushing into the cold rock. “You were playing a game, weren’t you? You understand what I’m saying too, and that I can assure you is indeed something special. Predicting my movements, using the techniques against me. You weren’t just fighting for a meal. You were learning, weren’t you?”
The creature clicked and gurgled, chittering against the ground as the hard surface of its arm began to crack.
“Now, I’m not opposed to teaching if I aim to gain something from it, but what I won’t abide is being played with. Now...” He plants his foot against the back of the creature's neck, both arms holding its locked appendage in a pulling motion. “I think I deserve to know a little more about you my foul-smelling friend, and if I’m right up until this point, you outta know exactly what I’m saying. I also assume you know a threat when you hear one. So...” His grip tightens, his leather boot slowly crunched against the creature’s skull. “Tell me what you are, and where you learned to be so damn special.”
The creature’s eyes widen, the dull grey returning, filling its retinas as it begins to violently convulse. A shrill screech fills the room, echoing along the walls, traveling through the twisting and winding tunnels of the long-forgotten mine. Shadows creep along the cave walls once more, scattering and convulsing, twisting into horrid and unimaginable shapes. Creatures that belong to fables and horror tales begin flooding along the shapes as the flame whips and crackles. The torch quickly combusts, the flames turning a sharp blackish violet. Heat bellows from the waves of ember emitting from the now monumental display of hellfire as the shadows multiply, taking over every inch of coverage. The Wanderer’s ears tremble at the immense noise, his vision begins to weaken as the shrill echo reaches a climactic crescendo. Any more of this and it’s all over, lights out.
He looks downward to the creature, its mind warped with whatever dark arts influenced it. His grip tightens as his foot presses firmly against the back of its head. Slow crunching and cracking sounds begin to intermingle with the terrible sounds of its cry. As the boot came down, harder and harder, the creature’s terrible screech began to thin and grow in pitch, like the air being slowly released from a balloon. Then, a horrendous snap before the head was no more. Violet and green brain matter covered the area around its neck as small fragments of skull of tissue caked along the sides of his boots. All at once the cry stopped, and along with it the room slowly began to darken. The flame began to slowly dwindle back to its original size, its color returning to a soft orange glow.
The Wanderer stepped back; his eyes firmly planted on the now deceased creature lying before him. A pool of its blood slowly trickled along the floor, reaching for his sword. Slowly, his body lumbered to the lost blade. Its handle was wrapped in scaled pitch blade leather, its blade a vibrant silver, still glistening with oil. The visage of a raven prominently scorn into the finish of the blade itself. Before the foul-smelling blood reaches the blade, the man slowly leans down to collect it. His body ached, his arms felt heavy and as the world around him began to dim, he retrieved the blade. Weighing it in his hand he felt secure, like a lost piece of him was restored with its retrieval. It felt so much heavier than before, or maybe he had just been weakened from the encounter. He gazed down upon it, his hand clenched hard around the dark leather handle. A dark fluid began to pool around his hand, streaming softly down from his arm.
The Wanderer turned his arm over, now looking at the wound he had taken from the creature’s first counterattack. It didn’t seem very bad, or at least not as bad as previous wounds he’d sustained, but the bleeding was alarming. It streamed softly, almost without notice. The blood itself was dark as well, as if it had already begun coagulation. A strange wound. A worrying wound. Suddenly his head became light, the room began to dim, and the walls started to blur. No, everything about this was wrong.
In the strange lucid state he was left in, he almost didn’t notice the changes around him. A quite fell over the room, the flickering flame seemed to even quite down to a faint whisper. A soft noise crept along the ground. Soft tapping, the sound of pebbles and rock being pushed aside, dust parting between single soft strides. The pain in his head grew louder, his heartbeat thumping from his chest to his forearm, ending finally against his forehead.
What is happening to me?
As if to answer, a rapid movement jostled him back to reality as he quickly turned, sword still gripped tightly in hand. A quick flash of movement rushed towards him, its motioned and sounds all too familiar to him. As nimbly as he can muster, he raises his blade outward in an attempt to impale the newfound enemy now barreling towards him, but a twinge of searing pain in his shoulder halts the attack. All he manages is a defensive stance, sword raised, arm placed behind the blade to prepare for impact as the creature crashes into him.
They both fall, splashing into the violet puddle of dank smelling blood that has pooled along the cave floor. A creature –almost identical to the one lying dead beside him- lies atop the blade protecting his body. Its arms crash against the leather bracers protecting his soft flesh. Claws come crashing down, scrapping against leather, making large slashes in them but not enough to break fully through the thick coating. Slime and mucus drip down from its maw, coating The Wanderer’s arms and neck. His arms are placed defensively against the side end of the blade, separating the two, but he can feel himself weakening further and further. Rough outlines of the creature emerge through blurred vision. Heat travels along his arm and forehead, casting confusion and sweat to pour over his body.
What the hell is happening!?
Suddenly, the creature lunges its head down, breaching the space between the blade and The Wanderer’s neck. Its snapping pincer like mandible opening and shutting in rapid and rabid bites. Before it has a chance to make contact, The Wanderer frees one of his trapped hands and grapples the creature’s head. With strength slowly fading from his body, he fruitlessly pushed back the creature's disgusting face. With every inch he pushes, the creature seemingly gains two. A battle of attrition begins. Snapping, clawing, drooling the creature continues its unending assault. Reach for the soft part of his neck in hopes of ending the encounter in a single bite. Just one slip, and its lights out. Forgotten and left to be fed on to a host of disgusting bugs. The thought rips through his mind, his veins fill with hot fire, his muscles contract creating energy that wasn’t there before. He pushes hard against the creature’s head, pushing it past the breach in the sword until his arm reaches full length.
The energy’s fading, the small window of opportunity’s closing, and for once in his miserable life, he can’t think of a thing to do. The hand not grappling with the creatures head pulls free from the back of the sword. His fingers slowly begin moving, drawing a pattern in the air. Faint lines form, like strokes from a dry paintbrush. Lines sparkle and faintly crackle with weak power, power being sapped away. The pattern is rough and unfinished, its edges not straight, its lines fumbling. The feeling in his fingers is weak. Strength fading, the pattern breaks as his hand twitches before returning to the blade. Fire begins erupting from the torch again, the strange violet flame re-emerges and casts strange shadows once again along the cave walls. Shadows depicting men falling in the thousands, figures standing above them. A strange light emits from the wrecked battlefield as the dominant figures rise, floating above, breaching unending clouds and sending a cleansing fire downward. Fire spreads along the walls, engulfing the shadows, casting them far away as it shrieks and flickers violently. The Wanderer’s vision begins to fade. The world around begins to dull. Rocky walls, granite floors, the creature all fade, losing color and becoming shadows themselves. Heat wells in his head, as tears stream down his cheek.
I can’t.
Shadows slowly engulf him as the energy drains from his arms.
I won’t
The creature’s face inches closer and closer to its target.
This is where it ends.
The fire erupts, banishing the shadows away once more, filling the room with soft orange light as the creature lunges uninterrupted at its prize.
Then nothing. The pain of stabbing pincers ripping along his throat never occurs. Instead, a loud CLAP echoes along the walls. It’s deafening and almost endless, but it's over in an instant. A river of fluid splashes along The Wanderer’s face and body. It’s warm and thick like syrup but smells like rotten apple cores. For a moment, he contemplates if this is death. A strange death, and a strange place to end up, but who’s to know. Before long his eyes opened. The creature that stood hunched over him was still there, but its head was entirely missing. Fragments of skull and viscera lined the walls and floor around him as the creature stood cold, dead. Seemingly out of nowhere, its head just seemed to explode.
“Did...” The Wanderer began quizzically. “Did I do that?”
Before an answer could be given, a shuffle could be heard across the room, hidden against the far wall deep within the dark. Slowly The Wanderer rose, knocking the deceased creature away from him, the feeling and strength slowly returning to his body. He stared off to the dark corner, waiting in vain for his eyes to adjust to the dark. They didn’t. Bending down, he grasped his sword in one hand, and what remained of the faint torch in the other as he cautiously meandered to the muffled sound coming from the dark corner.
“Gods, if it’s one more of these disgusting fucking things, I’m straight gone.”
Slowly, the image of a man appears. He almost seemed affixed to the wall due to some form of slightly translucent webbing sprawled across his body. His feet were a few inches raised from the floor as he hung limply against the wall. A thin layer of the same substance covered his mouth as he muffled violently to The Wanderer, his eyes red and spread as wide as they could go. Near the middle of the webbing his right hand was tightly bound, unable to move. On the other side, it seemed he was able to shake loose enough to free it. A silver revolver with gold carved inlays held tightly between his fingers. Faint trails of smoke emanated from the pistol’s barrel. The smell of spent gunpowder lingered In the air, a smell The Wanderer had memorized.
The Wanderer looked puzzlingly at the man stuck to the wall, before a spark of remembrance and realization came to life in his eyes. Sweat beaded down the side of his head, slowing before soaking into his shirt collar. That chance encounter had taken its toll, and had gone on for longer than he thought, longer than he had hoped.
“Hells man, I had forgotten entirely of you. Why not speak up next time?”
The stuck man convulsed in a fit of annoyance and fury as The Wanderer laughed heartily.

I'm looking at the e', E/e' and E/A that seem indicate Grade 0, but I don't know if it's other criteria that they're using further up.
I'm a bit worried as I eat healthy, have a healthy weight and don't smoke. Only 34 years old. Diastolic dysfunction never showed up on any of my previous echos. The results are from a new cardiologist after my previous one retired.
Thank you!
Left Ventricle Normal
LVEDV 52.4 ml
LVESV 16.9 ml
EF (Teich) 68 % (52 - 72)
LVSV 35.5 ml (81 - 109)
IVSd 0.8 cm (0.6 - 1)
IVSd (Mm) 0.9 cm (0.6 - 1)
LVIDd 3.5 cm (4.2 - 5.8)
LVPWd 0.8 cm (0.6 - 1)
LVPWd (Mm) 1.1 cm (0.6 - 1)
LV Mass 136.3 g (88 - 224)
LV FS (midwall) 37 % (14 - 22)
IVSs 1.0 cm (0.8 - 1)
LVIDs 2.2 cm (2.5 - 4)
LVIDs (Mm) 2.5 cm (2.5 - 4)
LVIDd (Mm) 4.0 cm (4.2 - 5.8)
LVPWs 0.9 cm (0.9 - 1.8)
IVST 23.0 % (27 - 70)
LVPWT 12.0 % (25 - 80)
LVRWT 0.45
Right Ventricle Normal
RVIDd (Mm) 1.6 cm
TAPSE (Mm) 20.2 mm (17 - 31)
TDI s' 12.4 cm/s
Left Atrium Normal
LA (Mm) 2.7 cm (3 - 4)
LA 2.3 cm (3 - 4)
Mitral Valve Normal
MV Pk E Vel 0.7 m/s (0.7 - 1.2)
MV Pk A Vel 0.5 m/s (0.4 - 0.7)
MV E/A Ratio 1.40 (0.73 - 2.33)
MV Decel Time 194.4 ms (138 - 194)
Septal e' 8.97 cm/s (10.1 - 20.9)
Septal a' 12.8 cm/s
Septal S' 9.1 cm/s
Septal E/e' 7.70 (<8)
Lateral e' 14.35 cm/s (14 - 25.6)
Lateral a' 9.5 cm/s
Lateral S' 11.4 cm/s
Lateral E/e' 4.80 (<=10)
MV E/e' 5.92 (<8)
MR Vel 1.5 m/s
MV Reg Pressure Gr 8.6 mmHg
Tricuspid Valve Normal
TR Pk Vel 1.5 m/s
TR Pk Grad 8.8 mmHg
RVSP 19 mmHg (18 - 25)
RAP 10.0 mmHg (<5)
Aorta Normal
AoD 3.1 cm
AoD (Mm) 2.6 cm
AoD CS 1.5 cm (1.5 - 2.6)
AoD Root 2.6 cm (2.8 - 4)
AoD Ascending (Prox) 2.6 cm (2.2 - 3.8)
Aortic Valve Normal
LVOT Diam 2.0 cm (1.8 - 2.2)
LVOT Pk Vel 0.72 m/s
LVOT Pk Grad 2.1 mmHg
LVOT SV 35.4 ml (60 - 100)
AV Pk Vel 0.97 m/s
AV Pk Grad 3.8 mmHg (<10)
AVA (Vmax) 2.33 cm2 (3 - 4)
AV index 0.7
Pulmonary Valve Normal
PV Pk Vel 0.8 m/s
PV Pk Grad 2.8 mmHg
PR Vel 1.7 m/s
PR Pk Grad 11.3 mmHg
Pulmonic Artery Normal
LA / Ao 0.7
IVC/Pulmonic Vein Normal
IVC Dim 2.0 cm (<2.1)
After informed consent, a complete Transthoracic Echocardiogram was performed. No contrast agent given.
Findings:

1. Left ventricle cavity is normal in size.

No evidence of thrombus is seen in the left ventricle during
this exam.
Normal left ventricular wall thickness.
Normal global wall motion.
Doppler evidence of grade II (pseudonormal) diastolic
dysfunction.

1. Left atrial cavity is normal in size.

No evidence of thrombus is seen in the left atrium during
this exam.
No evidence of mass is seen in the left atrium during this
exam.

1. Right atrial cavity is normal in size.

No evidence of thrombus is seen in the right atrium during
this exam.
No evidence of mass is seen in the right atrium during this
exam.

1. Right ventricle cavity is normal in size.

No evidence of thrombus is seen in the right ventricle
during this exam.
Left ventricle cavity is normal in size.
No evidence of thrombus is seen in the left ventricle
during this exam.
Normal left ventricular wall thickness.
Normal global wall motion.
Doppler evidence of grade II (pseudonormal) diastolic
dysfunction.
Calculated EF 68%.
Structurally normal mitral valve with mild (Grade I)
regurgitation.

I watched bleach TYBW recently and it introduced alot more powers for quincies than them just being able to absorb surrounding reishi. The powers introduced are blut vein, blut arterie, volstandig, etc. In the beginning the hollow powers of Ichigo were being suppressed by Zangetsu(Yhwach). When Ichigo got 🕳️ in his chest by Ulqiora it should have been the awakening of his blut vein. Also, what he was using as a bankai should've been his volstandig.

Abdominal US Report:
The liver has average size, regular margins, homogeneous dense and hyperreflective echostructure as for mild steatosis:
in particular, in the context of the parenchyma, a slightly HYPERECHOIC blurred focal area of about 15-16 mm is found in the first hypothesis referable to angioma;
in S6/7 an HYPOECHOIC focal lesion of about 11-12 mm is also found (with difficulty) which cannot be further characterized.
Normal caliber sovraepatic veins, patent.
Portal vein of normal caliber (about 8-9 mm at the junction with the hepatic artery), patent and with normodirect flow.
Splenic vein of normal caliber, responsive to respiratory movements.
No ascites.
Rest of the US is perfect, no other findings.
They suggested a MRI to better understand this findings
MY STORY:
I am 32M, no history of cirrhosis or past cancer.
Last week I had a gastroscopy (reported only grade a esophagitis and a small duodenal ulcer)
Two weeks ago I had a chest x ray (clear)
The day before this abdominal US I had another one that came back clear (but they didn’t see this lesions and didn’t see the pancreas very well so I made this one the day after)
SYMPTOMS:
I often suffer from right sided back pain, and sometimes a faint upper abdominal/chest right pain.
I am scared this hypoechoic liver lesion could be some metastasis from an unknown primary cancer.
I am having an MRI in two days but I am panicking
Please help me !!!

[First] [Previous] [Next]
Edited by sensei WaveOfWire
- - - - -
Everything had gone exceptionally well for the farmer, despite the daunting task forced into her talons. Kegara had ordered her to begin a march east in search of the expected banished by sunrise—not alone, but in a group of fourteen others. She thought it was too many for such a task, and would assuredly catch the ire of the abhorrent; the more Malkrin present, the more creatures would pursue them…
It was a risk. One she was willing to take if her beloved was safe, but he pleaded for her to find a way to avoid it. Unfortunately, were she to stay, it would land her in the worst of Kegara's rage. The orange-skinned female would have been made a gruesome example for those who disobeyed, tied up in the center of the camp and… She did not wish to think of what ghastly fate would have awaited her.
So, in the dark of night, her and the baker’s plan of escape was struck. Perhaps it was foolish to leave their safety behind, but considering the blood-moon and forced orders, was it truly ‘safe?’ They would gather their pitiful belongings and set off in the direction of the previously ostracized members—the water worshiper, and four others. There was little hope of finding them, less so after the blood-moon, but with so few of them, there was still a chance they evaded the beasts and the warped oddities of the mainland altogether. Maybe if the field hand and her mate could find them, they could start their own settlement. At least, those were her thoughts when she set out…
Her initial reaction to being thrust into the open wilderness was nothing short of horror. Indistinct animalistic screeches, otherworldly hums, and unsettling creaks from trees sent chills down her spine throughout the night. Hazy shadows underneath the dim moonlight crawled like creatures, stalking… prowling around the mated pair. Every step she made was made in pure uncertainty, every pace bringing her further into an abyss of unseen nightmares. Maybe Kegara would not have punished her so severely… Maybe it would have been best to stay where it was safe.
But, she continued. She stayed strong. She had to.
They had already ventured too far, and it was her job to protect her love. Her tail wrapped possessively around his waist as he stuck close to her. Morning would break soon, and they would be far away from the brutish paladin… Free to start anew. It would be difficult, but the two of them were far from incapable of fending for themselves; they learned enough in the way of survival from their time on the mainland and their respective professions, despite both being from the Golden City.
- - - - -
They were able to survive the night, persevering well into the day by making crude implements and harvesting what they could. They had even managed to discover a large cave perfect for their habitation! It was dry and large enough for a fire, though it went deeper than expected. Food and cooking arrangements were their prerogatives, so they elected not to scour it any further as it would only be a waste of their time. They worked tirelessly until the sun set beyond the red expanse of trees. Her love busied himself with making the smooth gray walls into a home by gathering small resources and forming makeshift beddings, while she had gone out to hunt. By the luck of the Mountain God, she managed to bring back not one but two feathered creatures, each of which were more than plump enough to feed the mated pair for the evening.
Her aching feet patted against the grass, the blades poking her worn soles. The vegetation swayed from side to side in the weak breeze, almost appearing to celebrate her small victory with her. The cavern entrance came into view, its shape too small for her frills to fit under. The edges were covered in pinkish moss, giving it a distinct feel compared to the rest of the biome. Perhaps it was a sign of the Mountain God’s will for them to inhabit it. The moist malleable moss stretched further inside, resembling small veins inside the larger chasm.
She ducked underneath the mouth of the cave, appreciating the yellow reflections of an ongoing fire from within, each flick casting long shadows over every rock edge. Yet once she entered the homely cavity, the flames were the only thing present… Her eyes scanned the room for Baker, only finding an unused leafy bed, piles of edible berries, and a stack of wood. A shock of anxiety bolted up her spine, sharply settling on her frills like cold ice. Where was her mate?
She stepped forward, her webbed toes pressing into… liquid. Her eyes shot toward the ground, the orange-skinned female only now realizing how slick the floor really was. Viscous moisture clung to her leg, stretching across like mucus. The room was… dry before. Her initial thought that it was blood, but that was easily proven false by the thin film’s clear color. That did not ease her worries, however; her betrothed was still out of sight. Perhaps he left to forage, or was possibly looking for her?
A deadened wet thwack from further inside the cave echoed throughout the room, drawing her attention and causing her ears to perk up. Baker…?
She squinted down the black corridor, its sturdy stone now only reflecting the low howl of the cavern’s natural wind. Her eyes stayed locked on it as she slowly grabbed a makeshift torch and set it alight with the campfire. It had to have been her mate down there. Perhaps the tunnel curved so that she was unable to see his torchlight? What was he doing in the dark? Was he searching for something? Food perhaps?
She was already heading toward him before she considered any other possibility. Short drips accompanied her footfalls into the talon-width thick liquid that proliferated along the ground, grabbing onto her every time she raised her foot with a disgusting sucking noise. Her skin soon felt a similar spreading moisture from the humid cave, a low heat building up as she went. It would have been welcoming if not for the sick feeling that settled in her stomach.
The flickers of her torch illuminated the smooth cave walls and the ever-present pink moss that accompanied them. The ‘flora’ grew in volume and presence, stretching everywhere in random lines, often crossing and connecting with one another into larger segments. It eventually lost its fuzzy texture, only a moist reflective red taking its place. The way it almost appeared to… pulse in sync with the surrounding ambience only furthered the notion of veins and arteries…
A creeping sense of wrongness etched itself in her mind. Her ears slowly drooped down and her back hunched as her wide eyes failed to make out anything a pace or two in front of her. She scoured the blackness for anything and everything as the stone path ebbed and flowed, bringing her further down into the heart of Ershah.
thwack
A startling yet familiar noise halted her advance. She stepped back, swiveling her head around wildly to locate its source. Nothing made its presence known. There was only a permeating darkness within the… tunnel… She froze. When did the corridor become so large? Just before, she was able to stretch her arms to reach both sides of the walls, but now… Now it was open like the ocean, the blackness surrounding her entirely, obscuring… everything. She couldn’t see the entrance, nor the ceiling. Her pitiful torch illuminated the ground below her and nothing more.
Plip... Plip… Plip. The dripping continued, now suddenly an overbearing presence… like that of a predator’s breath riding down one’s neck.
Her breathing quickened, eyes widening. Was her mind playing tricks on her? Hesitant paces backward drew her into what she presumed was the direction she came from. It was no use. Further and further she went into the abyss, finding nothing but more of the tenebrous expanse.
The only true sense afforded to her was hearing… Every stifled breath, every wet footstep, and every flick of her torch felt deafening and… revealing. She was but a spark in the wider cavern, waving herself down as prey in the unseen eyes of what awaited her. Something could have been right behind her, and she would have been none the wiser… especially with no wall to guard her back…
A shiver ebbed through her frills. Would it be wise to suffocate her only flame to cover her presence? She stopped her palm from doing so, realizing that the fire was her only light. If its illumination perished, she would be trapped in the abyss with no way out… She needed to leave. She had to find the tunnel. It was—
“Fa…r...mer?” a voice croaked out, its intent shaky and bogged down in black tar.
Her shoulders stiffened, back straightening as she turned toward its direction. It was… Baker’s… but it felt uncanny… foreign. Was that even his? It had to be. M-Maybe he was harmed, too injured to move? Perhaps it was a broken frill? It would make sense. She had to find her mate… no matter how much his pained voice terrified her. That was why she was here in the first place…
The thickness of the viscous ground liquid increased as nervous footsteps brought her closer, the air around her getting warmer with each pace. She called out hesitantly, praying for a positive response.
“B-Baker? Are you there?”
Another wet, fleshy sound echoed through the large cavern, followed by a sickening crack. Then, his voice returned. It was much clearer this time, despite the aura of unsettling… distortion to it.
“Come… closer.”
Her steps were tentative, but she continued forward. Everything around her screamed something was amiss, but that painful string in her heart told her to never let her lover go. He was in pain. He was clearly suffering. Why should she ignore the one who warmed her heart with a simple smile just because she was perturbed by unproven nervousness?
Labored breaths filled her ears as she descended a small incline toward her mate. The shin-high murky liquid at the bottom was ignored, only becoming a small nuisance as her long strides carried her across the unknown fluid. Her motions caused it to sway in all directions, the ripples and turbidity preventing her from seeing what caused the squishy feeling beneath her feet. It smelled putrid, though not like that of rot… The scent was something she could not place, yet it was consuming with how it pierced her nostrils with its presence. It hardly mattered. She was close to him, she could feel his very presence in front of her. She could almost hear the breathing of…
Her torch lit up a rock… no… a figure. It was upright, but its head was pointing downwards. She couldn’t see the legs well, but she did notice how its… his familiar gray arms hung limply.
Baker!
Joy and anxiousness ran thick within her intent. “My dear! Are you okay? W-What has happened to you?”
She received no response for an unsettlingly long moment before his head shook… loosely… Like that of a puppet, reminding her of the black abyss that surrounded everywhere his body was not… It hid something.
“Come… Closer.”
“…W-What? No… M-My Dear… I…” In a moment of fear she raised her torch closer, illuminating everything.
Flesh surrounded him wholly, replacing his legs with undulating tubes and wet meat. Tendrils attached to his back, pulsing from their ceiling-bound origins. His limp arms moved slowly… falling… melting. The very skin slopped off onto into the pile of red beneath him with a sick thwack.
She jumped backwards, but the viscous liquid beneath her held tight. She couldn’t move. Her torch flickered and flared as she fumbled with her footing.
Lumps and nodules swelled from that thing’s chest, the very organs within rearranging. Deafening cracks and vile squelching echoed. The skin down his center slowly tore itself apart, strings of sinew breaking like twine to reveal malformed limbs within.
She ripped her legs from the grappling pond beneath, doing everything in her power to turn away.
But it was no use.
Bolts of force perforated her body. Agony seared every surface of her body.
The chest had burst open, sending several tendrils right through her. They squirmed and extended into her, moving like worms. They ripped and melded to her own flesh. Roaring pain flowed through her being like fire and lightning, consuming her wholly.
She screamed, but nothing escaped her lungs. Blood and tissue filled them. She needed to rip at the invading terror, but could not move. The red abomination pulled them for her; a sickening puppet of muscle.
Everything faded. No pain. No breathing. No sight.
The last thing she saw were the sockets in which her beloved’s gorgeous yellow eyes once laid, now replaced with pulsing meat.
She missed them… dearly.
\= = = = =
Several days of ridicule and a merciless sea voyage were sure to have an adverse effect on one’s mental state—being cast out of one’s own religion even more so. Some would perhaps cope with such by lashing out against those higher up the mountain than themselves. Others might resign themselves to prayer and labor, hoping to fit back into place within God’s graces. However, an exceptional case may change the way one perceives their circumstance.
The script-keeper and her village-mates were hardy people, having survived the worst of the Gods’ trials and then some—rogue waves from the water worshippers, grand storms from the Sky Goddess, and great famines brought from those who sinned before the Mountain God. They persevered through their community, pooling what little they had and relying upon one another to get through. She had seen it for fifty winters.
Now, eight of them have been stripped of those they became interdependent on, thrown forth into an uncertain abyss with only the clothes on their backs. Yet, by the luck of the Gods, the very shore they came upon happened to be owned by that of a diety-sent. Perhaps it was a sign from the Gods that there was hope for them yet…
And it took all of a singular night to prove that assumption correct. The four Malkrin that followed the star-sent freely regaled their struggles with the vile wilderness and the cruelty of the only other settlement before they met with the Creator. Their opinions on Kegara’s settlement were duly noted, but not taken to heart as they were just that: opinions. The script-keeper would have to see it for herself; feeble belief in the words of few should not sway the mind of someone, especially with her profession. Still, the stories of the abhorrent were taken much more seriously, since despite the confidence shared by the few females about defeating them, the elderly Malkrin could certainly see their ears droop in disquietude when the topic was broached. Furthermore, the other more elusive star-sent refused entirely to elaborate on her experience with the beasts when the paladin wrapped her into the conversation.
Fine new clothes, filling meals, and protective castles could only do so much… In the splendor and awe, the script-keeper understood it could only cover up the aching wounds each of the villagers had come here with. She knew the lumberjack quite well, commonly having to assist her with purchasing and selling items across the sea… the very same sea that now separated the woman from her mate. God knows how the wood-cutter felt now.
All the elder knew from the sparse conversations she had with the orange-skinned female was that she wished not to think of it anymore. To which, the harvester did just that, delving into the work allotted to her without a second thought, and basking in the benefits of the star-sent. Much was the same for the others from their island—their hopes of returning to the Land Kingdom having already been thoroughly sundered by the inquisitors. The script-keeper was not privy to everyone’s pains, but she knew they were similarly prepared to shelve them away in service of building themselves anew with this peculiar situation.
\= = = = =
Female Malkrin eat a lot. Seriously, all the meal boxes Harrison and Akula had prepared were ran through like crab rangoons at a buffet. There were a few left, but certainly not enough for dinner that night—and especially not for the winter, much to his displeasure. The engineer wasn’t looking forward to cooking anymore than he already had… But, he had a trick up his sleeve. Not only did the green fisherwoman know how to use the kitchen, but their little camp just so happened to have another who was experienced in the culinary arts.
Around the time they put their tools down for lunch, Harrison was approached by the pink-colored chef who was assisting with some of the masonry prior. He was apprehensive, yet his eyes were practically sparkling when he asked about the barbecue sauce, spices, and common vegetables. The engineer had a bit of time before he needed to get back to work, so he gave in. They conversed about it over their meal, the human explaining the ingredients and methods of making several types of dishes while the several Malkrin in attendance listened intently.
That was around the time he got the idea: why not have Akula teach the cook how to use the barrack’s kitchen? She was pretty reluctant to return to cooking… until he reintroduced her to her new sous-chef, giving her the task of overseeing the male’s modern culinary equipment and meat smoking tutorial.
Harrison didn’t know exactly why she seemed happier then. It could have been something about her prejudices, just having someone else to help her, or something… else… That didn’t matter to him. As long as the job was done, he was happy—especially since it meant he could focus on other projects.
Take the entire home they were building for example; it was practically completed by the time the chefs were sent off to make dinner. They were working on it since dawn—the engineer was still incapable of sleeping—digging the foundation behind the barracks, layering the brick walls, and getting the wooden supports down in record time. Having several extra Malkrin around made the labor requirement almost trivial, even if he needed to ensure they were doing the job right by constantly keeping a close eye on them. It also helped how eager some of them were to settle in with their tasks—the fisher twins and the lumberjack specifically.
The new arrivals were definitely a lot more lively than last night, that was for sure. They held onto caution in the morning, but that broke rather quickly after they got more accustomed to Harrison’s group and received basic clothing—literally just sturdy plaid shirts and black pants. Cera’s—the ceramist’s newly accepted name, created by Tracy’s shorthand of her profession—tendency to look out for the group also had a hand in the change from guarded acceptance to genuine and vocal appreciation. She did as much as she could to ease their burden by offering water or a helping hand whenever she and the lumberjack weren’t busy bringing wheelbarrows full of clay to the workshop. The two new males gladly accepted both, but the females were quite set on keeping their honor, completing their share of the work ‘with their own talons.’
Then, there was the juvenile. He didn’t want to force a kid to work, but the decision apparently wasn’t his. She quietly joined her older village-mates in hauling wheelbarrows full of bricks to and from the workshop. She didn’t seem upset nor did she seem too enthused about it. His singular attempt to persuade her otherwise was only returned with a terse shake of her head before she continued working. She didn’t like to show much emotion, that was for sure. Were all Malkrin teens like that, or was it because of her situation? Christ… the fact that she was sent to the mainland without her parents—or at all—rubbed him the wrong way. It was fucked, but at least she would be safe here… or as ‘safe’ as was possible.
That was the other job of the day: defense via the new fabricator. Tracy helped out a good bit with organizing and designing the second barracks for the first half of the day, thoroughly combing through the engineer’s ideas and ripping out the ‘brutalist’ and ‘soul-crushing’ lack of ‘real’ architecture. She inserted her own ideas, further backed up by the input of Craftsman’s prior experience, making for an admittedly more pleasant-looking layout of the house’s exterior and interior. It would end up looking vaguely like a white-brick colonial house, but with less ‘posh noble,’ instead making use of Germanic-style exterior wooden supports. It was just big enough to fit eight Malkrin-sized cots, space for movement between them, and all the basics such as lighting, airflow, and a little bit of storage on top—because, what was a building without storage? Luckily for the tradeswoman, it hardly used any more resources than his original plans, so he allowed it.
After that, Tracy realized there wasn’t much else for her to do, so she returned to their other project. The technician did well in assembling the most basic parts, working well throughout the day to complete the forging and welding components. Again, having someone else to do help with a job that big was a massive blessing, cutting off hours of time he would have had to slave away in the workshop.
Hours of time that he was able to use for overseeing the now-completed barracks, simultaneously teaching the Malkrin and getting a feel for how to best utilize their strengths with a substantial amount of help from the craftsman. The male did a bang-up job at explaining tasks and concepts to the others. Much better than Harrison was able to. Once more, it was a job the engineer was more than happy to let someone else take off his hands. The olive-colored Male was perfect for the job anyway, having the technical know-how and experience explaining similar things to Malkrin back on the islands, so the pioneer trusted the task to be completed with little issue.
Now, the day was finally reaching a close, ending with the settlement eating their dinner by the fire. There were a few more benches made to give everyone a seat. That meant the radius had to be extended somewhat, but that wasn’t anything a bigger fire couldn’t fix. Plus, the alien’s intent meant that he could still hear clearly from anyone around the pyre.
The muted sounds of silverware clanking against meal boxes and plates were muddled by the constant breeze. The flames lazily flickered in all directions, casting shadows along the flowing grass, each person in attendance being doused in a mellow orange. The Malkrin conversed with one another over their meals, each sitting in pairs on the furniture. Shar was out on guard patrol, so Tracy ended up taking the seat beside him. It was a bit of a surprise given how much she preferred to stay in the workshop, but he didn’t mind her taking a break—she deserved it. If anything, it should have been him on the fabrication floor, picking up where she left off.
“…Hey…” Tracy’s soft, worried voice took him from his thoughts.
“Hm?” He lazily looked down at the shorter woman beside him, her legs swinging as they couldn’t quite reach the ground.
She worriedly raised her brows. “You alright, dude? You’ve had some major bruised eye action going on all day. Did you even get any sleep? I didn’t even see you when I woke up.”
“No, I actually didn’t—” He held up a palm, stopping the technician’s troubled response. “—but it’s more because of that potion… thingy… Cera gave me. I don’t feel tired at all.”
Her face contorted in confusion, the shadows cast by the fire’s glow emphasizing it further. “The… potion…? Oh, yeaaaah, right. It was supposed to help you with dizziness, I think, but it also prevents you from feeling tired. How does it even feel? Like taking an energy drink, or something else?”
He held out his arm, tracing a finger along it. “I just feel like I’ve got pins and needles all along my skin… and I don’t feel like sleeping. That’s it really, so sort of like taking a bunch of caffeine.”
Her brows dropped in faux-annoyance. “That can not be healthy for you. Have you checked up on yourself with the scanner? If not for that, then at least the radiation? Maybe the fuzzy stuff is from all those grays of radiation you received?”
“I did… I did, don’t worry. The scanner had nothing besides the usual, so I guess it was just a good bit of caffeine or something… I don’t know. It’ll probably wear off soon, though.”
She nodded, returning her gaze to the fire. Her voice mellowed, just barely loud enough to reach his ears. “Good. The aliens were worried sick about you, yesterday, ya know—Shar ‘specially… and so was I…”
He hardly heard that last part, barely able to piece it together seconds after she muttered it. He wasn’t trying to make them worried, it was just a part of being on this planet. Every day was a new close call. The first blood moon, that pink monster, the workshop ambush, the second blood moon, and now the anomaly field all terrified him, haunting his very dreams with brief flashbacks of those sights and sounds. Though, they all served to teach him, forcing him to stay on his toes and never stay complacent… Which was something he was doing now.
He had plans in the works already—the new fabricator being the crux of at least half of them—but what could he do currently? How could he prepare? Or, at the very least, what could he do to advance the group further?
Their day-to-day jobs had already been discussed, plans for a new wood storage building were already made, and his work on the printer was cut out for him tonight… Okay. Well, what could he prepare for in the future? Defense? Of course, now that people were going to be out doing their own jobs, they would be too spread out to protect everyone at once.
There were two components to any solution for that problem: reconnaissance and protection. The first was self-explanatory. If he had, say, a few dozen drones scouting around where people were, it would take a lot of the surprise out of random swarms. That would give people time to either return to the castles… modules… or prepare themselves to take the bugs on. That led him to the second part. Firearms help to kill spider-crabs, but are also pretty dangerous in the wrong hands… He was more than willing to trust the Malkrin he knew with guns to defend themselves, but he couldn’t just start handing them out to strangers. Maybe in time, though. There were always other means of protection, anyway; Kegara’s camp was apparently alive and well, despite practically being from the stone ages.
Cera, Akula, and Shar were most certainly getting some firepower, that was for sure. He’d have to think about what sort of weapons would suit them. That also brought up the current metal deficit… and his gunpowder was running out quite quickly…
That was definitely something he wanted to get on before the next blood moon. He wanted to revisit that metal cave he saw when the paladin and the fisherwoman got cornered by three colossi. He hadn’t analyzed the chunk of ore he hacked off yet—he’d been pretty damn busy—so it was about time he figured out whether or not he had a nearby source of metals. It would be a damn blessing if it was aluminum or iron, despite only being a surface deposit. No matter what it was, it was sure to be of use.
Then there was the gunpowder issue. The last time he checked, there was enough to last him for at least the next blood-moon, but it wasn’t enough for several other firearms, especially if he wanted anything automatic. There were three main ingredients—potassium nitrate, sulfur, and charcoal—which were essential for the production of any explosives. Charcoal was already solved for them, and potassium nitrate could practically be made out of thin air and water, considering they were right by an ocean. Bless the Ostwald process and acid-base neutralization.
The only real issue was sulfur… Christ, natural elements sucked. Either he had to deal with excessive organic recycling of amino acids… or go and mine the stuff directly, and there weren’t any obvious volcanic deposits or fault lines around. Neither of those methods sounded great.
Again, that would have to come later. He needed that fabricator done first and foremost. Then he could deal with the assorted problems that followed it and, well, every other compiling issue. Material harvesting tools, automatic defenses, larger fortifications, and radio-protectant armor were but a few of the big-ticket items on his mind.
Cera’s concoction was still running through his veins anyway, so he might as well finish the printer while he was at it. It looked like he wasn’t sleeping tonight either.
- - - - -
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Next time on Total Drama Anomaly Island - Hard work. Good company.

I had a pretty sudden onset of blood pooling, leg pain, POTS, and vein dilation in my legs in the weeks/months following COVID. I went through the typical circus of doctors/specialists where they didn't find anything and weren't very concerned, until I pushed for a referral to a vascular surgeon. I showed pictures of my legs and the vascular surgeon almost immediately suspected AVMs (Arteriovenous malformations) which are direct connections between arteries and veins that bypass capillaries.
I'm told this condition is EXTREMELY rare and she did an ultrasound specifically looking for it to rule things out, well, they ended up finding MULTIPLE AVMs in each leg. To give you an idea of how rare it is: AVMs are already a rare condition, and 90% AVMs occur in the spine/brain, 10% elsewhere, of those that occur in the leg, theres usually 1-2 in one leg. She said she's never seen a case like mine. Because they're so rare, most vascular surgeons don't even think to look for them.
I've never had a history of POTS/blood pooling/leg pain pre-covid so I'm pretty sure that something happened to either cause them to form or increase in size. They can be very easily missed on ultrasound if they aren't specifically looked for (infact, I had a leg ultrasound before where they missed it). If you have similar issues, push for a referral to a vascular surgeon who'll cooperate and ask for an ultrasound specifically looking for AVMs at a vascular lab that handles high case loads. You don't want it misdiagnosed as varicose veins because typical vein treatments can make AVM issues worse.
AVMs can either be congenital or form after trauma but I haven't had any leg injuries, truth is no one knows why exactly they form and given the effect of covid on blood vessels there could be a link.

48 yr Old Female, 5'5, 136lbs, White, Non-Smoker or Drinker
CT Scan in January said - Slight nodular contour-Cirrhosis
Recent (End of April) Liver Ultrasound
Liver
Size: 17.4 cm
Contour: Smooth
Echogenicity: Mildly Increase
Echotexture: Heterogeneous
All Portal, Hepatic Veins and Splenic Vein are antegrade with normal waveform. Same with Hepatic Artery. Proximal IVC: Normal, Gallblader Normal. No dilation in Intrahepatic or Common Bile Duct.
Spleen: Enlarged 13.4 cm
No Fluid
Conclusion:
Heptasplenomegaly with heterogeneous parenchyma and hepatic steatosis.
Blood work is all in normal range after having some elevations a few months back.
MRI/MRE End of May to check for Portal Hypertension/Cirrhosis.
How likely could this be Cirrhosis as opposed to Fatty Liver?

NOTE FROM AUTHOR: Hello Hello! I am a first-time writer embarking on my first dumpster fire; input is most welcome. I'm not the best self-editor, so get your hiking boots on. It's rough out there. Whenever I read it, I find or create more errors (:
OPTIONAL READS: For the Retro Computer or Programming Enthusiast OR if you are open to other formats of story telling. I tried to combine my love for programming as an UNDERSTANDABLE way to tell a story through a Visual Experience in the Command Line Interface;
A Stand-Alone VISUAL ASCII 'Programming Terminal' Story Prologue. Follow through(Screen Shots of my Command Line Interface) the UNE-EYE Observational Satellite Terminal as Kable extracts Classified Data about his Beloved Military Unit, THE HUMMINGBIRDS, a flying exoskeleton unit. This includes the origin story of a Technology Tree in Book 1.

####

INDEX

1. DEADCOAST - THE HUMMINGBIRDS PROLOGUE -> HERE <-
   
2. DEADCOAST - COMPLETE ILLUSTRATED INTRO -> HERE <-
   
3. HEAT & GRIZZLY REDS - CHAPTER 1 ILLUSTRATED -> HERE <-
   

"Deadcoast Book 1: Heat and the Grizzly Reds" transports readers to a 2063 Earth, a world on the brink, where the scarcity of fresh water has led to previously unseen geopolitical tensions. Amidst this backdrop, the nation-backed militant group DAGGR has emerged as a formidable force, leveraging advanced technology to assert control over Canada’s abundant water resources. At the heart of their arsenal is 'slugTech,' a technology pioneered by James Broadshaw, intended for ecological restoration but repurposed for militaristic dominance.
The story unfolds with the chilling invasion of Vancouver, marking a turning point as DAGGR makes its ambitions clear, culminating in the assassination of the Canadian Prime Minister. This act of aggression leaves the country reeling, exposing vulnerabilities and igniting a global reaction.
The UNE-EYE satellite is central to the international response, a significant narrative element representing the world's most advanced orbital tracking system. Once decommissioned in favour of privacy, the Dutch reactivated the satellite as a strategic move to monitor DAGGR's movements and coordinate a unified international effort against the aggressors. This revival of UNE-EYE symbolizes a crucial turning point, highlighting the global stakes and the interconnectedness of nations in the face of a common enemy.
As Canada grapples with its plight, the DAMU (Deserted American Military Units) rise in solidarity, breaching borders to fight alongside their Canadian counterparts. This act of defiance is mirrored by international forces, including the Netherlands and Ukraine, each bringing their unique strengths to the coalition, underscored by the strategic oversight provided by the UNE-EYE satellite.
Amidst the geopolitical chaos, a man who had all but given up, a boxer on the ropes, emerges from Vancouver's Gastown. Known as HEAT, this leader of the Grizzly Reds becomes a symbol of resistance and hope. HEAT's story, and that of the Grizzly Reds, is one of resilience, rallying not only Canadians but also global citizens to stand against DAGGR's tyranny.
" Deadcoast Book 1: Heat and the Grizzly Reds" is a compelling narrative of survival, alliance, and resistance. It deftly weaves together elements of advanced technology, international politics, and the indomitable human spirit. The inclusion of the UNE-EYE satellite serves as a testament to the complexities of modern warfare and the critical role of global surveillance and coordination in maintaining security and freedom. But something else stirs amongst it. The UNE still shrouds its use, albeit assuring it is for record-keeping purposes- there is no way to be sure. Join HEAT and the Grizzly Reds as they navigate the challenges of Time, War, Science and liberating their fellow man in Vancouver. THE GRIZZLIES NEED YOU, in this action-packed, emotional saga, speaks to the resilience and camaraderie inherent in the human condition.
CHAPTER 1 - The Blood Spattered Maples
ILLUSTRATED VERSION -> HERE <-
The early morning sun cast a serene glow over Vancouver, its golden rays gently coaxing the city from its slumber. The harbour lay still, bathed in a tranquil blend of crimson and amber, defiantly calm as if aware of the day's latent potential for tumult. The awakening streets, pulsating with the vibrant beat of daily enterprise, transformed into bustling arteries of life.
Amidst this urban renaissance, Ryan stood by his apartment window, one eye still tinged a fading shade of deep lavender from last night's ordeals. He absorbed the duality of the world outside – a peaceful façade masking an undercurrent of chaos, much like his own existence. The apartment, a silent guardian of his life's chapters, was awash with tangible memories; some stood proudly like trophies, and others lingered like indelible scars.
"Eugh, need to sort out this money mess," Ryan muttered, his voice a gravelly mix of resolve and weariness. He gingerly touched the bruise beneath his eye, a stark reminder of the previous night's fight. He wasn't just a boxer but a living, breathing paradox. His undefeated record of 12-0 was more than a tally of victories; it was a map of a life spent dancing in and out of shadows. At 17, he was a beacon of hope for Canadian Olympic Futures. Now, at 33, he was a spotlight in his subconscious, illuminating the relentless passage of time and a road riddled with 'what ifs.' Eleven of those wins were echoes from a past steeped in the sweat and blood of the ring before life's currents swept him into the city's gritty underbelly. There, he became an enforcer, not out of choice but a necessity, bound by ties, not of blood but of unbreakable bonds forged in adversity. Stepping back into the ring at 33, Ryan wasn't chasing glory; he was hunting redemption, a chance to rewrite a narrative that had veered off course.
Today's boxing was far from what he once knew; it had transformed into a digital spectacle, a charade he refused to partake in. The sport now paraded fighters adorned with loud chains and face tattoos, pretending to live a life of crime they don't. Vile symbols of fame he doesn't wish for. Ryan had always skirted the fringes of the spotlight, respecting the sport but despising what it had become - a glorified masquerade that he believed led the youth astray. He stared out at the awakening city, contemplating his place in this ever-changing world, just as the first notes of a familiar yet unwelcome voice crackled from the vintage radio on his shelf.
"Ah, jimmy2piece," he scoffed, the name leaving a bitter taste. The vintage radio crackled on, announcing the dazzling exploits of the heavyweight boxing champion, an embodiment of everything Ryan detested about the sport's current state. Ryan's hand lingered over the old radio, a relic amidst the bountiful thrift and trinket that abundantly filled his apartment. The announcer's voice, overly flamboyant in its praise of 'jimmy2piece,' clashed with the morning's tranquillity, grating against Ryan's every nerve. With a flick brimming with contempt, he silenced the intrusive chatter. The ensuing silence was a stark reminder of his path's divergence from the once-noble art of boxing to a life mired in moral ambiguity.
"Enough of this nonsense," he muttered, the disdain in his voice mirroring the snarl on his lips as he spun the dial back to silence.
*Click*
Ryan was a man of contemplation; opening his balcony door, he let the morning breeze mingle with the memories that haunted him daily. These reflections were a tormenting ritual, no matter the joys and love surrounding him. His only respite was constant movement – hobbies, work, art – anything to fend off the sharp claws of the past that threatened to shred the remnants of his self-respect. He had lost ten years to choices and actions that replayed in his mind relentlessly every single day.
"This 'jimmy2shoes' or whatever...pal throws pillows, a poser pretending he's about that gang life; I can see it in his eyes, he's not a killer," he grumbled, gazing out at the awakening city. This day promised a respite from his underground fights – at least for a while. His recent backstreet brawls, a far cry from the glory of the boxing ring, were what paid the bills now. "At least I've bought myself three more months..."
Leaning on the railing of his miniature balcony, Ryan cradled a cup of steaming coffee, his gaze drifting over the streets below. At this moment, the chaos of his life seemed distant, replaced by a transient calm. Despite his bruised, rough presentation, a certain peace enveloped him, a rare stillness that belied the storm of his existence. His thoughts meandered through the serene hum of the city and the gentle brush of the ocean breeze. The skyscape, with clouds dancing to the ocean's rhythm, offered a brief escape from his turbulent past.
Memories of Robin, his mentor and friend, floated into his consciousness. Robin's untimely death in Dubai was a wound that never healed. The sacrifices he had made to keep Robin safe, only to be absent on the fateful trip that claimed his friend's life, weighed heavily on him. "Why did it have to be you, Robin?" he whispered to the horizon, the question, a haunting torment upon his daily routines.
Ryan was a thinker; as he slid over his ashtray from the stool, he sparked up A morning 'dart' (cigarette), as he called them. His past began to creep into his head, as it did every morning. With each inhalation of addiction-soothing nicotine, his blazing thoughts followed as his brain began to become fully active from his sleep. It was a raven on his shoulder tormenting him, pecking at him ever haunting his consciousness. No matter the love he may have found or the happiness, friends, or family surrounding him. The time to reflect was always grim and consistently unbearable. If he stood still, the Ravel's claws sunk more profoundly; the only reprieve was constant distractions. It's why he kept so busy, creative, and active. Ryan constantly kept moving with hobbies, work, or art. Pushing off the switchblade thoughts ready to cut into his subconscious and bleed out whatever self-respect he had left that day. He threw away ten years of his life, and he relives them every. Single. Day.
"Damn man, what's the point of it all?" Ryan's voice was barely a whisper, lost in the morning breeze. His gaze lingered on the horizon, eyes clouded with confusion and pain. "Robin's gone, and here I am, a ship adrift; up shits creek without a paddle. What good can I do? What purpose do I serve? My skillset? My knowledge? Ive wasted my life, nothing is applicable." The questions hung in the air, unanswered. Ryan's life had indeed been a storm of violence and turmoil, from the gritty days working alongside Robin, watching his back to his hard-fought victories in the boxing ring. He had dreamt of leaving the world of fights behind, yet fate seemed to have woven a different path for him, one that he couldn't escape...
The distant sound of boat horns broke his train of thought. These weren't the usual rhythmic calls that echoed along Vancouver's shores; they carried a sense of urgency, growing louder and more frantic by the second. Ryan leaned forward, squinting into the morning light. The sight that greeted him was anything but ordinary. Dark, ominous and foreboding shapes were cutting through the waters toward the Seawall – military-grade ships that seemed like phantoms against the sun's bright backdrop.
"What the...?" Ryan murmured, a wry smile touching his lips as he recalled a line from a 1930s radio show. "Ah yes, the 'Anti-Frackers' upping their game, bravo!" He often found solace in humour, a shield against the world's harsh realities. Ryan was an unbreakable anvil to the world, always struck to sharpen others' steel. But what about his iron resolve? He bore the burdens so others didn't have to, a silent guardian shouldering the world's weight in stoic silence. Yet beneath that armour of stoicism beat the heart of a man grappling with his vulnerabilities, a man with a core as soft as it was intense.
Just like that- The world as we knew it, changed forever.
The morning's peace shattered abruptly as sirens wailed into life, slicing through the air with a sense of impending doom. The tranquil dawn was now a backdrop to a nightmare unfolding in real time. Ryan's eyes, mirroring the turbulent hues of a stormy sea, narrowed in primal alertness. These were not friendly vessels coming to grace the city's harbour; they were harbingers of chaos, their arrival a silent scream in the gardens of Vancouver's tranquility. As the city around him carried on, blissfully unaware of the looming threat, Ryan's mind shifted into high gear, honed by years of confrontation, conflict and reading other peoples intentions. He understood the unspoken language of death, the subtle shift in the air that preluded catastrophe. The serene calm that had greeted the day now seemed like the deceptive stillness before a devastating storm.
PFFFFT~~
Ryan's coffee ejected out his mouth, a clean mist dispersed, dancing in the ocean winds.
His eyes widened in shock. "That... No, that's not right. That honeycomb structure on the bow – that's rumoured military tech, not something you'd find on a civilian vessel. That's definitely not one of our decommissioned ships; Canada has always had a modest military budget- It's not the U.S. either; they've moved on to those massive city carriers," he muttered, recalling the recent unveiling of the U.S.'s latest naval behemoth designed to be a self-sustaining war ecosystem.
"These are destroyers...carriers...and what in the world are those landing crafts?" His voice trailed off as a wave of realization washed over him. A heavy breath escaped his lips, his heartbeat thundering in unison with a growing sense of dread. This kind of military might, sleek and menacing, was straight out of the pages of a dystopian novel. Ryan's pulse quickened, adrenaline coursing through his veins, mingling with an unsettling fear. Vancouver, with its serene beauty and peaceful reputation, was the last place one would expect a military invasion. Yet, as he stood there, the city around him persevered in blissful ignorance. Laughter and the sounds of daily life echoed up to his balcony, starkly juxtaposed against the darkening horizon of his thoughts.
Something sinister was unfolding, and he felt an urgent need to act. "Ah, damn it!" he exclaimed, frustration boiling over as he hurled his mug to the ground, where it shattered into razer sharp ceramic shards—a glimpse of futures past.
The walls of Ryan's apartment, once a gallery of memories from a life half-lived, now felt like they were closing in on him. The space that had been his refuge, adorned with mementos of a tumultuous past, suddenly felt like a prison. He felt trapped, not by physical barriers, but by the weight of the unfolding crisis. Who could he call? Who would believe him about an impending military assault? Was there even time?
Each option seemed as hopeless as the next, leaving him feeling powerless. His fists, which had once brought him victory in the ring, now seemed futile in the face of this immense and unknown threat.
BOOM
A thunderous crash tore through the city's fabric, piercing the veil of laughter and routine. Giggles changed to Shrieks, the buzzing of cars in the city turned screeching of panicked tires. It was a boom resonating with such force that it seemed to shake the very resolve of the most robust steel, a sound that demands attention and captivates a person, a sound of death; it rattles you to the bone. This explosion marked a pivotal moment that would forever alter the course of Vancouver's history and, indeed, the world's.
The resounding echo of the first explosion heralded a declaration of war on all that was ordinary. In Ryan, the shockwave ignited a transformation. Despair morphed into an unyielding determination, a fire kindled deep within. His skin prickled, each hair standing on end as if his nerves were braille, spelling out the moment's urgency.
"Are they firing at us?" Ryan's voice was a mix of disbelief and rising panic. The thought seemed almost too surreal to entertain. He hesitated momentarily, grappling with the reality of the situation. The explosion's roar, so fierce it shook the foundations of his apartment, jolted him back to the present. Racing back to his balcony, what he saw confirmed his darkest fears.
The ships in the harbour were no longer silent, ominous spectators; they had unleashed their fury, sending plumes of smoke and debris skyward. Vancouver's skyline, once a proud testament to peace and progress, now served as a harrowing backdrop to an unfolding apocalypse. Below, the streets descended into chaos. People scattered in a frantic attempt to escape, their screams piercing the air, a chorus of dawning terror.
Ryan's heart pounded against his chest, each beat a call to action. He was no hero, never the 'good guy' in his story, but he did value life above all. Standing there, witnessing his city being torn apart, he knew he couldn't remain a passive observer. Indecision and shock gave way to resolve.
"MOTHA FU-" he cursed, his words lost in the burst of an explosion, spotted at the last second.
The world around him had erupted into a maelstrom of fire and fury.
An air burst shell detonated with ferocious intensity a mere 50 meters from Ryan's sanctuary. The explosion ripped through the building, an unforgiving hatred that jolted reality itself. The blast wave, a monstrous force of destruction, assaulted his apartment, shattering the windows with an ease that mocked Vancouver's fragility. Glass shards, transformed into lethal projectiles, hurtled through the air with a hunter's precision, each piece seeking its target. Instinctively, Ryan lunged for cover, his only protection a vintage oak promotional board, a relic of a bygone era. This wooden guardian, decorated with the iconic image of Stan Lee, stood as a stoic defender, a symbol of comic heroism now repurposed to shield flesh and blood from the brutal onslaught.
A low hum erupts from the depths of his being as the fireball swirled around him. "Breathe... I can't... don't fall asleep... don't...sleep..." he whispered, fighting the encroaching darkness. His cobalt eyes, glazing over open, fighting to the last light, flickered between consciousness and oblivion. The distant, muffled voices of mentors past echoed in his mind, a fading chorus in the theatre of his memories. Ryan looked to his left, cast one last lingering look at the Vancouver sky, a canvas of blue that seemed so distant now. As his vision began to narrow, a tunnel drawing him away from the light, Ryan felt the grip of darkness pulling him under heavy, yet weightless. Once so vivid and alive, the world around him was fading into shadows.
Amid shrapnel-induced unconsciousness, Ryan's mind catapulted him back to a pivotal moment from his youth – the Ontario Canadian Olympic Trials.
The stadium's noise swirled around him, but it was an entirely different world within the ring. There, it was just Ryan and his opponent, every move a testament to the sacrifices he and Robin(Ryan's longtime mentor both inside, and outside the ring) had made together.
Ryan's style in the ring was unique, a blend of calculated ferocity in speed and agility. He adopted the elusive, angular movements that Robin had honed while serving alongside the hardened Ukrainians on the frontlines of Kyiv. This style was compelling and unpredictable, frustrating his opponents with swift and efficient strikes. Ryan's ability to slip away from counters, almost serpentine in its execution, left them grasping at straws.
Point fighting for the Olympics was a system that worked well with Ryan's style but not necessarily with his mindset. Ryan was a fighter at heart, and sometimes, when pushed, the disciplined techniques would give way to a rawer form of combat. Robin, who always believed in Ryan's potential, saw this as his greatest fault and biggest asset to "push past." In his gruff but encouraging voice, Robin would often spew "The stink in that mind, You've got a head on you that'd make an onion cry," highlighting Ryan's occasionally impulsive nature, and inability to control his emotions when it mattered. This characteristic made Ryan fearless in the ring but also sloppy, open, and vulnerable. It often led him into trouble outside of the solace in prizefighting.
In these trials, Ryan's physical attributes – his slender frame, broad shoulders, wide back and a peculiarly long wingspan that gave him an imposing presence in his weight class – it made him stand out. His frame synchronized with his style, creating a truly unique spectacle of genetic gifts, hard work, and skill.
These memories blended nostalgia and pain as they flickered through Ryan's mind. They were reminders of a path once trodden, a journey shaped by the influence of a mentor and the determination of a fighter's spirit.
As the Olympic Trials set to begin, Robin looked to Ryan to instill confidence for his upcoming bouts, but Ryan was in his element. It was fight day, the fun day, the day to show off all of the hard work. Ryan had confidence, and his style in the ring displayed it in full. He moved with an angular rhythm that was both art and battle – slipping, landing a quick stiff counter cross, then gracefully stepping out of reach inches from returning fire. He made it look fun and easy, as if playing with his prey before fangs clench throat, delivering the killing bite. Looking closer, you can only see fire and determination in his bright eyes. He found purpose in the beautiful science of boxing. His strategy was that of a technical boxer, The Counterpuncher; 1. To bait his opponent into committing, then counter, fight long, fight smart. 2. Beat em' up, Frustrate em', then start slinging the heat in the uppercuts and lead hooks.
The bell rang and the fight was officially underway. Ryan controlled the ring with his long frame. Each exchange was rapid yet controlled, a dance of precise strikes and evasive maneuvers. The world's complexities faded in these moments, leaving only Ryan and the pure essence of the sport he loved. He felt invincible, a force of nature within the confines of the ring. To Ryan, the fight was more than a competition; it was a performance, an exhilarating escape from the mundane. It was true Purpose.
The intensity of the round reached a frustrating outburst by his opponent, who grabbed Ryan by the back of his head– 'SPLIT' called by the referee, his hand placed between them. A judge calls for a correction, catching the referee's attention only for a split second. In this second, Ryan's Opponent saw an opportunity. Lifting his head to move away, Ryan locks eyes with his Opponent, sporting a grin and delivering a sly headbutt as a parting gift. It's against the rules, but part of the game's harsh reality if gone unnoticed. Expelling energy and detesting it was a waste of fuel. It was a jolting reminder of "at all times"(protect yourself), a stark contrast to the discipline and respect Ryan upheld, starting his boxing journey in Thailand under "Muay Thai" rules, ideology of the worrior spirit and discipline. There was a sense of Honor in Lumpinee Stadium.
The outcome of these unsavoury tactics here is an advantage for the opponent. Ryan's inner pools erupt, his mind swirled with raging white waters, crashing and colliding against each other, two oceans with opposite currents meeting in his consciousness. His once technical thoughts, muscle memory mixed with fight iq burst with flames, erupting and incinerating all strategy in his path. His eyes widened, open like he'd found his primal genetic ancestry hidden deep within. The slaughter and the war of history. The bloodshed of 1000 lifetimes. He felt it all. Manic in thought. Ryan wanted to take his glove off and rip his cheeks open from the inside out--
BREAK - Ryan snaps back into it, erupting in stoic, silent, primal rage.

░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░░ ░ ░░░ ░░░ ░░ ░ ▒ ▒▒▒▒ ▒ ▒▒▒▒ ▒ ▒▒▒▒▒▒▒ ▒▒▒▒▒▒▒ ▓ ▓▓ ▓▓▓▓ ▓ ▓▓▓ ▓ ▓▓▓ █ ███ ██ █ ████ █ ███████ █ ████ █ ████ ██ ██ █ █████████████████████████████████████ 

The fight escalated, Ryan's disciplined technique unravelled under the seething tide of his rage. The finesse and agility that once defined his footwork gave way to a heavier, more aggressive stance. His feet, usually light and swift under his commanding frame, now felt anchored to the floor, each step driven more by fury than finesse. This transformation in style played perilously into his opponent's advantage. Ryan, usually a master of stick-and-move tactics, found himself engaging in close-quarter brawls, trading his advantage for a risky gamble. His in-and-out maneuvers, once a blur of grace, turned into brutish, in-the-pocket exchanges. This was a terrain where his more muscular and compact opponent had the upper hand. A raw, primal contest of power replaced the tactical dance that Ryan excelled at. Ryan's precise strikes became wild swings, his movements predictable to his seasoned adversary. Seizing the moment, the opponent unleashed a devastating barrage of inside hooks with their compact frame. A vicious right hook, lands clean in the exchange, thrown with the grace of a milkbag, the power hooks brute force, cut through Ryan's defences. The blow landed with a bone-jarring impact, sending a shockwave through Ryan's frame. His world spun as he stumbled, his once dominant presence in the ring now faltering under the weight of his unchecked emotions.
The ground rushed up to meet him as he crashed onto the canvas, the taste of iron and the sting of defeat mingling in his mouth. The crowd's roar faded into a distant echo, a stark reminder of how quickly the tides of battle could turn. Robin's voice sliced through the ringing from the corner, resonating with a force that commanded attention.
"Get your shit together, JUMPIN JESUS RYAN! HEART OF GOLD AND HEAD OF STONE – GET UP, YOU LITTLE COWARD! YOU'RE LETTING IT WIN, AGAIN! STOP THIS ONION HEAD NONSENSE AND DANCE, BOX THIS FELLA – YOU'RE BETTER THAN THIS, ACT LIKE IT, BELIEVE IN IT!"
His words were more than just a call to action; they were a lifeline thrown into the stormy seas of Ryan's mind. Each syllable was drenched in the raw, unfiltered wisdom that only a life spent in the cauldron of combat could forge. Robin's tone was a volatile cocktail of fury and concern, the urgency palpable in his voice. His palms crashed against the ring mat; each hit thunderous punctuation to his fiery sermon.
"You've got the talent, kid, but it's as good as ash if you keep burning it to the ground. I'M HERE FOR YOU, IM RIGHT HERE. SNAP OUT OF IT AND BOX THIS PLASTIC PATTY! MOVE GOD DAMNIT, GET UP!"
On the canvas, Ryan lay dazed, the echo of Robin's voice ringing in his ears. It was more than a mere pep talk; it was a wake-up call that struck a chord deep within him. Amidst the haze of the crowd murmurs and the pulsating pain that coursed through his body, clarity began to emerge. Lying there, Ryan grasped the essence of Robin's message –
"coward? letting it win? Playing my ego are ya Robin...hes right though. Im throwing this shit away."
This moment, sprawled on the canvas under the glaring lights and the crowd's gaze, became a crucible of transformation. The raw emotion and the hard-hitting truth in Robin's words ignited a spark in Ryan. It was time to rise, shake off the shadows of rage, and embrace a fighter's true spirit like he had learned in Thailand – not just with fists but with heart and mind in unison.
Staggered yet stirred by the dual impact of the physical hit and Robin's piercing words, A padded fist crushed into the rings canvas, followed by a kneee and the eruption of the crowd. Ryan was back, and he began to pull himself up from the canvas. His resolve, momentarily dimmed, now reignited with a fierce, clear, calculated intensity. Memories of the gruelling hours spent in the gym flooded back to him – the relentless sparring sessions, the time spent in Thailand, the sweat and toil, and the invaluable lessons etched into his being under Robin's stern tutelage.
With a renewed spirit, Ryan stepped back into the battle, his movements now embodying controlled power and a fluidity to his step. He recalled his time fighting beside the backdrop of the "Sarama" a traditional Thai music played when in combat. The times of learning to move, fight with the music, to flow, to be fluid, to be concise. Ryan finally put it all together in the heat of battle. He had merged his inherent ferocity with the disciplined technique that Robin relentlessly drilled into him, and the mindfull practises of the years he spent under Burklerk Pinsinchai in the jungles of Chiang Mai. His style was now fully displayed, raw and visceral yet refined by countless hours of practice in mind, body and spirit.
The final rounds bell clang to a start in a clinic of skill and sheer willpower. Ryan, driven by a blend of desperation and unwavering determination, unleashed a barrage of calculated and explosive strikes. Each punch and maneuver was a nod to the efficient, no-nonsense Ukrainian style that Robin had imparted to him. Ryan moved rhythmically across the mat, steps measured and precise, executing short, angular movements and deft outside counterpunches. He had returned to his element – the dance of combat, where he felt most alive, a symphony of movement where every step and punch was a testament to his life's journey and experiences as a human being first, and as a fighter second.
In this wake-up call, Ryan reinvigorated and reminded himself of his love for the sport, the exhilarating blend of art and athleticism. He was not just fighting to win; he was celebrating boxing, combat, honouring the path he had walked with Robin, and reclaiming what it meant to be a true fighter through Burklurk Pinsinchai's Teachings.
The round pressed on, and Ryan executed his maneuvers with a surgeon's precision. First;
-- The counterpuncher; a display in timing and accuracy, delivered with the full force of training and innate skill. --

1. He deftly slipped his opponent's cross, a move as fluid as it was swift.
   
2. He angled off, creating a space wide enough for his next move.
   
3. With an almost predatory precision, Ryan unleashed a powerful right cross, targeting his opponent's cheek from the angle he had just created. But Ryan wasn't done yet.
   
4. He slipped out again, evading any potential counter from his disoriented opponent. The rhythm, he danced in and out with his precise timing, perfected down to inches and angles.
   
5. In a final, decisive movement of the exchange, Ryan slipped in. He timed his step with a long cross that came off-beat, catching his opponent utterly off-guard. The punch landed with a satisfying impact, culminating in a perfectly executed combination. As he watched his opponent stagger, Ryan couldn't help but think, 'cya sleepy boi,' a silent acknowledgment of his dominance in this singular exchange.
   

This sequence was a statement. Ryan was not only back in the fight but also commanding it.
ONE!…TWO!…THREE!…FOUR!…FIVE!…SIX!...SEVEN!..EIGHT!
Ryan's opponent stands, admirable, but futile, driven by sheer will but hampered by sluggish movements, the man rose to his feet, it was clear the fight was reaching its zenith.
The opponent, gathering his remaining strength for a final stand, launched a jab, a last-ditch effort relying more on brute force than finesse. But this was a fatal mistake in Ryan's world – playing right into what Ryan was best at. Counters.
Ryan read the move with the clarity of a seasoned fighter. As the jab came, he effortlessly slipped to the right, evading the punch with a short angular step that spoke of his ring intelligence. Instantly, he countered with the same sharp cross from his right hand, followed by a devastating hook that cut through the air with lethal intent in his left. Grasping at straws, reeling from the counter, Ryans opponent threw a desperate, looping last stand punch, Ryan dipped down and left, rolling the punch with an elegance that made it seem almost effortless. He was Hunting for the Kill Shot. Seizing the moment, Ryan unleashed a ferocious left uppercut, the force of the blow lifting his opponent's chin skyward. He followed up with a right overhand, but just before impact, he halted the punch. There was no need for it; his opponent was already collapsing, the "Lights were on, but no one was Home". The fight was effectively over, Ryan's last combination is the final note, a crescendo that echoed through the ring.
As his opponent hit the canvas, the crowd erupted. Ryan stood in the center of the ring, his chest heaving, every fibre of his being alight with the thrill of victory. This wasn't just a win; it was a performance, a display of skill, heart, and the indomitable spirit of a fighter who had walked through fire and flames to the otherside and emerge victorious.
The final bell Rings with not a single chair in the arena warm; a thunderous clap erupts from the crowd. It was more than just applause; it was an acknowledgment of a battle fiercely fought by both men. In that moment ringside, in a triumphant victory, Ryan and Robin shared a look that spoke volumes, a connection far beyond the usual bounds of mentor and protégé. Their bond, tempered in the crucible of hardship and struggle, was now sealed in the glory of this defining triumph.
Standing amidst the cheers and the adrenaline-fueled euphoria, Ryan found himself momentarily lost in the tide of memories. It was a poignant reminder of the journey that had brought him here, a path marked by triumphs and losses. Robin's teachings transcended the confines of boxing; they were life lessons imprinted deep onto him. Ryan began to slowly step out of the ring; the weight of these reflections settled upon him. The victory was sweet, but it carried the weight of all sacrificed to achieve it. Robin's presence was felt strongly, a guiding force that continued to shape his path, illuminating the way forward even in the most challenging times.

I am in San Jose, CA. I have arrived at ER by ambulance on May 8, 1am.

BACKGROUND:

CCI, AAI, internal jugular vein compression (?) at the C1 level secondary to CCI. I’ve also been diagnosed with HSD by an EDS neurosurgeon via physical exam—therefore I could have some vascular integrity issues. Previously ME/CFS. No history of anxiety or panic attacks. No CCI or IJV surgeries or medication. Primary symptoms: - Constant pressure headaches and feeling of venous congestion in the head. As if fluid does not go through the head or gets lodged up. Pressure on the sides of the head and at the temples - Constant brain fog and difficulty finding words - Burning eyes, worsening eyesight, blurry vision, veiny red eyes - Occasional tinnitus or sudden hearing loss and loud tinnitus for 1-2 minutes in episodes - Feel better laying down and pushing occiput against bed frame as if extending my neck - Hard collar helps—stabilizing my neck is helpful for symptoms - Oscillation between symptoms of high IH and low IH (CSF leaks?) - Feel terrible on planes with barometric pressure changes - No known trauma. No known acute cause of CCI. Had headaches and fatigue since 3 y/o but did not consider medical issue until 18. Now 22. - 150 pounds, 5’10, 22M, no drugs/alcohol/smoking/caffeine

ONSET:

At the time of onset, I had just overexerted both physically and cognitively (driving and some computer work, but I am primarily housebound due to CCI so this was above average for me). As soon as it was time to relax, I started having these symptoms: - Shortness of breath - Lightheadedness & dizziness. I normally have constant pressure headaches and feeling of venous congestion. The pressure headaches were gone within minutes, which is very unusual. Felt like I was losing blood. When I started to feel better, the pressure headaches partially returned - Mucus lodged in back of my throat with blood. I had much less mucus and little to no blood when coming down from the episode - Shaking and chills for 4-6 hours - Cold hands for 30 minutes - Heart rate oscillating between normal and very rapid in 1-2 minute intervals - Lost blood flow in the right arm for 60 seconds - Blood pressure systolic 176 in the ambulance. It was likely higher prior to the ambulance - Stomach growling and discomfort - Extreme weakness, difficulty standing

IN ER:

Doctor, upon seeing my medical history, wanted a no-contrast neck CT due to CCI. I explained that I have a recent neck CT, and I suggested a CT venogram of the neck to check vasculature. Doctor said they can only do an arterial phase since the venogram requires a technician that they do not have at the hospital. Doctor said that if I were bleeding from neck, I’d be vomiting blood and would have a notable neck mass.
We did not end up getting the angiogram, and my body started to calm down after 4 hours. I was discharged.

WHEN WE GOT HOME:

I am still shaking and it is difficult to sleep. I slept 3.5 hours and woke up with lots of adrenaline.
The morning and afternoon of May 8: I started to experience rapid heart rate changes and change in lightheadedness with any positional change. It takes me 5-10 minutes to go from elevated head position to sitting upright. I am extremely weak and cannot stand. It took me hours to muster the energy to go down the hall and back. It is difficult to eat and drink. I have very little appetite, but am trying to hydrate with sodium and electrolytes.

OTHER SYMPTOMS:

A few hours prior to onset, I had a feeling of something stabbing the inside of my upper throat. After the episode, the stabbing pain periodically came back somewhere between under my right ear and under my chin. I believe this is the first time this happened.
I also have periodic shooting or stabbing pain in the chest. It only stabbed a few times after the first episode and just spontaneously happens sometimes, not extremely painful. That pain is in the front of left chest, on the side, in the back, radiating from the center sometimes, and radiating toward the left arm sometimes. I am unsure if this is related, but figured it’s important. Along with this was my right shoulder lodged up. I had to move it into multiple positions before the pain went away (this has only happened once after the first episode). I initially suspected this was some mild TOS since I’ve been having this pain for about 2 weeks prior to onset.
It is also difficult to defecate without pain. I feel stabbing pain in the stomach lower left of the belly button. Have not had this.

NEXT EPISODES:

I had my second episode the afternoon of May 8th. It was small and the after effects lasted less than an hour.
Around 1-3am on May 9, I had a third episode of worsened severity. We did not go to ER. I had just eaten half a banana. Almost felt as if it was aggravated by the action of eating/swallowing. All the same symptoms returned from coughing up blood and metallic taste to stomach discomfort, lightheadedness and dizziness, shortness of breath, adrenaline, constant shaking, etc. Blood pressure was elevated (160) and pulse was 65-90 following the episode (I did not measure during episode). Oxygen levels 93-98. At this point I was extremely tired and got 2 hours of sleep in before waking up to elevated HR again. I am now exhausted.
Around 3:30pm on May 9 next episode. Was sitting motionless holding ice in mouth. First it was throbbing in head above right forehead, vasculature was hungry for air and HR doubled. 2 mins later calm. Then 2 mins later same throbbing in left of neck and HR doubled. 2 mins later calm. Then chest radiating from the back of the chest up the left shoulder and down the left arm, and some pinching in back of chest and sometimes upper left chest and on the side of left chest. After the episodes, I felt tired and weak, and had to rest for an hour+ before getting back up.
Around 1pm on May 10 smaller episode. HR elevated for 30-60 seconds, BP dropped a little (115 systolic), oxygen levels were fine. Prior to episode experienced slow onset of dizziness and lightheadedness + shortness of breath. then feeling flushed, red, and hot. This happened while I was at urgent care. Mild shaking. Did NOT have mucus or blood or metallic taste or smell, did not have stomach discomfort or stomach growling. Followed by moderate weakness and POTS symptoms. I was able to walk fine before, now it is difficult to walk without jittering and have to do so slowly
Around 6:30pm on May 10, another small episode. HR elevated for 30-60 seconds, BP upped a little to 125 systolic, oxygen levels fine, slight chest pain radiating from the back of the left chest, felt flushed and hot. Blood pooling in the legs. Did not have bloody sputum or metallic taste

SUSPICIONS:

1. Internal jugular vein (IJV) small tear or tearupture of a capillary or other compressed vascular structure around the neck. Seems somewhat interesting due to metallic taste and blood in sputum, but a tear is theoretically unlikely without a notable mass in the neck
   1. Could get Doppler ultrasound to assess flow
   2. Could get CT venogram to assess vasculature and stenosis
   3. Anything else?
2. Pulmonary embolism—could be a result of a clot somewhere in body. Risk factors include immobility—which I am frequently in bed due to CCI and have been losing a lot of weight. IJV or other could have clotted due to stenosis and traveled into the lungs. Maybe not IJV, maybe some other body part simply due to lack of mobility. Supports the blood in sputum finding
   1. D-dimer
   2. CTA of chest
   3. Anything else?
3. Aortic dissection—very common in EDS patients, especially with vascular types. Diagnosis not sure. Had chest pain but it was not excruciating. However, I mention it because I have HSD diagnosis (pre-EDS or non-hyperflexible type EDS) and I started experiencing chest pain for 2 weeks prior to these episodes. I wrote it off as thoracic outlet syndrome which is not urgent, but figured I’d mention it.
4. TIA—seems to be the most frequent cause of ER visits among CCI and IJV compression patients. Not sure though.
5. GI tract bleed (?). Didn’t see bloody stool. Supports bloody sputum finding.

MORE NOTES:

BP systolic 110 after laying down for some time following the minor episode on May 10 from urgent care. My BP is never this low. I normally have 135 systolic, that is my norm.

WHAT I HAVE DONE FOR TESTING:

1. EKG—normal
2. Blood—fibrinogen, CBC, D-dimer, comprehensive metabolic, hepatic function panel, Sed Rate by Modified Westergren, lipid panel with reflex to direct LDL. Awaiting results

QUESTIONS:

• How urgent is this?
• Do these symptoms and episodic nature sound like PE?

Back in early October, I started having PVCs out of nowhere. It was a mystery to me since I'm always well hydrated, my electrolytes are OK, and I eat a healthy balanced diet. My heart rate would zoom between 42 and 125 beats per minute while I was just sitting and watching TV. I saw my primary care doctor and after she did an ECG (three times), she said I was having nonstop PVCs and ectopic beats.
I went on to see a cardiologist and did all the tests (holter for 30 days, echo, treadmill, more EKGs). The cardiologist prescribed metoprolol, which did nothing, and then diltiazem, which took my burden from 25% to 22%. The electrophysiologist said I had left ventricular tachycardia coming from one spot behind an anterolateral papillary muscle node (he showed me on a plastic model heart). He said it was going to be very tricky to get to in terms of ablation.
Throughout this process over the course of months, every doctor, PA, and nurse who either listened to my heart or took my pulse was shocked and said something akin to, "Whoa. Can you feel that?" Sometimes I could, sometimes I couldn't.
On Wednesday, I went in for the ablation procedure. When I was in the pre-op room and hooked up to a heart monitor, every single person who came in the room and looked at the monitor stopped and said, "Oh. Oh, wow. That's a lot of PVCs." The EP told me he would be going in via both an artery and a vein. I had general anesthesia. The procedure took about three hours. The EP ablated four areas in my heart.
After the procedure, every person who looked at my monitor said, "Oh, wow, that looks better! No PVCs at all." My vitals were all stable and I had no pain, so I didn't have to spend the night in the hospital (I was there for 11 hours, though). I was told that I might have chest pain from inflammation and random PVCs, but so far, everything is fine. I keep taking readings with my six-lead Kardia device and it is a joy to keep getting back a "Normal Sinus Rhythm" result after months of nothing but "Unclassified" and "Possible Afib" results. Since October, my resting heart rate has consistently been 95-100 BPM after years of it always being 66. For the last two days, my RHR is steady at 77. Let's hope it lasts.
Overall, the ablation procedure was much easier to go through than I was expecting and I really glad I was able to have it done.

Rescued by a Thrill-Seeker Pilot (M4A)

free to monetize! :) For credits, all I ask is to link my YT Channel! Thank you! :D my YT - https://www.youtube.com/channel/UCdnlbfOFJv8c1WBGZCswamg (This is one of my first scripts, have mercy lol! wrote it a couple years ago, finally decided to post it here for anyone cause I don't think I'll fill it myself! Enjoy!) (also reddit confuses the heck out of me i hope i posted this correctly)
Location: A secluded, unexplored island in the middle of no where (can be realistic, fantasy, whatever) Ambience: Mountain ambience, trees rustling, wildlife Listener: A reckless researcher injured on a mountain while conducting research. Voice: Marcus: Small airplane pilot. Confident, bright “hero” voice. A bit snarky and a lot fearless. Feel free to genderbend!
Summary: A pilot named Marcus flies out to a dangerous place to rescue a lost researcher who got lost and injured in a storm. In this part, Marcus finds the researcher, gives them basic first aid, and helps them over the rough terrain back to the plane.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
small Cessna airplane landing sound, engine turning off, door squeaking open and clanging shut as the pilot gets out and lands in the thick vegetation
Whew, that was one heck of a landing - and I nailed it! Let’s go Marcus! (chuckle; sorta like “haha i just owned that shit”)
jingling and rustling of the rescue gear
Alright, let’s go find a little lost researcher!
a few moments of footsteps through thick vegetation/woods
(optional: Marcus commenting on the various weird things he sees while he journeys, like stinky plants, landslide destruction, huge downed trees, huge animal tracks he doesn't recognize, etc.)
Whew, what a climb! They should be around here somewhere… I’m pretty sure… When I flew over here, I saw them by a big uprooted tree like -
Gasp
THAT one! There they are!
running footsteps that stop when you, a bit out of breath, reach the listener, who is lying on the ground with their eyes closed
(optimistic, energetic) Hey! Found you!
puts bag down
Hello, you with me? I just saw you waving at me as I flew by! Come on…
gently pats their face to try and wake them up
Ah, there you are, can you hear me?
Mhhm! Right here, hello! That’s a bit better. Good to see you alive! My name is Marcus, I’m here to save you - er, take you back to civilization in one piece. Can you tell me your name?
Mm, good, that IS who they said I would find here, so at least I’ve got the right person! Haha. Not that… there should have been anyone else here… cause they all left before you… Anyway! Let’s get you off this weird island before the sun goes down.
Rummaging through the bag
Alright… so first let me just make sure you’re actually alive… can I just have your wrist here? Gunna listen to your heartbeat.
…
What’s that? Oh, haha. Yes, I can see you’re moving and are therefore alive.
HOWEVER, I dunno, this place is weird - I mean, maybe the wild inhabitants of this island did some unearthly things like… I dunno… making you look alive but actually you’re… EHM! (laugh as you realize that probably wasn’t a very good thing to say to someone you’re trying to rescue) All jokes aside, I’m certified in First Aid and I spent a few years as an EMT, so trust me, you’re in good hands!
What? No no no - you’re not dreaming, my reckless friend, nope, I’m real! I really came here to help you.
Hm? The storm? Between here and the mainland? Well it still is, yes, but you see, I’m no ordinary pilot! I was chosen to come rescue you because of my expert flying skills. And, well, no one else was brave enough, haha.
Now, I know you have a lot of questions but just… hold them just a few seconds so I can get your pulse. Thanks.
…(longer pause)
Alright… 65 ish, on the lower side, but still alright. Have you been laying here long?
You don’t know? Maybe a few hours? Mm, did you fall here? No? Just resting? Ok, thats -
Oh man - you knew the storm was coming but you still went up there anyway? Heh, and I thought I was a risk taker! That was a really crazy thing to do! You must be really passionate about your research here.
...
Are you hurt anywhere specifically?
Mm… Ok. Yeah, I see, you wrapped your forearm up yourself? Cut it pretty bad? And your back hurts? Like, did you land on your back? or -
ok, scratched up and bruised, gotcha.
And, yeah, I can see your leg doesn't look very comfortable - can you move it? Yes? Well hey, that’s good. But you haven’t been able to get far on that ankle - oh, yeah… that’s really swollen. Must really hurt. I’ll have a look at that in a bit.
Rustling in bag
So you stayed up here all night… and tried to get back down today, but lost your way cause the storm destroyed your path? Yikes. But look at you - all brave and confident - you made it this far! I find that -
…
Weak?! Hey hey hey, none of that, now! I wouldn’t be calling someone who came to a mysterious island to study a strange creature and climbed a mysterious mountain weak. I’d say you’re anything but! You just got yourself in a scrape, that’s all.
...
No, nope, you’re not stupid either. I like to call it… adventurously risky. Trust me, I can relate. Now shush and let me help you sit up so I can listen to your heart and lungs.
…
Alright you all good if I just… put my hand up your shirt with my stethoscope here… good, there we go. One sec…
Ok well your heart is still beating, so that's a plus! Now let’s hear those lungs… Could you take a nice deep breath for me?
take deep breath with listener
Perfect. How about another?
another breath
Alright that’s good enough. I didn’t hear anything to worry about. Did it hurt to breathe in or out?
Just a little in the back? Alright. But nothing sharp, right? Good, good. Now let me just feel your forehead real quick…
You’re a bit cold, honestly, but no fever, that’s apparent. I’m guessing you didn’t have a way to stay dry, did you?
No? I didn’t think so. Next time you gotta bring a slicker or something. If you’re gunna be risky you gotta get gud, you know? Be ready for the elements. Plan ahead.
Listen, I’m speaking from experience! I’ve been through the school of hard knocks. Been there, done that. I like to think every time I fucked up was a learning experience. Don’t stress it. I was able to come and rescue you, right? Could have been worse!
…
Ok now that we’ve got all your vitals, let me see that cut on your arm.
You wrapped it up yourself with a bandage? Just happened to have one on you? Well good thing! Let me see here…
Takes bandage off
Oh… that’s… eugh… nice. Hmmm… doesn’t look like any major arteries or veins were damaged, thank goodness, but it is still bleeding a bit and... yeah you're gunna need a few stitches. I… technically have the stuff with me to do that, but I’d rather just get you back to a proper hospital. I’d do it if we had to stay here for any length of time. If we move quick, we should be able to make it back to the mainland a little after the sun goes down. Let’s just clean it up and rebandage it for now.
Pulls water bottle out
Alrighty… so this is the not fun part, but I’ll be as quick as I can. There’s some debris in there… I’m going to use this water - yes, it’s just water - to flush it out a bit. Then I’m gunna bandage it all up again for you.
No, no peroxide and no rubbing alcohol. Did you want it to hurt more than it already does? (Laugh) Nah, nah, I’m just kidding, don’t look at me like that.
Here’s the thing. We’ve stopped using peroxide and alcohol for first aid because they damage the tissue and actually slows down healing. Nothin like good ole soap and water! It’ll still sting a bit, but not as bad. Nice, right?
Alright, are you ready? Try to hold still, it won’t take long.
Pours water over the wound
Ohp, easy, just a bit more, I know, it's not the best feeling in the world.
…
Ok! All done! See that wasn’t so bad. A lot easier than if I used the stronger stuff, right? Mhhm! Yeah, I’m a fan too. Here, let me wrap it up with a proper bandage. Hold this gauze on it, just like this. There you go, perfect.
Wraps the wound
That’s it, now you can let go, I got it.
It’s not too tight, is it? Ok good. It needs to be a bit firm to keep pressure on the cut, but not too much.
Ta da! Now that we’ve got that all fixed up - oh! Here! Have a water! (gives listener water bottle) Gosh, sorry I probably should have offered you that in the first place. I’d be willing to bet you’re dehydrated. Did you bring any water with you when you came up here?
…
yes… but you LOST it? BEFORE THE STORM HIT? (sigh) What am I going to do with you… I said it was alright to go off on adventures but… you have to be careful… oh, here, take a snack too!
Crinkling of granola bar wrapper
Hhm? No… I don’t think you’re stupid.
(pause - you’re not sure how to explain your thoughts here, as you’ve decided you like their spunk and bravery but their lack of ability to plan ahead and keep themselves together worries you)
It’s just that… what? No! I'm not saying you shouldn’t have come here! I DO think you should have maybe decided to come down the mountain before the storm hit, and been more careful with your water bottle…
…
Huh? Ah - uh! Hey… don’t - I didn’t mean to make you - why are you crying? Does something hurt?
…
Y…your feelings… well hey listen um… I can help your physical wounds and stuff… and I can give advice but…
(you fumble over your words as you try to decide if it would be ok if you followed your instincts and just hugged them until finally you cave)
Hey. Come here.
Scoots closer and carefully hugs the listener
Shh, shh. You’ve been through so much for the sake of your dream. You came here to study dinosaurs -
Oh sorry, yes - those, strange... rumored... creatures... what were they called again? Aren't they extinct? No? (clears throat)
Well, that’s pretty cool - so anyway you came here to study them on a once in a lifetime opportunity, but this nasty cyclone came up out of nowhere and got you into this whole big mess, you fell down a mountain, got yourself hurt… and now you’ve got a know-it-all stranger lecturing you. I’m sorry. I should… probably shut up and check the rest of you, right?
…
No?! Hey… listen, I have to. Ok, ok, alright, just for like, a minute, ok? Relax. I’m not gunna leave you here.
…
You really decided to stay here all on your own? Knowing that storm might mean you could get stuck here?
No, listen, I think you’re hella brave. Yes, I’m serious. You’ve really got a lot of… guts to do something like that. Didn’t they try to convince you to evacuate? Of course they did, but you - your passion wouldn’t let you give up so easily. I admire that tenacity.
And now let me quick check the rest of you cause if we don’t hurry, we’re gunna be stuck here for another night. As much as I love a good thrill, I don’t fancy sitting around here at the top of this other-worldly place for very long. So come on, show me that swollen ankle.
…
(whistles) Yikes**. How… how did this happen?**
listener says they just remember slipping down the slope and twisting it on a rock
And you can walk on this? Barely? Yeah, let's not walk on that again. Don’t worry, I gotchu. I’ll help you get back to my plane. For now…
Ice pack sounds
I’m going to put two of these on, one on each side of that ankle, once we get your boot off. Which… might be kind of difficult but I think it’s best since we’ve got to get you down without hurting it further.
Alright, you ready? Try to hold still, I'm just undoing your laces right now. Gunna make it as loose as I can. Mhhm. There… that’s about as loose as it’s gunna get. Off we go…
Sorry… there we go, it’s off now. Here come the ice packs! Hopefully they will really help with the pain - yeah, feels nice, doesn't it? Good, good! That’s… a better smile, now…
…
Wh- what? My… smile? I - I was just thinking, I was happy that you just smiled. You know, I could tell the ice helped you. And I’m glad.
Ok. Wrapping your ankle now. I want it to stay firm in place, but again…
I can’t make it too tight… it’s already very swollen… so if I just… wrap it like this… it should be…
Perfect! There!
Dusting hands off
Mk, I want to give you some Acetaminophen to help with pain and swelling, so let me grab that…
Pill bottle
Here, take these. Yep, and drink all of that water.
…
(stuttering) Wha... you like... my eyes? … I… well, thank you, but you know, when you were… talking about your project - you just… had a bright look in your eyes, too - you know, like - when you’re thinking about the one thing in your life that drives you. I can tell you love adventure, and I can really relate to that. Seeing it in someone else’s eyes is… special I guess you could say. Perhaps a little inspiring.
Oh? Same with you? Well - (flattered laugh) I guess we’re two crazy thrill seekers, then! Birds of a feather, they say.
Alright. Is there anything else you want me to check? You mentioned your back, right? Mmm. Yeah, I can check it.
…
Mmm, definitely scraped up, but it looks like your shirt and jacket took the brunt of it. It’s all kinds of pretty colors back there too, like your ankle.
(chuckle)
I’m glad you can handle my humor. I like to keep it light! No sense in making serious situations serious-er, right? Exactly! It helps reduce anxiety and lessens the traumatic response later on.
Zips up bag
Time to get you back down this mountain. I’ll help you up and you can lean on me, ok?
…
Nope - no, don’t give me that, I’m not the injured one. I can support! That’s why I’m here. Now let’s go, c’mon up!
you help the listener up to their feet and help them get balanced
Alright, you good? Let's get back to the bird!
Footstep sounds that fade out
[END]

¿Why does our hips click?
¿Why erections seem to improve at least a little when we open our legs, bend over, or do HF relax when we lean our torso forward without bending our knees?
¿Why does it also seem to relax a little when lying down, or lying on one side?
¿Why do many of us have neuralgia?
¿Why do many of us have urinary problems, increased frequency, urgency and hypertonic pelvic floor dysfunction?.
Why Hf also relax when pee.?
The coincidence is that it clicks in the hips on the leg that always bothers me, and on the side where I also have pudendal pain in my anus and the sensation of having a knot between my legs. Yesterday I also noticed something very curious that is not the first time it has happened to me. When I suddenly release adrenaline that knot seems to relax slightly. Then I remember that adrenaline/epinephrine injections are used to reduce airway spasms in patients with anaphylactic shock. Then I remember another important thing: Many of us notice improvement when taking Alpha@ adrenergic receptor inhibitors (dexazosin, Tamsulosin), which supposedly work by relaxing certain smooth muscles. Alpha "adrenergics", I'm not a doctor but some of this shit resonates in my head. Every day I confirm more that the vast majority of us have a chronically spasmed/hypertrophied obturator internus muscle that compresses our Alcock canal or pudendal canal. As a result, our corpora cavernosa undergo neurological spasm and cannot relax to allow a reasonable erection. It also compresses the pudendal artery and vein that travel along the nerve. For my part, the proof is that I also feel anal burning/pain and sometimes also in the penis right on the same side where my hip constantly "clicks". Regarding hip labral tears, or impingements, as a cause of spasm of this muscle, it is a possibility that I had not thought about until now, I also feel some uncomfortable pain in that area. I will have to visit a doctor specializing in that matter and do studies. Alcock's canal is literally a tunnel formed by the fascia of the obturator internus muscle, which means that the nerves and blood vessels that supply our penis pass through that damn muscle. If that muscle becomes tense, the canal would reduce its diameters and we would develop symptoms of pudendal neuralgia, or numbness, or urinary problems, or hip discomfort...etc etc etc etc etc. I also have sciatica in that same right leg. The piriformis and obturator internus can compress both the pudendal and sciatic. The obturator internus muscle shares fascia with the levator ani. ¿Could it be that the inability to do a complete kegel because my anus feels hard and does not respond with any force when I try to contract a kegel is due to the hypertrophied obturator internus preventing adequate mobility of the levator ani, or could it also be that when compressing the pudendal nerve, in addition to the aforementioned, the nerve signal is cut off and the muscles lose innervation, or a little of both? !!!!And when I stretch the obturator internus strongly (which is extremely difficult because it is a very deep muscle) I can do a much fuller and stronger Kegel and the HF seems to loosen up quite a bit!!!! So I think that: !!!!IT'S THE DAMN INTERNAL OBTURATOR MUSCLE AND THE PYRAMIDAL ROTATORS OF THE HIP CONNECTED WITH THE PELVIC FLOOR!!!!.