Faulty alternator symptoms

Understanding Vehicle Misfires

2024.05.19 05:18 diyautomotive Understanding Vehicle Misfires

Misfires in your vehicle can be frustrating and worrying, but they can be caused by a variety of common issues. It might be something simple like faulty spark plugs or ignition coils in the ignition system, which are essential for creating the spark needed for combustion. Alternatively, problems with the fuel system, such as clogged fuel injectors or a failing fuel pump, can disrupt the proper fuel-air mixture your engine needs. Sometimes, it’s more mechanical, like worn piston rings or a leaking head gasket causing trouble.
Figuring out the exact cause is key to getting it fixed properly. Regular maintenance and diagnostic checks are your best friends for preventing and catching these issues early on.
For more detailed information, including how to diagnose and fix these problems, check out the full blog post here: Understanding Vehicle Misfires: Causes and Solutions.
submitted by diyautomotive to DIYautomotive [link] [comments]


2024.05.19 05:14 JaydeRaven HRT and libido

All the posts I'm seeing here are folks saying menopause/HRT decreased their libido and I'm having the opposite result.
My libido is *through* the roof. I'm not complaining - I've always had a fairly high drive. However, both my long term partners (poly, together 10 years) are men in their 40s and their libidos .... well, not so high at this point. To the point that I'm getting frustrated and will likely have to have a conversation about finding a FWB. I'm really enjoying the results of the fairly minimal HRT I'm on (Estradiol Vaginal cream and OTC Progesterone*). I lost about 10lbs, no obvious menopause symptoms, and everything is back to functioning "normally" (no dryness). *My GYN prescribed the estradiol, but did not prescribe or even mention progesterone - I was doing reading and found it is recommended, so thought I'd try some OTC cream and it seems to help. I also take menopause vitamins with soy alternated with regular women's vitamins - started those when I started having hot flashes and that cleared them right up.
Anyone else been at this point and how are things now for you? Did you eventually need to increase the medications to maintain? (Note: I'm 52, started perimenopause at 37, had an ablation at 38, went through full menopause at 48-49. Still have my uterus and ovaries, even if the uterus is ultra well done).
submitted by JaydeRaven to Menopause [link] [comments]


2024.05.19 05:05 Hot_Sprinkles4852 Change in Bowel Movements

Male, 22.
About 6 months ago I had a bump internally that I could feel..that dissapeared in 3 weeks and another bump showed up two months ago..went to the university doctor and was told to use Prep H which I did for 3 weeks and the bump dissapeared but ever since then I have had loose stools, mushy stools that disinegrate after a bowel movement, or thinner stools..went to the university doctor again and was told to eat more fiber so I am starting to now but still I keep fearing crc. The symptoms are so ambiguous..what does "change in bowel movements even mean". I have alternated between constipation and diarrhea for weeks now, used to have one bowel movement a day but I have 2-3 per day now. I've done an FOBT test 5 months ago which was negative and did another recently which was negative too. No bleeding yet but everytime I google my symptoms it keeps saying colon cancer. I know a colonoscopy is the only proper way to rule it out but it's quite expensive here, so I'm still going to go to a proper GI doctor when I go home from university in July due to costs. Are my symptoms concerning? Any idea what is causing this.. The only symptom I have now is loose/narrower stool..and 3 bowel movements a day. I am trying to drink more water but a lot of times I forget to do so which might also be a causal factor.
submitted by Hot_Sprinkles4852 to AskDocs [link] [comments]


2024.05.19 04:51 Reasonable-Room-8848 Help about censor and Tegaderm film

I'm on my 2nd Libre 3. My 1st one fell off when I had a few days left. My body is producing too much insulin, since I'm not a diabetic my insurance won't pay for the device. I bought the 3M Tegaderm film. I used alcohol and shaved the area before applying. It's been a week and the flim is starting to peel off. I barely wash the area and don't use lotion close to the device. Can I remove the Tegaderm film or put another on top of this one. The film covers the sensor. Is there anything else I can do? I still have 6 days left and I will be upset if I pull this one off as well.
My 1st 2 weeks I went low a lot, I even went below 55 multiple times. I don't have another way to check my glucose level. This time I'm not going low as often, I'm having all the symptoms of low glucose sometimes. Is it possible that this censor is faulty?
Thanks for all the help. Sorry typo in title
submitted by Reasonable-Room-8848 to Freestylelibre [link] [comments]


2024.05.19 02:35 mirth4 First pregnancy, questions on hCG and general monitoring

I’m pregnant for the first time at 42. In addition to age, I have some health issues and medications that put me in a higher risk category. My husband and I tried for over a year with a reproductive endocrinologist, but that ended after several not great experiences and bad communication (and the closest alternative is at least a 2 hour drive away). This was over a year ago, and we had mostly reconciled ourselves to not having children. And now we found out I’m pregnant.
My cycle is regular, only 24 days, and ovulation happens ~day 10/11. 2 days after my period was due (16DPO), my at home pregnancy test was negative. 2 days later (18DPO), they performed another urine test in a clinic which was also negative. But I had a lot of symptoms. And my period is never late.
At 6 days past my expected period (20DPO), I asked my PCP to order a serum test and my hCG was 354.
Does it seem odd that the urine test was negative just 2 days before my serum level was 354? And isn’t a urine test almost completely accurate nearly a week after a missed period??
I’m now presumably 4w5d along. When I called my OB early this week, they scheduled a scan at 8-10 weeks where they would “confirm I’m pregnant” (which is a longer wait than I expected for my first appointment, especially considering risk factors).
In the meantime, my PCP is helping me monitor since she knows we’ve been trying for so long. At 22DPO, my hCG was up to 920 (from the 354 at 20DPO, which seems like a big increase — 160% in 48 hours, or doubling in only ~30hrs).
I wasn’t worried about these numbers until coming to this subreddit. The increase rate I take is a positive, but those numbers also seem much lower than posts from the same stage of pregnancy from people who are worried their numbers are “too low”? Do the absolute numbers matter, or more the rate of change?
Can someone help me make sense of this? I’m nervous, and since it sounds like I won’t be able to see an OB for at least another month, is there anything else my PCP can do in the meantime? Is a first scan at 8-10 weeks standard, even for higher risk pregnancies?
Thanks!
submitted by mirth4 to CautiousBB [link] [comments]


2024.05.19 01:41 Wild_Subject6133 MIL gave SO COVID!

ETA- I've been here and posted before but have a new account.
SO and I are low contact with MIL as she is a nightmare and there have been many issues over the last few years where she has been downright nasty or condoned GCSIL being nasty.
Anyway, SO received a message from GCSIL saying she was away for Mother's Day and that it was up to us to organise what we would do. SO called his mum and arranged to visit. We arrive on Mother's Day to find MIL in bed sick "with a cold". She is wearing a mask and we stay well back. FIL gives us dinner and we leave.
Next evening, SO calls MIL to see how she is and she tells him she tested positive to covid. I assume that she tested Monday morning but am starting to suspect she knew when we were there the night before. Important points- neither SO nor I have ever had COVID! We are vaccinated though. SO likely had asthma as a child as MIL always tells us how she sat up with him on nights when he would cough all night... SO is also not currently working so doesn't have any other contact point to have contracted COVID.
Fast forward to day 3 and SO is feeling unwell. He gets a faint line on his test and we wonder if it is faulty because it is out of date. Next day he feels worse and tests again, it's definite- there's a dark purple-red line within a second.
He calls his mother and she flat out denies that he could have possibly got COVID from her, and tried to insist he got it when we stopped on the way home in the middle of nowhere to take some photos and we were the only people around! She knows she is the only person he has had contact with and that she definitely has covid too. She admitted that her symptoms were identical- same strain! She and GCSIL went as far as trying to blame me for getting it from my work and bringing it home (still testing negative... not me!)
submitted by Wild_Subject6133 to JUSTNOMIL [link] [comments]


2024.05.19 01:23 AndroidCovenant Vaush on depression treatment in recent cass review video

Vaush said that SSRIs can exacerbate suicidal tendencies and cause erectile dysfunction and therefore not a good treatment for depression.
I'm on SSRI. 10 mg escitalopram. It has reduced my depression symptoms and lowered my libido. And I think that the libido lowering has something to do with my reduction is depression symptoms.
Is this not supposed to be happening? If so what are the alternatives to SSRIs? I do miss having good libido sometimes
submitted by AndroidCovenant to VaushV [link] [comments]


2024.05.19 01:13 Gildedfilth My experience with a Calyceal Diverticulum

I am in recovery from my ureteroscopy on a calyceal diverticulum, and while I found some journal articles and a few stray posts on here about them, I want to paint a bigger picture about my actual experience and what I felt.
This is a very long post because I wanted to err on the side of more information so that other may feel much less alone than I have felt. I have included subheadings so you can read only what is useful to you.
To start, I am a 31-year-old female with endometriosis (I explain the implications of that in one of my subsections.). I live in New York City and was operated on by a surgeon at Smith Institute for Urology at Lenox Hill Hospital, which specializes in “complex anatomy” and kidney stones.
TL;DR Calyceal diverticula are pockets on the kidneys affecting 0.5% of the population. Stones can form and get trapped due to their narrow opening (infundibulum). As a result, their pain pattern is different and diagnosis can be delayed. To resolve the problem, you will need a surgeon to remove stones and expand the opening and/or ablate the lining of the diverticulum via ureteroscopy or percutaneous nephrolithotomy.
What is a calyceal diverticulum?
For a good scientific review of what calyceal (kay-luh-SEE-uhl) diverticula are, there is a review study from 2014 with primary author Nikhil Waingankar. In short, these are pockets within the kidneys that have much narrower entry points (“infundibula”) than a normal calyx, and they are theorized to only occur in 0.5% of the human population, with an estimated 96% of those who have them forming stones inside them.
They are often found incidentally on imaging because many people remain asymptomatic. In my case, we saw “a cyst requiring further imaging to rule out neoplasm” (cancer) when I was having my appendectomy in 2022 and had a CT scan in the ER.
They will look like cysts until you either get a radiologist who knows what to look for and sees a stone inside, or until you do a CT urogram, which is a more involved CT scan where you can see if the urinary system communicates with the “cyst.” Simple cysts and neoplasms will not show urine entering the mass; a calyceal diverticulum will, because it has an entrance.
Important stipulation in my experience: endometriosis and its surgeries
My story is complicated by the fact that I have endometriosis, which is a disease wherein cells resembling uterine cells occur outside the uterus. This is an extraordinarily painful condition that causes widespread inflammation due to the uterus-like cells’ having “menstrual periods” outside the uterus. It that can occur anywhere in the body; while most people’s disease presents primarily in the ovaries, uterus, and Fallopian tubes, the disease has been found in every organ in the body. In my case, my disease was confirmed to be extrapelvic as soon as my appendix pathology report revealed that my appendix had endometriosis on it; the cells existed beyond the typical pelvic organs.
I have already had two laparoscopies for endometriosis, and while these were immensely helpful in restoring my quality of life, every abdominal surgery comes with the risk of adhesions. Adhesions are bands of tissue that the body forms when it experiences inflammation or trauma. Endometriosis forms adhesions by itself, and surgery to remove it risks further adhesions. In 2020, when I had my radical excision surgery, my surgeon had to perform ureterolysis to cut my ureters free: whether from previous surgery in 2016 or the disease, my ureters were stuck to my uterus due to adhesions.
I share this because having endometriosis and its surgeries in my history affected my path to diagnosis and probably my pain pattern. (Endometriosis forms its own nerve endings, too!) But for the record, the kidney stones and the kidney surgery in my case were more painful than endometriosis…probably because they freaked out any remaining endometriosis.
(Sorry for no source on this endometriosis information. I am unfortunately very well-read on the disease! If you want to learn more, I recommend The Center for Endometriosis Care website and the book Beating Endo.)
What did the calyceal diverticulum feel like at first?
On a Tuesday in January 2024, I was trialing prazosin, an alpha blocker related to Flomax (tamsulosin) due to PTSD nightmares.
One day after taking this drug, I woke up with 8/10 pain muscle spasms in my “iliac crest,” which is the top edge of my pelvis, on the right side. I thought I had “slept funny” and the pain subsided after about 3 hours. I tried to roll around on a lacrosse ball, thinking it was a muscle spasm.
I took the prazosin for two more days. By that Thursday, the pain lasted more like 6 hours and did not go away; I had the muscle spasms as well as a feeling that there was “trapped gas” right at my waist, right on the side of my body. Because the pain stayed at 8/10, nothing would calm it down, and I couldn’t focus on work, I went to the ER. We did a CT scan and saw nothing different from my last CT for my appendectomy. They decided it was probably a kidney infection with strange presentation due to my endometriosis and sent me home with cefpodoxime, an antibiotic.
I finished the course of the antibiotic over 7 days and felt better.
But then the “trapped gas” feeling returned and lasted 18 hours. I went back to the ER, mostly concerned that I had failed antibiotics and the “infection” was getting worse. I made a urologist appointment while I was waiting in the ER because I suspected this might be beyond their mandate of ruling out anything life-threatening. We did another CT, and this time I really carefully read the results: inside what we had identified as a calyceal diverticulum in 2022 during my appendectomy CT scan were two kidney stones, each about 0.2mm. Because there was not much change from my last ER visit, the doctor at the ER did not think this explained how I was feeling. He did not want to send me home with antibiotics because he thought his colleagues were too cavalier with testing, but he did send for a urine culture and sent me home at least assured there was no emergency.
The culture came back, and I did test positive for E. Faecalis, which is a rarer bacteria to have, so the doctor at the ER urged me to get on Levaquin, an antibiotic, as soon as possible. (My endourologist later theorized this bacterium was an incidental finding; he thinks I just happened to be colonized with it and it was not causing symptoms. Regardless, it was not present in my culture before surgery.)
Again, I took almost the full course of the antibiotic and was feeling better and safer. I also saw a urologist, and she was skeptical it was an infection but told me to continue the course. She was pretty sure it was endometriosis-related but saw that I had seen my gynecologist, who has been treating me for 5 years, days prior who was pretty sure this was NOT consistent with what she had seen when we operated in 2020. The urologist said she felt this might be beyond her skills and referred me to one of her medical school colleagues who is a specialist in “complex anatomy” like calyceal diverticula as an endourologist professor at Lenox Hill in NYC.
But before I could see the endourologist, only one week after my last ER visit, I was in 9/10 pain for 7 hours overnight. I really did not want to go to the ER again, but I was vomiting, sweating, using the bathroom (both ways) constantly. After 7 hours not being able to get it to calm down, I went back to the ER.
The first thing they did was test me for sepsis, because I was being treated for an infection. They also did a CT scan again and then we saw it: one of the kidney stones had left the calyceal diverticulum and was stuck in the ureterovesicular junction (“UVJ”). By the time I was diagnosed, I was in 9/10 pain for 18 hours, so what we now know to be the renal colic phase lasted for 18 hours. They admitted me overnight to the hospital to observe and had me on ketorolac (Toradol) and oxycodone/acetaminophen (Percocet) every 6 hours alternating. The pain subsided the next morning.
Confirmation and surgery
Luckily, I had the endourologist appointment on the books already, and I got all of my images from the ER to bring to this doctor, letting him know I was confirmed to have passed the stone.
What he was able to do for me I will never forget: he showed me exactly why I was in enough pain for the ER each of the three weeks I went. Unlike a normal stone situation, a stone in a calyceal diverticulum has far more opportunities to get stuck. Also unlike a normal stone, you can feel the stone passing before it reaches the ureter because it has to leave via the narrow opening of the diverticulum. This means the pain can feel different and, due to its location within the kidney is more prone to being referred pain (pain you feel in a place other than where it originates). This is why I did not feel the pain in the classic place and why it felt much more like trapped gas. Furthermore, most radiologists do not have the same training as he did to identify where in the opening the stone was, which explained why they believed the stone was in the same place each time.
We wanted to take a “wait and see” approach on the second stone, but my body did not want to wait. As I was falling asleep one night in early March 2024, I felt that familiar “trapped gas” feeling, way too far right to be my intestines. This is 6/10 pain, so I could go to work for an important meeting, but I called to get an ultrasound and appointment right away. (We have since found that for my specific diverticulum, ultrasounds are not useful. I will need a CT urogram any time we want to visualize the kidney post-op.)
My doctor said that he wanted to attempt ureteroscopy before percutaneous nephrolithotomy because it is a less-invasive modality and we were worried about impacting any endometriosis. He had me sign paperwork consenting to either method, and it was a “game time” decision based on what he saw with the camera.
In the two-and-half week wait til surgery, his hypothesis gained traction: I would have days “on” with the pain and “off,” suggesting the stone was able to enter the diverticular opening and then flow back into the diverticulum. When I was in pain this time, I would also feel a lot of fatigue and brain fog that made it hard to work. This could be consistent with a kidney blockage, but it is hard to say for sure with an area so small.
The surgery, the stent, and the pain after the stent
The surgery itself went pretty well and only lasted 1.5 hours. The surgeon let me know that it was not easy to get into the diverticulum because the opening was not straight, as expected. He was, however, able to complete the surgery with only ureteroscopy. He removed a 0.2mm stone and observed that the stone was exactly the width of the opening, meaning it could absolutely flow into and out of it and get stuck for days. He widened the opening with laser to be “wider than a normal calyx” to allow for scarring, and, at my request to avoid further operations, ablated as much of the lining of the diverticulum as he could, encouraging it to close up.
While the surgery was uneventful, I am one of the unlucky ones who cannot tolerate a stent. This is probably due to my endometriosis, which leaves me in a heightened baseline of inflammation and nerve arousal, as well as the fact that, for me, the stent had to go into the diverticulum, which had been lasered and burned, in order for it to heal. I spent four hours in the recovery room while we tried to get my pain down to my goal of 7, which meant we needed to dose me, as we did in the ER, with ketorolac (Toradol) and oxycodone every 6 hours with no gaps in between.
I only had the stent in for 3 full days, and unfortunately, due to my specific circumstances, that was the worst pain I have ever been in. I was agnostic about 10/10 pain until this time, in which I felt like I was passing a stone and experiencing my worst endometriosis cramps at the same time. I was in 8-10/10 pain despite the painkiller regimen, and since we found that dilaudid does not work for me, this was good as they could do for me.
Thankfully, my surgeon listened to my experience and agreed to take the stent out as soon as was responsible: 72 hours later. The actual removal was uncomfortable but not painful beyond a “scrape” sensation in the urethra, and as soon as it was out, my husband noticed I could move as normal and was talking more like myself.
However, 1 out of 4 people will experience pain after the stent is removed, and risk factors include female anatomy, being “younger” (I am 31.) and having a stent in for less than or equal to 7 days.
The day of the removal I had some muscle spasms but was mostly so relieved that I slept all day.
34 hours after the removal, I experienced a feeling like I was passing a kidney stone. I was in 9/10 pain for 6 hours, feeling like I needed to move my bowels (which was not easy after opioids!) and having unrelenting spasms above my right iliac crest (top of pelvis). I was on ketorolac (Toradol) during this and knew what it was, but I otherwise may have gone back to the ER. I refused to take more opioids because my bowel was upset as well.
Today, I have had one episode of the iliac crest muscle spasms lasting an hour. I have found that crouching on the floor, against a wall, and/or going into “reclined butterfly pose” may help. It may just make me feel like I have more control over the situation.
I will update this post if I feel more pain in the coming days.
What’s next?
My endourologist/surgeon thinks it is very unlikely that I am “a stone-former” because the stones were only in the diverticulum and likely formed due to the urine reflux of that structure.
We will follow up in 3 weeks to see if the sensation I felt in March of the “trapped gas” recurs. If it does, only then would we do a CT urogram to see if the diverticular opening closer up to anywhere near its former width of 0.2mm.
This is unlikely because the surgeon lasered the opening very wide, “wider than a normal calyx,” to allow for scarring to take place. The ablation of the lining of the diverticulum should also take care of its tendency to collect urine.
I am not expected to have further stones or need for surgery, but he has seen cases of recurrence, so we need to manage my expectations.
Despite the extreme pain of the stent, I am content with my decision and hope that I do not have to go through this again. The one blessing in my case is, if this surgery succeeds, I should not have any further kidney stones.
submitted by Gildedfilth to KidneyStones [link] [comments]


2024.05.19 00:59 grandvizierofswag Accepted that I’m never going to have a good relationship with my mother.

My (23M) mother (58F), after three weeks of traveling through Europe, came down with the flu or something similar. Her only symptom has been extreme fatigue, and she asked for wheelchair service through the airports and asked me to carry all of her luggage. Traveling with her was difficult, as she is the type to become extremely agitated and lash out whenever things get stressful. Even something as simple as walking to a new hotel would get her dialed to 11 and lead to her snapping at you for suggesting an alternative route. When we got home, she continued to say that she was too exhausted to do anything and has asked me to do her normal share of chores, buy everything and bring her things from the kitchen as needed. I have done all of these things dutifully, but when I was out and about, she sent me a text saying “If I die…” and went on to explain how her life insurance policy worked, gave me the number of her manager and told me to call them to collect her things and said me that she would give me important information later that night. Panicking and thinking something major had happened, I called and asked what happened. When she told me that nothing had changed and she still just felt extremely tired and ill, I became very upset with her and told her to not send me texts suggesting that her death was imminent. In response, she said “You have zero empathy” and hung up the phone.
I confronted her when I got home (and delivered her popsicles and tylenol), and said that she had leveled a very serious accusation at me that I did not appreciate, and that in fact, she was inconsiderate to scare me with death talk when nothing had changed and her doctor had even said that all she needed was bed rest and fluids. Initially she said nothing and asked me about something else. I repeated myself and she kept saying “ok”. I told her that ok is not a response and I wanted a proper answer from her, and she said “you shouldn’t start arguments with people when they’re feeling shitty”. When I pressed she paused for a few seconds and said “you shouldn’t be in here, I don’t want you to get sick”. I refused to relent, and she raised her voice at me that she felt like shit and that she had said I had no empathy because of my cold demeanor. I repeated that saying I have no empathy when I’m doing everything she asked of me and simply asked her to stop with the death talk is completely unfair and excessive. She then started talking as if she was going to cry and went on about how she’s “done so much for me” and “haven’t I shown you that I love you?”. She has done a lot for me, but it’s a false dichotomy to say I can’t be appreciative of that and critical of her behavior.
After going around in circles, I realized that I was never going to get an apology or acknowledgement that she shouldn’t have said that, and that she would continue to use diversion and manipulation tactics. She asked me to get her another popsicle, which I debated but did despite my frustration. After this conversation, the illusion finally disappeared and I realized what she truly was - a loving but unstable individual with deeply unhealthy attachment patterns and an inability to accept criticism, who will not shy away from underhanded tactics to avoid doing so. Which led me to accepting that I am never going to have a healthy, close relationship with her.
submitted by grandvizierofswag to Healthygamergg [link] [comments]


2024.05.19 00:37 mattyr428 Nagao Method - Microsurgical low ligation varicocelectomy

Hi, I recently moved to Japan and was referred to this doctor by my urologist. Dr. Nagao is a microsurgeon who operates out of this plastic surgery facility, but also works at Toho University.
He confirmed that I have grade 3 varicocele on the left side. My symptoms are generally pain. I’m a stomach sleeper my whole life, but I think perhaps my symptoms started getting worse since I started weight lifting regularly about 3 years ago. I haven’t had any tests on my fertility or testosterone levels.
In any case this subreddit has been a great source of info and there are so many knowledgeable people here so I thought I would share this link to see what you all think about the methodology this doctor developed.
From some of the horror stories I’ve read, and just as a general rule of thumb, I feel like any kind of surgery is a last resort. I don’t know if I should seek out a second opinion or request an embolism or just do the surgery.
The Nagao method is not cheap; it will be anywhere between 400,000 yen to 600,000 yen ($3-$5k) out of pocket. There are alternative surgeries covered by Japanese health insurance, but they have higher recovery times and higher recurrence levels (at least based on this doctor’s findings, which of course could be biased, but maybe he really is the authority on the subject!).
In any case I can’t help my Western skepticism; I ask a lot of questions before I do anything! I did send the office a ton of questions about the procedure and they answered what they could, but in Japan there really isn’t a culture of questioning the doctor / inquiring about other approaches, so I’m also trying to find a way to get comfortable with all of this and knowing that if there are post surgery complications, I may struggle to communicate with this doctor (he speaks some English but not very well in my experience).
That said I really I don’t mind spending the money if he truly is the pre-eminent master on this procedure and provides the best possible chance for a successful outcome that gets me healthy and back to an active lifestyle as quickly as possible!
Thank you for taking the time to read this post and in advance for sharing your thoughts!
submitted by mattyr428 to varicocele [link] [comments]


2024.05.19 00:23 PineappleOptimal52 Confused about newly developed allergies.

Question: Is it possible I have a gluten allergy or could it be something else in this dish? The only two things which stand out to me are the black pepper or wheat in the spaghetti?
I do eat bread but its always been when on taking fexofendine so im not sure.
22M.
I've developed allergies over the past 2 years it seems. I think I'm allergic to milk, egg, oat, either barley or rye. But I had a reaction to a spaghetti dish I made from scratch the other day while I was not taking fexofenadine. I'm waiting to see a dermatologist who specialises in allergy and my GP will not pescribe an epi pen.
Just for context dont have to read below.
why I think i'm allergic to x: milk: upper lip swelling immediately, 40.10 ige test result. egg: upperlip swelling immediately.
barely or rye: HP brown sauce causes immediate upperlip swelling.
oat: oat milk causes swelling and aveeno on skin causes extreme pain.
symptoms: eczema worsens and spreads, lip swelling, eyelid swelling, hives on arms. Swelling seems to be worse if I'm doing something like walking, then it can be full face. Doctor wont give me an epi pen for the full face swelling... I have been to the hospital once for the full face swelling although it has happend 6 times.
submitted by PineappleOptimal52 to FoodAllergies [link] [comments]


2024.05.18 23:30 grandvizierofswag Accepted that I’m never going to have a close relationship with my mother.

My (23M) mother (58F), after three weeks of traveling through Europe, came down with the flu or something similar. Her only symptom has been extreme fatigue, and she asked for wheelchair service through the airports and asked me to carry all of her luggage. Traveling with her was difficult, as she is the type to become extremely agitated and lash out whenever things get stressful. Even something as simple as walking to a new hotel would get her dialed to 11 and lead to her snapping at you for suggesting an alternative route. When we got home, she continued to say that she was too exhausted to do anything and has asked me to do her normal share of chores, buy everything and bring her things from the kitchen as needed. I have done all of these things dutifully, but when I was out and about, she sent me a text saying “If I die…” and went on to explain how her life insurance policy worked, gave me the number of her manager and told me to call them to collect her things and said me that she would give me important information later that night. Panicking and thinking something major had happened, I called and asked what happened. When she told me that nothing had changed and she still just felt extremely tired, I became very upset with her and told her to not send me texts suggesting that her death was imminent. In response, she said “You have zero empathy” and hung up the phone.
I confronted her when I got home (and delivered her popsicles and tylenol), and said that she had leveled a very serious accusation at me that I did not appreciate, and that in fact, she was inconsiderate to scare me with death talk when nothing had changed and her doctor had even said that all she needed was bed rest and fluids. Initially she said nothing and asked me about something else. I repeated myself and she kept saying “ok”. I told her that ok is not a response and I wanted a proper answer from her, and she said “you shouldn’t start arguments with people when they’re feeling shitty”. When I pressed she paused for a few seconds and said “you shouldn’t be in here, I don’t want you to get sick”. I refused to relent, and she raised her voice at me that she felt like shit and that she had said I had no empathy because of my demeanor. I repeated that saying I have no empathy when I’m doing everything she asked of me and simply asked her to stop with the death talk is completely unfair and excessive. She then started talking as if she was going to cry and went on about how she’s “done so much for me” and “haven’t I shown you that I love you?”. She has done a lot for me, but it’s a false dichotomy to say I can’t be appreciative of that and critical of her behavior.
After going around in circles, I realized that I was never going to get an apology or acknowledgement that she shouldn’t have said that, and that she would continue to use diversion and manipulation tactics. She asked me to get her another popsicle, which I debated but did despite my frustration. After this conversation, the illusion finally disappeared and I realized what she truly was - a loving but unstable individual with deeply unhealthy attachment patterns and an inability to accept criticism, who will not shy away from underhanded tactics to avoid doing so. Which led me to accepting that I am never going to have a healthy, close relationship with her.
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2024.05.18 22:38 RussellsFedora Dodge Grand Caravan Died on the road. Now it all glitchy, and I don't think its the battery.

Hey everyone!
My 2015 dodge grand caravan died and will not start. For the sake of clarity, I will try to be as detailed as possible here.
I was coming off the highway and slowed to stop at a red light when i felt a very slight rumble and it stalled. The rumble was similar to when you are driving a manual and start going to slow for the gear you are in. It was as if the transmission had an issue downshifting. When tried to turn it back on, it lost basically all power and I was unable to even put my hazards on. I neutraled it into a parking lot and some weird things started happening. For the first bit, the electrical components were doing a bunch of glitchy things, and showing the occasinal glimpse of a "no fuses" message.
I started by checking every fuse, and none of them seemed blown. I then disconnected the battery for a few minutes and once i reconnected it, the van was less glitchy. The electrical components seemed to operate a bit more normal (though I wasnt able to use my power locks and the stereo console didnt turn on - my blutooth was oddly connected though). The internal OBD reader was giving me the code P0562 (System voltage low). The van still wouldnt start, but there was now a single click in the front when I tried to start it. When I tried to start it, the electrical components would all briefly lose power before slowly coming back to life.
Googleing these symptoms seemed to point at the battery being dead, so I got a friend to come and give me a boost. A basic boost had the same kind of powerloss as before. We then tried to unhook the negative terminal from the battery on my vehicle to try and start it right from his battery. When we did this, my vehicle was no longer totally losing power when we tried to turn it on, but rather that same clicking sound would now repeat (around twice a second, maybe a bit slower).
At that point I knew it was an issue beyond my basic mechanical knowlege. Its a long weekend where I am, so it will be a few days before I can get it into a shop - does anyone have any idea what is happening here? I was thinking maybe it was the alternator, starter or maybe the timing belt, but I honestly have no idea.
submitted by RussellsFedora to MechanicAdvice [link] [comments]


2024.05.18 22:03 PristineTrouble527 Alternatives to antipsychotics?

I've been through Abilify, Caplyta, and now am on Latuda but considering going off. Had adverse effects from all of them. Was on Latuda the longest. I don't know if I can handle antipsychotics. My doc kept suggesting vralyar but I'm screaming no no no no because of another potential akathisia nightmare.
I was on Lamotrigane before all these. my body went haywire and it landed me in the ER so it's no longer an option. It was the best med I took, but my doctor will never put me back on it. It was what I was on before my 2.5 year bender off meds. Something in my body has changed and it's hard dealing with it. I've considered trying to ask my doc for an off label like trileptal as an alternative since anticonvulsants seem to work for me idk
Sometimes I suspect I might not even be bipolar because so many of these meds have done jack squat and I've wasted so much time and money trying to find a cure. Not just a cure, but something that will literally not make my body prickle with anxiety... something that will align my body and brain again and not just fix one of them. Sometimes I suspect it's PMDD because all the symptoms worsen around my period. I don't know.
All the while I've been jobless and rather socially isolated till recently. Life is very lonely for me. This has completely wrecked me in a different, sadder way than the 2.5 year long bender I had when I was off meds entirely. I lost everything.
Hell, I'll even take something with blood testing at this point, that's how desperate I am for wellness. I really need encouragement and help right now. So any input is appreciated.
submitted by PristineTrouble527 to BipolarReddit [link] [comments]


2024.05.18 21:54 wehadababyitsapizza Valid reasons for Dr. to refuse HRT

Had a gyn appointment yesterday where I brought up peri and asked about HRT, and she had me make an appointment with another provider in the same practice who apparently specializes more in meno. I’ve had my GP and previous gyn dismiss my peri complaints bc I still have a period, want me to get my hormone levels checked, and tell me there’s nothing they can do, so I’m really frustrated and hopeful that this new doc will help me.
They say they go by NAMS guidelines. I’m just very anxious about being dismissed and denied again, wondering what valid reasons may be and what arguments I should push back on. I vape, I’m overweight, my mother and paternal grandmother had breast cancer but as far as I’m aware were negative for genetic markers, and my half sister had uterine cancer. I still have my uterus and ovaries, I’ve had ovarian and breast cysts but never cancer.
I’m having absolutely miserable peri symptoms I honestly I don’t fucking care if I get cancer if the alternative is living this way. I just wanna mainline estrogen until I feel human again. They already have my family history, should I lie and say I quit vaping? I’m exhausted by trying to get doctors to take me seriously and just trying to gear myself up for this appointment.
submitted by wehadababyitsapizza to Menopause [link] [comments]


2024.05.18 21:33 Luther2637 Should I get checked out for GERD? PLEASE READ

I think and hope it may be temporary because it happened out of the blue. For context **it's very important**. : Five days ago I had chest pain starting on the left side of my chest, obviously as someone with anxiety and having that kind of pain I started panicking about having a heart attack and ended up collapsing from panic (did not lose consciousness though), EMS came, took my vitals, did that thing with the stickers and wires all over my body to see how I was and they said my heart was perfectly fine. The day after, I hadn't slept well and I drank some tea to help myself sleep, hours after I woke up to stomach pain. I went to urgent care they did blood tests and urine tests and everything came back normal. This was also accompanied by soft stool for three days. Today my stool is normal and the pain has been subsiding, it's not as bad as the previous days but I am still having chest pain mainly on the left and right, never really in the center but sometimes. Went to urgent care yesterday for reevaulation and they concluded that it COULD be that gas issue but the only symptom I have rn is chest pain and some stomach pain.
My mom wants me to try taking Alkeseltzer. Should I? Also, should I make an appointment to a gastronologist? The chest pain isn't painful painful but my anxiety makes me hyperfocus on it and it's uncomfortable sharp-ish or like poking pain that alternates between left and right throughout the day.
PLEASE HELP SO I CAN EASE MY ANXIETY!!!!
submitted by Luther2637 to GERD [link] [comments]


2024.05.18 21:29 PristineTrouble527 Should I go off?

I made a post about my symptoms probably a week ago and they've been yo-yo'ing up and down since then. My sleep the past few nights has been atrocious and I suspect it's not due to my changing my laxative, but the Latuda kicking my ass. I've been on this medication a month and a half and it was fairly gentle at first. After my period things started to go haywire, beginning with worsening insomnia.
I've started getting akathisia like and TD-like symptoms after I eat and before bed that I didn't have before. Restless legs, involuntary tongue movements against my teeth, tingilng in my shoulders and wrists, things I wasn't dealing with during the early dosage phase at all. It comes and goes but when it comes it's exhausting.
One night I had immense, pinching chest pain. Past few days it's woken me up at like 3-5am and I can't get back to sleep for an hour or so, I will wake up a couple more times. Today I had to take a benzo to take the edge off. Should I go off? I literally just had a conference with my doc a few days ago saying I'd try another month and now I can't handle. I get a blood test done on tuesday and I'm considering waiting it out till then to see if my blood levels come back weird but I don't really want to suffer till then.
The sad thing is that it was helping me with my depression, psychosis and focus, but I cannot focus when my entire body dips into akathisia mode for zero reason. It's not livable. Should I also consider asking my pdoc about birth control on Tuesday if my cycle or hormones is somehow driving the reaction?
Does anyone have recommendations for what I should try next? I've tried Lamotrigane (allergic reaction, worked for about 1.5 months), Abilify (Akathisia from hell), Caplyta (painful digestive issues), buspirone (see caplyta), and now Latuda. I don't know if I can handle antipsychotics anymore, should I ask doc to consider another mood stabilizer. I hate blood tests but at this rate I think I'd rather deal with blood tests than go on another AP knowing they tend to cause me akathisia and TDlike symptoms. I've considered alternatives like Depoteke Lithium or even an off label anticonvulsant like trileptal.
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2024.05.18 17:42 jaxonjason is treatment resistant schizophrenia a quantum phenomenon?

: Exploring Chronic Quantum Neuroplasticity in Schizophrenia: Insights from Individuals with Treatment-Resistant Schizophrenia
Abstract:
Schizophrenia, a complex and debilitating mental disorder, continues to present significant challenges in understanding its etiology and treatment. This article examines the hypothesis that schizophrenia may have quantum underpinnings, as perceived by individuals with treatment-resistant schizophrenia. Drawing from personal experiences and observations, this exploration suggests a novel framework for understanding the condition and its manifestation in the context of chronic quantum neuroplasticity.
Introduction:
Schizophrenia remains a perplexing psychiatric disorder characterized by disturbances in thought, perception, and behavior. Despite advancements in neuroscience and psychopharmacology, treatment-resistant forms of schizophrenia persist, posing profound challenges for individuals and clinicians alike. This article proposes an alternative perspective on schizophrenia, informed by the firsthand accounts of individuals with treatment-resistant schizophrenia, which suggests a potential connection to quantum phenomena. Referred to here as "chronic quantum neuroplasticity," this framework posits that alterations in brain function, possibly mediated by traumatic experiences and the pineal gland, may disrupt neural circuits and lead to aberrant brainwave patterns that resonate with primordial energies or frequencies. This could contribute to the development of schizophrenia symptoms, including hallucinations, delusions, and disorganized thinking.
Evidence from Personal Accounts:
Further evidence supporting the hypothesis of schizophrenia as chronic quantum neuroplasticity arises from observations of seasonal exacerbations in individuals with mental health disorders, particularly those who neglect their dental health. It has been noted that as summer approaches, there is a discernible worsening of symptoms in many individuals with schizophrenia, coinciding with increased environmental stressors and changes in circadian rhythms. Of particular interest is the observation that individuals who neglect their dental hygiene, often leading to a decalcified pineal gland, are disproportionately affected by these seasonal fluctuations. This neglect of dental health may be exacerbated by the presence of fluoride, a neurotoxic substance found in many municipal water supplies, which can contribute to a process often referred to as a "chemical lobotomy." Fluoride's interaction with calcium in the body can lead to the decalcification of the pineal gland, potentially disrupting its function and contributing to the development or exacerbation of schizophrenia symptoms.
Seasonal Exacerbations and Dental Health:
Research has shown a correlation between poor dental health, characterized by conditions such as periodontitis and tooth decay, and an increased risk of schizophrenia and other mental health disorders. Neglecting dental hygiene can lead to a decalcification of the pineal gland, a small endocrine gland located in the brain that regulates circadian rhythms and melatonin production. The pineal gland's function is integral to maintaining the body's internal clock and may play a role in modulating mood and cognitive processes.
Quantum Concepts and Schizophrenia:
Quantum theory posits that consciousness and perception are influenced by quantum phenomena, including the entanglement of particles and the superposition of states. Chronic quantum neuroplasticity in schizophrenia may arise from a complex interplay of factors, including genetic predispositions, traumatic experiences, and environmental stressors. This framework suggests that alterations in brain function associated with schizophrenia may result from disruptions in neural connectivity and plasticity at the quantum level, leading to the manifestation of psychotic symptoms.
Implications for Treatment and Research:
Understanding schizophrenia as chronic quantum neuroplasticity has significant implications for treatment and research. Integrating insights from neuroscience, psychology, trauma studies, and quantum theory may inform the development of more holistic and person-centered approaches to schizophrenia treatment. Moreover, fostering collaboration between individuals with lived experience, clinicians, researchers, and policymakers is essential in shaping the future of schizophrenia care and advocacy.
Multicultural Approaches to Treatment:
Addressing schizophrenia through a multicultural lens involves recognizing the influence of cultural factors on illness presentation, help-seeking behaviors, and treatment preferences. Culturally tailored interventions may incorporate traditional healing practices, family involvement, and community support networks specific to diverse cultural contexts. Moreover, clinicians and researchers should actively engage with diverse communities to understand their perspectives on schizophrenia and collaboratively develop culturally responsive treatment strategies.
Intervention and Support:
Central to addressing schizophrenia, whether viewed through a quantum lens or traditional medical frameworks, is the importance of intervention and support. Holistic approaches that acknowledge the multifaceted nature of the disorder and address the individual's physical, psychological, and social needs are essential. These may include trauma-informed therapy, mindfulness practices, and community-based support networks. Such interventions aim not only to alleviate symptoms but also to promote resilience, empowerment, and recovery.
Managing Neuroplasticity:
Additionally, the concept of neuroplasticity, the brain's ability to reorganize and adapt throughout life, holds significance in schizophrenia treatment. While neuroplasticity offers opportunities for therapeutic interventions and recovery, it also poses challenges, particularly in the context of treatment-resistant schizophrenia. Excessive neuroplasticity may contribute to the chronicity and severity of symptoms, necessitating careful management to prevent maladaptive changes in neural circuits. Strategies for slowly reducing neuroplasticity, such as targeted cognitive interventions and pharmacological approaches, warrant further exploration in the context of schizophrenia treatment.
Conclusion and Future Directions:
In conclusion, the exploration of chronic quantum neuroplasticity in schizophrenia provides a novel framework for understanding this complex disorder. Future research endeavors should prioritize the exploration of culturally competent interventions for schizophrenia, including their effectiveness, acceptability, and scalability across diverse populations. Additionally, there is a need for greater representation of marginalized and underrepresented communities in schizophrenia research to ensure that findings are generalizable and applicable to diverse populations. By embracing multicultural perspectives in both research and practice, we can strive for more equitable and inclusive approaches to schizophrenia treatment.
submitted by jaxonjason to schizophrenia [link] [comments]


2024.05.18 15:28 OutlandishnessNo1371 Is this treatment plan adequate? 5 doses and tablet

My vitamin B is 184 pg/ml (Ref: 239-931). I am 22M, vegetarian. I started having GI issues since April and now other issues such as hand, leg cramps, tingling feeling from past 4-5 days, and some other symptoms.
My GI doc today on follow up gave:
Along with weekly Vit D 60K as I am deficient in that. I didn't do any test for folate.
Is the folic acid in this quantity safe? Should I do alternate days or weekly? I asked if weekly is okay and he was okay with it. Please suggest which one will help me better.
submitted by OutlandishnessNo1371 to B12_Deficiency [link] [comments]


2024.05.18 15:00 SquishyCatChronicles Not sure who needs to hear this...

Recently our 9 year old void was diagnosed with lymphoma. She was acting completely normal except her meow was mute. I made her a regular appt for like a week out and then the night before, ended up in the ER with her because her lymphnodes in her neck were MASSIVE! The ER Vet came in to break the news, Multicentric Lymphoma. I immediately was like let's fight this thing! She was a happy healthy cat otherwise. The ER Vet said prognosis is bad, she maybe has a month, you can see an oncologist, but even with treatment, she may not make it..
I put the crazy in crazy cat lady, it takes a lot for me to give up. Annnnyway, started seeing an oncologist based off a redditors recommendation for where he went. She is incredible!! We started chemo two weeks ago and between week 1 and 2, Raven went into partial remission! Here's hoping for full and complete remission and a happy healthy girl!
So what I say to you cat parents of Reddit, go with your gut! If the prognosis isn't good from one Vet, see another. Don't feel bad about seeking a second opinion.
Alternatively, make the best decision for you long term. I'm definitely putting myself in debt (although 0% interest on Care Credit is helping, it's still a CHUNK). Not everyone is in that position and I respect that. Furthermore, not every cat is caught as early, since they hide their symptoms soooo well! Your cay may not respond the same way. Still, trust your gut, get those second opinions, and advocate for your cat friend!
Lastly, if you've been on the fence about insurance, freaking get the insurance! I'm kicking my own butt for how many times I've told myself, "I need to look at insurance!"
I finally bit the bullet and signed the rest of the crew up with MetLife. It's too late for Raven, I could sign her up for coverage of other things but just not worth it at the moment.
TL;DR: Trust your gut, get second opinions, get insurance! Oh, and give the cat some treats!
submitted by SquishyCatChronicles to cats [link] [comments]


2024.05.18 14:44 Prestigious-Ad469 Dogecoin Market cap 🧢 for dummies

Dogecoin Market cap 🧢 for dummies
Ladies and gentlemen shibes, today I want to share with you my humble view regarding the current state of the global economy and the potential consequences for the US dollar. Hyperinflation is a real threat to the dollar's value, and it's essential to understand the factors that contribute to this risk and how Dogecoin can be a possible solution.
In today's economic landscape The Chinese have understood this. They keep smiling, downloading dollars, and buying gold. They are not following the US's lead. They are building their own economic chain on the solid precious metal, gold.
Gold Standard and Debt-Based Currency: the US dollar was once backed by gold reserves, which limited the government's ability to print new money without a corresponding increase in gold reserves. Since the US went off the gold standard in the 1970s, the dollar has been backed by debt itself, which has led to an increase in the money supply and a subsequent decrease in the value of the dollar. Perhaps you are not aware, but there exists a system larger than the Federal Reserve itself, known as the Eurodollar system. This system enables private banks outside of the US to create dollars without being audited. This system born in the 1970s. the Bank for International Settlements has stated that over 65 trillions dollars are missing: https://www.bloomberg.com/news/articles/2022-12-05/-missing-65-trillion-in-derivatives-dollar-debt-sparks-concern?embedded-checkout=true
China's strategy of selling off US bonds and the BRICS nations' development of a gold-backed digital currency further threatens the dollar's dominance. The dollar's demise would have a ripple effect on the global economy, making it essential to consider alternative forms of currency, such as Dogecoin.
In conclusion:
The way central banks handle the unsustainable debt crisis is akin to administering therapeutic killing on a terminal patient: they raise interest rates and destroy states, commercial banks, and the entire financial sector. They lower interest rates, and inflation destroys the purchasing power of currencies. There is no solution. Only administration of monetary stimulus on one hand and a turn of the screw on interest rates on the other, like administering a cocktail of medications to combat both symptoms and side effects. No one has ever been saved from pharmacological coma. Time is gained to not admit that the patient is already dead.
The integration of Dogecoin across the X ecosystem could potentially lead to a surge in its value, surpassing $1 and more. Doge at $35 is 0.25% of Global cap. Very small for being the world's largest financial institution. Critics who argue that market cap constraints would prevent this don't understand the complexities of economics.
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2024.05.18 13:22 HRJafael Maternal health bill poised for breakthrough in Legislature

https://www.sentinelandenterprise.com/2024/05/16/maternal-health-bill-poised-for-breakthrough-in-legislature/
Warning that lives are at stake, the House co-chair of a commission focused on postpartum depression called on her colleagues Tuesday to advance legislation to stem the tide of worsening maternal health outcomes that are disproportionately impacting people of color.
Certified professional midwives (CPMs) would gain a pathway to become licensed in Massachusetts under a redrafted maternal health care package (H 4566) that was reported out favorably by the Committee on Public Health and the Health Care Financing Committee, which last week shipped it to the House Ways and Means Committee.
The bill would allow midwifery care to be covered by MassHealth, remove regulatory and staffing barriers to operate birth centers in Massachusetts, require postpartum depression screenings for new parents during visits to pediatrician offices, and expand access to lactation support, among other policies.
A similar bill (S 2734) cleared the Public Health Committee in April and was sent to the Senate Ways and Means Committee, and the bills could be poised to emerge in either branch if they are able to get through their respective Ways and Means panels.
“I truly believe that the more eyes we have on someone who has given birth, the better,” Rep. Brandy Fluker Oakley, House co-chair of the Ellen Story Commission on Postpartum Depression, said during a maternal health forum at the UMass Club hosted by the Massachusetts Association of Health Plans.
“Research has shown that when Black women in particular have a midwife as part of the birthing process, it improves their life outcomes, it improves the outcomes for the child that they give birth to,” said Fluker Oakley, who sponsored midwifery legislation folded into the maternal health omnibus bill.
The rate of severe maternal morbidity in Massachusetts nearly doubled from 2011 to 2020, with Black women experiencing the highest rate of complications. Sen. Julian Cyr, co-chair of the Public Health Committee, said the panel advanced the omnibus package “in response to the crisis we see in maternal morbidity and mortality.”
“A number of members in both the House and the Senate view taking action on maternal health as critical,” Cyr told the News Service. “As we come to the final months of the legislative session, the recipe for success in getting bills over the finish line is often having policies that are well vetted by the committee, demonstrated need for action, and a broad coalition of support, both among senators and representatives, and advocates outside of the State House. Maternal health legislation seems to have all three of those ingredients.”
A spokesman for House Ways and Committee Chair Aaron Michlewitz, asked whether the Boston Democrat supports the legislation and when it could potentially reach the floor for debate, said the panel is “still in the process of reviewing that bill.”
Rep. Marjorie Decker, co-chair of the Public Health Committee, said there’s a “lot of strong interest” in Speaker Ron Mariano’s office to advance the House bill.
“Ultimately, this is a really exciting opportunity to advance a number of maternal health bills that have been vetted for some time and with the support of the speaker, who’s really been a strong supporter for me over the last year and a half in developing this omnibus bill,” Decker told the News Service. “I think what’s before us is the opportunity to advance some really good legislative work that’s been uplifted by my colleagues.”
A spokesman for Senate Ways and Means Chair Michael Rodrigues, asked about a potential timeline to tackle the Senate bill, referenced the chamber’s support for maternal health initiatives in the budget slated for debate next week.
“The bill was just reported out of the Joint Committee on Public Health late last month and is currently being reviewed by Senate Ways and Means staff,” Rodrigues spokesman Sean Fitzgerald said in a statement. “The Senate has historically made a strong commitment towards maternal health, and in the FY25 budget, we dedicate over $30 million in funding on an array of programs, including reproductive health access, WIC nutrition, and family and adolescent health.”
CPMs, who provide clinical care for low-risk pregnancies, are eligible to be licensed in 38 states – but not in Massachusetts, according to the Bay State Birth Coalition. Midwifery care is linked to fewer maternal deaths, infant deaths, unnecessary C-sections, and postpartum complications, among other benefits, the coalition said.
CPMs, should they gain licensure here, are eyed as a key workforce for birth centers, an alternative care setting beyond hospitals for low-risk pregnancies. Recent closures have left the state with only one open birth center, located in Northampton. Midwives, who are accredited by a national organization, are also trained to provide care for at-home births.
“I think it’s hugely significant that these bills have made it to Ways and Means. It’s definitely some recognition from the Legislature, I think, of really a critical juncture we’re facing,” said Claire Teylouni, director of governmental affairs at Reproductive Equity Now, as she invoked the worsening maternal health crisis and a growing volume of home births.
“The reason why this bill is so important is that licensing them (CPMs) allows us to formally integrate them into the entirety of our maternal health care infrastructure, allowing them to prescribe certain medications, allowing them to work first and foremost at freestanding birth centers,” Teylouni told the News Service. “We are really excited to see the Legislature showing interest in leading on this because there’s tremendous amounts of research showing these are policies that will tangibly improve birthing experiences and birthing outcomes.”
In May 2022, the Special Commission on Racial Inequities in Maternal Health endorsed legislation to expand access to midwifery care, among a raft of other recommendations such as growing the doula workforce, modernizing birth center regulations, and creating a “birthing justice” omnibus bill that invests in social determinants of health like housing, transportation and education.
As part of Gov. Maura Healey’s review of maternal health services, the Department of Public Health this fall said officials “will continue to explore ways to support CPMs and develop pathways to expand the settings in which they can be part of pregnancy and birthing care and coverage for that care in Massachusetts.” DPH said there were 48 CPMs in the commonwealth in 2022.
DPH also said officials would update birth center regulations, including concerns raised over physician supervision and staffing requirements.
Fluker Oakley said the special commission’s report is not intended to sit on a shelf.
“Literally, lives are at stake. Even here in Massachusetts, Black women are twice as likely to die in the childbirth process – that’s here,” Fluker Oakley said. “For us to have this report that has so many wonderful ideas, which I also think are low-hanging fruit to deal with this issue, and for us just to kind of say, ‘Oh, we’ll get to it when we get to it,’ it really feels like a slap in the face. It’s like, oh, so you don’t care if we live or die.”
At the forum, Fluker Oakley also promoted the “Moms Matter Act” that she filed with Sen. Liz Miranda, co-chair of the postpartum depression commission, to grow the perinatal mental health workforce and provide grants to community organizations. The bills (H 1984 / S 1261) were reported out favorably by the Mental Health, Substance Use and Recovery Committee, and the Health Care Financing Committee has until July 3 to take action on the proposals.
Fluker Oakley, asked whether the Legislature has time to tackle the workforce bill in addition to the maternal health omnibus bill, told the News Service, “I have to remain hopeful and optimistic. Otherwise, what am I doing here?”
“So yes, I will say I think there’s time, and we’ll see what happens by the end of session,” Fluker Oakley said. “I’ve had several positive conversations with House leadership throughout the course of the legislative session.”
During the forum, perinatal mental health experts discussed the importance of boosting the use of postpartum depression screenings for new parents and connecting them with treatment.
Maternal mental health disorders are the most common complication seen during pregnancy and birth, affecting one in five women, said Lora Pellegrini, CEO of MAHP. Among Black mothers, 40% experience perinatal mood and anxiety disorders (PMADs), though Pellegrini said “few” end up being screened for anxiety or depression.
Research shows that 13 to 19% of new birth parents experience postpartum depression (PPD), a number that’s likely too low, said Beth Buxton, lead of perinatal mental health initiatives at the DPH. She said that range would indicate between 8,897 to 13,134 birthing parents in Massachusetts were affected by PPD in 2021, making the condition more prevalent than the combined cases of preeclampsia and gestational diabetes.
Buxton said only about 16% of eligible pregnant and postpartum people are being screened for PPD, based on regulations that require health plans and providers to report their screening to DPH annually. While Black and Asian individuals have higher rates of experiencing symptoms “often or always,” Buxton said they are far less likely to be screened than white women.
“And when you compare screening rates, the Hispanic birthing population is far less likely to be screened – that’s a new data point,” Buxton said, as she referenced information from the Massachusetts Pregnancy Risk Assessment Monitoring System. “One of the things we’re really asking providers to think about in the community is promoting universal postpartum depression screening. That is so important in multiple settings – not only within a provider setting, but a hospital setting, home visiting programs, a pediatric setting, so the gamut for universal screening.”
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