Hi so I suffer from depression and only work 3 days a week and I am glad I have this job buuut
It does not pay the bills, of course. And worse I'm already thinking about quitting again.
It's Callcenter outbound stuff 5 hours straight I call another person every 1 to 4 minutes and tell them exactly the same. It's so fucking boring I constantly keep standing up, strolling around, picking my hair or skin, manically spinning in my chair or other stupid escapist stuff like I'm a captive animal or something idk
I'm glad I have this job and I can do it from home, I really don't want to go outside but from July on I will also have to come to the office every other day. Not because I'm failing (quite the opposite, I am very good at my job and do more then expected ), it's just company bullshit everone has to follow.
So yeah idk I have a boring job that does not really allow me to distract myself from the boredom since I'm constantly talking to people. It does not pay the bills. I don't want to got outside but I have to starting July .
I'm trying to build up a side hustle by selling drawings but it's slooooooow and also the only three days of utterly boring work are draining my energy even more so I don't get shit done
I did not find any other Callcenter that allows 100% Homeoffice and also most of those are even more demanding and boring and the same time, I've been working at many withing the past 10 years and all of them suck. I guess a boring Callcenter job like this is better then one where you get yelled at by every customer, but still this is driving me crazy.
I don't want to quit because that would mean to go to welfare/job center and they are a pest over here, I'm sorry to say that but they will make your life a living hell although it would give me more money then I have right now... But it would also force me to give up my side hustle.
Please note: I'm currently on the lookout for free or cheap therapy but it's very hard to find (I'm at a waiting list for next year for only 10 appointments but better then nothing I guess...)
Like
Idk I'm fucked. Please tell me how to cope with this. How can I endure this boring af shit without going completely crazy. I also take recommendations for other jobs I can do 100% from home if there are any... Companies seem to hate home office

Lol now ihub punk is asking “What is the current sales pipeline for Lightwave Logic's polymer modulators and other products? Can you share any details on the size and timing of potential deals with the 20+ major corporations that have viewed the technology demo?"
"When do you anticipate Lightwave Logic will achieve its first $1 million revenue quarter? What milestones need to be hit to reach that level of quarterly sales?"
"What is the company's plan to become cash flow positive and profitable? When do you expect Lightwave Logic to reach profitability?”
Punkin has come a long way, he used to say that it could never be done, now he keeps falling back, apparently trying to hold the line, lol, now he is asking questions about revenue and dang even invoking God to help humanity as his reason for posting in his credentials. Even if one thinks that they are right that is quite a statement, typically something that a reasonable person keeps to themselves a life's effort is something between them and their creator. I have no idea where this technology will lead or what it will solve, my goal is an investment, certainly not divine, I have no clue in the end who it will truly benefit but the medical thing does have potential.
Today I'm happy with thousands of modulators on a foundry produced wafer. And thousands of modulators from a few ounces of Perkinamine. These modulators Triple the speed, reduce the power and are 1/30 the size of today's modulators. Lebby will fill us in on what we need, he is far more intelligent than anyone on this board.
Read on folks.
Oh and do not forget about those that sold early (or didn’t sell early) that purport to be long and like to consistently complain every single time the price drops. Let me try to explain it this way, this is not a sports game, this is a technology, so unlike sports, points can be literally be taken of the scoreboard by simply borrowing and selling shares (shorts). Remember though that those shares must be purchased back and until then the actual score of the game is not known. So the shorts agenda is to sell it down then try and convince folks to sell them shares at that discounted price. Some longs do not understand that they are helping the shorts at their game. That being said, there are currently 17% more shares sold than exist. They have borrowed those shares and pay interest daily and have sold them to us with the hope of buying them back at a reduced price (Some purported longs even try to help them) apparently, they think that if they complain it will force an NVDA, Microsoft, IBM, Amazon to reach an agreement with Lightwave sooner. Well, it will not change the speed of the adoption of the technology, I’m all for doing a tier1 agreement, but a few quick little agreements could force their hand so the Tier1’s do not have to have to honor those agreements should the company be taken over. Some seam to forget that until now Silicon photonics could keep up, but no more and with AI we just entered a new world, where the pace set by Moore's Law for silicon photonics is leisurely compared to this new demand. AI is totally on a sprint, with its computational power doubling not every two years, but approximately every six months.
Let me look at what the shorts have said over the years basically throwing spaghetti at the wall and have been proven wrong. Patents were filed in 2020, 2021, ALD I think was 2022. Patents were not made public, the shorts were babbling meanwhile Lebby had not only solved it but wrote and submitted patents.
Here are the 10 top B.S. short myths, trying to suppress the stock so they could try and cover I also think that there are a few purported longs that sold prematurely that are now helping to push the shorts game forward, meanwhile with the next deal announcement the dam is about to burst.
I’d love to see Punkin hold a conversation with Lebby one on one for 5 minutes, it would be hilarious,
Shorts and those paid by the shorts to act like they “know something” won't even tell you when they are short, they just say, no not short just here to spend my life 7 days a week helping folks that I have never met. Well, here they are, you tell me guys.
1.) The shorts had worked for months to try and convince investors that Lightwave had a problem poling. Then low and behold Lightwave unveiled 2 patents they submitted years prior solving that issue.
2.) The shorts claimed for years Lightwave could not protect the device in anything other than a gold box, then Lightwave unveiled the ALD patent that they had acquired. Basically, hair spray over the finished chip is all that is needed. The foundries are using the same thing over the electronics side of the chip. Understand that even if someone else invents an EO Polymer Lightwave Owns the Patent on ALD over Polymers. Comprende?
3.) The shorts claimed Lightwaves material was not stable, Wham Bam blown out of the water yet again.
4.) Shorts said that Lightwave could never get this under 1 volt, well Lightwave did, in fact Lightwaves polymer is so sensitive that their modulators can function without the aid of driver to boost the voltage. Basically the electrons in the 1's and 0's rolling off the silicon can embed themselves into the laser using Lightwaves polymer. Oh and by the way, Lightwave also owns the patent on a driverless Polymer Modulator. Even if someone perfects a stable sensitive EO polymer when the want to do direct drive, they have to come knocking on Lightwaves door with cash in hand.
5.) For the 6 months leading up to last years annual shareholder meeting the shorts stated Lightwave could not close a commercial deal all the then like now trying to convince us that the sky was falling and once again Lebby delivered.
6.) For months the shorts said Lightwave could not use anything other than gold on their electrodes, well guess the F what, yup, once again (at the shareholders meeting) Lebby put up a slide of successful foundry runs and when asked by me if the contacts labeled AL on the slide stood for Aluminum Lebby said “yes, we use that any many other materials as well”. I asked about aluminum corrosion, the response was, X (you idiot) that is what the ALD will also protect.
7.) The Shorts were trying to convince longs that the foundry had not made progress on PDK’s, Lebby certainly blew them out of the water on that as well. As info PDK’s are process development kits, it is how the foundries make Lightwaves devices available to the public so when an NVDA’s, Amazon (AWS), Cisco or Fujitsu are designing devices they can check that box and add that to their device in the foundry. 2 weeks ago lebby said the foundries have thousands of modulators per wafer. On question that I need to understand is that with thousands of devices on a wafer how many of those thousands of modulators are affected by the kerf when dicing (sawing or scribing?)
8) The shorts used to say that it couldn’t me done now as you see Pumpkin is asking Yes but “What is the current sales pipeline for Lightwave Logic's polymer modulators? Can you share any details on the size and timing of potential deals with the 20+ major corporations that have viewed the technology demo? When do you anticipate Lightwave Logic will achieve its first $1 million revenue quarter? What milestones need to be hit to reach that level of quarterly sales? What is the company's plan to become cash flow positive and profitable? When do you expect Lightwave Logic to reach profitability?” Lol, Lol and again Lol It sounds like Pumpkin is finally being honest, perhaps it is by divine intervention on his posts
9) As info the institutions now own 26% of the shares, The shorts would have us believe that is irrelevant, wait what?
10) I like this, Ted who also has another ID said that he gets his info from the internet because everything on it is true. When asked why he does not use first-hand information he said that he is not good at reading people, lol and yet he watches every video with baited breath.
I know some do not see it but as evidenced by their latest efforts the shorts are worried and it is obvious that whomever they got their info from was consistently years behind making up issues that had in fact already been solved. I would not want to have been an advisor to the shorts.
Lightwave is finally at the stage where they have the patents in place, moved into additional lab space, hired additional lab personnel for making larger quantities of perkinamine, (a few fluid ounces can make thousands of devices) the new lab will be equipped to test larger quantities of chips coming back from foundries, work on new polymers for additional devices (they even have another polymer available for licensing) produce data sheets, standardize bulk testing, they have even hired a dedicated deal maker, oh also a V.P. dedicated just to working with foundries that are actively running wafers. Now they have added a former Intel deal maker to the board of directors.
Soon this thing will in fact snowball because the industry's "go to" good old silicon photonics has hit the wall it simply cannot run faster. Lightwaves material when added applied to Silicon triples the speed and because it is so sensitive it is 30times smaller and uses 1/10 the power all at a time when AI is pushing the amount of data processed by the data centers through the roof.
~Some of us were wondering why the Lightwave employees were still in town (apparently held over) for an extra 2 days over after the OFC San Frisco meeting, now we see that there were no less than 20 companies that apparently requested an unscheduled impromptu demo on a holiday week (good Friday) after the convention was over. Not only did Lightwave employees not go home but it sounds like a bunch of Tier 1’s and such saw it as important enough to see ASAP. And yes while many on here say that NDA’s do not exist, LOL I’ll bet that not only were NDA’s mandatory but I bet that every demo was “private” by scheduled appointment only and also attended by the various expert employees at Lightwave to get the most bang for the buck.~
Lightwave makes the thing that makes the component better anyone communicating using fiber optics needs it, the entire industry needs it. Think if BASF produces a chemical that makes paint last longer. Why would the paint manufacture tell its competitors what makes their paint so durable. Lightwave is going partner with many and they will simply sell devices that are faster and require less energy, those companies are not going to tell the competition what they do to make that happen. Lightwave will quietly market to the tier1's and they will insist on it in their data centers and devices. The one exception that I see is that if the foundry runs were paid for by Lightwave Logic (vs. say an amazon or facebook etc) Lightwave would do joint public PR of where the industry can order chips with Lightwaves Perkinamine on it (It is called checking the box on the PDK).
The shorting situation will be solved by additional Partnerships and look out when those Partnerships are accompanied by a dividend in a new 3rd party company licensing say the ability to develop the Lidar device market or for the biotech crowd a medical sensing partner, wham short situation solved in short order. Remember that currently they are only talking about Telcom 2km to 10km market but there are so many more.
Currently 1k difference between the buys and sells changed it 1 penny. Folks this is just normal trading without any pressure on the price. This time next week we’ll either be in the lab or in the meeting.
Still trying to digest the effects of T+1 on the shorts especially the foreign exchange rate, Fails To Deliver, Naked shorting etc. it is coming the Tuesday after Memorial Day (Holiday in the U.S., which is the weekend after the Shareholders Meeting), Finra Settlement Date 5/31 which then will mean a trade date of 5/30.
Short Game, Market Maker Game, Institution Game, changing technology
Check it out rainy day so I thought I’d look Punkin “I never said any of those things in that context. I’m just here doing Gods work” https://investorshub.advfn.com/boards/read_msg.aspx?message_id=174419282 That was in reply to JimJet218’s statement. 1. Couldn't be poled. https://investorshub.advfn.com/boards/read_msg.aspx?message_id=169035142&txt2

1. Needed a gold case. https://investorshub.advfn.com/boards/read_msg.aspx?message_id=170733222&txt2
   
2. Would never be less than 1 volt. https://investorshub.advfn.com/boards/read_msg.aspx?message_id=144502197&txt2 Pumpkin claims to be doing “Gods Work”.
   

Xster Rainy day so I thought I'd spend few minutes today,
Getting spanked so far today.

Date: 5/16/1978 Time: 14:09
\Begin Transcript\**
Note - Subject is a five-year veteran of the Vietnam conflict. Highly trained; extremely dangerous. Dishonorably discharged on allegations of war crimes but never convicted by military tribunal due to advanced psychotic state. Since internment at [REDACTED] Psychiatric Hospital and following his procurement and admission into the program, subject refuses to acknowledge present situation or past indiscretions; instead choosing to believe that he never left Vietnam, and that on-site staff are ‘communist sympathizers’ out to coerce "sensitive information" from him.
[Patient 22] - Let go of me, you slope-loving bastards! I’ve killed a hundred before you and I’ll take you down just the same! Get the fuck off-
Note - Subject is restrained in chair.
[Doctor] - Don! Don, please. Nobody’s going to hurt you. It’s alright.
[Patient 22] - Bullshit! You don’t fool me for a second. I’ve been out there in that fuckin’ jungle hell for as long as I can remember! You think I don’t know a commie when I see one? I’m a fucking marine, you traitor piece of shit. Wipe that goddamn smile off your face before I smack it off!
Note - Subject begins to tense violently against restraints, grunting in an attempt to free himself.
[Doctor] - Hang on. Don… I mean, Sergeant… I wasn’t laughing at you, alright? I wasn’t. Please, will you let me explain for a second?
Note - Subject seems to calm down, somewhat; glaring/seething. Writhing against restraints subtly in an effort to loosen them.
[Doctor] - Now I know that you spent a helluva long time out there, and God knows that you did your country proud. I just want you to know that you don’t have anything to worry about here. You aren’t in Da Nang. In fact, you aren’t even in Vietnam anymore. You’re home, Sergeant. In the United States.
Note - Subject seems to take this in for a moment in a way previous attempts at reaching him did not. However, just as quickly, his face reverts back to the same stony affect that he entered the room with.
[Patient 22] - That isn’t possible…
[Doctor] - Think about it, Sergeant. The vietcong could never corrupt as many red-blooded Americans as you've seen just on your way down the hallway from your room, right? Nevermind since… Well, tell me, have you seen one foreign face since you arrived here last week? Where are the Communist comm centers? Where’s the number stations? The bamboo cages, the torture? There’s none of that here. Because you aren’t there, Sergeant. You’re here. You made it out alive. And in one piece, to boot. That’s more than can be said for lots of men who didn’t-
[Patient 22] - What the fuck would you know about who made it back and who didn’t?
[Doctor] - I never meant to say-
[Patient 22] - You said enough. If we aren’t in ‘Nam anymore, then I want to talk to my goddamn CO. Get [REDACTED] on the horn, have him tell me that it’s the God’s honest truth that the bastard pulled me out just when the fighting was getting good. We almost had ‘em! We pushed those bush monkeys back into the jungle! Are you saying he would do that? Are you questioning [REDACTED]’s competency?
[Doctor] - The fight is over, Sergeant. The President called it. In fact, it’s been over for quite a while now. Three whole years, to be precise.
Note - Subject is quiet, almost shaken. After a long moment, he looks up from the floor at Doctor [REDACTED], smiling.
[Patient 22] - Who’s the president? if it’s been three fucking years… then who is he. Huh?... Tell me!
[Doctor] - It’s Carter! It’s Jimmy Carter…
Note - Subject suddenly erupts from chair and lunges across desk towards Doctor [REDACTED], tackling him before he can press panic button.
[Patient 22] - You smug little bastard! I’ll tear your goddamn heart out so all the conspirators can see what a fucking coward you are! They would NEVER pull us out! You hear me! Never!
[Doctor] - Please, stop-
[Patient 22] - Shut the fuck up!
Note - Subject begins beating Doctor [REDACTED]’s skull with his fist while holding it by the hair in the other; is deceased by the time orderlies enter the room.
[Patient 22] - Come on, you freedom-hating fucks! I’ll take all of you, right here! Come on-!
Note - Subject is tazed via stun gun after mortally wounding Orderly [REDACTED] with a glass ashtray and using the broken remains to injure another. Tape runs for further seven minutes; mostly unintelligible due to the commotion as facility personnel go about removing Doctor [REDACTED]’s corpse following paramedics' evacuation of the wounded.
[Unknown] - Jesus… What a fuckin’ mess…
[End Transcript]

We will be bringing our kids (11 / 7) to NYC for the first time to celebrate my son and wife's birthday later this month. Son requested to see the Statue of Liberty and Starry Night (he has Lego sets of both.) We generally try to limit to one “major” activity a day as that is what works best for our kids. Kids are very into Lego and reading so we will plan to hit the Lego store on 5th and multiple bookstores. From a dining standpoint wife is Gluten Free, Kids are great eaters and have Sushi and Dumplings on the bucket list.
Here is our current itinerary with a few specific questions:

• Headlines about the Subway have been front and center over the past few months. I am not skittish but want to be reasonable about using the Subway with children – from a day-to-day standpoint is Subway travel as a family something you would be comfortable with or would you generally lean towards cabs and ride-share services?
• If using MTA how does fare-capping work when buying fares for multiple passengers? I know if you use the same card your fare is capped at $34 for a week but I am assuming this is per person.
• Any sushi recommendations in / around Theater District / UWS? It does not need to be a fancy Omakase experience. Solid Maki that the kids will enjoy is the focus here, carry out is fine.
• Any brunch recommendations in the Theater district?
• Any recommendations near Castle Clinton Monument in Lower Manhattan for an easy lunch?

Day 1:

• Fly into LGA
• Check-in to hotel (Hilton Midtown)
• Easy dinner (Los Tacos No. 1, Shake Shack, Twenty One Grains or similar)

Day 2:

• Breakfast / Brunch: Friedman’s (reservation made)
• Harry Potter and the Cursed Child
• Dinner: Ci Siamo (reservation made)

Day 3:

• 5th Avenue Walk
• New York Public Library
• Bryant Park
• Harry Potter Store
• Possible Option: The Math Museum
• Lunch: Nan Xiang Xiao Long Bao
• Afternoon / Evening TBD

Day 4: (Day 3/4 may be reversed depending on weather)

• Breakfast: Bread and Bagel
• American Museum of Natural History
• Afternoon in Central Park - simple lunch or eat take out in park
• Dinner: Senza Gluten (reservation made)

Day 5:

• Breakfast near hotel – Blue Bottle Coffee or similar
• Statue of Liberty (Crown) / Ellis Island (reservation made)
• Lunch: TBD in Lower Manhattan
• 9/11 Memorial Pools (Not Museum)
• Dinner: Keste or Simo for GF Pizza

Day 6: Wife / Son Birthday

• Lazy morning - donuts and coffee in room
• Open gifts
• Lego Store to shop for a Birthday present.
• Casual activities in / around Midtown
• Dinner: Osteria La Baia (reservation made)
• Wicked
• Post Theater cake or cupcake (Magnolia bakery or picked up before)

Day 7:

• Breakfast – TBD
• MoMA
• Afternoon / Evening (Parent Date Night)
• Dinner: Bird Dog (reservation made)
• Possibly Comedy Cellar if standby list is possible OR cocktails at Dead Rabbit or elsewhere.

Day 8:

• Sleep in
• Lunch at Chelsea Market
• Highline
• Little Island
• The Edge?
• Highline Hotel for cocktails / coffee
• Dinner: Shukette (reservation made)

Day 9:

• Head Home

Potential Activities as time allows:

• Brooklyn Bridge walk
• Top of the Rock (if we prefer to The Edge)

Hello everyone. I am a pre-PA student just finished with my undergrad in biology. I am grateful that I graduated and hope to go into PA program soon. I
I did my draft in my personal statement for PA program and was curious what you guys think on it. It might not be well-wrtten as this is my draft, but just wanted some honest feedback. (I tried not to look into other personal statement as I may unintentionally write it in my personal statement, and I just wanted to write it as honest as I can). Thank you guys!!!
Growing up, soccer was more than just a game; it was my sanctuary, a source of validation among friends. However, amidst the victories on the field, I often found myself navigating the complexities of the healthcare system due to various health challenges like atopic dermatitis, hearing impairments, and chronic sinusitis, which necessitated numerous surgeries. Despite these trials, my curiosity about the medical field remained latent, occasionally surfacing during my frequent hospital visits. It wasn't until an unexpected encounter during my stint at a restaurant that the seeds of my interest in medicine truly began to sprout.
As a young immigrant juggling familial responsibilities and the demands of the American dream, healthcare often took a backseat to financial concerns. However, witnessing my father's injury and the subsequent emergency response awakened a newfound appreciation for the healthcare profession. It was in those chaotic moments that I first encountered a Physician Assistant (PA) calmly orchestrating patient care, igniting a spark within me. This encounter, coupled with subsequent volunteering experiences in emergency rooms, propelled me towards a path of self-discovery and professional aspiration.
While the allure of medical school loomed large, it was the versatility and patient-centered approach of the PA profession that ultimately captured my heart. Through shadowing experiences and interactions with PAs, I gained a nuanced understanding of the integral role they play in healthcare delivery. Unlike the rigid hierarchy of traditional medicine, the collaborative nature of the PA profession resonated deeply with my values of teamwork and holistic patient care.
My journey towards becoming a PA has been characterized by resilience, adaptability, and a relentless pursuit of knowledge. From navigating the complexities of immigration to balancing academic pursuits with financial responsibilities, each challenge has fortified my resolve to excel in this field. As I embark on this next chapter as a PA student, I am committed to leveraging my diverse experiences and unwavering determination to thrive academically and professionally.
In preparation for this endeavor, I have immersed myself in various facets of healthcare, from serving tables at a restaurant to undergoing EMT training. Each experience has shaped my understanding of patient interaction, clinical assessment, and the importance of effective communication. Armed with a deep-seated passion for healthcare and a steadfast commitment to lifelong learning, I am poised to make a meaningful impact as a future PA.
In conclusion, my journey towards becoming a PA is not merely a career choice but a testament to my unwavering dedication to serving others. With each step forward, I am reminded of the profound impact that compassionate, patient-centered care can have on individuals and communities alike. As I eagerly anticipate the challenges and opportunities that lie ahead, I am filled with a sense of purpose and gratitude for the privilege of embarking on this noble profession.

Sorry, it's a long one, but I could really use your advice 😞. I'm not sure if I'm being paranoid due to my insecure attachment style and past relationship baggage, or if my gut feeling is onto something and I'm slowly losing it... My partner (46M) and I (40F) have been together for nearly a year, but so far, I've only met one of his friends and not a single family member on his side. He has met several of my friends. I have no contact with my family since almost 6 years, so he technically also never met someone of my family.
We met about a year and a half ago on a dating app geared towards casual dating. At that time, neither of us were looking for a serious relationship; we were just in it for some casual fun. On our first date, he mentioned he was still technically married but separated from his wife for about a year, and they shared a 13-year-old son. Since the separation, he's been staying with his parents, while his wife and son reside in the adjacent house. He never spoke ill of his wife, which is something I really appreciate.
He claimed it was love at first sight for him when he first met me, but I didn't feel the same way. I found him intriguing and attractive, but the idea of a relationship didn't appeal to me at that moment, mainly due to our lack of shared interests. He never pressured me and always respected my space, but he did actively pursue me. For every date we had, he brought food and flowers, even though we were just friends with benefits at that point. He also went above and beyond, helping me with various tasks like gardening, fixing my shower and car, all at his own expense. And even insisted on me not paying him back. He even picked me up in the wee hours of the morning when I was stranded in a bar with friends and couldn't find my way home, had medications delivered to my doorstep when we both had COVID-19 and couldn't meet, and these are just a few examples...
Our physical connection is fantastic, and he is very attentive to my needs. Surprisingly, from the beginning we also had dates without sex, despite that being our initial intention. Things quickly became emotionally and mentally intimate, and we started sharing more and more of ourselves. He treated me with more care and attention than anyone ever had, which initially set off alarm bells in my head, but his gestures continued, I just found myself enjoying his company immensely, both in and out of bed, feeling incredibly comfortable and happy with him. He always made me feel valued and appreciated, never failing to be loving and attentive. And to this day there has never been a single negative word or action from him towards me.
Around four months into our dating, he had to travel abroad for work for a week. During that time apart, I unexpectedly found myself missing him dearly, which came as a surprise because I wasn't looking for a serious relationship. One evening during that week, he insisted on hearing my voice, and we ended up talking on the phone all night. A few days later, I confessed to him that I missed him more than I expected and that everything felt strange, especially since I didn't even know his last name. In response, he admitted feeling the same way and expressed his desire to come over and properly introduce himself when he returned. True to his word, he showed up at my door late that night, despite his delayed flight.
However, what followed was a bombshell. As he sat on my couch, he handed me his ID, revealing not only his last name but also a different first name, birthdate, and birthplace. I was so stunned and literally nearly passed out. He had lied about his first name and was actually two years older than he claimed. Even details about his son, whom he claimed was 13, turned out to be false; the boy was actually 17. This revelation shook me to the core because I had never suspected he was lying to me. Being the child of an alcoholic, I prided myself on having keen intuition, but I had failed to detect his deceit. While I had actually suspected he was still married to his wife, his lies about his identity blindsided me. He apologized profusely that night, explaining that he didn't know how to come clean after lying for so long. But when I confronted him about his last name, he realized he couldn't keep up the facade any longer.
He confessed that he and his wife had indeed been living separate lives for a while, even agreeing to see other people. However, a woman he had met on the dating app years ago had stalked him, leading him to adopt a new identity to protect himself. He never intended to fall in love with someone and only sought casual arrangements. Although they broke up, he maintained proximity due to familial and business obligations, leading him to remain close to his family, and he committed to fulfilling his responsibilities towards them. His wife suffered from cancer a few years ago, which apparently returned at the beginning of this year.
The day after this revelation, he came to speak with me during his lunch break, begging for another chance. The following weekend, I met his best friend for the first time. Despite my shattered trust, I believed that he was sincere in his remorse and transparency, so we decided to it another shot and shortly after even committed to an official relationship. Things seemed to go well afterward; we even went on a vacation together, and he started spending more nights at my place. He continued to be incredibly supportive and attentive to my needs. However, he never made any efforts for me to meet his son, which I tried to understand given the sensitivity of the situation.
About three months later, I broached the subject of meeting his son again, but he claimed that he and his wife had agreed to wait until their son had settled into his first semester at university before introducing him to me. I had no children of my own so I have no experience with this, but friends of mine with adult children suggested that it was unusual to wait so long. Despite my doubts, I trusted his explanation, although I wondered if his family even knew about me. He told me that he was committed to his family until the end of the year and planned to move out thereafter. However, when the year ended, his mother caused a commotion when he moved out, leading to our first crisis over Christmas.
His parents insisted that he drive them to a city four hours away on Christmas Eve to celebrate with relatives, which disappointed me, but I understood. I assumed he would want to spend Christmas Eve with his son, so I suggested that we meet on Christmas Day instead to cook and spend a nice evening together. He informed me that his son didn't want to celebrate Christmas with the family anyway, so my suggestion was fine. Although we spent the evening before Christmas Eve together, our plans were disrupted when he insisted on going home instead of staying over as originally planned, leading to our first argument. He received a message from someone, read it, and his demeanor completely changed; he began to repeatedly look at the clock. When I asked, he said he needed to go home. I asked if I could read the message because I immediately had a bad gut feeling, but he declined and drove off. Despite feeling uneasy, I let it go until Christmas Day, when he arrived two hours late without prior notice. Also, I only rarely heard from him the entire Christmas Eve and most of Christmas Day, which is pretty unusual for him. This pattern continued after Christmas, with him becoming increasingly unreliable with his timing. After pressing him on the matter of meeting his son and family soon, he admitted that his family was resistant to the idea of accepting me due to their loyalty to his wife.
Our relationship hit another rough patch on Easter when he spent Easter Saturday with his son, arriving at my place much later than expected. Frustrated that I still hadn't met his son, I confronted him, leading to another argument and him storming off to his best friend's place without contacting me for the rest of the day. His lack of communication left me feeling hurt and confused, but we eventually reconciled after a few days. Even today, we're still crazy about each other and often behave like teenagers. But for some time now, I haven't been able to enjoy our meetings. I question everything he says and does, wondering, can I believe him? Can I trust him? He lied to me so skillfully at the beginning. Is what he says about his family even true? It feels like we're not making any progress. He insists it's exactly as he says. But over a year has passed, and it seems like nothing has changed. I just have to keep being patient and endure.
Actually, he never really settled into his own apartment. Everything is makeshift; there's no functional kitchen, no chairs... not even a mirror in the bathroom. Yet, we still occasionally sleep there. At first, it was amusing, but we’re both two old for this sh*t and the student apartment adventure ended for me after five months of stagnation. I really tried to make the best of it, and I'm actually really self-sufficient and easygoing. But it has become draining... He also sleeps at his family's place more often lately, and less frequently at my place...
What are your thoughts on this? Am I overreacting? Should I give him and his family more time? I'm feeling exhausted and grappling with my trust issues. Am I being paranoid, or is my gut feeling accurate? What steps should I take? Extend more patience? Show more understanding towards his son and family for their reluctance to get to know me? Consider giving him an ultimatum? I'm feeling lost.

https://twitter.com/isSCS4me/status/1742558882222760018
The following publication is further evidence of SCS inefficacy for opioid
reduction and potential treatment cost analysis. It compares conventional
medical management(CMM) versus SCS.
https://jamanetwork.com/journals/jamaneurology/article-abstract/2799084
"Long-term Outcomes in Use of Opioids, Nonpharmacologic Pain Interventions,
and Total Costs of Spinal Cord Stimulators Compared With Conventional Medical
Therapy for Chronic Pain
...
Key Points
Question What are the outcomes among real-world patients with chronic pain who
are treated with spinal cord stimulators compared with conventional medical
management?
Findings
In this propensity-matched comparative effectiveness research analysis of 7560
insured individuals, treatment with a spinal cord stimulator was not associated
with a reduction in use of opioids, pain injections, radiofrequency ablation,
or spine surgery at 2 years. Approximately one-fifth of patients treated with
spinal cord stimulators experienced complications and required device revision
or removal.
Meaning
Study results suggest that use of spinal cord stimulators is not associated
with reductions in opioid use or nonpharmacologic pain interventions.
Abstract
Importance Spinal cord stimulators (SCSs) are increasingly used for the
treatment of chronic pain. There is a need for studies with long-term follow-up.
Objective
To determine the comparative effectiveness and costs of SCSs compared with
conventional medical management (CMM) in a large cohort of patients with
chronic pain.
Design, Setting, and Participants
This was a 1:5 propensity-matched retrospective comparative effectiveness
research analysis of insured individuals from April 1, 2016, to August 31, 2018.
This study used administrative claims data, including longitudinal medical and
pharmacy claims, from US commercial and Medicare Advantage enrollees 18 years
or older in Optum Labs Data Warehouse. Patients with incident diagnosis codes
for failed back surgery syndrome, complex regional pain syndrome, chronic pain
syndrome, and other chronic postsurgical back and extremity pain were included
in this study. Data were analyzed from February 1, 2021, to August 31, 2022.
Exposures
SCSs or CMM.
Main Outcomes and Measures
Surrogate measures for primary chronic pain treatment modalities, including
pharmacologic and nonpharmacologic pain interventions (epidural and facet
corticosteroid injections, radiofrequency ablation, and spine surgery), as
well as total costs.
Results
In the propensity-matched population of 7560 patients, mean (SD) age was 63.5
(12.5) years, 3080 (40.7%) were male, and 4480 (59.3%) were female. Among
matched patients, during the first 12 months, patients treated with SCSs had
higher odds of chronic opioid use (adjusted odds ratio [aOR], 1.14; 95% CI,
1.01-1.29) compared with patients treated with CMM but lower odds of epidural
and facet corticosteroid injections (aOR, 0.44; 95% CI, 0.39-0.51),
radiofrequency ablation (aOR, 0.57; 95% CI, 0.44-0.72), and spine surgery
(aOR, 0.72; 95% CI, 0.61-0.85). During months 13 to 24, there was no
significant difference in chronic opioid use (aOR, 1.06; 95% CI, 0.94-1.20),
epidural and facet corticosteroid injections (aOR, 1.00; 95% CI, 0.87-1.14),
radiofrequency ablation (aOR, 0.84; 95% CI, 0.66-1.09), or spine surgery
(aOR, 0.91; 95% CI, 0.75-1.09) with SCS use compared with CMM. Overall, 226 of
1260 patients (17.9%) treated with SCS experienced SCS-related complications
within 2 years, and 279 of 1260 patients (22.1%) had device revisions and/or
removals, which were not always for complications. Total costs of care in the
first year were $39 000 higher with SCS than CMM and similar between SCS and
CMM in the second year.
Conclusions and Relevance In this large, real-world, comparative effectiveness
research study comparing SCS and CMM for chronic pain, SCS placement was not
associated with a reduction in opioid use or nonpharmacologic pain interventions
at 2 years. SCS was associated with higher costs, and SCS-related complications
were common.
...
Despite the increasing utilization of SCSs, there are limitations to the
evidence supporting its superiority over usual care, which includes conventional
medical management (CMM).6 Most SCS have been authorized by the US Food and Drug
Administration (FDA) without clinical data.7 Approximately 85% of large studies
of SCSs (ie, >100 patients) are industry funded.8 Independent evaluations have
generally been small, single-center, and nonrandomized.9
...
Eligible individuals were 18 years or older with an incident diagnosis of
failed back surgery syndrome, complex regional pain syndrome, chronic pain
syndrome, and other chronic postsurgical back and extremity pain (for the
latter diagnosis, history of spine surgery within 6 months of diagnosis was
required) between April 1, 2016, and August 31, 2019 (eTable 1 in the
Supplement for codes reviewed by multiple authors).9,16-18
...
SCS-Related Complications and Removal
Among the 1260 patients treated with SCS, 226 (17.9%) experienced complications
within the first 2 years after placement (Table 4). These complications included
breakdown, displacement, other mechanical complications, and infection of the
lead and/or generator. During the first 2 years, 279 patients (22.1%) had an
SCS removal and/or revision; 126 (10%) of these were in the absence of a
complication, suggesting lack of effectiveness.
...
"
The one editorial is worth your effort reading.
https://jamanetwork.com/journals/jamaneurology/article-abstract/2799086
"
While spinal cord stimulation (SCS) to treat multiple chronic pain indications
has been rapidly gaining popularity over the last decade, evidence of clinical
and public health effectiveness is limited due to small sample sizes or bias
related to authors that receive income from SCS manufacturers.
...
"
There are several critiques of the publication. Please use Google Scholar. I
advise using caution when reading because the source of the critique can be
conflicting.
I recommend reading the publication.

Thank you to Space paladin for the canvas and u/Acceptable_Egg5560 for proofreading and critique
Content warning; Educator abuse and syrupy love
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Memory transcript: Maarchal , MESEA Astronomers. Date: [Standard Farsul calendar ] January 26th, 3667
PLUNCK
Ponthyts blue stick clattered on the board, rolling around in a circle. Before settling on three. He then pumps his paw and moves to move a soldier that many paces.
“Well, I got you cornered now, whatcha going to do about it?” I smirk at Ponthyts soon to be dashed confidence as I take out my red stick and flip in the air much higher than he did with his own.
It hits the board with a loud clatter, bouncing on each end before settling on rolling. To which it landed on seven. I move my last interceptor through his ranks and take his general. The gobsmacked look on his features was evident, with his previously wagging tail so still it made stone seem fluid.
“I win.”
“How did you do that?”
I rolled my shoulders and readjusted my legs underneath. “Well, you left a clear path for my interceptor.” I pointed to the gaps in his remaining pieces.
“I know that! I mean how did you know you'd get a high enough number to do that? Your interceptor was all the way back here and it's your last red piece!!!”
I lean my head back and lean against the wall behind me. “I didn't, I just saw an opportunity and took it.”
He pointed a digit at me “ Mershit, that was some grandmaster trap!”
I give him the ear position of resignation with a mirthful little grin. “I promise you it was just luck.”
He waves his paw dismissively. “I don't believe you.”
“Well believe it, because I don't plan ahead like that. Want to play another game?”
He shakes his head. “Nah I think four games is enough for one night.” He begins moving the pieces into their containers and folds up the board and places it on top of them. Closing the box. He then stands up and offers me his paw, I use it to pull myself up off the floor.“Well Maarchal, I’ll see you tomorrow at the observatory. I’ll bring the set if you want to play it during lunch if you want.”
I froze, “what! What time is it? He turns over to look at the clock above his strove.
“Ahh about Fifteen minutes past 18.”
“Uh, that's not that late! We could play another game! C’mon let's have a tie breaker!”
He rubs his eyes, “I’m tired and we have work in the morning. Is there something you're avoiding?”
I rub my upper right arm and look off into the corner. “...”
He took on a worried look, “Why don't you want to go home Maarchal?”
I sighed and took a seat at his dining room table. “I… I don't like that house, I’ve lived there since I moved to LIghra six years ago but it's not a… home like here.”
I looked around at the messy abode. Dirty cloaks were strewn about on the back of chairs and the rubbish trough was just barely not overflowing. Paintings either from family or Ponthyts own paw were hanged up in the hallways, and the lightbulbs cast a warm orangish light. While the dishes from our dinner were placed in the sink, covered with animal gravy slathered all over them. It was tidy yet just barely so. A place filled with all the markers of being lived in.
“You've lived here less than a year but it feels like it's always had you in it. I feel … so comfortable here. My own home is so… cold and sterile. I Worked a lot the first few months I moved here. I just never got around to making it a home. It feels so bare, I started to work overtime just to avoid it. Which just made the problem worse.”
He sat down across from me, He put his head in his paws and looked at the scratched wood of his table. He held that position for a minute or two before breaking it and placing his paw on my own. “Maarchal, you are my best friend, I want you to feel comfortable. So if you want you can sleep on my coach, I can also help you make your home feel like one."
​
I shake my head, “no no, I shouldnt of imposed on you. Making myself feel at home is a job I need to do and have been avoiding for far too long. It's just… it's just so much easier to avoid you know?” I grabbed his paw and squeezed it. “I’ll see you tomorrow.”
​
I stand up and make my way to his front door before he speaks up.
​
“Uh hey Maarchal?”
​
I turn to address him “yeah?”
​
He shifts in his seat and fidgets with his fingers. “I’m uh, going to Ootra lake next week. I was wondering If you'd like… to come with me? I promise if you don't have a tent I’ll bring you one. We could have a fire, roast some meat on it and share ghost stories and stargaze… if you want?”
​
“ What about work?”
​
He rocks in his chair. “We'd have to call in for a day or so.”
​
I contemplated his words and mulled them over. It would be the first time I’ve ever willingly taken off a day, tarnishing my perfect attendance. But the prospect of spending more one on one time with Ponthyt was overwhelmingly tempting.
​
“Sure, I’d love to go. But I haven't gone camping for years so you will need to bring me a tent.”
​
He leapt from his chair, launching it backwards, before calming himself down. “I’ll take care of all the prep. You just have to come along. I promise it’ll be loads of fun!”
​
I chuckled while I watched his clearly restrained display as I slowly closed the door.
​
I could hear him howl with enjoyment as I turned into the driveway to get to my auto.
​
**\*
​
“Huff, Huff, you doin alright there Ponthyt?” I turned back to see him walking behind me.
​
“Yeah, oof I haven't walked this much in years!”
​
I waited for him to catch up, we sat together when he did and we caught our breath before tuning to make our way back up the bluff. When we reached it there was a stone gazebo made of limestone. The angle of the sun let it shine into it. We walked into it and sat down on the stone benches. I looked around at the lake.
​
It was surrounded by steep hills with many rock faces visible, the layered stone was clearly visible. The topography of the area around the bluffs was shaped like a bowl, with the sight of land of higher elevation faintly visible in the distance despite its gradual slope. Giving a scene of depth that was not as extreme then in more mountainous areas. This view was normally hidden by the trees below.
​
“Well isn't this view alone worth the trip?” Ponthyt proclaimed.
​
I looked around letting the mid morning sun warm my back, I stretched my arms and breathed deeply. Taking in all the wonderful scents of nature.
​
“Yeah, it's beautiful.” I let myself relax, just letting the sounds and scents of nature calm me like I have never been since I was a pup on an archeological trip with mom and dad.
​
“Hmm, I've missed this.”
​
I don't know for how long I had been like this, but Ponthyt broke the silence “Ahhem, so, you've gone camping before?”
​
I nodded, “yeah when I was a pup my parents would sometimes go off to a site for a couple of weeks and we would come with them. We would have to get homeschooled then. But we would always have to camp and I and my siblings would go off exploring while they worked during the day.”
​
He smiled and his tail was wagging.” That sounds wonderful. I only got to camp for a couple days a year. It was always so hectic. Me and my siblings would just muck around the camp and eat, sometimes hiking around. Heh” Ponthyt looked towards the ground and held his paws together, rubbing his digits together.
​
“What's wrong Ponthyt?”
​
“Oh it's nothing it's-” I put my paw on his shoulder which drew his attention towards me.
​
“I know that's not true, you can trust me. Just tell me what's wrong ok?”
​
He gave a look of reluctance before caving to my request “… sigh… I grew up in a big family, and I love them all but… I was born at a strange time. I was second to last of my parents pups. Which meant they were busy with the older ones' events and taking care of the youngest. I kind of got mixed up and forgotten. My interests rarely lined up with the others and I often messed up tasks that my sibling would just fix or do for me. It got to the point that I… didn't really do anything. They will never say this but… I don't think my parents ever expected anything of me.”
​
I rub his shoulder,” well… I know that you have amounted to something. I mean, you're an astronomer! You work to understand the nature of reality. You're also so… kind and patient. I tried to scare you off but you weren't deterred at my standoffish behavior.”
​
He turned his head and gave me a shallow but joyous expression. “Heh well living in a house that's rarely quiet leaves you with a high tolerance for stubbornness. '' he wipes away a single tear “Sniff well… should we make our way back to camp? Or can I take out my stuff?”
​
I shake my head. ”Nah, you can paint. I’ll just sit here and let this place wash over me.”
​
He smiles and gets up and sets up his easel, taking out his supplies from his bag and gets to work painting the landscape ahead of him. He was slow and each brushstroke was as deliberate as he could manage. He… wasn't very good, only starting out when he moved here. But his drive to get better was admirable. Even in adulthood he tried to learn, to grow, to become more than he was yesterday.
​
I kept staring at him. Feeling something warm in my gut, something an academic wasn't supposed to feel. Shame overwhelmed me and I quickly turned away. Cursing myself for having those accursed feelings.
​
​
**\*
​
Ponthyt, returned from his cauto (Cargo auto -> pickup truck) with an armful of wood he brought with us. He set most of it aside and threw a piece onto the fire he had started, causing a cascade of embers to fly into the late evening air. The dull purple of the sky cast overhead between the canopy of the trees as the chill of the night began to come in. A pleasant coolness that most would take advantage of to seek the comfort of warming oneself close to a fire.
​
Not me, I paced to a fro as Ponthyt set up our campsite. He had placed his painting for the day inside the cabin of his cautoa and was now seasoning some raw meat strips to cook on the open fire. Snacking on one or two as he did so. He hung them on the tripod to roast, the fat that dripped off them as they were cooking sizzled as they burned on the coals below.
​
“I’ll have these done as soon as I can, please sit down Maarchal. Walking like that is only going to make the wait worse.” He says as he prods the suspended meat with a claw like utensil.
​
“Hmm, ok I’ll just sit and wait. Waste my time. Make a waste of the whole evening!!!” I snapped back at him, throwing my paws into the air.
​
Ponthyt recoils from my outburst with his ears pinned back. “ We’re camping, there is no way to waste it.”
​
I turned to address him, “we shouldn't be here! This trip means nothing and we are just wasting our TIME!!!” I cross my arms and scratch at the biceps. Rufflying the fur and making a mess of myself.
​
Ponthyt drops his utensil and walks over to me. “ We’re together and we spent the whole day just mucking about. How is this any more of a waste than that?” He says as he looks at me with eyes full of worry.
​
“We’re scientists, academics!!! We don't waste time like the ignorant masses! We should spend our time wisely!!! Every action of connection is just another moment we waste that could be spent to advance our field.” I had tears forming in the corners of my eyes. Scratching at my fur until I felt a wetness on my arms and paws.
​
“We’re supposed to sharpen our minds! No-not seek pointless relationships! ” I said as I bared my teeth and began growling at him.
​
The look of betrayal and abject worry he had on his face was overwhelming. I didn't want to hurt him. What am I doing? He doesn't deserve my ire. My legs gave out and I cried into my hands.
​
Ponthyt walked over to his cauto and brought out a cover. He wrapped it around me and rubbed my arms through it. He rested his head on top of mine while I sobbed. I couldn't take this anymore. Repressing and lashing out at any attempt to connect. Ponthyt hugged me and rocked back and forth. Humming and rubbing on the cover. He was warm and soft. I don't know how long we had been like this but by the time my sobs turned to a faint whine the meat over the fire was well done and the sky was pure black and the stars were out.
​
“I-I think i’m good no-now.” I choked out. Ponthyt grabbed my hand and helped me stand up. We didn't say another word. He collects the meat and places it on two plates. I stare at my portion for some time, Ponthyt doesn't eat any of his either.
​
“Sigh… I know you might not want to but… Could you tell me why you said those things earlier?” He says with trepidation clearly miring his words.
​
“Yeah, it's just… When I entered college It was… not what I was expecting… I was sort of a hyper teen. Always going off about some book I read. Drawing pictures of stars, space stations or colonies we would make on inhospitable planets.”
​
He sits up and places his plate by his side. “You draw? I’d love to see some of them.”
​
“I used to. But I haven't since that first year of college.” I turned to stare at the dying inferno warming us. I pull the cover around me tighter.
​
“When I was doodling before class one day the professor walked by me. He noticed what I was doing and grabbed my paper. I objected but he just stared at me. When he started to address the class he showed it off and mocked me for wasting my time.” Ponthyt turns his head to look at me.
​
“That's a dick move, But at least he couldn't do the same when you did it in your free time right?” I turned to him with a somber expression. He seemed to understand the implications though he seemed to be confused as to how.
​
“He couldn't have gotten into your room right? That'd be a huge breach of privacy!!!”
​
I grabbed the poker and stirred the coals of the fire. “You're right, he couldn't. But he didn't need to, my roommate would take them with her to class and he’d pin them up on the board to mock. I called the staff but since she was my roommate she didn't break any privacy laws and since my art was only ever worth the paper it was on it wasn't even enough to get a misdemeanor theft charge. I tried to hide it but she would always find them. I tried to get another roommate but he stonewalled my attempts and I couldn't afford to rent a place in town. ”
​
He took on a look of absolute despair. “... How… how could he be so aggressively intolerant of such an innocent hobby?”
​
I chuckled “It wasn't just mine, a few others had made the mistake of having a roommate with the same professor. I remembered one who loved going out in the woods for hikes. When he found out about that he mocked him for “Pointless exercise and admiring a random assemble of dead and dying shit””. I waved my arms about to emphasize how he inflicted his words.
​
Ponthyt stared at the ground between us with a look of utter confusion.” … He mocked someone for appreciating nature and being healthy?”
​
I nodded, “if you were not engaging with study of his topic you were wasting his and everyone else's time.”
​
Ponthyt looks at me with concern and shared pain. “Why, why didn't you go to a different school?”
​
I stared at him in his eyes. A scene of shame overtook me. “It was the top class in the country. My family was so proud of me. I was so proud of myself, I didn't want to disappoint them and me. Looking back on it, I realize my own pride was something I rarely contended with until then. It didn't help when he found out who my family was.”
​
Ponthyt recoiled and waved his arms in a “what” fashion. “Wait, what does your family have to do with this?”
​
I poked at a log to knock off the charcoal to expose the untouched wood underneath. “They were happy. He spent a lot of time in academic circles so naturally he met people who knew my parents. And the way they described this happy family irritated him something fierce. He gave me such a hard time with it. Mocking me for being a lazy nepotism pick who didn't deserve her seat in his class. He mocked anyone for having any kind of non professional relationship, we never spoke to each other outside of class. We never left or met with friends or family. If we tried too he’d find out and call the one in question a “Lazy sentimental idiot.””
​
I breathed in deeply, “... that hurt my pride so severely that I just stopped seeing them or any of my friends. I always said I was busy or had a field study, but I was just reading and rereading his lectures. I didn't even go home for the summer breaks, I just apprenticeshiped at his museum to study even more. At graduation he looked so… proud, I only realized he was proud of what he turned me into and not what I did a few weeks after I met you. How I let him turn me into an angry starile shell of a person.”
​
Ponthyt turned his head towards the fire. His ears straight up and a soft growl in his throat. “... If I ever meet that piece of.. nuclear waste, I’ll kill him.”
​
He turns to me and his features soften immediately. “Anyone capable of manipulating someone as passionate and creative as you... I can't even imagine the kind of living hell he made you seek…”
​
I chucked and a slight wag entered my tail.” I’m responsible for my life. MY pride kept me there for him to mold. I hate him, but I hate myself for it too.”
​
Ponthyt shoots up and screams at me “MERSHIT, Maarchal, you have nothing to be ashamed of. You had a right to expect your teachers to be respectable people. Not abusive and manipulative Sherkires (Ambush insect. Commonly seen as sneaky and unhonorable due to making pheromones and calls imitating other insects mating signals). He starts to speak softer as he turners to address me.
​
“Even this version of you, so cut off of why you love space in the first place is just.. You are one of the most remarkable people I have ever met. So humble with addressing yourself. You inspire me to be a tenth of the person you are.” He kneels in front of me and grabs my paws in his own.
​
“You are… you are so passionate, so creative. Even with being a self described shell. I can't even imagine how you will be when you open up again and explore your creativity in full and banish that monster's influence for good.”
​
I turn and I can't help but smile at his words.”... I haven't been in practice in years. But … I’m willing to relearn it with you.” I stared deeply in his eyes and that feeling again bubbles within me. The feeling of never wanting to leave his side, the feeling as though I found a piece I had been missing. Before I knew it I bit on his snout, recoiling when I realized what I had done.
​
‘I-I’m so sorry!!! You were just so close and and I felt something and before I knew it-” I was caught off guard when he bit my snout, holding my top jaw between his own set. I bit down on his lower jaw and we locked together. He tried to let go after a while. But I growled to let him know I wasn't ready yet and I used my leverage to lead him into my tent.
​
**\*
​
I got up and exited my tent. I stood up and stretched and twisted my back around. Lifting my arms above my head and pulling them as far out as I could. I looked at the coals still burning in our firepit, I could only tell they were burning from the heat going off of them as the glow was hidden by the sun's light. Before noticing the meat Ponthyt prepared last night still on the plates on the log we sat on.
​
“Pff, hey Ponthyt. Come out here!!!” I said behind me. He crawled out my tent with a head of messy fur.
​
“Wut ?” He said with half closed eyes and a disposition of utter exhaustion . I pointed to the cold meat. He still had a look of drowsiness before he realized what the significance of the strange strips were.
​
“Heh, I guess we won't need to make breakfast?” I chuckled as I sat down and hugged his head. I groomed his messy fur as I absorbed the morning sun. I don't know what the future of my career looked like anymore. But it was no longer the most important thing in my life. I loved space, I loved to learn. But In these years I had lost track of what was truly important. As I groomed him Ponthyt fell asleep with his head in my lap.
​
As I felt the joy of reciprocal love again for the first time in years I leaned back and watched the sunrise, caressing my love's head and breathing in the fresh air.
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Thought I'd write down my experience, since the ones I read helped me too. Started studying almost 7-8 months ago, preparation was very intermittent since I had to concentrate on medical school assessments as well (IMG from India) Resources I used Bootcamp - really helpful, got all my concepts clear, excellent for cardio and Renal Uworld - Gold, prepares you adequately, did it first system wise and later moved to random FirstAid - Stuck to this from the beginning of prep, always annotated points from Uworld, revised it before every NBME Mehlman PDFs - used these towards the end of prep, really helpful in revising and understanding those specific points of information Risk factors, Arrows, Neuroanat are a must Practice scores - took all NBMEs offline and timed 25 - 67% 27 - 72% 28 - 72% UWSA 1 - 67% 29 - 75% 30 - 78% UWSA 2 - 76% 31 - 78% Free 120 (2024) - a week before - 75,75,70 - 73%
Took the Step on 4/24, started off well, stems were long, finished all the blocks with just 2-3 mins remaining. Lots of confusing ethics. Towards last few blocks fatigue kicked in bad, didn't even feel like reading the long stems anymore. Left the center unhappy, thought it went horrible.
Got my result today on 5/15 - Pass Congratulations and Good luck to everyone!

• so let me summarize or vent of a story of a 17 year old male meeting a 17 year old female my background is non denominational seeking orthodoxy, she is a pentocostal…..

She fits my type of personality allows me to feel soft and she is attracted to me and I am (when I see her 😳) though I doubt when I am alone
Yk comparing to oh other Christian women I could have this is fantasy…
We talked for 3-4 weeks (since we live in the same town, she first invited me to her church….) that’s how we met well actually text…
We went to the park, walked her home from school and chat about life And God and she dreams of living near a church aswell and she seems me as a good future father figure… and I tell her she has good motherly instincts just by how she treats her bunnies well alone…. I went to her church 3-4x, and well my first kiss after school… so yeah… young relationship
But she is a virgin, so am I, only one person before In a situation where she felt pressured and same with me… so this is very ideal and she waiting for marriage and so am I….
Though I was attracted to her, she really recripocate well with me; we FT a lot, text and communicate openly and honestly together even prayed for one another we are looking for a day where we can pray together because she is busy with school work….
She allows me to feel vulnerable and more safe…. She is learning but she tells me what bothers her aswell…. And we work on it only a month in….
We’re both Hispanics 🇸🇻🇭🇳, plan to do many things together
And she really likes me…. Values what I say… likes when I am goofy and the fact she shows me casually on share screen her messages, ig direct all and even gallery I trust her and even gives me password to her phone casually… she is honest so I am lucky
But here is the problem I am a chronic over thinker….
One day I feel like when we talk she is the most prettiest girl to me the next I feel a lack of peace…. Like is she really ? I think of other girls am I ready ? I said yes I am willing to learn and grow her and she is also willing aswell…
We are young so we expect a immature love to grow into a secure mature one and we both put God at the center of our relationship….
She even warns me if certain things leads to fornication… basically she has me in check aswell… though I lead… love is weird because it moved fast for us….
I am just afraid if she is not in Gods will or no what if she is… my mind is rambling what if I am not attracted but what if I am there is a lack of peace when I am not around her but when I am I feel more relieved
I wanna put God first, but make this workout anyone got tips…
because the problem is not her it’s me… she allows me to express and is patient and considers being learning to be more friends in our relationship I mean we can still kiss…..
My mind is still I feel a lack of peace
Uneasy dreams especially of other girls (temptations)
Despite praying over this relationship with her…
Also what helps to know I am a anxious avoidant style I am trying to fix myself aswell… but honestly…
Yeah it’s my first love and hers… we date for marriage.. and this made me pray even more and find God but recently I worry if she is in God will it’s a mess….
Because I know I am lucky but ahhh… I guess imma have to learn
But also Idk my mind is so perfectionistic because she is learning about Christ but is more baby level because she is learning to love him not cause of shame and I am relearning everything I know…. I lack patience

Hello, I am 31M, I don't drink , I don't smoke, I don't use any recreational drugs.
You see my situation is the following:
About 10 days ago, suddenly and out of nowhere I got sick at night, having a sore throat, as the days went by my feelings began to get worse, suddenly I had a lot of discomfort when I swallowed food or drink things, then I had a very bad coughing, being all the time just coughing and coughing during the week, at times my eyes were itchy and I was worried if I got conjuctivitis too while I was sick with the flu or whatever happened to me, I felt dry in my throat and I was out of breath sometimes, my voice wasn't in its normal state, I was more hoarse/higher-pitched (I'm not sure which of the two is the correct term since English is my second language and I confuse those words even in my native language) the point is, my voice isn't in its normal state so I can barely speak normally and and I need to make a little effort to speak, I had a lot of mucus in my nose, and my throat and mouth felt just weird.
As the days went by, my symptoms improved, I didn't have itchy eyes ever again (it was something I experienced for about 3 days and only for a short period of time in those 3 days, like, it wasn't something I felt all day, it manifest on suddenly and lasted for about 2 hours at most), and I felt less bad because I remember that there was a day when I could barely even speak.
But after all that time, I'm still sick.
My biggest and main problem is that I still have a lot of cough and I spend the whole day coughing and they don't know when I want it to stop, and my voice is still not in its normal state so I can barely talk much, which is a nuisance because I usually talk all day on Skype calls for multiple reasons, among other things but at least the eye itchy is gone and I don't feel so exhausted.
Today I went to see a doctor to review my case, because a lot of time had passed and I still have this problem of coughing too much, and I wanted to help it.
And my doctor came to the conclusion that it doesn't seem like I have a cold, it's most likely that I'm having problems with an Allergy, and I was like "Uhm really??"
The bases that my Doctor had for that diagnosis were the following:

1. I've been in this state for 10 days now and it's weird that it lasted this long, if it were a Cold/Flu, I would have recovered and it should have ended at the 7 days of being sick, as I we well know.
2. I have a more dry cough, without phlegm/mucus.
3. It seems I haven't had a fever (but I'm not sure about that, I didn't worry about taking my temperature at some point during the week to see if I had a fever or anything really, before going to see the doctor)
4. I have not had chest pain.

In addition, the Doctor asked me to open my mouth to see how my throat was, and with the stethoscope he listened to my breathing and my body coughing.
But the Doctor's diagnosis that what I have seems to be a problem with an Allergy than something else, sounded very weird to me for several reasons:

1. It's illness season on my city and in my city practically everyone is Coughing a lot everywhere, Like wherenever I went (the medical center, the supermarket) there were A LOT of people everywhere coughing in the same manner as me.
2. In addition, my Mother was also sick at the same time that she presented the symptoms, but she recovered quickly, it lasted 3 days her symptoms at most, and she didn't have the Cough that I still had.
3. I've had problems with allergies before in my life, but I've never had an allergy that made me cough or anything, especially so persistently.
4. I have also never had an allergy that affected my voice or my ability to speak.

And the thing is that because everyone is sick everywhere in my city, I was waiting several hours for the Doctor to check me, but when the time of my consultation arrived I was tired and my brain wasn't in its best state, which leads me to worry that perhaps I didn't explain my situation well to the Doctor and I wasn't as attentive to his questions as I would have liked to realize that I was answering correctly, the Doctor was also tired because he had a long day reviewing many patients and I felt like he wasn't checking me in like great detail and I rushed the job a little because it was obvious that he just wanted to finish his job day.
So all these factors together lead me to worry if the Doctor did his job well and/or if I did my part well and a If actually correct Diagnosis was reached, because the idea that what I have is an Allergies thing given the reasons I explained sounded Odd to me.
Then the Doctor prescribed me that he had to take the following:

1. CAM ( 2,00 Mg Dexchlorpheniramine maleate , 0,25 Mg Betamethasone) every 8 hours <- Antihistamine , one tablet
2. Diclofenac sodium , every 8 hours , one tablet (50 Mg)
3. Bion3 (Something with Probiotics and Vitamins), one tablet the day.

Whenever I have to take Medications, I Google everything about them, and I understand what Antihistamines are and how they work, that they are these things that calm your Immune system, to put it in simple words.
And well, what my Doctor told me is that I am going to take these medications for a week, let's see what happens and next Tuesday he will check how I did with those meds.
So to be honest, I'm really quite Scared and worried that I maybe fucked up??
What if I have Bronchitis that for some reason is happening with a Dry Cough without mucus/phlegm nor chest pain, or I still have an Active Flu and this persistent cough that I want to end and my voice problems has nothing to do with an Allergy.
Since, if that is the case, shouldn't taking Antihistamines make my health much worse by calming my immune system when a real illness is still happening??
Like, that's what worries me, what if taking those medications and following the Doctor's instructions actually entails a risk to my health due to a wrong diagnosis??
Because what I want to read and have tried to investigate is that well.
Something, whatever, that tells me that if it turns out that the Doctor gave me the wrong diagnosis, and I have Bronchitis or the Flu that is still active or perhaps with few symptoms but still there, taking these meds (Antihistamine) for a week shouldn't it do much damange??
I know I sound a little paranoid, but I already had a crisis in the past with a Doctor (another one) giving me the wrong medications for an illness, which ended up making my health much worse and it was horrible and I seriously don't want to relive that experience again.

I have an amazing acupuncturist who has helped me rexover from pcos i have had for 30 years and gives me the medicine (he’s the medical director for the brand) that has regulated my cycle for free . Despite that I have kind of noticed maybe a lack of emotional depth so i was probably unwise to share last week when i was going through a really hard time and began crying (very unusual for me) and talked about some of my family of origin issues and how trapped and hopeless i feel. He responded by asking why did i want validation from my parents anyway ( I don’t) and that im in my current relationship just for comfort (maybe?) and that my parents didn’t have the resources to understand their behavior like we do now, they couldn’t do any better, and i need to realize that they’re just people and i should think about why they were the way they were. He said I need to try to go out and socialize more and ended the conversation by saying “adulting is hard”.
He said he wasn’t trying to minimize but I felt that’s exactly what he did, and completely misunderstood the reason those things still affect me and what i’m dealing with and why. Ive felt pretty angered by his responses. So much missed the mark entirely and it bothered me that he would havevsuch little understanding of the ongoing effects of SA and verbal and emotional abuse because he started our work together talking about how emotions play into health and acting shocked that i said past healthcare providers didn’t ask me about those things. He asked me lots of personal questions since he said it helps him direct treatment, but yet has very blamey and minimizing responses and seems to constantly suggest i make changes like leaving my partner or job without really understanding the background and how that would impact my life. The comment about “adultung is hard” as a summary especially was so off- childhood was incredibly hard, i am grateful every day not to be a child anymore and have even some agency in my life as compared to none.
i’m trying to figure out how to respond next time. he could be a big support to his patients (he primarily works with cancer patients).. if he educated himself on trauma but like most people there’s an immediate minimizing and acting like it’s just one’s attitude or mindset and saying he’s had the same things. He’s a caring person but there’s definitely something very out of touch there. For instance I grew up knowing the ins and outs of my parents upbringing and problems, i never thought of them as perfect, it was that they were completely neglectful and treated me like their therapist from the age of 4. Even practically, when he’s suggested certain things and i mentioned that isn’t an option right now financially he says “well i believe everyone is capable of creating their own money” or something along those lines. Its like an unwillingness to believe anyone can actually have a problem they can’t just choose their way out of.
Again he goes out of his way to charge me less and gives me medicine for free before i even mentioned any financial concerns when he truly doesn’t have to but i’m trying to understand how i can make this an exchange both of us can grow from. I’m considering buying him a book on trauma that helps explain the field that's developed and understanding the long term impact on people… but i think what bothers me even more than what he said is that i just nodded and barely spoke up for myself even though i found his responses outright misjudging and really dismissive. I wish I had just stopped him and said "nevermind I don't think you are able to understand and I don't want to discuss this any further with you" instead of hearing more and more off base responses. Thats one of the main consequence I deal with is responding in the moment and just giving up and assuming no one can ever understand anyway. Rarely do I ever seek support or help or even open up about things i'm dealing with so it's sucks the rare times I do when that's the type of response I get. I’m trying to decide how much to mention next time when he'll inevitably ask how i'm doing about what bothered me and why.
Any advice on maintaining a relationship with a medical/caregiver person after feeling really misunderstood? My instinct is to try to explain the things he’s missing and where he was off base in his responses but who is to say if that would even get through anyway.

Hi all,
I've been lurking in this subreddit for the past two months and I got the P today so I thought I'd give some advice and do a write-up on my experiences.
First and foremost, I had a disability and had to apply for accommodations. I started the process in November for my test in May and submitted a packet of disability records and medical records going back to elementary school. If anyone needs accommodations, start as soon as possible and get a disability consultant if you can.
I used UWorld throughout my first two years of preclinical to study for NBME tests during my curriculum so I started dedicated with probably 30% complete and an average of 60%. The day I took my test I had 75% complete with an average of 64%. UWorld is a study resource first and foremost, so I spent a lot of time reviewing corrects and incorrects and walking through what changes to the question stem would make the given options the correct answer.
I only did Forms 25-27 because my school only gave us 3 vouchers, and I couldn't afford to buy more CBSAs, but I also did UWorld Self-Assessments 1-3. Scores: Form 25 (diagnostic) 56%, Form 26 64%, Form 27 72% (the week before I took Step 1), UWSA1 68%, UWSA2 62%, and UWSA3 69%. I got sick a few days before I took the test so I stopped studying and focused on getting better (chronic illness sucks), so I didn't do the Free 120 like I planned. But I had recovered by the time I took Step 1. Taking a few days before the exam off was probably the best thing I did for myself, actually. I didn't realize until I was getting better how exhausted and burned out I had been for the past few weeks.
I used CramFighter by Blueprint Prep to organize my study schedule. It was completely free. My main resources were Dirty Medicine, Pathoma, First Aid, and then reviewing those UWorld questions. I started doing 40 a day and the two weeks leading up to my exam I was probably doing 120-160 a day. I usually did a full practice test every Monday (take it in the morning, review in the afternoon) and then Tue-Sun spent my morning working through UWorld questions and my afternoon reviewing content. I usually studied 5-7 hours a day, depending on how my week went. I had 6 weeks of dedicated, but I decided to take the test 5 weeks in and delay to the extra week if I needed it (I didn't, I enjoyed my week off).
Day before the test, I woke up early so I would go to sleep early, and I spent about an hour and a half exercising out the stress. Day of the test, I had a big breakfast full of protein and fiber, and snacked on protein bars throughout the day so I didn't have a blood sugar crash. I also drank about 2 liters of water. Use your breaks! I spent them walking around my testing center or meditating (I know it sounds lame but breathing work actually works).
My best advice would be that you are your own worst enemy. If you think you're going to fail, you're more likely to fail. I told myself the entire time that I was definitely going to pass and that studying for it was just going through the motions. Otherwise, I think I would've been paralyzed by the stress.
Good luck to everyone out there!

TD;DR Newer relationship. Military boyfriend with a pattern of having a dog shit attitude but doesn't think he has a bad attitude. It's become exhausting trying to comfort him and calm him down when he doesn't want to help himself. Gets defensive when I try to shut down his shit talking spiral of negativity. I don't want to be the overly critical nagging girlfriend, so I want to leave while I still don't resent him. He's away for school and I want to wait until he gets back in a couple weeks. We've already talked about this issue a bunch. How to stay kind and compassionate while I wait for him to get back.
I've been with my boyfriend for only 7 months. Overall, it's pretty decent. We treat each other well, laugh a lot, have similar views on children and marriage, he's supportive, the sex is satisfying, and have had some pretty fun times together. It's been pretty drama free. He's active duty military. I am a veteran but have gone on to get my pilots license, work in aviation for a couple years, and now I'm a full time student studying software engineering. With the help of long term therapy, hobbies, and good friends, I would say I'm pretty happy in life right now. In the past though, I've suffered from not being able to regulate my emotions and having severe episodes of depression. Unfortunately, my boyfriend is not very happy in life. I try very hard to be validating, supportive, loving, and try to model healthy coping mechanisms but it's wearing on me. He has no friends. No hobbies. He hates his job. He talks poorly about other people. Everyone suck except for him. Everyone is a pussy except for him. Everything is stupid. The negativity spiral is a constant presence. And I don't like speaking poorly about other people how he does. I've gently encouraged seeking professional help because he has admitted that he might be depressed because his reactions to thing are disproportionate to whatever is triggering him. He has access to both medical and non medical mental health care. I'm exhausted from constantly validating him and trying to calm him down from the far reaching things he will start saying. He's very sensitive to criticism and gets defensive easily. I have to be very gentle with how I phrase things and avoid accusatory statements. It's really the only issue I have with him.
I did a lot of thinking and talk with my therapist and have decided that the negativity is a deal breaker for me. This negativity is exclusively work related. He doesn't treat me poorly, but I am baring the burden of his loneliness by myself. We live close to each other but He's away for a school right now.
First, I communicated that the negativity has become a constant presence, it dominates our conversations, and it's affecting my mood. I suggested that we try to find some balance together. He was cool about it.
A few days later, after he started talking poorly about other people, I set a boundary. I said that I would shut down the conversation once the it reached a certain intensity of negativity or once he started talking needlessly ill about other people. I said that if this seems like it's going to be a recurring thing, I'm going to have to assess if the relationship is healthy for me. He was cool about it.
Next, he talks about how he may have to a take a couple college classes (paid for by the military) to reach a certain goal he has. and then starts saying, "I HATE SCHOOL I HATE SCHOOL I HATE SCHOOL. IM NEVER GOING TO USE COLLEGE ALGEBRA". I said that if he goes into classes with that idea it will become a self-fulfilling prophecy. We do stuff we don't want to do to reach the goal we want. I said that he is capable, and even though general education courses aren't the most fun, it's still an opportunity to learn and develop new skills. He got defensive and said that I don't need to lecture him and that he doesn't have a shit attitude just because he said "college algebra isn't useful". The selective hearing is a recurring issue.
There's been a couple other times where he was able to self correct or apologized for getting upset with me when I would ask to change the subject. Most recently, he started calling a group of people cowards and that they shouldn't be in the Army. I tried to shut down the conversation twice but he kept going. I ended up playing into it more and shared my opinion and said that what he is saying is hypocritical because he may also be a part of the group hes talking about. He didn't see what he said as talking shit about other people. I said, "You can have that opinion. Im asking you to not voice it to me anymore". He got very defensive, saying that he isn't allowed to say anything with out having the opposite opinion. That we must disagree on everything.
I explained that I actually do agree with him a lot of the time, I just don't let the shit talking spiral out od control. He went to bed without FaceTiming me that night or saying goodnight. He did say good morning to me today.
I don't want to see myself turn into the overly critical, nagging girlfriend. I realize I am trying to change him. I am trying to fix him and that's not my job. I thought If I modeled better behavior and helped me breathe and relax when he got worked up, I could love him into being a more positive person. I can't. It's exhausting. I may just have to accept that we have different outlooks on the world. As much as I love him, this completely overwhelms his positive qualities. I can't see myself problem solving or raising children with this type of person (he already has one daughter that hes missed out on raising because of the military. He's basically just a fun uncle even though he tries to go home often to see her several time a year.) Sadly, he has no one else except me here and often tells me that he loves spending time with me and I make him so happy.
How can I practice being kind and compassionate towards him while still protecting my own mental well being while I wait for him to get back so I can end the relationship? I don't think he would be responsive to me saying that im thinking of ending the relationship.

Hello!
Just wanted to post some highlights and stats from the recent conference regarding GLP-1 meds etc. This is general information - most supported by current clinical trials. I cannot verify any of the information as I am not the author. I went to a conference and found a lot of interesting stats so I jotted them down: These include Q & A pages for Dr's to give out to potential patients of zepbound etc. answering potential questions.
Note: Some of these are based on different versions of the meds because it wasn't a conference focused soley on Zepbound. But it gives overall information.
· Usually cause muscle loss with all current meds.
· Eli Lilly and Novo are both trying to figure out oral versions of the medications.
· There is currently a class action lawsuit by roughly 60 ppl regarding GI complications as a result of the medications. (Philadelphia)
Continued weight loss post 12 months – (Ozempic)
18% Weight Regain
26% Some regain
20% Maintained loss
17% Additional Loss
12% Doubled Loss
Zepbound D/C Weight regain study:
473 women, 197 men. Mean age 48 years. Over 70 medical centers in 4 countries
335 received Zepbound, 335 Placebo - Primary outcome is that the mean percent change in weight from weeks 36 to 88.
At week 36 weight reduction was 20.9%
Findings:
At 88 weeks Zepbound loss – 89.5% of participants with Zebound at 88 weeks maintained at least 80% of the weight loss compared with 16.6% placebo.
(This does not include continued weight loss over time after D/C, only at a 88 week marker)
FDA Warnings and Precautions – Zepbound:
· Severe Gastrointestinal Disease
· Acute Kidney Injury
· Acute Gallbladder Disease
· Acute Pancreatitis
· Hypersensitivity Reactions
· Hypoglycemia
· Diabetic Retinopathy Complications in Patients with Type 2 Diabetes
· Suicidal Behavior and ideation
o Serious adverse effects were reported by 5.3-7% of patients taking Zepbound. As opposed to 2.8% in Wegovy group.
General Q&A Answers:
Are Ozempic, Wegovy, Mounjaro, and Saxenda (furthermore “GLP‐1/GIP RA”) controlled substances?

๏ No ๏
Can GLP‐1/GIP RA be obtained without prescription?

๏ No ๏ Is there a generic version of GLP‐1/GIP RA?

๏ No, and not expected until 2031 at the earliest ๏

Is Berberin the same as Ozempic or other GLP‐1/GIP RA?

๏ No, the mechanism of action and biochemical properties are different

๏ Are there patient assistance programs for GLP‐1/GIP RA?

๏ Yes ๏ https://www.novocare.com/psp/PAP.html for Ozempic, Rybelsus and Victoza ๏ https://www.mounjaro.com/savings-resources for Mounjaro ๏

Can I drink alcohol while on Mounjaro (and other GLP‐1/GIP RA)? ๏

You should avoid combining Mounjaro (tirzepatide) and alcohol if you can. Alcohol can potentially worsen Mounjaro’s digestive side effects, such as nausea and vomiting. In rare cases it may aggravate or cause hypoglycemia. ๏

Can GLP‐1/GIP RA reduce my desire to drink and other addictive behaviors? ๏

Research is ongoing. Preliminary results suggest that there may be a desirable effect.

๏ Are compounding pharmacies breaking the law by selling compunded GLP‐1 medications?

๏ No, as there is a current shortage of these drugs. The FDA allows to compound equivalent medications in cases of storage.(* Not legal advice, see a professional if legal opinion is needed).

๏ How long will Ozempic take to work? (similar but specific information is available for other GLP‐1/GIP RA) ๏

When you first start Ozempic, you’ll inject a low dose for the first 4 weeks to help your body get used to the medication. This dose isn’t meant to have a significant effect on your blood glucose (sugar) levels. But some people may start to see some improvements during this time. ๏ It takes about 4 to 5 weeks to reach a steady level of Ozempic in your system. Full effects may not be seen until at least 8 weeks of treatment. If after 2-3 months your A1C isn’t at the target, your provider may increase the dose

What can I expect after I stop taking GLP‐1/GIP RA ? ๏

Most people will regain some or all weight they lost. However, cardiovascular benefits are more durable. ๏

Should I stop Ozempic and other long‐acting GLP‐1/GIP RA before surgery? ๏

Specifically for Ozempic the recommendation is to stop at least 1 week prior to a planned surgery.

๏ How long should I wait after the last dose if I am trying to conceive?

๏ If you want to become pregnant, you may need to stop taking Ozempic at least 2 months before trying to conceive so it is fully excreted. ๏

Can I flush Ozempic or other long‐acting GLP‐1/GIP RA from my body?

๏ No. And if side-effects are affecting you, you cannot remove these medications by “detox”, laxatives or hydration. ๏

Do GLP‐1/GIP RA cause termination of pregnancy or birth defects? ๏

These drugs have NOT been studied extensively during pregnancy in humans, so the potential risks aren’t fully known. But animal studies have shown a higher risk of pregnancy loss and birth defects with some of the GLP-1 drugs. ๏

Do GLP‐1/GIP RA cause depression and/or psychosis? ๏

While prescrbing information for some of these drugs mentions such side effects, they are rare and causal connection has not been established. Warnings about suicidal ideation are included in prescribing information for Saxenda and Wegovy. ๏


Can GLP‐1/GIP RA interfere with oral contrceptives? ๏

Prescribing information for Mounjaro warns that it may reduce the efficacy of oral hormonal contraceptives. Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation with MOUNJARO. No such warning is provided for Ozempic/Wegovy and Saxenda ๏

Where can I find prescribing information for weight loss GLP‐1/GIP RA? ๏ https://www.accessdata.fda.gov/drugsatfda\_docs/label/2023/215256s007lbl.pdf = Wegovy ๏ https://www.accessdata.fda.gov/drugsatfda\_docs/label/2014/206321orig1s000lbl.pdf = Saxenda ๏ https://www.accessdata.fda.gov/drugsatfda\_docs/label/2022/215866s000lbl.pdf = Mounjaro
Comparison of Clinical Trials:
Zepbound 15mg at 72 weeks
Body weight change overall - -20.9
Ø 5% weight loss – 90.5
Ø 10% weight loss – 83.5
Ø 15% weight loss – 70.6
Ø 20% weight loss – 56.7
Semaglutide 2.4mg at 104 weeks
Body weight change overall – 15.2
5% weight loss – 77.22
10% weight loss – 61.8
15% weight loss – 52.1
Zepbound
Can cause delayed absorption of orally administered medications.
Acetaminophen – Take at least 1 hour before injection
Contraception – take at least 1 hours before injection - findings are possibly indicating a contradiction between Ozempic and contraception - possibly causing 'Ozempic babies' - still under investigation. Unsure if there are clinical studies yet.
Weight Loss Slows Brain Aging = 1% body weight loss was equal to gaining back 8.9 months’ attenuation of brain age.
Attenuation of brain age was significantly associated with improved liver biomarkers, decreased liver fat, and a visceral and deep subcutaneous adipose tissues after 18 months of intervention.

For context: I work in a small hospital with less than 20 bed med/surg unit. Two full time hospitalists consistently work at this location with very little consulting MD's available. One hospitalist does a terrible job communicating with staff (giving orders while walking down the halls and entering elevator, constantly talking loud, abrasive communication, very ego driven) and has been found to become unapproachable with multiple staff members since I have started at this job a year ago. The nocturnist on the weeks the hospitalist is working are related to one another and they will consistently cover the night shifts (isn't that payroll fraud?).
In the fall, I questioned this hospitalist on leaving the hospital as charge nurse / house supervisor when we had multiple patients with concerning issues since I was told during the interview coverage of the hospitalist was 24/7 and they would be in the building for patient safety. The hospitalist confronted me as I was leaving work that shift to essentially stop asking questions about it, to stay in my lane since this didnt concern me and was speaking to me in a very threatening tone as I was clocked out leaving work. I reported this interaction to leadership and nothing seemed to occur with this.
The situation: When I was charge this week, I communicated concerns brought to my attention by the primary nurse with the hospitalist for a patient needing a straight cath versus foley placement. The patient had a urology procedure earlier that day. Hospitalist stated to leadership I wasnt clear in attempting to explain the concerns and overstepped by communicating with the urologist, who ordered a foley catheter placement instead. He proceeded to immediately confront me on it, stating I wasn't clear and was talking in a heightened tone with his office door open and my peers hearing him yell at me. I told him "I dont know how much more clear i can make this" to him.
I got called into leadership office the following morning of my shift because this MD is the "medical director" in this small facility. I have never been questioned on my lack of clarity and clear communication in 10 years of nursing. In fact, I have been applauded by my peers and at previous workplaces for how I effectively advocate for the patient. Even the urologist who updated the order was thankful for my clear communication related to this situation.
Besides this one provider, I like this job. Its close to home, the work life balance is there and I get along well with the rest of the team. Do I consider leaving because of this one doctor since they are making this job unbearable on the weeks they work?
TL; DR: Working at a small hospital, dealing with a hospitalist who's terrible at communication and hostile when questioned. They even confronted you aggressively outside of work. You reported it, but no action was taken. Now, they're undermining you further by questioning your communication skills. Despite liking the job, this doctor is making it unbearable. Consider whether staying is worth it with them around.
Advice welcome - thanks!

Moving can be a stressful time for everyone, including our feline friends. Imagine being whisked away from the comfort of your familiar surroundings to a new and unfamiliar place. As you plan your relocation, it’s essential to consider the needs of your beloved cat to ensure a smooth transition for both of you. That’s why we will give you the best tips for moving with your cat.
Moving with a cat requires careful planning and consideration to ensure their safety and well-being throughout the process. Here are some expert tips for moving with your cat:

Create a Safe Haven:

Before the moving day arrives, set up a safe and comfortable space for your cat in your current home. This area should include their bed, litter box, food, water, and familiar toys to help them feel secure amidst the chaos of packing.

Gradual Introductions:

If possible, introduce your cat to their carrier well in advance of the move. Leave it open with familiar bedding inside, along with treats and toys, to encourage positive associations. Gradually increase the amount of time your cat spends in the carrier to help reduce anxiety on moving day.

Familiar Scents:

When packing your belongings, be sure to leave out familiar items that carry your cat’s scent, such as bedding or blankets. These familiar scents can provide comfort to your cat in their new environment and help them adjust more quickly.

Stick to Routine:

Amidst the chaos of moving, try to maintain your cat’s regular feeding and playtime schedule as much as possible. Consistency can help reduce stress and anxiety for your cat during this transitional period.

Secure Transportation:

On moving day, ensure your cat is safely secured in their carrier before transporting them to your new home. Consider using a pheromone spray or calming collar to help keep them relaxed during the journey.

Comfort in the New Home:

Once you’ve arrived at your new home, create a designated space for your cat with familiar items from their old environment. Allow them to explore their new surroundings at their own pace, and provide plenty of reassurance and attention to help them feel safe and secure.

Patience and Understanding:

Moving can be a challenging experience for cats, and they may exhibit signs of stress or anxiety during the transition period. Be patient and understanding with your furry friend, and give them the time and space they need to adjust to their new home.
Important tips: Hiring movers or DIY?

Conclusion:

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Recently broke up with someone (32f) who was amazing but was an anxious attachment with the most severe abandonment issues I’d ever seen. Everything turned into an argument because of her not trusting me and thinking I was being shady, when I had no desire to even THINK about other women.
In a lot of ways she was everything I wanted: incredibly creative and talented, smart, hot as hell, beautiful inside and out… and that’s also what makes this suck because I’d put a lot of work into myself to have the self esteem and courage to even feel like I deserve partner who is all of those things.
The best part though? She made me feel safe to enough to unmask my ADHD and be my true self. Only two other people in my life know that side of me, and she fully embraced it because she also had ADHD, though she was medicated. It was so freeing.
Anyway, the abandonment issues and anxious attachment style became too much. We’d been arguing a lot and I’d been super patient and supportive no matter how hard she unfairly laid into me because I knew it was just her hurt and traumatized inner child speaking, but I went on a birthday trip with one of my oldest and strictly platonic lady friends, and that’s when things blew up.
My ex knew about the trip and it gave her trouble at first, but we worked thru it. My friend even invited my ex but my ex couldn’t get off work. Then the trip ended up being just myself, my friend and her mom because my friend’s boyfriend also wasn’t able to come and the other friends bailed, which my ex also knew about. That wasn’t enough though; two hours into the trip things went downhill and I ended up snapping and ending things. At that point I was emotionally exhausted from constantly defending myself.
This is gonna be a hard one to get over because we were perfect for each other. We both felt it. But you have to be ready and willing to trust for a relationship to be successful, and she was not.
I miss her so much.

I started 3 months ago at this call center where we take orders for pizzerias. In those 3 months a lot happened and I made new friends there. In this situation there are 3 important people. The call center's manager (B) my supervisor (A) and my coworker (K). K is a bit older than me she's in her 30s and I'm in my early 20s just like A. The manager is in his early 70s. I live in Canada more precisely in Quebec. Last 2 months were rough at the call center. We had less calls meaning people got less hours and needless to say a lot of people were mad. Some were begging our manager for months to get more hours to no avail. I was lucky enough to get decent hours while others got half of what they asked to get.
Sorry for all the information now onto the story. I received a call from my supervisor yesterday when I was at home telling me that my manager heard a coworker make a complaint that I was trash talking the company and I encouraged my other coworkers to quit work and I was telling others how this company is shit. Mind you I never trash talked the company just the management. I know that K was the one who told my manager about that since my manager didn't say anything before she came to work.
I called my manager to talk to him about it and he said he could've fire me because of what he had heard. I just wanted to know if he had any right to fire me because of that. He never asked me what I said or questionned me about this situation. I haven't finished my probation and I know I can get fired for anything but it just feels wrong. I get that if I encouraged people to quit it would be wrong but the people concerned already felt like quitting and wanted to. I just supported their ideas but warned them that it would be smart to keep a few days in but I didn't blame them if they wanted to quit because they didn't have much hours scheduled.
Sorry if i made any grammar mistakes I'm typing this quickly since I'm doing something else too. If anyone has any questions feel free to ask them in chat.

Curious how the community would handle a strange situation I witnessed during a U15 boys competitive match this weekend. I was a spectator there to support some of the players I have coached in the past (playing for the Away Team), but it got me thinking about how I would address the situation as a CR because I had never seen something like it in my 35+ years as a ref, coach, or player.
TL; DR: While ball was in play during a U15 competitive tournament match, the keeper left the pitch over the end line and walked to the parking lot; his coach was asleep on the sideline and CR had to wake him up to put another keeper on the pitch; restart of game was delayed 10 minutes; CR didn’t issue the keeper who left or the coach a card; how would you handle the situation as a CR?
*EDIT: I say per LOTG below re: substitution rule. I meant ROC locally and in the specific tournament's ROC. Apologies for my oversight and lack of clarity.
*EDIT 2: I was not the CR or an AR during the match, just a spectator. I don't engage match officials unless I'm there in an official capacity as a coach, so my narrative doesn't include first hand knowledge about what was discussed with the officiating crew or the coaches. I think the match officials handled a very confusing situation really well; it just got me thinking about what I would do as CR.
Full context: This was a tournament match between two teams mathematically eliminated from moving forward in the tournament prior to kick-off, so it was the last match of the tournament for both teams. About ten minutes into the second half, the Away Team scored on a long direct free kick to go up 3-0. Ball was returned to center, kick-off restart, and game proceeded with the Home Team carrying the ball into their offensive third. This is where it gets weird.
As his team carried the ball up the pitch, the Home Team’s keeper exited the pitch across the end line and just kept going — walking to the parking lot. Because play was on the other end of the pitch the refs (and almost everyone else) were unaware the keeper walked off until the ball returned to that third of the pitch 30 seconds later. At that point, everyone on or near the pitch quickly became aware the Home Team keeper was absent — except his coach (the only coach on the sideline for that team), who sleepily remained seated in his chair at the other end of the pitch.
CR (early twenties) rightly let play continue until a natural stop in play. Unfortunately for the CR, it was a throw-in possession for the Away Team on the spectator touchline (AR was on the teams’ touchline on the same half). Per LOTG the team out of possession cannot make a substitution unless the team in possession initiates their own substitution on a throw-in. In this case, the away team was not making a substitution and they had a clear advantage in their offensive third, so their coach encouraged them to take a quick throw-in. It was immediately clear the CR was struggling to decide if he should enforce the LOTG or uphold the SOTG because the absent player was the keeper. Fortunately, two of my former players heard me over the din and threw it in to immediately play it back out over the touchline for a turnover.
After all the commotion, one would expect the Home Team’s coach to have his team’s only substitution ready at midfield to enter the game and be communicating with his team to assign a new keeper to net ASAP, BUT the coach remained sleepily seated in his chair and didn’t send his only sub to midfield to enter the game.
Upholding the SOTG, the CR stopped the play and jogged toward the Home Team’s bench while delivering repeated verbal instructions to the coach that he should put another player on the pitch and/or identify a new keeper. Home Team coach didn’t budge; finally the CR had to tell the PLAYER (who just came off the field after the previous goal) he should re-enter the game as keeper. As this kid frantically scrambled through teammates’ bags to find a keeper jersey and gloves, the CR had to leave the pitch to WAKE THE COACH UP and inform him what was going on!
CR then ran to his AR (14/15 years old at most) on the other half to confer and then chatted with the Away Team’s Coach. The game was delayed about 10 minutes as the CR ran around trying to sort the chaos. End result was the game finally resumed without a single card being shown. I think the CR and crew were pretty well in control of the game prior to the absurd circumstance, but as a ref, coach, and former player I struggle with the fact a card never came out.
When I CR U15/16 competitive club games I still try to educate more than caution because experience and talent levels can still be pretty diverse within and between teams (and I’m also working with teenage brains), but the CR not showing cards in this circumstance boggles my mind as a ref. It a missed opportunity to enforce clear LOTG, educate through accountability, and minimize the risk that the Home Team’s frustrations with their teammate and coach could carry-over onto the pitch.
I would have approached the absurd situation this way as CR. Prior to re-start: Yellow (1) — Keeper for leaving the pitch; Yellow (1) — Coach for delay of restart. Post-match: Yellow (2, Red) — Keeper for unsporting behavio lack of respect for the game (to not penalize his team by making them play down a man); Yellow (2, Red) — Coach for unsporting behaviolack of respect for the game (to not penalize his team by removing the only coach they had on the sideline, which would have resulted in them needing to forfeit the match).
I’m curious to hear the community’s thoughts on how you would approach the situation as CR because I have never seen anything like it before and I hope to never see anything like it again.