Gardasil contains a widely-renowned neurotoxin:
Gardasil Vaccine Contents (FDA):

What are the ingredients in GARDASIL? The ingredients are proteins of HPV Types 6, 11, 16, and 18, amorphous aluminum hydroxyphosphate sulfate, yeast protein, sodium chloride, L-histidine, polysorbate 80, sodium borate, and water for injection.

https://www.fda.gov/media/74356/download
Basic chemistry courses inform us that ionic compounds, such as the aluminum +3 in aluminum hydroxyphosphate sulfate, dissolve in water, and thus in your body, into their constituent ions.
Here is an image of the representation of aluminum hydroxyphosphate sulfate
http://www.chemspider.com/Chemical-Structure.16385247.html
https://pubchem.ncbi.nlm.nih.gov/compound/Aluminum-hydroxyphosphate

Its free ion, Al(3+) (aq), is highly biologically reactive and uniquely equipped to do damage to essential cellular (neuronal) biochemistry.
The Birchall Centre, Lennard-Jones Laboratories, Keele University, Staffordshire, UK.
https://www.keele.ac.uk/scps/chemistry/ourfacilitiesandequipment/laboratories/

https://pubmed.ncbi.nlm.nih.gov/24779346/

Aluminum is an experimentally demonstrated neurotoxin and the most commonly used vaccine adjuvant. Despite almost 90 years of widespread use of aluminum adjuvants, medical science's understanding about their mechanisms of action is still remarkably poor. There is also a concerning scarcity of data on toxicology and pharmacokinetics of these compounds. In spite of this, the notion that aluminum in vaccines is safe appears to be widely accepted. Experimental research, however, clearly shows that aluminum adjuvants have a potential to induce serious immunological disorders in humans. In particular, aluminum in adjuvant form carries a risk for autoimmunity, long-term brain inflammation and associated neurological complications and may thus have profound and widespread adverse health consequences. In our opinion, the possibility that vaccine benefits may have been overrated and the risk of potential adverse effects underestimated, has not been rigorously evaluated in the medical and scientific community.
Neural Dynamics Research Group, Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, V5Z 1L8, Canada.
https://www.ubc.ca/about/

https://pubmed.ncbi.nlm.nih.gov/21568886/
Additionally, aluminum is carcinogenic, likely causing or contributing to the formation of cancer.

Aluminium is present in the human brain and it accumulates with age.
...we know that aluminium is a potent pro-oxidant, its interaction with the superoxide radical anion establishing, fuelling and sustaining redox cycles.
The Birchall Centre, Lennard-Jones Laboratories, Keele University, Staffordshire, UK.
https://www.keele.ac.uk/scps/chemistry/ourfacilitiesandequipment/laboratories/

https://www.tandfonline.com/doi/full/10.1586/14737175.2014.915745
Pro-oxidant's cause cancer.

Under normal conditions, anti-oxidants outbalance pro-oxidants, but under oxidative conditions, pro-oxidants prevail over anti-oxidants, which can lead to many inflammatory diseases including cancer.
Cytokine Research Laboratory, Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
https://www.mdanderson.org/research/departments-labs-institutes/departments-divisions/experimental-therapeutics.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990475/
Here is a general summary on aluminum from the CDC.
https://wwwn.cdc.gov/TSP/ToxFAQs/ToxFAQsDetails.aspx?faqid=190&toxid=34
I would like to point out here that environmental aluminum exposure is something to avoid, only a very small amount will make its way to your blood. From past reading, ~99% ingested aluminum passes through via ingestion. Nonetheless, the CDC urges you to reduce environmental exposure. So why aren't they nearly as concerned about directly injected highly ionized aluminum?

Only very small amounts of aluminum that you may inhale, ingest, or have skin contact with will enter the bloodstream.

The CDC or it's agent doesn't have a position on carcinogenicity.

How likely is aluminum to cause cancer? The Department of Health and Human Services (DHHS) and the EPA have not evaluated the carcinogenic potential of aluminum in humans. Aluminum has not been shown to cause cancer in animals.

The CDC published document advises avoiding giving aluminum to kids with kidney problems. Do we regularly test children for kidney problems before administering aluminum injections?

Children with kidney problems who were given aluminum in their medical treatments developed bone diseases. It does not appear that children are more sensitive to aluminum than adults.

The CDC published document says birth defects in humans hasn't been tested, and in animals is at least not obvious.

We do not know if aluminum will cause birth defects in people. Birth defects have not been seen in animals.

The CDC published document then advises that certain amounts of aluminum causes skeletal and neurological development disorders. But... the CDC document just stated that they haven't seen birth defects? Am I misunderstanding these two statements? Do smaller amounts also cause issues, but less noticeably?

Aluminum in large amounts has been shown to be harmful to unborn and developing animals because it can cause delays in skeletal and neurological development.

Aluminum is being transferred from parent to nursing undeveloped infant.

Aluminum is found in breast milk, but only a small amount of this aluminum will enter the infant's body through breastfeeding.

Aluminum is everywhere. In the air, in your water, in your hygiene products, as a regular ingredient used in your food.

How can families reduce the risks of exposure to aluminum? Since aluminum is so common and widespread in the environment, families cannot avoid exposure to aluminum. Avoid taking large quantities of aluminum-containing antacids and buffered aspirin and take these medications as directed.

Aluminum accumulates long term in your bones. It doesn't simply "flush out".

Is there a medical test to determine whether I've been exposed to aluminum? All people have small amounts of aluminum in their bodies. Aluminum can be measured in blood, bones, feces, or urine. Urine and blood aluminum measurements can tell you whether you have been exposed to larger-than-normal amounts of aluminum. Measuring bone aluminum can also indicate exposure to high levels, but this requires a bone biopsy.

Additional source:

Aluminum (Al) is a neurotoxicant; however, efforts to understand Al toxicity are limited by the lack of a quantitative biomarker of cumulative exposure. Bone Al measurements may address this need.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7112220/
School of Health Sciences, Purdue University, West Lafayette, IN, USA
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
Department of Radiation Oncology, Emory University, Atlanta, GA, USA
School of Public Health, Yale University, New Haven, CT, USA
Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA
School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
Zunyi Medical and Pharmaceutical College, Zunyi, Guizhou, China
*Corresponding author: Ellen M. Wells, address: Purdue University, School of Health Sciences, Hampton Hall 1269, 550 Stadium Mall Drive, West Lafayette, IN 47907-2051, ude.eudrup@45sllew
These authors made equal contributions to the work
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7112220/

Before you post a question to this subreddit, please read the following points. I know, it's a lot to read, but 99% of you will get answers to your questions here. These points contain verified, accurate FACTS as verified through the Centers for Disease Control (CDC) and World Health Organization (WHO).
1. Is this a bat bite?
Bat bites cannot be identified from a photo. No one, not even a doctor or a bat biologist, can identify a bat bite from a photo. If you think you might have bat bite, ask yourself: Have you seen a bat in your home? Did you sleep outdoors where a bat might have bitten you? Did you pick up a bat in your hand? If you answer no, it's HIGHLY UNLIKELY you were bitten by a bat. Again, bat bites cannot be identified from a photo.
2. Can I get rabies from interacting with an animal? Can I get rabies from touching something? Can I get rabies from a dead animal, or a vaccinated pet? What about if a drop of liquid falls on me? Can I get rabies from contaminated food or water? Can I get rabies from a person? What about anything else that does not involve a rabid animal physically attacking me?
No. YOU CAN ONLY GET RABIES VIA DIRECT CONTACT WITH A RABID ANIMAL. This means being bitten or scratched by a rabid animal. Rabies is transmitted via the saliva of an infected animal in the late stages of the disease, when the virus is being shed in the saliva by the host animal. The rabies virus dies almost immediately once it’s outside the body. You can’t get rabies from touching something a rabid animal touched. You can’t get rabies from your pet meeting a rabid animal and then bringing it home to you. You can’t get rabies from touching roadkill. You can’t get rabies from something falling on you. You can’t get rabies from touching or kissing someone who has been vaccinated. You can’t get rabies from touching something wet. You can’t get rabies from touching any surface whatsoever, even if you have a cut on your body or you touch your eye/nose/mouth afterwards. Getting rabies from touching an animal and then touching your eye/nose/mouth is theoretically possible, but this has never happened to anyone in recorded history.
3. I found a suspicious mark on my body but I didn't see or feel a bat touch me and I didn’t find a bat in my house. Did a bat bite me while I was walking outside, and I just didn't notice it? Did a bat sneak into my house to bite me and then sneak back out?
Bats are NOT invisible or ninjas. If you wake up in the morning with a mark on your body, it is HIGHLY UNLIKELY to be a bat bite unless you find a bat in your house. If a bat gets in your house, you will see it. They are not good at finding their way out on their own. It’s very unlikely that a sober, alert, adult human would not notice being bitten by a bat. Finding little marks on your body is not unusual and that is no reason to assume an invisible bat attacked you.
4. I saw a bat near me. Or I heard a bat. Or I saw or heard something that might have been a bat. Did a bat bite me without me noticing?
Bats cannot fly past you and bite you in mid-flight. That is physically impossible. A bat must LAND on you, hold on to you with their tiny fingers, and then bite you. After biting you, they must then push off of you to take flight again. Bats can be small, but they're not invisible or imperceptible. You would notice a big bug landing on you and biting you, and you would notice a bat doing it too. If a bat crashes into you and makes physical contact with you, there is a possibility that it may have scratched you, and rabies shots are recommended unless you are in a country free of bat rabies. If you find a bat in your house and you are not in a country free of bat rabies, you should catch it and submit it for rabies testing; if you can’t do that, or if you have small children in the house, rabies shots are recommended.
5. An animal touched me, licked me, or sneezed on me. Could I get rabies from this?
You cannot get rabies from a wound that doesn’t break the skin. Rabies can only get into your body through an opening in your body: a scratch or bite. If you are bitten or scratched by an animal, you should wash the area with soap and water for 5 minutes. If it does not bleed at all, you may not have broken the skin and could be in the clear. You can test this by putting alcohol on the abrasion to see if it stings.
6. Can I get rabies from an animal that has current rabies vaccinations? Can my pet get rabies if it has current rabies vaccinations?
No. Animals with current rabies shots cannot catch or transmit rabies. If you are bitten or scratched by someone’s pet, ask the owner for proof of rabies vaccination, like a rabies tag on the collar. Take a photo or copy of these records and call their vet to verify them. If the shots are current, you're not at risk of rabies infection. If the pet owner cannot provide this proof of vaccination, contact your animal control department or rabies management / health department to file a "Bite Report". If you are in the USA, you can find a list of those agencies here: https://www.cdc.gov/rabies/resources/contacts.html
7. Can I get rabies from my pet, or from a friend or neighbor’s pet, that doesn't have current rabies shots?
You may not need to get rabies shots if you can observe the animal that attacked you for two weeks. If you are bitten or scratched by a pet that is not vaccinated for rabies, the standard protocol is to quarantine the animal in an animal shelter or veterinarian's office for 10-14 days. If you were attacked by someone else’s pet and that is not possible, you can observe the animal for 14 days. If it doesn’t get sick and/or die of rabies, then you are not at risk of rabies and do not need rabies shots. If the animal is healthy in 14 days, IT DOES NOT HAVE RABIES and neither do you. Since most animals in the late stages of rabies typically die in about 48 hours, this is a very cautious timeframe to observe.
8. Can I get rabies from a bug, bird, snake, or frog? Can I get rabies from a possum, or a rat or mouse?
No. Only mammals (furry animals) can carry rabies. Reptiles, amphibians, insects, and birds can’t carry rabies. Bats are one of the most common rabies carriers in the US, although less than half of 1% of all bats will ever get rabies. In the USA, the next most common species are raccoons, skunks, and foxes. Outside of the USA, dogs, cats, and other animals have been known to spread the rabies virus. The least common mammals include Virginia opossums, rodents (rats and mice), rabbits or hares, and squirrels. Globally, the #1 risk of rabies is dog bites.
9. Is there a risk of rabies in my area? Can I get rabies in India, or the UK?
To learn about rabies statistics for your area, Google your state or country's name and the phrase 'current rabies statistics'. These websites will tell you how many rabid animals have been found in your area and what species. They should also tell you who to call to report a bite. Some parts of the world are rabies-free and there is no rabies or risk of rabies infection. The UK (and most of western Europe) is free of rabies in most animals except for bats, which is rare. India has a high rabies risk which is mostly from dogs.
10. I was vaccinated for rabies. Does that mean I am protected for life and will never need booster shots? Will I need to get booster shots every single time I get attacked by an animal?
No. Previously vaccinated people still get boosters if they are re-exposed to rabies. Your rabies titer can be high for a few months or for many years, but it is assumed that you are protected for at least three months after getting your initial shots. If you are bitten by animal and it has been LESS than 90 days since your last shot, you don’t need to do anything. If it has been MORE than 90 days since your last shot, you would still need post-exposure booster shots IF you are directly exposed to an animal that could be rabid. You do not need to go through the entire series of shots again; you only need booster shots.
· For more information about rabies and rabies shots, see the CDC website here: https://www.cdc.gov/rabies/index.html
· If you are in the USA here is a link to the state and local rabies contacts. USA State & Local Rabies Contacts
11. I was vaccinated for rabies but I did not receive immunogloblin (HRIG/ERIG). Why? Is that OK?
RIG is sometimes not given if there is no visible wound or if you were bitten/scratched in a location that is hard to inject. For instance, it would be hard to inject RIG into your ear. If you have no visible wound, then there is no way to tell where RIG should be injected. If you have more questions about this, ASK YOUR DOCTOR.
12. I got rabies shots but I have questions about the specific medical care I received. Why did the doctor give me the care I received? I’m immunocompromised; do I need extra shots? Will my medication interact with the vaccine?
Ask your doctor questions about the specific medical care you received. People on the internet cannot answer those questions. A doctor’s job is to treat patients and explain their care to them so it is OK to ask follow-up questions even after you leave the office.
13. I waited a long time before I got rabies shots. Or I drank a beer after I got vaccinated, or I took an aspirin. Or a doctor gave me tetanus shots at the same time. Will the rabies shots still work?
Yes. Rabies vaccines are 100% effective if you get them before the virus reaches your brain and symptoms start, which usually takes 3 weeks to one year. For more info about symptoms, see FAQ #17. If you have more questions about your medical treatment, ASK YOUR DOCTOR.
14. I am in a country that is not the US, or I am traveling. Why did doctors in my country give me a different schedule of shots than the ones recommended by the CDC or the WHO? Why did doctors in two different countries tell me two different shot schedules? Will the shots work?
Yes. Rabies protocols vary by country. The CDC guidance is specific to the USA, and the WHO guidance is a recommendation for all countries. Some countries give different numbers of shots on different days. That is OK. The schedules all work as long as you stick to them and finish the series. To find more information about a country’s rabies shot schedule, google the name of the country + rabies vaccination + regimen or protocol or schedule.
15. I was attacked by an animal a long time ago but I never got rabies shots. Could I get rabies from that? How long does it take to develop symptoms?
The incubation period for rabies is typically 2–3 months but may vary from 1 week to 1 year. Bites on the hands or feet have longer incubation periods than bites on the neck or face, and bites from a scratch have longer incubation periods than deep bites. Extremely rare cases of longer incubation periods of up to 7 years have been documented. That is rare, and it's generally hard to prove that someone didn't have a more recent exposure to rabies.
16. I think I have health anxiety and I can’t stop thinking about rabies all the time. How can I get help for this?
See this link. The automod can be summoned to share this information with a comment that includes the word “helpbot."
17. Someone is asking questions in the sub that I think are super dumb. Should I tell them that?
No. Please do not be rude or impatient. There is a real difference between a legitimate rabies scare and Persistent Health Anxiety (PHA), a subset of Obsessive Compulsive Disorder (OCD). OCD and anxiety are real diseases that can have physical symptoms, and there are treatments for them that many people don’t know how to access. Both conditions are terrifying and life-altering, and both conditions deserve support. In this group, we support people who ask for help and we applaud them for finding the courage to do so. We will be kind, patient, respectful, and do our best to provide emotional support to anyone who seeks help here. All posts and/or replies that are in any way unkind, impatient, or rude will be immediately removed and the author may be temporarily or permanently banned from this group. Be nice!!
18. I feel sick. Do I have rabies?
If you feel sick, see a doctor. You may have another disease, including anxiety, which can have physical symptoms. We cannot diagnose you over the internet. See a doctor.
The incubation period for rabies is typically 2–3 months but may vary from 1 week to 1 year, depending on factors such as the location of virus entry and the viral load. If you believe you are experiencing symptoms before 1 week after exposure, that is not rabies. If you think you are experiencing symptoms more than 1 year after exposure, it is almost certainly not rabies. if you have not been exposed to a rabid animal and you believe you are experiencing rabies symptoms, you are not infected and are most likely experiencing anxiety. the prodromal stage lasts for a few days to a month and the acute neurologic stage lasts for a few days to a week; if you have symptoms that last longer than this, you do not have rabies.
Rabies symptoms only begin when the virus reaches the brain. It MUST reach the brain and produce SEVERE NEUROLOGICAL symptoms before it reaches the throat and salivary glands. This means that your sore throat is NOT caused by rabies unless you also have a severe fever, are experiencing loss of consciousness, paralysis, and seizures.
Also, rabies symptoms do not go away until death. You don't have a fever and then the fever goes away for the next symptoms. Every symptom stacks on top of the other symptoms. If you are experiencing 1 out 10 symptoms, it's NOT RABIES. Rabies is not mild. It's SEVERE in every way. If you are experiencing rabies symptoms you will need to be hospitalized within the first 8 hours of symptoms.
IT IS NOT TOO LATE TO GET VACCINATED UNTIL SYMPTOMS START, but only get vaccinated if you were attacked by a rabid animal. Waking up with a mystery scratch is not a rabies exposure.
Rabies symptoms are as follows, IN THIS ORDER:
Prodromal Stage:
• Extreme Fever
• Extreme Headache
Acute neurologic phase:
• Visual Disturbances, Hallucinations
• Delirium, Confusion
• Tremors, Seizures, Repetitive Uncontrollable Movements
• Fading In and Out of Consciousness
• Light Sensitivity, Sensitivity to Wind / Moving Air
• Partial Paralysis of Extremities, Paralysis of One or Both Legs or Arms
• Excessive Salivation, combined with the inability to swallow AT ALL, not even your own saliva which causes excessive drooling
• Inability to Swallow - NOT SORE THROAT - Inability to eat or drink, or swallow your own saliva production
• Extreme Aversion to sight or sound of water, food, or drink, AKA hydrophobia
• Coma
Without extreme medical intervention, which usually is an induced coma, these symptoms will progress to death very rapidly. Most patients who reach the point of excessive salivation and hydrophobia die within 12-24 hours without intervention.
IF YOU ARE EXPERIENCING THESE SYMPTOMS, CALL 911 AND GET TO A HOSPITAL IMMEDIATELY. IF YOU CAN REPLY TO THIS MESSAGE, YOU ARE NOT EXPERIENCING RABIES SYMPTOMS. PEOPLE WITH ACTIVE RABIES INFECTIONS CANNOT TYPE, TALK, OR DEBATE WHETHER OR NOT THEY ARE SICK. IF YOU CAN READ THIS AND REPLY, IT'S NOT RABIES.

My daughter is 14 and has very severe allergies to all grasses, trees, dogs and cats as well as mild allergies to tree nuts. She’s been on Zyrtec since she was 4 and her allergies have been mostly contained. She’s now taking 2 Zyrtec every morning.
However, this year in Utah, she’s struggling so hard. Her chest is tight and wheezy, she can’t stop coughing and feels horrible. She will be coughing every 2 seconds and up all night. Her dr added Flonase and Azelastine, but they aren’t helping. Benadryl also doesn’t help.
The dr then told us to add in Singulair but the side effects are terrifying, as she already suffers from some degree of anxiety.
Does anyone else have the severe cough and chest tightness symptoms and if so, what has helped you with them? Inhaler doesn’t seem to help either.
I was considering adding quercetin, but just feel so lost on how to help her.

Full article here:
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.

Full article here:
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.

Full article here:
https://sharylattkisson.com/2016/11/what-the-news-isnt-saying-about-vaccine-autism-studies/
A Small Sampling
Many of the studies have common themes regarding a subset of susceptible children with immunity issues who, when faced with various vaccine challenges, end up with brain damage described as autism.
“Permanent brain damage” is an acknowledged, rare side effect of vaccines; there’s no dispute in that arena. The question is whether the specific form of autism brain injury after vaccination is in any way related to vaccination.
So what are a few of these published studies supporting a possible link between vaccines and autism?
As far back as 1998, a serology study by the College of Pharmacy at University of Michigan supported the hypothesis that an autoimmune response from the live measles virus in MMR vaccine “may play a causal role in autism.” (Nothing to see here, say the critics, that study is old.)
In 2002, a Utah State University study found that “an inappropriate antibody response to MMR [vaccine], specifically the measles component thereof, might be related to pathogenesis of autism.” (“Flawed and non-replicable,” insist the propagandists.)
Also in 2002, the Autism Research Institute in San Diego looked at a combination of vaccine factors. Scientists found the mercury preservative thimerosal used in some vaccines (such as flu shots) could depress a baby’s immunity. That could make him susceptible to chronic measles infection of the gut when he gets MMR vaccine, which contains live measles virus. (The bloggers say it’s an old study, and that other studies contradict it.)
In 2006, a team of microbiologists in Cairo, Egypt concluded, “deficient immune response to measles, mumps and rubella vaccine antigens might be associated with autism, as a leading cause or a resulting event.”
A 2007 study found statistically significant evidence suggesting that boys who got the triple series Hepatitis B vaccine when it contained thimerosal were “more susceptible to developmental disability” than unvaccinated boys.
Similarly, a 5-year study of 79,000 children by the same institution found boys given Hepatitis B vaccine at birth had a three times increased risk for autism than boys vaccinated later or not at all. Nonwhite boys were at greatest risk. (“Weak study,” say the critics.)
A 2009 study in The Journal of Child Neurology found a major flaw in a widely-cited study that claimed no link between thimerosal in vaccines and autism. Their analysis found that “the original p value was in error and that a significant relation does exist between the blood levels of mercury and diagnosis of an autism spectrum disorder.”
[quote]The researchers noted, “Like the link between aspirin and heart attack, even a small effect can have major health implications. If there is any link between autism and mercury, it is absolutely crucial that the first reports of the question are not falsely stating that no link occurs.”[/quote] (Critics: the study is not to be believed.)
A 2010 rat study by the Polish Academy of Sciences suggested “likely involvement” of thimerosal in vaccines (such as flu shots) “in neurodevelopmental disorders such as autism.” (The critics dismiss rat studies.)
In 2010, a pilot study in Acta Neurobiologiae Experimentalis found that infant monkeys given the 1990’s recommended pediatric vaccine regimen showed important brain changes warranting “additional research into the potential impact of an interaction between the MMR and thimerosal-containing vaccines on brain structure and function.”
A study from Japan’s Kinki University in 2010 supported “the possible biological plausibility for how low-dose exposure to mercury from thimerosal-containing vaccines may be associated with autism.”
A 2011 study from Australia’s Swinburne University supported the hypothesis that sensitivity to mercury, such as thimerosal in flu shots, may be a genetic risk factor for autism. (Critics call the study “strange” with “logical hurdles.”)
A Journal of Immunotoxicology review in 2011 by a former pharmaceutical company senior scientist concluded autism could result from more than one cause including encephalitis (brain damage) following vaccination. (Critics say she reviewed “debunked and fringe” science.)
In 2011, City University of New York correlated autism prevalence with increased childhood vaccine uptake. “Although mercury has been removed from many vaccines, other culprits may link vaccines to autism,” said the study’s lead author. (To critics, it’s “junk science.”)
A University of British Columbia study in 2011 that found “the correlation between Aluminum [an adjuvant] in vaccines and [autism] may be causal.” (More “junk science,” say the propagandists.)
A 2011 rat study out of Warsaw, Poland found thimerosal in vaccines given at a young age could contribute to neurodevelopmental disorders. (Proves nothing, say critics.)
A Chinese study in 2012 suggested that febrile seizures (an acknowledged side effect of some vaccines) and family history of neuropsychiatric disorders correlate with autistic regression.
A 2012 study from the Neurochemistry Research Marie Curie Chairs Program in Poland found that newborn exposure to vaccines with thimerosal (such as flu shots) might cause glutamate-related brain injuries.
In 2013, neurosurgeons at the Methodist Neurological Institute found that children with mild mitochondrial defect may be highly susceptible to toxins like the vaccine preservative thimerosal found in vaccines such as flu shots. (“Too small” of a study, say the critics.)
In 2016, Frontiers published a survey of vaccinated vs. unvaccinated children. The vaccinated had a higher rate of allergies and NDD (neurodevelopmental disorders, including autism) than the unvaccinated. Vaccination, but not preterm birth, remained significantly associated with NDD after controlling for other factors. However, preterm birth combined with vaccination was associated with an apparent synergistic increase in the odds of NDD.
Then, there’s a 2004 Columbia University study presented at the Institute of Medicine. It found that mice predisposed for genetic autoimmune disorder developed autistic-like behavior after receiving mercury-containing vaccines. (Critics say that’s not proof, and the work was not replicable.)
There’s Dr. William Thompson, the current CDC senior scientist who has come forward with an extraordinary statement to say that he and his agency have engaged in long term efforts to obscure a study’s significant link between vaccines and autism, heightened in African Americans boys. (The CDC says the data changes made were for legitimate reasons.)
There’s the current CDC immunization safety director who acknowledged to me that it’s possible vaccines may rarely trigger autism in children who are biologically or genetically susceptible to vaccine injury.
There’s the case of Hannah Poling, in which the government secretly admitted multiple vaccines given in one day triggered her brain injuries, including autism, then paid a multi-million dollar settlement, and had the case sealed from the prying public eyes under a confidentiality order.
There was the former head of the National Institutes of Health, Dr. Bernadine Healy, who stoked her peers’ ire by publicly stating that the vaccine-autism link was not a “myth” as so many tried to claim. She disclosed that her colleagues at the Institute of Medicine did not wish to investigate the possible link because they feared the impact it would have on the vaccination program.
There’s former CDC researcher Poul Thorsen, whose studies dispelled a vaccine autism link. He’s now a “most wanted fugitive” after being charged with 13 counts of wire fraud and nine counts of money laundering for allegedly using CDC grants of tax dollars to buy a house and cars for himself.
And there are the former scientists from Merck, maker of the MMR vaccine in question, who have turned into whistleblowers and accuse their company of committing vaccine fraud.

I Hate The Character Limit, so much.
Previous Posts:
Part 1: https://www.reddit.com/PathToNowhere/comments/1clu2tn/path_to_nowhere_sfw_headcanons_part_4_shalom/
Part 2: https://www.reddit.com/PathToNowhere/comments/1clu7gw/path_to_nowhere_sfw_headcanons_for_shalom_part_2/
35. She has joined several other Sinners in keeping an eye on the chief and making sure she does not overwork herself too much, with her method of getting her to stop being to simply walk into the office, grab her by the wrist, and pull her away from her computer and off to either of their rooms.
When that does not work, she will resort to decidedly more underhanded methods, such as slipping into the office via one of the hidden passages, putting her hands over her eyes and telling her that it is time to go to sleep as she waits for her to surrender.
Another option is to utilize the most tried and true method, that being the NHH method, which involves sicking either Nightingale or Hecate and Hella on the Chief, with said method ending in her either being drug out of her office by the Adjutant, often still in her chair, or being bullied into going to sleep by Hecate’s pleading and Hella’s cursing as she chews her out.
But should all of the above fail, should all seem lost in this endeavor, then Shalom has perfected a final tired and true method of forcing the Chief to relax, one that, during her first attempt almost ended with her becoming a head shorter courtesy of a rather infuriated Sumire.
The method in question?
Step 1: Walk into the office. Utilizing passages is not necessary as the sound of approaching heels clicking on the floor and knocking on the door adds a valuable psychological factor to the approach.
Step 2: Do not respond to any of the Chief’s questions, merely meet her gaze with a smile and walk towards her, navigate around her desk and push her back towards the wall behind her.
Step 3: Utilize greater than average strength to force her to remain in the chair by pinning her to ii, typically done by straddling her lap.
Step 4: Lean in close to her ear and begin to hum a lullaby as you stroke her hair, and rub her upper back, certain fragrance perfumes also assist in this method, particularly ones including lavender.
Step 5: Wait for her to give in and then wheel her out of the office and towards her room.
So far this method boasts the 2nd highest success rate out of her other methods of coercing the Chief into resting, the highest being the NHH method, though other Sinners boast of having more successful ones…granted one of them involves rendering her unconscious and another involves paralyzing her, but they still work, thus the Hush shall not stop until she perfects a method of getting the Chief to cease overworking herself.
Her current approach being to simply insure that there is no reason for her to overwork herself, with her providing aid on matters that would otherwise take up too much of the Chief’s time, though the Chief is yet hesitant to fully trust her with much of her work, she has so far allowed for the help.
Only time will tell if this method works though.
36. She has a curiosity regarding the various other nations that exist beyond the walls of Dis, something that has led to her gathering as much information and memorabilia from those nations that she is capable of.
She regularly searches out any of the Sinners from foreign lands to speak with regarding their former homes, such as Pacassi and her long vanished hometown, Eirene and Fraser, KawaKawa and Stargazer for WhiteSands, or OwO and Goldion Ville.
It has become a small dream of hers to one day visit the lands beyond the walls of Dis and see what the world is like outside of the reach of Paradeisos and herself, though she does not want to go alone, so she has decided that she will try and take Rosa, Rahu, Christina (and of course where christina goes, Thistle goes.), and or the Chief with her come the chance to slip away.
But for now she will settle with enjoying what trinkets and information she can from those distant lands. She is particularly fond of the chess set that Eirene had brought over from her home city and the paper lantern that OwO made for her.
37. Similar to Langley, she has many times made use of the skills of the Phantom Thief pair of Priscilla and Tetra, though she has never directly spoken to them, instead utilizing multiple online accounts and middle-men to hire them.
The pair have long since ceased attempting to investigate just who it is that is behind all of the jobs that Shalom has given them, their previous attempts having ended with the pair finding a flash drive tucked into a drawer that contained their…toys, during a rather passionate moment.
Their session of intimacy being cast aside as they investigated what was on the flash drive, the pair soon finding themselves clinging onto one another as they saw a file containing both videos and images of them going about their daily lives, as well as on their missions, even their homes outside of the Bureau, including safe houses even the Chief was unaware of.
Amidst the flurry of images and videos was a single document, a simple text file that contained words which managed to send a chill through their cores.
“I would advise you to not bite the hand that feeds you, I harbor no malice towards you at the moment…but if you continue to pry into things best left unknown…then I will be forced to take much more direct action against you.
The presence of this hard drive should be proof enough of what I am capable of, as well as the extent of my influence, and be advised that what you see here is but a fraction of the data I have gathered on the two of you.
But that is neither here nor there at the moment, and I would truly hate to sully the wonderful working relationship we have at the moment, and in the same vein lose two exceptionally useful allies, thus I will take no action against you at the moment.
For now, I would advise you to hold one another close, perhaps enjoy the wine you have stored away in your cupboard. It is a wonderful vintage that pairs quite well with the dark chocolate that Tetra purchased a couple of days ago.
Take some time off to process this information, don’t worry about anything, your superior at the Bureau is a kind woman, she won’t pry too much, and you have likely received a rather sizable transfer to your account for a job well done in regards to your last few missions from me.
With that said, I must be going, I have a great many things to attend to that require my personal attention, though before I go, I have to admit that I was impressed by the variety of toys you possess. My own collection seems paltry in comparison…perhaps I should remedy that.
Sincerely X.”
The pair would take their mysterious benefactors' advice and spend the next few days with each other, not only scouring their homes and cell for bugs, but also in trying to bury the terror that the flash drive caused them.
That the damn thing vanished the next day, only further heightened their fears of this unknown X.
Curiously, the days following this incident would see Shalom spend a rather lengthy amount of time browsing certain…illicit sites in search of new additions for her own collection, that she asked Rahu, Rosa (Who she communicated with via sharing her screen in a call or by phone), and the Chief their opinion on the objects in question, is something 2 of the 3 mentioned would very much like to forget .
38. Upon learning that Peggy and Joan were two of the musicians whose tapes and records she possessed, she took time out of her schedule to ask for their autograph’s on the tapes and records in question, paying them quite handsomely in return.
She has likewise requested recording of several other musician Sinners performances, from Dudu, who spent several minutes in dumbfounded silence at just how much Shalom offered her before energetically shaking her hand and running off to get started, to Echo and her saxophone, the young musician being ecstatic to record a tape for someone at last.
Whether or not the music is any good by the standards of the masses is of no concern to Shalom, all that matters is that it is her choice to listen to and enjoy it, and not the whims of her former masters, with it also serving a memento of some of the more vibrant souls present within the Bureau.
39. Given her fixation on spreading happiness, and Shalom’s desire for happiness, it is a fair assumption to say that she has something of a relationship with Serpent, with the serpentine Sinner having taken upon herself the challenge of making Shalom give her a genuine smile through any means necessary.
As a result of this, Shalom has many times found herself given a front row seat to the shows that Serpent puts on within the Bureau, the serpentine Sinner having pulled out every stop during her shows to try and coerce as much genuine emotion as she can from Shalom, with the Hush often finding herself feeling emotionally drained and yet deeply satisfied after each performance.
She has also met the monstrous snake that Serpent keeps as a pet, granted their meeting involved it slithering through the vents and into her room as she was reading a book, but unlike many of her fellows she did not immediately panic and was instead able to keep the colossal snake busy until Serpent could arrive to recover it.
Though it did take them a rather long while to convince the snake to uncoil itself from around her and her chair, especially given that it seemed to be enjoying the story she was reading aloud to it.
That is not to say it is an entirely one-sided deal, as Serpent has come to find herself with enough money in her account to be able to afford the sun lamps she has wanted for a long while, with Shalom also taking upon herself the duty of babysitting Serpent’s snake when the woman has to leave it behind on a mission.
She has also aided Serpent in her quest to make the Chief happy, not only through funding but also by helping her in researching a rather large variety of means to try and appease the woman in question.
The Chief has since come to expect that whenever Serpent has a show, she will find herself being seated near the front with Shalom on one side, Eirene on the other, and Rahu and Christina as far away from the giant snake that accompanies Serpent as possible.
40. She gets cold easily due to her fragile nature, her heavy coat helps her with it to an extent, but during particularly cold or windy days, she needs to wear layers to the point that she needs several minutes to pry off all of them when she is out of the cold, otherwise she will begin to overheat.
In addition to getting cold easily, she also has a rather weak immune system, even with Paradeisos medicine at her back, thus she can easily fall ill during cold weather, leading to her being bedridden or consigned to the medical wing for several days before her condition stabilizes.
As a result of this, she tends to avoid leaving the warmth of the Bureau, or even her room for that matter, during such weather unless her presence is requested by the Chief for some matter, though even then she will demand heavy reparations for her presence.
Typically, said reparations will involve the Chief pampering her while she recovers from whatever illness has come to plague her, even should she be given medication to treat it, she will still request that the Chief stay with her till she is fully recovered.
That is not to say she fairs any better during hot weather, as she has to wear sunscreen or carry an umbrella to avoid sun burns during the intense heat, with her trying to minimize her exposure to the intense sunlight as much as she can to avoid heat sickness.
It is safe to say that she enjoys the more mild weather of spring or the cool and yet not freezing weather of fall as opposed to winter or summer, with those being the months she is able to enjoy the sights of the city and the world before she is forced to flee into cover at the changing weather.
41. She once requested Enfer to make use of her ability to try and sculpt something that could elicit genuine fear from her, with the artist devoting a rather obscene amount of time and effort towards the matter, Shalom funding her ventures as the sculptor tried everything she could.
Eventually, Enfer managed to create something that managed to provoke a reaction from Shalom, the exact nature of the work that managed to provoke a feeling of unease and distress within Shalom such that she was visibly unnerved is unknown however, as Shalom had any visual images of the work removed as she took it to a secure and hidden space within her room.
None but the Hush and the Sculptor themselves have seen just what was made that day, and Enfer refuses to share any information on the matter, the Mistress of Fear herself feeling no small amount of unease whenever she recalls the work she made, and sheer distress it caused to flicker through the normally blank faced Shalom as she looked upon it.
No threat was needed, no promise of revenge or wrath, nor was a bribe needed, only a glance at Shalom and at the artwork she had made was needed to bid her tongue to stay silent on the matter.
An oddity is that after the piece was finished and hidden away, the pair tried to spend as much time with the Chief as possible, as though something compelled them to do so…perhaps…no, it is better that road be left unwalked.
42. She is a regular listener to Eleven’s radio show, and is exceptionally fond of the radio host herself, finding her show to be the perfect thing to listen to as she focuses on work that has either kept her up late, or has awoken her exceptionally early.
Eleven is more than a little wary of the Hush, especially given the rumors she has heard of the woman, particularly from the agents of the Garden and various others, though at the same time she cannot ignore the way Shalom has spoken so highly of her, and the several times she has called in to her show to speak with her whenever she needed to take a breather during her work.
That said, Eleven wishes that the next time Shalom asks to take her photo, she does not have the flash on, especially given that the mirror she was standing beside managed to reflect it and disorientate both of them for several minutes.
43. She very much enjoys sleeping in on the days she has nothing to do though not quite to the extent of Coquelic, who prefers to spend almost the entire day in bed when there is nothing for her to focus on, with her trying to catch up on any sleep she has been forced to miss as a result of her work.
Whenever someone attempts to awaken her from this slumber they will typically either be met by her Mark blazing in one of her eyes as she glares at them, or with her reaching out to pull them into bed with her, something that Rahu, Christina, Rosa, and the Chief have been the victims of before.
The problem is that once she has a grip on them, and has begun to fall asleep, she very much refuses to relinquish her grip on them, with her poor victims having to either wait for her to awaken, or for them to find some way to wake her up.
Such as carrying her to, and proceeding to drop her into a tub of either warm or cold water, something that Rahu had to resort to at one point when something came up and Shalom was needed on one of those days.
She proceeded to learn that while Shalom is frail, she is still capable of throwing surprisingly heavy objects with no small amount of force at someone, particularly when they have their back turned to her.
On an unrelated note, she had to see Iron and Anne for some aspirin to help with a headache she gained that day, where it came from she would not say, only that both the source of it, and the headache itself, were exceptionally annoying.
44. Shalom is not counted among the “Sane People Of The Bureau” as the group of Nightingale, Cinnabar, and recently Matilda is called within the Bureau by both staff and sinner, this is no small part due to her past as the Hush and her fixation on the Chief, along with the extremes she is willing to go to in order to achieve her goals.
That said, she is still numbered among the “Somewhat Sane People Of the Bureau,” along with the likes of Langley, Zoya, and so on. As while she may not be the most sane of individuals, with Shalom even confessing such a thing herself due to her skewed view on morals and how she was brought up by Paradeisos, she is still more sane than most of the staff and sinners alike and is thus a candidate for leadership and advice should any of the Sane People Of The Bureau be indisposed after something occurs to effect the Chief…or when the chief needs to be overruled and or forced to take a break.
45. She has a deep seated fascination with the Immortals (Dreya, Vanilla, and Mantis) due in no small part to their own contributions towards paving the way for Dis to be founded by Keylan during the expedition into the Perishing Star, along with the wisdom and knowledge they hold regarding not only the star, but also what they can recall of the world before Dis was founded.
This is one of the few point where she and Paradeisos are in agreement, the information the Immortals possess has already caused several breakthroughs in regards to how the Perishing Star is viewed, along with information regarding both Mania and the effect it has had on the environment of the land around the star.
As such, Shalom has been asked by Paradeisos to keep an eye on the Immortals and to help act as an intermediary to exchange information with them, especially in regards to the subjects of the Illusory Moon and it seeming intelligence, alongside of information of the old world that was lost during the years before the Expedition breached into the Star’s domain.
She tends to speak most with Dreya as opposed to Mantis and Vanilla, as she find the astronomer to be the easiest to converse with of the group as opposed to the survivalist and logistician, though she has orders to try and gather information from Vanilla due to her being a largely unknown part of the Keylan Expedition, alongside of her understanding of the temporal hellstorm that rages within the Star’s domain and her ability to help in reconstructing some of the ruined monitoring stations around 00.
46. Shalom was rather surprised when she learned that the Chief refuses financial backing and aid from her sinners, alongside of only taking Hella and Hecate with her on her missions, the latter annoying her much more than the former due to potential safety risks.
As a result of this, she is one of many that have brought up the idea of the Chief taking other sinners aside from just Hella and Hecate with her during missions as while she may have success so far with just the pair, she also has tendency to run into situations that heavier firepower would be greatly useful in contending with.
As a result of this, she and several others, including Langley, Eirene, Demon, and Rahu, have worked to put together a means of coercing the Chief to accept further aid on her missions from those who are capable of doing so, with the more contaminated and mania sensitive sinners having to be kept on the sidelines due to contamination and potential risk of going full maniac allowing for them to narrow the suspects down.
That they have even been able to sway Nightingale to their side is proof of their devotion to this cause, though so far they have had little luck in convincing the chief to accept further help…at least willingly as they have several times simply either pulled rank on her (Langley) or threatened her with withholding her coffee and snacks (Nightingale) if she did not take aid with her on some missions.
Shalom would go with the Chief on missions herself, if she did not feel that doing so would run the risk of allowing Paradeisos too much information on the Chief and potentially causing the both of them future headaches.
47. Despite her fragility, Shalom possesses rather impressive healing capabilities, though not to the extent of Hella, she is still capable of surviving many wounds that would have been fatal to others, with Schorl furthering her healing abilities with its own technology.
She cannot regrow limbs or digits, nor can she regenerate organs, or is she immune to illness, but she is still capable of taking a stab or bullet and surviving, at least assuming it is not directly to her heart or brain, something she considers one of the few useful modifications Paradeisos made to her after she became the Hush.
48. She has an odd relationship with subjects unknown to her, as she is both wary of, and yet also fascinated by, anything that she has know knowledge or comprehension of, something which is quite rare given her eidetic memory and the amount of information she was taught by Paradeisos and has learned on her own.
This leads to her starting ventures into unknown subjects cautiously at first as she tests the waters before she begins to dive into them in full, hungrily devouring anything and everything she can on the subject until she feels that she is satisfied with it.
This is not something born of scholarly desire, but rather out of a desire to know what she can use and what can be used against her, alongside of it being something that she has the ability to choose to indulge in without being ordered to do so, it is also something she does to further cultivate her seemingly all knowing image to instill both respect and unease in those around her.
Among the subjects she has studied are things such as tailoring, animal husbandry (Christina learned far too much regarding breeding habits of animals when she was researching it), entomology (She felt it wise to learn more about her arachnid foes), cooking, and cocktail making.
49. It is a standing rumor in the Bureau that Shalom’s coat is able to repair itself, as no matter what is done to it, be it burned or slashed, it is always in immaculate condition the next time anyone sees her wearing it.
The truth is much less fanciful though, as Shalom simply owns many copies of her coat that she can use when she is unable to fix one of them or have a tailor fix it for her, with her having allocated a rather large sum simply to replacing and repairing her coats when they get damaged.
She at one point had to have a whole new batch made for her as, despite not being contaminated when the Garden and Langley unleashed a hell of spiders into her room, she one day went to put on one of her coats and found a rather large tarantula inside of it.
How it got there, she had no idea, only knowing that it was the doing of someone in the Bureau, especially given she has spider-proofed her room to the best of her ability since the ‘prank’ pulled on her.
Needless to say, she promptly had Schorl burn each of her coats for safety reasons.
50. She is very well aware of the irony of her name's meaning and of her profession and the deeds she has committed, with her finding it to be somewhat humorous in a rather dark way, with her using it as a part of several rather dark jokes that she makes when free of Schorl’s gaze.
51. While Shalom claims to have something of a Black Thumb when it comes to gardening, few know just how bad her attempts at gardening have ended over the course of her attempts at it.
As not only has she managed to kill the vast majority of her own plants, including ones that should not be easily killable by any stretch of imagination, but she has also managed to, through means known to not even Paradeisos, cause plants that others are tending to on her behalf to die whenever she tries any attempt at caring for them.
She was particularly upset the day she managed to kill a rose that Rosa had given her, with the maid having to visit the Bureau to console her former employer over the matter, said maid would later confide to the Chief that the flower was artificial and it should not have been possible for it to die.
52. Shalom very much enjoys egging people on when the chance arises, utilizing her position as a Paradeisian and her own connections to put people who have managed to earn her ire in a position of wishing to strike at her, but being unable to do so.
In particular, she enjoys doing this to high ranking officials or such that try and interfere in her aiding the Chief, finding the expressions they make as they grit their teeth in silent and indignant fury at her to be amusing to no small extent.
She is confident that should anything occur, Rahu would protect her, though her bodyguard has told her many times to cease her antics or to at least reign in her antics so that she did not have to have her hands on her weapons everytime Shalom meets an official that annoyed her.
The only response she received from Shalom was an amused smile and the faintest hint of exasperation from Schorl as the Hush went to another meeting with a board of officials, said meeting nearly devolved into a full on brawl due to her pitting them against one another as she sat back and enjoyed the show.
It is safe to say that Rahu has come to dread seeing Shalom smile during meetings.
53. She has many times commissioned Cassia to make perfume for her, with her finding the perfumers products to be vastly superior to even the perfumes that she would find in luxury stores in Eastside.
A part of the deal she has with Cassia is an exchange of fragrances so to speak, as she will let the perfumer take samples of her hair to make into perfume in exchange for custom perfumes, though her donations to help Cassia built her own Atelier within the Bureau don't hurt either.
Cassia considers the perfume she has made from Shalom’s hair to be an oddity, not just due to it smelling of a form of flower she has not smelled before, her best guess being some form of lily, with a rather spicy undercurrent of something akin to cinnamon, but also the feeling of peace it seems to bring the one wearing it, though she claims the feeling of peace feels…unnatural to her.
The perfumer would work to refine the perfume made of Shalom’s hair for several months before she seemed to reach some form of breakthrough, though it did not seem to be a desirable one as she soon destroyed the product and went back to her earlier iteration of the scent.
Why she did so, she would never say, but the look of pity and unease in her eyes when she looks at Shalom since her experiment ended, tells a tale all of its own.
54. She finds Hella to be rather adorable, though she is admittedly somewhat envious of the sheer amount and depth of emotions the young Syndician can feel, along with the ease at which she is able to display and switch between them.
Nonetheless, she has come to be rather fond of the gremlin’s antics, with her considering it a pleasant interruption to her day whenever she sees the hellion causing chaos within the Bureau, with her having gone so far as to aid her in her escapes and antics for her own amusement.
She is also oddly protective over the Syndician, as she has come to the conclusion that Hella is a vital component to the Chief’s happiness, and a valuable means of keeping her safe, and as such she takes many steps to insure that the little hellion is safe during her outings.
Hella once confronted her on the matter, surprising Shalom with her awareness of her involvement, the pair speaking for a while on their thoughts on the matter, with the Rat Queen Of Syndicate surprising Shalom with her maturity and intelligence during their conversation.
In the end Hella agreed to endure her meddling and watch, in exchange for her monitoring and protecting Ninety-Nine as well, with the gremlin threatening Shalom with going to the Chief and ruining her image in the Chief’s eyes if anything happened to the Berserker.
Shalom had chuckled at the statement, an honest chuckle of amazed amusement at the girl's audacity, before she acquiesced to her demand with grace, smiling to herself as she re-evaluated her opinion on the girl who finished her tea before she left.
Before Hella had left the room, however, she had asked her how it was she deduced that it was her that was involved, something which made Hella pause before she turned to look at her over her shoulder and said-
“I had a hunch it was someone high up, didn't know who though, so I took a gamble on it being you and you confirmed it for me.”
Shalom had been incredulous for a moment before she began to chuckle once more, basking in both her surprise and the genuine emotion she felt as she watched the young woman leave, silently vowing to herself to see the full potential of the young girl one day.
55. And the final one, is that Shalom fully expects to never truly achieve her happy ending and to die before she can be fully free of the shadow of Paradeisos, to never be able to watch movies with the Chief, see Rahu freed from her hatred, watch as Christina and Thistle grow together, or witness Coquelic and her Garden claim their own pound of flesh from both the Underground and Paradeisos.
Because of this, everything she has done and continues to do is her rigging the board as much in favor of the Chief and those she feels deserve it as possible, all to insure that once she is gone they will still be safe and can reach their own happiness.
She knows that nothing she has done can make up for even a fraction of the sins she has committed, but at the very least she hopes that these sins can pave the way to heaven for her loved ones while she descends into hell where the Hush belongs.
She could burn with a smile on her face, so long as she knows they will be safe and happy.
And with any luck, she will drag Paradeisos down to the depths of hell with her, so that they can all burn along with the monster they created.
And that is it, everything we have for Shalom, and our longest post on this sub to date, we hope you all enjoy it and that you share your opinions and thoughts on what we have here, along with some of your own headcanons should you wish to do so.
Till next time, stay safe and take care.

P.S. This is Tagged as spoilers for some pieces of infromation that may be spoilers for those who have not seen or done her interrogation or the Floral Unfurl and RainBurst Events. This is also the first post of mine to break the Character limit so I will be breaking it into two parts.
Link to Part 2: https://www.reddit.com/PathToNowhere/comments/1clu7gw/path_to_nowhere_sfw_headcanons_for_shalom_part_2/
Part 3: https://www.reddit.com/PathToNowhere/comments/1clua8k/path_to_nowhere_sfw_headcanons_for_shalom_part_3/
1. She has many times attempted to usurp Nightingale as the chief’s adjutant in an effort to get closer to the Chief, with her efforts ranging from subtle attempts to discredit Nightingale, to outright attempting to have her transferred to a different Agency, though these efforts have all been in vain.
She has since switched her efforts from removing the Adjutant from play, to making her into an ideal subordinate to aid the Chief and to use as a proxy for her own plans to benefit the Chief, herself, and the rest of the MBCC through a variety of means, some of which have left Nightingale adamant in putting a bullet in the head of whoever is responsible for them.
2. She does not like overly spicy food, something with a little kick is fine, but anything above that is too much for her, a weakness that Coquelic somehow figured out and used against her by lacing one of her meals with a notoriously hot pepper.
Shalom’s yelp of pain as the spice overwhelmed her, and the way her eyes had begun to water as she downed her entire drink before she asked Rahu to get her another one, is an image that has been immortalized in the halls of The Garden via several covertly taken photos and videos.
That the Garden found its flower garden in the Greenhouse dying barely a week later, in addition to the Chief being unable to get her hands on any additional flower seeds to replace the ones they had lost for several months afterwards was certainly just a coincidence…right?
3. She still has a soft spot for Christina despite past…incidents. And while she desires for Christina to make her own path, she still considers her to be her detective, and as such maintains a careful eye on her.
From keeping track of which cases she is working, the threat they pose to her detective, the people she socializes with, her newest interests, her family’s state of affairs, to the way she decorates her room, and so on, she feels at ease knowing that her detective is safe and sound.
She has made it clear to her detective that she will always be present to offer her help should she need it, granted her help tends to come with the requirement of Chris having to spend time with Shalom while she addresses her as ‘Big Sister Shalom’ during said time and allowing the Hush to call her ‘Little Sister’ as well.
As such she is never able to fight the smile that comes to her face when Christina needs her help, especially when she is able to use the chance to pamper her detective and see how far she has grown while on her own.
4. This suggestion came from EinarKaslana on Ao3, the credit for it goes to them.
That said, it is a shared headcanon between us that she is fond of photography, and maintains many photo albums throughout her places of residence, with specific people, such as the Chief, Christina, and Rahu, having entire albums devoted to pictures taken of them by the Hush.
That some of them were taken by cameras they were unaware of is neither here nor there to Shalom, and so long as they remain unaware of them, it will be nothing to them either…especially so long as they do not discover the albums that contain more candid pictures of them in various states of undress or in certain…compromising positions.
It is safe to say that those albums are among her most well hidden and well defended of treasures, with even Schorl being unaware of their location.
5. She has a soft spot for cats and dogs, often leaving out food for them or taking the time to pet and pamper them when she encounters them, as such she was one of the staunchest backers for the MBCC gaining an on site pound/shelter.
That said, she is also an avid fan of cat cafes having dragged Christina and Rahu to enough that they can reliably name the majority of the cat cafes in Dis off the top of their head, with but a few exceptions for those that have yet to have the Hush grace them.
She also tends to leave very sizable tips at said cafes, enough that the staff go out of their way to meet her expectations, and that they do not say a word about her gathering enough cats to cover herself and whoever is with her at the time in them.
6. Her room is surprisingly rather homey, with a number of bookshelves lining the walls, only broken up by small tables or wall fixtures with lamps and candles resting on them, an assortment of dark colored furniture, a large amount of flowers, both in pots on tables and hanging from the ceiling, and a rather sizable collection of horror related media.
She also has a large canopied bed that she has covered in enough pillows that many periodically fall off when anything jostles the bed, and a rather sizable amount of scented candles and incense scattered throughout her room.
Her main outfit of choice, along with several copies of her favorite coat, is kept in a dresser near her bathroom, while a much larger walk-in closet is dedicated to other uniforms and outfits that she has amassed over the years, though they are a subject for later on.
There is also a room that is hidden within her cell, a result of her machinations and of several deals made to allow her skills to be used to benefit the MBCC, said room being filed with a wall of monitors and terminals, a large number of filing cabinets rigged with incendiary devices that she can activate by tapping a button on her terminal, and a sizable amount of targets for her to focus her skills on.
She can never stop herself from chuckling everytime she enters the room, picturing the look on her former handlers faces were they to become aware that the Hush of Paradeisos, has become the Hush of Minos, granted said role is kept secret from the Chief, but it is the thought that counts…at least to her.
7. While there are many Sinners and staff within the bureau that adore Shalom, there are equally as many that hold in her both dread and contempt, be it because they know just Who she is, or because they feel that something is not quite right with her, some sixth sense warning them to avert themselves from aligning so closely with her.
Among those who hold her in disdain are Langley, who has seen enough of the mountain of corpses the Hush has built as an agent of Paradeisos to fully trust her, even with her devotion seemingly to have switched to her rookie.
As a result, the Spider has a special bullet with Shalom’s name written on it for the moment she feels the Hush has become more trouble than she is worth keeping around.
Another one that holds the Hush in contempt is Chameleon, the hypnotist being able to see through the mask that Shalom wears and finding the thing she glimpses beneath it to be of no small amount of concern, hence her own caution in regards to her.
Her trepidation regarding Shalom was only further cemented by the fact that the one time Chameleon attempted to use her power on Shalom resulted in her awakening in her cell with a migraine, a bloodied nose, and a letter reading- “Please, don’t try that again. I would hate to have to explain your loss to the Chief. Sincerely-Shalom”
Of course there is also the Garden and their own wariness of the woman to consider as well, as, while they do admit her actions allowed for them to escape the clutches of the Underground, her methods…have done their perception of her no favors.
Though they can agree with her desire to support the Chief and to safeguard their new home, it does nothing to keep them from having their eyes on her, and a blade marked with her name on it should she overstep her bounds.
While there are many more who feel wariness of the former Hush of Paradeisos, perhaps rivaled but by that of the former leader of Rustifre is that of her own former protegee and pseudo sister, Chirstina.
Having seen first hand just how ruthless her mentor can be, along with having gotten a glimpse as to the true nature of her work for Paradeisos, she has since found that while she yet has a fondness for Shalom, she can never feel as at ease in her presence as she once did due to what she has done, something which is bittersweet to Shalom.
8. She is one of a very select few to have actually beaten Eirene at both normal chess, and a specialized version of it designed by the Head Of Quinn, with her version of chess being something which involves multiple chess boards linked to a rotating table, where the players are playing multiple games simultaneously with but a few moments to make each decision and move.
Said game lasted nearly 12 hours, and ended with Shalom claiming a resounding victory with but minimal losses upon the other boards, a feat which has since earned her no small amount of fame within the bureau, even from her detractors, and a standing offer to play chess with Eirene whenever she wishes to.
9. While she is physically frail, especially for an S-Rank Sinner, she is still heads and shoulders above an average person in terms of speed, strength, and endurance, being as able of breaking bones with a punch as she is ruining someone's life with a few well placed whispers.
That said, she is surprisingly somewhat unaware of the extent of this strength, especially given that she is severely lacking in training for CQC and the usage of firearms and other weaponry, given her preference for remaining on the backlines and using the overwhelming might of Schorl to contend with any foe that gets in her way, and has thus not really had any reason to use it.
Yet even without training, she is still a capable threat should someone get in close, something which has lead to several sinners and staff seeing the surreal scene of her casually flinging a corruptor, that had somehow bypassed Schorl’s scanners, three times her size against a wall before it was vaporized by the aforementioned Paradeisian weapon.
10. She has gained a habit of messing with Schorl by putting stickers and such on it, something which the machine does not seem to enjoy given how it will try and find any way it can to remove the stickers or markings from itself the moment they are applied.
Shalom even once went so far as to write on the Paradeisian device with a pink marker, using it as a means of reminding herself of an appointment she had with Dr. Iron and Nurse Anne regarding her health, with the machine actually allowing the message to be written and to remain…at least until after her appointment, at which point it bore a hole through a water pipe and used it to wash itself off.
Similarly, she once brought up the idea of coloring the Schorl, with the machine and its operators adamantly rejecting the very concept of the idea, going so far as to destroy the can of paint and paint brush that she had purchased to do so before they scurried off.
11. She cannot drive. This is one of the few points of agreement the Chief and Paradeisos have ever been able to reach as Shalom’s driving can lead to no small amount of damage to the vehicle she is behind the wheel of, along with the sanity and health of her passengers.
The last time she attempted to drive she managed to make it a quarter of the way to her destination before Rahu and Christina, both of whom were holding on to one another for dear life, managed to convince her to switch with Rahu while Christina and Schorl spoke with the sherrifs regarding the collateral damage.
They were less than 3 minutes into what should have been a 9 minute long drive at the time.
12. She is fond of dropping by the Chief’s office and helping them with their work whenever the opportunity presents itself, something which has greatly endeared her to the Chief, and, albeit begrudgingly, Nightingale.
That she tends to leave each of these sessions wondering just how it is that the Bureau has not imploded in on itself or declared secession from Dis in some fit of mad lunacy, is something that tends to add some enjoyment to her day by trying to make sense of the insanity of the MBCC.
She has even gone so far as to compile many of the more interesting stories and reports into a personal collection to browse for her own entertainment whenever she feels the need for some levity.
To this day, one of her favorites remains the time that Emp managed to weave so elaborate a lie that it resulted in the FAC spending nearly 4 days investigating a ‘Duck Sinner’ that was responsible for the destruction of a power plant, with the Archer even managing to, albeit unknowingly, have Paradaisos waste several days investigating the same claim when it was relayed to them.
The true culprit of the Power Plant overloading was of course, EMP herself, though Shalom vowed to take that secret to her grave in exchange for the amount of humor her lie gave her.
13. Rahu once attempted to teach her how to use a conventional weapon for self defense, in the event that Schorl was destroyed or disabled and she was not present, only for the attempt to end with Christina having to get her hat repaired courtesy of the bullet ricocheting off of the target, off of the ground between Rahu’s feet, the ceiling above them, the railing of the shooting range, and then into the top of Christina’s hat.
That Langley had the audacity to not only laugh when she heard the report, but to then order Shalom not be allowed to touch any firearms in the Bureau has since been something of a sore spot for the Hush, especially since both Christina and Rahu aid the Spider in enforcing such a rule.
14. While her fondness for the horror genre of film has long been a well established trend in the bureau, with her appreciation for it in literature and art being similarly well known, her fondness for horror games is a relatively new obsession of hers.
Most of this fondness for the horror genre of gaming can be laid at the feet of Etti, who Shalom overheard running a horror themed tabletop session, EMP, who introduced her to horror anime as repayment for lending her a movie, and Nino, who she watched stream a horror game that caught her fascination.
Since then, she has devoured many horror games in terms of both playing them and watching them, with some of the games being of such disturbing levels that even Schorl was driven to escape the room to avoid the more disturbing scenes and gameplay.
That her new fascination has started a trend among the ones in charge of monitoring her via Schorl using the media she enjoys as a form of Test Of Courage, is something she is aware of enough to greatly enjoy.
With her fondness later extending to Tabletop games and the potential for horror and suspenseful storytelling within them as she learned of many of the horror campaigns that had been run by other DMs.
This being something that led to her approaching Etti to request her guidance on the matter, with Etti agreeing to help her DM a horror themed session, the young dragon all too happy to help a fledgling DM in the art of destro-*Ahem* creating an enjoyable session for everyone with minimal tears and screams involved.
That said session she ran resulted in Horo hiding under Zoya’s bed, Christina hiding with Thistle in a closet, Hella and Ninety-Nine refusing to leave their room without ear plugs on as they cursed her to hell and back, was something that lead to Etti declaring Shalom to be her new apprentice in the art of DMing.
The sheer panic that announcement caused nearly brought the Bureau to its knees.
15. Upon learning of Cabernet’s ability to materialize and consume souls, Shalom sought her out with a rather curious request, as she wished for the Franc Heiress to materialize a piece of Shalom’s own soul so that she could taste it out of her own curiosity.
After a rather lengthy debate with the Chief, and several tablets of aspirin, it was decided to allow the experiment of sorts to take place, with Cabernet materializing 2 pieces of Shalom’s soul as a pair of grapes, one being given to the Hush and the other being kept by the Glutton of Souls herself.
Cabernet would later remark that the taste was bizarre, as at first there appeared to be no flavor at all to her grape, only for her to be suddenly hit with an overwhelming bombardment of taste to such an extent she was nearly ill, the heiress later remarking to the Chief that beyond all of the myriad flavors there was something else…a feeling that was unnamable to her, yet left her feeling uneasy for many days afterwards.
Shalom would claim that she enjoyed the taste of the grape as well, though the true joy of the experience seemed to be an idea that had come to her as she would later approach the Glutton with an offer that she would request be kept between the two of them.
What was that offer?
Perhaps it is better off unknown if the way the Franc Heiress refused to leave her room for several days afterwards was anything to go by, and it is likely better still to not question why it is she seems to make a weekly tribute of a grape to the Hush, one that could not possibly have been made with Shalom’s own soul.
Indeed, it is better not to question what was said between the two.
16. She is still in regular contact with, and financially supporting, her former maid from her time at Erica Villa, Rosa.
The young woman having managed to somehow earn the fondness of the former Hush to such an extent that she has been working quite tirelessly to convince the Chief to allow for her to be employed at the Bureau, her main argument being that she could be of great help as part of any of the departments that need her…along with being another at least semi-sane and responsible person to help keep the MBCC in…relatively stable condition.
With each day she makes the argument to the Chief she wears her down more and more until she will be able to have her maid back at her side, and once more enjoy teaming up with her to make Rahu, and soon the Chief, as flustered as possible with their shared teasing.
17. She is not allowed any form of caffeine, a rule Paradeisos ‘forgot’ to inform the Chief of when Shalom was sent to the Bureau, with Rahu and Christina thinking the Hush herself or Schorl would have informed the Chief of this rule…only to learn that was not the case.
Indeed, the Chief learned of this rule when someone, she is willing to bet her life that it was either Hella or EMP, saw that the former Hush looked tired and offered her some of Summer’s Special Brew Coffee.
What happened next is something known but to those who were there that day and who managed to gain access to the security footage, something which was soon locked behind the highest grade of confidentiality that Paradeisos could create, with the files being further encrypted by Summer and Langley as well.
Any attempts at acquiring an answer from those who witnessed what happened that day would be met with nothing but a thousand-mile stare, with several others whimpering and curling into the fetal position or turning and fleeing as swiftly as they can, with none daring to vocalize just what happened that day.
All anyone knows is that a substantial portion of the bureau needed repair done to it, several officials that had been adamantly against the Chief and the MBCC had to resign from their positions in disgrace once certain information regarding them was leaked, along with a rather sizable amount of collateral damage being done to several major roadways and side streets.
Schorl has since been given permission to destroy any source of caffeine Shalom manages to get her hands on.
18. She has been utilizing her abilities to commune with the Mania Monster made of her discarded humanity known as Rebel in a bid to earn its compliance and to be assemble to utilize it to its fullest one day, her primary reason for doing so being something of an emergency measure should Paradeisos attempt to remove her from play along with having an emergency ace in the hole for rainy days.
That it could be an additional tool for the Chief and a means of further defending her should anything befall the Hush, the monster having long made clear its own deep seated adoration for the Chief to her during their…’Conversations’, is but yet another lie she has come to tell herself.
That she also wants to reconnect with her lost humanity and to try and bond with it is something she has tried time and again to deny even to herself, yet as time has gone by, and her emotions have begun to return to her, she has found it increasingly hard to deny her true reason for wishing to do so.
The truth of the matter…is that all of this is being driven by Her ability to feel the loneliness of that missing part of herself and her desire to end it and fill the gaping wound torn in her own soul all those years ago by Paradeisos.
All she truly wants is to feel whole again.
19. She has an odd relationship with Hecate, somewhere between an almost sisterly bond and that of a mentor, with the former Hush often volunteering to accompany the younger sinner into the field to act as a mentor to her, that she still unconsciously tries to protect her is something neither will directly mention to one another.
The pair have likewise somewhat exchanged hobbies with Shalom managing to get Hecate interested in the horror genre, while Hecate has managed to convince Shalom to take up sketching and, to a lesser degree, painting as a hobby, something the Hush has taken the somewhat relaxed leash and observation she is under during her stay in the bureau to thoroughly enjoy.
That most of her works feature the Chief, several even having her in a state of undress or in various…compromising positions, is something that only the Hush and Hecate, who happened to mistake her sketchbook for an empty one, knows of.
It is safe to say the following exchange was quite awkward for the pair, though they were eventually able to work past it and continue their regular sessions of shared artistic endeavor…with the addition of a rather bright tag to mark which sketchbook is Shalom’s.
In a similar vein, Shalom has taken a rather sizable amount of time in teaching Hecate how to think strategically and to plan for various scenarios, with the young Sinner having shown a marked improvement in her Dispatches as result of the tutoring, that the Chief saw fit to praise Shalom was simply a bit of icing on the cake to her.
That said, many Sinner feel no small amount of unease at the idea of the Hush having taken the Chief’s Shadow under her wing, especially given the uncanny similarities the pair seem to share, the only comfort most have been able to find in the matter being their shared loyalty to the Chief.
Though even so, most fear the idea of just what Hecate could become if Shalom is allowed to mold her enough, thus all of those within the Bureau tend to keep an eye on the pair whenever they are together and they can.
20. She has mapped out the vast majority of the secret tunnels that span the Bureau, particularly all of the ones that lead to the kitchens and to the Chief’s room, with her making use of them to not only be able to sneak away to the kitchen for late night snacks or when she needs a drink during her work, with her also using the tunnels to deliver snacks to the Chief and to surprise her when she is working.
She also makes use of them to avoid certain parties and to surprise others, with her usage of them having gotten to the point that a not so small number of Sinners and staff are of the opinion that she is in possession of some form of teleportation device.
That Shalom seems to find some humor in these rumors and even tends to encourage them through her own actions and inactions has likewise led to no small amount of confusion and unease among the Sinner population due to the potential threat she could pose with such a device.
The Chief has tried time and again to dispel these rumors, only for them to constantly re-emerge after enough time has passed, something which has led to the Chief and the rest of the administration staff of the Bureau nearing the end of their rope in regards to how to handle the spreading rumors, with Paradeisos offering no help on the matter.
21. She has found something of a way to utilize her “Mark” in tandem with the Chief’s Shackles, a method of piggybacking off of the Shackles and utilizing her ability in a way that makes it considerably less obvious towards both the recipient of the ‘Mark’ and the Chief herself that one is under the Hush’s influence.
Even with this loophole removing her need for direct eye contact with her targets among the Sinners, it still requires for the targets to be in a heightened emotional state, and for the Chief to not be aware of her actions due to her ability to sense the influence through the Shackles and throttle it before it truly spreads.
The knowledge of this influencing power is strictly confidential so as to prevent any panic from spreading among the Sinners, especially among those who have prior experience with the Hush and her power., with the Chief having further heightened her security around the Hush, despite her claims of only wishing to use her power to aid the Chief.
That said, the loophole has a further weakness in that Sinners of strong enough will, or those who are particularly Contaminated, such as Nox, Dreya, and so on, can not only resist the influence of the Mark through this loophole, but can also somewhat retaliate against it, causing Shalom a sizable amount of pain when they do so, Nox’s own retaliation leading to her having a severe nosebleed and being near catatonic for several hours.
The final weakness of this ability is that she requires time to focus on the Shackles, and the slightest of disturbances can interrupt her ability, with contact with the chief being an additional means of furthering her power’s stability, though since this loophole came to her awareness she has made certain to be on her guard around her the vast majority of the time.
A final note is that by some means she has been able to keep this development secret from Paradeisos, using it as yet another tool in whatever schemes of rebellion she harbors against the organization.
22. She has given Thistle the equivalent to ‘The Shovel Talk’, with the exception of her talk involving her simply sitting in silence for a while as she looked Thistle in the eye, smiling as a triangle Mark flared in her eye as an unspoken warning of what awaits the assassin if anything befalls Christina.
Thistle’s reply simply being to lift up her sword and set it alight with her own silent vow, that should any of the Hush’s schemes cause harm to the detective, she would not live long enough to enjoy whatever form of victory she managed to achieve.
That the Hush has the audacity to smile at her actions a low chuckle slipping past her lips as she finished her tea before rising and walking past the assassin, pausing but to ruffle Thistle’s hair with an amused glint in her eyes as she left the assassin, only caused her to further despise the woman even if they could agree on protecting Christina.
That Thistle collapsed back into her chair as she fought to control her heart beat and suppress the adrenaline tearing through her body after Shalom had left the room, is something that she will deny ever happened that day.
23. She has met Christina’s step sister several times, each time ending in her being chased out of the house courtesy of the wheelchair bound girl either throwing objects at her or swatting at her with something as she tells her to stay away from Christina.
That said, she has not stopped her attempts at somewhat courting the young woman’s favor, having arranged for, and personally done, many things to make life easier for the young woman, such as aiding in her finding a stable source of income from home, and ensuring that she and Christina are able to visit whenever they wish.
Even with all that she has done however, the young woman still does not trust her, and does her best to try and mitigate any influence Shalom has over her, that said, she does appreciate Shalom’s efforts and has at least allowed for them to chat for more than 30 minutes before she starts chasing her out of her home.
24. While Shalom can be said to have a rather refined palate, she does also have a taste for more simple foods as well, especially given that Paradeisos did not allow her to indulge in them before due to her needing to maintain an image as their Envoy and their close monitoring of her.
As a result of this, and the somewhat increased freedom she has at the Bureau, she has gained the habit of searching for small hole in the wall restaurants and such to dine at with the Chief, Rahu, or Christina, with her having gained a reputation as an exceptionally generous patron.
More than once, Rahu has been caught off guard by seeing staff greet the former Hush by name and show her to her favored seat in the establishment, one time of note involving a rather portly chef who was easily double Rahu’s own size and weight leaving the kitchen to greet Shalom with an embrace as he sat her down and spoke with her for a little bit before going to cook her meal.
She has even tried some of the more exotic foods brought back by Wolverine from his hunts, such as the meat of Sand Worms, which she claims has an oddly gamey flavor to it that is not that unpleasant, and a form of lizard that she actually quite liked the taste of, much to everyone’s shock.
That said, she did refuse to even look at the scorpions and other multi-legged insectoid like creatures the Hunter caught, due in part to a reason that will be touched on below.
To Be Continued in Second Part due to 40,000 character Limit.

As a separate question, (Sorry I have some more questions! :) )

1. The accident was when I was crossing the street.
2. The moment of the accident was when I was crossing the street.
3. The sunset was when I was crossing the street.
4. The question is when he knew that.
5. The real question is how he knew that.
6. The real question is when he knew that
7. The man in the cafeteria who is taking a phone call is my father.
8. I'm referring to the man in the cafeteria who is taking a phone call.
9. I'm referring to the man in the cafeteria taking a phone call.
10. If aspirin will ease my headache, I will take a couple tonight instead of this horrible medicine.
11. I think I will warm some water for tea if you will excuse me.
12. If I should see her tomorrow, I will ask about her trip.
13. When I can swim, I will join the team.
14. If I may offer some advice, I suggest you reconsider your decision.
15. When I could finally understand the math problem, it felt like a huge achievement
16. If you could help me with this project, I would greatly appreciate it.
17. I would consider your offer, provided that you could guarantee delivery by next week.
18. Please let me know when you could meet me for lunch
19. You have likely been injured.
20. You have been likely injured.
21. I don't know that which is better
22. I don't know which is better
23. I don't know that which he bought.
24. I don't know which he bought.
25. I am not sure that which is better.
26. I am not sure which is better
27. I am not sure that which he bought.
28. I am not sure which he bought.
29. I am not sure why.
30. I will go jogging tomorrow when there are no cars in the streets.
31. I will go jogging tomorrow, when there will be no cars in the streets.
32. I will go jogging tomorrow, the time that there are no cars in the streets.
33. I will meet her the next day, the time she is arriving from the US.
34. I eventually found my phone in the refrigerator, which is where I lose things when I’m especially frazzled.
35. The party, when I met her, was unforgettable
36. I'm thinking about the day, when she passed away.
37. To learn a new language is my goal for this year.
38. If you would kindly review the report, I’ll be able to submit it by the end of the day.”
39. I can proceed with the project, provided that you would allocate additional resources.
40. Please let me know when you would like to schedule our next meeting.
41. I appreciate your prompt response when you shall have a moment to discuss the proposal.

Q1) Are 1-41 above all correct English or at least acceptable English?
Q2) As for 21 and 23, I used the bold parts, as a whole, as the objects of the verb "know". If so, are 21 and 23 wrong?
Q3) As for 21-28, are 21-28 still correct English or at least acceptable English even if "which one" is used instead of "which"? And even with the change, is your answer to Q2 still the same?
Q4) As for 1-6, does the bold parts modify the verbs "was" in sentences 1 and 3 because 1 and 3 doesn't make sense if they modify the subjects "The accident" and "The sunset", but the bold parts modify and describe the subjects "The moment of the accient", "The question", and "The real question" in sentences 2, 4, 5, 6?
Q5) If so, is this example "No one may wear shorts to school. The exception is when there is a party" also correct English? If so, does "when there is a party" modify and describe the subject "The exception", but not the verb "is" because the when-clause refers to the time related to the exception?
Q6) What do 1 and 3 mean in other words?
Q7) As for 7,8,9, do all the bold parts modify "The man" and "the man" even though the bold parts are somehow far away from "The man" and "the man", which the bold parts modify?
Q8) Like in 7, 8, 9, is it possible and done by native English speakers for a relative clause like "who is taking a phone call" or a participle phrase "taking a phone call" to modify a phrase or a clause that is far away from the relative clause and the participle phrase?
But can it lead to confusion sometimes without any clear context?
Q9) As for 10-18 and 38-41, like in 10-18 and 38-41, can the auxililary verbs like "will, would, shall, should, can, could, might, may" be used in if-clause, when-clause, provided-clause or in any clause?
Q10) As for 19, does "likely" modify "been", but as for 20, does "likely" modify "injured"? Are both 19 and 20 the same in meaning? and even though the placement of "likely" is put at the front of or at the end of 19 and 20, are both edited sentences 19 and 20 still the same in meaning as the original and still correct English?
Q11) As for 29, is "why" the object of the adjective "sure"?
Q12) As for 31, 32, 33, 36, do the bold parts all, as appositives, modify or refer to the phrases "tomorrow" , "the next day", "the day"? So, are the bold parts used as additional information to "tomorrow" and "the next day" and "the day"?
Q13) As for 30, 31, 35, can the bold parts be anlayzed as modifying either the entire sentences 30, 31, 35 or just the verbs "go/go jogging/jogging" and "was" ?
Q14) Is there any difference in meaning between 30 and 31 according to the when-clauses in bold are set off by a comma or commas? I just found a website explaining that there is a difference in meaning according to whether the bold parts are set off by a comma or commas. In 31, the bold part is analyzed as additional information since it's set off by a comma, and even in 35, the bold part is analyzed as additional information. If so, is the meaning of 35 different if the bold part is not set off by the commas?
Q15) As for 36, even if there is no comma that sets off the bold part, does the bold part still modify "the day"? and is there no change in the meaning of 36?
Q16) As for 36, are both sentences "I'm thinking about the day that she passed away" and "I'm thinking about the day she passed away" correct English? Is it okay to omit "that" or "when" ? and is it okay to use that-clause like "that she passed away" to modify "the day" instead of "when-clause" ?
Q17) Are both sentences "The fact that you’re always willing to help others makes you a kind-hearted person" and The fact you’re always willing to help others makes you a kind-hearted person" correct Englih or at least acceptable English? In the second sentence, "that" is omtted, which was connected to "the fact".
Even so, is the second one acceptable? and are both the same in meaning? and do both "that you're always willing to help others" and "you're always willing to help others" modify and describe "The fact"?
Q18) As for 37, is the infinitive phrase as a whole the subject in sentence 37? If so, is it possible to use an infinitive phrase and a gerund phrase as a subject in a sentence? If so, does "my goal" describe and modify the subject "To learn a new language" ?
Q19) As for 37, does "for this year" modify "my goal"? or can "my goal" also be analyzed as modifying the entire sentence 37 or the verb "is"?
Q20) As for 37, can "for this year" actually be put at the front of or in the middle of sentence 37 when "for this year" is set off by a comma or commas? But in that cause, is "for this year" only be analyzed as modifying the entire sentence 37 ? or the verb "is"?
Q21) As for 21 and 23, if "which is better" and "which he bought" are set off by a comma, are 21 and 23 correct English since "which is better" and "which he bought" are just additional information that refers to "that"?
But I actually used the bold parts as a whole the object of the verb "know" by treating "that" as leading a clause that contains "which is better" and "which he bought". In this case, maybe is only 21 correct but 23 wrong?
Q22) When I use "which" or "what" or "whose" or "who as leading a clause, is it wrong to add "that" like in 21 and 23?
Thank you very much!

Hey all, I know this is not strictly a question about mountaineering, but it does relate closely to health and safety when you’re in challenging wilderness/alpine environments for extended periods of time.
I have been refining my wilderness medical kit to make sure I have all the essentials.
I am a geologist who works in the field daily, and also recreate extensively in the backcountry, recently getting more and more into mountaineering.
I am also commonly the only one in the group with a med kit that has more than bandaids, so I pack accepting that I’m essentially the group medic
I am trained to a WFR level, so my loadout reflects this level of training. ( i.e minimal advanced medication besides epi and antibiotics, but thorough with the fundamentals)
This is more of my loadout for general field work and day trips, and I pare down to be lighter when I climb or do long distance backpacking trips.
Here is my list so far:
TUMMY:
-Loperamide HCL (Imodium) + Simethicone (gasx)
-Bismuth subsalicylate (pepto)
-Polyethylene glycol 3350 (miralax)
.
ANTIHISTAMINE:
-Diphenhydramine (Benadryl)
-cetirizine hcl (Zyrtec)
.
NSAIDs:
-disprin (chewable baby aspirin )
-ibuprofen (advil)
-naproxen (Aleive)
.
Cold/Flu:
-acetaminophen (Tylenol)
-Pseudoephedrine (Sudafed)
-Guaifensin (muscinex)
-phenylephrine
.
ETC.
-Acetazolamide (diamox)
-Methylprednisolone (for extended care after administering epinephrine if evacuation is delayed)
-doxycycline (antibiotic/antimalaria)
-azithromycin
-albuterol
-epinephrine
-naloxene (narcan)
-electrolyte salts
-glucose gel
Am I missing anything? Any input is greatly appreciated, thanks,

tldr is I have been dealing with facial swelling (close to bee sting allergy range) and face and neck rash/eczema, crusty scalp border, my skin won't stop leaking clear fluid and some slightly yellow that dries grainy. My face swells overnight and (sometimes) de-swells throughout the day, but the skin inflammation doesn't stop. I'm a 23yr old female, and I feel so debilitated.
I've seen a few doctors, 1 rheumatologist, 2 derms, and 1 allergist, tried to test a lot of possibilities but I feel like I'm running out of options. Does anyone have any suggestions on possibilities I can explore with my doctor or just general tips on how to manage? whether you read this whole long post or not, thanks for reading! It's easy to feel alone and I really appreciate any support.
things i'm getting to right now:

• ask derm about head and neck eczema and to be prick tested for malessezia, also ask her about weeping eczema, which I though was plasma but since it's been so long with no healing I'm not so sure anymore. for that, hoping for some type of antibiotic which might help with the full rash at least
• switching to vaseline (lanolin might be making things worse for me? I haven't reacted well to lanolin creams in the past, and I only recently found out that aquaphor contains some)

The whole long story.....

dec 2020

1. front neck hives the next morning after a home-cooked special dinner. Hives eventually accumulated into rash.
2. got food allergy blood test, found out I was allergic to sesame (although it was really quite low?). Cut out sesame. Neck continues to have rash/dryness/swelling of rash area

febish 2021

1. still have front neck eczema, manageable but always a little dry, a little red
2. right temple gets an insane dry eczema patch that eventually gets infected, I use muprocin and I think a round of antibiotics to clear it up

oct 2021

1. neck rash still there, really hard to manage with all the cold weather starting up etc etc, very red and dry and irritated all the time, I began trying to manage it more with a prescribed topical steroid
2. began to get bouts of small rashes popping up on my face from time to time
3. one day woke up with eyelids very swollen (like cried for 2 days straight swollen) and red and a bit of raised red on my cheek. it subsided throughout the day, and I think the rashes would come and go over the course of days
4. a week later from 3., I wake up with my entire face swollen, most noticeable eyelids and cheeks, and skin is very red/rashy and sensitive/irritated, with hives down my chest and back, in my right elbow crease. I immediately scheduled a doctor's appt., where I was told to hydrate a lot with creams and aquaphor, and take a mix of allegra, zyrtec, and benadryl until I could get to the derm. My face skin's texture felt very thick and heavy. the swelling would go down slightly (but usually not all the way or sometimes not at all) throughout the day. In the morning, my face would swell back up. It didn't feel like any of the antihistamines were really doing much.
5. I see the derm around 5 days later. She doesn't have anything to say to me except that I should see an allergist. She prescribes me another type of steroid ointment and protopic (tacrolimus), and tells me that if that doesn't clear up the rash in a week, I should call her and she'll prescribe me oral steroids. She didn't refer me to an allergist and I didn't feel like it was in my means at the time (I was at university at the time and everything felt very hard, with school and dealing with school insurance as I was not in my home state).
6. My skin clears up; it feels like a miracle. the swelling stops and the old skin goops off in grainy glumps with the binder of aquaphor, leaving me with baby soft skin. in the cold weather, little blood flow to my face allowed no redness. Aside from the burning pain you have to sit through during the first couple uses of protopic, the side effects of protopic were extreme heat sensitivity for me and of course with that being unable to drink; I learned to love the cold weather after that. Showers were hard because all the blood would rush back to those places were I had rashed out the worst, leaving me red, hot and blotchy. It was hard to exercise because of this at first too.
7. Years go by with me using protopic. I hoped the face swelling rash breakout was a fluke. Weening off was hard, first of all because I noticed that if I went more than a couple days not using it, my eyelid (specifically my left) and some rash areas would start to pop up on my face. So I used it to keep those in check. Second of all, there was a lot of pain involved (because if I was unsuccessful and felt that I really needed to use it again, then I'd have to go through that burning pain of starting tacrolimus again).
8. I was gradually able to work out without becoming too hot-flushed as cause of tacrolimus vs just normal exertion, and I learned that if I stayed away from certain alcohols and mixes I could usually keep the heat flushing tied to that to a minimum. However, I really began to feel weighed down by the side effects of tacrolimus and the fact that I couldn't seem to stop using it. Still, I would use it as needed and even on other rashes I would get from time to time, mainly back of neck, chest, shoulders, and elbow crease eczema. Aside from my face, it wasn't as effective on the rest of my body. I'm not sure if it was because the rashes themselves felt different (composition wise, and in the way they would flake off? I'm not sure if they were really any different or not). but anyways, I did constantly have some type of eczema on one of those other parts of my body, that would never go away fully, even with ointment usage (tacrolimus, topical steroid) for weeks. Even on my face, sometimes my eyelids would get a bit swollen and the sensitive skin inflammation would pop up even with consistent tacrolimus use. hot flushing did occur very randomly from time to time as well.

sep 2023

1. if I don't use tacrolimus the face swelling comes back. I tested this by accident when I forgot my almost empty tube of it before going on a trip, and my eyelids (my learned hallmark of when everything's about to go down) start the swelling+inflamed sensitivity.
2. I'm back in my home state now. i go to the doctor about some wrist pain I've been having, with no specific cause or injury. she notices all the arm and neck rashes I have, as well as my flakey crusty ears. She points out the (weakly) symmetric nature of my rashes tells me it might be autoimmune related, sends me to get all the basic blood panels. I have some allergies I knew about, and a positive ANA, but the titer is on the low end at 80. She refers me to a rheumatologist.
3. -brief interlude-My inner elbow eczema is flaring up badly at this point, so I try an elimination diet of nightshades and garlic. I don't think it really helped, it was more just me being conscious of it that helped it a bit? Anyways, the eczema could never fully go into remission it seemed.
4. the rheumatologist hears my history, and I do more blood tests to test out autoimmune more extensively. The tests all come back normal, and the allergist says has no idea what is wrong with me. In regards to the rash aspect, he asked me if I've ever considered whether it was eczema? I was a little dumbstruck in the moment, because it felt so rudimentary-- I thought we were already well past that point of understanding, like I thought that we both already understood, yes, I have eczema on my arms and parts of my neck. I was a little shocked that he felt the need to mention that, as I had already told him all of my past history with rashes, eczema, and prescriptions. He refers me to a derm at my request.
5. It's october 2023. I'm going on a trip. I'm out of tacrolimus, and I request more from my home doctor. she ignores my request, and I go on the trip fine. I had been slowing and limiting my use naturally because my tube was almost done anyways, so I figured it would be ok. After the 6hr plane ride, I noticed that my face skin was very dry and textured, and getting a little red. I assumed it was because of the plane's uber filtered air, and quickly set to my usual routine of lots of aquaphor (a normal nightly thing for me). I was having trouble - the rash on my face (cheeks, eyelids, the usual) was textured and raised and red, and not going away. It wasn't really evident what made it worse. At this point I start taking claritin to try to help. 2 weeks of this, until I wake up with a very similar occurrence as that first swelling moment in 2021 - entire face swollen like a bee sting allergy, skin rash/textured, hives down my back. In addition to the claritin, I'm taking benadryl and extra strength ibuprofen. In a last ditch effort, I get the lowest dose topical steroid at the store. It pretty much clears up both the swelling and rash over the course of the next few days, except for some little patches that refuse to go away, even after the next 2 weeks.

feb 2024

1. It's months later since that trip. I still did not have any tacrolimus, an ending use of hydrocortisone after 2 weeks (standard I was told) didn't work, as the rash spots on my face kept coming back and I'd need to reapply. I was getting very concerned about the long term use of hydrocortisone and even my prior tacrolimus use, and the fact that I could not shake these random rash patches + the ones that popped up all over my body led me to consider TSW. Regardless of whether I had TSW or not, I decided that it was time to ween off use of hydrocortisone on my face, as I've heard of all the harm and risks. I followed a similar schedule as (here), and took b complex + taurine supplements that may help with the redness throughout the process.
2. Even with the gradual stop, my skin was not taking it. It felt painful to have to put it through so much stress, lay on the steroid again, and then repeat the process (talking about the weening off) Eventually as I got to the true slow down, of trying to miss 3 days of hydrocortisone use, i was really feeling like the hydrocortisone application wasn't even worth it anymore, and just continued my stopped usage hoping that the rash that would start on the 2nd day and increase by the 3rd/4th would sort itself out with my potentially more equipped skin.
3. Over weeks and weeks, the rash just kept getting worse until I woke up with a swollen face again. It wasn't to the point of bee sting allergy swelling, but enough to make me look like a completely different person to my mom (primarily eyelids, under eye area, cheeks). My skin hurt, as it was inflamed all the time, and all the fluid retention in my eyelids made me feel fatigued all the time. My neck started with hives and spots of rash.
4. interlude ll here -- I started another elimination diet that focused on chemical intolerances - namely salicylates and amines (the FID Program in the Eczema Detox book), and even slow introduction and monitoring my symptoms, keeping a log, it was unclear whether it really played any influence. I tried covering my hands before bed, wrapping my arms.... it didn't work to stop my night itching.
5. there were some portions on my face (the stickler spots on my face that refused to leave during hydrocortisone use) that immediately began weeping when I weened off the hydrocortisone. I wasn't sure if it was weeping in the infected way, or the healing/plasma way. As the days went on, my neck rashes seemed to get bigger. It made me more cold sensitive, since I would constantly have this chill/tingling from the dryness at the back of my neck (even drenched in aquaphor). My sleep began to get disrupted, as now I would fully wake up multiple times throughout the night from scratching.
6. My derm appointment finally arrived. The derm took a quick look at my face, neck, and arms, and said I should see an allergist. Then perscribed me opzelura for my neck and elbow creases, after I had told her about my rough relationship with previous prescription drugs and how I felt slapped by the temporary solutions and dependencies, and how I only really scratch in my sleep, meaning my hands get all over the place (which might be bad with opzelura based on its instructions). At this point, my elbow eczema didn't even feel like a concern to me, and I was really tired how every doctor I saw kept averting my concern of facial swelling+rash by only referring to my eczema. She said that in the meantime, until I saw an allergist, I should try doubling or tripling claritin. After some reminding she referred me to an allergist.
7. I gave my allergist the rundown, and gave him copies of all the bloodwork I had done thus far. He gave me a brochure for dupilumab. I kept trying to push the conversation back to my facial swelling concerns. he scheduled me for a prick test for environmental allergies (which I had done a blood test for and gave him a copy of) and sent out another blood test for a few other markers that he said I hadn't tested for yet (when I tried to ask what they were he just looked confused, said, for your... and pointed up to his face. I clarified, "what do they check for" and he mumbled something about liver and kidney.) as well as the environmental allergies blood test (again).
8. The next appointment (for prick test) was weird. My blood test results had come in, and he told me I was quite allergic to dust and mold, and a few tree pollens. The thing is, we were already aware of all of this, because it was in the blood tests that I had done prior and given him a copy of, and we had already discussed it. He was pronouncing it as if he had found the root. I did the prick test, and it showed similar results to my blood tests. To the allergist, it seemed like my case was closed. He asked me a bunch of questions about my environment (which he had already asked and I answered as he took notes, in my first appointment) and told me that if I cover my bed and pillow with protectors then my symptoms would clear up by at least 25% in one go. The thing is, I already told him and reiterated that my mattress and pillow were covered (My family was very careful with airborne allergens and dust mites as my brother had childhood asthma). Regardless, the allergist kept going in circles and basically just told me to take some claritin, close the windows, cover the mattress/pillow, get an air filter, stay away from cats and dogs, and I should be fine. You know the story by now, these were all things already at play in my environment (my room has a hepa filter, I don't have pets, my window is never open, I've tried antihistamines), and I had reiterated all of this to him. After I emphasized how debilitating my skin was, how bad it hurt, caused brain fog, made it hard to do normal things like shower, his only other option was applying for dupixent (dupilumab). I did consider it after he gave me the brochure during my first appt. I had concerns though, as there have been an increasing amount of accounts of users of dupixent developing head and neck eczema, something tied to increased sensitivity to malessezia.
9. Currently, I'm trying the allergist's recommendations. I washed/steamed everything in my room and even got new protectors for my mattress and pillow. I'm double dosing claritin for 2 weeks. So far, the swelling that comes overnight has only increased, and the neck rash/eczema spots have evolved into 1 large rash enveloping my neck and up around my jaw. It seems to be only increasing, trying to creep down my collarbones, chest, and shoulders. Yesterday night I woke to my ears and especially earlobes swollen and leaking clear fluid. Everything is constantly dry and red, painful, and things are weeping or feel wet all the time now with the night itching. I feel so gross, like I smell like plasma or sickness all the time (this sort of metallic smell), and there are constantly grimy skin cells gooping off of me, and clear or yellow fluid leaking from me. I've scheduled a derm appointment to check for infection and malessezia sensitivity.

notes on current condition:
the sun feels good, I try to take some time in the sun
i like exercise, recently only been doing hardcore treadmill walking at home because of social fears from everything.

Waves.
Sometimes things propagate as waves.
She found this moth(rat?)-eaten manual fromma time not ours that mentioned this. That was before the invaders came. It may as well be centuries ago. There were stores that sold candies then. Wrapped in cellophanes of every color of the rainbow. What I'd give for something sweet now...
The sky is grey. Its always a shade of grey now. Sometimes lighter, during the day, I guess, orran ashen smeared easel offan irrational pantheon of uncaring gods and goddesses. We've been walking in what we assume is the same direction for at least two weeks. Following the river, keeping it to our left. At least we know we're not walking in circles. There's always an unnatural sound, like a sweeping broom across the tiled entranceway to Hell, that is present over the rushing water. Maybe that's why we stay close to the flowing - it almost blocks out the new world we have found ourselves in. Some semblance offa documentary on nature we might have seen when young and entertainment and learning were possibilities. There aren't many animals anymore. The ones that catch our peripherals are as ashen as the sky. Funny. I don't recall seeing foxes before; not in person. How long have we really been picking our way along this rocky terrain?
Laura is ahead of me, carrying a long bamboo walking stick. Sometimes when I lie and smile I tell her that's sposta help one walk. She lies and smiles back that of course its helping her walk - if I keep it horizontal it functions assif I'm onna tightrope - look, I'm inching between downtown skyscrapers!
An explosion in the distance, probably building sized. Sounds don't travel as far as they used to. All the greyness that came with Them is heavy, a wet blanket on the Earth, makes breathing a chore if one pays attention. The last buildings we saw were three-quarters immersed in the river. What is this body of water called? How does one forget what the local river is named? The same way one forgets what one's first car was, or where one's first kiss took place. Drive-in? Couch? Under bleachers? The explosion must be far enough to not be an immediate concern. No underfoot rumblings. We barely look up, in fact. We decided that attempting to track our progress in terms of direction was boring and pointless. Its not assif there issa goal we're reaching, a dot onna map that hassa printed name next tooit. In fact, the farther away we stay from those former dots on maps the better. Out here in the Great Big Fucking State Park of Wherever The Fuck We Are its peaceful enough. No former right angles to remind us that there are no straight lines in nature. Can't remember the last time I waited forra red light.
I'm catching up to Laura, she's crouching, long stick still horizontal, picking at something on or in the ground with her sawtoothed machete. There's no movement in the treeline except the branches and leaves themselves. Birds are almost non-existent now. I swear I don't ever recall seeing a fox in the flesh before, now they're the most common animal besides us. As I reach the limestone platform she spins, triumphant, see-I-told-you-the-stick-works, and holds out a bottle of Jamaican Red Stripe, looking new and shiny. Her excavation has unearthed a blue and white Igloo cooler chest from between boulders. Its full of formerly imported beers, a couple of red wax-encased wheels of cheese and luckily unopened large packets of bison jerky.
Back when people milled like ants, endlessly constructing ventilation tunnels and waste depositories, they believed things. They had up to the minute holy documents crisscrossed with squiggly imaginary lines, like all holy documents. Wherever one found oneself in relation to the imaginary lines denoted certain realities. Foxes are more common than people now. Somewhere Walt Disney is not feeling irony. Sometimes those holy imaginary lines were rivers. People's most common trait was laziness. I remember viewing a satellite picture of Earth, and it seemed the only blue water left was that being fed the indigo stain for denim inna polluted tributary adjacent in what was China. So much holiness. When the need arose for things bigger than us to assist, those holy worshipped things, they remained as invisible and ineffectual as ever. The larger than our imaginations entities that did show themselves remained indifferent to our collective sigils and crossed hearts. These giants brought with them a new Art, a new way to draw lines on maps, and new definitions of what maps were. Blue is still the least common color of water, brown and red being much more favored. Faces old and young stare accusingly from just beneath the surface tensions now, no matter what the hue of the liquid. The Earth is somehow a quieter marble now, explosions less frequent. If one were being charitable one could say the new, gigantic forms had brought peace, finally, at last. The answers to so many prayers.
Light pollution is now an antiquated term. Sagan's billions and billions twinkle sparkle flash and swoosh above our heads now if our relative elevation to the sea is great enough. I am no eidetic astrologer, but Laura agrees that Orion's belt and Betelgeuse are no longer where they were. Or maybe obscured by clarity. Perhaps eventually we'll draw new imaginary lines in the night grey and link humanistic tragedies to them. That one's Boffo, the legendary fox masturbator, see his right hand has six fingers? And there's Yourmom, still popular as ever. Some of the stellar regions make audible strings of intermittent noises, attempting to ask our obsolete fax machines tooa matinee. At least they're not selling us used cars yet. I wonder, would that make us scramble nowhere faster or drag our feet? The dead do not walk the globe. Hooded skeletons do not ride pale horses in search of wheat fields. It is possible something with many arms dances to an idiot piper. We smoke 'em if we got 'em, and we usually do. Drugs were big business, and are more commonly laying around than cans of cranberry sauce. They brought peace on Earth with Them, and an end to poverty, however one measures it. And they didn't even demand praise.
We haven't seen any other people in at least two weeks. Not alive, anyway. Most of the corpses are floating in pieces unidentifiable down past us. Any former homes by the waterfront have been abandoned. Proximity to the new vast creatures does something to the thought processes. Makes the electrons jump track and wind up in the wrong brain receptors. They're not eating us. They're not even interacting with humanity unless we en masse attack them. Nukes were used. That was the last Laura and I heard. The largest groups of people we've seen were four, across the river. They made no sign of recognition, no waves or yells. A mutual noticing. They were headed the way we came, on the other side.
We've stopped at a two story home with a boatless dock. A fire has turned the former garage into ash, but the adjacent kitchen and walk-in pantry is still full of groceries. Sandwich creme cookies with evaporated milk on the master bedroom deck. Sheets still smell like scented detergent and the water still gurgles from the faucets when they're turned. No electricity. Those electrons don't do the same things either. The long drive leading up to the structure is buried under massive fallen pines. Debris clogs the river itself, using a boat seemed useless, as if there was a destination to speed away to. Laura calls it " Fort mumbleblarrg " , exhaustedly burying her head in a couch cushion laid out on the deck. I stuff more cookies between my teeth. The view provided of the terrain from the deck looks like an angry child shook the ant farm, and bored, tossed it away inna drainage ditch outside a seafood buffet inna resort town. My skin imagines it has been coated in egg and floured batter several times. Shaking the sludge off my head I collapse on the unmade bed by the sliding glass, very seriously stained doors.
[ they severed the hands that's what the Spaniards did. Halberded piles palms up
fires not cauterizing, smudging
glints of spittled grin thick lenses calloused fingers zipping up weatherbeaten
blood, from not yet a teenager
cotton briars, green bitterness
whens
please not again]
Fort Mumbleblarrg seems as good as any place to experience intense hallucinations and/or time slips and/or simultaneous dimensional realities. It has cookies. After dragging all the usable foodstuffage up to the master bedroom suite atop the remnants of the wooded structure and making use of the handily, almost obscenely organized tools to actually um, fortify the narrow stairwell, we immediately crash near comatose for days, ingesting sugars and fats like there were supermarkets with humming freezer sections on every city intersection. This place even has a wine cellar, a real one, not a glass doored cabinet. I am almost disappointed there is no cask of Amontillado.
On the fourth day another explosion, still far enough to not feel blasted heat or earthquaking floorboards, but it trails along with it a visible atmospheric channel that spins off like the arm offa hurricane. For hours all the colors in the spectrum become grimy, unctuous, the view from the bottom of a fast food fryer overdue for straining. Nausea sets in during and afterward. All offa sudden being onna carpet is the same as lying face down inna two-inch-deep tray of cultivated maggots, complete with crawling movements up the walls and greenish-grey waves lighting up the flatscreen of the now-defunct television across from the bed. Huddled in the center, trying desperately not to touch or even look at the floor while convulsively emptying our bowels and stomachs, the moldering lightshow starts to produce three dimensional effects, coming closer then sinking in far past the wall its mounted on.
Blankness. Grey. Millipedes. Water still runs, still looks clear. All of the carpet gets torn out and heaved over the deck's railing, along with the sodden mattress. Mumbleblarrg wassa perfect title, man. From the deck a three-foot-wide stripe is clearly visible across the landscape. Straight from our perspective, disappearing into the horizon, a charred, still smoking narrow strip of burnt. Trees that formerly stood in its path are simply gone, not piles of twisted branch stubs and ash. Gouges in the limestone, an actual scraping it seems. Smell of overripe, rotting fruit, something exotic like ugli or dragon with an artificial sweetener aftertaste in the nostrils; acrid, bulbous decay accelerated by molecular science students proud of their work. Evidence of this is visible in the river itself - a darkened stripe underneath the waterflow which now eddies at the banks. Added to the evidence of former civilization already present in the water are the carcasses of fish, or fish-like creatures, at least. It is difficult to discern what the original shapes of the savagely torn chunks of flesh might have been. The entire column of moving water is black and brown and maroon and bright fire truck red. There issa small fire burning on the opposite shore. Impossible to tell what exactly, just a blur of burning. For the moment there is a wind, steady, away from us. Blessedly, away from us.
Laura usedta tell stories about being born onna side offa river I was not. I was born on an Air Force base in Texas. This is not that river. It doesn't look familiar to either of us. We don't know what its called, or was called. I had lived in Texas for all but four of forty-three years. I have never seen a fox except on screens, maybe a billboard. Now they're like neighborhood dogs. The trees, the grasses, they're familiar, but not intimately so. What are all these foxes eating? What stopped eating all the foxes and let their population burgeon? Laura says since that last wave she has a scar missing. It was to the side of a bone in her wrist, she got it while working inna field with her mother assa child. I don't remember for sure - its not my wrist, but I believe her. Neither of us can relate to the other how we got here, and when we attempt it again the story breaks down at maybe a different point. The last memory we have that stays the same is that we were both inna friend's car driving up to the convenience store a mile from my parents' old trailer. Then... Even when telling our own stories over again they change. At least that's what the other person claims.
There is plenty of packaged, indestructible food left. Some of the vintages are over sixty years old. We start on those just because. I stick a sewing needle through one of the corks and float it inna bowl of water. It doesn't seem to do anything in particular, which means I've probably forgotten a step in compass making. Best as I can tell we're headed vaguely north. Absolutely nothing I have observed points definitively to that conclusion. For now this is as good a place as any.
Contrary to most horror movie logic there are several battery powered devices fully charged, more or less, and picking up all kinds of stations. Allot of them are preprogrammed and safeguarded against any possibility that silence could happen, lest our listeners disappear. There are no live voices, though even the public station is replaying an interview with a United Nations ambassador intermittently with blocks of humming where the local station breaks would be. Neither of us recognize any of the station call letters or frequencies. Even the fifty thousand watt WOAI transmission is absent. Quickly we settle on the classical public broadcast, coming in surprisingly clear. It is the only one playing music without lyrics exclusively. It helps make all the alien noises more tolerable. When stars are visible focussing one's attention on a certain grouping will now cause them to actually respond - both with sounds and visual effects. Its not just our poor human senses - recordings on our phones document the phenomena in even greater detail. Clear enough skies to see past the grey are rare, but at least two infinite directions yield beautiful results. I name them after Greek sirens in my head, not wanting to be outwardly anymore pessimistic than the situation demands. Most stars are silent and stationary enough. For now. There is still one sun in the sky that seems to do the same thing it used to, even though its greyed out usually. Maybe tomorrow it will offer two scoops of raisins.
And. Aspirin in the aftermath of wine. We've been here four or five days and just now notice that there are no identifying traces at all of who once lived here. No photos framed. No mail magnetted to the refrigerator door. No kids' homework, or children's toys at all. There are true crime and mystery novels. No religious items. There are also no clothes hanging in closets or folded in drawers. Like we interrupted the crew dressing the set.
The audio stream changes from madrigals to Gregorian chants. Its still less memory invoking than pop songs of love gained and lost and sex. We've noshed through most of the sugars and salts and fats and have begun opening cans of vegetables and beans. Laura reminds me she's a Mormon and I pick up the old argument that no, she is not. My father attended a seminary in Michigan to become a priest before he joined the Air Force assa chaplin and married a paranoid schizophrenic, what the Roman Catholic church labels a possession case officially. I like to get drunk and talk about religion and politics. When I carried a wallet it contained separate business cards for ghost and demon removal services. My reasoning being that demons are way more dangerous than the cranky old fartbag of Aunt Mabel bitching about your choice of cat food for Mr. Snuggles, and should be priced accordingly. My first official girlfriend assa teenager working at Wendy's wassa Mornon, so I have slightly more than a cursory familiarity of the doctrine. Worst girlfriend ever, by the way. Never kiss a girl who doesn't smoke. Its okay if she doesn't smoke anymore, but this advice, I contend, will not let one down if heeded. As the topic of baptizing ancestors breaches again the sky visible past the open sliding glass door abruptly shifts from grey to palish green. Notta seafoam orra seasick orra pea, but a shade reserved for floors of state mental hospitals, disinfectant ready and climbing the edges of the walls. There is something else that is different. Laura and I exchange searching looks, interrupted in our comfort food conversation. We sit staring at each other forra solid minute before knitting our eyebrows and proceeding out on the deck. The atmosphere is physically thicker past the doorframe. Not more humid - the air is cool and moist, but no more so than before. Heavier. Gravity is still a theory. Although we confidently launch rockets and probes and parasail we assa species are still uncertain as to whether gravity issa push orra pull. Gravity now feels like its the ocean, waves jostling in all directions. A propagating wave packet, my head insists. I can't hear the rushing sound of the river. At all. Nor the wind visibly moving the branches strung above. The radio is unaffected. I am not. The last thing I remember when I awake is opening my mouth, partially full of cooked peppered yellow squash, and screaming. Silently.
[ thousand segmented legs crawling
the monsters took her under cover of sunlight and treason I can't remember what she was wearing
rough hewn metals jagged under nails into nerve-riddled flesh, rusted dirt filled channels
you were there to nurture but instead you consumed until bloated and gaseous
unstable at this temperature NO!
claimed divinity with hives and fever, royal pink and chartreuse
steaming exhalations horses breath
they spasmed fits and palsy
perspiration to the soil
which grew poisoned flowers from their tears
the limb twisted before the hinged joint borne unto the Firmament unmade
flutes whistling graveyard breezes
sounds are vibrations
sinusoidal dips and troughs and peaks and valleys
how many decimalled hurts?]
There issan aching in the back of my skull. No cartoon birds and stars halo. Rising from my face-up prone position on the freshly painted deck, Laura is first in my field of vision, back solidly pressed against the railing, her eyes wide and staring. Settling next to her while rubbing my nape, I dig in my pocket and fish out Ann's antique silver cigarette case. Taking two Camels out I offer one widdershins, quickly accepted. The black and gold lazer etched Zippo fails to click when struck but lights both. Baroque woodwinds and harpsichord is quarteting through the filthy sliding glass doors. It is the only sound. I dreamt of my daughter Kallisti. I have no idea where she is or if she is. Burnt ash drops without crackles, being shaken off by my trembling lips. Hot tears are streaming down, blurring the soundless vista with eloquent soundtrack. I haven't seen Kallisti since she was eight. She would be ten now. Her mother abandoned us when she was two anda half, chasing heroin and cocaine with prostitution and psychopathic apathy. I don't remember dropping the finished butt or crawling to the pallet on the floor underneath the speakers. Batteries still holding out. Harpsichord and oboes give way to four cellos, dirge. Its suiting of the moment. Red wine has not helped the aching of my head. Laura's face is turned from my view, surveying silent scenery fit forra hotel wall painting. This is where you could be instead of MotorLodge #164. There is no chocolate mint on your pillow. Do not use blacklights in the vicinity of your bedspread, please and thank you. End of song, end of consciousness.
Floor shakes hard enough to propel me to my feet. Wagner's Ride of the Valkyries is blasting through the speakers, but its too loud, absurdly loud, there's no way cones that size could make that much air move. Fuck this. Quick steps and noiseless slamming of the glass door. Thankfully the music diminishes in volume somewhat with this action. Its nighttime now. Laura is standing at the railing, one hand gripping the wood with enough force to turn her knuckles white, the other solidly around the ornate neck offa wine bottle labelled in Portuguese. She turns her head, frowning, only slightly, acknowledging my presence, then returns her sentry's position to the heavens. Half of the grey is parted centrally, revealing the new map of burning stars. Tens or thousands of minutes later Wagner dissolves into what would have been a station break, now the amplified buzzing offan ultraviolet bug zapper with two dragonflies struck frying in the mesh. This allows the only other sounds audible through to our senses: sirens calling from beyond Earth, skyward. A sort of synthetic chime set, microtuned at random and played by feasting vultures onna weighted keyboard. There is something new this time - a long, lilting, occasionally harmonized chorus of voices drifting in and out from a different point of night than the chimes, almost sideways from the horizon. If it is a language it is none I recognize, though there are definitely parts repeating verse-chorus-verse. Many vowels, few consonants. Hours pass. The buzzing from the radio fades to nothingness leaving us with the calling of the stars. The chimes span about two octaves. The voices, if that's what they are, full spectrum. There are most certainly repeating themes, though mismashed between competing chorales. All of the voices are distinctly female, the epitome offan archtype of warrior class. A third distinct group sounds angrier than the first two, threatening. No, bitch, our dance moves slay your tired, weak-ass trots. Its beautiful, as much as it can be, but my ears are accustomed to atonality. Also very directional. The voices are coming from horizontal sources, maybe on the planet, while the chimes are beaming from a gyrating cluster of suns directly above our heads. I find that I don't care how my dehydrated body feels about this decision: I am getting as drunk as I can before a red graped woman's hand closes the staring eyes of my corpse.
" There is nothing new under the sun " somebody said once. Probably a guy. That's the kind of smug bullshit men get quoted saying. Fuck that guy. I'm glad he's dead. I hope it hurt the whole time. By all means, quote me on that.
The darkness of night is lasting longer than it should. When I climb in the upstairs shower the water again thankfully runs clear. Its cold and wakes me up, though I'm still staggering drunk. Drinking in stomachfulls of water I emerge humming a companion piece to the concert around us. At least, I'm vibrating my throat and chest. It feels like what making sounds used to do. We've laid out couch cushions covering most of the deck and are observing. Writing onna legal pad witha pen screenprinted Al's plumbing, Laura says it feels like noon. We've been dosing off in turns. She suggests Father Alien instead of Mother Nature. Our three local groups of singers have played through at least two albums of repeating hits. I turned off the radio, though it didn't respond immediately, stubbornly buzzing at least an hour after the off command was issued. My vintage is 1973, something in French. Saltine crackers, spray cheese inna can. I keep thinking about Mitch Hedberg's joke about it glowing in the dark, every bite. The chimes have almost completely faded, along with the brightness and location of its point of emanation. Glee club is picking up the tempo, but seemingly content with their distant concert halls. When I heavily plop down the notepad is passed over. Two words: Foxes. Below. Laura is strategically stationed under the thick fringed vinyl umbrella that formerly stood in the center offa round glass table next tooa propane cookstove. On its side its functioning assa lean-to tent. Hanging my head over the railing, my eyes are greeted with twenty to thirty smaller shiny pairs staring back. Ashen grey and brownish-red foxes are doing much the same as we are, minus alcohol. Laura hands me a bag of marshmallows and we toss them down one by one. They look cute, smiling almost. I shiver. Laura tugs at my jacket and I join her on the other side of the lean-to. We stuff marshmallows in our ears, hoping we don't wake to find ants crawling, searching through our brains.
Something is tickling my face and smells like bubblegum. Opening my sleepshut eyes I discover an orange fox on my chest, staring directly at me. It licks my nose several times and is instantly gone when a peal of gravelly smoker's laughter erupts from beside me. Some giant, probably taloned hand has turned the volume knob of the world back to the right again. Trees, river, that sweeping, scratching noise, all back. I haven't seen Laura happy, even briefly, like this since we found ourselves wandering. The little furry scamp ate the marshmallows out of her ears too, she says. For minutes it is easier to breathe, even with the obligatory cigarette smoke. Happiness is rare now, has been for years. Just a little reminds my body what its like to be alive. Lighter grey, occluded sky. Something like morning has arrived, however late. The same clawed huge fingers changed the world's gear ratio back to where it was. We're spinning...I see a flash of memory instead of what my eyes report. My autistic daughter spinning herself dizzy holding a ribbon, a glittery one, inches thick, sparkles fluttering. Quickly I pretend to cough and turn away, holding my closed fist in front of my face. There is no need to spoil whatever semblance of humanity is left in us by sharing this thought. " I'll make breakfast! Something hot! " She knocks the umbrella over leaping up like a clumsy feline. Burying my face in the rough cushions, I bite down on the material covering the foam, thankfull to be out of view.
Breakfast is handmade tortillas, generic, mechanically separated beef fromma squat can, diced tomatoes, black beans, corn. Blue rings of flames perform the chemistry on command. All the exciting little kid junk food has been torn through, leaving stacks of stolid, adult canned rations. There is plenty of wine. At first discovery I advised Laura not to quaff the ones that read " Port ". A friend's favorite author was Jack Kerouac. He mentioned more than thrice getting drunk on port wine. Turns out that's code for alcoholic cherry snow cone syrup. Which did provide me with the line " Man, I ain't shit my pants since I was twenty-seven! " For the record, my favorite author is HP Lovecraft. My takeaway was never, ever swim or float on, in, near, or near a painting of the ocean. Better include lakes to be sure. And iffit doesn't have fins reconsider your menu choice.
Considering the condition of the world around us we had immediately abandoned our lifelong commitment to living green and recycling. Throwing our refuse over the wooden railing wasn't an issue that required debate or reconsidering. Fort Mumbleblarrg, upon our commandeering, quickly became unfit to impress visiting colonels. Both of us passed out underneath the tilted umbrella, she under a thin blanket and I sporting a hideous shower curtain that was most certainly someone's stolen memento offa naughty liaison, the grey above us got brighter and dimmed. My eyebrows knitted upon being disturbed. Is today Wednesday? Forgot to set the cans out on the curb. Shitgoddamnmotherbitch the old couple two doors down are alcoholics. They're green container is full of-
Slowly raising my head and torso from the seat cushions I have the conscious thought that I really don't want to know what is making that waste management noise underneath my feet. I am tired of acquiring knowledge. My head is full, thank you. Try again next year. Mayhap by then I'll have finally succeeded in getting rid of those terrible '80s pop country lyrics that my parents thought would be useful to carry around with me for the rest of my life. Or that list of all the adverbs in the English language my frizzy-headed bitch offan AEGT teacher shoved in without permission. Then I'll have space for more data storage, but not now. Something is snorting and something is loudly crinkling. Maybe the social security office sent the wrinkly winos some of the CIA's cocaine stash covertly disguised as Sun Chips. They're humping furiously in the drainage ditch and feeling like teenagers again. That's sweet. Let 'em throw bottles and challenge life with a shaking skyward fist. She wassa cheerleader and he built an entire car from junkyard parts in Auto Shop. Their kid got dismembered five ways bya landmine, but that was at least six years ago. What-
Decking underneath vibrates as whatever is below us thuds against one of the support beams. A misty exhalation of partially digesting organic matter sprays into view on the other side of the railing. I still haven't sprung to my feet. Blood pressure hasn't come close to spiking. We all have our fetishes. Who am I to tell them what do after the evening news onna weekday? Can't believe you're poking me in the ribs to relate this story. Bullshit. You'll smile and wave when we drive by like always. A low, three second rumbling causes the deck to vibrate atta different wavelength. Fucking waves, man. No, I don't wanna go to the beach. They eat lots of cabbage and partake in excited conversations at mealtimes. They're passionate people. I am not getting out bed. That's what the largest sites on the internet are for. To see things like this whenever you wake up.
I. Am. Sleeping.
Go. Away.
Fuck. This.
Brown bears are smaller than black bears, which are in turn smaller than grizzlies. This one is grey. Its back sports the left arm and face offa human melted into it, off-center towards the animal's right flank. Impossible to tell if the face belongs tooa man or woman. Just the first two inches are showing, matted with the bear's greyed fur. The eyes are lidless and staring with tiny dots for pupils, pale brown eyes seeming to fade to grey with their surroundings. The left arm is active, flailing and grasping at anything that touches the palm momentarily. Mouth is slack, open, no tongue. I don't know how to judge how large the bear is. I think its bigger than a standard brown one, and I have no geographic clues. Fort Mumbleblarrg's newcomer is not okay with its tenants selfish policy of not sharing foodstuffs with the local wildlife, except insects. And its demanding toobe heard. I have been close tooa few brown bears before, seen pictures of the other ones, and I don't remember them having teeth this long and sharp. Jagged, like shark's teeth. At least they're not in rows. Huh. Whata strange thought.
An explosion, this one close enough to send flaming fist sized chunks of burning matter hailing down upon us and everything in sight. A searing blast of oven barrels directly sideways, transmuting the visible spectrum to the final day offa carnival, full of cheap plastic bottled whiskey, burnt sugar, understated menace, and malice overt. Both of us are thrown against the far railing. Almost losing consciousness, we scramble to toss several erupting couch cushions over the side before the rest of the upholstery ignites. The entire deck vibrates violently as the nightmare bear is thrown against the mooring posts, its jaws snapping several times like a shark's. A shriek far too reminiscent of human speech bellows from below. Laura is on her feet first, brandishing her sawtoothed machete but backing towards the sliding glass doors, one of which has cracked deeply but maintained its integrity. I follow her wide-eyed gaze to spy the offending creature coming into view as it woundedly staggers towards the riverbank. A two foot section of its rear flank is actively on fire, on the side opposite its unfortunate human addition. The human handed arm is flailing, fingers blurring. It becomes apparent that the unsettling sounds its making are also coming from the face enmeshed in the fur on its back. Unbelievably I find myself fascinated, unable to take in any other stimuli. Trailing an stench part burning hair and part Texas BBQ, it tumbles headfirst over a rocky ledge and is swept splashing fetid mudwater with the current. I lose my stomach contents over the railing, tannin-rich and sharply red. Behind me, a clang resounds as the machete hits now bare wood slats and a sound much more disheartening than any our mutant visitor had uttered bursts from Laura's lungs.
[ charred glass and copper, poly-fill and stuffed animals' eyes, once alive with children's imagination now splattered with phlegm and dirt
carousel uneven creaks flashing ticking bulbs in the humid summer air
the disappointment in her eyes
parasites replacing fish tongues
many eyed the reproach
ifs, not whens
dovecote abandoned
sharp stab upon kneeling]

https://web.archive.org/web/20210419222349/https://breaknutrition.com/omega-6-fatty-acids-alternative-hypothesis-diseases-civilization/

Omega-6 fatty acids: the alternative hypothesis for diseases of civilization

by breaknutrition Aug 25, 2017

Diseases of civilization

The world is facing a health crisis of unprecedented proportions. What have become known as chronic diseases, Western Diseases, or Diseases of Civilization (DC), have become pandemic as populations around the world adopt the lifestyle that first became prevalent in the country that perfected industrialization, the United States.

What are they?

The DCs revolve around the Metabolic Syndrome (MetSyn), a set of signs of disease that include central obesity, excess fats (or fatty acids) in the blood, high blood pressure and excess blood sugar. The diseases that associate with the MetSyn include the biggest killers in the industrial nations: heart disease, cancer, diabetes, neurological illnesses such as Alzheimer’s and host of seemingly unrelated autoimmune conditions.
Many causes have been blamed for the spread of the DCs; including lack of exercise, wheat consumption, excess consumption of calories, carbohydrates, sugar, animal fats, meat, environmental toxins such as pollutants or pesticides, genetics (most implausibly) and any cluster of associations dreadfully referred to as ‘multi-factorial’.
Each of these proposed causal factors fails, in my view, to explain the pandemic. What I’d like to introduce is an alternative hypothesis, one that better fits the observed epidemiology and that has clearly-described mechanisms that explain much of the pathology for the DCs.
Since it started in America, we’ll start with America. In the late 1800s and early 1900s three events occurred almost simultaneously. First, a method of detoxifying cottonseed oil, which had been an industrial waste product of the cotton industry, was discovered . Next came a method to ‘hydrogenate’ cottonseed oil, or make it into a solid-at-room-temperature edible fat . Thus cottonseed oil and the hydrogenated derivative known as Crisco—introduced in 1911—entered the food supply in large quantities for the first time .
Simultaneously, America began to experience heart disease in large quantities. Previously a very rare condition, heart disease quickly became an epidemic, and the relatively new modern medical profession began to track it, and attempt to devise treatments . Similarly, cancer “control” became a concern, with the forerunner of the American Cancer Society being founded in 1913 .

The single biggest change in the American diet over the 20th century was the increase in seed oils, which increased 1000-fold

What changed?

America, a massive agricultural exporting nation, exported the fruits of the industrial revolution, which included new foodstuffs, including white wheat flour, sugar and vegetable fatty acids— so called to distinguish them from the traditional animal fatty acids that had been used as food since human evolution.

I will refer to vegetable fats (or fatty acids) as seed oils, to distinguish fats made from seeds such as cotton, corn, soy, rape and others from fatty acids made from fruit like olives or palm fruit. This will become important later on.

Wherever American industrially-produced foods were introduced, DCs soon followed. Although not generally well known now, a number of doctors and scientists recognized the impact of industrial foods on populations abandoning their traditional diets for what has become known as the Standard American Diet (SAD) . I prefer the acronym MAD, Modern American Diet, as the American diet prior to industrialization was a largely meat-based one, and did not produce the same diseases, and will use that throughout . Original graph is from Teicholz, N., The Big Fat Surprise, Simon & Schuster: New York, 2014.

Japan as the canary in the coal-mine

While there are many cases we could examine, perhaps the most telling was the MAD being introduced to post-WWII Japan. After the Japanese surrender, America took over the southern Japanese island of Okinawa, and used it for their base of operations. Unlike most other traditional cultures into which the MAD was introduced, Japan was a highly industrialized country. Yet Okinawans still ate a traditional diet that revolved around pork, yams, and fresh vegetables, and made them famous as one of the “Blue Zones”, a population with exceptionally long lifespans—in fact, the longest in the world .
What is less known is what happened after America took control. The first American fast-food restaurant opened in Okinawa, 9 years before Tokyo, to meet the American soldiers’ appetite. Okinawans also enjoyed American fast food and rapidly adopted it as their own . In that one generation, DCs exploded into Okinawa. Fathers attending the deaths of their sons became a common occurrence, with obesity, heart disease and cancer becoming common.
Hirome Okuyama, a Japanese scientist exploring the dramatic change in longevity in Okinawa, in 1996 published a paper pointing the finger clearly :

Dietary fatty acids – the N-6/N-3 balance and chronic elderly diseases. Excess linoleic acid and relative n-3 deficiency syndrome seen in Japan
“The age distribution of the survival rates of male Okinawans in 1990 is also interesting. The mortalities from all causes for the generations over 70 years of age were the lowest, whereas for those males less than 50 years old they were the highest among the 47 prefectures…”

In a single generation, Okinawa went from the lowest mortality in Japan to the highest

Seed-oils and refined flours brought DCs to Japan

This one incident clearly disproves a number of leading hypotheses on the emergence of DC. It’s clearly not genetic (although that’s a factor, especially in Japan), as gene networks underlying complex adaptations don’t change that quickly. It’s not just caused by total carbohydrates per se, as the Okinawans had a high carb diet with tubers, rice and fruit prior to Americans arriving .
Americans introduced much larger quantities of cheap refined flours which replaced the Okinawan carb sources. It’s not caused by meat, as the rest of Japan had a huge increase in meat consumption after WWII, and longevity increased, unlike in Okinawa. It’s not caused by animal fatty acids, as they were rapidly replaced by cheap seed oils imported from America—which introduced a program to ‘Americanize’ the Japanese diet.
It’s unlikely to be caused by saturated fatty acids, as consumption of saturated fat was and remains lower in Japan than it was or is in America, and there are no mechanisms to explain how natural saturated fatty acids causes disease. Environmental toxins are an unlikely explanation too, as, while Japan was industrialized, Okinawa didn’t experience a major change in that regard.
There’s also no possibility of a local environmental factor in Okinawa, as Japanese who moved to America saw a similar increase in DCs. And just to throw it out there, this also disproves the cholesterol-heart disease hypothesis, as cholesterol is not associated with heart disease in Japan, but with increased longevity .

Excess Linoleic Acid Syndrome (ELAS)

In my reading, the diseases that surround the MetSyn share common traits. Inflammation and insulin resistance are oft-cited, but perhaps more significant traits include mitochondrial dysfunction, apoptosis (cell death), necrosis (tissue death) and genetic damage.
These point to the common mechanism, named ELAS by Okuyama . I think it’s the best candidate for cause and best explanation of the MetSyn and related, chronic DCs.

What’s Linoleic acid?

Linoleic acid (LA) is an Omega 6 fatty acid (n-6 PUFA) fat which is considered essential to human and animal function. To head folks off at the pass, n-6 fatty acids are found in all natural foods, plants and animals, so this isn’t something you need to avoid entirely – it’s not possible, nor necessary.
There are three major kinds of fatty acids. LA is a polyunsaturated fatty acid (PUFA) . It’s joined by monounsaturated fatty acids (MUFA) such as oleic acid (named for olive oil) and saturated fatty acids (SFA) such as stearic acid (named for steers, beef) or palmitic acid (named for palm oil). Fish oil is also a PUFA, but of the omega-3 variety (n-3 PUFA).
Omega 6 fatty acids are primarily made by plants, as are the similar n-3 PUFAs, and are concentrated up the food chain by animals eating those plants. The major sources of Omega 6 fatty acids in the MAD are oils refined from seeds and animals fed a high proportion of seeds.
PUFAs have traits which make them of interest: they’re highly susceptible to oxidation (rancidity), unlike MUFA or SFA, and they’re used throughout the body as building blocks for tissues and for various signaling functions, after being converted into other chemicals.

The rancidity of PUFAs is the root of the problem

When food goes rancid, it usually smells and taste bad because the MUFAs and PUFAs have decomposed into peroxides . Both n-6 and n-3 PUFAs are highly likely to go rancid. Humans don’t detect the rancidity of Omega 6 fatty acids particularly well, they smell slightly stale and people actually prefer the taste.
Contrast this to rancid n-3 PUFAs and imagine eating a rotten fish. No thanks! This is likely because concentrated n-6 foods were rare until the modern era .

The problems with rancid PUFAs

Both n-3 and n-6 PUFAs going rancid produce toxins, but the n-6 fatty acids produce worse toxins. Most notable of these—and best studied—are acrolein, HNE, and MDA; although there are many others. Collectively, they’re called oxidized linoleic acid metabolites (OxLAMs). Acrolein is the acute toxin found in cigarette smoke. HNE is the best marker of effects of ELAS, as it is only produced from n-6 fatty acids. All three are both produced in cooking or heating n-6 fatty acids, but are also produced in the body. How toxic are these products? Cooking with seed oils is the leading cause of lung cancer in non-smoking women in China .
The list of toxicities of these three chemicals is most impressive. Acrolein is a biocide, meaning toxic to all life. HNE and MDA are less bad than that but are cytotoxic (kill living cells), mutagenic (induce mutations in DNA) and genotoxic (destroy DNA). OxLAMs are also highly reactive, which means they can combine with other molecules in the body, inducing and stimulating malfunction .

A primary mechanism of ELAS

An increase in Omega 6 fatty acids consumption rapidly remodels the tissues in the body, as the fats are replaced throughout. In some tissues it happens within weeks, in others, like the human brain, it appears to take much longer . Increased n-6 consumption rapidly remodels cartilage, for instance, in all species studied, driving out the more stable omega-9 fatty acids (Oleic acid is a n-9 MUFA) . The same happens in mitochondria . As mentioned, mitochondrial dysfunction and DNA damage is a signature of the MetSyn and all related diseases. It’s seen in the fat cells in obesity, in the pancreas in diabetes and in the lining of the vessels of the heart in atherosclerosis, as well as in conditions of heart failure, fatty liver disease, neurological diseases such as Alzheimer’s and Parkinson’s, and, most notably, cancer.

OxLAMs trigger destructive chain reaction events

The mechanism for this is well-described, although not well-recognized. Excess n-6 linoleic acid (LA) consumption causes a remodeling of a molecule called cardiolipin in the mitochondria, the key energy-producing part of cells in all higher life forms. Cardiolipin comprised of LA is uniquely susceptible to oxidation compared to n-3 PUFAs, MUFAs or SFAs and this can happen spontaneously, as LA oxidation can be catalyzed by iron and cardiolipin is in constant contact with iron atoms in mitochondria. When cardiolipin oxidizes, a chain reaction can start. In vitro, so on the lab bench, this reaction continues until all cardiolipin is consumed, but luckily our body has countermeasures .
In this process OxLAMs are produced. HNE, for instance, causes other cardiolipin molecules to oxidize, thus potentially causing a self-sustaining chain reaction. Reactive Oxygen Species (ROS) are produced in the reaction, which can also cause adjacent cardiolipin to oxidize .
However, OxLAMs are several orders of magnitude more damaging to the bodies than simple ROS . HNE itself can induce the production of ROS. Oxidized cardiolipin causes mitochondrial dysfunction, as mitochondria are impaired with oxidized cardiolipin .
What follows is mitochondria either collapsing, inducing apoptosis or necrosis . Apoptosis is seen throughout DCs—in cancer the cells are essentially ignoring the apoptotic signal and going rogue. The Warburg Effect noted in cancers is thought to be a cellular reaction to mitochondrial dysfunction in which the cells adopt an alternative energy pathway to better suit their uncontrolled proliferation.
Thomas Seyfried, who has contributed much to the field of cancer metabolism, notes that dysfunctional cardiolipin has always been observed in cancer cells so far . Necrosis is seen in late-stage DCs, such as atherosclerosis, cirrhosis of the liver, heart failure and Alzheimer’s.
Once loose in the cells, the OxLAMs rapidly propagate, in a process known as Oxidative Stress (OxStr). HNE and MDA are the primary markers used to measure OxStr. ROS cannot leave mitochondria which are well prepared for them, but OxLAMs, being water-soluble, rapidly distribute throughout the cells and beyond. OxLAMs are also a regular part of mitochondrial function: HNE induces mitochondria to downregulate as a basic negative-feedback mechanism.
Presumably this is to limit HNE creation and the spare the important antioxidant glutathione (GSH), as well as the aldehyde dehydrogenase enzyme (ALDH). GSH and ALDH are both important in protecting the body against evolutionarily-expected levels of HNE. Unfortunately for us, excess HNE can impair the function of both GSH and ALDH, thus allowing propagation of a runaway chain-reaction.
Decreased levels of GSH are a typical sign of excess production of HNE, and a dietarily induced deficiency in GSH production predisposes to the DCs . A genetic deficiency in ALDH, which is highly prevalent in Japan and China, predisposes to all DCs .

Tissue health as a function of levels of different fatty acids

Confusingly, assays of n-6 status in pathological tissues often show a lower level of n-6 than other fatty acids, and in these cases, addition of n-6 can actually improve function. This appears to be due to the chain reaction depleting LA or arachidonic acid (AA). The latter is a long-chain n-6 fatty acid produced in the body from LA. N-6 levels are lower, but HNE levels have risen as N-6 is converted into OxLAMs .
OxLAMs can bind to and alter the function of DNA, both in the mitochondrion and cell nucleus. In fact, they appear to be the leading cause of genetic damage, as the markers used for genetic damage are those generated by OxLAMs . Widespread generation of mutagenic and genotoxic chemicals in a live organism (in vivo) would go a long way towards explaining the genetic damage common in DCs.

OxLAMs are inflammatory

OxLAMs such as HNE directly induce inflammation, increasing inflammatory markers. Excess levels of LA-derived AA also induces inflammation, as it is used to build chemicals that send pro-inflammatory messages to the body. The mechanism of anti-inflammatory drugs such as aspirin, NSAIDs and Cox-2 inhibitors partially impairs this pathway.
It appears that a fundamental job of macrophages, an immune-system cell that attacks foreign cells, is to remove toxic OxLAMs from the tissues. Macrophage infiltration into tissue is seen in various DCs other than atherosclerosis, including obesity . One explanation is that the modifications made by OxLAMs to molecules cause those molecules to resemble Pathogen-Associated Molecular Patterns (PAMPs)—the molecules appear the same to macrophages as those on bacteria.
Antibodies for oxidized LDL cholesterol (OxLDL) exist and development of these antibodies for therapy against atherosclerosis has revealed the antibodies to be equally sensitive to bacteria-derived lipopolysaccharides and OxLDL .
Anti-cardiolipin antibodies are seen in several severe autoimmune diseases and are only sensitive to oxidized cardiolipin. Thus excess n-6 is a known cause of autoimmunity. It may be the fundamental cause of the increase in allergic diseases seen in Okinawa and around the world .

Specific disease pathologies

Cardiovascular Disease (CVD)

Goldstein and Brown received a Nobel Prize for discovering the LDL receptor . The next thing they tried to do was to induce the first stage of atherosclerosis, the conversion of macrophages into foam cells, which form the core of the atherosclerotic plaques that are thought to cause heart disease. They failed . Steinberg and Witztum then discovered that LDL must be modified through oxidation to cause macrophages to become foam cells

The nature of the substrate for lipid peroxidation, mainly the in lipid esters and cholesterol, is a dominant influence in determining susceptibility. As noted by Esterbauer et al. (52), there is a vast excess of in LDL, in relationship to the content of natural, endogenous antioxidants. The importance of the fatty acid composition was impressively demonstrated by our recent studies of rabbits fed a diet high in linoleic acid (18:2) or in oleic acid (18:1) for a period of 10 wk. LDL isolated from the animals on oleic acid-rich diet were greatly enriched in oleate and low in linoleate. This LDL was remarkably resistant to oxidative modification, measured either by direct parameters of lipid peroxidation

Esterbauer discovered HNE which is always present in atherosclerotic lesions in all species. Oxidized n-6 PUFAs comprise a large proportion of the fatty acids found in these plaques . OxLDL is the second-best known predictor of myocardial infarction, exceeded only by the OxLDL/HDL ratio (HDL is high-density lipoprotein) .
Other aspects of circulatory disease, such as varicose veins and erectile dysfunction, also display increased rates of OxStr, as determined by the presence of OxLAMs. HNE and oxLDL are active throughout the pathological process to create foam cells, induce macrophage entrance into the lining of the vessels and spur apoptosis, necrosis as well as DNA damage seen in atherosclerosis.
Steinberg and Witztum followed up their rabbit study with a human study, which confirmed the importance of LA in creating OxLDL . Other studies have confirmed the effect. The most successful CVD prevention trial ever, the Lyon Diet Heart Study, which produced a 70% reduction in CVD rates, specifically reduced the consumption of LA and increased the consumption of n-3 and n-9 fats.
It adds validation to the mechanism in humans but should be noted that the metabolites were not measured . Clearing HNE reduces atherosclerotic lesions in an animal model .
Similarly, oxidative activities of OxLAMs are seen in varicose veins, with these markers always being present at affected areas . Erectile dysfunction also appears to be a consequence of this process. Erectile dysfunction drugs, aside from the obvious effects, also have an antioxidant effect, and appear to prolong life in those with vascular diseases .

Cancer

Cancer is considered by many to not be a single disease but a wide array of diseases with, so far as we know, different causes. Viruses are a well-known cause of certain cancers, so it is safe to say that there is no single causal agent of cancer, however appealing that prospect would be.
Much of the pathological behavior of cancer cells can be explained by the effects of OxStr: mitochondrial dysfunction, genetic damage, and a shift to glycolysis despite the presence of oxygen. HNE damages and impairs the function of pyruvate dehydrogenase, the enzyme that allows substrates produced by glycolysis to enter the mitochondria .
This loss, combined with malfunctioning mitochondria emitting high rates of ROS and OxLAMs, may explain the metabolic dysregulation and anti-oxidant upregulation often seen in cancer cells.
Epidemiological work has shown low rates of cancer in populations eating traditional diets. In Asians, migration to industrialized countries increases breast cancer rates many-fold to the point where they reach Western levels .
LA in the diet is in fact required to induce cancer in animals experimentally. The cancer-promoting effects of LA increase as it increases in the diet. This effect plateaus at around 4.4% of total energy, well below levels of consumptions seen in industrial civilizations .
One of the hallmark traits of cancer cells is the seemingly random mutations pervading unstable and disorganized nuclear genomes. There can be tens of thousands of mutations, much fewer than that and sometimes none at all . For many cancers, the theory of it resulting from a single mutation doesn’t hold for most cancers. HNE and MDA both damage DNA in vivo and HNE preferentially damages the p53 gene. The latter is part of the body’s natural cancer-control mechanism and is defective in colorectal and hepatocellular cancers .

Obesity

Omega 6 fatty acids consumption appears to be involved in obesity through several pathways. HNE, which is elevated in obesity, directly induces fat-storage across species at an intra-cellular molecular level by inducing pathological behavior in adipose tissue. The latter then fails to differentiate normally, leading to engorged adipose cells typical of obesity . As LA converts to AA, AA upregulation leads to increased production of endocannabinoids anandamide and 2-AG.
Anandamide and 2-AG are the cannabinoids our body’s produce themselves and are so-called mimetics of trans-Δ⁹-tetrahydrocannabinol (THC) found in marijuana. Injection of endocannabinoids in animal models induces overeating, regardless of how full they feel . Elevated 2-AG is a typical feature in human obesity.
Several studies by a group at the NIH have shown that dietary LA modulates production and levels of 2-AG and can directly induce obesity . Blocking the endocannabinoid receptor using a drug prevents obesity and metabolic syndrome, in animals and humans; however the side-effects like increased rates of suicide are unacceptable, leading to withdrawal of the drug .

Diabetes

One long-observed medical observation is that insulin resistance (IR) accompanies sepsis, a condition caused by infection. OxStr precedes IR in humans and OxLDL antibodies acutely reduce IR in a primate model of atherosclerosis . So the PAMPs found in OxLDL appear to be preoccupy by the immune system, with IR maybe being a reaction to a perceived infection.
A reduced LA diet has been shown to reduce IR in two human studies; one measured OxLAMs, which were also reduced .
HNE injected into skeletal muscle cells directly induces IR in those cells . Mitochondrial dysfunction is a common feature of diabetes and the resulting shift in energy production may play a role in IR. LA directly induces hyperinsulinemia in vivo in animal models of beta cells (which produce insulin in the pancreas) and OxLDL directly causes beta-cell death.
High levels of blood sugar (hyperglycemia) is a central feature of type 2 diabetes. Shulman et al. argue an adipose-centric theory whereby hyperglycemia in type 2 diabetes results from uncontrolled adipose tissue lipolysis which feeds into liver metabolism as an excess of acetyl-CoA that will go on to spur further gluconeogenesis (the creation of new glucose).
Others postulate a liver-centric theory where insulin directly changes the liver’s insulin-to-glucagon ratio, lowering it and thus leading to further gluconeogenesis .
Regardless of the explanation one subscribes to about why type 2 diabetics have high blood sugars, high levels of HNE accompany dysregulation of gluconeogenesis. However, I’ve not seen a mechanism to explain it.
The relation between the food you eat and insulin secretion is represented by the food insulin index, an interesting metrics to watch if you are diabetic.

Neurological diseases

OxStr has become recognized as a major pathological factor in several severe neurological conditions, the incidence of which has been increasing along with increasing n-6 consumption, as seen with Alzheimer’s, Parkinson’s and Lou Gehrig’s disease (ALS). As opposed to rat brains, human brains appear to have a rate-limiter for uptake of LA. AA however, which is only produced in small quantities from LA but concentrates in tissues, does pass the blood-brain barrier.
It’s been observed that AA increases prior to the onset of Alzheimer’s but decreases after its onset . AA is more subject to oxidation to HNE than LA is. HNE and other OxLAMs increase as AA decreases, perhaps indicating the self-perpetuating reaction is underway.
HNE is always found in the pathological areas of the brain. Injecting HNE in an animal model induces the formation of beta-amyloid plaques , the signature of Alzheimer’s disease.
People suffering from epilepsy have been prescribed high-fat ketogenic diets and often benefited from them immensely .
This is possibly because of direct neuronal effects of the diet on “ATP-sensitive potassium (KATP) channel modulation, enhanced purinergic (i.e., adenosine) and GABAergic neurotransmission, increased brain-derived neurotrophic factor (BDNF) expression consequent to glycolytic restriction, attenuation of neuroinflammation, as well as an expansion in bioenergetic reserves and stabilization of the neuronal membrane potential through improved mitochondrial function” .
However, these ‘clinical’ or ‘classical’ ketogenic diets have used highly inflammatory fats like hydrogenated soybean oil and have even been given as replacement shakes instead of a meal . This likely renders the treatment much less effective given how triggering (epileptogenic) inflammatory factors can be for epilepsy . This is why more modern incarnations of the diet tend to use a variety of non-inflammatory fats like butter, lard, coconut oil and olive oil which also happen to taste better.

Liver Disease

Non-Alcoholic Fatty Liver Disease (NAFLD) is a new disease which only appeared when n-6 consumption levels reached the current high levels.
It mimics the effects of alcohol-induced Fatty Liver Disease (FLD). Like cancer, LA is required to induce FLD in animals. Very low levels of LA in the diet allows animals to consume up to 30% of energy as alcohol without pathology .
Total Parenteral Nutrition (TNP) is a feeding strategy in humans with damaged or malformed guts. Fatty liver is a common consequence in TNP and replacing LA-rich oils with fish oils cures the condition in human infants .
A small pilot study from Poland examining NAFLD in humans reduced the dietary levels of n-6 while providing the bulk of calories as carbohydrates.
OxLAMs were reduced, as was insulin, HOMA-IR, weight and NAFLD resolved in 100% of subjects . HNE directly induces the fibrosis seen in advanced liver disease and in other DCs.

Blindness

The leading cause of the blindness in the United States is Age-related Macular Degeneration (AMD). This is probably the only condition where the causal role of n-6 has not only been established but is becoming widely recognized. It’s illustrative of principles that should likely be informative for treating other DCs. The retina of the eye is rich in PUFAs and like other tissues is affected by diet.
N-3 supplementation does not affect the progression of AMD unless it’s accompanied by low n-6 intake . That combination is preventative—an evolutionarily-appropriate balance of the fats appears to be crucial. N-6 fatty acids are very susceptible to oxidation by radiation, even visible light; blue light will induce retinal n-6 PUFAs to oxidize to highly toxic HNE.
This may also be the causal pathway behind sunburn and skin cancer.

And more!

Osteoporosis, osteoarthritis, asthma, diabetic side-effects such as kidney failure, chronic pain and my personal favorite, sunburn, all have pathological roots in ELAS. Even high rates of violence have been compellingly linked to ELAS.

Pathological cofactors

Several cofactors induce worsened OxStr is humans. In vitro, mixing LA, glucose and water at physiological concentrations induces peroxidation of LA into OxLAMs; the same has been shown in an in vivo animal model where increased n-6 feeding induced cardiolipin breakdown with subsequent induction of hyperglycemia causing mitochondrial collapse and cardiac necrosis .
This is seen in heart failure, now epidemic amongst humans. Alcohol, fructose, smoking, radiation and infection all increased levels of OxStr and as in FLD, the effects of OxLAMs may play a role in the pathology associated with those factors. If two factors contribute to a disease but the disease only appears when one is present, it’s logical to conclude that the required factor is causal.

A final note on epidemiology

The epidemiology around n-6 consumption and DCs reminds me of an old joke. A policeman sees a drunk crawling around under a street light.

“What are you doing?”
“I’m looking for my keys!”
“You lost them here?”
“No, I lost them over there.”
“Why are you looking here, then?”
“Because this is where the light is!”

Applying epidemiology to nutrition is a very daunting task. Conducting it in a modern, industrial society is much easier than going to a traditional society with no government statistics or wealthy research institutions.

So most of the epidemiology looking at food consumption is done in the industrial nations, which have mostly had high incidences of seed oils for a very long time, before nutritional epidemiology became a science

Seed oils appear to cease increasing rates of cancer appearance after they comprise 4.4% of energy, and saturate tissues at 5% .
Most industrial populations get more than 5% of energy from seed oils , so comparing one to another is to compare high to high, when what one wants to see is high vs low.
Nevertheless, there are a number of studies looking at DCs in populations with differing food patterns, and they strongly support the hypothesis, with the incidence of DCs in populations consuming fewer seed oils being either fractional or non-existent . This likely explains the rapid increase in DCs seen in countries eating MAD-type diets.

What’s missing?

According to several scientists I’ve read the work of or listened to lately, funding is missing. This is highlighted by Dr. Ron Krauss who works at the National Institutes of Health (NIH). According to him, the NIH have largely stopped funding clinical nutrition research.
That, combined with the pro-n-6 PUFA bias in the American nutrition establishment, means that it’s unlikely much research will be done in the U.S. Much of the research seems to be done in either second-tier US institutions or in Europe and Asia.
There’s a lot of lab work looking at mechanisms but not a lot of human interventional studies. The few that do exist however, like the Lyon Diet Heart Study, Christopher Ramsden’s work and the pilot LA metabolite intervention from Poland are all very compelling .
Research I would like to see on this question is an examination of PUFA status and OxLAM load in those few people still eating a traditional diet free from DCs, as well as interventional studies lowering n-6 PUFA.

Most such studies make no attempt to lower n-6, but just add n-3 on top of it. Due to competition between the two types of fatty acids and as seen in AMD, this is unlikely to be a successful strategy

It’s essentially the modern Japanese diet: excess n-6 but good n-3. This has not prevented DC in Japan, but they do have lower rates of some diseases, like cardiovascular diseases.

Conclusion

HNE was discovered in the early 1980s, many decades after seed oils were introduced. The relationship between n-6 and endogenous production of signaling molecules was discovered later. N-3 fatty acids became recognized as important after that.
Research into this topic was in the 10s of papers in the 1970s and has increased by 135-fold today. It’s a burgeoning field but one that appears to be very much under the radar. In reading through the literature, I have come to the conclusion that the case for ELAS as the root cause of Diseases of Civilization is overwhelming.
Personally, I came to this topic through Stephan Guyenet and his excellent Whole Health Source blog. After months of reading his posts and reading the papers he linked to, I decided to cut seed oils from my diet on the spur of the moment, standing in front of the salad dressings in a cafeteria.
My irritable bowel syndrome of 16 years disappeared in two days. My carb cravings disappeared as quickly, allowing me to discover an underlying wheat sensitivity. Sunburn became a thing of the past and as a pale blonde who had always assumed I was ill-adapted to life under the sun, this was revolutionary.
My excess weight dropped off, along with my now too-large pants one morning, never to return. And after six broken bones in two years, I haven’t broken one since.
I started reading on the topic because I wanted to understand what had caused my personal health recovery – and I guess because I like puzzles.

What to do about excessive n-6 consumption?

Avoid eating seed oils, foods containing seed oils—junk food and animals fed high levels of grains and seed oils, like pork and chicken. Don’t go crazy with the nuts. Eat some fish. But no, you can’t fix ELAS with extra n-3 fatty acids like fish oil, as the Japanese case demonstrates.
Except for fasting, this is the simplest health intervention ever, as it’s impossible to become deficient in n-6 fatty acids when eating whole foods. Even if a fraction of the diseases with pathological signs pointing to n-6 are proven, you’ll still be far better off.
William E.M. “Bill” Lands spent his scientific career studying the role of n-6 and n-3 fatty acids in the body. His conclusion, the title of an article written during his retirement, deserves to be the note to end on here :

Prevent the cause, not just the symptoms

Felt like I should share some things that I don’t see posted very often but that have made a marked difference in my PMDD symptoms.
Dramamine Nausea & Vomiting - NOT regular Dramamine - I take two of these each day of my luteal phase plus some during my period. It is non-drowsy and has made a huge difference for me.
Histamine-free probiotics - apparently probiotics often produce histamine??? Nobody ever told me this but my brain fog is so much better since switching. I take the “Bifidus Mood Boost” from Lifted Naturals.
FOOD - Green apples (quick and easy to eat when you have no appetite but they are also said to be good for nausea - no studies as far as I know but in my experience they work!) and La Colombe oat milk lattes because they have 120mg of caffeine in 9oz and seem to be much easier on my stomach than regular coffee. Plus they’re delicious and I DESERVE A LITTLE TREAT WHEN I AM HAVING A HARD DAY. Lastly, Yogi brand Blueberry Green Tea slim life gives me longer lasting energy and diuretic effects on the days I know the coffee crash will incapacitate me.
Instead of taking Midol (which contains an antihistamine, acetaminophen for pain, a diuretic and caffeine) I take the following each morning of my PMDD days: • 1 Claritin (antihistamine - supposed to be best for preventing drowsiness but Zyrtec works for me too) •Aspirin (better than acetaminophen because it is an NSAID, so it helps with pain AND inflammation) •Zantac (an acid reducer but more importantly an H2 blocker - I know this isn’t new info for some people but was a HUGE game changer for me) •La Colombe lattes, Blueberry Green tea Slim Life :) OR 60mg in caffeine pills to replace the caffeine I would’ve gotten from the Midol - not necessary but a option for the girls who NEED the caffeine the midol supplies • for bloating, if needed, you can try Midol Bloat Relief or consider switching to a hormonal birth control like YAZ that is already a diuretic
I already take YAZ, adderall (which are essentially tictacs for half my cycle) and an SNRI (did genetic testing so I know it works better than an SSRI for me personally) but the items mentioned above really saved me from the little things doctors don’t care about like losing my job, damaging friendships etc.
If you knew all of this already, good for you! Please take this as a virtual pat on the back! If not, I’m hoping I can spare someone from some of the frustration and hopelessness that I felt before I curated this little list. Thanks!

I am a 46 year old male, who is trying to sort out which items to keep in the medicine cabinet, for whenever I have cold/flu symptoms in the future. Of course, no one wants to go out and buy anything when they are already sick, so I am trying to plan ahead.
I am trying to make a high-quality post to address cold and flu symptoms we all unfortunately experience throughout our lives. Even if you may feel that I am asking "stupid" questions, please consider that I am putting a lot of time and effort in to learn, while helping to share all of this with others. Some people may feel that I am making this all way too complicated. While this may be true, I still feel there is a lot for us to learn here. Thank you in advance to everyone who takes time to read this post, as well as those who also take time to respond.
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I assume most people just have one or two pain relievers at home. However, is it worth having most or all of these?
After spending many hours of Google searches, here is my new understanding of the pros and cons of the main options.
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Acetaminophen (Tylenol).
Ease pain and lower fever, but won’t reduce swelling or inflammation. Best for headache/fever, toothache, back pain, colds. Mild to moderate pain.
Least likely to cause an upset stomach. Be careful not to double dose with cold/flu medicine. Take every 4-6 hours.
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Acetylsalicylic Acid (Aspirin, Bayer).
Reduce fever, pain, and inflammation. Best for headaches, toothaches, colds, fever. Mild to moderate pain.
Can be difficult on the stomach. Take every 4-6 hours.
Slows blood clots, lowers chance of heart attack/stroke.
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Ibuprofen (Motrin, Advil) - Does it make sense to have both Ibuprofen and Advil?
Reduce fever, pain, and inflammation. Best for headaches, toothaches, back pain, muscle strains, colds. Mild to moderate pain
Can be difficult on the stomach. Take every 4-6 hours.
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Naproxen (Aleve).
Reduce fever, pain, and inflammation. Best for headaches, toothaches, back pain, colds. Mild to moderate pain.
Can be worse on the stomach. Lasts longer in the body. Take every 8-12 hours.
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In each of the four above categories, should a person just always go with the cheapest generic, or under which circumstances should a person pay more for a trusted name brand? It seems the active ingredients are the same for all generic vs name brands.
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My takeaways from this, if my understanding is right is that

1. Aleve, or a generic version, is a must have for when pain is expected to last longer (8-12 hours or more). Also helps with inflammation.
2. Ibuprofen, or a generic version, is also a must have for pain with inflammation. This works faster than Aleve, but also does not last as long (4-8 hours).
3. Tylenol, or a generic version, is a must have for pain without inflammation, or when you need something easier on your stomach.
4. Aspirin/Beyer, or a generic version, is a must have for blood clots, and lowers the chance of a heart attack/stroke. If in good health, when do you know if you should take this daily?

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Cough Suppressants are also important. When does a person know when to use each of these? I assume a person may not need to own all of these
Dextromethorphan (Delsym).
Dextromethorphan (Robitussin).
Menthol Cough Drops.
Vicks Vapor Rub.
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Expectorants should also be considered.
Guaifenesin (Mucinex).
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Decongestants.
Pseudoephedrine.
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Nasal Decongestants.
Oxymetazoline (Afrin).
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Antihistamines also help.
I personally prefer Cetirizine (Zyrtec) over Diphenhydramine (Benadryl), Loratadine (Claritin), and Fexofenadine (Allegra).
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Anti-Inflammatory for sneezing, stuffy, runny, or itchy nose.
Fluticasone propionate (Flonase).
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Sinus infection, allergies.
Neil-Med bottles and packets for nasal irrigation. I prefer this over Neti-Pot.
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Sore throat.
Warm salt water gargle is highly suggested.
Which of the following three should also be kept on-hand?
-Herb Pharm Soothing Throat Spray Herbal Formula with Echinacea and Propolis.
-Chloraseptic Sore Throat Spray, Menthol.
-Propolis Throat Spray by Beekeeper's Naturals.
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Can Dimenhydrinate (Dramamine) help to reduce nausea when sick, or is it really just for motion sickness?
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Eyes - dry, red, itch, burn -
Genteal Tears Preservative Free Eye Drops.
Warm compress.
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Many stomach symptoms; nausea, diarrhea, acid reflux.
Bismuth subsalicylate (Pepto Bismol).
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Severe diarrhea.
Imodium AD.
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Laxatives for Constipation.
Polyethylene glycol (MiraLax).
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Is there anything that I am forgetting? Perhaps there is an item under a specific category that I should consider that I did not list? Or maybe I am forgetting about a symptom I should be ready for?Now I know things become even more complicated when considering cold/flu products that have a combination of ingredients. A main concern is that people can double their doses of pain relievers without even realizing it, as they do not read the labels of these products.
Do doctors and pharmacists usually just suggest buying the items above to treat specific symptoms, or are some of the products listed below also highly recommended under the right circumstances...
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NyQuill.
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TheraFlu.
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Tylenol Cold and Flu Severe.
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tldr; for each cold and flu symptom, which are the best products to own, and when should a person just go with the cheapest generic option rather than a trusted name brand?

I am 28F, Caucasion, 175cm tall and 100kg. I want to preface this with I have a condition known as Dissociative Identity Disorder (DID). If you are unfamiliar with the disorder it is the most complex and extreme trauma disorder that exists. If PTSD was a level 1 and CPTSD is a level 2, then DID is a level 5 on the trauma disorder scale.
One of the key features of this condition is that it can only develop during early childhood, while neural networks in the brain are still connecting. As a result many neural networks are left disconnected. This is a very simple explanation but can be referred to as structural dissociation.
Like with PTSD, a trigger can activate flashbacks, and these memories will be contained within the certain disconnected neural networks. This effectively means that neural networks can switch on and off and all of the associatied functions with it.
For example- I have a neural network that is mostly cognitively akin to a 3yo. When it is switched on I have the motor skills, impulse control and delayed gratification of a 3yo as well as childlike interests and perceptions.
Here is the problem with medications- it is not very well understood of researched but many medications are completely ineffective or have very little effect compared to a typical patient.
I know that all opioid medications are ineffective, because dissociation produces endogenous opioids, and I believe to the extent that I have experienced this has made my opioid receptors extremely downregulated. I now take naltrexone that assists to lower my dissociation and up regulate my receptors. (But yet opioid meds still dont work at all whether i am taking naltrexone or not).
I have also discovered that meds like benzos have no effect. From my research I have found that this probably means my Gaba receptors are down regulated as well. I have previously tried gabapentin for other symptoms and this was ineffective too.
I even had a lung operation and every single med they put me on felt 90% ineffective. I had a paravertable block, a PCA with morpheine, oral tramadol and other pain killers and still I would find myself viscerally screaming seemingly out of my control from how painful the procedure was.
I have recreationally taken drugs and things like cocaine have no effect.
I have felt the effects of MDMA once (and taken many times). Unsure if that pertains to quality or other factors.
I have had psilocybin- this has had profound healing effects for me- however sometimes I can take 10g dried with no effects, other times I am tripping akin to a heroic dose. Yes i have considered factors such as what I ate that day etc- there is no indetifiable pattern.
Cannabis i have been prescribed has similar effects, and some days It has effect and other days none (and vice versa- no patterns with tolerance. I could have 3g one day and feel nothing, the next day one puff of the same strain and I am baked).
My theory is that certain parts of my brain have extremely down regulated receptors, others not so much. So with the neural networks switching on and off seemingly at random changes the effects of how I feel the meds if at all.
I am wondering if anyone here has any ideas, similar experiences or suggestions? Does anyone have any insight into what may be haopening beyond my basic understanding, and if there are any treatments, specialists, supplements etc you could recommend?
I have been doing research to find things that could help upregulate these receptors and honestly I have already tried most of these (for 3+ months minimum each, up to a year or more).
I have tried these supplements/ meds. I am listing everything even if it ties to other conditions as I feel maybe thats important to consider (and probably forgetting a few).
My other conditions are PCOS, chronic fatigue, iron deficiency, suspected fibromyalgia and hypermobility ehlers danlos syndrome (awaiting screening), possible POTS (however when i went on prorpanolol for anxiety it cleared every POTS symptom I had), ASD level 2, ADHD (though i question if this is just trauma), CPTSD. I also likely have FND and am awaiting screening. I currently struggle with extreme chronic pain and fatigue. I am going crazy thay no pain meds work.
Supplements (hard to say whats effective) - various medicinal mushrooms - maca powder (feel effects) - ashwaganda - Bioceuticals brand "adrenoplex" ( mix of adaptogenics) (was once very effective, now not) - saw palmetto - spearmint - damiana - so many types of magnesium - b12 - iron - iodine - zinc - d3 - b12 - inositol (very effective)
Medications (ineffective) - diazepam - lorazepam - alprazolam - codeine - oxycodone - tramadol (slow and fast release) - morphine - local anesthetic (need huge doses) - dexamphetamine - modafinil - atomoxetine (slight effect possibly)
Medications (unsure if effective or not, if so very mild) - pregablin - gabapentin - paracetamol - aspirin - melatonin - cbd oil - spironolactone - several anti biotics (cannot remember, but every time I need anti biotics I nees more rounds than expected or they change to something stronger)
Medications (effective) - propranolol - orphenadrine - clonidine - metformin - meloxicam - naproxen - ibuprofen - cannabis (higher thc strains)

Yes, many people say that creams and oral antihistamines have given them relief from itchy skin, swelling, and dermatographia symptoms. We asked our community of 400 people with dermatographia, urticaria, and hives, what medicines worked best.
Our focus was primary OTC (over-the-counter) medications. Yes, antihistamines are a type of medication that you can take in order to prevent allergic reactions. You can also take itchy skin antihistamines to treat your symptoms.
This type of medication works by stopping the effects of a chemical called “histamine.” People with dermatographia produce large quantities of histamines when they are exposed to allergens and irritants.
Histamines can cause you to have a number of uncomfortable allergy symptoms, like a runny nose, watery eyes, and itchy skin. Because these symptoms are so uncomfortable, people take antihistamines for relief. Antihistamines counteract the chemicals inside your body so that you won’t develop an intense allergic reaction.
Antihistamine medication comes in different forms, including creams, gels, and pills. Here's what people with dermatographia say works best...
What are the best antihistamine creams for dermatographia?
Antihistamine creams are a particularly popular choice for people struggling with itchy skin. If you have rashes, hives, or even bug bites, antihistamine creams can provide a lot of relief.
Every brand of antihistamine cream is a little bit different. Read on to learn more about the different options for this medication. And be sure to talk to your doctor before trying any new topical creams.
Extra Strength Benadryl
This is one of the most widely available topical creams for skin rashes. You can easily find this in Walgreens, Target and Walmart, as well as most local drug stores. The medication is quite affordable at just 4 dollars per tube.
Every kind of topical cream has its own “strong point.” Since Benadryl’s topical cream does contain antihistamines, you can use it to treat most dermal allergic reactions.
It is also a great option for people of almost all ages. According to the Benadryl brand website, this cream is great for anyone over the age of two.
However, the company especially recommends the medication for allergies related to the great outdoors. You can use Benadryl’s cream to treat bug bites, poison ivy, poison oak, cuts, scrapes, and even burns.
Simply unscrew the tube’s cap and squeeze the bottle. Take a small portion of cream and gently apply it to the affected area of skin.
Do not use Benadryl topical cream more than three or four times per day. Do not sure Benadryl topical cream on chicken pox or measles without a doctor’s permission. Do not mix the topical cream with other antihistamines.
Ivarest Itch Cream
This isn’t as easy to source as Benadryl. However, Ivarest Poison Ivy Itch Cream has many unique benefits.
For one thing, Ivarest is much more than just an antihistamine. It contains several different ingredients to treat your itchy skin from a number of different angles.
The first major ingredient is Benzol Alcohol. This product will give you an immediate sense of relief, as it kills the bacteria on your skin. Its anesthetic properties will also prevent your skin issue from turning into a nasty infection.
The second important ingredient is calamine lotion. You may know calamine lotion as the infamously pink cream that has been used to treat itchy skin for decades.
The calamine lotion provides a cooling effect to your skin. It soothes any kind of discomfort. It will also absorb any of the fluids that may be leaking from the irritated areas around your pores.
Like Benadryl, Ivarest Poison Ivy Itch Cream contains antihistamines. These chemicals will prevent your body from increasing its allergic reaction.
Do not use Ivarest more than three or four times per. Do not apply it to chickenpox or measles without consulting a doctor. Do not mix it with other antihistamines. Do not apply it to an open wound.
Do oral (pills) antihistamines work for dermatographia too?
Sometimes, topical creams are not strong enough to provide relief. If you are suffering from constant itching, you may want to consider taking an oral antihistamine to help your dermatographia.
Oral antihistamines provide relief to itchy skin, just like topical antihistamines do. However, they tend to have a slightly stronger effect because they enter your body via the mouth.
The list below outlines a couple of our favorite oral antihistamine pills.
Fast Acting Xyzal
Some allergies are more severe than others. If you are experiencing hives, as opposed to rashes, you may want to ask your doctor about taking an oral anti-histamine.
Xyzal claims it lasts longer than Benadryl and faster than Claritin, but you will have to be the judge. Lots of people with dermatographia claim it helps them quickly.
Allegra 24 Hour Relief
Allegra is one example of an oral drug that provides fast relief to allergy symptoms. Unlike other antihistamines, this one lasts for 24 hours. This means that you won’t have to stop your life to take more pills every few hours.
It is also considered a non-drowsy antihistamine. As a result, you won’t have to worry about any of those embarrassing antihistamine episodes, like falling asleep at work.
Anyone between the ages of 12 and 65 can use Allegra. Simply swallow on 180 mg pill every 24 hours. Be sure to take the medication with water.
Do not take Allegra if you are over 65 years old and have not consulted with a doctor. Do not take Allegra if you have kidney disease and have not consulted with a doctor.
Do not take Allegra if you are allergic to the drug. Do not take Allegra with magnesium or aluminum supplements. Do not take Allegra with fruit juice.
Claritin 24-Hour Antihistamine
Claritin treats most common allergy symptoms. And if you suffer from hay fever or rhinitis, you can use Claritin to treat those conditions as well.
Zyrtec 10mg Oral Antihistamine
Zyrtec allergy pills have a wide range of potential uses, including for Dermatographia. The most common tablets are 10mg and come in a 45-count bottle.
The great thing about Zyrtec is that they only have a few side effects compared to other pills. They are also readily available anywhere.
Chlorphen-12 Allergy Medication
While Allegra is a great pill for people who want to stay awake, many people with chronic itchiness struggle to sleep. As a result, it can be a good idea to consider sleep-inducing allergy pills.
Chlorphen-12 is an oral antihistamine that provides relief for allergy symptoms. In addition, the medication can make you drowsy. This improves your overall ability to sleep through the night.
However, because you shouldn’t sleep all day long, Chlorphen-12 only lasts twelve hours. This allows you to rest for one half of the day and be alert for the other half of the day.
Be careful not to drive or operate heavy machinery when taking Chlorphen-12. You should also be sure not to drink any alcohol, or ingest any other sleep-inducing substances. This could cause excessive drowsiness.
If you have a breathing problem, do not take Chorphen-12 without first consulting your doctor. If you have glaucoma, do not take Chorphen-12 without consulting your doctor. The same is true for patients with prostate issues.
If you are pregnant or breast feeding, talk to your doctor about whether or not Chorphen is the right choice for you.
Are there natural alternative treatments vs. antihistamines?
The answer to this question is: yes. If you aren’t suffering from constant itchiness, you may want to consider aloe vera.
Aloe is a naturally occurring gel that comes from the inside of a cactus-like plant. The plant contains many healing properties, including antibacterial properties. The substance is also antiviral and antiseptic.
Simply break apart a piece of an aloe plant and squeeze the green gel onto your hand. Then, carefully apply the gel to the affected area of your body. The gel will not only cool your skin, but it will also bring down the inflammation. Aloe Vera will also hydrate the dermis, providing even more relief.
You can also try a soothing aloe or mint lotion that will really help you as well. If you do not have access to an aloe vera plant or aloe lotion, fear not! You can purchase an aloe or soothing lotion or topical gel at most local pharmacies.
Find the root cause of your dermatographia too
Have you been suffering from chronic itchiness? Do your symptoms tend to come back after periods of relief? If so, you might want to look more into a medical condition called dermatographia.
Dermatographia can’t be cured by antihistamines for itchy skin. Unfortunately, dermatographia antihistamines can only alleviate symptoms of the disease. And it’s important to not only treat the pain and itchiness with antihistamines, but also find the long term solution to your dermatographia.
However, there are other solutions. The disease is treated by a combination of medication, diet, and lifestyle changes.
To learn more about dermatographia, click here. Our page is full of information on dermatographia. Our articles can help you determine whether or not you need to speak to the doctor about the condition.

Please do not share..
My MIL wanted me to be with her son since we were preteens. It did not work out until our mid-twenties. All was going well, until we got engaged. She did several things, making comments, not interested in being involved in our wedding planning or helping etc. I tried to overlook and not get my feelings hurt by this, because I tried to understand I was "taking" her son away from her. One night, she called me 57 times while I was in night class, to threaten to have me arrested for stealing a quilt from her house. The quilt was later found in the back of a closet. Honestly she made lots of ugly comments and remarks about me, my family. I really have a hard time holding grudges, because my memory is awful, and I usually forget why I was even mad at someone. However, I know that my ex-communication is valid.
Right before our wedding it went downhill fast. She called my mother the day before our rehearsal to tell her that she needed to convince me to call off our wedding. She stated that I deserved a doctor or lawyer, not her son. She made a production of how I was making a mistake and that if I married him, I could not "give" him back, he was my issue. My mom took up for me and her soon to be son in law, and my MIL decided she would not come to her only son's wedding.
After a short time my husband forgave her for not coming to the wedding and started communicating with her on a regular basis. She called me several times yelling at me and telling me how much I would regret my decision to marry my husband. She would cuss me out and then get mad that I did not invite her to our house. My husband took up for me. She told my Sister in law (SIL) horrible lies about me which she told my husband right before our one year anniversary, that almost caused us to break up. She was constantly going between my husband, my SIL, and myself talking about the other one. It caused lots of hard feelings that have since been resolved. This has gone on for the last 7 years.
I stopped communicating with her almost two years ago. I found out around that time that I was pregnant with our first child. We had a hard time getting pregnant and when we told her, she said "Well, forgive me for not being excited". You probably will not even be able to carry "IT" to full term". I will be excited after you give birth." I completely blocked her on everything. I told my husband that if he needed a relationship with her that was his decision, but I was done. When we got closer to the due date, I knew in the back of my mind that I may have to give in a little so she could see her grandson. My only request is that she not come to the hospital. I gave birth to a beautiful baby boy. I had some issues with my blood pressure so I had to stay in the hospital an extra day. My MIL showed up, and told the nurse to ask if she was allowed to come in. The nurse knew something was weird, because visitors had come and gone all day and other than asking my room number, none of them asked if they were allowed in. The nurse asked my husband and he allowed her in the room. I was so hurt. I could not get away (I was still hooked up to an IV, and a catheter). I cried the entire 10 minute visit. Even when she spoke to me, I could not form words. I think some of it was hormones, and some was just that I was hurt. After she left, my husband apologized. I could not talk to him about it, I was afraid I would say something I could not take back. I asked for one request and he did not respect me enough to tell her to leave. I did get over it, I know he felt like he was in a difficult situation, but I still think he handled the situation wrong.
By this time, I decided I was not willing to see her and I did not want her to have anything to do with our son. 8 weeks later she showed up at the house while I was out and demanded to see her grandchild. She told my husband she would take us to court to get visitation (this cannot happen and I knew that, it was an empty threat). She threatened to wait on our porch or driveway until I came back. My husband told her that if she did not leave he would call the cops to make her leave. She did finally leave and I knew nothing about it until I got back home.
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She is now very ill, and having surgery soon. The surgery is going to be a lot on her body and she could not make it out. She has requested to see my husband and our son (I was not mentioned, no tears were lost on this). I told my husband that I would never stop him from seeing his mom, that he was the one that would have to live with his decision not me. However, I do not think our 16 month old needs to meet her during this time. He wouldn't remember anyway and if I can protect him from toxic people like this I think I should. Am I wrong?
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**I know it is some type of heart surgery. She had a procedure done last month and did not stop taking her Goodys (which contain aspirin), and her blood was thin and there were complications ( all due to her decisions, not the procedure), she was in the ICU several days and had to get blood transfusions. This surgery is to help with blood flow, so I do understand that it is or could be series and not an elective procedure or minor. However, my feelings about our son seeing her have not changed, the surgery is scheduled for later next week. I have dealt with her mistreatment and have forgiven her to a sense. I don't want anything bad to happen to her, but when I speak of her, it's like speaking of a person I do not know. I don't wish ill feelings on her but I just don't have a reaction. I have lost the ability to care for her like I feel I should. I hate that she is going through this, my only obligation is to make sure my husband is okay, because I will not have lost or gained anything ( which when putting this to words sounds harsh). My husband has not accepted the way his mother is, and he still believes she can do better, or my favorite "that is just the way she is", to which I reply "that does not make it okay". I do feel that my lack of empathy is because of her actions. I feel like as a whole this entire situation has made me harder on people in general and less likely to continue to give them chances if they betray my trust or respect towards me or my family. I guess on the positive note it has made me stand up for myself faster, because I have realized that some people do not deserve so many chances to change. If they want to they will. My only real concern now is that I do not want my husband to resent my stance on this. I feel like as a whole we have been through so much, and I do not want him to think differently about me, because of me standing my ground about this. He has not pushed the issue, he told me what was going on and asked what I thought. I told him and he has not brought it up again. He does understand why I feel the way I do, but if something happens will he see the situation differently?

Hopefully this post is acceptable, even though I am currently not sick. I am attempting to compile a list of all of the over the counter medications the average person should have for potential illness, allergies, and injuries. Hopefully someone in the medical field can help to answer the questions throughout, and to generally speak to what is and is not needed on this type of list. I am a single 46 year old male, but I hope this post and responses helps many people who should also stock up their medicine cabinet a bit. I also need to spend $300 in OTC money, or I lose it at the end of this month.
I spent hours searching online and piecing this list together. I am really trying to pay attention more to my health. I appreciate everyone who takes time to respond to any of this.
PAIN RELIEF - When do I use each and when do I avoid each?
Acetaminophen (Tylenol).
Acetylsalicylic acid (Aspirin) - Does it matter if Bayer or are they all the same?
Ibuprofen (Motrin, Advil) - Does it make sense to have both Ibuprofen and Advil? If so, when to use and when to avoid each?
Naproxen (Aleve).
GI
Pepto Bismol - It seems best to use when many stomach symptoms like nausea, diarrhea, acid reflux.
Imodium AD - Used strictly for severe diarrhea when necessary. Should it be strictly Imodium AD, or just anything with Loperamide all the same?
Acid Reflux - Omeprazole (Prilosec). Unfortunately Pepcid does nothing for me.
COLD/FLU/SINUS INFECTIONS (in addition to pain relievers)
**I know an easy mistake is that people take a pain reliever in addition to a medicine like NyQuil, Theraflu, Tylenol Cold and Flu Severe, and not realizing they are exceeding their dose of pain relief.
Cough Medicine - Robitussin or does it matter which one? Should a person have a cough syrup or just pills for symptoms?
Cough Drops - Does it matter which ones? Some say Zinc helps, others say that is a myth.
Vapor Rub - I assume Vicks or any are all pretty much the same.
Decongestants (such as pseudoephedrine) - It seems to make sense to buy this separately, and also be aware if it is in other things taken while sick.
Anything else for sore throat in addition to salt water gargle, cough drops? Maybe throat spray?
Neilmed bottles and packets for nasal irrigation. I personally prefer this way over Neti-Pot.
Expectorant - Mucinex (Guaifenesin)
Cough Suppressant - Delsym
Afrin
SHOULD I EVEN BUY THERAFLU, NYQUIL OR TYLENOL COLD AND FLU SEVERE, OR BEST TO AVOID THOSE AND JUST TREAT EACH INDIVIDUAL SYMPTOM?
ALLERGIES
Antihistamines - diphenhydramine (Benadryl), Loratadine (Claritin), cetirizine (Zyrtec), and Fexofenadine (Allegra). I personally prefer Zyrtec for my allergies.
Anti-Itch Cream - Hydrocortisone 1% Cream or Calamine Lotion? When use each?
Anti-Fungal Cream - clotrimazole, miconazole, or butenafine hydrochloride. When use each?
Eye Drops - Genteal Tears Preservative Free - this is what my optometrist suggested to me for dry/red eyes.
Fluticasone propionate (Flonase).
Warm Compress - Optometrist suggested using this for eyes when red. Should this just be a warm washcloth, or should I buy something specific if I might need this regularly due to allergies?
MISC.
Cracks in heels - both Aquaphor Healing Ointment and Eucerin Cream together is suggested online.
Nausea (motion sickness) - Dramamine
Burn Cream - I assume all pretty much the same and some should come in a first aid kit.
Antibiotic or antibacterial ointment - Neosporin or Bacitracin. When use each?
Laxatives - Does it matter which one?
First Aid Kit (includes many things, some that may be already listed)
Rubbing Alcohol - Recently read that 70% is often better than 91% since it does not dry as fast?
Hydrogen Peroxide
Reading Glasses - My age is finally catching up to me.
Sunscreen SPF what is suggested now days?
Aloe Vera Gel
Oral care like toothpaste, toothbrush, floss, mouthwash is surprisingly covered with my plan.
Consider multi-vitamins?
Lotion
Carmex
Insect Repellant
Hand Sanitizer
Epsom Salt
Q-tips
For sore muscles or swelling - Hot Pad and Cold Pad. Any specific ones out there?
Anything else?

1) WHAT IS CAVERNOUS MALFORMATION?

Cavernous malformations are also known as cavernous angioma, CCM, and cavernoma. They are made of abnormal blood vessels. They are not cancerous. Cavernous malformations are made of the smallest blood vessels, called capillaries. They resemble mulberries and have very thin walls compared with other blood vessels. Blood moves through them very slowly. The thin vessel walls can be leaky, allowing blood into the surrounding brain or spinal cord tissue. We believe about one in every 500 people has a cavernous malformation, but most people never have symptoms. Of the people who have a cavernous malformation, we believe many will never have a symptomatic hemorrhage.
The rarest place for a symptomatic cavernous malformation is in the spinal cord. A spinal cord cavernous malformation is not the same as a spinal hemangioma, which is located in the vertebra (bone). Cavernous malformations may also occur in the area of the brain called the brainstem. Spinal cord and brainstem cavernous malformations can cause more severe symptoms when they hemorrhage.

2) WHAT IS AN INCIDENTAL CAVERNOUS MALFORMATION?

Your doctor may have discov­ered your cavernous malformation (cavernous angioma, cavernoma) when you had brain or spinal imaging for a reason not related to your cavernous malformation. For example, you may have received a CT scan or an MRI after a car accident or concus­sion. In this case, doctors will call your cavernous malformation an incidental finding. Research has shown that incidental cavernous malformations that have not had a previous hemorrhage have a very small chance of ever becoming problematic. While you may want to follow the precautions listed in the Hemorrhage section of this book­let, you may not need repeat imaging unless instructed by your doctor or you develop symp­toms. However, many doctors and patients choose to have imaging, typically with MRI, to monitor the lesion. For example, your doctor may order imaging during pregnancy, after medication changes, if another illness is diagnosed, or at times of dramatic lifestyle change, which can include ex­treme or unusual exercise.

3) WHO MIGHT BE INVOLVED IN MY CARE?

• NEUROLOGIST – manages symptoms like seizure and pain
• NEUROSURGEON – evaluates for surgery
• REHABILITATION SPECIALISTS – improve functioning after brain event
• ORTHOPEDIST – monitors spine in CCM3 patients (see Genetics)
• NEURO-OPHTHALMOLOGIST – cares for brain-related vision problems
• GENETICIST – evaluates for the hereditary form of the illness
• DERMATOLOGIST – cares for vascular skin lesions in hereditary illness

4) WHAT CAUSES MULTIPLE CAVERNOUS MALFORMATIONS?

Some people have more than one cavernous malformation (cavernous angioma, cavernoma). This can happen for several reasons:

• Most commonly, people with more than one cavernous malformation have a hereditary form of the illness. People with the genetic form of the illness typically develop additional cavernous malformations over time.
• Some people may have a second kind of abnormal blood vessel called a developmental venous anomaly (DVA). Your doctor might also call this a venous malformation or venous angioma. This dilated blood vessel only rarely causes symptoms on its own. However, it may create conditions that make it more likely for cavernous malformations to form. This is not hereditary.
• Brain or spinal radiation for cancer treatment can cause cavernous malformations to form many years later. In people with the hereditary form, radiosurgery to treat a cavernous malformation may also cause more lesions to form. You can find more information about radiosurgery in the section on Other Treatments.

5) WHAT IS SPORADIC CAVERNOUS MALFORMATION (CAVERNOUS ANGIOMA, CAVERNOMA)?

Sporadic cavernous malformation means that you are the only one in your family to have a cavernous malformation, and you do not have a genetic mutation that would cause your children to inherit the illness. Usually, individuals with the sporadic form of the illness have just one cavernous malformation with no other visible blood vessel abnormalities or medical history to explain the lesion.
Sometimes, individuals have a different kind of blood vessel abnormality called a developmental venous anomaly (DVA) or they have a history of brain radiation for cancer. A DVA or brain radiation can lead to the development of one or more cavernous malformations (see What Causes Multiple Cavernous Malformation? above). To be certain you have the sporadic form of the illness, you will need to have an MRI with some special images called susceptibility-weighted imaging or SWI. Ask your doctor if this was part of your original MRI. See Stacie and Vern’s Patient Stories to learn more about sporadic cavernous malformation with and without a DVA.

6) WHAT IS A BLEED OR HEMORRHAGE?

All cavernous malformations (cavernous malformations, cavernomas) have some chronic oozing of blood in the area of the lesion. This is what gives their typical appearance on MRI. Oozing is different from the more significant hemorrhage or bleed. A hemorrhage is new bleeding in the cavernous malformation and is often associated with new symptoms. Symptomatic hemorrhage is the most serious complication of cavernous malformation and is the most common reason for surgery. The hemorrhage may cause new symptoms or an increase in symptoms. The specific symptoms a person experiences will depend on the location and size of the cavernous malformation and the amount of blood that has leaked outside the lesion. Eventually, the blood breaks down leaving behind an iron deposit called hemosiderin.
Most lesions never hemorrhage. However, once a cavernous malformation has had one hemorrhage, it is at a significantly greater risk of bleeding again. In the first five years after a hemorrhage, the risk of another hemorrhage in a cavernous malformation that is not in the brainstem is 17-20% (1 in 5 lesions will have a second hemorrhage). The risk of a second hemorrhage in brainstem cavernous malformations is greater at 30% (1 in 3 lesions will have a second hemorrhage). Most of these second hemorrhages will take place in the first two years after the original hemorrhage. Fortunately, five years after a hemorrhage, the risk of another hemorrhage gradually returns to a rate that is similar to the risk from a lesion that has never bled.

7) WHAT CAUSES HEMORRHAGE?

We do not know what causes hemorrhage. Without evidence, it is hard for doctors to recommend specific precautions.

• People with multiple cavernous malformations, usually caused by a familial form of the illness, are at higher risk.
• There is no evidence at this time that medications or supplements that thin blood, such as ibuprofen or aspirin, can cause hemorrhage. However, doctors may recommend limiting their use. It is also not clear whether hormonal birth control or estrogen supplements should be restricted, but some doctors advise this, especially if a patient had a prior bleed on such medications or while pregnant.
• Behaviors that can increase inflammation like smoking cigarettes may increase the risk of hemorrhage.
• There is no reason to avoid flying in airplanes.
• This is no reason to reduce aerobic exercise. We do not have enough data to determine whether weight-lifting may place one at higher risk.
• Researchers don’t know if head trauma, including that which you might experience with contact sports, can cause hemorrhage.

Things you can do:

• Animal studies have shown that MAINTAINING NORMAL VITAMIN D levels may be protective. Clinical research has indicated that patients who are Vitamin D deficient are more likely to have had active lesions. Your doctor can check your Vitamin D level with a blood test.
• PROTECT YOURSELF against preventable, contagious illnesses with hand washing, and vaccinations.
• FOLLOW YOUR DOCTOR’S ORDERS to manage other chronic illnesses, such as high blood pressure and diabetes.

8) WHAT SYMPTOMS CAN A CAVERNOUS MALFORMATION CAUSE?

• Seizures are one of the most common symptoms of cavernous malformation (cavernous angioma, cavernoma). Seizures fall into two general groups: focal seizures that are local to one area of the brain and generalized seizures that involve both sides of the brain. All cavernous malformation seizures begin as focal seizures but some progress to generalized seizures. Neurologists use anti-epilepsy medications to control seizures. However, neurosurgeons have had good results in eliminating seizures with brain surgery if they are able to pinpoint which cavernous malformation is causing the seizures. Surgery is most successful when it occurs within two years of a first seizure. Brainstem and spinal cavernous malformations do not cause seizures.
• We know people with cavernous malformation experience more frequent headaches than other people. A headache does not necessarily mean a new hemorrhage. For the most part, we can’t distinguish a cavernous malformation headache from any other kind of headache. A headache unlike one you have ever experienced or headaches, particularly on the same side or general location as your lesion, may be related to your lesion. A headache may be related to your cavernous malformation if it is unlike one you have ever experienced or if it is in the general location of your lesion.
• The symptoms of a cavernous malformation hemorrhage depend on its location and size. Cavernous malformations can cause attention, memory, social skills, mood, and learning problems, particularly if the lesions are in the frontal, parietal, or temporal lobes, or in the cerebellum, even without obvious bleeding. This is particularly true for individuals with many lesions throughout the brain.
• Cavernous malformations in many parts of the brain and spinal cord can cause weakness or numbness in the arms or legs. In some areas, such as the thalamus, they can also cause pain. A cavernous malformation in the brainstem can cause coordination problems called ataxia or can cause facial paralysis, usually on one side.
• Cavernous malformations can cause vision problems. There are two kinds of vision problems: those caused by lesions in the occipital lobe of the brain, which affect how visual information is processed, and those caused by lesions in the brainstem, which affect how the eyes work.
• A cavernous malformation can cause hearing problems, including loss of hearing and tinnitus, dizziness, or nausea, particularly if it is located in or near the cerebellum.
• A cavernous malformation in the medulla, the lowest part of the brainstem, can cause spasms of the diaphragm, which resemble hiccups that don’t go away. More rarely, these can cause swallowing or even breathing problems.
• Cavernous malformation hemorrhages in the brain can cause fatigue. Individuals may complain of fatigue for months to years after a major hemorrhage or brain surgery.
• Spinal cord cavernous malformations can cause numbness, weakness, paralysis, tingling, burning, or itching. The location and extent of the symptom depend on the level of the spine affected. Spinal cord lesions can also cause difficulty with bladder and bowel control.

9) HOW OFTEN DO I NEED AN MRI?

You and your doctor will decide how often to repeat your MRI. Some doctors advise their patients to obtain repeat MRIs on a specific schedule. Others suggest waiting until there are additional symptoms Experts suggest more frequent imaging for those who may not be able to report symptoms, like young children or those with intellectual or communication problems. These individuals may also need sedation for MRI. You and your doctor will weigh the risk of sedation against the benefit of imaging. CT scan is another kind of imaging that is sometimes used. CT scan is much faster than MRI, but the images are not as clear, and the CT scan involves exposing a patient to radiation. You may have a CT scan in an emergency when MRI is not available. People with multiple cavernous malformations should limit their exposure to CT scans as much as possible because it is not clear whether the radiation exposure can cause the development of more lesions. A doctor may suggest a cerebral angiogram also known as a cerebral arteriogram. This procedure allows the doctor to see the arteries and veins in your brain. A cavernous malformation is not visible on an angiogram, but the test is done when another type of blood vessel lesion, called an arteriovenous malformation, is suspected. If a cavernous malformation has a typical appearance on MRI, it does not require a cerebral angiogram as part of routine care.8) WHAT SYMPTOMS CAN A CAVERNOUS MALFORMATION CAUSE?

• Seizures are one of the most common symptoms of cavernous malformation (cavernous angioma, cavernoma). Seizures fall into two general groups: focal seizures that are local to one area of the brain and generalized seizures that involve both sides of the brain. All cavernous malformation seizures begin as focal seizures but some progress to generalized seizures. Neurologists use anti-epilepsy medications to control seizures. However, neurosurgeons have had good results in eliminating seizures with brain surgery if they are able to pinpoint which cavernous malformation is causing the seizures. Surgery is most successful when it occurs within two years of a first seizure. Brainstem and spinal cavernous malformations do not cause seizures.
• We know people with cavernous malformation experience more frequent headaches than other people. A headache does not necessarily mean a new hemorrhage. For the most part, we can’t distinguish a cavernous malformation headache from any other kind of headache. A headache unlike one you have ever experienced or headaches, particularly on the same side or general location as your lesion, may be related to your lesion. A headache may be related to your cavernous malformation if it is unlike one you have ever experienced or if it is in the general location of your lesion.
• The symptoms of a cavernous malformation hemorrhage depend on its location and size. Cavernous malformations can cause attention, memory, social skills, mood, and learning problems, particularly if the lesions are in the frontal, parietal, or temporal lobes, or in the cerebellum, even without obvious bleeding. This is particularly true for individuals with many lesions throughout the brain.
• Cavernous malformations in many parts of the brain and spinal cord can cause weakness or numbness in the arms or legs. In some areas, such as the thalamus, they can also cause pain. A cavernous malformation in the brainstem can cause coordination problems called ataxia or can cause facial paralysis, usually on one side.
• Cavernous malformations can cause vision problems. There are two kinds of vision problems: those caused by lesions in the occipital lobe of the brain, which affect how visual information is processed, and those caused by lesions in the brainstem, which affect how the eyes work.
• A cavernous malformation can cause hearing problems, including loss of hearing and tinnitus, dizziness, or nausea, particularly if it is located in or near the cerebellum.
• A cavernous malformation in the medulla, the lowest part of the brainstem, can cause spasms of the diaphragm, which resemble hiccups that don’t go away. More rarely, these can cause swallowing or even breathing problems.
• Cavernous malformation hemorrhages in the brain can cause fatigue. Individuals may complain of fatigue for months to years after a major hemorrhage or brain surgery.
• Spinal cord cavernous malformations can cause numbness, weakness, paralysis, tingling, burning, or itching. The location and extent of the symptom depend on the level of the spine affected. Spinal cord lesions can also cause difficulty with bladder and bowel control.

10) DO I NEED SURGERY?

If your cavernous malformation (cavernous angioma, cavernoma) is causing symptoms, you should have a very detailed discussion about surgical options with your neurosurgeon. The decision to have surgery always involves weighing risks and benefits. In general, experts recommend surgery if three criteria are met. First, the individual must have symptoms. Second, the cavernous malformation must have had at least two hemorrhages. Finally, removing the cavernous malformation will cause fewer deficits than another hemorrhage would. Sometimes, experts recommend surgery after just one hemorrhage. For example, surgery may be a good option for someone with epilepsy caused by a cavernous malformation even if they have only had one hemorrhage.
There are neurosurgeons who specialize in cerebrovascular (brain blood vessel) and skull base (brainstem) surgery. The experience level of a surgeon is the best predictor of a good surgical outcome. The American Academy of Neurological Surgeons offers a searchable directory of neurosurgeons by specialty. It is helpful to interview a number of surgeons, including asking them about their experience, and to consult with other patients through Alliance to Cure Cavernous Malformation before making decisions.

11) ARE OTHER TREATMENTS FOR CAVERNOUS MALFORMATION (CAVERNOUS ANGIOMA, CAVERNOMA) AVAILABLE?

Doctors have treated cavernous malformation with stereotactic radiosurgery, also known as gamma knife, linear accelerator, X Knife, Brainlab, or cyberknife, for many years, but its effectiveness is not clear. In stereotactic radiosurgery, focused radiation is directed at the cavernous malformation without opening the skull. Experts now recommend that radiosurgery be considered only with individuals who have a single symptomatic lesion that is in an area of the brain where the risks of traditional surgery would be too high. Radiosurgery should not be used for treating cavernous malformations that do not cause symptoms or for cavernous malformation in people with the hereditary form of the illness, as the radiation itself might trigger new cavernous malformations to form. Other minimally invasive surgical techniques are being used more widely.
Researchers are working to find medications to treat cavernous malformations. It may take more than one medication to treat every situation. Medications could be useful to:

• Stabilize the cavernous malformation so it does not hemorrhage. Patients could use medications even before a first hemorrhage. This is particularly true for people with hereditary forms of the illness.
• Stabilize the cavernous malformation after a hemorrhage to reduce the risk of the lesion bleeding again. Remember, there is a high-risk time in the first years after a hemorrhage. During this time, it might make sense to use a stronger temporary medication.
• Slow or stop the development of more lesions in people who have multiple cavernous malformations.
• Shrink or destroy existing cavernous malformations. This is the ultimate goal.

12) DO I NEED GENETIC TESTING?

Most people with a cavernous malformation do not need genetic testing. We believe only 20-25% of individuals with a cavernous malformation have a hereditary form of the illness. If you have just one cavernous malformation, you need an MRI with special imaging called susceptibility-weighted imaging (SWI) to rule out the hereditary form. If you have multiple cavernous malformations but you also have a developmental venous anomaly (DVA), SWI will show whether your lesions cluster near the DVA or whether they are in other areas of your brain. If the cavernous malformations are only around the DVA, you do not need testing. Having multiple cavernous malformations clustered around a DVA is typical of the sporadic form of cavernous malformation. You can’t inherit or pass down the sporadic form of the illness. People who have multiple cavernous malformations that are not associated with a developmental venous anomaly should request genetic testing. Sometimes people are the first in their family with a hereditary form. You do not need other affected family members to justify testing.

13) WHICH GENES WILL THE LABORATORY TEST?

There are three known genes that, when mutated, can cause a hereditary form of the illness. Researchers have named them CCM1, CCM2, and CCM3. In the United States, individuals who trace their ancestry to the original settlers of New Mexico and Chihuahua, Mexico have passed a specific mutation of the CCM1 gene down from generation to generation since at least the early 1600s. Researchers call this the common Hispanic mutation. However, you do not need to be Hispanic to have the hereditary form of the illness. Hereditary forms of cavernous malformation exist in every ethnic group everywhere in the world.
Each child of a person with the hereditary form has a 50/50 chance of inheriting the illness. It does not skip generations. However, up to half of the people with a hereditary form may have lesions but have no symptoms. Individuals with a mutation of the CCM1 or CCM2 gene develop multiple cavernous malformations and some develop cavernous malformations under the skin.
Individuals with a mutation on the CCM3 gene may have additional features. About half of individuals with a mutation on the CCM3 gene have their first hemorrhage as children. They hemorrhage more often and develop new lesions more quickly, at a rate of 2-3 new lesions per year (compared to an average of one lesion every two years for those with CCM1 or CCM2 mutations). They may have other physical issues such as scoliosis and benign brain tumors, most commonly meningioma. They are also likely to be the first in their family with the illness. Patients with a CCM3 mutation need additional monitoring and should contact Alliance to Cure Cavernous Malformation to learn more about our special programs.

14) HOW DO I GET GENETIC TESTING?

A medical professional such as a neurologist, neurosurgeon, geneticist, or genetic counselor must order genetic testing. Only a few labs in the United States perform testing, and many insurance companies do not cover the expense. Our website contains a list of testing laboratories and information about our free genetic testing program for individuals who qualify. Depending on the laboratory, you will submit either a blood or a saliva sample for testing. It may take up to six weeks to receive results. After you have received your result, your doctor or genetic counselor can talk with you about genetic testing for other family members. This can be a difficult topic for extended families, and it is important to have the support of a health professional. Family members who are not experiencing symptoms may choose not to be tested or have their asymptomatic children tested. Genetic testing is a very personal decision.

15) SHOULD I HAVE CONCERNS ABOUT PREGNANCY WITH A CAVERNOUS MALFORMATION (CAVERNOUS ANGIOMA, CAVERNOMA)?

At this time, experts believe women are no more at risk for hemorrhage during pregnancy than at any other time. But, a bleed during pregnancy can present challenges. Brain surgery to remove a cavernous malformation (cavernous angioma, cavernoma) during pregnancy is very rare but is undertaken in cases where a second hemorrhage would be life-threatening. Women with cavernous malformations can have a vaginal delivery if they have not had a recent hemorrhage. If your doctor suggests an MRI during your pregnancy, your MRI should not include gadolinium contrast. Women who have epilepsy and are on anti-epilepsy medications should talk with their doctors about the choice of medication and folate supplementation. Ideally, you should have this conversation before you become pregnant to prevent harm because some antiepilepsy medication can increase the risk of birth defects when taken in the first weeks of pregnancy. However, having a seizure during pregnancy can cause harm that is far more serious to the fetus. It’s important to continue antiepilepsy medication during pregnancy if you have had seizures and are pregnant.

16) ARE THERE SPECIAL ISSUES FOR CHILDREN WITH A CAVERNOUS MALFORMATION?

There is the potential for many special issues with children, depending on their age at diagnosis and their symptoms. Young children may not be able to tell you about symptoms, so it becomes important to schedule imaging regularly. On the other hand, it is also important to avoid overreacting so that children aren’t exposed to unnecessary medical procedures, radiation from CT scans, MRI contrast medication, and sedation. It is not always possible to strike a balance, and every parent will err in both directions at one point or another. As a child grows older and parents become more experienced, managing this illness becomes easier. Telling your child about his or her diagnosis can be emotional and can require a period of adjustment for your child. Try to explain in simple terms that are age-appropriate. Having a pediatric mental health professional ready to help can make this easier. A mental health professional can also help if a child with hemorrhage or surgery-related deficits struggles with peer relationships, restrictions on activities, or academics. You will need to explain your child’s illness many times to many professionals including school staff, as well as friends and other caregivers. Good support from other parents in the Alliance to Cure Cavernous Malformation community or your local special needs community can be helpful for you.

17) WHAT SHOULD I ASK MY DOCTOR?

If you don’t already know the answers to these questions, you may want to ask these at your next appointment and write the answers here.

• WHAT SIZE IS THE CAVERNOUS MALFORMATION (CAVERNOUS ANGIOMA, CAVERNOMA)?
• HOW MANY CAVERNOUS MALFORMATIONS DO I HAVE?
• WHAT IS THE EXACT LOCATION OF THE CAVERNOUS MALFORMATION?
• WHAT FUNCTIONS DOES THIS AREA OF THE BRAIN CONTROL?
• DO THERE APPEAR TO BE ANY VENOUS OR OTHER MALFORMATIONS NEAR THE CAVERNOUS MALFORMATION?
• DOES IT APPEAR TO HAVE BLED PREVIOUSLY?
• IN YOUR OPINION, WHAT ARE THE CONDITIONS UNDER WHICH YOU RECOMMEND SURGERY TO REMOVE THIS CAVERNOUS MALFORMATION?
• IF I HAVE ANOTHER BLEED, WHAT SYMPTOMS WOULD YOU EXPECT?

Please also consult our additional questions to ask your doctor about specific situations, like surgery.

18) HOW DO I COPE?

Receiving a diagnosis of cavernous malformation (cavernous angioma, cavernoma) in the brain or spinal cord for you or a loved one can be difficult and upsetting. No matter your level of medical involvement, you will require a period of adjustment to a “new normal” which will include a time of grieving for what has changed. A counselor or other mental health professional can help if you experience emotional difficulty that interferes with your ability to get through your days. Close friends and family may have difficulty understanding, particularly if you don’t appear ill. The Alliance to Cure Cavernous Malformation online community or one-on-one peer support can be helpful as you look for others who share your issues.

19) ARE THERE OTHER WAYS I CAN BE SAFER?

Request a CD with your most recent MRI and a printed copy of the radiology report. This is good to have with you when you travel and in case of an emergency. You may also want to wear a medical alert bracelet indicating you have a condition that can cause a brain hemorrhage. Finally, you can have your medical information in more detail on your cellphone. Some cellphones offer apps that emergency personnel can access even when your phone is locked.

20) WHAT DOES ANGIOMA ALLIANCE OFFER PATIENTS AND FAMILIES?

Our mission is to inform, support, and empower those affected by cavernous malformation (cavernous angioma, cavernoma) and drive research for better treatments and a cure.
PATIENT INFORMATION: Alliance to Cure Cavernous Malformation provides extensive information on our website and in our newsletter. We announce new research findings as they are published. We host patient conferences with presentations by disease experts. You can view these at any time on our YouTube channel.
PATIENT SUPPORT: Alliance to Cure Cavernous Malformation offers patient support through Facebook, facilitated video conferences, and through our local Community Alliances. At our patient conferences, we offer time for attendees to share their stories.
GENETIC TESTING: Alliance to Cure Cavernous Malformation offers free genetic testing to individuals with multiple cavernous malformations who can’t get coverage through their insurance.
OPPORTUNITIES TO PARTICIPATE IN RESEARCH: Alliance to Cure Cavernous Malformation has a patient registry where you can sign up to be notified about research studies, including clinical drug trials, that are recruiting. We also are collaborators in multiple projects that are exploring the impact of the illness on patient’s quality of life.
CLINICAL CENTERS: Alliance to Cure Cavernous Malformation has a growing network of recognized Clinical Centers that provide expert multi-disciplinary care.
AWARENESS EVENTS: We sponsor volunteer-organized awareness opportunities around the country including community walks. In addition to these patient and family activities, Alliance to Cure Cavernous Malformation sponsors the annual International CCM Scientific Meeting, which brings together researchers from around the world. We provide consultations to assist with their clinical drug trial planning.

Waves.
Sometimes things propagate as waves.
She found this moth(rat?)-eaten manual fromma time not ours that mentioned this. That was before the invaders came. It may as well be centuries ago. There were stores that sold candies then. Wrapped in cellophanes of every color of the rainbow. What I'd give for something sweet now...
The sky is grey. Its always a shade of grey now. Sometimes lighter, during the day, I guess, orran ashen smeared easel offan irrational pantheon of uncaring gods and goddesses. We've been walking in what we assume is the same direction for at least two weeks. Following the river, keeping it to our left. At least we know we're not walking in circles. There's always an unnatural sound, like a sweeping broom across the tiled entranceway to Hell, that is present over the rushing water. Maybe that's why we stay close to the flowing - it almost blocks out the new world we have found ourselves in. Some semblance offa documentary on nature we might have seen when young and entertainment and learning were possibilities. There aren't many animals anymore. The ones that catch our peripherals are as ashen as the sky. Funny. I don't recall seeing foxes before; not in person. How long have we really been picking our way along this rocky terrain?
Laura is ahead of me, carrying a long bamboo walking stick. Sometimes when I lie and smile I tell her that's sposta help one walk. She lies and smiles back that of course its helping her walk - if I keep it horizontal it functions assif I'm onna tightrope - look, I'm inching between downtown skyscrapers!
An explosion in the distance, probably building sized. Sounds don't travel as far as they used to. All the greyness that came with Them is heavy, a wet blanket on the Earth, makes breathing a chore if one pays attention. The last buildings we saw were three-quarters immersed in the river. What is this body of water called? How does one forget what the local river is named? The same way one forgets what one's first car was, or where one's first kiss took place. Drive-in? Couch? Under bleachers? The explosion must be far enough to not be an immediate concern. No underfoot rumblings. We barely look up, in fact. We decided that attempting to track our progress in terms of direction was boring and pointless. Its not assif there issa goal we're reaching, a dot onna map that hassa printed name next tooit. In fact, the farther away we stay from those former dots on maps the better. Out here in the Great Big Fucking State Park of Wherever The Fuck We Are its peaceful enough. No former right angles to remind us that there are no straight lines in nature. Can't remember the last time I waited forra red light.
I'm catching up to Laura, she's crouching, long stick still horizontal, picking at something on or in the ground with her sawtoothed machete. There's no movement in the treeline except the branches and leaves themselves. Birds are almost non-existent now. I swear I don't ever recall seeing a fox in the flesh before, now they're the most common animal besides us. As I reach the limestone platform she spins, triumphant, see-I-told-you-the-stick-works, and holds out a bottle of Jamaican Red Stripe, looking new and shiny. Her excavation has unearthed a blue and white Igloo cooler chest from between boulders. Its full of formerly imported beers, a couple of red wax-encased wheels of cheese and luckily unopened large packets of bison jerky.
Back when people milled like ants, endlessly constructing ventilation tunnels and waste depositories, they believed things. They had up to the minute holy documents crisscrossed with squiggly imaginary lines, like all holy documents. Wherever one found oneself in relation to the imaginary lines denoted certain realities. Foxes are more common than people now. Somewhere Walt Disney is not feeling irony. Sometimes those holy imaginary lines were rivers. People's most common trait was laziness. I remember viewing a satellite picture of Earth, and it seemed the only blue water left was that being fed the indigo stain for denim inna polluted tributary adjacent in what was China. So much holiness. When the need arose for things bigger than us to assist, those holy worshipped things, they remained as invisible and ineffectual as ever. The larger than our imaginations entities that did show themselves remained indifferent to our collective sigils and crossed hearts. These giants brought with them a new Art, a new way to draw lines on maps, and new definitions of what maps were. Blue is still the least common color of water, brown and red being much more favored. Faces old and young stare accusingly from just beneath the surface tensions now, no matter what the hue of the liquid. The Earth is somehow a quieter marble now, explosions less frequent. If one were being charitable one could say the new, gigantic forms had brought peace, finally, at last. The answers to so many prayers.
Light pollution is now an antiquated term. Sagan's billions and billions twinkle sparkle flash and swoosh above our heads now if our relative elevation to the sea is great enough. I am no eidetic astrologer, but Laura agrees that Orion's belt and Betelgeuse are no longer where they were. Or maybe obscured by clarity. Perhaps eventually we'll draw new imaginary lines in the night grey and link humanistic tragedies to them. That one's Boffo, the legendary fox masturbator, see his right hand has six fingers? And there's Yourmom, still popular as ever. Some of the stellar regions make audible strings of intermittent noises, attempting to ask our obsolete fax machines tooa matinee. At least they're not selling us used cars yet. I wonder, would that make us scramble nowhere faster or drag our feet? The dead do not walk the globe. Hooded skeletons do not ride pale horses in search of wheat fields. It is possible something with many arms dances to an idiot piper. We smoke 'em if we got 'em, and we usually do. Drugs were big business, and are more commonly laying around than cans of cranberry sauce. They brought peace on Earth with Them, and an end to poverty, however one measures it. And they didn't even demand praise.
We haven't seen any other people in at least two weeks. Not alive, anyway. Most of the corpses are floating in pieces unidentifiable down past us. Any former homes by the waterfront have been abandoned. Proximity to the new vast creatures does something to the thought processes. Makes the electrons jump track and wind up in the wrong brain receptors. They're not eating us. They're not even interacting with humanity unless we en masse attack them. Nukes were used. That was the last Laura and I heard. The largest groups of people we've seen were four, across the river. They made no sign of recognition, no waves or yells. A mutual noticing. They were headed the way we came, on the other side.
We've stopped at a two story home with a boatless dock. A fire has turned the former garage into ash, but the adjacent kitchen and walk-in pantry is still full of groceries. Sandwich creme cookies with evaporated milk on the master bedroom deck. Sheets still smell like scented detergent and the water still gurgles from the faucets when they're turned. No electricity. Those electrons don't do the same things either. The long drive leading up to the structure is buried under massive fallen pines. Debris clogs the river itself, using a boat seemed useless, as if there was a destination to speed away to. Laura calls it " Fort mumbleblarrg " , exhaustedly burying her head in a couch cushion laid out on the deck. I stuff more cookies between my teeth. The view provided of the terrain from the deck looks like an angry child shook the ant farm, and bored, tossed it away inna drainage ditch outside a seafood buffet inna resort town. My skin imagines it has been coated in egg and floured batter several times. Shaking the sludge off my head I collapse on the unmade bed by the sliding glass, very seriously stained doors.
[ they severed the hands that's what the Spaniards did. Halberded piles palms up
fires not cauterizing, smudging
glints of spittled grin thick lenses calloused fingers zipping up weatherbeaten
blood, from not yet a teenager
cotton briars, green bitterness
whens
please not again]
Fort Mumbleblarrg seems as good as any place to experience intense hallucinations and/or time slips and/or simultaneous dimensional realities. It has cookies. After dragging all the usable foodstuffage up to the master bedroom suite atop the remnants of the wooded structure and making use of the handily, almost obscenely organized tools to actually um, fortify the narrow stairwell, we immediately crash near comatose for days, ingesting sugars and fats like there were supermarkets with humming freezer sections on every city intersection. This place even has a wine cellar, a real one, not a glass doored cabinet. I am almost disappointed there is no cask of Amontillado.
On the fourth day another explosion, still far enough to not feel blasted heat or earthquaking floorboards, but it trails along with it a visible atmospheric channel that spins off like the arm offa hurricane. For hours all the colors in the spectrum become grimy, unctuous, the view from the bottom of a fast food fryer overdue for straining. Nausea sets in during and afterward. All offa sudden being onna carpet is the same as lying face down inna two inch deep tray of cultivated maggots, complete with crawling movements up the walls and greenish-grey waves lighting up the flatscreen of the now-defunct television across from the bed. Huddled in the center, trying desperately not to touch or even look at the floor while convulsively emptying our bowels and stomachs, the mouldering lightshow starts to produce three dimensional effects, coming closer then sinking in far past the wall its mounted on.
Blankness. Grey. Millipedes. Water still runs, still looks clear. All of the carpet gets torn out and heaved over the deck's railing, along with the sodden mattress. Mumbleblarrg wassa perfect title, man. From the deck a three foot wide stripe is clearly visible across the landscape. Straight from our perspective, disappearing into the horizon, a charred, still smoking narrow strip of burnt. Trees that formerly stood in its path are simply gone, not piles of twisted branch stubs and ash. Gouges in the limestone, an actual scraping it seems. Smell of overripe, rotting fruit, something exotic like ugli or dragon with an artificial sweetener aftertaste in the nostrils; acrid, bulbous decay accelerated by molecular science students proud of their work. Evidence of this is visible in the river itself - a darkened stripe underneath the waterflow which now eddies at the banks. Added to the evidence of former civilization already present in the water are the carcasses of fish, or fish-like creatures, at least. Its difficult to discern what the original shapes of the savagely torn chunks of flesh might have been. The entire column of moving water is black and brown and maroon and bright fire truck red. There issa small fire burning on the opposite shore. Impossible to tell what exactly, just a blur of burning. For the moment there is a wind, steady, away from us. Blessedly, away from us.
Laura usedta tell stories about being born onna side offa river I was not. I was born on an Air Force base in Texas. This is not that river. It doesn't look familiar to either of us. We don't know what its called, or was called. I had lived in Texas for all but four of forty-three years. I have never seen a fox except on screens, maybe a billboard. Now they're like neighborhood dogs. The trees, the grasses, they're familiar, but not intimately so. What are all these foxes eating? What stopped eating all the foxes and let their population burgeon? Laura says since that last wave she has a scar missing. It was to the side of a bone in her wrist, she got it while working inna field with her mother assa child. I don't remember for sure - its not my wrist, but I believe her. Neither of us can relate to the other how we got here, and when we attempt it again the story breaks down at maybe a different point. The last memory we have that stays the same is that we were both inna friend's car driving up to the convenience store a mile from my parents' old trailer. Then... Even when telling our own stories over again they change. At least that's what the other person claims.
There is plenty of packaged, indestructible food left. Some of the vintages are over sixty years old. We start on those just because. I stick a sewing needle through one of the corks and float it inna bowl of water. It doesn't seem to do anything in particular, which means I've probably forgotten a step in compass making. Best as I can tell we're headed vaguely north. Absolutely nothing I have observed points definitively to that conclusion. For now this is as good a place as any.
Contrary to most horror movie logic there are several battery powered devices fully charged, more or less, and picking up all kinds of stations. Allot of them are preprogrammed and safeguarded against any possibility that silence could happen, lest our listeners disappear. There are no live voices, though even the public station is replaying an interview with a United Nations ambassador intermittently with blocks of humming where the local station breaks would be. Neither of us recognize any of the station call letters or frequencies. Even the fifty thousand watt WOAI transmission is absent. Quickly we settle on the classical public broadcast, coming in surprisingly clear. It is the only one playing music without lyrics exclusively. It helps make all the alien noises more tolerable. When stars are visible focussing one's attention on a certain grouping will now cause them to actually respond - both with sounds and visual effects. Its not just our poor human senses - recordings on our phones document the phenomena in even greater detail. Clear enough skies to see past the grey are rare, but at least two infinite directions yield beautiful results. I name them after Greek sirens in my head, not wanting to be outwardly anymore pessimistic than the situation demands. Most stars are silent and stationary enough. For now. There is still one sun in the sky that seems to do the same thing it used to, even though its greyed out usually. Maybe tomorrow it will offer two scoops of raisins.
And. Aspirin in the aftermath of wine. We've been here four or five days and just now notice that there are no identifying traces at all of who once lived here. No photos framed. No mail magnetted to the refrigerator door. No kids' homework, or children's toys at all. There are true crime and mystery novels. No religious items. There are also no clothes hanging in closets or folded in drawers. Like we interrupted the crew dressing the set.
The audio stream changes from madrigals to Gregorian chants. Its still less memory invoking than pop songs of love gained and lost and sex. We've noshed through most of the sugars and salts and fats and have begun opening cans of vegetables and beans. Laura reminds me she's a Mormon and I pick up the old argument that no, she is not. My father attended a seminary in Michigan to become a priest before he joined the Air Force assa chaplin and married a paranoid schizophrenic, what the Roman Catholic church labels a possession case officially. I like to get drunk and talk about religion and politics. When I carried a wallet it contained separate business cards for ghost and demon removal services. My reasoning being that demons are way more dangerous than the cranky old fartbag of Aunt Mabel bitching about your choice of cat food for Mr. Snuggles, and should be priced accordingly. My first official girlfriend assa teenager working at Wendy's wassa Mornon, so I have slightly more than a cursory familiarity of the doctrine. Worst girlfriend ever, by the way. Never kiss a girl who doesn't smoke. Its okay if she doesn't smoke anymore, but this advice, I contend, will not let one down if heeded. As the topic of baptizing ancestors breaches again the sky visible past the open sliding glass door abruptly shifts from grey to palish green. Notta seafoam orra seasick orra pea, but a shade reserved for floors of state mental hospitals, disinfectant ready and climbing the edges of the walls. There is something else that is different. Laura and I exchange searching looks, interrupted in our comfort food conversation. We sit staring at each other forra solid minute before knitting our eyebrows and proceeding out on the deck. The atmosphere is physically thicker past the doorframe. Not more humid - the air is cool and moist, but no more so than before. Heavier. Gravity is still a theory. Although we confidently launch rockets and probes and parasail we assa species are still uncertain as to whether gravity issa push orra pull. Gravity now feels like its the ocean, waves jostling in all directions. A propagating wave packet, my head insists. I can't hear the rushing sound of the river. At all. Nor the wind visibly moving the branches strung above. The radio is unaffected. I am not. The last thing I remember when I awake is opening my mouth, partially full of cooked peppered yellow squash, and screaming. Silently.
[ thousand segmented legs crawling
the monsters took her under cover of sunlight and treason I can't remember what she was wearing
rough hewn metals jagged under nails into nerve-riddled flesh, rusted dirt filled channels
you were there to nurture but instead you consumed until bloated and gaseous
unstable at this temperature NO!
claimed divinity with hives and fever, royal pink and chartreuse
steaming exhalations horses breath
they spasmed fits and palsy
perspiration to the soil
which grew poisoned flowers from their tears
the limb twisted before the hinged joint borne unto the Firmament unmade
flutes whistling graveyard breezes
sounds are vibrations
sinusoidal dips and troughs and peaks and valleys
how many decimalled hurts?]
There issan aching in the back of my skull. No cartoon birds and stars halo. Rising from my face-up prone position on the freshly painted deck, Laura is first in my field of vision, back solidly pressed against the railing, her eyes wide and staring. Settling next to her while rubbing my nape, I dig in my pocket and fish out Ann's antique silver cigarette case. Taking two Camels out I offer one widdershins, quickly accepted. The black and gold lazer etched Zippo fails to click when struck but lights both. Baroque woodwinds and harpsichord is quarteting through the filthy sliding glass doors. It is the only sound. I dreamt of my daughter Kallisti. I have no idea where she is or if she is. Burnt ash drops without crackles, being shaken off by my trembling lips. Hot tears are streaming down, blurring the soundless vista with eloquent soundtrack. I haven't seen Kallisti since she was eight. She would be ten now. Her mother abandoned us when she was two anda half, chasing heroin and cocaine with prostitution and psychopathic apathy. I don't remember dropping the finished butt or crawling to the pallet on the floor underneath the speakers. Batteries still holding out. Harpsichord and oboes give way to four cellos, dirge. Its suiting of the moment. Red wine has not helped the aching of my head. Laura's face is turned from my view, surveying silent scenery fit forra hotel wall painting. This is where you could be instead of MotorLodge #164. There is no chocolate mint on your pillow. Do not use blacklights in the vicinity of your bedspread, please and thank you. End of song, end of consciousness.
Floor shakes hard enough to propel me to my feet. Wagner's Ride of the Valkyries is blasting through the speakers, but its too loud, absurdly loud, there's no way cones that size could make that much air move. Fuck this. Quick steps and noiseless slamming of the glass door. Thankfully the music diminishes in volume somewhat with this action. Its nighttime now. Laura is standing at the railing, one hand gripping the wood with enough force to turn her knuckles white, the other solidly around the ornate neck offa wine bottle labelled in Portuguese. She turns her head, frowning, only slightly, acknowledging my presence, then returns her sentry's position to the heavens. Half of the grey is parted centrally, revealing the new map of burning stars. Tens or thousands of minutes later Wagner dissolves into what would have been a station break, now the amplified buzzing offan ultraviolet bug zapper with two dragonflies struck frying in the mesh. This allows the only other sounds audible through to our senses: sirens calling from beyond Earth, skyward. A sort of synthetic chime set, microtuned at random and played by feasting vultures onna weighted keyboard. There is something new this time - a long, lilting, occasionally harmonized chorus of voices drifting in and out from a different point of night than the chimes, almost sideways from the horizon. If it is a language it is none I recognize, though there are definitely parts repeating verse-chorus-verse. Many vowels, few consonants. Hours pass. The buzzing from the radio fades to nothingness leaving us with the calling of the stars. The chimes span about two octaves. The voices, if that's what they are, full spectrum. There are most certainly repeating themes, though mismashed between competing chorales. All of the voices are distinctly female, the epitome offan archtype of warrior class. A third distinct group sounds angrier than the first two, threatening. No, bitch, our dance moves slay your tired, weak-ass trots. Its beautiful, as much as it can be, but my ears are accustomed to atonality. Also very directional. The voices are coming from horizontal sources, maybe on the planet, while the chimes are beaming from a gyrating cluster of suns directly above our heads. I find that I don't care how my dehydrated body feels about this decision: I am getting as drunk as I can before a red graped woman's hand closes the staring eyes of my corpse.
" There is nothing new under the sun " somebody said once. Probably a guy. That's the kind of smug bullshit men get quoted saying. Fuck that guy. I'm glad he's dead. I hope it hurt the whole time. By all means, quote me on that.
The darkness of night is lasting longer than it should. When I climb in the upstairs shower the water again thankfully runs clear. Its cold and wakes me up, though I'm still staggering drunk. Drinking in stomachfulls of water I emerge humming a companion piece to the concert around us. At least, I'm vibrating my throat and chest. It feels like what making sounds used to do. We've laid out couch cushions covering most of the deck and are observing. Writing onna legal pad witha pen screenprinted Al's plumbing, Laura says it feels like noon. We've been dosing off in turns. She suggests Father Alien instead of Mother Nature. Our three local groups of singers have played through at least two albums of repeating hits. I turned off the radio, though it didn't respond immediately, stubbornly buzzing at least an hour after the off command was issued. My vintage is 1973, something in French. Saltine crackers, spray cheese inna can. I keep thinking about Mitch Hedberg's joke about it glowing in the dark, every bite. The chimes have almost completely faded, along with the brightness and location of its point of emanation. Glee club is picking up the tempo, but seemingly content with their distant concert halls. When I heavily plop down the notepad is passed over. Two words: Foxes. Below. Laura is strategically stationed under the thick fringed vinyl umbrella that formerly stood in the center offa round glass table next tooa propane cookstove. On its side its functioning assa lean-to tent. Hanging my head over the railing, my eyes are greeted with twenty to thirty smaller shiny pairs staring back. Ashen grey and brownish-red foxes are doing much the same as we are, minus alcohol. Laura hands me a bag of marshmallows and we toss them down one by one. They look cute, smiling almost. I shiver. Laura tugs at my jacket and I join her on the other side of the lean-to. We stuff marshmallows in our ears, hoping we don't wake to find ants crawling, searching through our brains.
Something is tickling my face and smells like bubblegum. Opening my sleepshut eyes I discover an orange fox on my chest, staring directly at me. It licks my nose several times and is instantly gone when a peal of gravelly smoker's laughter erupts from beside me. Some giant, probably taloned hand has turned the volume knob of the world back to the right again. Trees, river, that sweeping, scratching noise, all back. I haven't seen Laura happy, even briefly, like this since we found ourselves wandering. The little furry scamp ate the marshmallows out of her ears too, she says. For minutes it is easier to breathe, even with the obligatory cigarette smoke. Happiness is rare now, has been for years. Just a little reminds my body what its like to be alive. Lighter grey, occluded sky. Something like morning has arrived, however late. The same clawed huge fingers changed the world's gear ratio back to where it was. We're spinning...I see a flash of memory instead of what my eyes report. My autistic daughter spinning herself dizzy holding a ribbon, a glittery one, inches thick, sparkles fluttering. Quickly I pretend to cough and turn away, holding my closed fist in front of my face. There is no need to spoil whatever semblance of humanity is left in us by sharing this thought. " I'll make breakfast! Something hot! " She knocks the umbrella over leaping up like a clumsy feline. Burying my face in the rough cushions, I bite down on the material covering the foam, thankfull to be out of view.
Breakfast is handmade tortillas, generic, mechanically separated beef fromma squat can, diced tomatoes, black beans, corn. Blue rings of flames perform the chemistry on command. All the exciting little kid junk food has been torn through, leaving stacks of stolid, adult canned rations. There is plenty of wine. At first discovery I advised Laura not to quaff the ones that read " Port ". A friend's favorite author was Jack Kerouac. He mentioned more than thrice getting drunk on port wine. Turns out that's code for alcoholic cherry snow cone syrup. Which did provide me with the line " Man, I ain't shit my pants since I was twenty-seven! " For the record, my favorite author is HP Lovecraft. My takeaway was never, ever swim or float on, in, near, or near a painting of the ocean. Better include lakes to be sure. And iffit doesn't have fins reconsider your menu choice.
Considering the condition of the world around us we had immediately abandoned our lifelong commitment to living green and recycling. Throwing our refuse over the wooden railing wasn't an issue that required debate or reconsidering. Fort Mumbleblarrg, upon our commandeering, quickly became unfit to impress visiting colonels. Both of us passed out underneath the tilted umbrella, she under a thin blanket and I sporting a hideous shower curtain that was most certainly someone's stolen memento offa naughty liaison, the grey above us got brighter and dimmed. My eyebrows knitted upon being disturbed. Is today Wednesday? Forgot to set the cans out on the curb. Shitgoddamnmotherbitch the old couple two doors down are alcoholics. They're green container is full of-
Slowly raising my head and torso from the seat cushions I have the conscious thought that I really don't want to know what is making that waste management noise underneath my feet. I am tired of acquiring knowledge. My head is full, thank you. Try again next year. Mayhap by then I'll have finally succeeded in getting rid of those terrible '80s pop country lyrics that my parents thought would be useful to carry around with me for the rest of my life. Or that list of all the adverbs in the English language my frizzy-headed bitch offan AEGT teacher shoved in without permission. Then I'll have space for more data storage, but not now. Something is snorting and something is loudly crinkling. Maybe the social security office sent the wrinkly winos some of the CIA's cocaine stash covertly disguised as Sun Chips. They're humping furiously in the drainage ditch and feeling like teenagers again. That's sweet. Let 'em throw bottles and challenge life with a shaking skyward fist. She wassa cheerleader and he built an entire car from junkyard parts in Auto Shop. Their kid got dismembered five ways bya landmine, but that was at least six years ago. What-
Decking underneath vibrates as whatever is below us thuds against one of the support beams. A misty exhalation of partially digesting organic matter sprays into view on the other side of the railing. I still haven't sprung to my feet. Blood pressure hasn't come close to spiking. We all have our fetishes. Who am I to tell them what do after the evening news onna weekday? Can't believe you're poking me in the ribs to relate this story. Bullshit. You'll smile and wave when we drive by like always. A low, three second rumbling causes the deck to vibrate atta different wavelength. Fucking waves, man. No, I don't wanna go to the beach. They eat lots of cabbage and partake in excited conversations at mealtimes. They're passionate people. I am not getting out bed. That's what the largest sites on the internet are for. To see things like this whenever you wake up.
I. Am. Sleeping.
Go. Away.
Fuck. This.
Brown bears are smaller than black bears, which are in turn smaller than grizzlies. This one is grey. Its back sports the left arm and face offa human melted into it, off-center towards the animal's right flank. Impossible to tell if the face belongs tooa man or woman. Just the first two inches are showing, matted with the bear's greyed fur. The eyes are lidless and staring with tiny dots for pupils, pale brown eyes seeming to fade to grey with their surroundings. The left arm is active, flailing and grasping at anything that touches the palm momentarily. Mouth is slack, open, no tongue. I don't know how to judge how large the bear is. I think its bigger than a standard brown one, and I have no geographic clues. Fort Mumbleblarrg's newcomer is not okay with its tenants selfish policy of not sharing foodstuffs with the local wildlife, except insects. And its demanding toobe heard. I have been close tooa few brown bears before, seen pictures of the other ones, and I don't remember them having teeth this long and sharp. Jagged, like shark's teeth. At least they're not in rows. Huh. Whata strange thought.
An explosion, this one close enough to send flaming fist sized chunks of burning matter hailing down upon us and everything in sight. A searing blast of oven barrels directly sideways, transmuting the visible spectrum to the final day offa carnival, full of cheap plastic bottled whiskey, burnt sugar, understated menace, and malice overt. Both of us are thrown against the far railing. Almost losing consciousness, we scramble to toss several erupting couch cushions over the side before the rest of the upholstery ignites. The entire deck vibrates violently as the nightmare bear is thrown against the mooring posts, its jaws snapping several times like a shark's. A shriek far too reminiscent of human speech bellows from below. Laura is on her feet first, brandishing her sawtoothed machete but backing towards the sliding glass doors, one of which has cracked deeply but maintained its integrity. I follow her wide-eyed gaze to spy the offending creature coming into view as it woundedly staggers towards the riverbank. A two foot section of its rear flank is actively on fire, on the side opposite its unfortunate human addition. The human handed arm is flailing, fingers blurring. It becomes apparent that the unsettling sounds its making are also coming from the face enmeshed in the fur on its back. Unbelievably I find myself fascinated, unable to take in any other stimuli. Trailing an stench part burning hair and part Texas BBQ, it tumbles headfirst over a rocky ledge and is swept splashing fetid mudwater with the current. I lose my stomach contents over the railing, tannin-rich and sharply red. Behind me, a clang resounds as the machete hits now bare wood slats and a sound much more disheartening than any our mutant visitor had uttered bursts from Laura's lungs.
[ charred glass and copper, poly-fill and stuffed animals' eyes, once alive with children's imagination now splattered with phlegm and dirt
carousel uneven creaks flashing ticking bulbs in the humid summer air
the disappointment in her eyes
parasites replacing fish tongues
many eyed the reproach
ifs, not whens
dovecote abandoned
sharp stab upon kneeling]
Fort Mumbleblarrg has grown more than a few charred scars on its outer walls and roof, but demurely extinguished itself on behalf of its pair of new occupants. Which is fortunate, since neither of us remembered the fire extinguishers under the kitchen sink, cabineted away from prying eyes until far too late for them to have done us any good. Our favorite perch of second story deck still holds our weight when we jump onnit, and gets a new coating of upholstered cushions, the aforementioned red spray cans taking sentry post at each corner. I use a jet-nozzled water hose to spray off or away any unpleasant remnants underneath. Taking stock of rations we find several weeks worth of gluttony still shelved, with far more wine than either of our stomachs will forgive us for. There are no other structures in view, at least nothing that could still be recognized assa structure, but we decide that an exploratory mission a bit farther down wouldn't hurt, spoiled as we are from all the junk food consumed previously. A search of the premises turns up no maps or information regarding our Fort's geographic relationship to anything else. There are no firearms either. Colors are still skewed unwholesomely. It is voted that any expedition for more supplies be held off until, well, something changes. The propane canister attached to the cookstove is full. Cans of ham and pork product, sliced potatoes, name brand government cheese. Add heat. Stir. Pass out from exasperated exhaustion. Maybe getta chance to repeat.
Tapioca morning. Beigeish-grey with lumps of sky pus. Just like mom usedta make, including streaks of burnt char floating here and there and everywhere. Colors have not returned to - previous? Browns are lighter tans. Blues are non-existent. Reds are darker, as are the lightest hues. Yellows are peppered mustard. Greens are in the army now. It is observed the wind direction has been generally the same as far back as we recall starting this trip. Which keeps a fairly consistent speed forra weather pattern. When my father died I found a notebook embossed with a gold US Air Force Chaplaincy seal dated 1974 that he had partially filled with the weekly rainfall amounts on our half acre property for fourteen years. He would watch the Weather Channel non-stop. And that was some of the more interesting data tables meticulously recorded. Weekly expenditures on groceries, including exciting annotations, such as the BX discontinuing their brand of generic grade " A " cigarettes. Monthly lottery totals - spent, won, and lost. If I were writing all of this down assan account of my life during what most surely is the final chapters, this would be the most horrific part. As I had such a meteorological inspiration at home, the specific scientific study of weather was not one of my favorites. My brain stubbornly insists nevertheless that a constant, unchanging wind pattern is not only wholly unnatural but surely cataclysmic. Of course it is. And not even top five on my probable events to be concerned about list.
Laura uses a plastic folding stepladder to climb onto the roof, easily attaining the peak. After about a minute she yells that she can see two more similarly constructed roofs further up the riverbank, hiding silent and ominous amidst the pines. The one closest looks like it took a direct hit fromma meteor, maybe recently. I don't ask why she thinks that and she doesn't explain. Also reported is the absence of anything else. Sliding down the shingles directly to the deck she takes the gutter with her to the floor. Triumphantly. I applaud.
​