This story is also being posted on royal road, my username over there is cosmicslime. You can find the rest here: ROYAL ROAD
If you do end up reading this story, then I'd appreciate a follow over on Royal Road. I'd also like to hear your thoughts on it up to chapter twelve. You can share them in the form of a review, mentioning what you did and didn't like about the story, I'll try to get through as many of them as possible.

Chapter Two - Beginning Of Ruin - Part Two

Slowly coming to a halting stop, the wooden boat previously acting as my mode of transport came to a complete rest against the river's gentle current, precisely lining up with the river dock now on my right.
Stepping out of the drifting craft, my feet made contact with the solid ground once more. For some reason the ground below me felt somewhat ethereal after travelling that short distance by water. Laid out in front of me was a paved path that perfectly divided the rows of red spider lilies on either side.
Strewing the familiar weapon across my shoulders, I flicked the timeless hood over my head before traversing the vacant road with no particular destination in mind, as I walked by, the spider lilies blowing in the wind would halt their swaying motions in an unnatural display of primal fear.
No matter how much I tried to tone it down, it seems the ominous pressure being emitted by this body couldn’t help but inspire fear in the hearts of living creatures. Even here in this Celestial realm, it was still the domain of the living so my presence here was hardly ever warranted, nor welcomed for that matter. It wasn’t hard for me to see the effect my presence had on a given setting, it would always elicit a combination of three reactions from those around me.
It was either fear, hatred or anxiety.
That was the case for all but one....just a single girl didn’t seem to mind me being near her at all.
Just as I was about to rescind myself to the inevitable fate that came along with this existence, I saw something or rather, someone approaching in the distance.
It was another young female wearing glasses and speeding towards me as fast as her nimble legs could carry her. She was holding something like a scroll in her right hand and given how awkward her tumbling strides were, it was clear that athletics weren’t her forte.
As soon as she’d gotten within range, her eyes sparked with a sudden realization, and she abruptly placed her right leg in front of her to slow her awkward sprint. Kicking up a fit of dust in the process, the green haired girl stopped just a few footsteps away from me before immediately bowing in a trembling motion.
“G-G-good evening, Sir Shinigami....or would you prefer Sir Reaper instead?” That timid question trailed behind her upturned eyes.
“It doesn’t matter. What is it Minerva? I doubt you sprinted all the way here just to give me such an awkward greeting.”
“Eh....you-you know my name?”
“Naturally.”
I saw her face lose a bit of its color after I spoke those words, but she soon collected herself before correcting her posture.
“Ah! I wanted to ask you about something. You see I’m in charge of managing the souls that get sent to reincarnate from both the overworld and Eden, but something odd has come up.”
“Something odd you say?”
“Yes, I was going through the archives just now and from what I’m seeing, none of the celestial souls that were sent to reincarnate have entered the cycle. Our souls usually tend to take a little longer to recycle but this is just an anomaly, for the past four hundred years very few of the celestial souls have managed to successfully reincarnate. That’s why I was rushing over here, I wanted to see if you could somehow properly escort Luelle instead of just letting things happen the usual way.”
“I saw her off just as she’d requested, she didn’t want me to personally send off her soul for some reason.”
Minerva’s neon eyes drooped a little lower just then, it almost seemed as if she was staring at the scroll now in her hands but after a few seconds it quickly became clear that it wasn’t the case at all.
“I see...so she’s really gone then.”
“Yeah.”
The distant silence that fell over us seemed to drown out even the humming winds now passing through the field of lilies.
“That scroll...doesn’t it automatically record everyone who enters the source?”
“Yes, I was just about to check it myself.”
She unraveled the thick parchment like material, scanning the myriad of letters that were appearing on its surface.
Her eyes widened in anticipation and after a while, a careless stream of words escaped her mouth. “It’s.....not....here.”
That was the beginning of it.
“Not there? You mean her soul....hasn’t returned to the source?”
The edges of the well-aged scroll crumpled under the force now being exerted by her slender fingers.
“Usually if I want to search for a particular soul, I just need to concentrate on the name of the person I'm trying to find. Even a vague image would usually be enough but....no matter how hard I focus, nothing comes up when I skim through the archive for Luelle’s name.”
This was a problem. All souls were originally supposed to return to the source, a realm even beyond reach of the Celestials for reincarnation, but for some reason that just wasn’t happening this time.
Souls did occasionally lose their way along that journey and eventually become evil spirits, but that kind of thing only happened by coincidence, the mere prospect of it ever occurring for a Celestial spirit like Luelle was simply absurd.
“Well, this is a problem. I’m certain I witnessed Luelle’s soul drifting off just now, but I’ll have to look into this. For now, you shoul-”
Before I could even finish speaking, a strange mechanism appeared in the skies above us.
It was a large white crack, the kind of thing you’d almost exclusively see on a mirror. The sprawling white lines spread across the sky, leaving an ominous screeching sound behind every time they expanded their jagged paths. Each fissure seemed to tear through the fabric of the heavens, revealing glimpses of an otherworldly darkness beyond. As the cracks widened, a sense of foreboding filled the air, suffusing the atmosphere with an eerie tension that seemed to reverberate through every fiber of existence.
“What....is that?” Minera barely managed to mutter those words in astonishment.
Soon after, a litany of white cryptic markings began escaping from the jagged openings, spreading across everything from the skies above to even the waves washing below. The strange symbols glowed with a demeaning white light, emanating a strange kind of energy each time it cast its ethereal glow.
“U-Uhm....Shinigami...do you know what this is?” Minerva asked from beside me, timidly surveying our unusual surroundings.
“No....but you should head back just to be-”
Cutting me off once again, the strange markings etched on to the world itself began emitting bright white sparks like a timid, yet persistent firework display. The sparking lights grew fiercer and fiercer by the second, and before I could even execute my next move, the entire world was seemingly engulfed in a blinding cascade of light. It was as if the very essence of existence had been ignited, and we were just insignificant specks adrift in the vast expanse of creation.
Before my vision was completely overpowered by the tormenting flash, I saw Minerva extend a hand towards me with tears flowing from her eyes. I wasn’t able to hear the words that escaped her, but for a second it looked like she was calling out to me.
Apparently, even Celestials found solace in my presence at the end.
The world was divided into three realms. The first of these was the lower realm that the humans inhabited, we called it ‘Terrania’. It was a land festering with humans, a world where only they were able to dominate and reign supreme - Or at least that’s what they thought anyway.
In reality, that realm had only managed to continue functioning because of the efforts of the beings known as ‘Celestials’. These Celestials resided in a realm that was far above Terrania known as ‘Eden’. They were responsible for overseeing the various aspects of the world these humans inhabited and that just meant that they were in charge of maintaining its balance. If things ever started getting out of hand, then they would intervene to re-establish that balance, but that would only happen if it was absolutely necessary. Though they could influence aspects of the world itself, the Celestials weren’t gods but rather akin to something like a superior version of humanity, the humans of the lower realm often referred to them as ‘angels’.
The only thing in the entire world that came close to mirroring anything even close to that level was the entity known as ‘Akasha’ or the ‘Source.’ It wasn’t an actual person but rather, the mechanism in place that managed the influx of both mortal and Celestial souls accordingly, managing them in a timely manner and allowing them to reincarnate given time.
It resided in an exclusive realm that surpassed both Eden and Terrania. Akasha was the recycling mechanism put in place to cleanse and return souls to the mortal cycle. Every time a human died, their souls would naturally return to Akasha over a number of years given that they hadn’t become an evil spirit or deviated from the natural order in some other way. That’s why even as a Reaper, I didn’t actually need to guide the souls of every single mortal that had perished, but rather just the ones still clinging on to the mortal realm or those that had deviated from the natural order.
Seeing as only pure souls could pass between the realms without restrictions, very few Celestials had ever gone directly to Akasha, but just about anyone who wasn’t mortal could detect its overwhelming essence radiating from some far-off place. The same went for me and I was neither mortal nor a Celestial.
That was how it had been, the way in which the world managed to maintain some amount of balance even without outside intervention, but the moment I saw those strange cracks appear in the sky I could already tell that the fragile balance keeping this world afloat was beginning to crumble.

Apart from having autism and ADHD, I (26F, turning 27 at the end of the month) also have what my previous psychiatrist called a “neurological feeding disorder”.
This is due to impaired interception (internal body sensations) from neonatal brain damage. This brain damage was caused by a hemorrhage, which also caused cerebral palsy. I also have general anxiety disorder and depression.
As a child and teen, I definitely had ARFID behaviors, which were dismissed as picky eating behaviors. It’s just that “high-level” autism, ADHD, and ARFID wasn’t diagnosed in girls in the early 2000s.
I basically lived on a “beige diet” of cereal, bread, snack cakes, pasta, pizza, and some meat, like chicken strips or cheeseburgers. I wouldn’t eat sandwiches, eggs, seafood, fruits, or vegetables, except for peas and white potatoes.
I was somewhat underweight until high school, and I remember my mom would always offer me “chocolate milk” (Pediasure / Ensure) when I was younger. I then gained weight in high school due to depression and just generally eating processed food. At my highest weight in school, I was 135 pounds.
Here’s some backstory about where things started to shift. Trigger warning for numbers, skip over if needed.
///
That carb-heavy diet was up until I turned 24, when I first tried a keto diet for mental health. Things were going really well, until I eventually developed malnutrition from losing too much weight unintentionally. My height is 4’8” tall.
I went from 110 pounds (BMI 25) and 28% body fat to 90 pounds (BMI 20) and 20% body fat in 10 months. October 2021 to August 2022. I couldn’t get warm worth a damn from subnormal body temperatures, and I lost my period at around 95 pounds.
Even so, a calorie intake of 1000-1200 per day on top of 2-3 miles of walking (daily activity and steps) would have eventually lead to relative energy deficiency (RED) at some point because I never knew about planning scheduled refeeding periods to mitigate the down-regulation in metabolism.
Especially when considering that my hunger signals are impaired due to my brain damage. My interception is about half as sensitive as normal. I don’t really feel stomach hunger until it’s very strong. Lots of times, I can hear the noise before I actually feel it. And I can’t say that I’ve ever identified satiety correctly before.
I didn't know that low-calorie interventions shouldn't be done for months at a time without proper nutritional supervision to prevent deficiencies.
Then I gained 20 pounds in 14 months from October 2022 to December 2023 (93 to 113) after having my previous IUD removed, stopping keto, and hormonal eating patterns once I realized that I had PMDD when my period resumed in July 2023 once I had gained back enough weight.
///
Now, I do my best to meet my keto macros and make sure that I get enough calories every day.
I try not to eat under 1200 kcal and keeping a food log helps keep me accountable that I’m not under-eating due to not feeling hungry. Logging wasn’t something that I did last time. I also keep up with my electrolytes, because being in ketosis is very diuretic and sheds electrolytes quickly due the carb restriction.
However, my current diet is relatively… limited, to put it lightly. I mostly eat heavy cream in coffee, heavy-cream ice cream, cream cheese, eggs, and some kind of meat every day to meet my protein requirements. This isn’t the previous “beige diet” of my youth, but rather what I call a “heavy cream diet”.
I used to be hypersensitive to flavors and textures when I was younger, for example, I never ate salads before the age of 24, but that switch “flipped” when I started having reactive eating episodes when I was underweight.
I started eating sandwiches, spicy foods, and seafood, all of which were foods that I was previously very avoidant of, to the point of having anxiety attacks when seeing the shells in shellfish.
Those reactive eating episodes really showed the kind of primal need for food that malnutrition does to the brain, because the body needs a lot of calories to gain back weight while underweight.
Now, instead of avoiding fruit/veg and shellfish, I still avoid sweet fruits, starchy veggies, nuts/seeds, peanut butter, and any other kind of carb food.
I avoid eating because the food isn’t enjoyable anymore. Instead of being hypersensitive, it feels like I’m now hyposensitive, like I just have a general disinterest in food, apart from the usual low appetite. Even when I try to focus, sometimes I can’t mentally “taste” the food.
I can also eat quickly because I can’t feel the food inside my stomach, which makes pacing difficult.
I’m also currently averse to cold coffee because my mouth just says no to for some reason, which may be because my mom explained that cold coffee is less acidic than hot coffee (she was a barista) and tastes different?
However, I will get what I call “vagus hunger” after passing a bowel movement, and I’ll get very hungry. It’s a very distinct feeling, and it’s one of the few times that I can clearly recognize the feeling of hunger.
I eat only one or two “meals” per day, not including the “fat boluses” like cream, oil, or butter that I eat straight or put in my coffee during the day to maintain my ketone levels. The fat helps because I have neurological delayed bowel motility and I take GI meds to manage this.
By the way, I’m using “avoidant” to describe sensory overstimulation, and “averse” to describe choking/nausea symptoms, as that’s what I was previously taught in speech therapy when I when for a few sessions when I was 24 due to neurological swallowing spasms.
Does this sound like ARFID behaviors? OSFED? Where is the line between an “eating” disorder and a “feeding” disorder, if there is one? I was always told that my circumstances were FD related, not ED related, but no one ever explained the difference. Apparently, ARFID isn’t on the ED side, but rather the FD side?
I wouldn’t want to say that I have orthorexia, even though I have some food rules, because I literally eat butter to increase my calories, and that seems against the premise of “healthy foods” even though it’s perfectly acceptable within a keto context.
At the mental health practice I’m currently with, the former psychiatrist left, and the practice is still waiting on a new one. But I want to bring this all to the attention of my psychologist, who knows about my longstanding feeding issues, and then the new psychiatrist, whenever they get hired.
Advice is appreciated, and my chats are open if you don’t want to publicly comment. Thanks in advance!

Methods of Inducing Psychological Problems through Continuous Stress and Substance Manipulation

Psychological and chemical manipulation of a target represents one of the most insidious and effective methods to destabilize and control an individual. These techniques are essential in the art of hybrid warfare, where the goal is to profoundly affect the mental and behavioral state of the adversary without direct confrontation. In this chapter, we will explore how continuous stress and the use of psychoactive substances can be employed to generate severe psychological issues.
1. Inducing Continuous Stress
The first essential step to induce psychological problems is creating an environment of constant stress. This can be achieved through various methods:

• Psychological harassment: Continuously sending threatening messages, anonymous calls, and visibly monitoring daily activities.
• Instigating fear: Spreading false or exaggerated information about imminent dangers, such as being pursued by enemy agents or facing severe health risks.
• Social isolation: Alienating the victim from their support network by manipulating social and familial relationships, inducing feelings of loneliness and abandonment.

These tactics, used systematically, can lead to chronic anxiety, insomnia, and paranoia, creating a fertile ground for other forms of manipulation.
2. Use of Psychoactive Substances
If continuous stress does not produce the desired effects, the next step is chemical intervention by introducing psychoactive substances into the target's food. This method can be applied through:

• Contaminating food: Adding psychoactive substances to food or drink, gradually altering the victim's perception and behavior.
• Exploiting existing addiction: If the target is already dependent on certain substances, it is much simpler to introduce stronger drugs. For example, a cannabis user can be gradually exposed to heroin, increasing doses over time to create a severe addiction.

3. Exacerbating Drug Addiction
For targets who are already drug-dependent, the method of manipulation becomes much more direct and effective:

• Introducing stronger substances: For a cannabis user, heroin can be introduced in a small dose initially, gradually increasing the quantity to induce a severe addiction.
• Control through withdrawal: Once the target has developed a strong addiction, their behavior can be controlled by inducing withdrawal symptoms whenever necessary. This can be achieved by abruptly cutting off access to the drug or by contaminating their usual drugs with substances that cause acute withdrawal.

By combining continuous stress and chemical manipulation, hybrid warfare reaches a profound level of control over the individual. This strategy not only destroys the target's mental stability but also turns them into a manipulable pawn in the power game. It is important to emphasize that these methods, although effective, are extremely inhumane and illegal, and their use raises serious ethical and moral issues. Understanding these techniques serves not only to highlight the dangers of hybrid warfare but also to find ways to protect and prevent against these forms of attack.

This will be a remote study for Latinos with regular alcohol consumption & anxiety! No you don't have to stop drinking - this is an intervention to become more self-aware of your habits and outcomes. Please contact RESTORE via email ([study83restore@gmail.com](mailto:study83restore@gmail.com)) for more information or click the link below for our Prescreen Survey:https://uhpsychology.co1.qualtrics.com/jfe/form/SV_9zTBxD8Hnc4ldrg

This will be a remote study for Latinos with regular alcohol consumption & anxiety! No you don't have to stop drinking - this is an intervention to become more self-aware of your habits and outcomes. Please contact RESTORE via email (study83restore@gmail.com) for more information or click the link below for our Prescreen Survey: https://uhpsychology.co1.qualtrics.com/jfe/form/SV_9zTBxD8Hnc4ldrg

This will be a remote study for Latinos with regular alcohol consumption & anxiety! No you don't have to stop drinking - this is an intervention to become more self-aware of your habits and outcomes. Please contact RESTORE via email ([study83restore@gmail.com](mailto:study83restore@gmail.com)) for more information or click the link below for our Prescreen Survey:https://uhpsychology.co1.qualtrics.com/jfe/form/SV_9zTBxD8Hnc4ldrg

This will be a remote study for Latinos with regular alcohol consumption & anxiety! No you don't have to stop drinking - this is an intervention to become more self-aware of your habits and outcomes. Please click the link below for our Prescreen Survey:https://uhpsychology.co1.qualtrics.com/jfe/form/SV_9zTBxD8Hnc4ldrg

My journey towards my first injection of Zepbound the Friday before last started at an age earlier than I can remember. I was told that I would finish bottles twice as fast as my brother and sisters did and that was just the beginning. I can remember my first official diet at the age of 10 and can recall the allowances given by Weight Watchers to this day, 6 protein, 5 starch, 5 dairy, 3 fats, and 3 fruits, with unlimited servings of vegetables. At the time this was the accepted way of doing things and the family followed this plan together. We would calculate these portions and buy frozen meals that had these values written on the side. I never would have known that this would be the start of a lifelong battle, where I was accepted and validated while losing weight, dismissed and ridiculed when I wasn’t. In my house weight loss was looked at as a matter of willpower and my father would take me to the grocery store where we would open the bakery cabinet and breathe in the scents of the muffins, brownies, and other pastries without giving in the the temptation of eating any of them. The yo-yoing of my weight started then and continued through 5 years ago, when I was larger than ever and found my way to a weight loss clinic that restricted calories down to 800 a day before building back up over time, mostly through the use of bars and shakes, alongside a meal of protein and veggies. Just like in the past I was able to shed weight on command with a restrictive system, eventually losing 140 pounds, which brought me from 388 down to 248. This was by far the largest loss of my life, having had losses of 90, 75, and multiple losses in the 30-50 range. This time it felt different, but the binge eating at night came back every time I would get to the 250 range. Like clockwork I would creep up and the nurse practitioner would ask if I wanted to try a medication to help and instantly I would take offense and lose the 15 pounds that crept back on, realizing along the way that I needed someone to doubt me, that I needed someone to not believe in me to get back on track. Through this entire journey I had told every person involved that I would be impressed if they could help me keep myself within a 15 pound range for over a year. This method came close but it was always 15 up and 15 down, cycling nearly every other month. This epiphany was met with curiosity and I eventually was referred to a mindful nutritionist that focused on talking through my binge eating issues and removing the good vs. bad labels that I placed on each food my entire life as it relates to food. It took some time to get on their calendar and by then I had risen to 270 pounds. I started this new part of the journey barely eating any real foods and over time I incorporated foods into my life, while removing the labels associated with them. My weight crept up, but I knew this was part of the plan as I judged less and shamed myself even less. I knew this as I had taken up zen meditation over the past few years and along the way I noticed a voice in my head, that voice used my mother’s nickname for me and whenever clothes started to tighten I would hear this admonition, and then one day I realized that I was saying these shame ridden insult out loud to myself. Over the course of a year I reduced my binge eating considerably and accepted more foods into my life. I also noticed that I would often tell my children that “I couldn’t be trusted” with his food and that food and over time I stopped doing these things, both to my benefit and their’s, as the parentification wasn’t good for either of us. Despite all of this I still continued to see the numbers climb, but didn’t weigh myself and felt better than I ever had at such a high weight. As I went past the 300 mark the guilt wasn’t there and the shame was lessened to a a degree I couldn’t imagine. Along this path I believed that the more self acceptance I could show, the less shame I would feel, and in turn I would eat only one hungry, at least eventually. My weight stabilized and I thought I was in my way,but my clothes kept getting tighter, bit by bit over time. At my next physical my doctor looked at my weight and immediately went to suggesting medication. As I tried to explain my work with my nutritionist he was dismissive and kept referring to the work I was doing as being on a diet, which I had refused to do. I was incorporating all foods in my life while not binging and although I physically didn’t feel great, I was proud of the mental place I was in. It was at this time that I began a 4-5 month dialogue between my doctor and my nutritionist. Talking about my goals, fears, and everything in between. I had become comfortable in a bigger body and accepting of it, however I was starting to notice the effect on my psyche, especially at work when I had to present and speak publicly or on camera. I came to the conclusion that I just wanted to be able to exercise regularly and buy clothes at a regular store, staying at XXL sizes or below. My nutritionist was along for the ride and while she never had a patient on Zepbound her approval meant the world to me as I had my doctor place the prescription in at the pharmacy. It was another 2 months before I asked them to fill it and I eventually had it delivered and in my fridge. I had been dismissive of everyone who had bariatric surgery and other interventions, for they didn’t have the “willpower” that I had to lose weight on command. Swallowing my pride I injected myself 11 days ago not knowing what to expect. The injection instead served as admission that I was no better than anyone else and that I could accept medical intervention for something that I just couldn’t solve in any way. After the injection I experienced a profound moment where I went to the pantry prior to a Zoom panel discussion that would have 400 people on it. In this moment I realized that I always came here prior to speaking publicly, it his time was different. I realized I wasn’t hungry and I also realized that my anxiety was lessened in a way far beyond my appetite and impulses. In the 11 days since I have come to terms with the fact that I suffered from anxiety deeper than I ever knew and this new medication made that completely clear. I now move forward hoping to stay in XXL or lower, but fearful that without this medication my anxiety will come back, with my impulsive eating right behind. I then come back to the fact that I will continue the meditation practice, exercise routine, and self acceptance tools that I’ve worked on diligently over the years to guide my path. I don’t know where this journey will take me, but I am glad that I was able to share this publicly for the first time here on Reddit

 it’s sick and twisted, yes 

 god knows us all by name 

 how about you? 

 we will shift to sheen 

Impact of Cystic Fibrosis on Adults

Cystic Fibrosis (CF) is a genetic disorder that primarily affects the respiratory and digestive systems, but it can also have implications for other parts of the body. With advancements in treatment and care, more people with CF are living into adulthood. However, managing the condition in adults involves dealing with a range of challenges and complications.

Respiratory System

1. Chronic Lung Infections: Adults with CF often experience recurrent lung infections due to thick, sticky mucus that traps bacteria. Common pathogens include Pseudomonas aeruginosa and Staphylococcus aureus.
2. Reduced Lung Function: Over time, repeated infections and inflammation can lead to a decline in lung function, making breathing more difficult.
3. Bronchiectasis: The airways become permanently widened, leading to persistent cough, mucus production, and further infections.
4. Respiratory Failure: In severe cases, lung damage can progress to the point where the lungs cannot provide adequate oxygen to the body, requiring advanced interventions like oxygen therapy or lung transplantation.

Digestive System

1. Pancreatic Insufficiency: Thick mucus can block the ducts of the pancreas, preventing digestive enzymes from reaching the intestines. This leads to malabsorption of nutrients, malnutrition, and vitamin deficiencies.
2. Diabetes: CF-related diabetes (CFRD) is common in adults due to the damage to the pancreas. It shares characteristics of both Type 1 and Type 2 diabetes.
3. Liver Disease: Blockages in the bile ducts can lead to liver damage, cirrhosis, and portal hypertension.
4. Intestinal Issues: CF can cause intestinal blockages, gastroesophageal reflux disease (GERD), and distal intestinal obstructive syndrome (DIOS).

Reproductive System

1. Infertility: Most men with CF are infertile due to congenital absence of the vas deferens, which carries sperm from the testes. However, assisted reproductive technologies can help achieve pregnancy.
2. Reduced Fertility in Women: Thick cervical mucus can make it harder for sperm to reach the egg, but many women with CF can still conceive naturally or with assistance.

Musculoskeletal System

1. Osteoporosis: Due to malabsorption of calcium and vitamin D, adults with CF are at higher risk for osteoporosis and fractures.
2. Arthritis: Some adults may develop CF-related arthritis or musculoskeletal pain.

Psychosocial Impact

1. Mental Health: The chronic nature of CF can lead to anxiety, depression, and stress. The need for continuous treatment and hospitalizations can impact quality of life.
2. Social and Work Life: Managing CF often requires time-consuming treatments and frequent medical appointments, which can interfere with work and social activities.

Treatment and Management

1. Medications:

• Bronchodilators: To open the airways.
• Mucolytics: To thin mucus.
• Antibiotics: To treat and prevent infections.
• Pancreatic Enzymes: To aid digestion.
• CFTR Modulators: Target the defective protein in CF and improve its function.

1. Airway Clearance Techniques: Daily physiotherapy to clear mucus from the lungs.
2. Nutritional Support: High-calorie diet, vitamin supplements, and enzyme replacements.
3. Exercise: Regular physical activity to maintain lung function and overall health.
4. Psychological Support: Counseling or therapy to help manage the emotional aspects of living with CF.
5. Advanced Therapies: Lung transplantation may be an option for those with severe lung disease.

Conclusion

While cystic fibrosis poses significant challenges for adults, ongoing advancements in medical care and treatment strategies are helping many individuals manage their condition more effectively and lead fuller lives. Comprehensive, multidisciplinary care is essential to address the complex needs of adults with CF, including respiratory, digestive, reproductive, and psychosocial aspects. Regular follow-up with healthcare providers specialized in CF care is crucial for optimizing health outcomes and maintaining quality of life.
Blaze0 notes Impact of Cystic Fibrosis on Adults
Cystic Fibrosis (CF) is a genetic disorder that primarily affects the respiratory and digestive systems, but it can also have implications for other parts of the body. With advancements in treatment and care, more people with CF are living into adulthood. However, managing the condition in adults involves dealing with a range of challenges and complications.

Respiratory System

1. Chronic Lung Infections: Adults with CF often experience recurrent lung infections due to thick, sticky mucus that traps bacteria. Common pathogens include Pseudomonas aeruginosa and Staphylococcus aureus.
2. Reduced Lung Function: Over time, repeated infections and inflammation can lead to a decline in lung function, making breathing more difficult.
3. Bronchiectasis: The airways become permanently widened, leading to persistent cough, mucus production, and further infections.
4. Respiratory Failure: In severe cases, lung damage can progress to the point where the lungs cannot provide adequate oxygen to the body, requiring advanced interventions like oxygen therapy or lung transplantation.

Digestive System

1. Pancreatic Insufficiency: Thick mucus can block the ducts of the pancreas, preventing digestive enzymes from reaching the intestines. This leads to malabsorption of nutrients, malnutrition, and vitamin deficiencies.
2. Diabetes: CF-related diabetes (CFRD) is common in adults due to the damage to the pancreas. It shares characteristics of both Type 1 and Type 2 diabetes.
3. Liver Disease: Blockages in the bile ducts can lead to liver damage, cirrhosis, and portal hypertension.
4. Intestinal Issues: CF can cause intestinal blockages, gastroesophageal reflux disease (GERD), and distal intestinal obstructive syndrome (DIOS).

Reproductive System

1. Infertility: Most men with CF are infertile due to congenital absence of the vas deferens, which carries sperm from the testes. However, assisted reproductive technologies can help achieve pregnancy.
2. Reduced Fertility in Women: Thick cervical mucus can make it harder for sperm to reach the egg, but many women with CF can still conceive naturally or with assistance.

Musculoskeletal System

1. Osteoporosis: Due to malabsorption of calcium and vitamin D, adults with CF are at higher risk for osteoporosis and fractures.
2. Arthritis: Some adults may develop CF-related arthritis or musculoskeletal pain.

Psychosocial Impact

1. Mental Health: The chronic nature of CF can lead to anxiety, depression, and stress. The need for continuous treatment and hospitalizations can impact quality of life.
2. Social and Work Life: Managing CF often requires time-consuming treatments and frequent medical appointments, which can interfere with work and social activities.

Treatment and Management

1. Medications:

• Bronchodilators: To open the airways.
• Mucolytics: To thin mucus.
• Antibiotics: To treat and prevent infections.
• Pancreatic Enzymes: To aid digestion.
• CFTR Modulators: Target the defective protein in CF and improve its function.

1. Airway Clearance Techniques: Daily physiotherapy to clear mucus from the lungs.
2. Nutritional Support: High-calorie diet, vitamin supplements, and enzyme replacements.
3. Exercise: Regular physical activity to maintain lung function and overall health.
4. Psychological Support: Counseling or therapy to help manage the emotional aspects of living with CF.
5. Advanced Therapies: Lung transplantation may be an option for those with severe lung disease.

Conclusion

While cystic fibrosis poses significant challenges for adults, ongoing advancements in medical care and treatment strategies are helping many individuals manage their condition more effectively and lead fuller lives. Comprehensive, multidisciplinary care is essential to address the complex needs of adults with CF, including respiratory, digestive, reproductive, and psychosocial aspects. Regular follow-up with healthcare providers specialized in CF care is crucial for optimizing health outcomes and maintaining quality of life.

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If you're seeking effective Best Tinnitus treatment in Hyderabad, look no further. Tinnitus, characterized by ringing, buzzing, or humming sounds in the ears, can significantly impact one's quality of life. Fortunately, Hyderabad offers a range of cutting-edge treatments tailored to manage and alleviate tinnitus symptoms, allowing individuals to regain control over their auditory health and overall well-being.
At our state-of-the-art healthcare facilities in Hyderabad, individuals experiencing tinnitus receive personalized care from expert otolaryngologists, audiologists, and allied healthcare professionals. Our multidisciplinary approach to tinnitus management begins with a comprehensive evaluation to identify the underlying causes and tailor treatment plans accordingly.
Our team understands that tinnitus can stem from various factors, including age-related hearing loss, exposure to loud noise, ear infections, or underlying medical conditions like Meniere's disease or temporomandibular joint (TMJ) disorders. That's why we prioritize a thorough assessment to pinpoint the root cause of tinnitus before recommending a course of action.
One of the cornerstones of Best Tinnitus treatment in Hyderabad is counseling and education. Our compassionate professionals provide invaluable support, helping individuals understand their condition and develop coping strategies to mitigate tinnitus-related stress and anxiety. Through counseling sessions, patients gain insights into the emotional and psychological aspects of tinnitus, empowering them to better manage their symptoms and improve their overall quality of life.
Sound therapy is another integral component of our tinnitus treatment approach. Our cutting-edge facilities offer a variety of sound therapy options, including wearable devices like hearing aids and sound generators, as well as smartphone apps and bedside sound machines. These devices deliver soothing sounds such as white noise, nature sounds, or relaxing music, effectively masking tinnitus noise and promoting relaxation.
For individuals with underlying hearing loss exacerbating their tinnitus, our audiologists specialize in fitting advanced hearing aids tailored to their unique needs. These modern hearing aids come equipped with tinnitus masking features and customizable settings, providing personalized relief and enhancing auditory clarity for improved communication and quality of life.
In cases where tinnitus is linked to specific medical conditions, our team collaborates closely with specialists to explore targeted interventions. Whether it's prescribing medications to alleviate symptoms or recommending surgical procedures to address underlying issues, we prioritize the most effective and least invasive treatment options to optimize patient outcomes.
In addition to conventional treatments, we recognize the value of complementary and alternative therapies in tinnitus management. Our integrative approach may include acupuncture, mindfulness meditation, and relaxation techniques, offering holistic benefits to complement traditional interventions and promote overall well-being.
At our healthcare facilities in Hyderabad, we go beyond medical treatment to foster a supportive community for individuals living with tinnitus. Through support groups, educational workshops, and rehabilitation programs, we empower patients to connect with peers, share experiences, and access valuable resources to navigate their tinnitus journey with confidence.
In summary, if you're seeking comprehensive Best Tinnitus treatment in Hyderabad, our dedicated team is here to help. With personalized care, innovative therapies, and a commitment to patient-centered excellence, we're dedicated to improving the lives of individuals affected by tinnitus and helping them rediscover the joys of sound and silence. Contact us today to schedule your consultation and take the first step toward tinnitus relief.
For more details visit our site: https://ashokahearingclinic.com/tinnitus/

Play is a fundamental aspect of childhood development, fostering creativity, social skills, and cognitive growth. For children with autism spectrum disorder (ASD), however, engaging in play activities can present unique challenges. In this article, we'll explore 10 autism-inclusive play ideas designed to promote development and provide enjoyable experiences for children on the autism spectrum.
Sensory Play
Sensory play engages the senses and can be particularly beneficial for children with autism who may have sensory processing differences. Consider setting up sensory bins filled with materials like rice, sand, water beads, or textured fabrics. Encourage exploration and experimentation with different textures, smells, and tactile sensations to stimulate the senses and promote sensory integration.
Pretend Play
Pretend play offers opportunities for imaginative expression and social interaction. Create a dress-up corner with costumes and props, or set up a pretend kitchen with play food and utensils. Encourage children to role-play different scenarios, such as cooking a meal, going on a pretend adventure, or acting out everyday activities. Pretend play can help develop language skills, creativity, and social understanding.
Visual Supports
Many children with autism benefit from visual supports to enhance communication and understanding. Incorporate visual supports into play activities by using picture schedules, visual timers, or visual cue cards to provide structure and predictability. Visual supports can help children navigate transitions, follow routines, and comprehend expectations, promoting independence and reducing anxiety.
Structured Games
Structured games with clear rules and expectations can provide opportunities for learning and social interaction. Choose games that are simple, repetitive, and easy to understand, such as matching games, board games with visual cues, or turn-taking activities. Structured games can help children develop important skills like turn-taking, sharing, and following directions, while also providing opportunities for fun and enjoyment.
Movement Activities
Physical activity is essential for promoting gross motor skills, coordination, and body awareness. Plan movement activities that cater to the interests and preferences of children with autism, such as yoga, dancing, or obstacle courses. Provide sensory-friendly spaces with options for proprioceptive input, such as crash pads, trampolines, or therapy swings. Movement activities not only support physical development but also help regulate sensory processing and promote emotional well-being.
Nature Exploration
Nature offers a rich sensory environment filled with opportunities for exploration and discovery. Take children on nature walks to observe plants, animals, and natural landscapes. Encourage hands-on exploration by collecting leaves, rocks, or shells, and incorporating them into sensory activities or crafts. Nature exploration fosters curiosity, appreciation for the environment, and connections with the natural world.
Art and Creativity
Art activities provide a creative outlet for self-expression and can be adapted to accommodate the needs of children with autism. Offer a variety of art materials and techniques, such as painting, drawing, collage, or sculpting. Focus on process-oriented art rather than product-focused outcomes, allowing children to explore materials freely and express themselves without pressure. Art activities support fine motor skills, creativity, and sensory exploration.
Social Stories
Social stories are short narratives that describe social situations, concepts, or expectations in a structured and visual format. Create social stories related to play activities, such as going to a playground, attending a birthday party, or participating in group games. Use simple language, clear visuals, and personalized details to help children understand what to expect and how to navigate social interactions. Social stories can reduce anxiety, improve social skills, and enhance participation in play activities.
Technology-Based Play
Technology can be a valuable tool for engaging children with autism and supporting their development. Explore interactive apps, educational games, or virtual reality experiences that cater to the interests and learning styles of children with autism. Use technology-based play activities to target specific skills, such as communication, academic concepts, or social skills, while also providing engaging and motivating experiences.
Joint Attention Activities
Joint attention refers to the ability to share attention with others and coordinate attention between objects, people, and events. Plan activities that promote joint attention, such as building with blocks, playing with toys that require turn-taking, or engaging in interactive games like peek-a-boo or pat-a-cake. Use prompts, modeling, and reinforcement to encourage children to attend to and interact with others, fostering social engagement and communication skills.
If you're seeking aba therapy for autism virginia beach,va, look no further! Our dedicated team offers comprehensive Applied Behavior Analysis services tailored to meet the individual needs of children and adults on the autism spectrum. With a focus on evidence-based interventions and personalized treatment plans, we are committed to helping individuals with autism reach their full potential and thrive in all aspects of life. Contact us today to learn more about how we can support you and your family on the journey towards growth and success.
Conclusion
Play is a powerful vehicle for promoting development, fostering social connections, and enriching the lives of children with autism. By incorporating autism-inclusive play ideas into everyday activities, we can create meaningful opportunities for learning, growth, and enjoyment. Whether through sensory exploration, imaginative play, structured games, or nature adventures, every play experience has the potential to unlock new possibilities and support the unique strengths and needs of children on the autism spectrum. Let's continue to explore, create, and play together, building a more inclusive and enriching world for all children.

I don't really no where to start. I feel I've lost myself, consumed with anxiety and guilt and fear and regret and I fear, this new fear, that it's going to be the end of me if I don't start to get it out in some way, shape or form.
I guess I'll begin at the beginning...
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I had a difficult childhood with fairly neglectful parents. A mother who openly expressed she never felt she really stepped into her mom shoes until she gave birth to my younger sister, who is three years younger than me. She is my only sibling. My mother told me when I was a kid that she "had to love me", but when my sister came around "she was finally a mother and over the moon", or simply "I always always wanted a girl". I'm not sure if this could be attributed to Post-partum depression, not that she ever researched that or was daignosed with it. That's probably just me trying to pardon my mother or something to the effect. She was 17 when she had me and I'm sure times were different then, my parents both were raised religious, father christian, mother mormon. Maybe their guilt. I ask myself why they brought me into this world if I wasn't wanted to begin with. Or, give me up for adoption to a set of guardians that would have loved me better. I know I was an accident and that's not what gets me down, I get that life be lifing and what happened happened. My difficulties stem from the feeling that my presence never gave my mother any sense of purpose, responsibility or love, or concern. She was emotionally unavailable to me virtually my entire life and I feel like that caused many issues later in my life and how I perceive myself and what I deserve. Coupled with the fact that my neglect met such extremes that I am frankly shocked that I was never picked up by child care services, maybe things were different in the 90's. I'm not sure, I was just a child then.
Much of my upbringing I didn't receive a lot of the things most people would consider essential. As a baby my crib was the sock drawer, then I grew large enough to have a closet, then slept on the floor of a walk-in closet, then I had a single bed from what I recall for maybe a year or maybe two years and I remember feeling metal springs poke me in the my ribs and I recall it being uncomfortable enough for me to move back to sleeping on the floor next to the ratty old used mattress my father found from who knows where. I remember feeling like I had to keep that secret, that the mattress they gave me was uncomfortable enough for me to sneak sleeping on the floor next to it. I think I was really afraid as coming across as ungrateful. My father came from a third world country, so the "gratefullness issue" was address frequently by my mom because "I don't have it even half as bad as what my father had to endure. And she was probably right. But it just silenced me ultimately, didn't put things into a mature context for me. I just learned that I can't complain about anything ever. Anyway, that trend didn't really change when I grew older. grade 9-10 I was sleeping on the living room couch so my sister could have privacy and a bedroom to exist in for herself - which I realize is important for an individual so I encouraged her to have the bedroom. Although I figured my parents expected me to do this for my sister regardless. I was okay with making sacrfices for those I love, it was instilled in me from a very very young age.
I do feel like my father took advantage of me in the form of labour as well, having to do custodial work with my father from 10pm to 3am, at two highschools I believe he was contracted, at that young age I honestly enjoyed just spending time with my father I think, working alongside him. When I was in grade 2 and 3 I had garbage bag duty for all the students bathrooms, and I remember loving snapping the bags open by rushing air into the bag and making it blow up like a baloon. I remember the scary unlit shadowy hallways that I couldn't perceive the ends of. No bodies to see, it felt eerie but exciting in a way - like it was a whole different world.
School was a different experience for me. It was very stressful, my parents had to move a few times a year because they would dodge rent or just generally be selfish with their dual income. They loved to party hard on the weekends. I remember wondering why my father did this to himself all the time. Hoping that we could spend quality time on a saturday, but he wouldnt get out of bed until just before dinner. I didn't really understand hangovers or alcoholism and how it meant our plans would get cancelled. I think I remember trying to wrap my head around willful self-poisoning for entertainment and how could that be more enjoyable then spending time with your son? I couldn't tell my mother why I was so sad about it. Why I didn't want to move again and again and again. Why I found it so difficult to make new friends everytime I had to switch schools. Why I couldn't just do one single full school year with one class of students. It was so hard and at the time, I didn't know anything different. It was so hard to make friends and I think it created this approach to making a "new family" of friends when I became a teenager and young adult.
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I remember always wanting to be a "good kid". The "best kid" for my parents. I feel like my parents attached this moniker to me that made things harder for me to mature into a rounded adult later in life. My parents always flaunted me as this point of accomplishment, the accomplishment that I was "so extremely well behaved". I would strive to be super polite, and a good host, try to help out when my parents had their friends over, literally fill their cups when the opportunity presented themselves. I think I did this because I must have made the conclusion that if I was quiet, super polite, helpful and useful then I had value. That I could be loved. That I could earn this love from my parents through acts of service.
I remember feeling like my sister and I had extremely different experiences growing up. When my parents were at work I took care of her, cleaned and cooked. one time my sister told my mom to eff off when she was 5 and I was 8. My mind was blown. I couldn't wrap my head around the fact that she had the bravery and courage to defy my mother. Looking back, my sister was just mirroring the language she learned from my parents from whenever they fought. I remembering seriously worrying and getting scared that my father was going to belt her, or use the coat hanger, which was his preference with me. I feel like my mom was always checked out and I'm hurt that she allowed my father to take his rage out on me. That my mom could care less about me being beat, but never my sibling. It was very confusing and difficult for me to process. Not that I really processed it much as a kid. I honestly just wanted to be loved and be the best child possible. Honestly though, 'm seriously so glad that my sister was spared all of that complete non-sense. I don't wish that on anyone in the world. There were some punishments where he would walk in and tell me to pull my pants down without explanation. I have memories of tearing up and saying I didn't know why this was happening, asking what I did wrong and he would just remind me that if I resisted then I would get it worse and to hurry up and get ready. My father has since apologized. I think it is how he was raised. I didn't know what to say in response, but I told him I loved him and it's in the past. But I don't know if I was being honest when I said that. My mother would still gaslight me to this day if any of this became topic of discussion, not that I'm guessing. A year ago she told me that much of my pained memories were false and this never happened. My father on the other hand typically stays pensive and unchallenging.
It seems so damned crazy writing all of this out, it feels like a heartbreaking novel and not my life at all. But it was and is my life. I have difficulties opening up and expressing my feelings and advocating for myself when the moments are true and appropriate to do so. I know it's the healthier way to communicate, but I was literally taught to stay quiet and be useful. Fast forward 20-25 years and I'm going to be 35 and I feel like just ending it all. Every year my birthday passes and I'll get a text from my family happy birthday. But they know I'm in a difficult place, they know I miss them, they know I love them and forgive them, I try the high road whenever I can but I just don't see the point anymore. they won't celebrate my life and existence, but they'll throw family gatherings for each other, birthdays, christmas, fathers day and mothers day.
On that note, another mother's day has recently passed and my mother never invited me over, I texted my father three weeks in advance in hopes of securing a time to come over and celebrate my mothers life with my family as a family. I felt particularly stung this mother's day when they celebrated and didn't text or call to invite me over. I live in the same small town so it's easy to hop over. I literally live three blocks away.
Anyway, my mother was diagnosed with cancer over christmas this year and I have been worrying for my mother ever since and thinking about my life with her and the mortal coil and the finite mount of time I may have with her. I feel like there is a large empty part in my heart that wishes my mother and I could go grab a coffee together. She can show me her ipad app art that she has been really excited about for a couple years now. She loves showing off her digital art and I love seeing her joy and how proud she is about her art. I just don't know why she couldn't feel the same for me, her only son. Maybe I'm just a her dissapointment.
I dropped out of highschool and left the family home when I was 16. I just couldn't work for my dad during the night AND go to highschool AND socialize. Something had to give. Unfortunately it was highschool and my parents didn't really care about that at all. They were just... fine with it. they supported my sister through college and she was fortunately able to graduate with a veterinary degree of sorts. she still lives with them now as she pays off her student debt, but I left and travelled and worked on music for over a decade so I admit that I was entirely out of the family picture for some time. But as I get older, not wanting to repeat the mistakes of my parents I fear that that is precisely what's been creeping up in my life.
five years ago I met the absolute most wonderful human being and I am so lucky to have my partner in my life. She and I are engaged now and set to be married. I hoped that the news would overwhelm my parents with excitement and joy. Maybe a facebook post about their son, share some family pictures or something. But they did nothing at all. I think they showed off pictures of the trip to Mexico that week instead.
I just don't really understand how I'm this unworthy of their love and unfortunately now I'm realizing that illusion that I am unworthy has infected my relationship with my fiance. I love her so much but when I can't fix everything in her life I feel like I am the failure and the guilt overhelms me so much and the guilt is such a strong motivator for me, and it usually motivates me into becoming the biggest doormat in the world. I've never worked harder for a relationship or invested this much energy. I feel she deserves it. But I don't advocate for myself. So I build up resentment. Like I clean the house constantly and work and help bail out of her bad spending habits and cover her rent without question and this and that. To be clear, she doesn't take advantage of me and that's not how I feel about it. But I do let this annoyance build up inside of me because I don't know how to communicate my feelings in a healthy way. I'm scared I'll lose the person if I speak up, or I'll be gaslit. Again, that's not my partner that gaslights. That's just generally how I feel I'll be treated if I open up with people. It all goes back to my childhood. It's affected every friendship and work relationship I've had since.
When I was 20-ish, 15 years years ago I did the classic, "seek the relationship that most comfortably fits into the patterns you experienced with your parents". And so I trapped myself in a horrific and extremely damaging relationship with a girl I'll call K. She has undiagnosed bipolaBPD, she would never seek help but self-medicate. She ended up in the hospital maybe four times for self-harming and this where she was considered to have these diseases by a few doctors on different occasions. Anway, it turned into a relationship of abuse and it wasn't exactly new territory for me. I was ashamed in that 8 year relationship. I wanted out so bad, but she would threaten to unalive everytime I tried to get away. Of course, some weeks would go by and i would get my hair pulled out of my scalp, a knife waving in the air in front of my face, spat in the face, kicked, punched, bit, a pot of freshly boiled ramen soup thrown in my face and eyes. What's worse is that I seeked police intervention on multiple occasions. Every single time the police visited, they talked me out of pressing charges, asking me " well if she doesn't have any place to go, then do you have a place you can stay at, or the shelter?". twice they talked me out of a restraining order, that legal proceedings would take forever. Adn de-escalting me from wanting to take measures to ensure my safety because she may end up on the street as a result. To this day, I absolutely wish I advocated for myself here and pushed for a restraining order. I'm so mad at myself for not doing so.
Unfortunately, fast forward a couple years into that relationship and one evening everything would finally hit the fan. I told her to never touch me again and I absolutely meant it. she had just yanked out the largest chunk of my hair to date, to the point where my scalp was bleeding and I could even see epidermal matter still attached to the folicle ends that were in her clenched fingers. My head bled a bit and I pushed her off of me. Telling her that I needed to leave, that I was walking to my secure jam space just a 10 minute walk away. It had a leather couch in a cold concrete basement, but hey at least I would be safe for the night and I could play my drums and try and blow off this anxiety and fear in a way that was safe albeit very noisy.
She hated that I wanted to leave and convinced herself I would never return. To be fair, that was the energy I had. I never wanted to see her face again and have her name on my lips after that night. So her tactic was simple, to threaten me with calling the cops and tell them that I violently pushed her. I called her bluff and said "go ahead and I will just tell them everything you've done - yet again. All I am doing is going to the space to sleep, I said, maybe play drums." She called the cops and told them she was pushed into a wall, and she felt very unsafe. Which yes, I did push her off me when she attacked me. In the past, I tried various tactics, to run away didn't work, she just always chased me down. Or sometimes I would just sit there while she was violent against me and I just "dissapeared" kind of like how I would when my dad used his coat hanger. This time, I just pushed her off of me, I was done with the relationship at that point and we both knew it. Anyway, she called the police, they arrived and when questioned I told them that I pushed her off of me in self-defence. I was drinking that night and it didn't help my case as I was arrested without question that evening and I was charged on the spot without question with domestic assault. It devasted me. I asked the police how this could happen lawfully. That she is an abuser and there is a history of this multiple times. That I've requested a restraining order. They explained that in quebec the laws are a little different and in the case domestic cases, if there is a male aggressor against a female, then the male is automatically charged to the fullest extent. I was absolutelyu devasted by this. I can't tell you the amount of fear and anger I felt in that jail cell that night.
I feel so incredibly betrayed by the justice system, keep in mind, this is law that from what I understand is only in Quebec, I was there for music at the time with an old friend whom I am no longer in contact with. I don't think the rest of the country operates under law in this way. Now I appreciate that they are vigilant about woman abuse victims, but the law shouldn't be this absurdly biased. It just doesnt feel just and fair to me. Covert abusers shouldn't be able to take advantage of the justice system in this way, but it happens.
It was an awful experience, I was homeless for a couple months afterward, not allowed to retrieve my belongings, so I lost all of my life "crap" that I had built up, years of hardwork and investment. I mention this because I realize later in life that I have intense collecting behaviour. maybe as a self-soothing behaviour. But I love building up collections of my hobby stuff as I have many and I feel they keep me regulated and it's a form of therapy for me. In any case, I lost everything when I left that whole situation. It sucks, although ultimately it's clearly best that I got out of that dreadful circumstance. I flew across the country to my hometown and to be closer to my family and old friends from highschool. It's quite a small town mind you.
Unfortunately, my classic tendency to hide and not advocate for myself created an opportunity for my abusive ex. A year following those events, despite me assuring her that I had to block her because I flew away to start a new life provinces away. That I wished her the best. That I even promised I would never tell a soul what she did to me. Not to mention that unfortunately we live in a society where nobody really has an ounce of sympathy for a male abuse victim. I had every intention to keep that promise, but she couldn't trust me ultimately. I think her logic was maybe to just beat her ex to "the punch". Kill or be killed or something like that. I don't live my life like that so I don't really know what her plan was. But she made a bunch of posts on various social media platforms for all of our mutual friends, music friends, coworkers etc. that the relationship was over and she was free. That she got out of a cycle of abuse and she was ready to start a new chapter of her life. She never used my name, just that she was glad she got away from her toxic and abusive ex once and for all.
It was exactly like that night a year prior, she threatened me with this outcome she could design for me, and I called her on her bluff by saying I was still going to block her and I can't control what she does with her life or how she conducts herself, but that I was out and to never contact me ever again. She made me regret that decision.
The posts she made that day got so many likes and support from so many of our mutual friends, even musician mates that were closer to me than her, and it absolutely destroyed me, not just internally but socially. I no longer make music anymore and it hurts to go outside into the world because it feels like everybody sees me as this monster. And still I don't have a voice to inform anyone otherwise - except my family and my fiance. I have no friends anymore. They all left my life with the belief that I did all of these horrible and awful things.
I just don't trust people anymore as a result and it's just caused me to become extremely bitter and depressed. I ruminate on the past, maybe in attempts to fix the past so I can move on. So I could do better, so I don't have to punish myself for my mistakes in the past. But it just reopens every emotional wound I have and they never get a chance to heal. That was maybe 7 years ago now and I'm still replaying these events in my head every single morning for about 1 - 2 hrs. Then I go completely numb for the majority of the rest of the day, shallow breathing, and the mildest sadness that mascarades as fatigue and disinterest.
There are some days where I seriously fear for the future and I just feel like every cruel soul will inherit this earth and that's the future, they built this world of suffering and they deserve to inherit it. Their toxic flag staked so deep into the earth in reclamation. The future isn't holding any seats for people like us. I'm so heartbroken and defeated. I feel like white-wolfing my fiance because she deserves better than this traumatized person that hides from the world. I feel like giving her my collection of collections so she can sell it all off and pay off her 10k of credit debt, then with this act of kindness I can go out not feeling like a guilt-ridden defeated loser. And leave on a high note.
When I'm alone, I get trapped in these ruminating cycles and it's the angriest I ever get. It's reached the point where I feel like I am actually reliving all this past trauma every morning and I can't do it anymore. I just feel like I am so at the end of whatever this ride was.
I don't have any friends anymore and everyone but my fiance thinks I am a monster and it's just unbearable.
I just don't even know. I am even afraid that someone will read this post and suss through all of this and make the connection. Then I'll get another new email or random throwaway account with an insta message that says "I told you you would never be able to get over me. You can move on, but you will never be able to erase the past. Never truly. You know where to find me."
It's haunting and it's poisonous. I just feel haunted and poisoned and I don't know if there is a snake oil potent enough or antitode true enough to get me back to the generous, lighthearted, energetic kid I once was.
To whoever was willing to read through all of this, thank you for hearing me out. I don't know what advice I am even asking for here. I'm hoping just speaking this out into the world in some way can alleviate this misery. I don't know.

I had a patient on my unit a month ago where I work as a charge nurse. High anxiety, borderline delusional, asking for clinically inappropriate interventions. She seems to have an obsession with hating me as we had some interaction (appropriate and professional) when I was charging while she was on the unit. Things like me telling her she couldn’t walk off the unit with her tele/IV pole to go o the ER to have a doctor look at her stubbed toe, which she was requesting an orthopedic surgeon for. That’s just the tip of the iceberg. She of course left a 3 page essay in her Press Ganey survey about how awful our unit is and I am and messaged the president of our hospital on his personal Facebook about it.
A month later and she isn’t letting it go. Now she somehow found my personal email and sent me a long email about how I’m a terrible nurse. Has anyone had an experience like this? What should I be expecting from my leadership about this? And how the heck would she have gotten my personal email?

I need advice, though this is partially to vent, I want to get my thoughts and feelings out there, so that maybe something someone says can help me. I (F18) live in my childhood home with my father (M55), mother (F50), sibling (NB14), sister (F21) and brother in law (M23). I get along great with everyone, except for my father. I've known my father, mother, and sister as long as I can remember, my sibling is 3 years younger than me, and we've known my brother in law for about 5 years.
In childhood, my father was never really present in our lives. He worked a normal job with normal hours, but when he got home all he did was watch TV. I remember this very distinctly as we were kicked off the TV at 5, when he came home. Even when he was off of the TV, he was distant and never really involved with us. Even when he did take one or more of us out, it was just to something we liked for a small amount of time, then we had to go to a hardware store or something with him for hours. All of us quickly learned to not accept his offers of going to McDonald's for a quick meal. He'd occasionally trick us, saying it was a reward for something, then drag us somewhere anyway.
His distant behavior became worse when his dad died, and his mother came to live with us. To make a long and horrible story short, she put me and my sibling through hell, bullying us about weight, appearance, behavior and anything you could ever think one would nitpick children for. This was when I was 13-14, and it left a lot of issues for myself and my sibling to deal with. At first he denied anything was happening, but then it got so bad I slipped to my therapist that I wanted to end my life, and he took me seriously after that. My father's mother was kicked out, but I was in rough shape.
Ever since then he has treated me like a fragile flower, always trying to say things like "You can always talk to your mom or I", but he knew this wasn't the case. I could never bring up anything with him as he would just tell me to go to mom, and never really supported me emotionally. He has depression and anxiety just like myself and my sibling, but unlike us he doesn't take his meds or go to therapy; he basically just doesn't do anything to improve himself.
But it really got bad when my sister graduated from high school and moved out. She had been with her boyfriend for about 3 years when they got engaged, and were married. This sent my father on a downward spiral. According to my mother, he had a bad drinking problem in the past, and had calmed down for a while, but this is when it started up again. My sister was always his obvious favorite; she looked like him, was athletic, smart, extroverted, and she had none of the mental issues he did. So her "leaving" him was very hard. He just couldn't deal with her growing up. I think it was partially because he never spent time with us, since after that he kept asking me to spend time with him, but at that point I had checked out of the relationship as much as he had.
He started spending more time in front of the TV. It really didn't help that he had an injury at work and had surgery on both of his shoulders, and he was being bullied when he did work. At this time, my mother had gotten a job to help pay for everything, and I was mostly home with my father, and he decided this meant I would do everything-all of the chores, cleaning up after him, cooking... everything my mom would normally do. They operated on his non-dominant shoulder first, so he could've helped, but no, he's just a poor helpless baby. I was 16 at the time, and also trying to learn to drive. His "driving lessons" consisted of him scolding me occasionally if I did something wrong, but not helping me learn at all.
I wanted to find a job, but between school and taking care of the house I was unable to. I got an allowance, but it was rather pitiful, and didn't even partially compensate me for the hours of endless work. Then there was an incident. My mom had told me to watch out for him when he'd been drinking, and I can easily tell when he was drinking. This was a day where I could tell he was drunk, but he came in asking for my help with something. He said that our truck was having issues and he wanted to look at the engine, so he asked me to help him wipe it off. I agreed. I went out with him, and my "helping" him was him watching while I wiped off the hood. Then he started to get angry.
I was focusing on the hood since he said he needed to lift it to look at the engine, but he told me to focus on the windshield. I was obiviously confused, but he grabbed another wiper and started to violently break apart the snow and wiping it off. I was still confused and kept wiping off the hood, but that made him more angry. He was moving in a way I knew would hurt him, but he was now raising his voice with me, angry and showing it. I started to dissociate, as that is my coping strategy, so I don't remember the exchange very well. All I know was there was a lot of swearing and yelling and calling me useless. Eventually he threw down his scraper and stormed off to the house.
I remember I was cold, sad, and I wanted to cry and run off into the woods never to be seen again. I wanted to scream, sob, punch a wall; but I did none of that. All I did was stand there for a while, then remember it was garbage day and take the garbage cans down. When I got inside, he was in his chair, watching TV, whistling to a song. I went to my room and cried. I hated myself, him, and the world so much, and that day I broke a streak of almost a year of self harming. I wanted to do more, but my dog helped me not to.
I wish I had let him go. I wish I had let him drive. At that point I still had some slight love for him, and that made me want to prevent his death. I honestly regret that now. He often got mad and snapped at mom, but it was never directed at me before. I knew that mom, with all the stress she was going through with her job and being both the house- maintainer and breadwinner wouldn't be able to handle that he had snapped at me. So I downplayed it, just telling her what happened and she said he probably either wanted fast food or alcohol, both of which he is addicted to. I still haven't gotten an apology.
I'm going to skip over some time here, as honestly his behavior is too frequent and habitual to mention every frustrating thing, so I will fast forward to the worst of it. A few months before my sister's wedding, it got really bad. He had yelled at my mom a few times, and every time we just took the dogs into our rooms, and we had gotten door knobs with locks specifically for this sort of thing. It happened often enough that all it took was a text to the other, and my sibling and I knew what to do. The worst happened on March 23rd, 2023. I don't know how it started; we never knew, but it didn't matter. The worst part is, my sibling was stuck in the bathroom when it started, right next to where my dad was screaming at my mom. They can't use that bathroom now when he's home because of this.
All I knew was I got the text and got our 2 dogs in my room. All I could hear (I was on the 2nd floor and this happened on the 1st) was how my mom was a bad person, getting the kids to hate him, she was a female dog, etc. Again it's a little fuzzy, but it got worse when he got to the 2nd floor. When you get to the top of the stairs, to the right there is their bedroom, and down a short hallway there is a bathroom and 2 bedrooms, one being my sister's old room. He went in to their room, and all I can remeber is him screaming over and over, "And you can just go F YOURSELF", all while slamming their bedroom door.
He did this for a while. All I know is that I, my mom, and my sibling all recorded it, but I am not willing to listen through that recording to figure out how long he was yelling at the top of the stairs, but the recording is 10 minutes and 47 seconds. Eventually his slamming of the door got too forceful, he broke the whole door frame, and the door ended up wedged in the staircase. He knocked himself out in this process somehow, and was out for a while. When his friend came (mom had called him), he even tried to fight him, but he was put into bed. He says he doesn't remember this whole night.
There was an intervention after, with mom and his friend, and he agreed to stop, or at least slow down. He didn't. There were some more screaming fits, and the last major one was in the beginning of December. But now, instead of screaming, he'll just get mad and snap at mom for nothing. I hate seeing her cry, and this affected my sibling and I as well. My sibling hates him, and is just waiting for him to die. They felt conflicted about this at first, but after father corrected himself after using their correct pronouns and made a comment around them about how anyone who's trans is just mentally ill, they lost the tiny sliver of affection they had for him. I have done my best to be a good older sister, assuring them it's normal, and helping them come to terms with their feelings. Now they just say we really are just waiting for him to die, and they feel nothing towards this idea.
Father has gone to therapy once, after a screaming fit where I wrote down how much him doing this made me want to die, but he says he doesn't want to go back. He continues to drink, and to not take his meds. My reason for this post was yesterday. Mother's Day.
Despite both mom and I working later than him, he still does minimal house work. If he does anything, it is to empty the dishwasher into the dish drainer, then bug mom for praise. Mom, sibling and I do almost all of the housework. I thought maybe he'd pitch in on mother's day, but no. I told mom she was not allowed to do any housework, and I did all of the laundry, dishes, cleaning, etc. The only thing I couldn't do was cook. But then, as I'm cleaning off the countertop and the table, father walks in and asks mom, "So what are you planning on doing?"
I wanted to punch him. He had been drinking, too. He'd been at least slightly drunk since noon. But HOW DARE HE. I think that was when I lost all hope for him. Then mom said, "I was just gonna leave it to you", and he had the audacity to look surprised, and even a little mad. He then walked away, I think to get stuff, but I don't care. I looked at mom, and she had the same baffled, amazed, and angry look I assume was on my face. But she looked a little sad, too. He couldn't do even this one thing on his own, on mother's day.
I had been angry with him for a long time, but at that it just grew into this huge raging fire. I hate him. With every bit of me. His disrespect and unwillingness to fix himself made me want to scream at him, give him a taste of what he gave us. But I couldn't. For the rest of the evening, mom couldn't just sit there; he needed to know the temperature and time things needed to cook, and she was just so frustrated.
Everything's at a boiling point. I want to tell him off, tell him how I feel, how much he's hurt everyone, and just how much I hate him. But I know I can't. If I do, he'll take it out on mom. Mom's too stressed already, as her job is hard and she's saving to separate if needed. She won't divorce him, since he could take the house, though they are both on the title, and she doesn't want to risk it. He's unhealthy as it is, my sibling is right; we really are just waiting for his liver to give out from all of the alcohol. But still, I am having a hard time living in the same house.
Sorry for the length, I get long winded when emotional. I'm just ignoring him for now, but I feel like my emotions could explode any day. Please give any advice you have. Thank you all.
TL;DR!: My father who is abusive has made me reach my limit, but I can't say anything. If I do, he'll yell at my mom, and I don't want that. I can't move out and she doesn't want to risk a divorce, in fear of losing everything, what do I do?

Hi Somebody Folks,
I want to start by expressing appreciation for the quality vegan food your establishment brings to Denver, Colorado. Although our city doesn't have the extensive selection seen in other major cities, your offerings at Somebody People, particularly the Sunday Supper, are exceptional. The approach reminds me of Tamar Adler's philosophy of using what's available, which is delightful.
However, I have several concerns that detract from an otherwise excellent experience with your brand:

1. Staff Behavior: The staff at both locations consistently come across as rude and standoffish. During a recent Sunday supper, a staff member swinging a handful of cutlery nearly hit my partner's face while carelessly serving another table and only offered a curt scoff without an apology before returning to their duties.
2. Noise Levels: The ambient noise at Somebody People is overwhelmingly loud. It's challenging to converse with my dining partner across a two-person table, much less in a larger group setting. Frequently having to ask your waitstaff to speak up or repeat themselves adds a layer of anxiety and irritation.
3. Closure of Everyday Pizza: I'm disappointed that Everyday Pizza closed. It was a relaxed spot perfect for grabbing a bite before shows at the comedy club. The lasagna was excellent, and the vegan options were digestibly satisfying. Why was this space converted into a nightclub?
4. Patron Behavior at Stay Tuned: This is my most significant concern. As a coach, and performer at the comedy club, which shares a common space with your business, I've observed unacceptable behaviors. This happens everyday your space is open. For instance, last Sunday at 5 PM no less, a patron was openly using cocaine on the bathroom counter and even offered some to one of my students. This type of activity is a frequent irritation and safety concern. Patrons from Stay Tuned are often aggressive, invade private spaces like the closet where Biker Jim's stores dry goods to use drugs, and the lack of intervention from your security and coat check staff perpetuates an unsafe environment. It's distressing to be solicited for drugs when using the restroom, reflecting poorly on Somebody People’s leadership and the brand you are trying to build.

There isn't a way to send this to them. They don't acknowledge complains on their instagram and i don't have an email address.