Hi AskDocs friends,
Some preliminary information about me:
• I am 20 and AFAB (FtM, pre-transition).
• Physically, I likely have Ehlers-Danlos syndrome (preliminary diagnosis as I have not been able to see a rheumatologist), whereas mentally, I am diagnosed with Bipolar disorder, borderline personality disorder, attention deficit hyperactivity disorder, and both generalised/social anxiety disorder.
• In the morning, I take 10ug Clonidine, Vitamin C, Vitamin D, and Ashwaganda supplements. In the evenings, I take 50mg Quetiapine XR and Ashwagangha again. I also have the Mirena IUD levonorgestrel implant.
Last night I made the extremely poor decision to finish a bowl of pasta that had previously been thrice reheated and returned to the fridge and have been suffering the consequences ever since.
The offending bowl was consumed around 5:30pm last night and I started to experience the first symptoms around 8:00pm. This included bloating, stomach cramping, and gastric reflux. This escalated to severe nausea around 10pm that continued throughout the night and I was unable to vomit for most of the night, leaving me tossing and turning in bed between hourly bathroom trips to retch over the toilet. I was unable to keep many fluids down at this hour because not only would water make me extremely nauseous but it also would make me reflux into my mouth.
I finally was successful in vomiting around 7:30am and the vomit itself was a dark brown colour. Very liquidy with some chunks of undigested food in it, but no “coffee ground” appearance thankfully. Just very dark.
I managed to get back to sleep and woke up around 9:30am to get ready for my 10am - 1pm shift, which I am currently working. I work from home so I chose not to take the day off. Liquids are still making me feel nauseous, but it is not vomiting levels of nauseous anymore and I am able to keep it down. My biggest concern now is the severe ache I am feeling in my stomach - lying down has helped, but sitting up brings me to literal tears from pain. It seems to come in waves and can be described like a dull, twisting ache.
My question is whether this was a case of food poisoning (I do microbiology at university and have narrowed it down to either Bacillus cereus or Staphylococcus aureus), severe gastric reflux, or severe constipation. Severe GERD runs in my family and my dad in particular is on a prescription antacid due to Barrett’s esophagus caused by his reflux, and much of my experience has been unbearable reflux so far. Alternatively, I thought it may also be a case of severe constipation - practically every stool I have passed for months now has been hard and pebble-like, and I have been hospitalised as a child in the past for vomiting induced by severe constipation. I have been meaning to look into the potential of gastroparesis as I know it is common in folk with EDS. Finally, was just wanting to know at what point (if any) it would be smart to attend an emergency room for my symptoms?
Thanks so much in advance y’all. I am aware that eating the pasta was an incredibly stupid thing to do and I have sufficiently learnt my lesson, so please don’t be hard on me in the comments about this - I come from a poor background and have major food insecurities fears that make it very difficult for me to comfortably throw out food, but I will be pursuing psychological help regarding this anxiety as I would quite frankly rather starve than ever get this miserably sick again! 😭

(First Chapter)
Chapter 04
Mystery Number 1 and Number 2!
As Finn pushed open the creaking door and stepped into the dimly lit archway of the shabby wooden shack bearing the label of the renowned Magyo Magic Academy Library, an inexplicable sensation washed over him. It was as though he had plunged into a current of raw mana, the very essence of mana itself. Before he could even take another step, he was engulfed by a sudden surge of disorientation. His vision wavered, flickering like a candle in the wind, before being swallowed whole by an inky blackness.
In the silent black void that he suddenly found himself in, time seemed to lose all meaning. Finn drifted, adrift in a sea of nothingness, his senses dulled to mere whispers in the void. It was as if he had been stripped bare, reduced to nothing more than a consciousness adrift in the emptiness of space.
Then, just as suddenly as the void had overtaken his vision, the darkness receded, replaced by the familiar sights and sounds of the academy. But something was different. Finn was no longer stepping into the dimly lit archway of the academy, nor could he see the shabby old shack that he could have sworn wasn’t the real library. Instead, he found himself standing on an unfamiliar balcony, high above the academy grounds, with the moon casting its silvery light over the tranquil garden below.
Confusion clouded Finn’s thoughts as he tried to make sense of his surroundings. How, and why was he here? And why did everything feel so… off? The air was colder than he remembered, the cold moonlight a stark difference from the warm summer sunlight he had been under only a few moments ago, It was as if he had been transported to another time, another place entirely.
Before he could ponder these thoughts and questions any further, his body began to move of its own accord, turning back toward the glass door that led into the room behind him. With a sense of inevitability, his hand reached forward and pulled down on the cold metal handle, the glass door sliding open with a soft hiss.
But as he was about to step through into the bare room, a sudden vibration on his wrists interrupted his movement. Startled, Finn looked down at the source of the disturbance on his wrist, his eyes widening in surprise as he realized what it was. Someone was calling him.
Without hesitation, his other hand reached down and tapped on the watch strapped to his wrist, answering the call with a hint of urgency. Instantly, a familiar voice echoed in his ears, the sound of it both comforting and unsettling all at once.
“Finn!” she exclaimed, her voice urgent with concern. “Something’s wrong, I can feel it… I think they are-”
Before she could finish her sentence, the call abruptly cut off with a faint static, leaving Finn alone once more in the disturbing silence of the night. Panic gripped him anew as he stared down at the silent watch resting on his wrist, his mind racing with questions that had no answers. What had she been trying to tell him? And more importantly, what was happening to him?
Finn’s heart raced as panic continued to grip him tightly. He felt a surge of distress coursing through his veins, a primal fear clawing at his already alerted senses. It was as if the very air around him had turned heavy with foreboding, pressing down on him relentlessly.
In those harrowing moments, every second felt like an eternity. Then, just when it seemed the tension couldn’t escalate any further, a deafening explosion shattered the stillness, jolting Finn out of his reverie. The shockwaves sliced through him like a sharp knife, cutting short the eerie sensation that had enveloped him and bursting into his ears, leaving only but a constant ringing echoing in his mind.
Abruptly, Finn found himself snapped back into reality, back within the confines of his own body. He blinked, disorientated, as he struggled to comprehend what had just transpired. His mind reeled with confusion, grasping at half-formed fragments of memory that slipped through his fingers like grains of sand.
He involuntarily fell forward and knelt on one knee, his heart still racing with unease. He racked his brain continuously, trying to comprehend the phenomenon that he had just experienced. What? What… was that? He thought to himself amidst deep breaths. Almost instinctively, he lifted his arm and looked at the watch resting on his wrist with intent. Tapping on the screen a couple of times, he sorted through the logs of his recent calls. Not there, he confirmed to himself with both relief and lingering discomfort.
Was it a dream? A nightmare? A memory? He was almost certain that it wasn’t the latter at least. It could have been a dream, but it felt so surreal. It was almost like he was actually there like he remembered being there. No. I’ve never been there. I don’t even recognize that room! He thought to himself. Finn’s mind stirred with a mixture of confusion and worry, his thoughts swirling like a raging tempest inside his head. He wanted answers, he wanted clarity.
With determined resolve, Finn began pushing himself to his feet, his taut muscles straining as his back straightened fully. Shaking off his limbs and taking deep breaths, Finn finally looked up, taking in his surroundings. He expected to see the outside of a shabby wooden shack, with a small sign labelling it as the famous library, but to his astonishment, the sight that lay before his eyes was simply impossible.
With what had been but a humble wooden shack from the outside, now revealed itself as a monumental structure, akin to something of a higher realm. The ceiling soared hundreds of meters overhead, forming a majestic dome reminiscent of classic architecture. The walls, if they even existed, were lost in the vastness of space. Everywhere he looked, countless shelves stretched in the distance, laden with millions upon millions of books. Cyan-blue pulsed through the air, trailing the tomes as they floated about at an impossible speed. Hovering platforms ferried students, professors, and librarians across the library’s expansive chambers while eager scholars navigated the labyrinthine levels with towering stacks of books.
Finn couldn’t help but stand frozen in awe–rooted to the spot near the arching entrance he had presumably just entered, overwhelmed by the overwhelming sight of the spectacle before him.
“Ha…” he murmured, his gaze darting around in bewilderment.
With what he had just experienced in addition to the spectacle now unfolding before him, Finn's mind was now on the verge of imploding. Finn’s complexion quickly drained seconds later as an irresistible sensation began rising from the bottom of his stomach. His abominable muscles tightened as the unstoppable force continued quickly surging its way through his body and up toward his mouth.
Finn’s stomach churned violently, a relentless storm brewing within him as the sickening feeling grew stronger. With each passing second, the pressure mounted, threatening to overwhelm him entirely. His throat constricted, a strangled gasp escaping his lips as he fruitlessly tried to suppress the rising tide of nausea.
With a sudden, gut-wrenching lurch, Finn doubled over, a primal instinct driving him to expel the contents of his stomach. A guttural retch tore through him like a raging bull as he began to empty his stomach onto the pristine, wooden floor of the library. Unexpectedly, before the vile, acrid vomit could reach and stain the library floor, a small, grey bucket suddenly appeared from seemingly thin air, catching every ounce of the putrid vomit effortlessly and effectively.
Several moments passed as Finn continued to empty the remains of his breakfast into the small grey bucket until finally, the last remnants of his ordeal passed and he couldn’t help but stumbled backwards and use the nearby bookshelf to support his now drained, energyless body. Taking several deep breaths and struggling to hold his head up, Finn’s body wanted nothing more than to fall to the ground unconscious.
No… not here. How embarrassing and humiliating would it be if I was found by someone else, asleep on the floor? He said to himself over and over, trying his best to stay standing. Amidst his almost futile attempt at keeping his dignity, he suddenly heard a faint chuckle echoing from the side. With effort, Finn managed to turn his head to the side, catching a glance at the person chuckling.
The chuckle emanated from a figure positioned a few paces away, stationed behind a grand desk adorned with layers of books, likely serving as the circulation desk. The librarian, a middle-aged man with short, brunette hair and a meticulously groomed goatee decorating his chin was draped in elegant cream-white robes, intricately embroidered with golden runes. He exuded an air of authority, wisdom and knowledge akin to that of a great mage who had lived many decades, despite his seemingly young age.
“Apologies,” he muttered, trying to stifle his amusement. “It’s just… amusing, you know? The sight of fresh students arriving and promptly losing their lunches and breakfast,” he clarified.
Observing Finn’s bewildered expression, the librarian nodded empathetically. “Ah, I see. When one traverses a spacial barrier for the first time, it can… induce disorientation and nausea. It’s quite common for newcomers to have a sudden upheaval upon encountering the library grounds. Nearly every student undergoes the same… initiation, per se.”
“After the many… accidents, I've learnt that a bucket is the simplest tool to effectively combat the student's putrid attack on the precious library floor,” he explained as he clicked his fingers together, causing the bucket holding Finn’s vomit to vanish in to thin air.
Finn stared at the librarian, completely dumbfounded by his casual approach to potentially the worst moment of his life. Finn’s eyes stayed locked onto the middle-aged librarian for several moments before the librarian nodded to himself and turned around.
In the ensuing awkward silence, the rather annoying librarian appeared to disregard Finn entirely, returning to his previous tasks. Realizing he now had ample time and space to compose himself, with a loud exhale Finn eased his body down from the unforgiving bookshelves and onto the library’s chilly wooden floor.
“He could at least have explained it in a little less harsh way,” Finn muttered under his breath. “I… I feel like I've just been hit by a three-story bus,” he audibly complained, lowering his head into his hands.
Finn let his mind wander as he felt his body ease up and relax, the previous events had taken a large toll on his body, and now was a great time to rest. He leaned against the cool wooden floor, the solid texture grounding him as his thoughts slowly settled.
Minutes passed in relative silence, broken only by the occasional rustle of pages or soft footfalls of other students or librarians in the distance. Finn’s breathing steadied, his heart rate gradually returning to a steady rate. Just as he was beginning to feel somewhat restored, a shadow fell across him. He looked up to see the annoying librarian standing over him, a slight smile playing at the corners of his mouth.
“I see that you’ve taken a liking to the floor, “ the librarian remarked, his tone lighter this time. “But… perhaps a seat would be more comfortable?”
Finn’s eyebrow raised at the suggestion. Huh, guess he’s not as bad as he seemed, he thought to himself with curiosity.
Finn sighed, pushing himself up with some effort. “Sure, I guess you're right.”
The librarian offered a hand, helping Finn to his feet. “Come, I know of a quiet corner where you will be able to rest up properly.”
*
Finn followed the librarian through the vast, labyrinthine librarian, the towering shelves and floating books seeming less overwhelming now, though they still filled him with an inspiring sense of awe. It won't be too long until he would be capable of creating such things, and potentially something even greater!
Along their journey through the library, they passed by many students and professors alike, engrossed in their studies. Some were working alone, others collaborating in hushed voices. Seeing the students passionately studying with friends, Finn began to feel a tinge of jealousy. He really wanted to spend time with a small group of friends just like them, but unfortunately, he didn’t have many friends back at home—or really any at all.
They eventually reached a secluded nook, a small corner of the library surrounded by shelves that formed a small, cosy enclosed area. Inside the nook, a lime-colored plush armchair awaited Finn. Seeing the librarian’s gesture for him to take a seat, he gratefully sank into the chair, the soft cushions a stark contrast to the hard wooden floor. The librarian followed suit, settling into a grey armchair opposite him with an air of practised ease. After they both took a moment to catch their breath and take in the sight of the enclosed nook, the relaxing silence was finally broken by the voice of the librarian.
“Nice to meet you, Finn. I’m Aldric,” he said, a pleasant smile at the edges of his lips.
“Huh? I didn’t tell you my-”
The librarian let out a small chuckle at Finn’s confusion. “When someone enters through the spacial barrier, I basically receive the equivalent of a full body scan of them. And you…” he paused, pointing his bony finger at Finn’s pocket, “Happen to be carrying something with all of your details on it.”
“Ah,” Finn exhaled with a small nod.
Of course, he would know my name, if he got a full scan of my body and saw my identification card he already knows everything he needs to about me! Finn thought to himself upon the realization.
“Well, nice to meet you too then, Aldric,” Finn said, showing the top row of his teeth as he smiled.

Hello,
I am wondering if anyone has had this problem and what did they do or find out about it because my doctor is not helping.
Since August 2023 I’ve had 8 severe throat infections (so in the span of 9 months).
I’ve been tested for strep multiple times and it’s always negative but I have every symptom of strep. I can’t even express how ill I feel when I have these infections, and I am physically unable to work.
It’s not a type of sickness where I can push through and still get on with my day, I literally cannot get up or out of bed for at least 2-3 days straight. I get a severely run down feeling, weakness, very high fevers (sometimes 104), body aches, complete loss of appetite, the only thing I want to do is close my eyes and not move. Not to mention my throat is extremely painful, swollen, red and white. My lymph nodes under my jaw also get super tender and swollen which is so uncomfortable.
This is honestly ruining my life and I’ve heard that this type of infection can affect your heart and cause many other health complications.
Do I just need to get my tonsils out? I genuinely don’t know what else I could possibly do to prevent this from happening anymore, whenever I get better it’s just a countdown to when it’s going to happen again and it’s making me miserable. For reference, yes I do change my toothbrush, disinfect my retainers, change my bedding, disinfect my room, etc after each infection.

Doctors,
Good morning.
The poll for the second round of the PinoyMed Virtual Journal Club has closed. The clinical research article for discussion is
Priya G L, Dhibar DP, Saroch A, Sharma N, Sharma V, Verma N, Chaluvashetty SB, Prakash A, Kaur H. Efficacy of empirical ciprofloxacin or cefixime plus metronidazole therapy for the treatment of liver abscess: A randomized control clinical trial. Sci Rep. 2024;14(1):11430. doi: 10.1038/s41598-024-59607-1

Reading the clinical research article

Please find a quiet moment to read the article. Typically, it should take no more than 15 minutes. Your reading of the article should not be the same as the way you read a novel. Your reading must be directive.
There are four basic questions that you need to consider. The order of the questions is important.

1. 1. Is the basic study design valid?
2. 2. Was this well-designed study methodologically sound?
3. 3. What are the results of this well-designed and methodologically sound study?
4. 4. Do the results of this well-designed and methodologically sound study help my patient?

You will note that the previous questions build into subsequent ones. This means that if you find that a study is designed poorly (question 1), there is no need to continue reading. If the study is well-designed (question 1) but not methodologically sound, then there is no need to continue reading.
There are a series of sub-questions under each of the basic questions. Consider each one in turn as you read the clinical research article. After each question, decide whether you would answer YES, NO, or CAN'T TELL.

Questions for critical review

The full list of questions that you need to consider is as follows

1. Is the basic study design valid?

a. Did the study address a clearly focused research question?
CONSIDER: Was the study designed to assess the outcomes of an intervention? Is the research question ‘focused’ in terms of the population studied, intervention given, comparator chosen, and outcomes measured?
b. Was the assignment of participants to interventions randomised?
CONSIDER: How was randomisation carried out? Was the method appropriate? Was randomisation sufficient to eliminate systematic bias? Was the allocation sequence concealed from investigators and participants?
c. Were all participants who entered the study accounted for at its conclusion?
CONSIDER: Were losses to follow-up and exclusions after randomisation accounted for? Were participants analysed in the study groups to which they were randomised (intention-to-treat analysis)? Was the study stopped early? If so, what was the reason?

1. Was this well-designed study methodologically sound?

d. Were the participants ‘blind’ to the intervention they were given? Were the investigators ‘blind’ to the intervention they were giving to participants? Were the people assessing/analysing outcome/s ‘blinded’?
e. Were the study groups similar at the start of the randomised controlled trial?
CONSIDER: Were the baseline characteristics of each study group (e.g. age, sex, socio-economic group) clearly set out? Were there any differences between the study groups that could affect the outcome/s?
f. Apart from the experimental intervention, did each study group receive the same level of care (that is, were they treated equally)?
CONSIDER: Was there a clearly defined study protocol? If any additional interventions were given (e.g. tests or treatments), were they similar between the study groups? Were the follow-up intervals the same for each study group?

1. What are the results of this well-designed and methodologically sound study?

g. Were the effects of intervention reported comprehensively?
CONSIDER: Was a power calculation undertaken? What outcomes were measured, and were they clearly specified? How were the results expressed? For binary outcomes, were relative and absolute effects reported? Were the results reported for each outcome in each study group at each follow-up interval? Was there any missing or incomplete data? Was there differential drop-out between the study groups that could affect the results? Were potential sources of bias identified? Which statistical tests were used? Were p values reported?
h. Was the precision of the estimate of the intervention or treatment effect reported?
CONSIDER: Were confidence intervals (CIs) reported?
i. Do the benefits of the experimental intervention outweigh the harms and costs?
CONSIDER: What was the size of the intervention or treatment effect? Were harms or unintended effects reported for each study group? Was a cost-effectiveness analysis undertaken? (Cost-effectiveness analysis allows a comparison to be made between different interventions used in the care of the same condition or problem.)

1. Do the results of this well-designed and methodologically sound study help my patient?

j. Can the results be applied to your local population/in your context?
CONSIDER: Are the study participants similar to the people in your care? Would any differences between your population and the study participants alter the outcomes reported in the study? Are the outcomes important to your population? Are there any outcomes you would have wanted information on that have not been studied or reported? Are there any limitations of the study that would affect your decision?
k. Would the experimental intervention provide greater value to the people in your care than any of the existing interventions?
CONSIDER: What resources are needed to introduce this intervention taking into account time, finances, and skills development or training needs? Are you able to disinvest resources in one or more existing interventions in order to be able to re-invest in the new intervention?

Patient case and clinical question

As you read, please consider how the clinical research article can be used in the case of this patient. The clinical question is,
Could this patient have benefited from a course of oral antibiotics? If so, what benefits and harms should he expect?

Clinical Case Report: Liver Abscess in a 47-Year-Old Male

Abstract

A 47-year-old male presented with severe abdominal pain, fever, and jaundice. Clinical evaluation, imaging, and laboratory tests confirmed the diagnosis of a liver abscess. This case highlights the critical presentation of liver abscess and underscores the importance of timely diagnosis and intervention in improving patient outcomes.

Introduction

Liver abscesses are localized collections of pus within the liver, typically caused by bacterial, fungal, or parasitic infections. They are associated with significant morbidity and mortality if not promptly treated. This report describes the presentation, diagnosis, and management of a 47-year-old male with a liver abscess.

Patient Description

The patient is a 47-year-old male with a past medical history significant for type 2 diabetes mellitus and hypertension. He presented to the emergency department with a five-day history of severe right upper quadrant abdominal pain, high-grade fever, chills, and jaundice. He also reported nausea, vomiting, and a general sense of malaise.

History and Symptoms

The patient stated that the abdominal pain began insidiously but progressively worsened, becoming sharp and constant. He denied any history of recent travel, trauma, or known liver disease. His diabetes had been poorly controlled, with his last hemoglobin A1c recorded at 9.2%. He was compliant with his antihypertensive medications but admitted to inconsistent use of his diabetic medications.

Physical Examination

On examination, the patient appeared acutely ill and was diaphoretic. His vital signs were as follows: temperature 39.5°C, heart rate 110 beats per minute, respiratory rate 24 breaths per minute, blood pressure 140/85 mmHg, and oxygen saturation of 94% on room air.
Abdominal Examination:

• The abdomen was distended with marked tenderness in the right upper quadrant.
• Guarding and rebound tenderness were present.
• Hepatomegaly was noted, with the liver edge palpable 4 cm below the costal margin.

Other Systems:

• Scleral icterus and jaundice were evident.
• Cardiovascular and respiratory examinations were unremarkable except for tachycardia.
• No peripheral oedema or signs of chronic liver disease (such as spider angiomas or palmar erythema) were observed.

Laboratory and Diagnostic Investigations

• Complete blood count (CBC): White blood cell count was elevated at 18.5 x 10^9/L with a neutrophilic predominance.
• Liver function tests: Elevated bilirubin (total bilirubin: 0.077 mmol/L), elevated transaminases (AST: 1500 nkat/L, ALT: 2250 nkat/L), and alkaline phosphatase (5333.3 nkat/L).
• Blood cultures: Pending at the time of initial evaluation.
• Serum glucose: 15.54 mmol/L.
• Serum creatinine: 0.1149 mmol/L, within normal limits but elevated for the patient's baseline.
• C-reactive protein (CRP): Significantly elevated at 1428.5 nmol/L.

Imaging

• Abdominal ultrasound: Revealed a large, hypoechoic lesion in the right lobe of the liver, measuring approximately 8 cm in diameter, consistent with an abscess.
• Contrast-enhanced computed tomography (CT) of the abdomen: Confirmed the presence of a solitary liver abscess with rim enhancement and central low attenuation, without evidence of rupture or secondary peritonitis.

Diagnosis

The clinical presentation, laboratory results, and imaging findings confirmed the diagnosis of a liver abscess.

Management

The patient was admitted for close monitoring and management.
Percutaneous drainage of the abscess was performed under ultrasound guidance, yielding approximately 100 mL of purulent material. The fluid was sent for microbiological analysis to guide targeted antibiotic therapy.
Intravenous fluids were administered to maintain hydration and haemodynamic stability.
Blood glucose levels were closely monitored and managed with insulin.
Pain and fever were managed with acetaminophen and opioids as needed.

Clinical Question

Could this patient benefit from a course of oral antibiotics? If so, what benefits and harms should he expect?

Release of the critical analysis

The critical analysis of the clinical research article will be released on Monday 17 June.

[Part 3]
The new knight approached the base of the wet ladder and began to climb. He reached halfway and stopped to listen above. The thunderstorm roared its fury, and the Blackfish was already speaking.
“What kind of knight threatens a pregnant woman?” Ser Tully voiced his rhetorical question.
“We did not know she was pregnant. She fooled us with her sister. But I am one that follows the orders of his liege lord.”
“You mean the Lannister one that killed his king once? Or the other Frey one that killed his other king too? Or the dead lord who killed Dornish babes? How do the princes of Dorne feel about you cheap-honor Lannisters?”
“You were the ones that rebel against the crown.”
“And it was the Kingslayer that threw Bran Stark out the window in a time of peace! At his own home! Do the Lannisters enjoy killing children and murdering unarmed people at dinner?”
“He is my liege lord.”
“Aye, and you seem like someone who knows his role and shuts his mouth. Do you want to be remembered for the rest of time as the knight that cleans up after his shit? ‘Here lies Ser Forley Prester, the legend that wipes the Goldenhand’s ass,’ will be written on your tomb in gold. Too bad your grave-mark will forget the part where everyday you take his golden-hand, shine it up real nice, turn that piece of metal sideways and shove it up your own candy arse for pleasure!”
The men above laughed as a shriek of thunder rumbled not too far from the Rock.
“You seem like a charming man Ser Brynden, but we are not here to discuss the rights or wrongs of men, knights, lords, kings and princes who are far far away from here.”
“Well here in my garrison I have Ser Olyvar Frey, son to Walder Frey, and a loyalist to his King, Robb Stark. Please ask Ser Olyvar Frey which is right and which is shit?”
Olyvar realized the Blackfish is chatting to buy time for Jeyne to escape.
“Is he a knight now?” A familiar voice that sounded like Edwyn Frey asked. “How did that come to pass?”
“Kill the right people I suppose. And whom do I have the pleasure of speaking to now? What is your name my lord?”
“My name is Ed–“
“IT DOESN’T MATTER WHAT YOUR NAME IS!”
Giggles tickled the rainy circular drain above Olyvar.
“And aye, I knighted him myself. And his Queen in the North even made him a new coat of arms to differentiate himself from his disgraceful family,” the Blackfish announced to Edwyn Frey.
“And how would I know what cloak he wears now?” Ser Forley’s voice continued.
“Fastened by Queen Stark herself, it’s the bridge of the twin towers with a river flowing underneath, colored Stark grey and Tully red & blue. But every one of my friends here are all championed by our Queen. Are any of you beloved by a queen?”
Ser Forley tried to counter, “A new sigil of water flowing underneath a bridge? Did he make the water flow himself? Is he a plumber?”
“Aye, he may be a plumber knight, but you got shit for honors.”
“My honor is in tact.”
“Was it in tact when you abandoned your army at the Battle of the Camps? Claiming that you have honor is like claiming turtles can grow wings and fly. My plumber knight has more honor than your shit!”
Ser Forley paused … and then exulted, “Will this plumber be cleaning up my shit later?” Quiet chuckles whispered from the higher balconies.
The Blackfish retaliates, “As long as you acknowledge your honor as shit, he will.”
Loud laughter filled the air, but with Olyvar hiding in the hole of the floor, he could not tell if it was from his brothers, from his foes or both. Alive or facing death, one should know better not to trade japes with the Blackfish.
“Enough!” yelled Ser Forley. “You are clearly out manned down there at this courtyard! At least three of my men to one of yours! AND I have the high ground! So I won’t say it again, drop your weapons and I will let your men live!”
“Do you take me for a motley fool? You just don’t want us to loose back when you shoot your crossbows at us. You Lannisters cannot win in a fair fight against us if we are armed, but you men sure do a good job of killing defenseless people and children. And I will not give you that pleasure!”
“I do not know what you heard, but that is not entirely true.”
“Not entirely true? Do you Lannisters fondle the children first before you kill them? Do you give the children a good sniff before you cook them like Mad Danelle Lothson? Mother have mercy!” Ser Brynden teased.
“Enough! I will let your men live if you drop your weapons! I swear it on my hon-“
“We shit on your honor! Are there no true knights among you lot? You men following this shit knight’s shitty order, do you not have any honor yourselves? To chase after and kill a woman who is in labor? To kill a babe? Our king—”
“OUR CHOSEN KING!” Lord Galbart Glover’s voice thundered in before the Blackfish continued.
“—chose to execute his own kin and bannerman for butchering children … Lannister children! Frey children! But your knight here serves men without honor. Ser Jaime Lannister the Kingslayer! Lord Walder Frey the Guestslayer! Lord Roose Bolton the Turncloak! COWARDS! Men who serves hospitality with bloodshed beneath their roofs and massacre innocents! Will you continue to serve these false knights and false men? Are you not fathers, nor aspire to be fathers some day? Well serve your CHOSEN lord’s bidding and be cursed! A predator of children is no lord of mine!” Ser Brynden Blackfish Tully spat and thunder boomed. “The gods will never forgive that, the slaughter at the Twins, the murder, the treason, the mutiny!”
Ser Forley began to scream louder, “You call it what you want! You’re down there, we’re up here! You came into the wrong damn castle Ser!”
“Stand fast brothers!” Ser Tully alerted.
“Gods damn this, I am telling you this one last time. Order your men to drop their weapons to the deck.”
“So you could parade us as prisoners before executing us? I cannot give that order,” defied the Blackfish.
“I am not going to repeat that order!”
“I WILL NOT GIVE THAT ORDER!” Thunder boomed again.
“WHAT IN SEVEN HELLS IS WRONG WITH YOU? THIS IS USELESS!”
“STAND FAST!”
“ONE LAST TIME! ORDER YOUR MEN TO –“
“Ser Forley!” an unfamiliar voice called. “Queen Stark and her group are spotted. They are escaping on a rowboat at sea below. They appear to be heading west,” the watchman said.
Edwyn Frey’s voice commanded, “Archers, to the western edge! Kill them! Kill them all!!”
“BROTHERS! Kill the watcher first and anyone on that western edge!” the Blackfish thundered in the order.
A quick shoosh was heard above and a cry of pain immediately sounded from the west, as a body thumped and squished onto the lower muddy ground.
And suddenly the air was filled with it, as the thunderstorm raged on.
Shoosh shoosh shooosh shooosh shoosh ahhhhhh ahhhhh shoooosh ahhhh shooooshhh shoosh boom doom boom doom boom doom shooosh shooosh ahhhhhhh boom doom boom!
The heavens exploded from above, illuminating Olyvar’s drain instant after instant. Men were heard screaming and dying in agony. Whether or not it was his brothers or his foes, Olyvar couldn’t tell. He caught a glimpse of three bolts speeding above his small hole in different directions, and knew there were a hundred more he could not see. The enemy has the high-ground, Olyvar remembered, all my brothers are probably dying. He was unsure whether to descend down or ascend up the ladder into the chaos. He started to tear up, the cold rain still soaking his face as lightning continued to flashed and thundered through the pit above him.
“GOOSE!!!” Leo’s voice screamed. No!
“LEO TAKE COVER!”
“KEEP LOOSING BRO—AHHHHH!”
“FATHER!!”
“BROTHER, NO!!”
“TO THE WEST! LOOSE! LOOSE! LOOSE! PROTECT YOUR QUEEN!!!”
“I’M GOING TO KILL YOU ALL YOU MOTHERFUCKERS!!!”
Men were still crying up there, along with the bass of the approaching storm, blending with the streak of arrows and bolts hitting stone, mud and flesh. Still clung to his ladder, Olyvar looked down cowardly as a teardrop fell off his face. It landed on Alesander.
“You fool, what are you doing here? You left the rowboat?”
“I came back to fight.”
“You are no fighter, you are a singer. Leave here. Escape into the tunnels and save yourself my brother.”
He hesitated to answer, his own tears trickling down. “Aye, I will. And when I leave here, I’ll sing about what has happened today, what is still happening above us.” The screams were not stopping. Bolts, arrows and curses could still be heard flying above. Alesander moved towards a fissure in the cavern wall, spying to the west. “The Queen should be far out of harm’s way. The winds are kind, and the bolts are missing its mark away from the LionsJape.” He walked back to him. “Come with me Olyvar if you want to live.”
“Soon. But not yet. I need to hold this ladder. Leave my brother. Sing about this and immortalize our sacrifice.”
“Don’t go.” He grabbed Olyvar’s leg.
“Just let go of me!” Olyvar winched free.
“If you can escape, escape. I’ll fly away now. Farewell my honorable brother.”
“Wait!” Olyvar almost forgot. “Do you know what it is?”
His brother smiled a smile that Olyvar will never forget. “We have a Stark princess.” His footsteps faded into echoes as Alesander descended into the darkness of the tunnels.
But Olyvar began the climb in his. The hole above was gaping wider with each slow step up, ready to swallow him whole. Olyvar trembled. Besides the flashes of lightning, he could not see what was going on, but he could feel it in the air. He can taste the rain from above. He can hear the music of defiance to House Lannister, the sounds of arrows and loud screams drowning into silence. He can even smell it too. The smell of the Rock cooked with the salt of the sea, the iron of his brothers’ blood, the piss & stool of honorable dead men, staining & stinking the courtyard of Tywin Lannister’s home, leaving Casterly Rock an empire of shit.
He stood on the one rung that exposed his head just above the ground. Bodies. Brothers’ bodies and bolts everywhere. Rain and blood soak the mud, and fading cries of pain filled his ears. He saw the Queen’s uncle and master schemer of this plan, Ser Rolph Spicer, had a bolt in his eye as he died by the kitchen doors. The Seashell Knight was lifeless with his face first in the middle of the mud near Olyvar’s pit. Donal with bolts to his shoulder, stomach, and legs was on one knee shouting & cursing as he continued to loose arrows from three quivers as his brothers Raff & Mikkal laid dead beside him. Lord Glover had two bolts in him and took another in the chest. He paced backwards and fell over the parapet into the sea. A bolt was stuck on Goose’s neck, as he and Leo rested motionless together at the foot of a column, sharing a single bolt that shot through their hearts. The shield that Leo had held up was decorated with a dozen bolts, but it was too late for the other ones that got through.
Olyvar’s soul ached in agony, the clutch of his hand shaking as he clung onto the ladder. A small pile of feathered Lannister men had fallen from the western balcony and onto the courtyard. But he could not feel the victory in it … not now, nor not yet, perhaps never. The rest of his brothers Olyvar could not see from his ladder, but he spotted a few arrows still loosing up to the second floor behind cover, still fighting back. It is so few. Many more bolts were still shooting down from the top. Crossbowmen hid as they reloaded, popping up to release before ducking again.
He spotted Ser Brynden Tully the Blackfish crawling towards him, needled like a red porcupine blowfish. “Olyvar!” He hooted bluntly. “Why are you still here?” Olyvar’s heart quenched at the sight of the blood of Riverrun; his pink life flowing in a thin river and draining out towards his ladder. The water-downed blood reached Olyvar’s fingers. He wanted to help but did not know how, nor know the words. He offered his hand and Ser Tully held it. “Did she make it out to sea?”
“Yes Ser, she should be safe,” Olyvar prayed.
“So, do we have a prince or a princess? Or one of each? Heh!”
“Do not get greedy Ser,” Olyvar jested. “We have a she-wolf.”
The Blackfish smiled a hard smile with blood filling his mouth. “Good, they should be safer this way. And I hope she takes after her fierce grandmother.”
“Which one? Lady Catelyn Tully?”
“Of course heh. That would be a great granddaughter name for our storm-born she-pup … Catelyn,” the Blackfish joked.
Olyvar smiled while Ser Tully reciprocated a red one. “I like the name Adara.”
“Adara? That sounds like a wonderful name. Where did that come from?” Ser Tully asked, tearing and bleeding.
“It was Captain Samullu’s mother’s name.”
“Aye, that is a terrific name. Princess Adara Stark. Tell that to our Queen Jeyne that I concur to the name choice, pass that final message of mine. Now fly along Ser Olyvar, escape here, reunite with your Queen and protect your family. There is nothing left to do here but die, so fly! Let the divine swift winds of winter push Adara to safety. You have King Robb’s spirit within you. The babe does not have a father nor Grey Wind, so you must keep her safe.”
“We are all her fathers,” Olyvar declared.
The Blackfish grinned, knowing Olyvar probably out teased him in his final moments. “No … a band of fathers brothers? That would make us a band of uncles.” He chuckled bloodily.
Olyvar laughed and teared a drop. “That was a very clever. Just don’t tell Lady Mormont.”
“Don’t worry fellow Uncle, I won’t.”
“It has been an honor fighting by your side, Ser Uncle Brynden Tully, the great Blackfish.”
“It has been an honor living by yours, Ser Uncle Plumber Knight,” the legend replied.
He watched the knight’s life wash away, his last breath tasting the rains of Casterly Rock. The legendary Ser Brynden’s last words were for me. Wells flooded in Olyvar’s eyes, beginning to blind. He lets go of his hand.
He takes a few steps down the ladder, and then suddenly stops. What honor is this? Leaving my brothers and my commander like this? Am I a little cowardly rat of a ratty family, hiding in a tunnel? Or am I a brave knight?
The thunder and rain continued, but the arrows have stopped. Nothing but silence, only stares if Olyvar had to guess. His brothers were all dead. I need to get up. One step up and he suddenly stopped again. No, I need to escape and protect my Queen, does that make me a coward?
He checked his pocket and made sure his letter to his father sat below his heart. It was still there. Olyvar’s grip on the rung was firm and quivering.
To flee or not to flee? That is the riddle.
“Soldiers! To the lower floor! Grab their bows and quivers. Get down that ladder, find a boat, chase Queen Stark and kill them! Kill them all!” Edwyn Frey’s voice ordered.
Well, that made answering the riddle a lot easier.
Ser Olyvar Frey ascended from the pit of his ladder, his arms pulling, legs pushing, up and up into the chaos. The thunderstorm loomed above as his soul was escaping into the hole that was gaping wider with every step. He was ready.
At the ground level, he stood up. Cold rain and warm tears danced down his face, his cloak whipping in the air to the winds, his heart and fists began to fill with fiery rage. From up here, he can see the full horror of the slaughter. Brothers with bolts. Was this the same scene of my King’s death? Before he could ponder any further, he unsheathed Honor from his back, the sword was singing off its scabbard just as a bolt of lightning ripped across the sky … its twin mirrored off the steel’s reflection, the blade alive with blinding light for an instant.
Ser Olyvar counted the ill-fitted armored and shield-less men as they came pouring out from the kitchen doors at his level. Two, three, four, five, six … seven. Thin white stripes splits the sky. His heart was thumping and rumbling to the same beat of the thunderstorm that was mumbling in every distance.
I’m going to fight them all, no soldier in any Seven Kingdom army can hold me back!
The distance between the first unarmed man closed. His shocked face eyed Ser Olyvar’s new twin tower sigil on his cloak. Confused, he began to slow down, but Olyvar sped up. He greeted him with a deep slash, ripping him off as the skies flashed again. He darted forward to the next man, allowing the first one to take his time dying behind his back.
The second reached for his sword but was too slow to the draw. Honor found the front of the pink man’s chest and the rear of his back. For a heartbeat, the bloody front half of the exposed steel glowed damped red, while the clean side sparkled in purple. Olyvar pulled back his sword after a twist, and the soldier dropped to his knees to the boom of thunder.
The third drew his sword halfway before Olyvar swung at his head as his steel electrified, emitting blinding light to his eyes. He smelled Honor up close with his nose, as a gash ran from ear to ear while teeth and tongue exploded in the air. Olyvar paid him no more mind.
The fourth with panicked eyes was just a boy. He successfully drew his weapon from his belt and lifted above his head a short wooden stick. A flute? He stared up at his own wind pipe as his sword rested in his scabbard untouched. Between his legs, his breeches began to darken more with moisture, as the rest of his body was frozen like ice. A fLuke? It doesn’t matter. The Plumber Knight began to raise Honor high. The boy cried out, “Mother have mer—“.
“No,” Olyvar cuts him off, his voice was cold as stones. “I am not your mother.” Honor fell in a bright silvery-blue arc as the force of the blade severs the soldier’s right stick-bearing wrist, and splits the skull & brains underneath. Ser Olyvar Frey kicked off the mayhaps-fourth-corpse as its limp body slid from his red wet steel.
The fifth one was ready with his sword, as the sixth and seventh began pincering around Ser Olyvar with theirs. The rain began pouring heavily, cleansing the blood and brains off Honor, ready to shine again.
Olyvar’s wits returned from his blind rage, and began backing up calmly before they could surround him. The rear of his heel tapped a fallen shield that once belong to one of his brothers. Olyvar grabbed it instinctively and raised it up. “Come on you apes! Do you want to live forever? Come at me then!” No one came forward to answer the riddle, so Ser Olyvar went to them.
He charged at the one on his right as Honor slashed and flashed, but the soldier jolted backwards avoiding the swing. The shifty swordsman slipped on the surface with his hop and fell face-first into the mud. The other two took their chances when Olyvar swung and missed. He caught the cut of the left soldier on his shield, as the middle fighter aimed high. To the ground, the knight ducked under, saving his head. The middle slugger lost his balance at his empty decapitating slice, and a crouching Olyvar stroke savagely at his knees in a splash of red and bright purple. He fell face-first too, as the other soldier on his left began hacking at the wooden shield that Olly held up. Doonk! Doonk! Doonk! Before his challenger could swing a fifth time, Olyvar Frey on one knee whirled the apex of his shield viciously at the man’s wrist and sent the sword flying from his hand. Without hesitation, the Plumber Knight stabbed upwards from crotch to brains as the steel surprised the man with shock. Olyvar stares into the white of his eyes as they reflected a flash of lightning. The eyeballs then slowly rolled up into the back of his head. He unsheathed Honor downward from the dead man, as blood and shit fell like loose stool to the ground.
The other fighter with no knees rolled around to face up before he could drown in the mud. He was crying and screaming on the ground. “Nooooo!” But the Plumber Knight jumped on him without mercy. He tried to dart and evade, but forgot he had no knees to push from. Olyvar’s feet stomped the man’s stomach as he thunder-slammed the edge of his shield to kiss his opponent’s mouth, silencing him forever.
The first armed man that dodged his death finally got up from his struggles with the slippery ground, only to meet at it again. Soaking in mud, he began to bull-rush Olyvar, trying to stab or slash an opening with his sword. Olyvar dashed towards him in squishing strides, and took his charging strike at his Brother’s shield as he stepped aside. The former squire of Robb Stark, Olly, instantly planted his foot and twirled. His Queen’s wet cloak spun and smacked his opponent’s head. Suddenly the Plumber Knight had the enemy’s rear and naked. He lifted his King’s sword up, pointing down with both his hands on the grip. Ser Olyvar and thunder roared together as Honor brightly stabbed from above into the mudman’s back with the flash and fury of the gods. “AHHHHHHHHH!!!”
He lifted his sword back up as the seventh corpse fell to the ground, face-first again. Suddenly a mosquito buzzed from behind his ear and a short wooden stick skidded off the flat stone-path in front of him. He then felt a bite in his back, lost a breath and saw another wooden rod. But this one was lodged in his right breast. Red blood slowly began to seep from his black scaled boiled-leather armor as he grunted in pain. He reached for the stick trying to push it backwards from where it came from. Quickly he felt the pain again as he saw another bolt stab the front of his stomach while his Brother’s shield slid off from this left forearm. The third one struck the side of his left thigh, sending Ser Olyvar to the ground on one knee. He braced on his King’s sword to keep him from falling flat.
“Cease fire! Cease fire!” Ser Forley Prester ordered.
Cold rain danced on his face with the warm tears he tried to hide, his cape was flapping in the wind, and his heart was thumping quicker in unison to the beat & the flash of the storm. Ser Olyvar Frey, you honorable fool, why did you rush in? You can’t help yourself falling in love with bloody vengeance for your fallen brothers and King? For an instant, lightning popped again above the Rock and thunder rolled. You should have taken your time killing them as they descended down your pit, instead of you going up the ladder to their chaos. Frey blood, -no … blood of Roses By another name welled from the bolts that had punched him. He had known nothing half gallant and half stupid at the same time for what he just did. Or at least you could have flown away, such a fool! You should of just beat it. No one wanted to be defeated like this. Why did you have to show off how funky strong your fighting skills were? At this point, it doesn’t matter who’s wrong or who’s right … you should of just beat it!
Ser Forley Prester spoke from his balcony above. “You must be the Plumber Knight that the Blackfish talked about, judging by the sigil on your cape. A traitor to your own family. But for the honor of your lord grandfather, let us pass and I will let the maester do his job to save you. Or would it please you Ser, if you wanted some more bolts?”
More? Olyvar twisted his mouth in defying silence, his gruesome wounds spitting out blood. He had a job that he promised to do. He must rescue his pregnant Queen. Little did he know, he had to rescue a princess from this castle too. We all died for Robb’s little girl, there was no more to ask of them. Did these uncles succeed for her safety? He turned around to the west to see as far as his eyes could see into the sun setting sea. Her boat was far enough from any archers, and soon it would be too dark for a chase. The thought brought him joy. Thank the gods for this swift divine wind. We did our duty.
Impatient for a reply, the shit knight said, “I will not ask again. Knight to knight. Let us pass. We need to take back the Queen and her unborn son. I will bring them no harm, you have my word. Drop your sword, bend the knee like you mean it, let us pass … and I will tell Lord Walder Frey what an honorable warrior and a great grandson you are.”
That offer was a lie, a conjurer’s cheap trick. They would just humiliate and shame him before executing him for treason. That was not the song he wanted, not for his despicable old father. Olyvar would rather die sword in hand to the tune of another. He wanted Alesander’s song about the Motherfunker, Ser Brynden “Blackfish” Tully, his real brothers and the band of uncles. And he had one last shot, one last opportunity, to seize everything he ever wanted here. In this one moment, can I still capture it? Or will I let it slip? His palms were bloody, knees weak, arms were heavy … but the Queen and Princess are safe. Mother’s mercy. He was nervous, but on the surface, he looks calm and ready to drop bombs. But he had forgotten what he wrote down in his father’s letter, as the crowds above goes so loud. He opens his mouth but the words won’t come out. He is choking. How? Everyone was joking now.
“Your luck has run out. The time’s up, it is over SER Olyvar. Bow.”
No. I refuse to BOW Ser. And I cannot die yet. There is something I still need to do. Both hands on hilt and pommel, he pushes himself up with Honor, surrounded by the doom above. He can feel his life leaving him. The skies blurred between light and dark, white and grey, with the black slowly creeping in.
“It’s a girl,” Uncle Olyvar said gently as he thought about his princess niece. The Plumber Knight then roared a roar that would put any craven into tears. “AND NO! YOU SHALL NOT PASS!” Honor rose and fell, the pointy end of his King’s sword squishing the blood soaked mud and crunching the rocks underneath.
KABOOOOOOOMMMM!!!
Instantly, lightning and thunder erupted above them at the loudest exploding caliber of the evenfall, blinding the sights of men and gods alike.
Uhoooooooooo! boom doom boom doom boom doom
Suddenly drums were beating, and trumpets were blasting from the east. Lord Gawen Westerling’s diversion! But they’ve come too late to rescue Olyvar and his brothers. The enemy did not divert to their last jape yet … their silent scared eyes still on the dying Plumber Knight. They began to reload their crossbows. This is my moment. The things I do for love, but I’m sorry Jeyne, I can’t do that. I can no longer keep my promise. Robb was waiting and I can finally rest again. We three will meet again together some day, but not today, he thought.
The band of drums, trumpets and thunderstorm blended into a sweet sad song that Olyvar wanted. This music is for me, and I will lose myself in it.
Charging up his final energy into his wounded lungs, he began to scream again.
“OUR QUEEN— ” A howl of blood cuts him off from finishing what he meant to say … our Family is safe.
“OUR KING—” A pool of iron filled and choked him before he could declare … we have done our Duty.
Still standing, he dips his chin low to empty his mouth, coughing out his mother’s Rosby blood. He needs to say his final words loud and clear. After the last spoon of blood poured down, he snapped his chin up towards the heavens and reality … ready for the gravity. With all the weight of his life, he pressed his King’s sword deeper into the Rock as the Plumber Knight thundered a roar, “OUR HONORRRRR!!!”
From below, Ser Olyvar of the disgraced House Frey faced off to the sad conflicted look of Ser Forley Prester with his garrison of archers beside him. The darkest gloom of the grey stormclouds had arrived and hovered above them, wet and heavy. The gods want their vengeance for the Red Wedding, he thought. The skies of Casterly Rock began to blacken with the rain of bolts and arrows. The only thing that could be seen is the single golden teardrop of the shit knight, reflected by the last light of the setting western sun.
BOOM!
Thank you everyone for reading! Thank you George for helping me with your clue!

So I was really feeling bad today was day 8 I could barely get out of bed, I’ve had muscle aches, a fever, chills, headaches nausea. I have no rash, tounge issues, sore throat, etc. I went to urgent care and they did a rapid mono test (the pricking finger blood test) and it was positive. I have been in a google hole about this because I’ve never had mono but before I was diagnosed today I was convinced I had HIV because I had unprotected sex and I guess they have similar symptoms. I’m a female- should I be concerned about HIV or could this really just be mono? Please give me your advice!!

My dog, Sweet Pea, is a 15 year old pit bull terrier. Until earlier this year, she showed zero signs of slowing down.
She yelped one day while doing a bit of play in the bed. (March 11th) After which she acted as if her leg was a little tender, but nothing terribly concerning. She's geriatric after all.
After a week of no improvement, we did a telehealth vet visit, and were told she most likely had arthritis. Suggestions of glucosamine supplements and fish oil were given, which was followed.
Still, there was no improvement. April comes and her thigh muscle becomes tense, her leg is up against her body. She is NOT holding it up. It requires force to move down.
A in person visit is completed, no x-rays done at time. She is diagnosed with an ACL tear, but I disagree because she passes the cruciate failure test. White willow anti inflamatories are given. Shows small improvement for a few days, then returns to the same.
May 10th. Comes out of crate after sleeping with severely swollen leg (50% larger than other leg). We are in a rural area and call to go to a better vet. First appoinment possible is June 7th.
June 3rd. Wakes up with SEVERE swelling in leg. Triple the size of the other leg. Leg is now straight down. Bears weight on leg, mobility severely affected. NO pain. Eating and drinking, playing, not lethargic, not dehydrated, no fever.
June 7th. Vet visit. Tentative diagnosis of osteosarcoma, pending x-rays on June 28th. Given carpofen for swelling, gabapentin as needed if pain. Kidneys and liver tested with good function.
Gabapentin has not been given. She's not in pain. I know a lot of vet owners won't see the signs of it. But truly she is not in pain. Willing to run on leg. Happy. Sleeps well. No panting. You can manuever the leg, squeeze the leg, palpate the leg and she'll sleep through it if asleep.
Carpofen given 5 times. And the mass is now no longer AS hard. It seems to be breaking up in spots, which (correct me if wrong) osteosarcoma wouldn't do.
But what else could it be? Could it respond this way if osteosarcoma. Please please help.
Images and videos of progression included in imgur link.
https://imgur.com/a/m7zmoD7

Species: cat Age: the shelter gave her an age that would put her at 8, could be older Sex: female Altered: yes Weight: 20 pounds
Hello, I’m posting this on behalf of my mother. She has a cat that is suffering greatly from stomatitis, we’re afraid we’re going to have to put her to sleep because she is suffering so greatly. She had a partial extraction of all her top teeth, intact lower tooth set. She’s been given steroids, antifungals, anti inflammatories, antibiotics, and they did an x ray of her mouth and said they don’t see anything of concern. Her top gums on her right side are badly swollen, she paws at her mouth constantly. She still eats but sometimes struggles. She strangely hasn’t lost any weight, only keeps gaining weight. She’s having trouble walking now. They are aware that she is overweight, we played with her constantly until she lost interest with the onset of the disease. Her food was also cut down significantly to try to get her to lose weight.
We really don’t want to lose her. Is there anything you would suggest for us to try so that she doesn’t have to be put to sleep?

My birthday is in october, but due to scheduling issues with family, my sweet 16 ended up happening mid-late november. I'm homeschooled and my parents dont like throwing parties, and I had to beg them for MONTHS to allow me to have a sweet 16 because for stupid reasons I cant remember at the moment, they didn't want to. So after weeks of pulling the "But [older sister's name] got one, so why can't i?" card, they finally gave in.
It was expected to be super big, and I even got my family from different states to come dow, which was a big deal because they never come down for anything. I invited all my friends, even ones I had a bit of a falling out with, but we're cool now, just not close like before. I'm homeschooled, so all of us are a bit awkward with each other irl despite meeting a few times.
The setup was amazing and me and my favorite cousins mapped out and strategized the best place to sit the night before, so we were all prepared. I gave them heads up on each of my friends and what to expect from them so that they dont worry. But even with all this, I was a nervous wreck.
I have selective mutism, which is a severe social anxiety disorder I was diagnosed with when i was in preschool, but have gotten a bit better over the years but it still affects me to this day. So I was feeling very overwhelmed but excited at the same time. I kept thinking "What if my family doesnt like my friends?" "What if my friends dont like my family?" "What if something goes wrong and drama starts?"
When the party started and my friends arrived, thats when it started going downhill. The things i worried about never came true though, I'll give it that. But things that didn't even occur to me, however, did happen. For example, I expected my friends to come sit with me at my table. None of them did. 8 of my friends sat at another table (I invited 9) and the only one who did sit with me was my best friend, who was the last one to arrive. And that was because I didnt even give her the chance to go over to the others' table, and plopped her right down at mine. Also, the friend who arrived before her, I offered her to sit at my table but she ended up going to the others'. (also forgot to mention, but some days after the party my bsf told me that they were inviting her to sit with them, but she declined. My friends never invited me though)
During the party, my table was the only one that wasnt full. That doesnt sound that big of a deal, but I have a past of people abandoning me and purposely leaving me out and developed FOMO because of it, so it was really triggering me.
I normally don't express my emotions, and I've gotten quite good at keeping a stoic look on my face, so much to the point where everyone thinks I'm "emo" (i have an RBF), but at the party, I allowed myself to show my sadness so my cousins could see it. I know that sounds pick-me, but I wanted them to see how it affected me without having to say it. They caught on too.
At some point in the party, speeches started. My aunt grabbed the mic and went to my family members to give a speech. It was okay, as I had asked this for my party a few months prior. However, it was going on for so long and what I thought would be like 3-4 family members turned into closer to 20. I became so embarrassed and I made sure to show my facial expressions to my cousins, while also trying my best to smile so I didn't look mean.
When the speeches were over, I felt a sense of relief. Until my aunt grabbed the mic and announced a "special dance" to take place. I immediately knew what was about to go down as she called up my dad and announced for a surprise father-daughter dance. I turned to my cousins and gave them a pleading look as my dad came over to my seat, but I knew they couldn't do anything. And they knew it too. I felt like I was gonna have a full breakdown in the moment. I was so embarrassed and helpless.
I know I sound bratty, but I don't like being the center of attention unless asked for it. That's why I told my mom that one thing I do NOT EVER want is a surprise party. I also hate dancing in front of other people, as I know I'm bad at it. So this was a nightmare. We made it to the dance floor and I turned my stoic phase back on to shield the tears I could feel coming if I didnt.
My memory of the dance is quite foggy, I wonder if my subconscious did that on purpose because it was too painful for me, but I do remember at one point my dad pulled me close and for a second, I felt comfortable and calm. That was until I remembered all eyes are on me, and I pushed away without thinking.
After the dance was over my dad made his way back to his seat and I stood there like stone. Idk why, but when I'm overwhelmed with emotion I freeze. It's almost like if I move, it makes the moment too real. And so I stay frozen. I knew I couldn't stay there for long though bc that would be awkward.
My aunt came over and asked if I was glad she kept it short, because my other aunt wanted it to be a long dance but she said no. I didn't respond. She also asked if I needed anything, and I told her I needed to go to the bathroom and asked if she could go get my mom. I really needed her in that moment. She sat me at a nearby chair and I didnt want my friends to see me sad, because then they'd come over and try to comfort me. And I didnt want that. So I went for a sort of bored look so they wouldnt be concerned.
My mom came over a few minutes later and walked me to the door, then two of my cousins ran over and asked what happened. I told them I'm fine, but it wasn't convincing because my eyes started welling up with tears despite the smile on my face. My mom impatiently assured them that I was fine and led me out the door. We went into the hallway and hid behind a wall. My mom checked if anyone could see us, then she turned to me and started scolding me. She asked me why I was crying, but not in a worried way, in an irritated way. I was trying to tell her that it was all so overwhelming, to which she replied "Well it's over now!" all mad. she scolded me for about 5-10 minutes I believe, which felt long in the moment. When I was finally done crying she took me to the bathroom to clean myself up. My mom then told me that when we go out, if she looks over at me during the party and I'm not smiling, I'm gonna get it.
As we were leaving the bathroom, one of my friends (we'll call her P) happened to be entering the bathroom and asked if I was okay. Remembering what my mom said, I smiled and told her I was alright. When I made it back to my table, one of the two cousins from earlier asked if I was okay, and I smiled and said yes. I could tell she didn't believe me but she didn't press any further.
The rest of the party my parents told me to go be with my friends, but I didn't want to because I felt that they didn't want me there anyway. Still, I did what I could to be near them. Pulling up a chair, standing by them and asked how they were doing, but I could tell they weren't all that interested. I looked clingy. And I have a thing where if someone doesn't want me around, I'll avoid them because I know what its like to have someone bothering you after you made it clear you want them to go away.
Towards the end of the party, my friends wanted to go to the nearby park, and my best friend came over to tell me, and said she wanted to wait for me and the others already left. I told her that I cant go, because I would be ditching my own party, and she understood. The others still left though. That wasnt that big of a deal, but it still left a bitter taste in my mouth.
And the last bad that that happened at my party was when I was playing hot-hands with my cousin and we were standing right next to my friends. All of a sudden, I noticed in my peripheral vision that my friends were gone. I looked around, assuming they all had to leave and forgot to say goodbye, when I spotted the. All 9 of them at the photobooth. and they were taking a group picture without me. My cousin noticed my sudden change in expression, and looked where I was looking. I watched as they all took their group photo smiling and happy without me. I changed back to stoic as I saw them finish up and my best friend walked back towards me. the rest of the night was a blur, but next thing I know, I'm standing outside as everyone starts leaving and I watch my friends head to their car. I yell out a goodbye, but none turn back to me. I make a joke to one of my cousins saying "wowww they dont even say bye to me? such fake friends!" (i was joking though, not serious).
I was riding home with my cousin, but her parents were helping take everything down, leaving only me and her in the car. I started crying and bawling my eyes out in the car. Then when I got home I was crying in the shower. I know that on paper, my (bitter)sweet 16 wasnt that bad. The party itself was amazing (except one of my friends later calling it "thrifty" and made a comment on how the DJ sucked... my aunt was the DJ), and I know everyone had so much fun, but for some reason its been 6 months and I still cant get over it. especially since the day after the party, I woke up with swollen eyes and a headache from crying all night. The cherry on top was my parents scolding me for hours about how I ruined my own party and humiliated them, and i made thousands of dollars go to waste.
I dont know what to do or why Im so hung up on this event. Im suffering from maladaptive daydreaming bc every single day I daydream about the party going differently. And secretly, I've lost so much trust in my friends over this stupid party, and hold a bit of a grudge over them for it. My friend who didnt attend the party told me how unhealthy it is that im still moping over it, and he says my party just sounded like an average family reunion. And said that if the party happened last week or a month ago, it would be understandable. But 6 months?? But yeah, anyway. Can anyone please tell me how I can heal from this? I'm so sick of being easily hurt and dramatic

I’ll keep this as short as possible. 2 years ago I needed some work done. Upper right back teeth needed work, I ended up getting root canals on two teeth side by side.
I saw an Endodontist for the root canals and a general dentist for the crown and placement etc.
Since the crowns were placed, I have had pain, swelling, bleeding, and sensitivity in that area. The space between these 2 crowns is very narrow (according to the dentists) and is always swollen and painful.
I went back to that general dentist with complaints of the ongoing pain. They did thorough X-rays and found nothing wrong. They agreed that my gums were inflamed. I asked them if the crowns could possibly be slightly misaligned or something? They said not really and stated removing them would be next to impossible.
I went back to the Endodontist who also did X-rays and like a special 3D scan and found nothing wrong. He pinpointed the area of pain but was puzzled about it. He suggested maybe inflammation from all the work done and prescribed antibiotics and special mouth wash. For a couple days I felt relief but it didn’t last long.
On to another dentist. (Specialist is too expensive). Xrays look fine. She did a cleaning and used numbing cream on the area and had to stop a few times because it hurt so much. she said rinse with hydrogen peroxide nightly. Here we are with the same problem. It’s been 2 years and a lot of money. Since every xray is fine, maybe it’s just my gums?? Im ready to take a scalpel to the area and just cut it out of my face.

I was given a 2 week dose of SMZ/TMP for what I'm hoping is either a very pissed off UTI or prostate infection based on my urologists assumption after certain STI testing.
I'm 5 days in on a 14 day prescription, and about two days in I've had a slight sting to the left side of my neck. Similar to when you get a throat infection and it hurts your lymph nodes when you swallow. I've checked my lymph nodes and they're not swollen. I mean, they probably are now since I keep pressing them.
It's just on one side and it only happens when I drink cold drinks or something acidic, along with a feeling of slight tight discomfort at the lower end of my esophagus that is probably a trailing side effect of Doxycycline. It's not very painful, but more of an annoyance. The wiki says to go see a doctor if you experience a sore throat, but I imagine that's more if the throat is feeling simliar to like strep and is painful to swallow in general or just painful, right?
I've also found myself somewhat feeling like I have a fever, but have checked and temperature is perfectly fine. I don't really have chills either, it's just a feeling of exhaustion or off feeling. Also my mouth has felt super dry since I got on this stuff. Can't drink enough water to keep my mouth/throat hydrated.
I'm not gonna stop taking it , of course, but I want to know if other people have gotten weird side effects from this as the "common side effects list" online is massive haha. Apparently it's a pretty strong antibiotic.
All this to say that none of the side effects are "major" or bothering me enough to stop or go to the doctor. They're all just kind of light for the most part, but I've never felt a medication do the whole "fever" feeling. Usually I feel something similar to this when I actually have a fever and take something to kill it off.

Intro:
I'll begin by saying that I'm one week in and feeling good. Better than I've felt in years. However, for some reason, I'm not entirely convinced and find myself constantly waiting for the other shoe to drop. I'm afraid to become overly optimistic.
Short Background:
I've been struggling with depression since mid-2020 but only started seeking help in late 2022. In late 2023, I was prescribed Wellbutrin as my first medication. One of my biggest challenges with depression has been chronic lethargy. At first, I appreciated Wellbutrin for the increased energy it provided. Unfortunately, this energy came with severe nervousness, frequent panic attacks, insomnia, and a persistent sense of impending doom. These negative side effects far outweighed the slight boost in energy. It's also important to note that I didn't experience any anxiety-related issues before starting Wellbutrin. I've recently discontinued Wellbutrin and have started taking Lexapro.
Dosage:
I was prescribed 2.5 mg of Lexapro for the first week, followed by 5 mg thereafter.
Symptoms:

1. Nausea - This has persisted since day one.
   
2. Drowsiness - Reminded me of high school after smoking a massive blunt. I slept the first three days except to occasionally get up for food and water. Muscles felt heavy. Breathing slowed down. Pillow felt amazing. By day four, this feeling had significantly diminished.
   
3. Munchies - This goes with number 2. Feel stoned and want all the most most greasy foods. Still have the cravings but my willpower to eat health came back on day four.
   
4. Dry mouth - This was really bad but subsided after the first two days.
   
5. Neck swelling/Headache/Increased Anxiety - These symptoms appeared a few hours after taking the medication during the first two days, but would only last for 30 minutes to an hour before being replaced by an overwhelming sense of peace.
   

Current State:
Aside from the previously mentioned side effects, I've primarily felt a general sense of well-being, which is a stark contrast to how I've felt over the past few years. Situations that triggered panic attacks on Wellbutrin now feel entirely manageable. The insomnia I experienced on Wellbutrin has completely disappeared; I can now tell myself I'm tired, lie down, and fall asleep. This improvement is significant. When I wake up, I feel rejuvenated, which never happened on Wellbutrin or before. Previously, no amount of sleep alleviated my fatigue. On Wellbutrin, I constantly felt like I was trying to catch up on missed sleep. Now, my desire to engage in activities I enjoy is returning, and I have the energy to go outside and exercise again. I do feel moody at times, but it seems like I'm experiencing emotions that were long suppressed, which feels appropriate. So far, the side effects have been minimal, and the positives are promising. However, I'm a little worried about increasing my dosage after a successful first week. As I mentioned earlier, I feel like I'm waiting for something to go wrong. Has anyone else experienced this? Can I dare to believe that this medication might be the one? I'd appreciate any thoughts and experiences you might have. Otherwise, thanks for reading this far. I hope we all find our way to a better place.

It’s kind of hard to explain but my tongue gets kind of stuck to the roof of my mouth when I initiate it
Pls help me I’m getting fed up

Summary: Vessel has the worst headache of his entire life and Laughingstock tries to comfort him.
He was used to headaches, left over from when the ship spoke and his mind was jolted with searing hot-cold, tearing at his temples. He was used to those, even if they were dreadful. The kind that felt like a knife was slowly being pressed into your temple and burning the nerves and corneas of your eyes.
A few minutes ago, he’d felt himself wincing more than usual, a dull hurt that he was well used to. The hurt then turned to a pounding he couldn’t even brush off like usual, mainly because since then, the pounding turned to dull drumming that had grown louder and louder in sync with his heart to the point where he couldn’t just ignore it. The usual flashes of pain, left over from when the ship spoke, were amplified by it.
Pressure seemed to be the only thing that eased the pain, even by a little bit, as he’d discovered. He had been sitting here for what felt like an hour now against one of the wooden walls, ankle-deep in seawater, hands pressed against his temples, eyes squinted shut.
"Hello?" A voice came from around him. "Are you in there?"
That voice. He recognized that voice.
And strangely, his mind wasn’t being jolted, and the words he was hearing were coming from his mouth. Instead, they boomed throughout the space, causing him to jump and for his hands to release his aching head, causing a fresh wave of pain to sear through his cortex as the consequence of He groaned and pressed this back, his breath hitching in momentary relief.
It was the ship. It was the voice of the ship, Ed Wynn-sounding and all.
And it was talking to him this time.
"Hello...?" the ship said again after a little bit.
He didn't understand why the ship was just now talking to him. It was clearly aware he was inside it, was clearly scared before, but...
Surprise turned to disdain and anger that pulsed through whatever veins he had left. Again why was the ship talking to him just now? Had it finally noticed him in here, struggling to breathe and choking on the seawater it swallowed and the salty air it breathed. Had it come to taunt him?
"You..." he rasped. "YOU!" His attempt at shooting up and banging his fists on the wooden walls faltered and left him on his knees. A hot wave of dizziness and vertigo washed over him, along with a fresh pulse of agony. He still needed his hands to at least pull himself to the same sitting position as before, aware that relief in pressure would none in pain, so the same burst of knives speared at his skull again, only briefly.
"Y'know," the ship quipped. "You oughta tie yourself to the floor. You might break something shooting up like that...and by 'something' I mean part of you or part of me." A laugh. Clearly it was trying to put humor into the situation. Laughingstock indeed.
"YOU DID THIS!" He screamed through the pain. It had come to taunt him! Just to guffaw at his misery!
"I know," Its voice suddenly turned somber and regretful. "I know."
Feigning regret. The anger began to ebb, but not by much. He wanted to scream, to scream about how he wanted to go home, how he missed his wife and kids, how every day was pure torture, serving as the living force behind this blasted ship.
Another hot wave of nausea washed over him and he couldn't prevent the groan that came from him echoed through the space as he squeezed his eyes shut again. The pain speared at his brain like a blunt needle.
"Are you alright?" the ship asked, sounding startled. Concerned. Taken aback.
"Yes," That was a lie, obviously. What was he doing? Talking to the thing that was keeping him trapped, the reason for
"Then why'd I find ya curled up on the floor?" It pointed out.
"Why?" he asked it. "Why do...why do you do this?"
It sighed. Wait, it could sigh? Why did it sound so...sad and regretful? "I wish I knew."
A pit began to form in his stomach. As he opened his mouth, the pit suddenly rose, as did the pressure in his head. He lurched forward.
"WAIT!" The ship exclaimed. "Don't-"
Too late. At that point, without warning, he'd already begun to gag and cough.
The only thing allowing him to hold back his pained tears as he choked, coughed up, and spat out salty smelling, gray-blue bile was the fact that the ship couldn’t actually see him hunched over. After his last gag proved ineffectual, he let his eyes fall shut once more. As unpleasant as it had been, it actually relieved a bit of pressure in his head.
He sat back, head still pounding.
"Couldn'tcha at least...do that before I even started talking to you?" The ship quipped again, clearly a little annoyed.
He noticed the water that had previously been up his ankles had dissipated by now, as it often did, and the bile sat in a gross pile, melting into the floor.
"Are you sick?" It asked.
"I don't know," he responded. "Maybe thanks...to you."
It sighed again.
"I know. I wish I could help more, but I'm..." it trailed off, seemingly struggling to find the right words. "...I...I'm just worried about ya."
Worried? About him?
"W-why?" he rasped again. Did it pity him? "Why now?"
“Why wouldn’t I be?” Another pause. “I mean…I don’t know how long you’ve been in m-in there, but…I gotta be honest, I’m…I’m as scared as you are.”
“You…you are?”
A “mm-hmm” type noise. "I…I’m actually glad you’re here, y’know?”
“W-” he coughed. “Why?”
“I…” the ship’s voice suddenly took on a quiver. “I just...don’t like being alone. With Percy and Janice...whenever they're not here, it's...it's like I'm not here."
It broke off with a sharp inhale, as if choking back emotion, before continuing.
"Maybe...maybe one day we'll...finally be freed and we won't have to deal with eachtother anymore." A bitter chuckle. "Even if you don't want to keep doing this, I'll still be with ya. You...you do know that, right?"
"You...do?" He didn't exactly know how to respond. "You mean that?"
"Of course!" the ship said cheerfully.
“We…” he rasped. “We…suffer together?”
A laugh. “If that’s how you see it…” It laughed some more.
It had helped ground him and rid a bit of the sickening trembling he felt. Though the pain of his headache still agged at his mind, threatening to tear it apart, maybe things would be a bit more bearable.
Maybe they really did suffer together.
"No...NO! I'M SORRY! the ship screeched out of nowhere, not directed at him but someone else. "I'M SORRY! I'M SORRY! NO! PLEASE!"
And then it went silent, perhaps for the final time...for now. Hopefully it would come back later.
At least someone understood his pain.
Even if it was the one keeping him trapped.

The blaring of the fire alarm woke me from my sleep. I swore loudly as I dragged myself out of bed. The alarm had been malfunctioning since early evening and this was the third time it had gone off since I had decided to go to bed for the evening. Each time I had checked everywhere for any sign of a fire and each time I had found nothing. The landlord would not come to fix the problem until the next day and I was not willing to take the risk of taking out the alarms.
So it was that I decided to put on my housecoat, grab a blanket and head out to sleep in my car for the night. Perhaps this was not the best idea. Perhaps I should have gone to a hotel, to gone to stay with a friend. However, I was exhausted both from lack of sleep and the previous days’ work, and my brain was not really working at full capacity. As such, I decided to sleep in my car. If I had known what would happen I would probably have just tried to suck it up and sleep through the fire alarms.
Needless to say, trying to sleep in my car was no fun. It was hard to find a comfortable sleeping position and, even with my pajamas, my housecoat and the blanket, it was cold. I am pretty certain that I spent at least two hours uncomfortably laying in the driver’s seat, trying to sleep and getting increasingly frustrated with my inability to do so.
At that moment, it started to rain. It had been overcast for most of the previous day and the forecast had been for overnight showers, so I suppose I should not have been surprised. Nevertheless, it came as a shock when I saw the flash of lightning and, about twenty seconds later, heard the thunder, followed by the tap, tap, tapping of raindrops on the roof of my car and on the windows. The already cold weather got a little bit colder and I contemplated going back inside, but then I heard the distant sound of my fire alarm once again going off for several seconds before stopping and decided not to do so.
And so I remained where I was. Lying in the driver’s seat of my car, a decidedly uncomfortable position. Clutching my blanket to myself and trying in vain to escape into unconsciousness, to ignore the discomfort of my impromptu bed, the discomfort of the cold, the sounds of the thunder and the tapping of the rain. And deep down inside, I felt, though trying to suppress it, the slight gnawing sensation of fear, a deep-buried, primal fear of the storm outside, the sort of fear that most can ignore, sheltered behind walls and doors when the bad weather comes out, but from which I had only the limited protection of the metal and glass box which I normally used for transportation but which had now become my shelter.
It was at that moment that I heard another tapping. At first I could not distinguish it clearly from the raindrops but eventually I started to tell it apart. A light tapping, regular and persistent, coming in a sequence of three, then a pause, then another sequence of three, then another pause, then another sequence of three, and so on. At first I tried to convince myself that it was nothing, just the rain. After a time, however, I could no longer convince myself of anything other than that somebody must be on the other side.
Part of me thought that perhaps it was somebody who needed help, or maybe someone who had noticed me and had gotten worried. I thought for a moment that perhaps I should look and see if one of these things was the case. However, the other voice in my head, the frightened one, was stronger and overruled in my thoughts. I wondered if perhaps it was a burglar, or someone on drugs who might attack me. And deep down inside, I feared something else. The persistence, the fact that there had been no interruption to the regularity of the tapping, the fact that nobody had called out my name and, possibly, something else, all made me wonder what could be on the other side of the glass. While the rational part of my mind told me that it was just a person or, more likely, a tree branch being blown by the wind or some such thing, some part of me, buried deep in my mind, feared the source of the tapping, feared that it might be something far worse than human, and did not dare to look.
But I did look, eventually. The tapping just would not stop and the worry would just not go away. I do not know how long, it felt like hours but it was probably not more than thirty minutes, all while the rain kept coming down. The tension kept building and building as the tapping would not let up and I clutched by blanket to myself like a frightened child. In the end, it was simply too much and I uncovered my face and stared through the driver’s side window.
What stared back at me was not human. A face, white as paper, oval-shaped and far wider near the top. The entire top part of the face was dominated by two circular, lidless eyes, solid silver glinting in the streetlight save for small black pupils rimmed by red irises, no nose and a wide mouth stretching in a grin from one pointed, bat-like ear to the other, revealing what must have been more than a hundred needle teeth. There was a strange quality about the apparition, which I do not know how to properly describe, something insubstantial, as if it were a reflection in a pond. Except for the eyes. Those were solid, silver disks with black pinpricks staring at me with hatred and nothing can convince me that they were not real.
As I stared at the creature, stiff with terror, the pale white fist that it had raised to knock once more stopped and opened slowly as the grin on its face grew even wider. Moved by a sudden realization of how much this thing resembled a reflection, I turned suddenly to face the passenger side, fearing that it might be in the car. Noticing that nothing was there, I breathed a sigh of relief, turning back to face the driver’s side window, only to see that the creature was on the other side of the glass, in the car with me.
I did not have time to scream before it was upon me, one hand covering my face, claws digging into the flesh of my cheeks, the other holding me down by my chest as its mouth filled with needle teeth opened wide, slowly approaching my neck.
I had accepted, in those seconds, that I was about to die, when suddenly the force of the creature’s hands bearing down on me seemed less solid, almost as if it were fading somehow. The expression in those terrible eyes which had been one of sadistic glee, suddenly turned to one of frustrated rage as the horrifying mouth which had been slowly approaching my neck rushed in that direction, as if the creature were desperate to finish what it had started. The needle teeth were barely able to break the skin, however, before they faded along with the rest of the creature.
After my attacker had vanished I looked about, bewildered, wondering how I had suddenly survived this attack. I noticed in that moment that the rain was beginning to die down. Looking out of the window, I even perceived a few stars. I was not able to register anything else, however, before I fell into a deep, dreamless sleep.
The sound of tapping on my driver’s side window caused me to wake, screaming, only to realise that it was my neighbour wondering if I was all right and why I was sleeping in my car. Tired from my poor night’s sleep put relieved that this had apparently all been a dream, I lowered the window and explained to him the situation with my fire alarm.
I was about to exit my vehicle and return indoors to get myself ready for work when my neighbour asked “what happened to your face and neck? Did someone attack you?”
I felt my spirits sink as I asked “what do you mean?”
“You’ve got scratch marks on your face and neck,” he answered.
Looking into the rear view mirror, I noted with growing horror the puncture marks and scratches breaking the skin where the creature’s claws had cut into my cheeks as it held a hand over my face and where its teeth had broken the skin on my neck. The proof that what had happened last night had not been a dream, that it had all been real. Struggling to come up with an answer, I simply mumbled something about having been fallen and scratched my face before returning indoors and calling in sick from work.
There is not much more to say, really. My landlord showed up that day and fixed the fire alarm, which worked fine up until I moved eight months later. I am living in a new place now and doing all right.
There are a few more things which I would like to say, however. I did some research about what had happened to me the day after this horrific experience, to try and get some explanation. Most of the results which I got online were related to sleep paralysis and night terrors and in truth part of me believes that that is what happened to me that night.
However, in my research I came across two news articles. One was about a woman found dead in her car one morning seven years before my experience, having died the night before. Her throat had been torn open and a wild animal was suspected of being responsible, even though her doors had all been locked and the windows were up. The front driver’s side window was shattered, though police investigation suggested that it had been broken from the inside. The other story was from twelve years before my experience. This was about a man who was fatally attacked one night. He was found by a pedestrian running down the street, clutching his bleeding neck, then collapsed and died before he could say anything. The man was found to have run from his car which was parked beside the road, and blood stains indicated that he had been attacked while seated in the driver’s seat. Both attacks had taken place at night, during heavy rainstorms, while the individuals in question were alone. I will not provide their names out of respect for the deceased.
Whatever attacked me that night, I think it can only manifest itself at dark and in heavy rains. I also think it meant to kill me and that I only survived by chance, from the storm letting up just in time. I also firmly believe that it has killed before and intends to kill again. This is a warning to everyone to be careful when alone at night in the rain. That is when it hunts.
For my part, I rarely go out at night these days and never when rain is forecast. I especially avoid driving. I furthermore have always shut my blinds when it has gotten dark or overcast ever since that night, and when it rains and I hear the tapping of raindrops on my windows, I never look in their direction, especially when I hear a certain regular tapping that does not quite sound like rain.

The blaring of the fire alarm woke me from my sleep. I swore loudly as I dragged myself out of bed. The alarm had been malfunctioning since early evening and this was the third time it had gone off since I had decided to go to bed for the evening. Each time I had checked everywhere for any sign of a fire and each time I had found nothing. The landlord would not come to fix the problem until the next day and I was not willing to take the risk of taking out the alarms.
So it was that I decided to put on my housecoat, grab a blanket and head out to sleep in my car for the night. Perhaps this was not the best idea. Perhaps I should have gone to a hotel, to gone to stay with a friend. However, I was exhausted both from lack of sleep and the previous days’ work, and my brain was not really working at full capacity. As such, I decided to sleep in my car. If I had known what would happen I would probably have just tried to suck it up and sleep through the fire alarms.
Needless to say, trying to sleep in my car was no fun. It was hard to find a comfortable sleeping position and, even with my pajamas, my housecoat and the blanket, it was cold. I am pretty certain that I spent at least two hours uncomfortably laying in the driver’s seat, trying to sleep and getting increasingly frustrated with my inability to do so.
At that moment, it started to rain. It had been overcast for most of the previous day and the forecast had been for overnight showers, so I suppose I should not have been surprised. Nevertheless, it came as a shock when I saw the flash of lightning and, about twenty seconds later, heard the thunder, followed by the tap, tap, tapping of raindrops on the roof of my car and on the windows. The already cold weather got a little bit colder and I contemplated going back inside, but then I heard the distant sound of my fire alarm once again going off for several seconds before stopping and decided not to do so.
And so I remained where I was. Lying in the driver’s seat of my car, a decidedly uncomfortable position. Clutching my blanket to myself and trying in vain to escape into unconsciousness, to ignore the discomfort of my impromptu bed, the discomfort of the cold, the sounds of the thunder and the tapping of the rain. And deep down inside, I felt, though trying to suppress it, the slight gnawing sensation of fear, a deep-buried, primal fear of the storm outside, the sort of fear that most can ignore, sheltered behind walls and doors when the bad weather comes out, but from which I had only the limited protection of the metal and glass box which I normally used for transportation but which had now become my shelter.
It was at that moment that I heard another tapping. At first I could not distinguish it clearly from the raindrops but eventually I started to tell it apart. A light tapping, regular and persistent, coming in a sequence of three, then a pause, then another sequence of three, then another pause, then another sequence of three, and so on. At first I tried to convince myself that it was nothing, just the rain. After a time, however, I could no longer convince myself of anything other than that somebody must be on the other side.
Part of me thought that perhaps it was somebody who needed help, or maybe someone who had noticed me and had gotten worried. I thought for a moment that perhaps I should look and see if one of these things was the case. However, the other voice in my head, the frightened one, was stronger and overruled in my thoughts. I wondered if perhaps it was a burglar, or someone on drugs who might attack me. And deep down inside, I feared something else. The persistence, the fact that there had been no interruption to the regularity of the tapping, the fact that nobody had called out my name and, possibly, something else, all made me wonder what could be on the other side of the glass. While the rational part of my mind told me that it was just a person or, more likely, a tree branch being blown by the wind or some such thing, some part of me, buried deep in my mind, feared the source of the tapping, feared that it might be something far worse than human, and did not dare to look.
But I did look, eventually. The tapping just would not stop and the worry would just not go away. I do not know how long, it felt like hours but it was probably not more than thirty minutes, all while the rain kept coming down. The tension kept building and building as the tapping would not let up and I clutched by blanket to myself like a frightened child. In the end, it was simply too much and I uncovered my face and stared through the driver’s side window.
What stared back at me was not human. A face, white as paper, oval-shaped and far wider near the top. The entire top part of the face was dominated by two circular, lidless eyes, solid silver glinting in the streetlight save for small black pupils rimmed by red irises, no nose and a wide mouth stretching in a grin from one pointed, bat-like ear to the other, revealing what must have been more than a hundred needle teeth. There was a strange quality about the apparition, which I do not know how to properly describe, something insubstantial, as if it were a reflection in a pond. Except for the eyes. Those were solid, silver disks with black pinpricks staring at me with hatred and nothing can convince me that they were not real.
As I stared at the creature, stiff with terror, the pale white fist that it had raised to knock once more stopped and opened slowly as the grin on its face grew even wider. Moved by a sudden realization of how much this thing resembled a reflection, I turned suddenly to face the passenger side, fearing that it might be in the car. Noticing that nothing was there, I breathed a sigh of relief, turning back to face the driver’s side window, only to see that the creature was on the other side of the glass, in the car with me.
I did not have time to scream before it was upon me, one hand covering my face, claws digging into the flesh of my cheeks, the other holding me down by my chest as its mouth filled with needle teeth opened wide, slowly approaching my neck.
I had accepted, in those seconds, that I was about to die, when suddenly the force of the creature’s hands bearing down on me seemed less solid, almost as if it were fading somehow. The expression in those terrible eyes which had been one of sadistic glee, suddenly turned to one of frustrated rage as the horrifying mouth which had been slowly approaching my neck rushed in that direction, as if the creature were desperate to finish what it had started. The needle teeth were barely able to break the skin, however, before they faded along with the rest of the creature.
After my attacker had vanished I looked about, bewildered, wondering how I had suddenly survived this attack. I noticed in that moment that the rain was beginning to die down. Looking out of the window, I even perceived a few stars. I was not able to register anything else, however, before I fell into a deep, dreamless sleep.
The sound of tapping on my driver’s side window caused me to wake, screaming, only to realise that it was my neighbour wondering if I was all right and why I was sleeping in my car. Tired from my poor night’s sleep put relieved that this had apparently all been a dream, I lowered the window and explained to him the situation with my fire alarm.
I was about to exit my vehicle and return indoors to get myself ready for work when my neighbour asked “what happened to your face and neck? Did someone attack you?”
I felt my spirits sink as I asked “what do you mean?”
“You’ve got scratch marks on your face and neck,” he answered.
Looking into the rear view mirror, I noted with growing horror the puncture marks and scratches breaking the skin where the creature’s claws had cut into my cheeks as it held a hand over my face and where its teeth had broken the skin on my neck. The proof that what had happened last night had not been a dream, that it had all been real. Struggling to come up with an answer, I simply mumbled something about having been fallen and scratched my face before returning indoors and calling in sick from work.
There is not much more to say, really. My landlord showed up that day and fixed the fire alarm, which worked fine up until I moved eight months later. I am living in a new place now and doing all right.
There are a few more things which I would like to say, however. I did some research about what had happened to me the day after this horrific experience, to try and get some explanation. Most of the results which I got online were related to sleep paralysis and night terrors and in truth part of me believes that that is what happened to me that night.
However, in my research I came across two news articles. One was about a woman found dead in her car one morning seven years before my experience, having died the night before. Her throat had been torn open and a wild animal was suspected of being responsible, even though her doors had all been locked and the windows were up. The front driver’s side window was shattered, though police investigation suggested that it had been broken from the inside. The other story was from twelve years before my experience. This was about a man who was fatally attacked one night. He was found by a pedestrian running down the street, clutching his bleeding neck, then collapsed and died before he could say anything. The man was found to have run from his car which was parked beside the road, and blood stains indicated that he had been attacked while seated in the driver’s seat. Both attacks had taken place at night, during heavy rainstorms, while the individuals in question were alone. I will not provide their names out of respect for the deceased.
Whatever attacked me that night, I think it can only manifest itself at dark and in heavy rains. I also think it meant to kill me and that I only survived by chance, from the storm letting up just in time. I also firmly believe that it has killed before and intends to kill again. This is a warning to everyone to be careful when alone at night in the rain. That is when it hunts.
For my part, I rarely go out at night these days and never when rain is forecast. I especially avoid driving. I furthermore have always shut my blinds when it has gotten dark or overcast ever since that night, and when it rains and I hear the tapping of raindrops on my windows, I never look in their direction, especially when I hear a certain regular tapping that does not quite sound like rain.

TW: Blood, kidney/liver issues, vomiting, sex stuff, etc.
I smoked prior to getting sick and off and on before my illness really took a lot out of me.
They're not sure what's wrong with me, but I had a period of peeing blood and fevers. Been tired for two years. Sex problems, peeing constantly, diarrhea, fatigue, fevers, vomiting without nausea, orthostatic hypertension, neuropathy and about a million other things.
I really want to smoke again because I'm stuck at home puking and feeling miserable. You can only play so many video games and watch so many shows. This was my dream like 5 years ago, but it's ass tbh.
I had some weird liver things and values recently, whatever it is seems to be hitting my liver like it did my kidneys a few months ago.
I want to smoke, but I'm concerned that if I need a transplant down the line it will affect my chances, I also have some serious diagnostic testing in August that I don't want to mess with. Do you all smoke marijuana with your stuff? Anybody with liver issues smoke?

31m, 5’10 155 lbs, scoliosis, moderate alcohol consumption. No meds.
Three weeks ago I was having some slight/moderate pain and discomfort on my right side. Location is just below and alongside ribs from just below diaphragm to even with bellybutton. It comes and goes and is normally mild but sharp. One spot in the upper portion that feels like something is swollen behind my rib. Like if I lay on my stomach, it feels like something is pressing up against the inside of my rib. Bloating is very noticeable (especially while standing) Also was having nausea.
Went to the doctor and he ordered some test. CBC, lipid panel, CMP and ultrasound of RUQ.
All blood work came back fine with the exception of slightly elevated bilirubin (1.2 with a Normal range of 0-1) and slightly low Creatinine (.8 with a normal range of .9-1.3)
Ultrasound of RUQ (liver, gallbladder, right kidney, portion of pancreas) came back as unremarkable.
Doctor said it was probably just some sort of stomach virus/bug and nothing to worry about.
Well three weeks later and I am still having the same symptoms minus the nausea for the most part. Still have the pain and discomfort and bloating.
Scheduled another appointment with him, but earliest he had was 3 weeks out.
In the meantime, any ideas?

Hey, I hope everyone is doing good.
First of all, I know that nobody here can identify my sickness, I am already going to a doctor but I am waiting for my next appointment so I wanted to ask if some people maybe had a similar experience until yi get some answers.
In the beginning of December 2023 I had a cold and decided to get some food from the Doner Kebab store next door. So I went out, grabbed my food ate it, took a Ibuprofen and went to sleep. A few hours later I woke up with Intense Nausea which didn't make me throw up but it kept me awake for 3 hours. I also had this weird pressure on my lower right stomach.
I finally managed to fall asleep and next day I went to the doc. They sad that it was just akute Gastritis, they gave me Omeprazol and send me home. Sadly everything went downhill from here.
2 days later I had diarrhea followed by Nausea and weakness again. It was so bad I had to go to the ER. They did a CT scan and an Abdomen MRI. They found signs that something was swollen in my lower right abdomen and kept me in the hospital for 1 more day but send me home because they didn't think anything of it. Sadly just a few hours after I was released everything started again and I had to go to another hospital where they finally decided to go for an Gastro/Colonoscopy. First they found nothing and they told me that I have to wait 3 weeks for my Lab results. These were hell since during the 3 weeks I had loose stools, Nausea and a lot of stomach ache. The lab results "only" showed H Pylori and mild Gastritis.
I had to go through 2 Antibiotic treatments and a really careful diet. But the Symptoms didn't go away. No doctor was helpful. I would always tell them about the pressure in my lower right stomach but they would always ignore it.
I got another Colonoscopy in may and they found something interesting. After my Colonoscopy the Doc came to me and told me that everything looks normal except, they found inflammation in my Ileum. Thes send it to the lab and I had to wait again for the results. When I finally got my results it just said.
"The inflammation is compatible with Crohn's".
I went to my normal Gastroenterologist who then said it can't be Crohn's because I had no chronic Diarrhea. He was right with the Diarrhea, it was very rare that I had Diarrhea and to be honest I didn't get to much stomach ache. He then told me that I am just anxious and stressed and that's why I am nauseous (I was really never stressed). He told me to eat whatever I want and that there was nothing wrong with me. He gave me Budenofalk 3mg for the inflammation which was found and told me to take it anyways.
I said to myself that maybe he was right. So I decided to eat normally again. I ate 1 cheeseburger and that night, was one of my worst nights ever. I had the worst stomach ache/cramps of my life. I couldn't move and it was horrible. The stomach ache didn't go away it took 5 hours till I was able to move again. I was taken to the ER and they told me to get an appointment this week at their local Gastroenterologist so that he can talk to me about this.
Has anyone else had similar experience where Nausea is really the main symptom of Crohn's ? I also have this weird pressure which sometimes really hurts on my lower right stomach and I have crazy amounts of weight loss over the last 6 Months (30 KG)
Thank you guys in advance :)

I've been learning Spanish for 2 years. I've gone with a balanced approach between traditional grammetop down study and 1 on 1 conversation. I'm an engineer who works with spreadsheets a lot so putting conjugations into a spreadsheet in my mind is pretty easy. My goal is/was to learn this way so that I could be "useful" ASAP. And it worked. It's very useful. (I lose interest in things easy but I knew if I got "good enough" I could improve just by using it. And I knew if I could make it part of my daily life I would keep it up)
But I find myself stuck in my head a lot. I think about what I'm saying and I see "r" in "caro" and I imagine tapping the roof of my mouth as I'm doing it. Or "cansado" I recognize the intervocalic d and imagine "voiced th". It happens so fast that I can actually keep up and my hope is that it'll eventually be fully automatic.
To be honest it's working. Maybe I just need to practice more.

21F uk, take 5 mg folic acid for low folic acid lol and 100mg of sertraline for OCD. Both once daily. No alcohol or drugs but I do vape
Symptoms started yesterday, was aching all over and had a really dry / scratchy throat. Chalked it down to allergies and sleeping funny- my mattress is rock solid lol. Didn’t feel unwell and managed to go up the park with my nephews
Woke up this morning with a slight a cough, nose isn’t blocked but I have a lot of mucus down my throat, my body is aching all over pretty bad and I have the chills, but don’t think I’ve got a fever- I don’t have a thermometer but my mum checked my chest / head (she’s A health care assistant) and said it doesn’t feel warm. Also have a general feeling of being unwell. Have managed to eat pretty normally though, have had paracetamol and lots of sleep throughout the day
Thing is, my sister (35F) had Covid 3 weeks ago. I didn’t have it, she doesn’t live with me and I didn’t see her, but we all tested as we’d met up a few days prior. She was asymptomatic for Covid, but developed pneumonia. She was very unwell for 2 weeks, bad chest and lots of vomiting. After an antibiotic change I’m pleased to say she’s much better, and I saw her yesterday (she came over to see us, you wouldn’t even know she’s been so unwell.)
The thing is, my mum went over to her house when she was very unwell to help care for her 1 year old son. She had little to no contact with my sister as she spent the day in bed. The 1 year old was not ill. That visit was 10 days ago
Thing is, I have agoraphobia so hardly leave my house. I’ve seen my mum, little sister, another older sister and her son recently, none of who are ill. I haven’t been anywhere other than the supermarket briefly a few days ago.
I’m worrying that I caught my sisters pneumonia even though I know it’s unlikely, and my cough isn’t bad at all. The body aches are driving me crazy though.
Is this likely nothing more than a common cold? I’ve had the flu before but was probably worse than this. I’ve also had bronchitis recently-ish and that was different too. I’m just so confused I have no idea where it’s come from
Mum will nip out to get me a Covid test tomorrow just to double check it isn’t that.
Yes I am a hypochondriac and am terrified of it being pneumonia because my sister vomited a lot. I have emetophobia so am terrified of being sick. I don’t think I feel nauseous and again have managed to eat smaller meals, and have felt hungry
No change to my taste or smell but my mouth is really dry, as is my throat and cough. It’s the muscle aches that are bothering me
I haven’t been sleeping well at all recently so don’t know if that’s contributing.