Why is lopressor prescribed after mi

Soul Eater

2011.11.04 02:01 Mywhy Soul Eater

Here is the place where you can find everything to know about Soul Eater and Soul Eater NOT! Come take a peak inside! You will never know what kind of things you will find!
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2014.03.01 04:22 ARMOUR IS MASTER RACE

This is the place to vent about the frustrating idiocy of online thyroid communities. Mock the woo!
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2014.11.11 00:21 NicholasCajun FoundationTV - Respect and enjoy the Peace.

A place to discuss the Apple TV+ adaptation of Isaac Asimov's Foundation series. Respect and enjoy the peace.
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2024.05.15 16:05 healthmedicinet Health Daily News May 14 2024

DAY: MAY 14, 2024

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2024.04.24 16:56 Tredolski Trappenergetix Banq Limited

The Rick Ross/Drake beef reminded me about this post I tried to make a while back. Kind of forgot about this company until they started beefing and I need to share what I've found. It's insane. Sources are found at the end of the post.
A couple months ago I was scrolling through this sub-reddit when I saw a post that caught my eye. A user on the subreddit pointed out that Drake is on the board of directors of a company by the name of Trappenergetix Banq Limited. When diving in further, we see there are numerous celebrity entertainers on the board of directors. Those celebrities include: Drake, Lebron James, Rihanna, A$AP Rocky, A$AP Ferg, Rick Ross, Nicki Minaj, DJ Khaled, Dababy, and Cardi B. There are 2 more names listed that will be unfamiliar to many of us: Leon Howard and Jaroslaw Hieronimczuk.
Leon Howard is known as the "Wall street trapper" and has a million followers on his Instagram. He's from New Orleans and seems to be known in the crypto/stock market community, which will play a huge part in what will follow. The guy is doing good for himself, especially for an ex-con, but he is not doing nearly as good as any of the entertainers listed above. Looking at the Linkedkin of Jaroslaw, he has a bunch of different holdings companies and after doing some digging, we see Lebron James sits on the board of at least one of them and is listed as the person with "significant control" (422 G Club LTD). It's practically impossible to find any information on these companies. Somehow Leon and Jaroslaw met, and are now partners running a company called the Wall Street Investment Hub. Seems innocent right? Just some guys who know how to invest money the right way to make more money for the group. But we have to ask the question: How did these guys get tapped in with some of the biggest entertainers in the world?
When you look this company up, you find absolutely nothing besides a couple company profiles listing the most basic information about this company. Company was started March 13, 2023. Trappenergetix Banq Limiteds registered office address is 86-90 Paul Street, London, England. When I saw the address I thought maybe this was a method rich entertainers use to avoid paying full taxes or something. Well, I was wrong. The company profile has 4 SIC codes listed. If you don't know what SIC codes are, they basically tell the purpose of a business for tax purposes. None of the SIC codes really stood out to me until I saw SIC code 64191: "Bank".
I started reading the filing history and this is where things reach somewhat of a grey area for me. I'm not too much of a finance guy so I understood it the best I could. Looking at a statement of capital following an allotment of shares on April 30th, 2023, Trappenergetix allotted 1,000,000,000 shares at a Nominal value of $20/share to a company called Ari-Howard-Medical-Centres USD. When looking up Ari Howard Medical Services I couldn't find anything. I really didn't quite understand what the purpose of this company was until I started reading deeper. Here is what is said word for word from the statement of capital, which I will attach links to:
"1000000000 ARI-HOWARD-MEDICAL-CENTRES $20.00 SHARES HAVE BEEN ALLOTTED FOR THE CONSIDERATION OF OUR NEW SHARES SYSTEMS ARE BASED ON CUTTINGEDGE TECHNOLOGIES SUCH AS SMART CONTRACTS, ZERO-KNOWLEDGE PROOF, AND DISTRIBUTED DATA STORAGE AND EXCHANGE. THESE TECHNOLOGIES ENABLE US TO OFFER YOU DIGITAL WALLETS, DIGITAL ASSETS, DECENTRALIZED FINANCE (DEFI), AND NON-FUNGIBLE TOKENS (NFT) THAT ARE FAST, TRANSPARENT, AND COST-EFFECTIVE........... WITH OUR NEW SHARES SYSTEMS, YOU CAN BENEFIT FROM: - DIGITAL WALLETS THAT ALLOW YOU TO STORE, SEND, AND RECEIVE DIGITAL ASSETS SECURELY AND CONVENIENTLY - DIGITAL ASSETS THAT REPRESENT FRACTIONAL OWNERSHIP OF REAL-WORLD ASSETS SUCH AS STOCKS, BONDS, COMMODITIES, REAL ESTATE, ART, AND MORE "
If you don't want to read all of that, basically they have the technologies to run a successful digital currency. On the VERY NEXT PAGE 99,999,999,999 shares of Britcoin are allotted, but this time in GBP (pounds). Then, stated in black and white,
"BRITCOIN PRESCRIBED BRITCOIN IS A POTENTIAL BRITISH DIGITAL CURRENCY WHICH WILL BE ISSUED BY THE BANK OF ENGLAND AND BACKED BY THE GOVERNMENT. UNLIKE BITCOIN AND OTHER CRYPTOCURRENCIES, WHICH ARE NOT BACKED BY A 'REAL' CURRENCY OR AN ASSET, BRITCOIN WOULD BE TIED TO THE POUND AND A SO-CALLED STABLECOIN. THAT MEANS THAT ITS VALUE WOULD BE STABLE, JUST LIKE BANKNOTES, WITH £10 IN BRITCOIN DIGITAL POUNDS HAVING THE SAME VALUE AS A £10 BANKNOTE. "
From my understanding what this group wants to do is be the first to emerge with a government backed cryptocurrency. From the same statement of capital again:
"THE DIGITAL POUND WOULD BE BUILT USING THE BLOCKCHAIN, TOKENISED AND STORED ON A DIGITAL WALLET ACCESSIBLE VIA SMARTPHONES OR SMARTCARDS. LIKE PRIVATE CRYPTOCURRENCIES, THESE WALLETS WOULD MOST LIKELY BE PROVIDED BY A PRIVATE COMPANY, SUCH AS BANQ GROUP(Trappenergetix)"
To cap it all off:
"COMPRESSOR PAYMENT PROCESSOR INTRODUCED BY LEON HOWARD, AN AMBITIOUS AMERICA ENTREPRENEUR WILL BE INTRODUCING ALL THIS UNDER THE BANQ GROUP SCHEME TO BOOST BRITISH AND AMERICAN ECONOMIES AND BRITCOIN TO BE UNDER TRAPPENERGETIX BANQ. COOPERATIONS BETWEEN OUR PARTNERS AND OUR LEADERS WILL HELP US ACHIEVE OUR OBJECTIVES IN THIS IMPORTANT GLOBAL CLIMATE TRANSITION."
What does this all mean? Well, my guess is that this company was MAINLY formed to become the frontrunner in becoming the first internationally, bank and government backed digital currency. With the company being located in England it only makes since. What I don't quite understand is why are these entertainers on the board of directors? Like Cardi B knows shit about crypto lol. Obviously it's the teams of these entertainers working with Leon and Jaroslaw not the entertainers themselves. What do you all think? Is there a conspiracy here or am I grasping at straws? I think that the board will reap financial benefits for generations if this goes the way Leon Howard and Jaroslaw hope. In my opinion, this is huge. We knew the first government backed currency was coming, but for this company to own the tech and have grasp over the currency itself is pretty substantial. Maybe I looked way too much into this and I misunderstood some of it. Y'all let me know.
Sources (I would have posted screenshots but my computer sucks) if links don't work let me know I'll try my best to edit them:
Company history- https://find-and-update.company-information.service.gov.uk/company/14725483/filing-history?page=2
Ari Howard Medical Centres/Britcoin
422 G Club LTD (Jaroslaw and Lebron)
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2024.04.16 10:19 Blame-Mr-Clean An Argument for the Plausibility of Guided Theistic Evolution

(Mirror version with proper formatting)
Prologue
Let's assume that Adam never sinned, no fall of humanity ever occurred, and no fall of angelic beings ever occurred. In Genesis 1:28 you still have man's being told to be fruitful and to multiply. If we assume that there were no other humans besides Adam and Eve and that it was up to just Adam and his progeny to do the job of populating the earth, then the world's population plausibly would have consisted merely of Adam, Eve, and a very large number of their children or first-generation descendants.
Adam would have no other way of filling the earth with his offspring apart from either: A) either crude or sophisticated (e.g. IVF) methods of sexless impregnation; or B) incest. Let's be honest: if pressed on the matter, I think that most of us would say that incest is plumb bad--not bad merely after the Mosaic Law was given, as if God were so desperate to get the world populated that he outlawed incest only later in human history, but inherently bad or perhaps even abominable. So (B) was likely never to be a divine-prescribed option. As for (A), these are unnatural or “inorganic” enough for us to find it implausible that such would ever have been options. Consequently, in an unfallen universe Adam's offspring might have had gonads that lay dormant just as males' nipples do not provide milk.
But Adam did sin, humanity did fall, and death became an inevitability for Adam and Eve that would disallow their indefinitely populating the earth strictly by having more children. Based on the contrast of the ugly Genesis 19:30-38 episode and the technological wisdom of Genesis 4:17-22, I am going to assume that ancient man never came up with primitive methods of impregnation that did not rely on sex. Therefore, the popular creationist idea that the world was populated by means of incest in the early days of humanity would probably be correct.
Notice that I use the word “would” above. If in Genesis 3:21 God made clothes for Adam and Eve after the fall and if in Genesis 4 Cain is made to pay a price for the crime of murder but remains protected nevertheless, should we believe that Adam's offspring would not have been spared from the necessity of weird methods of populating the earth? Ladies and gentlemen, you can believe that the world was populated through wide-scale incest if *you* want to do so; personally, I think this idea is both morally and epistemically dubious while I also *know* that the Bible never explicitly states that incest was a means of the populating of the earth whether before Noah or immediately after him.
Gone are the days when I for one will just shrug my shoulders, throw up my hands and say, “What else can I say? It must be true because this Bible verse says X, Y and Z.” Forget that. Audit your interpretation of the said Bible passage first; only if your idea passes a rigorous re-examination should you be content to live with cognitive dissonance. In fact, an audit of both YEC and OEC begins right now....
------------------------
Here are some preliminary facts:
1 ) Adam is said to be everyone's ancestor: Acts 17:26.
2 ) Adam is said to be “the first man”: 1 Corinthians 15:45-47.
3 ) Eve is said to be “[the] mother of all living”: Genesis 3:20.
4 ) Genesis 1-3 is not meant to be a comprehensive account of the creation of the universe. Some of the many things that are not mentioned in that account are bacteria, angels, cherubs, seraphs, black holes, comets, meteors, meteorites, dwarf planets, exoplanets, etc.
So apparently there were no humans before Adam was made. Also, if any Adam-unrelated human being emerged after Adam was made, that person either has had no lasting blood line or it has crossed paths with that of Adam. Genesis 3:20, meanwhile, does not allow much realistic narrative wiggle room for the idea that humans unrelated to Adam emerged after he was made, but a small amount of wiggle room apparently exists nonetheless. This helps to allow for a hybrid account of guided evolution, teleological creation, and a late, short-lived parallel race of humans.
5 ) The following is an assumption that one may hear or encounter among the rank and file in Christendom: “The Bible has to be so simple that a child could understand it.”
This assumption is perfectly false. What does Peter say about the apostle Paul's writings in 2 Peter 3:15-16? What do we see in Acts 8:26-35 with Philip and the Kushite eunuch? We see proof that this assumption is false and naïve; that's what.
6 ) The following is an unspoken, subconscious assumption that pervades nearly all of evangelicalism and fundamentalism: “Whatever tools, wisdom and understanding that *I* have are adequate for making sense of all the Scriptures.”
This assumption is also false. For example, there are still parts of the Scriptures having a few words or phrases that even scholars do not know the precise meaning of. For example, no one can say for certainty what the Nicolaitans of Revelation 2 really believed.
Based on such faulty assumptions, and given humanity's natural inclination toward instant gratification, there will be people who gravitate toward hyperliteralism in their biblical hermeneutics. To be fair, given humanity's natural inclination toward intellectual sloppiness, half-measures and laziness, there will also be people who will slap the label of “allegory” onto this or that Scripture, without explaining how it does not contradict various grammatical, pragmatic or discursive rules, and call it a day. Both actions are mistakes.
7 ) Allegory and history are not mutually exclusive. 2 Samuel 12:1-7 (ESV):
«12 And the LORD sent Nathan to David. He came to him and said to him, “There were two men in a certain city, the one rich and the other poor. 2 The rich man had very many flocks and herds, 3 but the poor man had nothing but one little ewe lamb, which he had bought. And he brought it up, and it grew up with him and with his children. It used to eat of his morsel and drink from his cup and lie in his arms,[a] and it was like a daughter to him. 4 Now there came a traveler to the rich man, and he was unwilling to take one of his own flock or herd to prepare for the guest who had come to him, but he took the poor man's lamb and prepared it for the man who had come to him.” 5 Then David's anger was greatly kindled against the man, and he said to Nathan, “As the LORD lives, the man who has done this deserves to die, 6 and he shall restore the lamb fourfold, because he did this thing, and because he had no pity.”
7 Nathan said to David, “You are the man! Thus says the LORD, the God of Israel, ‘I anointed you king over Israel, and I delivered you out of the hand of Saul.»
Nathan delivered an allegory. The allegory was practically truthful. The allegory referred to a real person while using artistic or rhetorical flourish, as in Bathsheba's becoming a poor man's lamb. Therefore, 2 Samuel 12:1-7 furnish one of multiple proofs that the idea that Genesis 1-2 are allegorical should not be dismissed out of hand.
8 ) We know for a fact that at least some of the book of Genesis was not meant to be taken literally. For example, Genesis 3:14 (ESV) reads as follows:
«The LORD God said to the serpent,
“Because you have done this, cursed are you above all livestock and above all beasts of the field; on your belly you shall go, and dust you shall eat all the days of your life.»
Do you, the reader, really believe that the devil was a beast of the field and was cursed to literally crawl on his belly and to literally eat dust? If so, what then are we to make of Ephesians 2:2 or Job 1:6-12 which seem to portray the devil as someone who was free to roam the universe even after the events of Genesis 3? So it is clear that Genesis 3 is partly allegorical or partly figurative given its proximity to Genesis 1-2, those chapters plausibly do the same.*1*
8a ) The structure of this particular allegory does not seem arbitrary or random in nature. Ezekiel 28:11-19 seem to portray the devil as a cherub who was cast to the ground (verse 17); this jibes with Luke 10:18 and Revelation 12:4 (cf. Isaiah 14:12-16). Meanwhile, it should be noted that it is never established in the Scriptures whether “seraph” and “cherub” have different meanings or whether one denotes a sort or kind of what is denoted by the other. With that said, note that the word translated as “seraph” in Isaiah 6:2 is translated in Isaiah 14:29 and Isaiah 30:6 as “fiery serpent”; this is to be compared with Revelation 20:2 (ESV): «And he seized the dragon, that ancient serpent, who is the devil and Satan, and bound him for a thousand years,».
So regardless of whether the devil really did have a form of a winged serpent (i.e. a dragon) or wingless serpent in the garden of Eden, Genesis 3 has non-literal elements, Genesis 1-2 therefore plausibly does the same, and any allegorical elements of Genesis 1-3 will likely be similar to the reality that it represents: for example, man's being formed of dust (if allegorical) would *not* likely represent a far-removed idea such as Adam's being born of a humanoid mother but indirectly made of stardust that was made millions of years prior, as has been suggested in the past.
9 ) So Genesis 1-3 accomplish what they need to accomplish--not to provide a comprehensive and literal account of the world's creation as a contemporary science textbook would, but something else.
In Matthew 12:40 it is said that Christ will be in the heart of the earth for “three days and three nights,” despite the fact that Christ died on Friday and rose on Sunday morning for a total of less than exactly three days and three nights. So Hebrews of old simply did not share the sum of our modern commitments to semiotic precision; keep this in mind when reading about a “morning” or “evening” in Genesis 1-2. Then again, even modern man is not totally committed to speaking precisely about all temporal matters (from https://elegantmemorials.com/funeral-program-format, 04/16/24):
«Birth Date and Death Date. You can also refer to this as "Sunrise" and "Sunset"»
These facts about allegory, imprecision and discourse analysis are to be matched with the following: the observation that weird stuff occurs in 2 Peter 3, Psalm 90, and Genesis 1-2, with all passages mentioning the creation of the world. Here, for example, the number one suddenly becomes plural:
Genesis 1:9-10 (ESV): «9 And God said, “Let the waters under the heavens be gathered together into one place, and let the dry land appear.” And it was so. 10 God called the dry land Earth,[a] and the waters that were gathered together he called Seas. And God saw that it was good.»
After all, how can it be that the waters are gathered to “one place” in an *ordinary sense* when almost immediately afterward we get the plural word “seas”? Again, the number one suddenly becomes plural:
Genesis 1:26a (ESV): «Then God said, “Let us make man[a] in our image, after our likeness.»
After all, despite the use of plural “our” we remember the words of Deuteronomy 6:4 (ESV): «“Hear, O Israel: The LORD our God, the LORD is one.[a]» The number one is also plural below:
2 Peter 3:8 (ESV): «But do not overlook this one fact, beloved, that with the Lord one day is as a thousand years, and a thousand years as one day.»
Psalm 90:1-4 (ESV): « A Prayer of Moses, the man of God.
90 Lord, you have been our dwelling place[a]in all generations.2 Before the mountains were brought forth, or ever you had formed the earth and the world, from everlasting to everlasting you are God. 3 You return man to dust and say, “Return, O children of man!”[b]4 For a thousand years in your sight are but as yesterday when it is past, or as a watch in the night.»
In fact, the number one apparently equals six:
Exodus 20:11 (ESV): «For in six days the LORD made heaven and earth, the sea, and all that is in them, and rested on the seventh day. Therefore the LORD blessed the Sabbath day and made it holy.»
Genesis 2:4, 7 (ESV): «These are the generations of the heavens and the earth when they were created, in the day that the LORD God made the earth and the heavens.»
«7 then the LORD God formed the man of dust from the ground and breathed into his nostrils the breath of life, and the man became a living creature.»
The overall point here is this: for some reason there is a conflation of oneness and plurality in creation texts. Within this would-be conflation are multiple indications that the “‘Yom’ never means anything other than a 24-hour day” YEC claim is perfectly questionable, right along with the claim that the words “morning” and “evening” somehow emphasize Genesis 1-2's being entirely literal. (Of course, it also remains plausible that the six days of creation are six days of direct creation, with intervening intervals of indirect creation through evolution.)
So once again Genesis 1-3 accomplish what they need to accomplish--not to provide a comprehensive and literal account of the world's early history as a contemporary science textbook would, but something else.
10 ) If this were not proof enough that Ussher's chronology is incorrect and not binding, let's speak one more time about Hebrew imprecision of language, this time from Deuteronomy 4:25 (ESV):
«“When you father children and children's children, and have grown old in the land, if you act corruptly by making a carved image in the form of anything, and by doing what is evil in the sight of the LORD your God, so as to provoke him to anger,»
Apparently Biblical Hebrew was like other languages in that they all have idiosyncratic weird ways of speaking. In Deuteronomy 4 “to father” or “to beget” does not carry the meaning that we Modern English speakers would expect; instead, it seems to refer to one's becoming either a father *or* a grandfather. If you carry that principle over to the biblical genealogies that people like Ussher use to conclude that the world is 6000 years old, it is not possible to say with confidence that gaps aren't missing from those genealogies.
11 ) In Numbers 32 the tribes of Gad, Reuben and half-Manasseh took land east of the Jordan River despite that land's not belonging to a foregoing prescribed set of land allotments to national Israel west of the Jordan River; and that turned out to be morally permissible. By analogy, Genesis 1:29-30 conceivably speak of dietary conditions that were ideal without being absolutely restrictive.
12 ) Of course, many YEC apologists will use Romans 5:12-14 (cf. 1 Corinthians 15:22) to argue that death began when Adam fell. Here is what that passage says (ESV):
«12 Therefore, just as sin came into the world through one man, and death through sin, and so death spread to all men[a] because all sinned— 13 for sin indeed was in the world before the law was given, but sin is not counted where there is no law. 14 Yet death reigned from Adam to Moses, even over those whose sinning was not like the transgression of Adam, who was a type of the one who was to come.»
YECs forget that the devil sinned before Adam did. Therefore, it cannot be that the word “world” in this passage means *universe* or *earth* or anything like these. Instead, this word ends up referring to humanity or the realm of humanity, if you will, as it does in 1 John 2:2 (ESV):
«He is the propitiation for our sins, and not for ours only but also for the sins of the whole world.»
So it need only be the case in Romans 5:12-14 that the apostle Paul is talking about humanity's becoming subject to death when Adam sinned and lost access to the tree of life.
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Here is what we get when we add up the data: theoretically it could indeed be the case that there was a late, short-lived parallel race of humans. Adam was indeed the first man and along with Eve is an ancestor of everyone alive today, but his direct origins in the dust of the earth would be contrasted by a divinely-guided, evolutionary emergence of a parallel race of humans which existed for Adam's populating the earth through children's children without having to rely on incest. I am not saying that such a race existed; however, that such a race existed is possible in theory.*2*
That such a short-lived race existed is also more likely to be the case than the existence of a short-lived, parallel hybrid race of bad Watchers or fallen angels or “sons of God” and female descendants of Adam.*3* Firstly, if the Watchers produced such a race, then Adam's first male descendants still would have ended up having relatively close relatives as wives (e.g. Seth's niece). Secondly, an explanation of guided evolution toward a second human race is more parsimonious; a theory of Watchers is more or less ad hoc whereas ideas of contemporary evolutionary theory already end up supporting the likelihood of each other in various independent ways, thus establishing a larger cohesive and coherent system of thought.
Of course, some young, ham-fisted YEC apologist will dismiss this idea out of hand and accuse me of “cOMproMiSe wITH thE wORld!” This, of course, would be a mistake because creationists themselves consistently rely on extrabiblical reasoning to do biblical exegesis. After all, who believes Psalm 75:3 when it says that the earth is atop “pillars”? Who rejects Isaiah 11:12 when it says that the earth has “four corners”? Who takes Isaiah 40:22 literally when it talks about “the circle of the earth”? Who does not continue to believe that the earth both rotates and revolves when he observes that Psalm 104:5 speaks of the earth's not being moved from its foundations?
As much as people don't like it, it really is sometimes necessary to allow extrabiblical philosophy to inform one's attempts at biblical exegesis.*4* So here is a message to those creationist apologists out there who are ham-fisted in their approach: Why don't you just believe and accept what the Bible says? Again, why don't you just humbly accept what the Bible clearly says in:
2 Samuel 8:4 (ESV): «3 David also defeated Hadadezer the son of Rehob, king of Zobah, as he went to restore his power at the river Euphrates. 4 And David took from him 1,700 horsemen, and 20,000 foot soldiers. And David hamstrung all the chariot horses but left enough for 100 chariots.»
1 Chronicles 18:4 (ESV): «3 David also defeated Hadadezer king of Zobah-Hamath, as he went to set up his monument[a] at the river Euphrates. 4 And David took from him 1,000 chariots, 7,000 horsemen, and 20,000 foot soldiers. And David hamstrung all the chariot horses, but left enough for 100 chariots.»
2 Samuel 10:17-18 (ESV): «17 And when it was told David, he gathered all Israel together and crossed the Jordan and came to Helam. The Syrians arrayed themselves against David and fought with him. 18 And the Syrians fled before Israel, and David killed of the Syrians the men of 700 chariots, and 40,000 horsemen, and wounded Shobach the commander of their army, so that he died there.»
1 Chronicles 19:17-18 (ESV): «17 And when it was told to David, he gathered all Israel together and crossed the Jordan and came to them and drew up his forces against them. And when David set the battle in array against the Syrians, they fought with him. 18 And the Syrians fled before Israel, and David killed of the Syrians the men of 7,000 chariots and 40,000 foot soldiers, and put to death also Shophach the commander of their army.»?
Yeah, to just accept what the Bible clearly says is kind of hard to do *automatically* in this case, isn't it? You kind of have to do some extrabiblical philosophy or heuristics or reasoning to figure out which numbers are correct, or whether it's 40,000 horsemen or 40,000 foot soldiers, don't you? And that is the sort of thing that OECs and theistic evolutionists would point out: sometimes extrabiblical research can or must inform one's biblical exegesis, like it or not. For even when we're comparing and contrasting a Final Nun and a Zayin to make sense of the latter pair of Scriptures, we're talking Hebrew semiotics, which is not exegesis.
Addendum
Someone will claim that dinosaurs gave rise to birds and that the sequential order of Genesis 1 is incorrect on that basis. Even if some dinosaurs evolved into birds, it need only be the case that Moses or whoever Genesis 1 was only thinking about beasts that walked the earth as of the time of writing. Remember, in the meantime, that we saw earlier that Genesis 1-2 was not meant to be a comprehensive account of the creation of the world, things such as angels and cherubs not being mentioned there.
ENDNOTES
*1* Of course, at least as early as the 3rd century there was the belief that not all of Genesis 1-2 was meant to be taken literally. For example, see Origin's De Principiis, Book IV: 16-17. However, Origen would have done well to consider the modern idea that Genesis 1 describes a series of events in which the sky gradually changes from being opaque to transparent, hence the appearance of plural “lights” in on the fourth day in Genesis 1:14-18.
*2* If the idea of unrelated, post-Adamic human beings with short-lived bloodlines or genealogy is to work, then certain other things must first be in place. On Leviticus 18:23 and 20:15-16, we can't have Adam's offspring mating with animals: these other human beings have to be real humans, not soulless facsimiles or approximations or what-have-you. Ideally, there would also be other textual hints, large or small, that such human beings coexisted with Adam and his immediate family.
Let's say you tinker with a simian spermatozoon, and a simian ovum, and have one fertilize the other such that the resultant zygote's structure is just like that of the prophet Moses when he was a zygote: is this mirror Moses a human being or not? (Bear in mind that the man Jesus Christ became a human through unordinary means.) Someone will say, “No, because God hasn't breathed life into it.” Yet there is no reason to believe that this zygote, if it treated like any successful zygote is treated in IVF, will not grow and eventually be born. So this zygote seems to be a human just as much as Christ himself was a man born through unusual means.
Meanwhile, the very phrase “make man in our image” in Genesis 1:26 seems to suggest that one's having the said image is a contingent property. By analogy, I could take a single lump of clay, say “I'm going to form a statue of an elephant,” and later cause that lump of clay to have the form of an elephant, but I could just as easily use the same lump to fashion a pot that looks like a pot that I broke last week. Man himself was formed from the dust of the earth, so it becomes easier to imagine that a short-lived, parallel race of humans might have been humans that were not made in God's image. Consider this to be grounds for further research or thought.
*3* Compare Luke 3:38, Job 38:4-7, Genesis 6:1-4, Jude 1:6-7, 2 Peter 2:4-10, and Exodus 7:10-12.
*4* To be sure, it's not about haphazardly making this or that passage of literature receive a forced-fit eisegetical interpretation. It's all about a right use of abductive reasoning in different walks and matters in life.
...And speaking of matters of parsimony, let's concede the idea that light was in transit on Creation Day Four in order to make season-marking, navigation, etc. to be immediately possible for Adam on Day Six (cf. https://en.wikipedia.org/wiki/Omphalos_hypothesis). That's fine, but there are still objects behind that light, right? If these objects were truly close, then should they not have noticeable and measurable effects on neighboring heavenly bodies to suggest proximity? Or if they're instead far away, then why shouldn't they be as far as red light shift metrics suggest?
Meanwhile, are tree rings necessary for an immediately functioning world? Presumably, they are not. Why then should someone suspend good sense or a consistent use of abductive reasoning to support a biblical interpretation that was never necessarily true in the first place?
These are some of the reasons that I for one have not subscribed to YEC for the longest time.
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2024.04.08 03:05 picklechick84 Do you think drugs affect you differently than they do the general population?

I am not in any way trying to promote drug use, especially the misuse of controlled substances. I am simply curious about the experiences of others compared to my own. We have bipolar disorder here, so I know I'm not the only one who's enjoyed a buzz. Drugs are bad, m'kay?
It has been my experience that frequently, drugs, prescribed or otherwise, do not always affect me the way they are expected to, or the way most people experience them. I am curious if this is something related to having bipolar disorder. I tried Google. I typed in "do drugs affect people with bipolar disorder differently than they affect the general population," and all I got back was stuff about comorbidities and how people with bipolar disorder are more likely to be addicts, and how to get help for addiction. So it didn't really answer my question.
But for example, some people think it's fun to take benzos to get high (I honestly don't really understand the draw, why is it fun to get so high you nod off in your dinner?), but when I take them, I don't always experience the same effect as the last time I took them. Like one time I might take them and feel loopy and silly and have a good time, but I might take them another time and just go straight to sleep, and yet another time I don't experience much of anything at all, beyond a calmer state. I've been prescribed benzos, and just using them as prescribed is fine, they manage my anxiety, but if I take more than the prescribed dose there's no telling what I will experience, because it's never been the same twice in a row.
When I smoke weed, it seems like I have to smoke just a little more than everyone else in order to get as high as them, and I suspect that even then, in general I do not get as high as most people. Where others will stay high for a couple of hours, I usually start coming down after 45 minutes to an hour.
One time, I was prescribed some Percocet for a mi or surgery I'd had. The pain was intense and I'd been taking them two at a time to quell it, and I'd feel kinda relaxed and nice, but not super high or anything. Well I had one left over after the pain subsided, so I decided to take it for fun, and holy shit I was so loopy I could barely stand! Makes no sense to me at all.
So, what about you guys? Do you have similar experiences, or is there some other reason drugs hit me differently?
submitted by picklechick84 to bipolar [link] [comments]

2024.02.28 11:10 Unfair-Vermicelli-16 Sleeping pill/supplement (personal) experience master post. Will be updated as I have the time to add more and try any suggestions from the comments.

This is an unfinished post. I will be adding more in the coming days and as people suggest them

*Disclaimer: These are my own personal experiences. Someone with less severe, occasional, or insomnia caused by other factors such as stress may not respond the same way as I do. Everyone's body and brain chemistry work differently and this is not a substitute for a doctor's advice. I have no medical training, just a lot of personal experience as I have been dealing with severe insomnia for well over 15 years. *
I see a lot of posts like "Experiences with _____?" and as someone who has tried almost everything, I decided sharing my experience with each one may be helpful. I'll be listing my overall experience, the pros and cons, and probably a rating out of 100. They'll all be sorted into their own drug categories. It's hard to remember everything I've taken, so if I've missed anything, please let me know in the comments. I'm also open o trying new things (legal and available in the US), so if you have any suggestions, I'll try them out and add them here,
For reference, I have pretty severe chronic insomnia that is clinically "idiopathic" but is made slightly worse from ADHD and recently acquired chronic pain. Even with the best sleep hygiene, without sleeping pills, I just don't sleep. I get around 1-3 hours of poor-quality sleep every 72-100 hours when I don't take anything.
Now for the list. I will be labeling each medication and/or group/class as such:
🔒 Prescription required (USA)
🔓 Available over the counter (USA)
✅ Very safe/ low risk
⚠️ Moderate risk
⚠️⚠️ High risk
🚫 Very high risk. Should only be taken in severe and specific cases.
💀 Very dangerous. Do not consume.
DOE - Duration of effects

🔒⚠️Sedative/ Hypnotics (Non-benzodiazepines or Z-drugs)

Sedative/ hypnotics, or "non-benzodiazepines" in general are the most widely prescribed treatment for insomnia. They are less dangerous than benzodiazepines, having a lower chance of dependence and lower mortality rate when combined with other depressants such as opioids. The word "non-benzodiazepine" is misleading, leading people to believe that they are "not" benzos, when they act very similarly, and on the same receptors, the just have a slightly different molecular structure and cannot be labelled as such. Although they are known to be safer, they still have a high chance of dependance, abuse, and adverse effects.
*Not all of these have been available to me, so I will only list the ones I've done. If you have similar insomnia to mine and I've tried ay that I haven't listed, let me know in the replies and I may add your experience.*
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🔒⚠️Lunesta (Eszopiclone)
Dose Range: 1-3mg
Onset: 30 - 90 minutes
Duration of effects: 3 - 6 hours
Experience:
I was on Lunesta for only a few months. I started at 2mg and shortly after, switched to 3mg. It took around an hour to kick in and I noticed a very strong metallic taste in my mouth shortly after I began to feel the effects. It was very strong, and water only made it worse, I had to have a glass of juice to drink in the middle of the night instead of water because the taste was so strong. It felt very similar to a mix of a low dose of Ambien and a low dose of Ativan. It was pretty subtle. It did not work to put me to sleep, but if I did fall asleep, it worked pretty well to keep me asleep. I was pretty disappointed it didn't work because it had a lot of promise. It was very relaxing and caused a good amount of drowsiness, so I could definitely see it working for someone who has slightly less severe insomnia. Though, I have read experiences from other people saying it did absolutely nothing for them, and others saying it works amazing, so it's definitely a hit or miss medication.
Pros: Slight euphoria but still a low chance of abuse, gives a sedating and confused feeling without the "Ambien urges", no next day drowsiness
Cons: Causes a terrible metallic taste, works for some but does nothing for others, possibility of dependence if take for more than a few weeks
Recommendation: 65/100 Would definitely recommend giving it a try if the typical "sleep hygiene, melatonin, and supplements" doesn't work for you. Not many downsides trying it out.
​
🔒⚠️Ambien IR (zolpidem instant release)
Dose Range: 5-10mgOnset: 15 - 45 minutesDuration of effects: 4 - 8 hours (therapeutic dose)Experience:
I've takes this many, many times (always 10mg). I've probably been prescribed it around 10 years total and it's still my go-to if nothing else is working. It starts to work in around 15 minutes, and I start to feel a little "weird", my mind starts to slow, and I start to take a little while to respond to people. It's a very uncommon side effect, but I always need to go to the bathroom shortly after it kicks in. It no longer causes any amnesia for me, but it's the most common side effect people notice. For me, it's a hit or miss. Sometimes it will knock me out within an hour of taking it, as long as i attempt to sleep. Sometimes ill be eup all night cleaning, cooking, or just doing semi-weird things. I've never done anything crazier than putting my mattress in the living room (for some reason) but some people will (rarely) sleep eat, sleep drive, and there have even been reports of murders done on ambien. But like I said, very rare. It does cause a delusion of sobriety, so people usually feel the need to take more than they need. I had a time where I had a pretty bad adverse effect because of this, mixing my dreams with reality and ended up calling the police. This is also very rare, especially if you only take it as prescribed. It does cause some depression if im in a bad place while taking it, nothing crazy, just a geeral low feeling. I have also had withdrawals a few times after stopping it. They're usually just a combination of feeling weird throughout the day and a terrible time sleeping at night. As in if I'm able to fall asleep, i toss and turn all night, wake up every 15-20 minutes, and get pretty confused when I wake up.
Pros: Great for onset insomnia, usually makes your mind too slow to stay awakeCons: Delusions of sobriety, odd behavior, can worsen depression, can cause dependency, does not keep you asleep, the high can be addicting
Recommendation: 90/100 I'd recommend this to anyone who's tried all of the non-scheduled medications and doesn't have a history of depression. As long as you set rules for yourself, like right after you swallow the pill don't get on social media, don't leave your front door, no cooking etc. and you have someone else kind of watch for any worrying behavior, it can be a great medication. There's a lot of scary stories, and I've listed some scary things here, but the majority of people either just go right to sleep or act a little silly. I'd highly recommend.

🔒⚠️⚠️Benzodiazepines

Benzodiazepines aren't usually prescribed to specifically treat insomnia. While there are a few that were created to treat insomnia, the others are usually only prescribed for short-term use or as a last line in chronic, treatment resistant insomnia. They are very addictive physically as well as psychologically and should be treated as such. They should not be demonized; people should take them carefully and be aware that tolerance builds quickly, and it doesn't take long to experience withdrawals. Withdrawals can range from very uncomfortable to deadly.
🔒⚠️Restoril (Temazepam):
Dose range: 7.5mg - 30mg
Onset: 15-60 minutes
Duration of effects: 30 minutes - 3 hours
Experience:
I was prescribed this at 2 different points, 4-5 years apart. It felt very similar to any other weak benzo but had more of a "confusing" and drowsy feeling. I was prescribed 15mg, but occasionally took 30mg. I started to feel the effects around 15 minutes after ingestion on an empty stomach. It caused my mind to feel slowed, loss of short-term memory, muscle relaxation, and lethargy. I had to actively lay down and try to sleep in order to fall asleep, but sleep came pretty quickly. There were days I would take it and think I didn't feel it, so I would feel the need to take another. There was very mild drowsiness the day after, but it was negligible and gone within 20-30 minutes after getting out of bed. It only worked for 1-2 weeks before tolerance kicked in and I no longer felt the effects of the highest dose (30mg) and chose to switch to a different medication rather than cycle it. I did not have any withdrawal after stopping, as I've only ever taken it for a few weeks at a time.
Pros: Very sedating, no euphoria so low chance of abuse, short DOE so no next day drowsiness
Cons: Short DOE so you have a very small window to sleep, builds tolerance quickly, chance of dependance/withdrawal, delusion of sobriety can cause you to take more than needed.
Recommendation: 55/100 It worked well enough while it did work, and i can see it working even better for less severe insomnia. I would only recommend it to occasional or short-term insomnia due to stressful periods.
🔒⚠️Ativan (Lorazepam):
Dose range: 0.5-2mg
Onset: 5-30 minutes
Duration of effects: 4 - 8 hours
Experience:
I've been on this a few times, once for around 8 months for anxiety (2mg, 3x a day), and once strictly for sleep (1mg 1x a night). It did not work on its own when I was taking it only at night, I always needed a Benadryl/other antihistamine and melatonin along with it. It did help with the anxiety around not being able to sleep. When I was taking it regularly throughout the day, it worked amazing when it came to sleep. I was so tired after being on it all day that I passed out at the same time every night and woke up feeling very refreshed at the same time each morning. I would never recommend (nor would any doctor prescribe) taking it multiple times a day just to be able to sleep at night. It did cause lots of "dramatic" and irrational behaviors, periodic suicidal ideation, and a suicide attempt that I had no memory of. This is an uncommon side effect for benzos (which is why I only put moderate risk), but it does occasionally happen when taking any depressant medication. Since I was taking it frequently for months on end, I did end up withdrawing pretty badly. I had tremors, terrible anxiety, a general "weird and very uncomfortable" feeling, then eventually short-lived delusions and auditory hallucinations a few weeks after stopping cold turkey.
Pros: Very good for sleep anxiety, long DOE, mildly sedating, mild or no euphoria so less likely than other benzos to be abused
Cons: Cannot be taken with alcohol, possibility of depression or suicidal thoughts/ideation, very likely chance of dependance and withdrawal
Recommendation: 30/100 I would not personally recommend this medication to treat insomnia alone. It DOES have some sedating effects, but not any better than some less dangerous medications. If this medication works for your insomnia, it's likely that there is a safer alternative. The only time I would recommend it, is if you have no history of suicide attempts or severe depression, you have severe anxiety, and it is cycled frequently with one or more other non-benzo medications.
🔒⚠️⚠️Valium (Diazepam):
Dose range: 2-20mg
​
Onset: 20 - 40 minutes
​
Duration of effects: 4 - 10 hours
Experience: I was on this recently, I started at 2mg and switched to 5mg. It did not work for me at all, I felt nothing even when taking more than prescribed. I've had a similar experience when I've been given it before procedures such as a wisdom tooth extraction. It is the weakest benzodiazepine in my opinion.
Pros: Can be mildly sedation for some people, very long DOE, very mild morning drowsiness
Cons: Chance of dependence and withdrawal, lots of people report euphoria so it's likely to be abused, cannot be consumed with alcohol
Recommendation: 10/100 Since this medication has no effect on me for some reason, I can't really recommend or not recommend it. but based on my own experience, I couldn't recommend it for anything but occasional severe anxiety attacks.
​
🔒⚠️⚠️Klonopin (Clonazepam)
Dose range: 0.5 - 2mg
Onset: 20 - 60 minutes
Duration of effects: 8 - 12 hours
Experience: This is the medication mi currently on. I take 1mg and cycle with 25-50mg of Unisom to avoid tolerance and dependence. I take the clonazepam for 2-3 weeks and then switch to Unisom util it no longer has an effect. I've been on it for around 6 months. I started by taking it like a normal pill and it took 30-45 minutes to kick in, but medication doesn't seem to be absorbing anymore when I swallow it, so I now take it sublingually. It takes around 15 minutes to dissolve fully, and I start to feel it by the time its fully dissolved. This is another one that I have to actively try to go to sleep, because I don't actually feel mentally tired while on it. Once I attempt to sleep, I'm usually out in less than 5-10 minutes and I sleep very deeply for at least 10-12 hours. It's honestly been the only thing that has ever worked this well. I do have some next day drowsiness that lasts 30 minutes to an hour after getting out of bed. It only works for a few weeks until I have to take a break and switch to Unisom, but once I switch back to the clonazepam, it works just as amazing as before. I have slight amnesia while on it, but it's never caused me to do anything crazy. It does cause an increased sex drive for me personally.
Pros: Increased sex drive while on it (pro for me, con for some), very sedating, muscle relaxant, little next day drowsiness compared to some other medications.
Cons: Increased appetite while on it, muscle relaxant properties can cause sore muscles, big chance of dependance, can cause euphoria so high chance of abuse.
Recommendation: 70/100 I would recommend this to anyone besides people in a similar situation as me. If you haven't tried everything else, don't try this. If nothing else works, you don't have a history of addiction, your insomnia is very severe, and you're aware that you can't continuously take it every night, I would highly recommend as long as you take the lowest dose that works for you.
​
🔒🚫Xanax (Alprazolam)
Dose range: 0.25 - 2mg
Onset: 20 - 40 minutes
Duration of effects: 5 - 8 hours
Experience: I will say that I've never been prescribed this specifically for insomnia, but I *have* taken it to sleep many times. It's similar to the klonopin, where (at low doses) you have to actively try to go to sleep. The higher the dose you take, he easier it is to sleep. It's VERY sedating. I've never been able to actually stay asleep after taking it, I aways wake up, wide awake, 3 - 5 hours after falling asleep. It is similar to the lorazepam in the way that it caused me to be very dramatic, angry, and very depressed. It also is far more euphoric, mind-slowing, and lowers your inhibitions far more than any other benzos listed. If you take a high dose, it's likely that you will do something you wouldn't normally do and wake up without memory of it. I also had the worst withdrawal by far from this medication. After stopping cold turkey, I had an episode (not sure how long, at least a 1 1/2 months) where I basically had a psychotic break. I was completely I my own world and had delusions, auditory hallucinations, tactile hallucinations, and visual hallucinations. I had no idea where I was or who my family was and would regularly leave my house thinking someone was after me. I had multiple seizures and haven't been the same since this incident. I am, by no means, trying to demonize Xanax, plenty of people are already doing that, I just want to make everyone aware that this medication is not to be taken lightly.
Pros: Very sedating, no morning drowsiness
Cons: Very euphoric so high chance of abuse, likely to cause "benzo/bar rage", very high chance of dependence, does not keep you asleep
Recommendation: 0/100 (for insomnia) This medication is very rarely prescribed for insomnia now anyways, but I would only recommend it I the most serious cases of medication and treatment resistant insomnia, and only for a very short time just to be able to get *some* sleep when the insomnia is becoming dangerous. Its great medication for debilitating anxiety attacks, but i would never take it for insomnia unless I was at the point of wanting to end things because I couldn't handle not sleeping anymore.
Sources:
https://psychonautwiki.org/wiki/Restoril
https://psychonautwiki.org/wiki/Ativan
https://psychonautwiki.org/wiki/Valium
https://psychonautwiki.org/wiki/Klonopin
https://psychonautwiki.org/wiki/Xanax
https://psychcentral.com/anxiety/lunesta-lowers-anxiety-improves-sleep#safety-precautions
https://psychonautwiki.org/wiki/Ambien
submitted by Unfair-Vermicelli-16 to insomnia [link] [comments]

2023.11.27 14:48 Army_Bot Summary For: Weekly Question Thread (11/13/2023 to 11/19/2023)

Happy Belated Veterans Day.
I am thinking of joining up after some of my own research, I have a few questions. I'll try to keep them shorter here.
-I have a degree and wish to pursue MOS 19k, with the aspiration of hard work to command a tank crew some day. My recruiter said I could plan a path to complete BCT as an E-4, then attend my armor OSUT and then apply for OCS/WOCS. Does this order sound right? Other path options?
-If my background is very math/spreadsheet based (Not opposed to or unfamiliar with working outside with my hands. I prefer it.) would the army likely allow me to pursue 19k, or is it more likely I'll be put eslewhere?
-Recruiter mentioned most days there are 7-5 with PT. But that most nights and weekends are mine, and that I can still train civilian skills on my own time while on base or with base resources. 1-2 hours most days let's say, getting an SQL certification. Is this something I can do outside of my primary day?
Thank you very much for your time!
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Joining as a 12B under airborne yet im scared of heights. Cant be that bad right?
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I'm currently in sustainment but thinking of re-classing, I'm an E5, but was just curious on if you guys actually enjoyed your jobs? Or are you guys on crappy details most of the time? I've heard rumors of both since some units are over strengthed and people just get out on details all day everyday. I'd also love to hear some insight on other MOS's and what you guys actually do on a day to day basis so I can look into my options. Thank you all in advance!
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Enlistment issue
Hi, I want to enlist. I was diagnosed with ADHD when I was young and took medication for it until Dec. 15, 2022. I went to see a recruiter and was told I have to be off medication for at least 2 years. I really don’t want to wait another dam year to enlist. Is there any way I can enlist sooner that a year? I’ll do anything if it means I get a chance to enlist and serve my country.🇺🇸
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I’m 25 YO, I’m interested in joining the Army as an officer but I’m also a newly engaged man and don’t want my career to ruin my relationship / future family. I’ve worked 4 jobs since graduating college and want a career with purpose and that’s not feeling like a waste of my energy. I’ve spoken to Marine officer recruiters and switched to Navy and even completed MEPS. I ultimately did not join because of the extensive and often deployments that come with being on a navy ship. Would the Army be much better for me as an officer? Is being home by 6pm most nights unreasonable and are deployments more often than the typical deployment every 2-3 years?
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I went to meps last March got DQ’d now they are requesting my 3 letters of recommendation , my applicant statement, and doctors notes which I just now submitted. They are requesting this on behalf of anxiety medication I was prescribed. I already submitted doctors notes, pharmacy records, a note from the doctor who diagnosed me saying I was good to go. Also I got a psych eval done outside of meps. What is the process from here. Am I in the final steps, I’m surprised they didn’t recommend a psych eval of their own. Will they recommend I get one now? Or since they didn’t ask I’m good.
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So I’m at 28% body fat, plan on getting in by February, need some advice for running, 270 ish 6 foot 4, should I just start running till I can’t or do a program/set schedule?
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Can I join the army with hypertension? I’m 18 male and Readings 130-140 I haven’t been diagnosed but checking my BP at home and multiple clinics I have high readings I take no meds and have been lowering it, losing weight, more cardio, less sodium. If a wavier is needed is it difficult to obtain a waiver for HBP?
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Waiver Question
Ok I need a legitimate reply from someone so please no joking around or whatnot. Anyways I have to get a waiver to enlist for reactive attachment disorder and a depression disorder that I had when I was like 10-12 years old, and was marked by the phycologist as in full remission when I was 13 for the depression disorder and 14 for the reactive attachment disorder. I'm 25 now so these diagnosis were both removed by a doctor over 10 years ago. Just for further background I was in the foster care system growing up, and was adopted into a military family and even civilian doctors and army phycologists both agreed that they believed part of these disorders being diagnosed was just because of the environment I was in, as everyone in the foster system tends to get diagnosed with some form of depression or whatnot because an unfortunate view on children in the system is that something must be wrong with them and not the parents they got taken away from.
Anyways after submitting a waiver for these disorders to USAREC they returned it to my recruiter without action stating that before an official decision could be made instead of 3 years they now want 5 years worth of pharmaceutical records to prove that I havent taken meds for these disorders in the last five years. Thing is I didnt start using a pharmacy as I didn't get health insurance as an adult until I was 22 so I can't provide them records that are 5 years old.
My recruiter has said we are going to have to submit a USM form 40-1-2-R-E, which from my general understanding of all the forms out there, this is the one that pretty much just says hey I don't have anything else to give you as I have literally given you everything I possibly can give you. My question is what are my chances for getting this waiver approved? Because honestly if it doesn't get approved I'm really not wanting to sit around for 6 months partially putting my future on hold if they deny the waivers because I know that once the waivers are denied I have to wait 6 months before the recruiter can resubmit them.
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Social Worker 73(a) question. Currently a MSW student in the final year of the program. Will the army direct commission social workers with an MSW and entry graduate level license, or is an advanced clinical licensure required? Also, are opportunities available in the guard and reserve? If so , would I need to contact a healthcare recruiter before I graduate or after graduation and licensing ?
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Did my recruiter ghost me or what’s good
I talked to a recruiter for the first time in march and since then, we have been dealing with waivers and getting shit for my medical stuff (psych). In mid September, I talked to a psych professional and from there on, they said I was good to go and im not crazy anymore. So my recruiter told me that they need to update my record for the medical parts and he doesn’t know how long it’ll take. I reached out to Him 4 weeks ago and he said we waiting to resubmit waivers and I haven’t heard from him since. The anticipation is annoying and I’m just trying to get in already.
Yeah I know I shouldn’t be trying to join if Iva had previous psych issues but the military is something I’ve recently gained a lot of interest in. Still going to go to college of
I figured he would have just dropped me cause of all my psych shit. He even said that but he decided to stay working with me because his buddy from his early army days was my stepmoms aunt so family shit. Should I try reaching out to her too?
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Anyone S1 smart here able to answer this question:
When is the cut off for submitting Promotable status to make December list? Where do I look this up? Thanks!
Can I get a Chipotle burrito bowl with double chicken?
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My recruiter spoke of two prescreens, one of which came back which was the one Fort Knox handled, he spoke of another MEPS handles, he said this one should take around 10 days to get back then he spoke of a complex prescreen. Is the one MEPS handles the complex prescreen, or is this something separate? Thank you
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Preparation question
I've been thinking about joining the army as either a 68w (combat medic) or 35p (cryptologic linguist). What are some tips on how to prepare for BCT and AIT, preferably for both MOSs? Also, what is life after AIT like in these professions? After I finish my contract, which will most likely only be one enlistment, I am planning on going to college for chemistry. Are either of these jobs helpful for this?
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I have a background in IT/Cybersecurity.
I'm a semester short of my BS in Cybersecurity (Can't pay anymore and not going ROTC)
Wanna do Ranger, Jump, and 18X training to prove it to myself. Not hellbent on joining them, but kinda wanna see how far I can go before I break.
I'm primarily wondering how 17C, 35F, 35N, and 35S above stack up against each other in terms of:
  • Daily grind
  • Variety of duties
  • Further specialization (within the MOS)
  • Training opportunities
  • Vertical mobility
  • Duty stations
Whatever I get, I just want to have some kind of variety in the work I do and for some of it to be interesting.
Also
  • Can I still do SIGINT as a 35L?
  • What is the Tactical SIGINT course? (Heard about it, but couldn't find anything)
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is it possible to commission via OCS route if you have a medical Marijuana card?
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I was separated from basic training before 180 days for medical reasons. I found a recruiter who helped me get back in with waivers, and my ship date is January 2.
With less than 180 days in the Army, would I have to start basic training from scratch?
Thanks in advance.
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Anyone here successfully or know of someone who successfully enlisted with a previous misconduct discharge? I was in the Navy and had received a general discharge with an RE4 JKQ for misconduct several years ago. Wasn't drugs or assault, or anything that led to any arrests or criminal convictions. After I get my B.s. in Cybersecurity in 2025, I would like to try to enlist in the Army. After speaking to someone, I was told I need to get my reenlistment code upgraded because I have no chance of reenlisting with an RE4. I originally thought about applying to have my discharge / reenlistment code upgraded after I graduate, but knowing how long these things take I figure there is no harm in trying now. I will be working in my field and time is not my concern, I just don't want to go about my life not having had tried to go back. I'll save my full length story for the boards, but if given the option, I would 0 hesitation drop everything to correct my past and have a fulfilled military career. I have bettered myself over the years, and accumulating more skills and experience, and want to show the Army my past mistakes do not define who I am and will continue to be.
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Not sure if this belongs here, but I feel like behavioral health has not been helping me very much. What should I do instead?
I have mental health and anger problems and it’s just not doing anything, it just makes things worse. I have talked to an mflac and it was more helpful but still not really, though I’ll keep going I guess. I am wondering what other options there are. At this point I have almost no motivation left but I just re-enlisted. I just feel tired of the way my life is going and see no future in the army
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For ruck marches, can anyone explain why exactly we ruck in "sterile" uniforms. Is it a regulation, tradition, standard, or is the reasoning simply to prevent damage to patches and loss of patches.
(I am simply just trying to find the reasoning for it because some people argue to keep patches on or make it sterile every time we ruck).
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Hiw hard is to get armor officer as your mos. That is the one i want the most.
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For those that switched from another branch to the Army, what were some of the biggest differences (good and bad)?
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I am looking to re-class to 68P, is the program still accredited by JRCERT and is phase one and two done at Fort Sam Houston?
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If I end up going something 35 series or 12t like I want to will I have time to work on my degree? If not what are some examples of jobs where I would have time?
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Getting to the point where I'm about to go to MEPS except I have only one concern that's been bothering me, for some reason I have "homicidal ideation" on my record but there is no documentation to prove this and my recruiter said it can easily be "hurdled" over because of the fact there is no proof to support it, were also working on taking this off my record, am I fucked?
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Hi everyone. I really need help and advice from people who currently serve in army and who retired either after one contract or full 20 years +. I am at a cross point in my life. I just graduated with BS degree in STEM with great GPA and wanted to pursue PA career as civilian. I wanted it for a few years and worked really hard for it. I recently got accepted to PA program and I can start next year. So you can say i did the hardest part. I recently also got the opportunity to go to the army because I was not eligible to join due to immigration status. I am from a different country originally and my grandpa served in their army and I was little and wanted to maybe be a soldier one day, but then I just focused on the academia and army was not an option since we came here and I could not join US army. I work in healthcare rn and see PA and doctors and I really loved it for some time but recently It became not so engaging and not so appealing as it used to be. I will be over 100$k in debt upon graduation and maybe struggle to find a job and will be constantly worried about my debt which will take at least 5 years to pay off. Rn I want to enlist as E-4 into infantry, get citizenship, and try for special forces like the rangers or green berets and after maybe 4-6 years commission as officer in the respective units. I am having a hard time deciding which one I should do. I am a bit afraid to join and then be disappointed in what I will be doing. But I am also young and healthy and have a great potential to move through the ranks (at least in my opinion). Military benefits are really good and I would love to have the opportunity to retire after 20 years or stay longer if I really enjoy. Being in shape and do fun things from time to time also intrigues me and I feel like I am character fit for military. On the opposite side there is no guarantee that I will get to SF and commission as officer and get to do what I like. I do not want to waste my potential if I will not be able to realize it in the military. Personally, I really want to join I just do not want to be disappointed. Even if I really want to become a PA down the line, I know I can do it again, but it can be a bit harder since I will be out of school for few years, but I will never have so many opportunities in the army due to me being young and physically fit. I feel like the army will provide me with some peace of mind, opportunity to do cool things and travel. I want to make a conscious decision about what will be better for me. I have so many pros and cons for each, so it is really hard to decide.
I want to hear from people who went through the same and who can share your opinions and outcomes from being in the military.
Thanks to everyone for helping.
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I enlisted to the Army Reserves and I leave in 2 days. I am in the Delayed Entry program for (Military Intelligence (MI) Systems Maintainer / Integrator. Basically I will be be gone for a year to learn system administration and IT.
But would it be better to go for a Intelligence Analyst role instead. That would only be 6 months of my life instead of a year. The reason I want either is because they come with a Top secret clearance which I plan to use.
> I already have a bachelors and masters
> I want to leverage this job in the reserves to boost my civilian career
> I just want to do the one that will set me up the best once i return from the military. And I would prefer not to spend a year away from my family if I could reduce it to 6 months instead. 35T AIT is 10 months long
Please help give me some advice? Can aynone help?
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I have graduated from college and was interested in going to OCS. I have not yet talked to a recruiter and want as much time to prepare. Would I take the ASVAB or is that only for enlisted? Is there a specific aptitude test for officers?
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as a 153a post flight school, how does the army decide which aircraft to assign you
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Is there any degree requirement to become a Signal Officer? Or is it just recommended to have degree in IT/Network or communication?
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68k: Medical Laboratory Specialist Will I be able to take organic chemistry after completing training? I noticed that 68k would have to do chemistry 1&2 during training and wanted to know if I would be able to transfer those credits in order to continue education.
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My recruiter told me its easier to get promoted in the Army Reserve than the National Guard because its more interchangeable, is this true and if so would I have to move locations in order to be promoted with the reserve? I've got about a year to sort out the details, I'm planning on going with the split training program after my junior year in high school. I'm considering either motor transport operator or canon crewman for my MOS, but I think I'd enjoy artillery more, and I live in the bay area of California. I also intent to go to OCS after college and I don't particularly intend to go AD as I'd much rather pursue a career in law enforcement.
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Hello Im at a crossroads in my life. 32 yo, single, with an illegitimate kid (not legally the parent, genetically yes), unemployed (trying to break into IT). I played semi pro sports for 7 years, Obtained my bachelors in applied math. Spent a bit of time in africa, ME & latin america so i speak some french (7/10 on a fluency scale), and spanish (3/10). Im looking to join after a year or two of civilian work so I can save some money for a downpayment, and improve my french & spanish for flpb. if I cant find a job before new years 2024 fuck it Ill just join. My goals during my service period purchase a home (or two) get access to the veterans community post service benefits for my children Language skills - DLI or other school (Arabic or Mandarin) IT Skills - specifically info sec. I have my sec+ and cysa+. Tuition Assistance while serving, GI Bill for graduate school once I get out. Post service Id like to work for a couple years & recoup some $, and then start my own business(es) sooner rather than later. I want something challenging, be part of a solid team, develop some real world skills (navigation, teamwork, leadership, survival skills, discipline). I hate the idea of a corporate desk job, but Ive been told even in the armed forces that is quite common. --------------------------------------------------------------------------------------------------------------------- Ive been considering Army NG - CA/PSYOPS - try for SF Army AD - CA/PSYOPS - try for SF AF AD or Air NG - Pararescue, LEAP, FAO? Im less knowledgeable about the air force branches & MOS's and what they entail What is life in the national guard like, especially as a SF officer? Can I go directly in as a SF Officer? Id prefer to go as an enlisted so I can actually do my job and get some experience, but money talks... Besides I dont want to fail out and be an enlisted cook or infantry. no disrespect. Should I go as an Officer? Enlisted? What are the contract lengths, I want to keep my stay short, and have no intention to re enlist Do i have any influence where I would get stationed? As far as stateside, Id like HI, San Deigo or Atlanta area. But beggars cant be choosers... Any advice on this route, suggestions, personal experience/stories, or words of wisdom would be much appreciated. Thanks yall
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my dream to go to the millitary. Of course i took a look to Vietnamese millitary but i saw that there are something happen in there that cant accept like bullying in millitary and media hides that, the weakness of personal armed and lack of freedom in millitary.I would like to know if there are the same problems that i saw in vietnam armed force Thanks P/s:pls rate my english essay write.I have learnt it from Hanoi University just a few month cause i start a course at September
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Best MOS for me
Im 20 years old with no idea what I want to do with my life. I'm currently looking to enlist for about 3-4 years max. Go to college during my time serving and want to use my GI bill after. But I literally have no idea on what MOS that would be the best fit for me. Anything having to do with mechanical, electrical, and medical seems like something I wouldn't enjoy. Combat MOS are a little iffy to me because I definitely want to make it back to my family 100%. People say we are at peace time but the US are allies with nations that are in war right now as we speak. It's only a matter of time before 11B puts down the broom. I want to do something with my life. Doesn't have to be military, I just want something. Thank you for your time!
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PiCat score of 54, should I try for a higher score?
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how do you mentally prepare yourself for possible deployments/rotations? i’m 19, living at home with parents, have a lovely partner that i plan to marry before i join, and have never really left my hometown. i literally just can’t imagine being away for 9 months in a totally different country, not like in a bad way i just can’t actually wrap my head around that idea, and it does kinda freak me out. i plan on joining sometime mid next year(42a), and this is one of those things that i think about a lot.
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I’m interested in becoming a cyber warfare officer 17A and would like to know more information about it. I’m going to go back to school for electrical engineering and want to join the rotc program at my school. I’m already in the Texas army National guard and would like to commission in the guard. Any advice.
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I'm a Cpl in the Marine Corps transferring into the Army as a 68W I leave for AIT at Ft Sam Houston in January. Any advice, tips, anything to look forward to. I've been in the Marines for 6 years now as a radio operator and work as an EMT as well on nights or weekends. Love emergency medicine and the Army provides the best options for my focus and aligns with my interest, What can you hero's on reddit share with me about preparing for my move over?
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submitted by Army_Bot to army [link] [comments]

2023.11.27 14:48 Army_Bot Summary For: Weekly Question Thread (11/13/2023 to 11/19/2023)

Happy Belated Veterans Day.
I am thinking of joining up after some of my own research, I have a few questions. I'll try to keep them shorter here.
-I have a degree and wish to pursue MOS 19k, with the aspiration of hard work to command a tank crew some day. My recruiter said I could plan a path to complete BCT as an E-4, then attend my armor OSUT and then apply for OCS/WOCS. Does this order sound right? Other path options?
-If my background is very math/spreadsheet based (Not opposed to or unfamiliar with working outside with my hands. I prefer it.) would the army likely allow me to pursue 19k, or is it more likely I'll be put eslewhere?
-Recruiter mentioned most days there are 7-5 with PT. But that most nights and weekends are mine, and that I can still train civilian skills on my own time while on base or with base resources. 1-2 hours most days let's say, getting an SQL certification. Is this something I can do outside of my primary day?
Thank you very much for your time!
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Joining as a 12B under airborne yet im scared of heights. Cant be that bad right?
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I'm currently in sustainment but thinking of re-classing, I'm an E5, but was just curious on if you guys actually enjoyed your jobs? Or are you guys on crappy details most of the time? I've heard rumors of both since some units are over strengthed and people just get out on details all day everyday. I'd also love to hear some insight on other MOS's and what you guys actually do on a day to day basis so I can look into my options. Thank you all in advance!
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Enlistment issue
Hi, I want to enlist. I was diagnosed with ADHD when I was young and took medication for it until Dec. 15, 2022. I went to see a recruiter and was told I have to be off medication for at least 2 years. I really don’t want to wait another dam year to enlist. Is there any way I can enlist sooner that a year? I’ll do anything if it means I get a chance to enlist and serve my country.🇺🇸
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I’m 25 YO, I’m interested in joining the Army as an officer but I’m also a newly engaged man and don’t want my career to ruin my relationship / future family. I’ve worked 4 jobs since graduating college and want a career with purpose and that’s not feeling like a waste of my energy. I’ve spoken to Marine officer recruiters and switched to Navy and even completed MEPS. I ultimately did not join because of the extensive and often deployments that come with being on a navy ship. Would the Army be much better for me as an officer? Is being home by 6pm most nights unreasonable and are deployments more often than the typical deployment every 2-3 years?
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I went to meps last March got DQ’d now they are requesting my 3 letters of recommendation , my applicant statement, and doctors notes which I just now submitted. They are requesting this on behalf of anxiety medication I was prescribed. I already submitted doctors notes, pharmacy records, a note from the doctor who diagnosed me saying I was good to go. Also I got a psych eval done outside of meps. What is the process from here. Am I in the final steps, I’m surprised they didn’t recommend a psych eval of their own. Will they recommend I get one now? Or since they didn’t ask I’m good.
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So I’m at 28% body fat, plan on getting in by February, need some advice for running, 270 ish 6 foot 4, should I just start running till I can’t or do a program/set schedule?
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Can I join the army with hypertension? I’m 18 male and Readings 130-140 I haven’t been diagnosed but checking my BP at home and multiple clinics I have high readings I take no meds and have been lowering it, losing weight, more cardio, less sodium. If a wavier is needed is it difficult to obtain a waiver for HBP?
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Waiver Question
Ok I need a legitimate reply from someone so please no joking around or whatnot. Anyways I have to get a waiver to enlist for reactive attachment disorder and a depression disorder that I had when I was like 10-12 years old, and was marked by the phycologist as in full remission when I was 13 for the depression disorder and 14 for the reactive attachment disorder. I'm 25 now so these diagnosis were both removed by a doctor over 10 years ago. Just for further background I was in the foster care system growing up, and was adopted into a military family and even civilian doctors and army phycologists both agreed that they believed part of these disorders being diagnosed was just because of the environment I was in, as everyone in the foster system tends to get diagnosed with some form of depression or whatnot because an unfortunate view on children in the system is that something must be wrong with them and not the parents they got taken away from.
Anyways after submitting a waiver for these disorders to USAREC they returned it to my recruiter without action stating that before an official decision could be made instead of 3 years they now want 5 years worth of pharmaceutical records to prove that I havent taken meds for these disorders in the last five years. Thing is I didnt start using a pharmacy as I didn't get health insurance as an adult until I was 22 so I can't provide them records that are 5 years old.
My recruiter has said we are going to have to submit a USM form 40-1-2-R-E, which from my general understanding of all the forms out there, this is the one that pretty much just says hey I don't have anything else to give you as I have literally given you everything I possibly can give you. My question is what are my chances for getting this waiver approved? Because honestly if it doesn't get approved I'm really not wanting to sit around for 6 months partially putting my future on hold if they deny the waivers because I know that once the waivers are denied I have to wait 6 months before the recruiter can resubmit them.
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Social Worker 73(a) question. Currently a MSW student in the final year of the program. Will the army direct commission social workers with an MSW and entry graduate level license, or is an advanced clinical licensure required? Also, are opportunities available in the guard and reserve? If so , would I need to contact a healthcare recruiter before I graduate or after graduation and licensing ?
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Did my recruiter ghost me or what’s good
I talked to a recruiter for the first time in march and since then, we have been dealing with waivers and getting shit for my medical stuff (psych). In mid September, I talked to a psych professional and from there on, they said I was good to go and im not crazy anymore. So my recruiter told me that they need to update my record for the medical parts and he doesn’t know how long it’ll take. I reached out to Him 4 weeks ago and he said we waiting to resubmit waivers and I haven’t heard from him since. The anticipation is annoying and I’m just trying to get in already.
Yeah I know I shouldn’t be trying to join if Iva had previous psych issues but the military is something I’ve recently gained a lot of interest in. Still going to go to college of
I figured he would have just dropped me cause of all my psych shit. He even said that but he decided to stay working with me because his buddy from his early army days was my stepmoms aunt so family shit. Should I try reaching out to her too?
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Anyone S1 smart here able to answer this question:
When is the cut off for submitting Promotable status to make December list? Where do I look this up? Thanks!
Can I get a Chipotle burrito bowl with double chicken?
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My recruiter spoke of two prescreens, one of which came back which was the one Fort Knox handled, he spoke of another MEPS handles, he said this one should take around 10 days to get back then he spoke of a complex prescreen. Is the one MEPS handles the complex prescreen, or is this something separate? Thank you
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Preparation question
I've been thinking about joining the army as either a 68w (combat medic) or 35p (cryptologic linguist). What are some tips on how to prepare for BCT and AIT, preferably for both MOSs? Also, what is life after AIT like in these professions? After I finish my contract, which will most likely only be one enlistment, I am planning on going to college for chemistry. Are either of these jobs helpful for this?
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I have a background in IT/Cybersecurity.
I'm a semester short of my BS in Cybersecurity (Can't pay anymore and not going ROTC)
Wanna do Ranger, Jump, and 18X training to prove it to myself. Not hellbent on joining them, but kinda wanna see how far I can go before I break.
I'm primarily wondering how 17C, 35F, 35N, and 35S above stack up against each other in terms of:
  • Daily grind
  • Variety of duties
  • Further specialization (within the MOS)
  • Training opportunities
  • Vertical mobility
  • Duty stations
Whatever I get, I just want to have some kind of variety in the work I do and for some of it to be interesting.
Also
  • Can I still do SIGINT as a 35L?
  • What is the Tactical SIGINT course? (Heard about it, but couldn't find anything)
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is it possible to commission via OCS route if you have a medical Marijuana card?
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I was separated from basic training before 180 days for medical reasons. I found a recruiter who helped me get back in with waivers, and my ship date is January 2.
With less than 180 days in the Army, would I have to start basic training from scratch?
Thanks in advance.
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Anyone here successfully or know of someone who successfully enlisted with a previous misconduct discharge? I was in the Navy and had received a general discharge with an RE4 JKQ for misconduct several years ago. Wasn't drugs or assault, or anything that led to any arrests or criminal convictions. After I get my B.s. in Cybersecurity in 2025, I would like to try to enlist in the Army. After speaking to someone, I was told I need to get my reenlistment code upgraded because I have no chance of reenlisting with an RE4. I originally thought about applying to have my discharge / reenlistment code upgraded after I graduate, but knowing how long these things take I figure there is no harm in trying now. I will be working in my field and time is not my concern, I just don't want to go about my life not having had tried to go back. I'll save my full length story for the boards, but if given the option, I would 0 hesitation drop everything to correct my past and have a fulfilled military career. I have bettered myself over the years, and accumulating more skills and experience, and want to show the Army my past mistakes do not define who I am and will continue to be.
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Not sure if this belongs here, but I feel like behavioral health has not been helping me very much. What should I do instead?
I have mental health and anger problems and it’s just not doing anything, it just makes things worse. I have talked to an mflac and it was more helpful but still not really, though I’ll keep going I guess. I am wondering what other options there are. At this point I have almost no motivation left but I just re-enlisted. I just feel tired of the way my life is going and see no future in the army
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For ruck marches, can anyone explain why exactly we ruck in "sterile" uniforms. Is it a regulation, tradition, standard, or is the reasoning simply to prevent damage to patches and loss of patches.
(I am simply just trying to find the reasoning for it because some people argue to keep patches on or make it sterile every time we ruck).
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Hiw hard is to get armor officer as your mos. That is the one i want the most.
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For those that switched from another branch to the Army, what were some of the biggest differences (good and bad)?
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I am looking to re-class to 68P, is the program still accredited by JRCERT and is phase one and two done at Fort Sam Houston?
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If I end up going something 35 series or 12t like I want to will I have time to work on my degree? If not what are some examples of jobs where I would have time?
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Getting to the point where I'm about to go to MEPS except I have only one concern that's been bothering me, for some reason I have "homicidal ideation" on my record but there is no documentation to prove this and my recruiter said it can easily be "hurdled" over because of the fact there is no proof to support it, were also working on taking this off my record, am I fucked?
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Hi everyone. I really need help and advice from people who currently serve in army and who retired either after one contract or full 20 years +. I am at a cross point in my life. I just graduated with BS degree in STEM with great GPA and wanted to pursue PA career as civilian. I wanted it for a few years and worked really hard for it. I recently got accepted to PA program and I can start next year. So you can say i did the hardest part. I recently also got the opportunity to go to the army because I was not eligible to join due to immigration status. I am from a different country originally and my grandpa served in their army and I was little and wanted to maybe be a soldier one day, but then I just focused on the academia and army was not an option since we came here and I could not join US army. I work in healthcare rn and see PA and doctors and I really loved it for some time but recently It became not so engaging and not so appealing as it used to be. I will be over 100$k in debt upon graduation and maybe struggle to find a job and will be constantly worried about my debt which will take at least 5 years to pay off. Rn I want to enlist as E-4 into infantry, get citizenship, and try for special forces like the rangers or green berets and after maybe 4-6 years commission as officer in the respective units. I am having a hard time deciding which one I should do. I am a bit afraid to join and then be disappointed in what I will be doing. But I am also young and healthy and have a great potential to move through the ranks (at least in my opinion). Military benefits are really good and I would love to have the opportunity to retire after 20 years or stay longer if I really enjoy. Being in shape and do fun things from time to time also intrigues me and I feel like I am character fit for military. On the opposite side there is no guarantee that I will get to SF and commission as officer and get to do what I like. I do not want to waste my potential if I will not be able to realize it in the military. Personally, I really want to join I just do not want to be disappointed. Even if I really want to become a PA down the line, I know I can do it again, but it can be a bit harder since I will be out of school for few years, but I will never have so many opportunities in the army due to me being young and physically fit. I feel like the army will provide me with some peace of mind, opportunity to do cool things and travel. I want to make a conscious decision about what will be better for me. I have so many pros and cons for each, so it is really hard to decide.
I want to hear from people who went through the same and who can share your opinions and outcomes from being in the military.
Thanks to everyone for helping.
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I enlisted to the Army Reserves and I leave in 2 days. I am in the Delayed Entry program for (Military Intelligence (MI) Systems Maintainer / Integrator. Basically I will be be gone for a year to learn system administration and IT.
But would it be better to go for a Intelligence Analyst role instead. That would only be 6 months of my life instead of a year. The reason I want either is because they come with a Top secret clearance which I plan to use.
> I already have a bachelors and masters
> I want to leverage this job in the reserves to boost my civilian career
> I just want to do the one that will set me up the best once i return from the military. And I would prefer not to spend a year away from my family if I could reduce it to 6 months instead. 35T AIT is 10 months long
Please help give me some advice? Can aynone help?
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I have graduated from college and was interested in going to OCS. I have not yet talked to a recruiter and want as much time to prepare. Would I take the ASVAB or is that only for enlisted? Is there a specific aptitude test for officers?
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as a 153a post flight school, how does the army decide which aircraft to assign you
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Is there any degree requirement to become a Signal Officer? Or is it just recommended to have degree in IT/Network or communication?
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68k: Medical Laboratory Specialist Will I be able to take organic chemistry after completing training? I noticed that 68k would have to do chemistry 1&2 during training and wanted to know if I would be able to transfer those credits in order to continue education.
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My recruiter told me its easier to get promoted in the Army Reserve than the National Guard because its more interchangeable, is this true and if so would I have to move locations in order to be promoted with the reserve? I've got about a year to sort out the details, I'm planning on going with the split training program after my junior year in high school. I'm considering either motor transport operator or canon crewman for my MOS, but I think I'd enjoy artillery more, and I live in the bay area of California. I also intent to go to OCS after college and I don't particularly intend to go AD as I'd much rather pursue a career in law enforcement.
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Hello Im at a crossroads in my life. 32 yo, single, with an illegitimate kid (not legally the parent, genetically yes), unemployed (trying to break into IT). I played semi pro sports for 7 years, Obtained my bachelors in applied math. Spent a bit of time in africa, ME & latin america so i speak some french (7/10 on a fluency scale), and spanish (3/10). Im looking to join after a year or two of civilian work so I can save some money for a downpayment, and improve my french & spanish for flpb. if I cant find a job before new years 2024 fuck it Ill just join. My goals during my service period purchase a home (or two) get access to the veterans community post service benefits for my children Language skills - DLI or other school (Arabic or Mandarin) IT Skills - specifically info sec. I have my sec+ and cysa+. Tuition Assistance while serving, GI Bill for graduate school once I get out. Post service Id like to work for a couple years & recoup some $, and then start my own business(es) sooner rather than later. I want something challenging, be part of a solid team, develop some real world skills (navigation, teamwork, leadership, survival skills, discipline). I hate the idea of a corporate desk job, but Ive been told even in the armed forces that is quite common. --------------------------------------------------------------------------------------------------------------------- Ive been considering Army NG - CA/PSYOPS - try for SF Army AD - CA/PSYOPS - try for SF AF AD or Air NG - Pararescue, LEAP, FAO? Im less knowledgeable about the air force branches & MOS's and what they entail What is life in the national guard like, especially as a SF officer? Can I go directly in as a SF Officer? Id prefer to go as an enlisted so I can actually do my job and get some experience, but money talks... Besides I dont want to fail out and be an enlisted cook or infantry. no disrespect. Should I go as an Officer? Enlisted? What are the contract lengths, I want to keep my stay short, and have no intention to re enlist Do i have any influence where I would get stationed? As far as stateside, Id like HI, San Deigo or Atlanta area. But beggars cant be choosers... Any advice on this route, suggestions, personal experience/stories, or words of wisdom would be much appreciated. Thanks yall
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my dream to go to the millitary. Of course i took a look to Vietnamese millitary but i saw that there are something happen in there that cant accept like bullying in millitary and media hides that, the weakness of personal armed and lack of freedom in millitary.I would like to know if there are the same problems that i saw in vietnam armed force Thanks P/s:pls rate my english essay write.I have learnt it from Hanoi University just a few month cause i start a course at September
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Best MOS for me
Im 20 years old with no idea what I want to do with my life. I'm currently looking to enlist for about 3-4 years max. Go to college during my time serving and want to use my GI bill after. But I literally have no idea on what MOS that would be the best fit for me. Anything having to do with mechanical, electrical, and medical seems like something I wouldn't enjoy. Combat MOS are a little iffy to me because I definitely want to make it back to my family 100%. People say we are at peace time but the US are allies with nations that are in war right now as we speak. It's only a matter of time before 11B puts down the broom. I want to do something with my life. Doesn't have to be military, I just want something. Thank you for your time!
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PiCat score of 54, should I try for a higher score?
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how do you mentally prepare yourself for possible deployments/rotations? i’m 19, living at home with parents, have a lovely partner that i plan to marry before i join, and have never really left my hometown. i literally just can’t imagine being away for 9 months in a totally different country, not like in a bad way i just can’t actually wrap my head around that idea, and it does kinda freak me out. i plan on joining sometime mid next year(42a), and this is one of those things that i think about a lot.
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I’m interested in becoming a cyber warfare officer 17A and would like to know more information about it. I’m going to go back to school for electrical engineering and want to join the rotc program at my school. I’m already in the Texas army National guard and would like to commission in the guard. Any advice.
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I'm a Cpl in the Marine Corps transferring into the Army as a 68W I leave for AIT at Ft Sam Houston in January. Any advice, tips, anything to look forward to. I've been in the Marines for 6 years now as a radio operator and work as an EMT as well on nights or weekends. Love emergency medicine and the Army provides the best options for my focus and aligns with my interest, What can you hero's on reddit share with me about preparing for my move over?
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submitted by Army_Bot to ArmyWQT [link] [comments]

2023.11.21 07:14 super_sonic_bat Philly Marathon (an MCM redemption)

Race Information

Goals

Goal Description Completed?
A Sub 4 No
B Sub 4:05 Yes
C Sub 4:14 (PR) Yes

Splits

Location Time Pace
5K 28:17 9:06 /mi
10K 57.18 9:13 /mi
15K 1:26:37 9:18 /mi
Half 2:01:54 9:18 /mi
30K 2:53:26 9:20 /mi
Finish 4:03:59 9:18 /mi
TL;DR: Originally targeted the Marine Corps Marathon (MCM). Tested positive for COVID the day before the race and decided to DNS. Signed up for the Philly Marathon immediately with three weeks to recover from the mild case. Finished Philly with a 10-minute PR.

Background and Training

I (36M) have run 3 marathons. The first in 5 hours, the second in 4:30, and most recently the third in 4:14 at the Pittsburgh Marathon 2022. After that, I did two half marathons (2:14 and 2:01) with less-than-ideal training and some injuries before I signed up for the MCM. I've been using Jack Daniels 2Q training plan with a peak weekly mileage of 40 since my last marathon. One reason I like this plan is, since I'm working remotely from home, I have the luxury of doing longer Wednesday morning runs in addition to Sunday long runs. Another reason is that I find the time-capped long workouts a better fit for my pace than the 20-milers prescribed by some plans. My training went fine despite a back injury in July. I did a 10k tune-up race in September in 48 minutes, which greatly boosted my confidence. I got a slight hamstring strain from the 10k but nothing too bad. I hit all the long workouts even while traveling. Everything seemed set for a major PR from last year's 4:14.

Pre-race MCM

During my taper, I started to have a sore throat 4 days before the race. After testing negative for COVID twice, I assumed it was just a cold. My wife and I drove to DC Friday night and I did a shakeout run Saturday morning and felt fine, but tested positive afterward. I was crushed. Went to the expo anyway to pick up the packet. The queue was ridiculously long and I felt I was the only one wearing a mask. I considered racing despite the mild symptoms but, after reading about others experiencing long COVID post-marathon, decided it was best for my health and others' to DNS. One silver lining was that MCM turned out to be an unusually warm and humid day so not a day for PR anyway.

Pre-race Philly

My wife found Philly marathon was still open for registration and I was thrilled. After registration, I focused on resting to recover from COVID as soon as possible. I tested negative for COVID within a week and resumed training, repeating the last two weeks of Jack Daniels. The forecast suggested mid-30s to high-40s conditions, and I decided to race in a short-sleeved shirt rather than a long sleeve, ambitiously aiming for a sub-4 finish.
We flew to Philly on Friday, staying at a hotel right next to the Pennsylvania Convention Center, where the marathon expo was held. I did a short shakeout run Saturday morning and saw some half marathon and 8k runners racing. Walking to the expo and getting the packet was much easier than MCM, taking about only 15 minutes. We had a big lunch in Chinatown and a light pasta dinner. I slept unbelievably well both nights before the Sunday race. I woke up at 4 a.m. on Sunday to do my pre-race routine. We took the shuttle to the marathon security checkpoint and I quickly went through without any issues. It was chilly even with my disposable raincoat, but the warming tents were a pleasant surprise. The potty line however took forever so I decided to go straight to my corral instead.

Race

Miles 1–13: The plan was to maintain a slightly slower pace than my A goal (9:10 min/mi for a 4-hour marathon). After a crowded first mile, I sped up to meet my wife downtown and ran two sub-9 miles. Then I tried to slow down a bit, only to be a tad too slow for miles 6–10 (9:20-ish), and my heart rate (HR) gradually rose to 150. I convinced myself it was the hills. At mile 9 I felt the urge to use the bathroom just as I ate the second Gu gel. At this point the potties I had seen seemed sparse and crowded, so I decided to join other runners using the bushes along the roadside. I felt bad for the female runners for a moment because they didn't have the convenience, but quickly concentrated back on the race. With the help of some downhills, I managed to increase my pace to between 9 and 9:10 for miles 11–13. I finished the first half in 2:02, and the fact that it didn't feel exactly easy made me doubt if I could achieve a negative split today.
Miles 14–20: Entering the second half, I knew that to have any chance of a sub-4, I needed to maintain a pace between 9 and 9:10. I managed this for three miles but then fluctuated. At this time the aggregated GPS drift on my Garmin was around 0.2 miles, so the actual pace was even a little bit slower. The warming air and my increasingly heavy legs, coupled with My HR rising to the high 150s, indicated that a sub-4 was unlikely.
Miles 21–25: Acknowledging that a sub-4 was out of reach, my focus shifted to achieving a solid PR without hitting the wall. Balancing the desire to push for a sub 4:05 and the risk of bonking, I decided to trust my training and run by feel. This reminded me of the quote in Jack Daniels' training plan: "Run with your head for the first two-thirds of every race and with your heart for the last third". I ended up averaging a 9:16 pace over these 5 miles without any major struggles. Maybe the JD 2Q training worked?
The final 1.5 miles (according to my Garmin): It was a blur. I finally decided the remaining distance was too short for a significant slowdown and picked up the pace, maintaining an 8:35 pace till the finish. I felt my finish looked heroic and stupid at the same time: finishing strong looked great, but why didn't I push harder earlier?

Post-race

Reuniting with my wife after crossing the finish line was a joyful moment. I was very happy with the time, and thrilled to learn I almost did an even split. We took the shuttle back to the hotel and were awarded a free late checkout so I could take a much-needed shower. Later I tried a massage chair at the airport and found it very relaxing. I think I will start doing this after every future marathon.
One lesson from this experience is the importance of using the bathroom before a race. My next marathon will be either Chicago, if I win the drawing, or a return to MCM in 2024 to complete the redemption.
Made with a new race report generator created by herumph.
submitted by super_sonic_bat to running [link] [comments]

2023.09.27 10:10 Avaale META Rule Breakdown Addressing "Mods Suck" and other complaints (with mod log proof)

META Rule Breakdown Addressing
It's come to our attention that some users have issues with how this sub is run, the mods and moderating decisions. Rather than sending a modmail to the mods directly to gain clarity, users resort to running wild with their assumptions and making public accusations and character attacks on the mods.
Now, moderation on this sub has always been extremely transparent. We continuously use community opinion to shape the direction the sub goes in. Exhibit A, our recent request for feedback post was mostly ignored. Exhibit B, C and for more filter by mod post or search for state of the sub and start reading. We explain our thought process in every one.
We are and will always be ready to own our mistakes. We are completely aware that we are not infallible.
But dignifying every baseless public accusation (and yes, all of them are baseless) we come across, with a response is an enormous waste of our time. We’ve done it once if you’ll recall.
But, since this is something that comes up repeatedly, we'll refute these claims. If for no other reason than to prevent further escalations and accusations being made on other subs.
Update: In the few days' time it took us to compile mod logs for participants in this particular thread, additional meta complaints have gone up. All on different subs. All disrespecting those subs by engaging in off topic discussion.
Not worth our time to debunk every claim there too. But this further cements why this rule is zero tolerance.
The following is the first and last time we'll explain why the meta rule is in place. Future queries will be directed to this thread for explanation.
And while we're going through the mod logs and claims, please remember:
  • Karma limits ONLY affect new members. Not regular contributors. These have been in place for the last 4+ years to prevent spam, creeps and bots from posting in the sub.
  • Moderators. Are. Not. Employees. We are not paid for this. We volunteer our available time in between our full time jobs and other IRL responsibilities.
  • If you have an issue, modmail us. We will pull up the post, share it in our discussion group, all mods discuss the rationale behind the action, then we revert to the modmail with our reasoning and conclusion. If errors were made, we acknowledge it and make amends with corrective course of action.
Let's take this example, where a thread in another sub was derailed from the topic being addressed.
Some of the claims made in other subs
We'd like to address these claims.

Complainant: "Sa"

Comments: "power trip", "that their comments don't get approved", and that their helpful post didn't get approved.
Proof: Full Mod Log and screenshot of pertinent post
https://preview.redd.it/zyggiqvoplqb1.jpg?width=2000&format=pjpg&auto=webp&s=fc4dc8c8d7b3e827326cbff50d96e60652be4a46
Summary of Mod Log
Type Posted on and at Action by Time Lapse
Comment 07/09/2023 at 2:45 PM Approved by u/southernresolution at 3:49 PM 1hr 4 mins
Post 15/09/2023 at 4:16 PM deleted by user
Comment 15/09/2023 at 4:19 PM Approved by u/Avaale at 7:17 PM 2hrs 58 mins
Comment 17/09/2023 at 11:19 PM Approved by u/Avaale at 4:30 AM 4hrs 21 mins
⚜️ Our conclusion: OP deleted their post themselves. Can't comment on how soon after posting they deleted it. Can't comment on how "helpful" their post was cause no mod saw it. Cause they deleted it on their own.
All comments were approved. Longest time to approve - 4.5 hours for comment posted in the middle of the night.
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Complianant: “Ed”

Comments: “The mods seem to have a superiority complex”
Proof: Recent Mod Log. Only one comment before that anyway
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https://preview.redd.it/3k6x5205qlqb1.jpg?width=681&format=pjpg&auto=webp&s=3ffef29de52dd54c29243bcdddfc041aef99f0c4
Summary of Recent Mod Log
  1. u/Avaale adding as approved contributor when we were considering private-ing the sub.
  2. u/Avaale removing the ‘me’ comment that Ed had posted asking to be an approved submitter (removed to keep track of people who hadn't been added)
That's it, no other action.
⚜️ Our conclusion: No idea where this grievance comes from. Ed has minimal activity on the sub, and no interactions with mods. Let alone any that would justify a label of "superiority complex".
In fact, the instructions on that post said to comment one's user name for approval. Ed did not follow directions. We went out of our way to process their approval.
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Complainant: "Mi"

Comments: Moderators of indianskincareaddicts have a “superiority complex”, “I hate them. They're acting like snobs”
Proof: Full Mod Logs
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https://preview.redd.it/o0exj24eqlqb1.jpg?width=2000&format=pjpg&auto=webp&s=a40b93d5e1b6971859aad1c552a86eb245ee53f1
Summary of Mod Log
Type Posted on and at Action by Time Lapse
Comment 26/07/2023 at 6:09 AM Approved by u/sriv_m at 8:40 AM 2 hrs 31 mins
Comment 27/07/2023 at 1:23 AM Approved by u/sriv_m at 09:04 AM 7hrs 41 mins
Comment 4/08/2023 at 12:27 AM Approved by u/sriv_m at 01:06 AM 0 hrs 39 mins
Comment 16/08/2023 at 1:00 AM Approved by u/sriv_m at 09:30 AM 8 hrs 30 mins
Comment 5/09/2023 at 5:41 PM Approved by u/Avaale at 07:27 PM 1 hr 46 mins
Our Thoughts: Longest time taken to approve was 8 hr 30 mins and 7 hrs 41 mins, both posted at night. Same thoughts as our previous friend's mod log- minimal activity on the sub, fast approvals, no interactions with mods. Truly don't know what inspired hate or makes us come off like snobs here.
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Complainant: “Co”

Comment: that we "approve comments after a week"
Proof: Full Modlogs
https://preview.redd.it/glpjy4piqlqb1.jpg?width=2000&format=pjpg&auto=webp&s=5e1124a9023d37df2a856c3a53e47e7bda4cf45f
Mod Log Summary: Literally nothing to summarise
⚜️ Our Conclusion: Demonstrably false. Absolutely no action taken by, for or against this account. Account is not active on IndianSkincareAddicts.
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Complainant: Zz

Comment: “sick of indianskincareaddicts overdoing it”, “sadly mods are not open to taking criticism. A part of me also thinks maybe it’s just a lot easier to operate the sub if you don’t approve any posts whatsoever lol”
Guys. We’re okay with criticism as long as it’s constructive. We frequently reach out for feedback (and are mostly ignored), we also take all feedback that’s sent via modmail into consideration.
Sadly, zz's mod log and history shows no participation in the feedback posts (3 are linked above), where we openly invited constructive criticism. In fact, our latest post made 3 weeks ago specifically asked all members to be as detailed in their criticism as possible.

ETA: CORRECTION Zz has commented in one feedback post. Posting the screenshot below

https://preview.redd.it/nk38iofxurqb1.jpg?width=328&format=pjpg&auto=webp&s=b123b60bea748fa80fa1ae169c21a407e86afa24
https://preview.redd.it/ui887abtvrqb1.jpg?width=320&format=pjpg&auto=webp&s=55779ad66271675e472636783ed88151474755fc
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So we're unsure where, on the sub, zz offered this criticism that we apparently "were not open to taking". We can only take what is communicated to us.
Proof: Recent Mod logs . Zz posted two posts in 2022, they were approved. The post is getting long, so we’re going to focus on 2023 mod actions. Of which there isn’t much. A comment and a post.
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https://preview.redd.it/psi3803uqlqb1.jpg?width=2000&format=pjpg&auto=webp&s=303eb6062fca0f0363650de16c0507bacbe925d2
Summary: Post titled "A very Challenging set of empties from my pan project" was removed.
  1. Product names aren’t in the title. Low effort / unsearchable title.
  2. Insta-style caption Empties posts are allowed. But only in the Hauls, First Impressions and Empties thread. So not adhering to the weekly schedule.
  3. But let’s give them the benefit of the doubt that it’s meant to be a review since it’s flaired so. Review guidelines are not followed...
⚜️ Our Conclusion: This is one of those posts that break so many rules, that we get uncertain about which rule to remove it under and share it in discussion to decide. Removal took time for this reason. But it was removed within guidelines and the removal reason was mod mailed to Zz.

ETA: Zz had commented on a feedback post. Our reply is also posted

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Complainant: Li

Comment: Omgg thank god someone said this. I genuinely hate the mods now for this.
Proof: Mod logs and screenshot of pertinent post
https://preview.redd.it/d6ie67svrlqb1.jpg?width=2000&format=pjpg&auto=webp&s=8a6ee23abe1b6a4f242f4fdf7d9ba1f5f9105844
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Mod Log Summary: Quite a few comments in March 2023. All approved within a short period of time. 1 Post removed on Sep 2, 2023 by u/Avaale with the reason, ‘This sub is not a substitute for medical help’.
⚜️ Our Conclusion: In the post titled "redness only in smile lines". Op suspected perioral dermatitis. But there’s no diagnosis. Depending on severity derms prescribe steroids for this. Does anyone think that we in the sub are equipped to diagnose / guide OP in the direct direction? We do allow posts where OPs ask others for experiences with their DIAGNOSED medical condition. This was not that.
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Complainant: Ok

Comment: “Same man, nothing I try to post ever gets approved on that sub earlier they were on ban and now are heavily moderating the sub”.
Proof: Mod logs
https://preview.redd.it/yw7z2xqqslqb1.jpg?width=1990&format=pjpg&auto=webp&s=e3635fa0ee1016911d69c4c76bee6cfface7ff5d
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Summary of Mod Logs
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Type Posted on and at Action by Time lapse
Comment 25/05/2023 at 12:36 AM Approved by u/sriv_m 8 hrs 20 mins
Comment 25/05/2023 at 09:39 AM Approved by u/SouthernResolution 52 mins
Comment 25/05/2023 at 06:21 PM Approved by u/SouthernResolution 38 mins
Comment 26/05/2023 at 01:12 AM Approved by u/sriv_m 7 hrs 36 mins
Post 05/06/2023 at 10:20 PM u/SouthernResolution Removed. Reason - Personal Query. Deleted by user. 44 mins.
Comment 05/06/2023 at 11:08 PM Approved by u/SouthernResolution 12 mins
Post 09/06/2023 at 01:12 PM u/SouthernResolutionRemoved. Reason - Sub is not a substitute for medical advice. 21 hrs 2 mins.
Post 21/06/2023 at 06:59 PM Reddit Protest (Removed by Automod, Did not enter queue) Reddit Protest
Post 26/06/2023 at 01:27 PM Reddit Protest (Removed by Automod, Did not enter queue) Reddit Protest
Post 11/07/2023 at 02:12 AM Reddit Protest (Removed by Automod, Did not enter queue) Reddit Protest
Post 13/08/2023 at 11:14 AM Removed. Reason - Post Format for ‘Authentic/Safe for Use’ not followed u/sriv_m 10 hrs 29 mins.
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Our Thoughts:
You can read about the WHYs of the protest here 1, 2, 3, 4, . As far as posts are concerned, for that period, automod was set up to remove all posts automatically and notify OPs and those posts did not enter mod queue at all. All Weekly threads were live and active.
Post 1 - "This is right after air drying my hair. I think I put too much shampoo in order to get rid of the oil I had applied. My hair is scalp oily dry ends and the scalp gets oily in less than 48 hours. I’m scared of how empty my crown area is getting" That's it. Op had posted their photo that did show severe concerning hair loss that is above reddit's pay grade, ie cannot be fixed by OTC serums or hair oiling etc. Post was removed under Reason - Sub is not a substitute for medical advice.
Post 2 - "Is this item fake?" This post has now been deleted by poster, so we're not able to view it.
But the title, which does not include product name, indicates the rest of the post likely did not follow the format.
Post purchase format guidelines were created because just posting a pic of a product is not enough information to determine authenticity. We genuinely need more information to help. Like the site it was purchased from, seller (to check if they are authorised dealer), communication with site / dealer etc. Without this background info, how much can anyone help with queries like this?
⚜️Our Conclusion: 'Ok' seems to be the only frequent IndianSkincareAddicts user of the people complaining so far. While their statement that their posts were removed is true, it is also true that none of the posts removed by a moderator were rule abiding. Judgment calls to remove were inline with posting guidelines.
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Complainant: Su

Comment " It's ridiculous to wait for the comments to be approved in a sub. Even major subs don't do that."
Proof: Screenshot of Post & Mod Logs
https://preview.redd.it/9olv5j7vslqb1.jpg?width=2000&format=pjpg&auto=webp&s=cfb3835f80ed07b3daf31bbdb59fdf7c1673f7cd
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Type Posted on and at Action by Time lapse
Post 09/08/2023 at 11:19 AM Deleted by user
Comment 22/08/2023 at 3:26 PM Approved by u/southernresolution 2 hrs 50 mins
Comment 16/09/2023 at 5:28 PM Approved by u/Avaale 1 hr 42 mins
Comment 16/09/2023 at 10:49 PM Approved by u/Avaale 10 hrs 55 mins
⚜️ Our Conclusion: Another post deleted by user. No comment.

Karma / Account age limits are in place only for users new to the sub. Comments from frequent users, regular contributors DO NOT enter mod queue unless reported. Their comments are posted right away.

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Complainant: Fl

Comment: “My comments there don't get approved ever for some reason. Idk what's up with that sub.”
Proof: Mod Logs
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https://preview.redd.it/6c44teevulqb1.jpg?width=585&format=pjpg&auto=webp&s=5441c0a9494c9b706a58110bc8353db02e3ccdda
Mod Log Summary:
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Type Posted on and at Action by Time lapse
Comment 17/06/2023 at 07:37 PM Reddit Protest (Removed by Automod, Did not enter queue)
Comment 19/08/2023 at 01:50 PM Deleted by user
Comment 19/08/2023 at 01:51 PM Approved by u/Avaale (comment is deleted by user now) 1 hr 58 min
Comment 07/09/2023 at 08:28 PM Approved by u/SoutherResolution (comment is also deleted by user now) 1 hr 4 mins
Comment 10/09/2023 at 06:05 PM Approved by u/Avaale 4 hrs 43 mins
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⚜️ Our Conclusion: The summary speaks for itself. Handful of comments, now deleted, fast approvals every time.
For anyone who doesn't know what is happening with the sub, asking the mods directly will give you answers.
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Complainant: Go

Comments: "Right? It's like they have a secret treasure there that normal people will loot if they comment or post 😂"
Our Thoughts: Go posted one post, that shows user has deleted it. All comments stand approved. We're not reproducing mod logs, since at this point it' feels like we're pretty much going over the same thing again and again. Mod Logs attached here for your perusal.
Anyone who reads mod posts and updates their knowledge would know we've repeatedly stressed how easy it is for bad actors to infiltrate subs with Reddit's API changes affecting mod tools and bots.

This is an all ages sub.

There are minors here.

We're trying to keep out child sexual abuse rings, predators, traffickers, scammers, and more high risk, bad faith actors. Which also flood other major subs on Reddit. Just because you guys aren't exposed to the dark side of Reddit, doesn't mean it doesn't exist.

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Before we sum up, we'd like to circle around to the complaints. The whole hate the mods snobby, superiority complex, power trip, personal attacks. Looks like that's a popular sentiment on other Meta threads as well, so we'd like to focus on that.
To all the people in this and other threads who said that their main issue was, things not being approved. This is the kind of thing we're working with:
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https://preview.redd.it/cbm6uw7i7rqb1.png?width=2000&format=png&auto=webp&s=29b3986d5f9ffa1832189d797e34e33e915e185b
https://preview.redd.it/1iwu4rji7rqb1.png?width=2000&format=png&auto=webp&s=2ba2a4f47754949f4a1b508d80ff27a3502c2ea5
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You're aggravated when a few posts aren't removed? Imagine how we feel. We can't see it half the time, and can’t even access the sub sometimes. This isn't even a comprehensive list of issues we face.
You're entitled to your opinion that it's taking a long time. But please extend some grace instead of throwing hurtful personal attacks. You don't know whats happening BTS and as mentioned already, we're devoting a lot of time and energy to doing things for you guys when this isn’t our full time job

In Summary

We’ve taken our time. We’ve discussed every single mod action on here and we still feel our judgement was fair.
All calls were reasonable.
All removals in accordance with publicly posted guidelines.
All comment approvals within a short amount of time. Except when we dared to be human and sleep.
99.999999999999% of public complaints have no basis in reality. They're alarmingly aggressive, disruptive and disingenuous.

Public complaints we see, usually share the same pattern:

  • Minimal participation in the sub
  • Minimal interaction with moderators.
  • No attempt to modmail or otherwise maturely communicate concerns to moderators
  • Complaints of heavy moderation or mods overdoing it? Made by users who do not follow rules and are unwilling to repost to meet quality standards. But feel entitled to have their low effort post approved anyway.
  • Complaints about post removal? OPs did not bother to follow rules in the first place, or are misrepresenting (OPs deleted their own content, no moderator took action)
  • People defaming and vilifying mods for no logical reason
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Which brings us to

The meta rule: Entitled and disruptive activity will earn you a ban.

Meta rule is effective since this mod post. We'd like to reiterate this here.
“Mods will ban all users engaging in any form of entitled or disruptive activity, including meta comments/posts”
  • Acting entitled will result in a ban. Lying about your experiences with us, will result in a ban.
  • Public comments or posts asking why one post is approved and yours isn't will result in a ban.
  • Publicly speculating, questioning or discussing moderating actions,decisions, or judgment calls will result in a ban.
  • Cribbing about the sub or mods- will result in a ban.
  • Publicly asking about the approval status, or a moderating call on your post, comment, or account will result in a ban. Ask in modmail ONLY.
Use modmail for ALL questions and concerns. Do not DM mods (except in emergencies. Post/comment approval is NOT an emergency.)
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Answering from questions that we know will arise

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What's wrong with asking about my post/comment publicly?
The only people who know anything about it are the mods.
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So i can't say disagree or anything negative? How is this fair?"
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2023.09.14 19:28 EasyFlaccid The link between Hard Flaccid Syndrome, Pelvic Floor Dysfunction, Chronic Pelvic Pain Syndrome, Post-SSRI Sexual Dysfunction, Post Finasteride Syndrome, and advice on how to start your healing journey based on 8 years of research and personal experiences

Here are all my thoughts and advice based on my personal experiences, other people’s insight and helpful experiences, and research I have done on and off about pelvic floor issues from the past eight years or so. There is still a lot left to learn, but I am putting everything I know currently here. I am not claiming that any of this is revolutionary, but I hope it can help some of you out there to give you a head start on healing and advance our understanding of these conditions. As I am a 27 year old male with previous major problems with pelvic floor issues and hard flaccid, some of my advice may be biased towards my condition. However, I believe everyone can benefit from a lot of this because I really do think that all of these conditions that I mentioned are linked in at least some way, especially by pelvic floor dysfunction and sex hormone desensitization. I try not to come to these forums because it increases anxiety and negative emotions which leads to worse pelvic floor symptoms, so my apologies if I do not respond to your questions. For hard flaccid and pelvic floor affected people, follow my advice and I am confident you can heal and reach a place where your symptoms barely affect your life, if at all, which is where I am at now. The mentality of trying to find a 100% “magic cure” solution just leads to anxiety and catastrophic thinking if you have a set back which will only worsen your symptoms. You can and will heal. I know this is a lot of information, but try to implement just one or two things at a time. Focus on the present, and take it one day at a time. Don’t get overwhelmed.
Post Finasteride Syndrome (PFS), Post-SSRI Sexual Dysfunction (PSSD), Hard Flaccid Syndrome (HFS), Pelvic Floor Dysfunction, and Chronic Pelvic Pain Syndrome all can have some similar symptoms. I believe that they are all either caused or can be exacerbated by androgen and estrogen receptor insensitivity and are triggered by medication, genital injury, and pelvic floor inflammation and dysfunction. The pelvic floor is rich in androgen receptors and estrogen receptors. However, without proper androgen receptor activation and sensitivity, the pelvic floor muscles don’t have enough DHT which line the tissues of the pelvic floor, genitalia, and lower urinary tract. DHT is vital for healthy sexual functioning in both sexes - it provides an anabolic effect to tissues to provide strength, stability, healing, and relaxation to tissues. As a result of androgen receptor insensitivity and lack of DHT, the pelvic floor can become chronically weakened, tight, and inflamed which reduces blood flow to the region leading to even more androgen receptor insensitivity and thus less DHT. These symptoms can cause psychological stress to the individual which tightens the pelvic floor further leading to more symptoms and less blood flow. One study found that androgen sensitivity has raised the possibility that androgens can be used to rebuild the weakened and/or damaged muscles comprising the pelvic floor - source. Some people may also have normal sex hormone levels in the blood when tested, but these hormones cannot reach or be effective in the pelvic floor tissues or brain due to sex hormone insensitivity and the lack of the blood flow in the region caused by pelvic floor tightness and dysfunction.
Desensitized estrogen receptors leading to decreased estrogen levels in local pelvic floor and genital tissues may be causing a similar mechanism of dysfunction in some people like androgen receptor insensitivity and DHT because estrogen is important for pelvic floor and sexual health in both sexes. This study says that “Estradiol in men is essential for modulating libido, erectile function, and spermatogenesis. Estrogen receptors, as well as aromatase, the enzyme that converts testosterone to estrogen, are abundant in brain, penis, and testis, organs important for sexual function. In the brain, estradiol synthesis is increased in areas related to sexual arousal. In addition, in the penis, estrogen receptors are found throughout the corpus cavernosum with high concentration around neurovascular bundles.” Steroid users report that low estrogen causes decreased or numb penile sensitivity, shrunken flaccid penis, dull orgasm, urinary hesitancy, urinary frequency, low sex drive, and erectile dysfunction. Here is a paper from a PSSD community member that hypothesizes, as do an increasing amount of people, that the main issue of PSSD, PFS, and Post-Retinoid Sexual Dysfunction is estrogen receptor insensitivity. PSSD and PFS sufferers often have similar hard flaccid and pelvic floor issues, so if those conditions are caused by estrogen insensitivity, then perhaps our pelvic floor dysfunction, HFS, and CPPS, is also impacted by a lack of estrogens in the pelvic floor tissues, not just androgens. The most important element to remember to help start the healing process for these disorders is to boost blood flow through supplements, stretches, and exercises which will increase both androgen and estrogen receptor sensitivity over time.
Post Finasteride Syndrome (PFS) caused by Finasteride, a 5-alpha-reductase inhibitor (5-ARI), plummets DHT levels in the body to try to help hair loss causing sexual dysfunction and pelvic floor issues. Androgen receptors that surround the pelvic floor, genitals, and brain become desensitized due to the Finasteride leading to less DHT binding to these receptors causing dysfunction and a tight, weak pelvic floor. The tight, dysfunctional pelvic floor now restricts blood flow which impacts healing and the delivery of testosterone to this area that further exacerbates androgen insensitivity leading to less DHT in these tissues. Since androgen receptors are found in the brain and androgens have neuroprotective effects, this could be one reason why some PFS and PSSD sufferers are also impacted cognitively. An herbal supplement called Saw Palmetto has also been reported to cause a disorder similar to PFS because it is also a 5-ARI that blocks the conversion of testosterone into DHT. Another disorder called Post Accutane Syndrome (PAS) is also similar to PFS and it reduces DHT as well through being a 5-AR.
For Post-SSRI Sexual Dysfunction (PSSD), SSRIs are also known to decrease androgens and down regulate androgen receptors. This study shows that SSRIs can have an anti-estrogenic effect as well and can even reduce the expression of estrogen receptors (ER), including in the hypothalamus.. As androgen and estrogen receptors get desensitized in the pelvic floor, genital region, and brain, it causes localized DHT and estrogen levels in these tissues to decrease causing emotional blunting, sexual dysfunction, pelvic floor issues, hard flaccid syndrome, and more. The pelvic floor dysfunction can then prevent the sex hormone receptors from being reactivated and sensitized in this area due to restricting oxygen and sex hormone rich blood flow to the tissues. SSRIs can cause androgen receptor insensitivity and estrogen receptor insensitivity by severely inhibiting the serotonin transporter (SERT) leading to increased serotonin levels which desensitizes those receptors throughout the body. It is also interesting that some PSSD community members are trying to restore estrogen receptor sensitivity via boosting estrogen in various ways including by taking hops extract which is a potent phytoestrogen. Check out the PSSD Network for more information on this condition as they are helping to give a voice to the unheard..
Hard Flaccid Syndrome (HFS) - There are many men suffering from HFS and pelvic floor issues due to PSSD, PFS, heavy weight lifting, excess kegeling, or in the case I’m presenting here, physical damage to the genitals and/or PF muscles from excessive, vigorous sexual activity (my case) or penis enlargement exercises. When the genitals or surrounding PF muscles get damaged, an inflammatory process starts and the pelvic floor contracts to protect itself. Since the pelvic floor is now in a chronic, contracted state, it limits oxygen and sex hormone rich blood flow to the genitals and pelvic floor which leads to sex hormone insensitivity and negatively impacts healing, muscle relaxation, and DHT production in these tissues. Finasteride, Accutane, and SSRIs also desensitize sex hormone receptors in the genitals and pelvic floor tissues leading to hard flaccid and pelvic floor dysfunction. Since the pelvic floor tightness restricts blood flow, it is difficult for hard flaccid sufferers to reactivate and sensitize their pelvic floor muscle androgen receptors again to regain relaxation and strength in their pelvic floor muscles, including the ischiocavernosus (IC), bulbocavernosus (BC), and pubococcygeus (PC) which are in a contracted state; the IC muscle in particular is thought to be the most implicated in the cause of hard flaccid. We first need to promote relaxation in the pelvic floor by boosting blood flow through supplements and stretches because tight muscles are weak muscles. Once the pelvic floor is in a chronic state of tension, it is hard to heal from pelvic floor issues because you likely already had bad habits such as poor posture, unhealthy sexual practices, stiff muscles, sedentary lifestyle, unchecked anxiety, and other negative lifestyle factors. Along with supplements, exercises, and stretches, correcting these bad habits is necessary to heal to have an even healthier pelvic floor than you ever had before because it likely was already tight and dysfunctional to begin with before developing obvious issues, but it was more subtle and you had no awareness of your pelvic floor muscles until now. You have the potential to now become a much healthier person overall than you ever would have been without being affected by pelvic floor dysfunction and hard flaccid.
What I see in all these conditions is that sex hormone receptors become desensitized in the pelvic floor and genital tissues either from a drug, pelvic tightness, or inflammation from injury leading to less localized sex hormones causing sexual and pelvic floor dysfunction. The pelvic floor now goes into a chronic tightened state as a response, leading to more inflammation and less oxygen and testosterone rich blood flow to the genital and pelvic region which leads to more androgen insensitivity and subsequently less DHT. This all explains why many people who have these conditions are helped by supplements that improve androgen receptor sensitivity and blood flow, and why pelvic floor therapy and exercises are so helpful to many of them. Estrogen receptor insensitivity in the pelvic floor also appears to have a similar mechanical negative effect by leading to less estrogen levels in the pelvic floor and genital tissues. It is also possible that some people with PSSD/PFS may have subtle or no pelvic floor symptoms, but the medication still desensitizes sex hormone sensitivity in their genitals and pelvic floor tissues that is leading to sexual dysfunction.
Another study linking androgens and the pelvic floor: Levator ani and other muscles of the pelvic floor and lower urinary tract are sensitive to the anabolic effects of testosterone. Androgen receptors are also expressed in the pelvic floor and lower urinary tract of both animals and humans. Anabolic effects of androgens may play an important role in the female pelvic-floor and lower-urinary-tract disorders. The action of androgens in the lower urinary tract and pelvic floor is complex and may depend on their anabolic effects, hormonal modulation, receptor expression, interaction with nitric oxide synthase, or a combination of these effects.
My solution to help heal and improve the well-being of people with these issues is to try to improve sex hormone receptor sensitivity and pelvic floor function through supplements, stretches, exercises, and boosting blood flow which will hopefully restore normal levels of estrogens and androgens in pelvic, genital, and brain tissues. The body has a tremendous capability of self-healing, but we need to support it through active recovery methods.
We will first start with supplements (this is not professional medical advice - talk with your doctor before taking):
L-citrulline - This is the precursor to l-arginine, and it will improve blood flow and levels of nitric oxide to help get oxygen and testosterone rich blood to the pelvic floor and genital tissues to increase androgen sensitivity. Nitric oxide can also induce smooth muscle relaxation which is important for relaxing the pelvic floor. Herein we report on a young man affected by PSSD who regained sexual functioning after 3-month treatment with EDOVIS, a dietary supplement containing L-citrulline and other commonly used aphrodisiacs.. I recommend taking at least 6000 mg daily by taking 2000mg three times throughout the day. The max dose is 10,000mg. Even potentially better, people report great results using Cialis to improve blood flow and healing rather than L-citrulline and some doctors will even prescribe it to women if you show them the evidence - talk with your doctor. “Tadalafil (Cialis) reversal of sexual dysfunction caused by serotonin enhancing medications in women”. L-Citrulline and Cialis are not recommended to be taken together.
L-Carnitine - This will improve the number of androgen receptors and their sensitivity to testosterone to increase levels of DHT in the pelvic floor, genital tissues, and brain. Acetyl-L-Carnitine can pass through the blood-brain barrier, while Propionyl-L-carnitine has a high degree of interaction with testosterone. Propionyl may be better for sexual and pelvic floor dysfunction, while Acetyl might help people suffering from the mental effects of PSSD. This study used each at 2000mg daily to improve erectile dysfunction along with Viagra.. I would work up to 2000mg each of Acetyl and Propionyl L-Carnitine along with Cialis instead of Viagra as it lasts in the body for much longer (36 hours) for increased blood flow healing purposes. You can also use L-Citrulline instead of Cialis as mentioned earlier. Discuss with your doctor before taking them.
Vitamin D - This vitamin, which acts more like a hormone, works directly with the endocrine system. It has its own receptors throughout the body and they are often in close proximity to androgen receptors. Deficiency in vitamin D is associated with a stunting of testosterone's effects on androgen receptors and a decline in testosterone levels. Vitamin D will encourage androgen receptor resensitization. One study found that higher vitamin D levels are associated with a decreased risk of pelvic floor disorders in women, and The levator ani and coccygeus muscles are skeletal muscles that are critical components of the pelvic floor and may be affected by vitamin D nutritional status. I recommend 4000IU of vitamin D daily or whatever gets your levels to 60 - 80 ng/ml. I would also take 100mcg of vitamin K2 to ensure that any excess calcium from vitamin D is deposited into the bones and not arteries.
Magnesium Glycinate - This will help relax your pelvic floor muscles to help restore function and blood flow. I recommend starting with 300mg.
If you have inflammatory issues or pain due to pelvic floor dysfunction, I recommend a fish oil supplement daily. I take fish oil, and I find that it helps limit pelvic inflammation. Take quercetin and bromelain as needed if you experience pelvic inflammatory flare ups, pain, and bladder issues, but just be careful as quercetin can also inhibit the production of DHT from testosterone as well. Some say fish oil blocks DHT too, but experiencing chronic pelvic floor pain and inflammation will do more harm to you than minimal DHT blocking.
I also recommend doing some form of yoga or pelvic floor stretches daily to improve blood flow for pelvic floor relaxation and sex hormone receptor sensitivity. You also need to request to see a pelvic floor therapist for an evaluation and treatment. Learn how to do reverse kegels. Doing reverse kegels will be difficult at first because your pelvic floor is tight and you have little to no awareness of these muscles, so just focus on lengthening and relaxing the pelvic floor through stretches for now. Do not do regular kegels for pelvic floor issues. Learn how to diaphragmatically breathe in 360 degrees to create expansion in your rib cage and abdomen to encourage pelvic floor relaxation. Do not breathe through your chest, and “belly breathing” isn’t the right term because the ribs need to expand as well. You can learn how to diaphragmatically breathe through an exercise such as 4-7-8 breathing. Here is a great video on diaphragmatic breathing and another video. Retraining yourself to properly breathe diaphragmatically is the single most important thing that you can do to heal from pelvic floor issues.
Stretches/Yoga poses I recommend:
Hold the Malasana/hindi/yoga squat pose for at least 5-10 minutes at least twice a day, but doing it morning, mid-day, and at night would be the best. Some get great results holding it for 15-20 minutes.This is one of the most important things for your pelvic floor because it will help lengthen and release it. Doing them barefoot is also very beneficial to strengthen your ankles and feet which are connected to your pelvic floor. Again, remember to breathe deeply down into your belly and pelvic floor for all these stretches.
Begin your stretching routine with an Exercise ball ab stretch and Upward-facing dog/cobra pose. This will help stretch your lower abs and psoas muscles so that you can get more breath deeper down into your pelvic floor for the rest of your stretches. Some people say that these types of stretches aren’t great for people who have Anterior Pelvic Tilt, which we should fix, but I still do them as it is important to stretch the lower abs that are hard to get to. You can experiment with doing them sporadically instead of every time you stretch.
This is my current personal complete stretch routine I do in order 3+ days a week:
Myofascial release on my glutes with an orb massage ball but you can use any small hard ball (don’t do this if glutes are currently sore) > Calf stretch against a wall or a yoga block which is what I use > exercise ball ab stretch > upward facing dog > (optional) Do a handful of cat cows > Supine hamstring stretch with yoga strap or an IdealStretch tool which is what I use > Kneeling hip flexor stretch > flat on back supine single knee to chest stretch > then bring knee to opposite shoulder stretch > supine figure four > I do this stretch next right after figure four > Reclined bound angle pose > (optional) butterfly stretch > (optional) A little bit of downward facing dog to stretch the calves > (optional) Lizard Pose) > (optional) Half split stretch/Half monkey pose with yoga blocks > Half-pigeon pose > Child’s pose > Wall quad hip flexor stretch > Wall figure four stretch > Wall straddle pose > Wall happy baby pose > Flat on back while pulling knees apart > kneeling with one leg, other leg out to side for adductors > (optional) Frog pose with feet together > regular Frog pose with feet separated in line with the knees > Yoga squat/malasana > Corpse pose
All these stretches are the ones I found most useful in a routine. See what works for you and develop your own routine. Consistency is the most important. This long stretching routine may not be possible for you to complete regularly so make adjustments, but doing this routine at least 3 days a week is ideal. Stretches such as the yoga squat, supine hamstring stretch, hip flexor stretches, and wall stretches are vital and should be done most days to help relax the pelvic floor. For how long you should hold each stretch, just go by how you and your body feels. Really let go, breathe, and sink into every stretch. On rest days, doing some deep breathing in child’s pose, reclined bound angle pose, flat on back while pulling knees apart, and the happy baby wall pose is really great while trying to do gentle reverse kegels.
You can also work on more individualized stretches for posture to correct anterior pelvic tilt, muscle imbalances, and to release other tight muscles, such as the upper body. Listen to your body if you need to give yourself a rest day from stretching. Adding in a 30-60 minute walk/swim on rest days is incredibly beneficial as well. Eventually, you can also try to learn isometric PNF stretching to incorporate it into some of the stretches such as the kneeling hip flexor stretch and hamstring stretch.
Exercises I recommend:
After working to relax and lengthen your pelvic floor through yoga and stretches, I would begin gentle body strengthening exercises that are pelvic floor safe. The pelvic floor is a master compensator. So, if the glutes, adductors, deep hip rotators, transversus abdominis, and other supportive muscles are weak, then the pelvic floor is in the prime position to pick up the slack which leads to a lot of strain on the pelvic floor which results in tightness and dysfunction. You need to strengthen the surrounding muscles to relieve tightness in the pelvic floor. This is where working with a pelvic floor therapist would be helpful to point out safe individualized exercises for you. Yoga will help strengthen your muscles in a safe way too.
The glutes and transversus abdominis in particular are very important to strengthen. Glute bridge, single glute bridge, side lying leg raises, lateral band walks can help build up glute strength. Deadbugs, Bird Dog, 8- point planks, or planks with pelvic floor-friendly modifications, can help to strengthen the transversus abdominis (TVA). Abdominal work may be triggering to your pelvic floor symptoms, especially the 8 point plank, so you can instead look into hypopressive exercises to work the TVA without overworking the pelvic floor. These exercises will help you bring more awareness to your breathing, diaphragm, TVA, and pelvic floor which are all important for recovery. Here is how to find and become aware of the TVA. Do side planks for your oblique ab muscles.
For hip/abductors do the side lying hip abduction exercise, fire hydrants, and the shinbox lunge. For the adductors, do Copenhagen adductor exercise, cossack squats, and an exercise where you squeeze a soft ball between the knees just don’t do any crunch movements with pelvic floor issues. For hamstrings, Nordic hamstring curl/glute ham raises, and single leg bridge. For the back, do supine pelvic tilt. One person even reported that dorsiflexion exercises and stretches were one important element to solve his pelvic floor issues; this is most likely because the ankle bone, like everything else including even our jaw, is connected to the pelvic floor.
Like with anything, do all these exercises in moderation and stop if you sense your pelvic floor is not responding well to them - do them one at a time to see which ones your pelvic floor can handle for now. Here is an exercise routine from another poster that has helped many people. Just be careful of the ab exercises such as the ab wheel and 5 minute planks with your pelvic floor issues - don’t over do it or avoid it if they cause too many symptoms.
Myofascial release and foam rolling to release trigger points also helps a lot of people to relax their pelvic floor muscles and improve blood flow. The glutes are the most important area to target for pelvic floor issues when foam rolling in my experience if you only had limited time. Using a soft ball to lay on and breathe deeply can help release trigger points in the abdominal muscles and psoas which can help you breathe better and relax the pelvic floor. I haven’t done it, but you can also try out a massage gun for myofascial release; just be careful and don’t use it in sensitive pelvic areas. Some men and women also report success using a therawand to release internal trigger points that are causing them pelvic floor dysfunction symptoms.
Walking and swimming for 30-60 minutes are some of the best exercises to lengthen, relax, stretch, and release your pelvic floor, boost blood flow, and help to retain and build strength in muscles that give support to the pelvic floor. Walk or swim for 5+ days a week for the best results. The breaststroke and freestyle are very helpful for pelvic floor sufferers. Along with swimming, people also use an elliptical at a low resistance to help provide a cardio workout that is safer for your pelvic floor.
Fix your posture. Pelvic floor issues and hard flaccid syndrome are closely associated with Anterior Pelvic Tilt and other postural issues. Get evaluated by a physical therapist so that they can give you exercises and stretches to fix it. You could also look into the Postural Restoration institute and see one of their providers and try to implement some of their exercises. In the meantime, here is one video playlist on how to fix APT. Another video to fix APT says to stretch the hip flexors, lower back, while focusing on strengthening the abs, glutes, and hamstrings. Make sure that you sit and walk with good posture - watch this to learn how to walk correctly - activate your glutes during each step and push off with your back foot!. I also recommend getting a standing desk to try to avoid sitting for long periods of time.
Weight training can be effective for boosting active androgen receptors in the body to increase testosterone and DHT levels. However, you need to make sure that it isn’t making your pelvic floor symptoms worse which defeats the purpose. If you are going to lift weights with pelvic floor issues, don’t lift heavy, do any intensive ab workouts, or any other exercises that can put extra strain on your pelvic floor. Do lifts where you can sit down instead of standing up. Start with yoga, stretching, and gentle body exercises to relax your pelvic floor and strengthen surrounding muscles before incorporating consistent weight training. I highly recommend, however, just sticking with yoga and pelvic floor safe body weight exercises to build strength instead. Remember to see a pelvic floor therapist to get evaluated first before starting any weight lifting.
Work on your mental health. Anxiety can worsen pelvic floor issues. Just as dogs tuck and tense their tails when stressed, we tense our pelvic floors which are directly connected to our tailbone where we used to have tails ourselves in our evolutionary history. As we are impacted by sexual dysfunction and pelvic floor dysfunction symptoms, we become anxious along with other negative emotions which leads to more pelvic floor tension symptoms due to the fight or flight mode response causing even more anxiety leading to more symptoms. It is a vicious cycle that needs to break by not becoming anxious and negative when we experience pelvic floor symptoms or hard flaccid and instead let go, accept, surrender, and realize that it is a normal process when trying to heal because sometimes our muscles that are used to that tightness don't want to let go of the tension we hold in our pelvic floors. Daily yoga, meditation, stretching, and walking will help with anxiety. I would also see a mental health therapist because all of these issues are deeply traumatic, and we cannot go through this alone. We often hold tension in the form of emotions and trauma in our bodies, especially our pelvic floor and genital areas. By openly talking about these issues with a therapist, it will help us process and release our emotions and trauma that we are holding inside our bodies to improve our anxiety, relax our pelvic floor, and to let go of all of our tension. Many people who healed their hard flaccid and pelvic floor issues said that solving their anxiety and negative thoughts by talking to a mental health counselor was vital in recovery. The mind-body connection is so powerful, and it directly impacts our pelvic floor. Those who are stuck in the cycle of experiencing pelvic floor symptoms leading to anxiety and negative thoughts will also benefit from Cognitive Behavioral Therapy you can do by yourself like in this video or preferably with a trained therapist. Here is an informative mini lecture on how stress impacts the pelvic floor.
I would also definitely go on a healthy anti-inflammatory diet. Avoid caffeine, alcohol, marijuana, and other triggering substances. Avoid foods and liquids that can trigger pelvic floor inflammation such as highly acidic fruits and veggies, carbonated beverages, very spicy foods, and artificial sugars. To maintain a healthy gut to reduce inflammation in your body I recommend trying a low-histamine probiotic supplement along with eating healthy. You should also work on preventing or fixing constipation; eat a lot of soluble fiber to not get constipated - take a supplement such as metamucil if you have to. Check the Bristol stool shape chart to identify if you are constipated because even mild constipation can contribute to pelvic floor tension. This is because the constipation leads to a lot of pressure being put on your rectum and pelvic floor leading to the muscles becoming weak and dysfunctional. I am willing to bet many of you are constipated and don’t know it because it isn’t just whether you go regularly, it is also how your stool is shaped. People with pelvic floor disorders are at a high risk of constipation which makes their tension and dysfunction worse which then worsens the constipation, another cycle to fix. I recommend getting a Squatty Potty to reduce strain on the pelvic floor during elimination.
Sexual health advice:
This is a good reddit guide on how to reverse kegel.
However, I will also give a shot at explaining how to reverse kegel because it is one of the most confusing things for people about this healing pelvic floor issues, and many people unfortunately do it wrong. This is why visiting a pelvic floor therapist would be helpful.
If you know how to do a kegel, the reverse kegel is the opposite feeling of that. I describe the kegel as a pull feeling, while the reverse kegel is a pushing out feeling. The reverse kegel helps to lengthen the pelvic floor through the front using the penis (front rk) and the back (back rk) using the perineum behind the testicles near the anus, but not the anus itself. I learned to reverse kegel by diaphragmatically breathing down into the belly and pelvic floor. On the inhale, inflate your diaphragm and belly, breathe down into your pelvic floor area and feel a gentle pushing movement out the front of the penis and out the back of the perineum. You can then gently release this pushing feeling on the exhale. Never force any movements - it should be a gentle process guided by the diaphragmatic breath. You can also try to do the front rk and back rk separately to try to concentrate on each better. To give another perspective, one person described the reverse kegel as like blowing up a balloon in the whole front area between the perineum and pubic bone inside out - so to me this means blowing up the balloon with your diaphragmatic breath into your pelvic floor and making a pushing feeling out the front of the penis and out the back of the perineum. You should also reverse kegel during sexual activities to help keep your pelvic floor relaxed and prevent involuntary kegels that lead to a tight, imbalanced pelvic floor and premature ejaculation. Reverse kegeling when erect may be difficult at first, but it will become easier to understand during sexual stimulation when you get the feeling of wanting to involuntary kegel, but doing the opposite of that and gently doing the push feeling through the front reverse kegel.
I would stay away from regular kegels when dealing with pelvic floor and hard flaccid issues - it will only lead to contraction and tightening. The kegel (BC) muscle works plenty involuntarily on its own without us needing to exercise them. Once again, the reverse kegel helps to counterbalance the pelvic floor that has been overusing regular kegels leading to hypertonic pelvic floor dysfunction. Positions that I am most able to feel the reverse kegel the most in are the wall happy baby pose, lying flat on my back while spreading my knees apart, child’s pose, and the yoga/malasana squat. Do not be discouraged if you have no awareness of your pelvic floor or the concept of reverse kegeling just yet. Your pelvic floor is tight and dysfunctional giving you little to no feeling of the proper movements. Once your pelvic floor becomes relaxed and lengthened through pelvic floor stretches, you will have an easier time gaining awareness. Learning how to reverse kegel is often the hardest part of recovery for men. It may take many months, so have patience with your body while it is healing.
To help heal hard flaccid and pelvic floor issues, never watch pornography again (this is vital). Go on NoFap for 90+ days to help heal your brain and body from any unhealthy pornography and sexual habits you have partaken in. Pornography leads to involuntary kegels, a tight pelvic floor, desensitizes you, and messes up the dopamine and arousal circuitry in your brain. Don’t climax too often. Use lube and a very gentle gliding motion if you are going to self-pleasure, no more tugging on your penis that is then pulling on your pelvic floor muscles, and avoid masturbation positions that puts you into an anterior pelvic tilt - stick to neutral/posterior pelvic tilt positions. Sex is much healthier compared to masturbation for the penis and pelvic floor muscles because the head of the penis is stimulated by the vaginal walls which creates a reflex that helps activate the ischiocavernosus (IC) muscle, which is vital for erection health and is likely in a contracted state causing hard flaccid - thank you to this thread for this information. If you do have a partner, only climax through sex. Make sure you have proper erection quality during sexual activities - take supplements or medications if you have to. Climaxing flaccid or semi-flaccid is what causes many people to develop hard flaccid and pelvic floor issues in the first place. This is likely due to a complicated process of the IC muscle being improperly activated due to flaccidity during climax leading to a cramping of the muscle leading to hard flaccid and causing dysfunction across the pelvic floor muscles causing a cascade of inflammation. Only partake in sexual activities when you have relaxed your pelvic floor enough through stretching and the rest of the techniques. Again, I do recommend abstaining from masturbation as long as possible while healing and preferably after as well.
One interesting and strange thing that I also want to mention is that a person with hard flaccid and pelvic floor issues reported significant improvements after changing the position in which they masturbated and climaxed in to an elevated glute bridge position while reverse kegeling, some commenters also reported improvements - here is the thread. Another post here said that using a squatting position while sitting at the edge of a chaibed with feet flat on the ground and not touching himself during climax helped him. Another reminder, I would only attempt this if you have gotten your pelvic floor to a relaxed state through stretching and learned how to reverse kegel when erect during sexual activities. Going gentle and using lube is necessary. During all sexual activities you should be erect as possible to support proper pelvic floor function.
The reason why masturbating in a posterior pelvic tilt along with glute muscles activated likely worked for them is that we have been masturbating and climaxing in an Anterior Pelvic Tilt (APT) all of our lives. This is unnatural and goes against our evolutionary biology because during sex throughout all of our human history, thrusting and climaxing puts us into more of a posterior pelvic tilt position with a lot of activation of our glutes. Men are often self-pleasuring with an APT while edging for sometimes hours at a time throughout their lives while sitting on a chair, couch, bed, etc. which has put unnatural pressure, or improper activation on their pelvic floors that has likely caused dysfunction with our BC, PC, and especially IC muscles. By switching to more of a natural sex position during masturbation that puts us in a posterior pelvic tilt state, such as during an elevated glute bridge, it is reactivating and counter correcting the function of our pelvic floor muscles, such as the IC muscle in particular, that has been dormant or dysfunctional due to our bad sexual habits. This of course isn’t a miracle cure, but it could be worth a try if you first applied the rest of the recommendations.
You can and will heal. Stay strong and never give up. Thank you for reading.
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2023.09.14 04:49 Flankerdriver37 Myopia - don't let the asian parents use it to control you. They are creating it with their lifestyle demands.

Here's the TLDR version: outdoor sunlight exposure decreases myopia. Our entire asian lifestyle of studying indoors, playing piano indoors, going to cram schools indoors etc. is what is driving myopia. It's not the videogames or whatever other bullshit the asian parents are blaming it on so they can control you. The BS eye exercises or hocus pocus interventions they are making you do to control myopia are probably not going to work. Here's the whole article.
The View From the Center of the World’s Myopia Epidemic In Taiwan, so many people are nearsighted that the island nation has already glimpsed what could be coming for the rest of us. Amit KatwalaAug 22, 2023 6:00 AM ILLUSTRATION: VANILLA CHI Doing surgery on the back of the eye is a little like laying new carpet: You must begin by moving the furniture. Separate the muscles that hold the eyeball inside its socket; make a delicate cut in the conjunctiva, the mucous membrane that covers the eye. Only then can the surgeon spin the eyeball around to access the retina, the thin layer of tissue that translates light into color, shape, movement. “Sometimes you have to pull it out a little bit,” says Pei-Chang Wu, with a wry smile. He has performed hundreds of operations during his long surgical career at Chang Gung Memorial Hospital in Kaohsiung, an industrial city in southern Taiwan. Wu is 53, tall and thin with lank dark hair and a slightly stooped gait. Over dinner at Kaohsiung’s opulent Grand Hotel, he flicks through files on his laptop, showing me pictures of eye surgery—the plastic rods that fix the eye in place, the xenon lights that illuminate the inside of the eyeball like a stage—and movie clips with vision-related subtitles that turn Avengers: Endgame, Top Gun: Maverick, and Zootopia into public health messages. He peers at the screen through Coke bottle lenses that bulge from thin silver frames. Wu specializes in repairing retinal detachments, which happen when the retina separates from the blood vessels inside the eyeball that supply it with oxygen and nutrients. For the patient, this condition first manifests as pops of light or dark spots, known as floaters, which dance across their vision like fireflies. If left untreated, small tears in the retina can progress from blurred or distorted vision to full blindness—a curtain drawn across the world. When Wu began his surgical career in the late 1990s, most of his patients were in their sixties or seventies. But in the mid-2000s, he started to notice a troubling change. The people on his operating table kept getting younger. In 2016, Wu performed a scleral buckle surgery—fastening a belt around the eye to fix the retina into place—on a 14-year-old girl, a student at an elite high school in Kaohsiung. Another patient, a prominent programmer who had worked for Yahoo, suffered two severe retinal detachments and was blind in both eyes by age 29. Both of these cases are part of a wider problem that’s been growing across Asia for decades and is rapidly becoming an issue in the West too: an explosion of myopia. Myopia, or what we commonly call nearsightedness, happens when the eyeball gets too long—it deforms from soccer ball to American football—and then the eye focuses light not on the retina but slightly in front of it, making distant objects appear blurry. The longer the eyeball becomes, the worse vision gets. Ophthalmologists measure this distortion in diopters, which refer to the strength of the lens required to bring someone’s vision back to normal. Anything worse than minus 5 diopters is considered “high myopia”—somewhere between 20 and 25 percent of myopia diagnoses around the world are in this category. In China, up to 90 percent of teenagers and young adults are myopic. In the 1950s the figure was as low as 10 percent. A 2012 study in Seoul found that an astonishing 96.5 percent of 19-year-old men were nearsighted. Among high schoolers in Taiwan, it’s around 90 percent. In the US and Europe, myopia rates across all ages are well below 50 percent, but they’ve risen sharply in recent decades. It’s estimated that by 2050, half the world’s population will need glasses, contacts, or surgery to see across a room. High myopia is now the leading cause of blindness in Japan, China, and Taiwan. If those trends continue, it’s likely that millions more people around the world will go blind much earlier in life than they—or the societies they live in—are prepared for. It’s a “ticking time bomb,” says Nicola Logan, an optometry professor at the UK’s Aston University. She wasn’t the only expert I talked to who used that phrase. Because so much of Taiwan’s population is already living life with myopia, the island nation has already glimpsed what could be coming for the rest of us. And in a rare confluence, the country may also be the best place to look for solutions. ILLUSTRATION: VANILLA CHI On the bullet train south from Taipei, you can see the smog hanging over Kaohsiung from miles away, blurring the edges of the buildings. During the Japanese occupation, which ended in 1945, what had been a small trading port transformed into one of Taiwan’s biggest cities, a riot of heavy industry and shipbuilding. Over the next four decades, as Taiwan made the rapid transition from a predominantly agricultural economy to a manufacturing powerhouse, the lives of its citizens shifted too. Families flocked into cramped apartment blocks that still make up much of the urban housing. Education for children was mandatory and became increasingly intense. A network of after-school establishments called “cram schools” sprang up, making room for parents to work long hours without the childcare support from elderly relatives they would’ve had in the old society. At the end of the school day, some kids would board a bus, not to go home, but to ride to their cram school, some of which were open until 9 pm. Pei-Chang Wu was born in Kaohsiung, at the height of the city’s transformation, in 1970. His grandparents, neither of whom were myopic, were farmers in central Taiwan. Both of his parents were teachers, and like many Asian parents, they put a huge emphasis on education as one of the few levers they could pull to move up through society. His father enforced a strict daily routine: up at 5 am for calligraphy and violin practice, school from 7:30 am to 4 pm. Once Wu got home in the evenings he had to complete his schoolwork. On the weekends, he participated in calligraphy competitions. By the age of 9, Wu had been diagnosed with myopia. Pei-Chang Wu. Photograph: An Rong Xu Across the modernizing world, this pattern repeated itself. For economies to continuously expand, education had to become central, and as this happened, the rates of myopia started to climb. But hardly anyone noticed, in Taiwan or anywhere else. If current trends continue, it’s likely that millions more people around the world will go blind much earlier in life than they—or the societies they live in—are prepared for. Then, during one summer in the early 1980s, a group of incoming college students gathered at Chengkungling, a military training facility in central Taiwan, for a ceremony to mark the beginning of their mandatory national service. The United States had recently cut diplomatic ties with the island and formally recognized the government in Beijing, and cross-strait tensions were high. At first, the early morning ceremony went smoothly. A single cadet—tall, good posture—received a rifle on behalf of his classmates, symbolizing their duty to defend their country. As the ministers of education and defense rose to deliver their speeches to the young men they hoped would be the future of Taiwan, the sun also rose higher into the sky behind the stage. The government officials were dazzled by the glare reflecting back at them from hundreds of pairs of glasses. The ceremony was the seed for a joke about how to ward off an alien invasion—just ask Taiwanese students to look up—and the spark for the government’s fight against myopia. The first step was to understand the scope of the problem. The president, alarmed by what had happened, asked health officials to begin a regular survey of myopia rates in Taiwan. It revealed a previously hidden epidemic, which seemed to be getting worse. By 1990, the myopia rate among Taiwanese 15-year-olds had risen to 74 percent. By the time Wu started medical school in the early 1990s, he was seeing floaters—“strange animals in the sky,” as he called them—when he closed his eyes. At first, he dismissed them and focused on his budding career as an ophthalmologist. But during his residency, Wu examined hundreds of patients with retinal detachments who’d had the same symptoms. He grew worried about his own long-term vision. So he asked one of his professors to examine his eyes. “He found a break in my retina,” Wu said. He was lucky. It was a small tear, minor enough to be fixed with a laser in five minutes. Shining a light through the pupil creates scar tissue that the retina can reattach to. “The laser saved me,” Wu said. “Otherwise I would be blind in one eye.” Wu decided he had a responsibility to rescue others from high myopia and its potential complications. “If I cannot save myself, we should save our next generation.” It wasn’t until the mid-1990s that a better understanding of what caused myopia—and what could prevent it—finally cracked open. In 1999, the government convened a group of experts in medicine and education to try and fix the problem. Jen-Yee Wu, who worked at the Ministry of Education and had done his doctoral thesis on eyesight protection, was asked to write a set of guidelines for schools to address nearsightedness. Later that year, he published a thin green book full of advice for teachers. It paid careful attention to desk height (to keep texts the right distance from the eyes) and room lighting, and advocated eye relaxation exercises, including a guided massage of points around the eyes and face. The book also advised giving children more space in their notebooks to pen the intricate characters that make up written Mandarin. And it formalized the 30/10 rule: a 10-minute break to stare into the distance after every half hour of reading or looking at a screen. None of it worked. Nearsightedness rates continued to climb because, as it turned out, Taiwan, and the world, had been thinking about how to address myopia completely wrong. ILLUSTRATION: VANILLA CHI Here is a non-exhaustive list of things that have been blamed for nearsightedness: pregnancy, pipe smoking, brown hair, long heads, bulging eyes, too much fluid in the eyes, not enough fluid in the eyes, muscle spasms, social class. “Any ophthalmologist who experienced a night of insomnia arose in the morning with a new and usually more bizarre theory,” wrote Brian Curtin in an influential 1985 book about myopia. Folk theories have changed with technologies. Ask people today and they’re likely to blame smartphones and video games. Before that, it was sitting too close to the television and reading under the covers with a flashlight. Those activities all come under the broad umbrella of “near work”—using your eyes to look at something close to your face—which had been the leading scapegoat for myopia for centuries. In 1611 the astronomer and scientist Johannes Kepler wrote, “Those who do much close work in their youth become myopic.” In the mid-19th century, there existed a contraption called the “myopodiorthicon,” which was designed to gradually move a book backward during reading to strengthen the eye’s ability to adjust to objects at different distances. The Hygiene of the Eye in Schools, by Hermann Cohn, published in 1883, paid careful attention to lighting and advocated the use of headrests to physically prevent the eyes from coming too close to the text during reading. In 1928, British ophthalmologist Arnold Sorsby surveyed Jewish boys in East London and discovered that they were more myopic than their non-Jewish peers. At first, he thought this was because of the extra time spent doing near work while studying holy texts. Eventually, though, he came to believe there was a genetic element to myopia. He conducted studies of twins that seemed to confirm this: The severity of myopia was more similar among identical twins than fraternal twins. The science of genetics was in vogue, and as Sorsby’s theory swept away Victorian concerns about the state of the schoolhouses, it became dogma for decades. Myopia became seen as a condition to be managed, not a disease that could be prevented. It wasn’t until the mid-1990s that a better understanding of what caused myopia—and what could prevent it—finally cracked open. In these years, an Australian researcher called Ian Morgan stumbled on a scientific mystery that would consume the next 25 years of his life. Morgan, now a genial 78-year-old with sun-wrinkled skin and large dark-framed glasses, was working as a research fellow at the Australian National University in Canberra, where he was studying the neurotransmitter dopamine and its role in the eye’s signaling systems. Back then, he didn’t know much about myopia—he could barely tell you the difference between far- and nearsightedness. Pei-Chang Wu with a patient. Photograph: An Rong Xu But as a part of his weekly reviews of the latest scientific literature, he started to see some of the first evidence coming out of Asia about the growing myopia epidemic. He couldn’t understand how myopia rates could be close to 80 percent for kids leaving high school in East Asia and so much lower in his native Australia. He soon found other research casting doubt on Sorsby’s genetic view of myopia. In Inuit and Eskimo populations, during the 1970s, myopia incidence increased from 5 percent to more than 60 percent prevalence in the span of one generation. Genetics couldn’t explain such a jump. The sharp increase in schooling among younger Inuits, however, might. In the early 1990s, researchers had found that ultra-orthodox Jewish boys are more myopic than their sisters—something that was likely due to the extra studying they have to do. Morgan started to seek out a better understanding of what causes myopia, and by the early 2000s, he was convinced there had to be a behavioral reason for the boom. But if near work was really to blame, why hadn’t the interventions tried in China and Taiwan made any difference? In 2003, with colleagues Kathryn Rose and Paul Mitchell, Morgan began a two-year study of thousands of 6- and 12-year-olds in Sydney, looking for lifestyle differences that might explain their lower levels of myopia. They used a technique called “cycloplegic autorefraction,” in which the patient’s eyes are first relaxed with eye drops before a machine measures how light is focused on the back of the eye, providing an objective measure of the length of the eyeball. The results, which were published in a landmark 2008 paper, confirmed Morgan’s suspicions. As expected, overall myopia rates among Australian 12-year-olds, at about 13 percent, were significantly lower than in Asia. Morgan and his team also surveyed the participants about their daily routines and hobbies and discovered a surprising relationship. The more time kids spent outside, the less likely they were to have myopia. The next question was why. “This was where my background became really important,” Morgan says. It all came back, he thought, to dopamine—the neurotransmitter he had been studying before his detour into myopia research. “We knew that light stimulated the release of dopamine from the retina, and we knew that dopamine could control the rate at which the eye elongated,” Morgan says. (In 1989, an American ophthalmologist named Richard Stone found that he could induce myopia in chickens by manipulating light levels, and that there was less dopamine in the retinas of the myopic chickens.) “So once we had the actual epidemiological evidence that being outdoors was important, the mechanism was, to us, very obvious.” Without adequate exposure to sunlight, the eye keeps growing longer, images are focused in front of the retina, and vision becomes blurry. In August 2008—after a decade of research—Morgan published a paper that he believed contained the key to solving Asia’s myopia epidemic. ILLUSTRATION: VANILLA CHI Around this time, Wu’s clinic was busy—his operating table often full, with a steady stream of parents with young children in tow seeking treatments for myopia. For instance, orthokeratology contact lenses improve vision by temporarily squishing the cornea into a different shape, reminiscent of how ancient Chinese soldiers are said to have slept with sandbags over their eyes for the same effect. Then there’s atropine—a muscle relaxant derived from the toxic nightshade and mandrake plants. Nightshade has been known as “belladonna” because women in Renaissance Italy—and maybe even as far back as Cleopatra—used it to dilate their pupils to make them appear larger and more beautiful. Atropine paralyzes the ciliary muscle, which controls the size of the pupil and, for reasons scientists haven’t yet pinned down, also seems to slow down the progression of myopia. (Since 2008, new treatments have become available: miSight contact lenses and MiyoSmart glasses, which arrest the growth of the eye by manipulating light patterns.) In his studies in Taiwan, Wu observed the same phenomenon that Morgan had documented: More outdoor time equalled less myopia. But Wu knew that none of these treatments were dealing with the underlying cause of the problem. And as a newly minted member of Taiwan’s Vision Care Advisory Committee, a different group of academics behind some of the country’s well-meaning but ineffective attempts to tackle nearsightedness, he had adopted a determined, systematic approach to finding a solution. Every week, he gathered his colleagues to review the latest academic research on myopia. He even corralled his mother into making snacks as an added incentive. During one of these Thursday sessions, with the smell of home-cooked food in the air, Wu discovered Ian Morgan’s research in Australia. It was a eureka moment. Were Taiwan’s classroom interventions failing because kids weren’t spending enough time outside? Wu decided to run his own version of the Sydney Myopia Study in Cimei, an island off the west coast of Taiwan. He observed the same phenomenon: More outdoor time equalled less myopia. Around the same time, Wu chanced on an opportunity to go a step further than Morgan—to move from simply observing the myopia problem to fighting back. His son was starting elementary school, and the parents of incoming students had been invited to an orientation talk. They gathered in a classroom at the school, surrounded by small desks and kids’ drawings on the walls. At the end, the principal opened the floor to questions. Wu raised his hand and voiced his concerns about what Taiwanese schooling might do to his son’s vision. “Under your education system, will he become myopic or not?” Other hands started going up. One woman had a daughter in the third grade who was already minus 2 diopters, and she feared for her son. Wu saw a chance to put Morgan’s theory into action. At the time, the Taiwanese government was encouraging schools to switch the classroom lights off and send kids outside during breaks—to save electricity, not eyes. Wu convinced the principal of his son’s school to go further and usher the children outside six times a day, which added up to an extra six and a half hours of outdoor time each week. When Wu took measurements at the start of the program, in February 2009, the myopia prevalence among 7- to 11-year-olds at both his son’s school and another school, which he used as a control for his experiment, was around 48 percent. A year later, the control school had almost twice the rate of new cases of myopia as his son’s school. Wu began to preach the gospel of outdoor time, appearing in the media and touring rural Taiwan. On many of the stops, Wu, on guitar, and his wife, on keys, play their own renditions of pop songs with new lyrics about myopia prevention. (A recent effort turned “Despacito” into a ballad about atropine). He wrote a book, Kids Could Be Free From Myopia, outlining the principles of good eye health and how he applied them to slow the progression of myopia in his own young children. “Sometimes,” he says, “we don’t appreciate the free things.” Wu also worked on translating his research findings into a simple program that could be rolled out across the country. To do that, he needed to know how much time kids should spend outdoors. Wu thought back to Ian Morgan’s research, which had found that Australian kids spent an average of 13.5 hours a week outside. Another study suggested 14 hours. And so two hours a day became the cornerstone of Taiwan’s national myopia strategy, launched in 2010. It’s called Tian-Tian 120, which translates to “every day 120,” for the number of minutes children should spend outside each day. At Mingde Elementary School in Kaohsiung, I watched as muzak blasted over the speakers and kids of all ages came streaming outside in their uniforms, grabbing balls and jump ropes. As the school’s principal, Ching-Sheng Chen, proudly showed off the array of outdoor equipment, a boy who couldn’t have been much older than 7 grabbed a unicycle and began riding laps around the playing field. At another school in northeast Taiwan, known for its changeable weather, the playground has been equipped with a giant covered area called “Sunny Square” so the kids can still spend time outdoors when it’s raining. The results of the Tian-Tian 120 program were immediate and impressive. After years of trending upwards, myopia prevalence among Taiwanese primary school children peaked in 2011 at 50 percent, and then started to come down. Within a few years, it was at 46.1 percent. “You can see this very beautiful curve,” Wu says. ILLUSTRATION: VANILLA CHI In 2014, a young ophthalmologist in Yilan County, on Taiwan’s rugged northeast coast, began a project that he hoped would eradicate high myopia entirely. Der-Chong Tsai—who wears round black frames and a white lab coat and shares Wu’s earnest energy—first became interested in eye health while training at Taiwan’s National Defense Medical Center. From there, he worked at Taipei Veterans General Hospital, and he’d come across Wu’s and Morgan’s work on nearsightedness after completing a PhD in epidemiology in the early 2010s. He was impressed but had a hunch that intervening even earlier than primary school could make a significant difference—not only to slow down the progression of myopia, but to try and stop it from taking hold in the first place. It’s been found that for every year the onset of myopia is delayed, the ultimate severity of the condition is reduced by 0.75 diopters—catch it early enough, and you might be able to prevent a kid from ever needing glasses. “We thought primary school was too late,” Tsai said. “In terms of myopia prevention, the earlier the better.” Taiwan finally seemed to be getting the upper hand in its long fight against myopia. Then Covid hit, and Wu’s beautiful curve began to invert. Yilan County now runs one of the most ambitious myopia prevention programs in the world. Each year, Tsai and his team visit every preschool in the region, running screening tests to look for what’s called “pre-myopia”—the earliest signs of the eyeball getting too long. Tsai wants to catch children whose eyes are already too long for their age—who may not have myopia yet, but who might be at higher risk once they start formal schooling. Today, Tsai screens more than 98 percent of preschoolers in Yilan County, and at a cost of just $13 per child, he’s found hundreds of cases of pre-myopia that wouldn’t have been spotted until much later, when it was more advanced. The children most at risk of developing myopia are prescribed atropine alongside their time outdoors, and the results have been spectacular. By the end of 2016, after two years, the Yilan program had driven down the prevalence of myopia in the region by 5 percentage points. Between the Tian-Tian 120 initiative, aimed at older kids, and the Yilan program, Taiwan finally seemed to be getting the upper hand in its long fight against myopia. Then Covid hit, and a whole generation of kids were stuck inside for months at a time. Studies show that in China, Turkey, Hong Kong, and India, myopia worsened during the Covid lockdowns. Taiwan was no exception: Wu’s beautiful curve began to invert. In March 2023, Taiwan lifted its final pandemic restriction, allowing international travelers to visit without having to quarantine. I arrived there half-expecting some mythical Land of the Blind scenario: pavements populated by people with white sticks stumbling into everything, a pair of glasses perched on every nose. It wasn’t like that, of course. Although there were seven eyewear shops within a 10-minute walk of my hotel in Kaohsiung, and the stylized eye logos of oculists all around, like the eerie billboard from The Great Gatsby. There are long-standing cultural forces driving Taiwan’s myopia boom—the emphasis on education and a notion that paler skin is more attractive both conspire to keep people inside. Navigating the organized chaos of traffic snarls in cities like Taipei and Kaohsiung, I couldn’t help but think how difficult it would be for someone with impaired vision to get around, and how challenging it is to find safe outdoor spaces for children to play in the sun in such a dense metropolis. But the pandemic has entrenched what was already a global problem. On our current trajectory, viral diseases, air pollution, and extreme heat are just some of the things that will continue to keep young children indoors. By 2050, according to the International Myopia Institute, 10 percent of the world’s population will have high myopia, and up to 70 percent of them will have pathologic myopia—the kind that causes blindness. That’s as many as 680 million people affected by vision loss or blindness, with catastrophic effects for economies and health care systems. In that sense, Taiwan’s myopia boom is a blurry glimpse of a potentially blurred future: one where technology has to compensate for the societal changes that are driving nearsightedness. Ian Morgan has been involved in prototypes of glass-walled classrooms in China, enabling children to get the benefit of time outdoors without having to cut back on education. Other research suggests that shining a bright red light directly into the eye with a special machine may slow the progression of myopia. But many of the existing treatments are expensive, and they don’t work for everyone. Some ophthalmologists predict a future where bad eyesight, like crooked teeth, becomes a marker of an impoverished childhood. Others argue that myopia prevention should be publicly funded—that, like programs to encourage people to quit smoking or exercise regularly, a little funding now will save a lot in the future. “Prevention is better than cure,” is one of Pei-Chang Wu’s mantras. While children in Taiwan’s Yilan County experienced the pandemic years much the same as kids everywhere—less time outdoors and more time watching screens—intervening when children are quite young has proven to be the best strategy: Across the county, myopia rates in preschoolers remained stable throughout the lockdowns. Technology and industrialization may have contributed to the myopia problem, but sometimes the best solutions are cheap and simple. Just go outside, and see. Let us know what you think about this article. Submit a letter to the editor at mail@wired.com.
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2023.09.10 21:42 Question_of_lust Samsung. From the point of Xiaomi fan.

Samsung. From the point of Xiaomi fan.
https://preview.redd.it/0zop5i7j9hnb1.jpg?width=3840&format=pjpg&auto=webp&s=83129f4d1109585128004fda5cb0f627b2f23a95
Devices specs:
  • Samsung Galaxy s22 Ultra 5g, SM-908O (Hong Kong), OneUI 5.0 (Build Number: S9080ZHS2BWA2), Android 13
  • Xiaomi mi note 10 Pro (or cc9 Pro), MIUI 13.0.3 stable (RFDRUXM), Android 11
I decided to write down story about me experience of switching between Xiaomi mi note 10 Pro and Samsung Galaxy s22 Ultra 5g. Because to my surprise I stumbled upon things I never thought of. And I assume that my experience will be helpful for someone. Never the less I do not regret my transition, but this process could be less “painful” if I was more attentive to details during before buying stuff.
Yes, I will compare flagship Samsung device with so called “photo flagship” Xiaomi and the first one will lose. But not because it is so bad, but because different companies implement the same things in different ways.
After spending about 7-9 years on Xiaomi, I managed to get used to the functions, which, as it turns out, many people do not even think about. Therefore, at first it was difficult to adapt to some decisions of the Korean company. But I do not want to say that Samsung is a bad device. It is just different. And this is a story about how people tend to compare everything old with everything new and say that old was better.
Xiaomi on the screenshots will be on the left or on top with blue marks. Samsung, respectively, on the right or bottom with yellow marks.

1) Camera

I'll start with what I could have discovered at the stage of "going to the store to hold it in my hands", but recklessly did not pay attention to it.
Xiaomi (and as far as I know all of them) have such an option as a constant flash. For those who do not know (and among my friends there were some), this is when the flash works like a flashlight, and at this time you can adjust the focus, exposure and other parameters. This option can be encountered when recording a video. And I never thought that you can not want to create such a button. But in Samsung, apparently, engineers or programmers did not think about this option so there is none. You will say: "You can download a third-party application." And I will answer: "Yes, you can." But now I'm talking about stock features that limit the user in such a strange way.
xiaomi/samsung
The next interesting point is 108MP. The thing itself is situational, but since it exists, it is worth mentioning. In Xiaomi, this mode was turned on with one movement - by scrolling the screen in the direction you set it. And that is all, after that you can shoot. Samsung has gone a little further, and unless you intend to ever change the aspect ratio of your photos, you won't find this mode. Here it is called [3:4]108MP and is hidden in the mentioned menu, and in order to shoot very beautifully, you need to additionally press the “Detail enhancer” button. If you calculate all this, you get 3 taps on the screen versus 1 for Xiaomi. Is it critical? — no. But we have what we have. Xiaomi was fast for taking high quality pictures, while Samsung is to slow (in the context of some scenarios). If you just need to take a photo of a landscape everything is fine, but I like taking pictures of birds flying and I need to be fast. (The 1x camera suits me for this, but for me this fact was worth mentioning)
xiaomi
samsung
And, according to my feelings, Samsung somehow processes the picture differently regardless of the “Detail enhancer”, which, by the way, can sometimes go too far and add too much sharpness.
In addition, in Pro mode, 108MP is not available (available in Xiaomi).
Now a little about the ultra-wide camera. It doesn't have flash. At all. And this is built into the system, so even the good old GCam does not save the situation (well, either you have to prescribe the entire configuration yourself). It's just sad. I suppose that Samsung thinks that 0.6x is only for daytime architecture, but the guys obviously forgot about macro. Interestingly, there is a way out of this situation and it is proposed by the camera application itself, although it is implemented, as for me, very controversially. So here is the thing:
If you bring the subject close enough to the camera, then it will offer to turn on the “Focus enhancer”. And now, with this mode turned on, the camera itself will switch to the 0.6x lens and at the same time leave the opportunity to turn on the flash, because technically you are in 1x mode.
Focus enhancer
It all sounds, you see, very strange, but at least it works, right?
The last thing I'll talk about here is the Pro mode. There is really nothing bad to say about it, these are just observations.
For Pro shooting, there are 2 options: either a stock application, or an additional application from Samsung - Expert RAW. I did not notice any cardinal difference in the quality of the photo, but I will not say with a 100% guarantee. The applications are absolutely identical except for a couple of points: if you want to know which stars you are shooting, then Expert RAW has a star map built in (really cool feature), it also has a multiple exposure mode and you can save settings presets. That's all. Why it was impossible to fit all this into the stock application, I do not understand. Nevertheless, if you are not going to use the modes described above, then most likely you do not need Expert RAW, because the standard functionality will be very enough for lovers of camera settings.
But despite my admiration for the star map, there is something that upsets me about Expert RAW: the S pen cannot be used to release the shutter, although everything works in Pro mode of the stock application. The absence of this functionality remains a mystery to me.

2) Alarms

I never thought that I would be dissatisfied with the alarm function, but Samsung excelled here too(for me at least). Sometimes I turn off my phone at night, sometimes not (an old habit), but when I do, I know that my Xiaomi will turn on to play the introductory music to the next episode of the series about my life. And I really thought everyone did that. But no. One fine day, I decided to turn off Samsung for the night and woke up in the morning with the device still turned off. And I was just lucky that there was someone to wake me up that day. After this incident, I learned from my friends that their phones do this too and was quite surprised that I was the only one complaining about it.

3) More settings for more settings

Xiaomi, unlike Samsung, had the ability to satisfy any of my desires regarding the customization of different settings. I won’t list everything, but here are 2 things surprised me the most:
The first is deleting screenshots. If you are used to the fact that you can quickly delete an erroneous screenshot without going to the gallery, then I have bad news for you - Samsung has come up with this only for users of the GoodLock application with the NiceShot addon. If you download it, you'll get access to the "add delete button" toggle to your screenshot toolbar. Until then, take the long road through the gallery.
Secondly, you cannot change the sound of individual applications (a stupid but understandable example - here I am and I want to watch YouTube with quiet music, and you can make the music quieter only with YouTube together). For this you need to download the Sound assistant app. While in Xiaomi this feature could be found in the standard settings application.
xiaomi multisound
samsung multisound
In addition to the above, I installed applications for additional settings for the S pen (this one I found mostly useless some time after), camera and themes (because the size of the icons can only be changed there).
Considering that I have a 512GB version, it’s not too painful not to delete all of them, but for those who have less memory, it can be more difficult, because the system here consumes about 60GB of storage (numbers might differ depending on the version). And this is not a little, I tell you, especially considering that MIUI takes 6 times less (~10GB for 256GB version).

4) And the rest

The following points cannot be classified as global, but I would like to mention them.
Flashlight. The way you turned it on is the way to turn it off. Again, only the guys from Xiaomi thought of tying flashlight shutdown to the power button.
AOD. The flexibility of settings is sometimes pleasing, and sometimes depressing. It's nice that there is a large selection of watches and you can put GIFs, but the meager choice of colors for text is frustrating. Compared, again, with Xiaomi. (also I liked some of Xiaomi kaleidoscopes and fancy clocks and I just miss them sometimes)
Notifications. Unless it's brief pop-up style your notifications will take up a large part of the screen (depending on the length of the notification) and leave a significant gap between the edge of the screen and the notification itself. In Xiaomi, in this case, there are “video tools” that can be enabled in any application and all notifications will be neatly minimized and not overlap the content on the screen.
xiaomi (above) / samsung (from below)
Usable screen area. Partially echoes the previous paragraph. For some reason, in landscape mode, the phone completely forgets that it has a large display and shifts the bottom menus (and sometimes the top ones) away from the edge. At least it doesn't look very nice. As I later found out, it is Gesture hint responsible for this and if you remove it my claims will also disappear. I will mention that it can also be made transparent and it will, as it were, climb onto the interface of an opened application, but for this you will need the GoodLock, which does not work in some regions.
gesture hint example
Pop-up application mode. This thing turned out to be very unintuitive at first and still sometimes raises questions, although I got used to it. And the first thing I want to note is the size of these windows and the ratio of their contents to it, and the second is controlling.
In Xiaomi, the application can be opened in pop-up mode either through the recent menu or through the above-mentioned “video tools”. And the app will look like it's just open on a smaller screen, i.e. all proportions will be preserved. Management is just as simple: slide up - it closed, brought it to the upper corner - it became even smaller and does not interfere.
xiaomi (above) / samsung (from below)
In Samsung, the mode is also opened through the recent menu, or the edge panel. Everything is fine here, except that in landscape mode the edge panel is not available. But not all applications have been optimized for it, and if everything is fine with the explorer, then the Telegram increases the font size so that it becomes simply inconvenient to read.
xiaomi (above) / samsung (from below)
There are 2 options for controlling this: either the menu on top, which also wants to take part of the already strange window, or the disappearing menu, which you can find by clicking on top and which I eventually chose.
https://preview.redd.it/369zjm3vchnb1.jpg?width=2880&format=pjpg&auto=webp&s=0e6524c09c6856f2e15b723fae5a058aaf84f1f1

Conclusion

What conclusion would I like to draw from this? For the conservative Xiaomi user(aka me), Samsung was full of surprises.
Would I buy this device if I knew about all this in advance? - Yes. Because everything described is actually little things that you can get used to within a couple of months and stop noticing. And you can read about the advantages in a huge number of reviews.
This article is written solely to get acquainted with the differences between the two systems, and its purpose is to describe things many people do not pay attention to, because it simply exists or simply does not exist.
After 9+ months of using Samsung, I can say that this transition was worth it, all my frustrations described above have been forgotten and now that I have everything set up the way I like, I really enjoy the S22 Ultra.
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2023.09.04 02:42 kai_mazz Folate toxicity

25F
para 3 gravida 4
Hx: Adhd Amplified muscuskeletal pain syndrome Anxiety Concealed placental abruption Depression Inflammatory arthritis Gestational diabetes Gestational hypertension(not preeclampsia Maternal tachycardia Undifferentiated connective tissue disease
Medications:
  1. Adderall 5-10mg twice daily
  2. Folic acid 1mg daily
  3. Hydroxychlorquine 200mg twice daily
  4. Wellbutrin 450mg daily Night meds
  5. Lyrica 150mg nightly
  6. Buspar 15mg nightly
  7. Methotrexate 20mg once weekly PRN medications
  8. Cyclobenzaprine 10mg as needed for muscle spasms
Relevant rheum info: Ana positive 1:160 speckled and homogenous patterns, Ena positive anticentromere antibodies 1.9. Vitamin-D 20, vitamin b-12 350 all other labs unremarkable
Family history
Paternal: congential heart defect-bi cuspid aortic valve Hypertension Paternal grandfather: Hypertension Lung cancer Paternal grandmother: Arthritis Periventeicular nodular heterotopia Biological sister: Antiphopholipid syndrome Lupus Rheumatoid arthritis Periventeicular nodular heterotopia Maternal: Bradycardia Hypotension Maternal grandfather: First stroke at 40 5 stents placed by age 49 Died from MI at 49 Maternal aunt: Hypertension First stroke at 39
Rheumatological issues first began presenting over time as: 4/22 New onset raynauds 4/22 Chest pain 4/22Tachycardia 5/22 Livedo reticularis 5/22 Shortness of breath 6/22 Muscle weakness in big muscle groups 7/22 Malar rash
48hr holter Min heart rate: 71 Max heart rate: 154 Tachycardia burden: 31%
Pft TLC: 125.81% of predicted (7.69L) RV: 150.83% of predicted (2.51L) Hyperinflation with air trapping without evidence of obstruction
I was prescribed 20mg weekly of methotrexate and with it prescribed 1mg daily of folic acid. Rheumatologist explained the importance of taking folic acid in addition to the methotrexate to prevent hair loss and unpleasant GI side effects.
After a host of recent issues, my primary decided to test my folate level to see if it was a contributing factor which to both of our surprises came back high at >40.0 ng/ml (7.0-31.4). I was supposed to follow up with her but due to her having a personal emergency I saw a different provider in her office who was very honest about being just as perplexed about the situation. He also told me he did not know if I should discontinue the folic acid or continue taking it until I see my rheumatologist next.
My concern is that over the last several months I haven’t been getting the same relief as I have had from the methotrexate and rheumatology said they cannot increase the dose further and we are looking at adding a biologic to the mix.
From my very very basic understanding methotrexate works by eating up the folic acid/folate so that inflammation can’t be perpetuated and often results in low blood folate levels hence the prescription for the vitamin in conjunction with the methotrexate and why my primary wanted to check to see if I was having side effects from a low folate level.
Is this a normal occurrence? Could the high folate be causing the methotrexate to be ineffective? What could possibly be causing this to happen?
Please reach out if any further info is needed/wanted
Thank you 😊
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2023.08.30 16:10 normanboyster NURS 6050 – Policy And Advocacy For Improving Population Health

In today’s rapidly changing healthcare system, political decisions affect the future of health delivery systems, healthcare professionals, and the populations they serve. Students will examine the policy-making process and its effect on healthcare delivery, cost, quality, and access. Students consider the importance of bringing healthcare issues to the forefront of the federal and state agendas, the governmental response through legislation and regulation, and the areas in which they can advocate for positive outcomes in program/policy design, implementation, and evaluation. Global health issues are analyzed for their relevance and impact on the nurse advocate’s development. Students demonstrate the integration of policy decision-making into professional nurse practice for the benefit of individuals and populations through discussions, reflection, case studies, and professional communications techniques as political tactics to influence policy outcomes.

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Prerequisites
MSN Nurse Practitioner Specializations
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NURS 6002N or NURS 6003N
MSN Other Specializations
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NURS 6002 or NURS 6003
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NURS 6050 Curriculum & Program Development (3 Credits)
Curriculum development and program development in nursing are dynamic and ever-changing processes. Individual courses in a nursing program of study represent a whole integrative curriculum responsive to internal and external stakeholders. This graduate-level course examines the history, development, and future trends in the nursing education curriculum. The course focuses on curriculum development, which includes the creation of an undergraduate or graduate nursing program of study. An in-depth examination of professional nurses’ evaluation and accreditation processes is provided. Asynchronous discussions and collaborative learning activities will facilitate dialogue about curriculum development and evaluation. This course was previously NUR-560000
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NURS 6050 - Policy and Advocacy for Improving Population Health
NURS 6050 – Policy and Advocacy for Improving Population Health
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Policy and Advocacy for Improving Population Health Care (NURS 6050)
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To Get Ready:
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Examine the resources and consider the mission of state/regional boards of nursing, which is to protect the public through the regulation of the nursing practice.
Consider how essential regulations may affect nursing practice.
Examine key nursing practice regulations from your state’s/board region’s of nursing and those from at least one other state/region, and choose at least two APRN regulations to focus on for this Discussion.
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Compare at least two APRN boards of nursing regulations in your state/region to those in at least one other state/region. Explain how they may differ. Provide specifics and examples. Then, please explain how the regulations you chose might apply to Advanced Practice Registered Nurses (APRNs) who have the legal authority to practice within their education and experience. Give at least one example of how APRNs can follow the two regulations you chose. Policy and Advocacy for Improving Population Health Care (NURS 6050)
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NURS – 6050N Policy and Advocacy for Improving Population Health
Each state board of nursing has the authority to impose regulatory restrictions to protect the public. It was interesting to look through the state regulations and how they differed while deciding to return to school for an advanced practice degree. I live in rural Northwest Missouri, about thirty minutes from the Iowa border. The nurse licensure compact, which all states surrounding Missouri are a part of, allows nurses to practice in multiple states as an RN (Nurse Licensure Compact, 2020). Unfortunately, after obtaining my PMHNP, I discovered that the regulations in Missouri and Iowa differ quite a bit.
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To begin, Iowa allows nurse practitioners to practice independently within the scope of their degree specialty, which is known as full-scope practice. In Iowa, an APRN may prescribe medications to patients with the nurses’ specialty and independently prescribe controlled substances up to level two as long as they have a current license and are registered with the controlled substance acts (Iowa Board of Nursing, 2020). The APRN must have a collaborative practice agreement with a physician to see patients in Missouri. Furthermore, unless stated explicitly in the joint practice agreement, nurse practitioners are not permitted to prescribe controlled substances. The APRN must have prescription authority, proof of 300 hours of precepted pharmacological experience, and 1,000 practice hours if specified (Board of Nursing, 2020).
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Another distinction between Iowa and Missouri is the authorization signature required for a patient to obtain a medical marijuana identification card. The medical diagnosis requirements for the use of medical marijuana remain consistent across states. However, in Missouri, a nurse practitioner cannot sign the authorization form (Board of Nursing, 2020). Nurse practitioners, physician assistants, MD/DOs, and podiatrists are permitted by Iowa law to sign the health care practitioner attestation (Iowa Board of Nursing, 2020).

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​
References
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(2020). Retrieved from Iowa Board of Nursing : https://nursing.iowa.gov/
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Board of Nursing . (2020). Retrieved from Missouri Division of Professional Registration: https://www.pr.mo.gov/nursing.asp
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Nurse Licensure Compact. (2020). Retrieved from NCSBN: https://www.ncsbn.org/nurse-licensure-compact.htm.
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NURS 6050: Improving Population Health Through Policy and Advocacy
Regulations of the Board of Nursing
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For a long time, advanced practice registered nurses (APRNs) in Michigan have been fighting for full prescribing authority. The state of Michigan does not have a nursing practice act. Instead, APRNs are governed by the Public Health Code 1978, which also governs 25 other health professions (Nurse Practitioner Schools, 2020). With the passage of MI HB 5400 in 2017, Michigan nurses celebrated a victory. This bill empowers Michigan APRNs to prescribe non-scheduled medications, perform hospital rounds, make independent house calls, and order speech and physical therapy without the involvement of a collaborating physician. They still require the collaboration of a collaborating physician to prescribe controlled substances in schedules two through five. As a delegated act, controlled prescriptions require the physician’s and APRN’s names and their DEA registration numbers (Michigan Legislature, 2017). On the other hand, Minnesota’s APRNs have full prescribing authority (Minnesota Board of Nursing, n.d.). They can prescribe any medication, controlled or not, without the involvement of a collaborating physician. They also have complete freedom to practice without the supervision of a collaborating physician. A collaborating practice agreement is not required.
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Giving APRNs the legal authority to practice within their education and experience will help alleviate the healthcare provider shortage, lower healthcare costs, increase patient access to care, and allow APRNs to fully utilize their knowledge and skills (Nurse Practitioner Schools, 2020). As members of the collaborative healthcare team, APRNs must continue to fight for their rights. To ensure continued progress toward this goal, APRNs must participate in the political process (Milstead & Short, 2019).
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APRNs in Michigan can comply with MI HB 5400 by learning about the specific changes to the regulations. They must renew their collaborating agreement on an annual basis or whenever there are changes to the agreement. It is critical to understand which medications are considered controlled and uncontrolled and the schedules. To combat the opioid epidemic, Michigan, for example, made gabapentin a schedule five controlled substance in 2019. (Department of Licensing and Regulatory Affairs, 2019).
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References
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Department of Licensing and Regulatory Affairs. (2019, January 9). Gabapentin scheduled as controlled substance to help with state’s opioid epidemic. https://michigan.gov/lara/4601,7-154-11472-487050-00.html
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Michigan Legislature. (2017, April 9). Public Health Code Act 368 of 1978: 333.17211a
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Advanced practice registered nurse; authority to prescribe nonscheduled prescription
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drug or controlled substance. https://legislature.mi.gov/(S(au34kb10nbx0fbhmhac50qc)))/
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Milstead, J.A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
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Burlington, MA: Jones & Bartlett Learning
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Minnesota Board of Nursing. (n.d.). Advanced practice registered nurse (APRN) licensed
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general information. https://mn.gov/boards/nursing/advanced-practice/-practice-registered-nurse-(aprn)-licensure-general-information/-licensure-general-information/)
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Nurse Practitioner Schools. (2020, October 26). Michigan nurse practitioners: The fight for full
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practice authority. https://nursepractitionerschools.com/blog/michigan-np-practice-
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authority/
NURSING 6051:
To Get Ready:
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Examine the resources and think about the web article Big Data Means Big Potential, Big Challenges for Nurse Executives.
Consider your own experience with complex health information access and management and potential challenges and risks you may have encountered or witnessed.
BY DAY 3 OF WEEK 5
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Post an explanation of at least one potential benefit of using big data as part of a clinical system. Then, explain why you believe at least one potential challenge or risk of using big data as part of a clinical system exists. Propose at least one strategy that you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using the big data you described. Provide specifics and examples.
RE: Discussion – Week 5
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Big Data Risks and Rewards
Data interpretation occurs at all times of the day, whether a person is aware of it or not. If a large pool of data is integrated in a meaningful way, it can be extremely useful. According to Wang et al. (2018), Pooling big data can “improve the quality and accuracy of clinical decisions.” Profit is always the goal where I work, and probably in any healthcare facility. When our chief financial officer (CFO) and admissions team send out their weekly forecast, I see data that they use. This chart displays how many patients are being discharged, how many new patients are expected, and our current census. Having the data organized is critical because it shows the admission coordinator if more outreach is needed to bring in new patients. It also shows them whether we have enough beds to accommodate the influx of new patients. It is directly relevant to me because it is used for staffing requirements. This data is critical to the operation, but it wouldn’t be as useful if it hadn’t been aggregated into a concise template for quick access to the information (Thew, 2016).

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However, there are risks to combining large amounts of data. As more data is collected, the organization’s storage requirements will grow. Storage has a cost, and lowering those costs may jeopardize patient privacy (Wang et al., 2018). Our company’s computer system was recently infected with ransomware. Having all of our data in one place turned out to be a bad idea. The confidentiality of our patients’ and employees’ information had been jeopardized. It is critical to have proper IT security in place when dealing with large amounts of data. An intriguing idea for reducing the risk of ransomware recurrence is to divide data into blocks that are distributed across multiple virtual servers (Levitin, 2019). By hacking into a single database or server, the attacker would not have access to the data. In addition to dividing the data, an early warning detection system would be helpful in detecting a breach (Levitin, 2019).
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The risks and benefits of big data aggregation are well documented. Data can be collected and stored securely, ensuring patient and user confidentiality by mitigating some risks by increasing security protocols.
References
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Levitin, G., Xing, L., & Huang, H.-Z. (2019). Security of Separated Data in Cloud Systems with Competing Attack Detection and Data Theft Processes. Risk Analysis : An Official Publication of the Society for Risk Analysis, 39(4), 846–858. https://doi-org.ezp.waldenulibrary.org/10.1111/ris…
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Thew, J. (2016). Big data means big potential, challenges for nurse execs. Retrieved December 27, 2020 from https://www.healthleadersmedia.com/nursing/big-dat…
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Wang, Y., Kung, L., & Byrd, T.A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3-13.
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RE: Discussion – Week 5
Big data sets are examined by information professionals, particularly in the hospital setting, for budgeting, staffing, patient admissions and discharges, etc. Data can be computed for all areas that aid inefficient operation. According to Tishgart (2012), more data means more knowledge and opportunities for organizations to use and benefit from that data. McGonigle and Mastrian (2018) This is partially true because the goal of storing this data is to learn and improve, but there are always risks when dealing with technology and large amounts of data.
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Some advantages of using big data in a clinical system include improved patient outcomes, as big data allows us to see what is working well for our patients and where we are falling short. If med errors or patient incidents occur frequently, big data sets can help see a bigger picture of what is causing these issues, such as noticing that these incidents occur on days when the floor is understaffed. Another advantage of big data is that it helps with budgeting because even though we are there to care for patients, we are still a business that needs to profit. Big data sets can show where budget cuts are required and which departments require more funding to run efficiently.
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Errors and setbacks are possible whenever technology is involved. One disadvantage of big data sets is the possibility of a security breach. In 2016, my workplace was the victim of a cyber attack in which patient and employee information was compromised. In exchange for the computer system, the hackers demanded a ransom. We operated under the Emergency Operations Plan during this time, and paper charting was used. Since then, the organization has upgraded security measures and made changes to email and internet access to accommodate the transition. All employees received training on how to avoid phishing and ransomware and how to identify potential threats. Homomorphic encryption can be used to prevent third parties from accessing data and storing data across multiple servers to make sensitive information more difficult to access. Policy and Advocacy for Improving Population Health Care (NURS 6050)
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References
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McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
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Thew, J. (2016, April 19). Big data means big potential, challenges for nurse execs. Retrieved from https://www.healthleadersmedia.com/nursing/big-dat…
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Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understand its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3-13.
​

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2023.08.27 19:38 EasyFlaccid The link between Pelvic Floor Dysfunction, Hard Flaccid Syndrome, Chronic Pelvic Pain Syndrome, Post-SSRI Sexual Dysfunction, Post Finasteride Syndrome and advice on how to start your healing journey based on 8 years of research and personal experiences

Here are all my thoughts and advice based on my personal experiences, other people’s insight and helpful experiences, and research I have done on and off about pelvic floor issues from the past eight years or so. There is still a lot left to learn, but I am putting everything I know currently here. I am not claiming that any of this is revolutionary, but I hope it can help some of you out there to give you a headstart on healing and advance our understanding of these conditions. As I am a 27 year old male with previous major problems with pelvic floor issues and hard flaccid, some of my advice may be biased towards my condition. However, I believe everyone can benefit from a lot of this because I really do think that all of these conditions that I mentioned are linked in at least some way, especially by pelvic floor dysfunction and sex hormone desensitization. I try not to come to these forums because it increases anxiety and negative emotions which leads to worse pelvic floor symptoms, so my apologies if I do not respond to your questions. For hard flaccid and pelvic floor affected people, follow my advice and I am confident you can heal and reach a place where your symptoms barely affect your life, if at all, which is where I am at now. The mentality of trying to find a 100% “magic cure” solution just leads to anxiety and catastrophic thinking if you have a set back which will only worsen your symptoms. You can and will heal. I know this is a lot of information, but try to implement just one or two things at a time. Focus on the present, and take it one day at a time. Don’t get overwhelmed.
Post Finasteride Syndrome (PFS), Post-SSRI Sexual Dysfunction (PSSD), Hard Flaccid Syndrome (HFS), Pelvic Floor Dysfunction, and Chronic Pelvic Pain Syndrome all can have some similar symptoms. I believe that they are all either caused or can be exacerbated by androgen and estrogen receptor insensitivity and are triggered by medication, genital injury, and pelvic floor inflammation and dysfunction. The pelvic floor is rich in androgen receptors and estrogen receptors. However, without proper androgen receptor activation and sensitivity, the pelvic floor muscles don’t have enough DHT which line the tissues of the pelvic floor, genitalia, and lower urinary tract. DHT is vital for healthy sexual functioning in both sexes - it provides an anabolic effect to tissues to provide strength, stability, healing, and relaxation to tissues. As a result of androgen receptor insensitivity and lack of DHT, the pelvic floor can become chronically weakened, tight, and inflamed which reduces blood flow to the region leading to even more androgen receptor insensitivity and thus less DHT. These symptoms can cause psychological stress to the individual which tightens the pelvic floor further leading to more symptoms and less blood flow. One study found that androgen sensitivity has raised the possibility that androgens can be used to rebuild the weakened and/or damaged muscles comprising the pelvic floor - source. Some people may also have normal sex hormone levels in the blood when tested, but these hormones cannot reach or be effective in the pelvic floor tissues or brain due to sex hormone insensitivity and the lack of the blood flow in the region caused by pelvic floor tightness and dysfunction.
Desensitized estrogen receptors leading to decreased estrogen levels in local pelvic floor and genital tissues may be causing a similar mechanism of dysfunction in some people like androgen receptor insensitivity and DHT because estrogen is important for pelvic floor and sexual health in both sexes. This study says that “Estradiol in men is essential for modulating libido, erectile function, and spermatogenesis. Estrogen receptors, as well as aromatase, the enzyme that converts testosterone to estrogen, are abundant in brain, penis, and testis, organs important for sexual function. In the brain, estradiol synthesis is increased in areas related to sexual arousal. In addition, in the penis, estrogen receptors are found throughout the corpus cavernosum with high concentration around neurovascular bundles.” Steroid users report that low estrogen causes decreased or numb penile sensitivity, shrunken flaccid penis, dull orgasm, urinary hesitancy, urinary frequency, low sex drive, and erectile dysfunction. Here is a paper from a PSSD community member that hypothesizes, as do an increasing amount of people, that the main issue of PSSD, PFS, and Post-Retinoid Sexual Dysfunction is estrogen receptor insensitivity. PSSD and PFS sufferers often have similar hard flaccid and pelvic floor issues, so if those conditions are caused by estrogen insensitivity, then perhaps our pelvic floor dysfunction, HFS, and CPPS, is also impacted by a lack of estrogens in the pelvic floor tissues, not just androgens. The most important element to remember to help start the healing process for these disorders is to boost blood flow through supplements, stretches, and exercises which will increase both androgen and estrogen receptor sensitivity over time.
Post Finasteride Syndrome (PFS) caused by Finasteride, a 5-alpha-reductase inhibitor (5-ARI), plummets DHT levels in the body to try to help hair loss causing sexual dysfunction and pelvic floor issues. Androgen receptors that surround the pelvic floor, genitals, and brain become desensitized due to the Finasteride leading to less DHT binding to these receptors causing dysfunction and a tight, weak pelvic floor. The tight, dysfunctional pelvic floor now restricts blood flow which impacts healing and the delivery of testosterone to this area that further exacerbates androgen insensitivity leading to less DHT in these tissues. Since androgen receptors are found in the brain and androgens have neuroprotective effects, this could be one reason why some PFS and PSSD sufferers are also impacted cognitively. An herbal supplement called Saw Palmetto has also been reported to cause a disorder similar to PFS because it is also a 5-ARI that blocks the conversion of testosterone into DHT. Another disorder called Post Accutane Syndrome (PAS) is also similar to PFS and it reduces DHT as well through being a 5-AR.
For Post-SSRI Sexual Dysfunction (PSSD), SSRIs are also known to decrease androgens and down regulate androgen receptors. This study shows that SSRIs can have an anti-estrogenic effect as well and can even reduce the expression of estrogen receptors (ER), including in the hypothalamus.. As androgen and estrogen receptors get desensitized in the pelvic floor, genital region, and brain, it causes localized DHT and estrogen levels in these tissues to decrease causing emotional blunting, sexual dysfunction, pelvic floor issues, hard flaccid syndrome, and more. The pelvic floor dysfunction can then prevent the sex hormone receptors from being reactivated and sensitized in this area due to restricting oxygen and sex hormone rich blood flow to the tissues. SSRIs can cause androgen receptor insensitivity and estrogen receptor insensitivity by severely inhibiting the serotonin transporter (SERT) leading to increased serotonin levels which desensitizes those receptors throughout the body. It is also interesting that some PSSD community members are trying to restore estrogen receptor sensitivity via boosting estrogen in various ways including by taking hops extract which is a potent phytoestrogen. Check out the PSSD Network for more information on this condition as they are helping to give a voice to the unheard..
Hard Flaccid Syndrome (HFS) - There are many men suffering from HFS and pelvic floor issues due to PSSD, PFS, heavy weight lifting, excess kegeling, or in the case I’m presenting here, physical damage to the genitals from excessive, vigorous sexual activity (my case) or penis enlargement exercises. When the genitals get damaged, an inflammatory process starts and the pelvic floor contracts to protect itself. Since the pelvic floor is now in a chronic, contracted state, it limits oxygen and sex hormone rich blood flow to the genitals and pelvic floor which leads to sex hormone insensitivity and negatively impacts healing, muscle relaxation, and DHT production in these tissues. Finasteride, Accutane, and SSRIs also desensitize sex hormone receptors in the genitals and pelvic floor tissues leading to hard flaccid and pelvic floor dysfunction. Since the pelvic floor tightness restricts blood flow, it is difficult for hard flaccid sufferers to reactivate and sensitize their pelvic floor muscle androgen receptors again to regain relaxation and strength in their pelvic floor muscles, including the ischiocavernosus (IC), bulbocavernosus (BC), and pubococcygeus (PC) which are in a contracted state; the IC muscle in particular is thought to be the most implicated in the cause of hard flaccid. We first need to promote relaxation in the pelvic floor by boosting blood flow through supplements and stretches because tight muscles are weak muscles. Once the pelvic floor is in a chronic state of tension, it is hard to heal from pelvic floor issues because you likely already had bad habits such as poor posture, unhealthy sexual practices, stiff muscles, sedentary lifestyle, unchecked anxiety, and other negative lifestyle factors. Along with supplements, exercises, and stretches, correcting these bad habits is necessary to heal to have an even healthier pelvic floor than you ever had before because it likely was already tight and dysfunctional to begin with before developing obvious issues, but it was more subtle and you had no awareness of your pelvic floor muscles until now. You have the potential to now become a much healthier person overall than you ever would have been without being affected by pelvic floor dysfunction and hard flaccid.
32% of women will develop a pelvic floor disorder in their lifetime which is double that of men. While childbirth and pregnancy plays a role in this discrepancy, women also have far less testosterone and DHT levels than men which I believe plays a major factor. Since women have less testosterone, their androgen receptors that line the pelvic floor don’t make enough DHT to adequately support these tissues compared to men. This makes them more prone to pelvic floor dysfunction that causes them a disparate amount of pain, tightness, and inflammation. Androgen receptors and their ability to convert testosterone into DHT play such a vital role in pelvic floor health and sexual functioning. This is mentioned in a research study: Prevailing scientific literature has indicated the presence of androgen receptors in the levator ani muscle and pelvic fascia. The existence of androgen receptors in the vaginal wall can play an essential role in the development of pelvic floor disorders in women.Thus, androgen-related disorders may interfere with the function of pelvic floor muscles.. Many people mistakenly believe that androgens are only important for male sexual health: Androgens have a three-fold action on female sexual function. They (1) increase libido by providing the fuel for a woman’s psychosexual stimulation, (2) increase sensitivity and blood flow to the external genitalia, and (3) increase the intensity of sexual gratification..
What I see in all these conditions is that sex hormone receptors become desensitized in the pelvic floor and genital tissues either from a drug, pelvic tightness, or inflammation from injury leading to less localized sex hormones causing sexual and pelvic floor dysfunction. The pelvic floor now goes into a chronic tightened state as a response, leading to more inflammation and less oxygen and testosterone rich blood flow to the genital and pelvic region which leads to more androgen insensitivity and subsequently less DHT. This all explains why many people who have these conditions are helped by supplements that improve androgen receptor sensitivity and blood flow, and why pelvic floor therapy and exercises are so helpful to many of them. Estrogen receptor insensitivity in the pelvic floor also appears to have a similar mechanical negative effect by leading to less estrogen levels in the pelvic floor and genital tissues. It is also possible that some people with PSSD/PFS may have subtle or no pelvic floor symptoms, but the medication still desensitizes sex hormone sensitivity in their genitals and pelvic floor tissues that is leading to sexual dysfunction.
Another study linking androgens and the pelvic floor: Levator ani and other muscles of the pelvic floor and lower urinary tract are sensitive to the anabolic effects of testosterone. Androgen receptors are also expressed in the pelvic floor and lower urinary tract of both animals and humans. Anabolic effects of androgens may play an important role in the female pelvic-floor and lower-urinary-tract disorders. The action of androgens in the lower urinary tract and pelvic floor is complex and may depend on their anabolic effects, hormonal modulation, receptor expression, interaction with nitric oxide synthase, or a combination of these effects.
My solution to help heal and improve the well-being of people with these issues is to try to improve sex hormone receptor sensitivity and pelvic floor function through supplements, stretches, exercises, and boosting blood flow which will hopefully restore normal levels of estrogens and androgens in pelvic, genital, and brain tissues. The body has a tremendous capability of self-healing, but we need to support it through active recovery methods.
We will first start with supplements (this is not professional medical advice - talk with your doctor before taking):
L-citrulline - This is the precursor to l-arginine, and it will improve blood flow and levels of nitric oxide to help get oxygen and testosterone rich blood to the pelvic floor and genital tissues to increase androgen sensitivity. Nitric oxide can also induce smooth muscle relaxation which is important for relaxing the pelvic floor. Herein we report on a young man affected by PSSD who regained sexual functioning after 3-month treatment with EDOVIS, a dietary supplement containing L-citrulline and other commonly used aphrodisiacs.. I recommend taking at least 6000 mg daily by taking 2000mg three times throughout the day. The max dose is 10,000mg. Even potentially better, people report great results using Cialis to improve blood flow and healing rather than L-citrulline and some doctors will even prescribe it to women if you show them the evidence - talk with your doctor. “Tadalafil (Cialis) reversal of sexual dysfunction caused by serotonin enhancing medications in women”. L-Citrulline and Cialis are not recommended to be taken together.
L-Carnitine - This will improve the number of androgen receptors and their sensitivity to testosterone to increase levels of DHT in the pelvic floor, genital tissues, and brain. I recommend taking 2000mg daily. Acetyl-L-Carnitine can pass through the blood-brain barrier, while Propionyl-L-carnitine has a high degree of interaction with testosterone. Propionyl may be better for sexual and pelvic floor dysfunction, while Acetyl might help people suffering from the mental effects of PSSD. This study used each at 2000mg daily to improve erectile dysfunction along with Viagra.. I would work up to 2000mg each of Acetyl and Propionyl L-Carnitine along with Cialis instead of Viagra as it lasts in the body for much longer (36 hours) for increased blood flow healing purposes. You can also use L-Citrulline instead of Cialis as mentioned earlier. Discuss with your doctor before taking them.
Vitamin D - This vitamin, which acts more like a hormone, works directly with the endocrine system. It has its own receptors throughout the body and they are often in close proximity to androgen receptors. Deficiency in vitamin D is associated with a stunting of testosterone's effects on androgen receptors and a decline in testosterone levels. Vitamin D will encourage androgen receptor resensitization. One study found that higher vitamin D levels are associated with a decreased risk of pelvic floor disorders in women, and The levator ani and coccygeus muscles are skeletal muscles that are critical components of the pelvic floor and may be affected by vitamin D nutritional status. I recommend 4000IU of vitamin D daily or whatever gets your levels to 60 - 80 ng/ml. I would also take 100mcg of vitamin K2 to ensure that any excess calcium from vitamin D is deposited into the bones and not arteries.
Magnesium Glycinate - This will help relax your pelvic floor muscles to help restore function and blood flow. I recommend starting with 300mg.
If you have inflammatory issues or pain due to pelvic floor dysfunction, I recommend a fish oil supplement daily. I take fish oil, and I find that it helps limit pelvic inflammation. Take quercetin and bromelain as needed if you experience pelvic inflammatory flare ups, pain, and bladder issues, but just be careful as quercetin can also inhibit the production of DHT from testosterone as well. Some say fish oil blocks DHT too, but experiencing chronic pelvic floor pain and inflammation will do more harm to you than minimal DHT blocking.
I also recommend doing some form of yoga or pelvic floor stretches daily to improve blood flow for pelvic floor relaxation and sex hormone receptor sensitivity. You also need to request to see a pelvic floor therapist for an evaluation and treatment. Learn how to do reverse kegels. Doing reverse kegels will be difficult at first because your pelvic floor is tight and you have little to no awareness of these muscles, so just focus on lengthening and relaxing the pelvic floor through stretches for now. Do not do regular kegels for pelvic floor issues. Learn how to diaphragmatically breathe in 360 degrees to create expansion in your rib cage and abdomen to encourage pelvic floor relaxation. Do not breathe through your chest, and “belly breathing” isn’t the right term because the ribs need to expand as well. You can learn how to diaphragmatically breathe through an exercise such as 4-7-8 breathing. Here is a great video on diaphragmatic breathing and another video. Retraining yourself to properly breathe diaphragmatically is the single most important thing that you can do to heal from pelvic floor issues.
Stretches/Yoga poses I recommend:
Hold the Malasana/hindi/yoga squat pose for at least 5-10 minutes at least twice a day, but doing it morning, mid-day, and at night would be the best. Some get great results holding it for 15-20 minutes.This is one of the most important things for your pelvic floor because it will help lengthen and release it. Doing them barefoot is also very beneficial to strengthen your ankles and feet which are connected to your pelvic floor. Again, remember to breathe deeply down into your belly and pelvic floor for all these stretches.
Begin your stretching routine with an Exercise ball ab stretch and Upward-facing dog/cobra pose. This will help stretch your lower abs and psoas muscles so that you can get more breath deeper down into your pelvic floor for the rest of your stretches. Some people say that these types of stretches aren’t great for people who have Anterior Pelvic Tilt, which we should fix, but I still do them as it is important to stretch the lower abs that are hard to get to. You can experiment with doing them sporadically instead of every time you stretch.
This is my current personal complete stretch routine I do in order 3+ days a week:
Myofascial release on my glutes with an orb massage ball but you can use any small hard ball (don’t do this if glutes are currently sore) > Calf stretch against a wall or a yoga block which is what I use > exercise ball ab stretch > upward facing dog > (optional) Do a handful of cat cows > Supine hamstring stretch with yoga strap or an IdealStretch tool which is what I use > Kneeling hip flexor stretch > flat on back supine single knee to chest stretch > then bring knee to opposite shoulder stretch > supine figure four > I do this stretch next right after figure four > Reclined bound angle pose > (optional) butterfly stretch > (optional) A little bit of downward facing dog to stretch the calves > (optional) Lizard Pose) > (optional) Half split stretch/Half monkey pose with yoga blocks > Half-pigeon pose > Child’s pose > Wall quad hip flexor stretch > Wall figure four stretch > Wall straddle pose > Wall happy baby pose > Flat on back while pulling knees apart > kneeling with one leg, other leg out to side for adductors > (optional) Frog pose with feet together > regular Frog pose with feet separated in line with the knees > Yoga squat/malasana > Corpse pose
All these stretches are the ones I found most useful in a routine. See what works for you and develop your own routine. Consistency is the most important. This long stretching routine may not be possible for you to complete regularly so make adjustments, but doing this routine at least 3 days a week is ideal. Stretches such as the yoga squat, supine hamstring stretch, hip flexor stretches, and wall stretches are vital and should be done most days to help relax the pelvic floor. For how long you should hold each stretch, just go by how you and your body feels. Really let go, breathe, and sink into every stretch. On rest days, doing some deep breathing in child’s pose, reclined bound angle pose, flat on back while pulling knees apart, and the happy baby wall pose is really great while trying to do gentle reverse kegels.
You can also work on more individualized stretches for posture to correct anterior pelvic tilt, muscle imbalances, and to release other tight muscles, such as the upper body. Listen to your body if you need to give yourself a rest day from stretching. Adding in a 30-60 minute walk/swim on rest days is incredibly beneficial as well. Eventually, you can also try to learn isometric PNF stretching to incorporate it into some of the stretches such as the kneeling hip flexor stretch and hamstring stretch.
Exercises I recommend:
After working to relax and lengthen your pelvic floor through yoga and stretches, I would begin gentle body strengthening exercises that are pelvic floor safe. The pelvic floor is a master compensator. So, if the glutes, adductors, deep hip rotators, transversus abdominis, and other supportive muscles are weak, then the pelvic floor is in the prime position to pick up the slack which leads to a lot of strain on the pelvic floor which results in tightness and dysfunction. You need to strengthen the surrounding muscles to relieve tightness in the pelvic floor. This is where working with a pelvic floor therapist would be helpful to point out safe individualized exercises for you. Yoga will help strengthen your muscles in a safe way too.
The glutes and transversus abdominis in particular are very important to strengthen. Glute bridge, single glute bridge, side lying leg raises, lateral band walks can help build up glute strength. Deadbugs, Bird Dog, 8- point planks, or planks with pelvic floor-friendly modifications, can help to strengthen the transversus abdominis (TVA). Abdominal work may be triggering to your pelvic floor symptoms, especially the 8 point plank, so you can instead look into hypopressive exercises to work the TVA without overworking the pelvic floor. These exercises will help you bring more awareness to your breathing, diaphragm, TVA, and pelvic floor which are all important for recovery. Here is how to find and become aware of the TVA. Do side planks for your oblique ab muscles.
For hip/abductors do the side lying hip abduction exercise, fire hydrants, and the shinbox lunge. For the adductors, do Copenhagen adductor exercise, cossack squats, and an exercise where you squeeze a soft ball between the knees just don’t do any crunch movements with pelvic floor issues. For hamstrings, Nordic hamstring curl/glute ham raises, and single leg bridge. For the back, do supine pelvic tilt. One person even reported that dorsiflexion exercises and stretches were one important element to solve his pelvic floor issues; this is most likely because the ankle bone, like everything else including even our jaw, is connected to the pelvic floor.
Like with anything, do all these exercises in moderation and stop if you sense your pelvic floor is not responding well to them - do them one at a time to see which ones your pelvic floor can handle for now. Here is an exercise routine from another poster that has helped many people. Just be careful of the ab exercises such as the ab wheel and 5 minute planks with your pelvic floor issues - don’t over do it or avoid it if they cause too many symptoms.
Myofascial release and foam rolling to release trigger points also helps a lot of people to relax their pelvic floor muscles and improve blood flow. The glutes are the most important area to target for pelvic floor issues when foam rolling in my experience if you only had limited time. Using a soft ball to lay on and breathe deeply can help release trigger points in the abdominal muscles and psoas which can help you breathe better and relax the pelvic floor. I haven’t done it, but you can also try out a massage gun for myofascial release; just be careful and don’t use it in sensitive pelvic areas. Some men and women also report success using a therawand to release internal trigger points that are causing them pelvic floor dysfunction symptoms.
Walking and swimming for 30-60 minutes are some of the best exercises to lengthen, relax, stretch, and release your pelvic floor, boost blood flow, and help to retain and build strength in muscles that give support to the pelvic floor. Walk or swim for 5+ days a week for the best results. The breaststroke and freestyle are very helpful for pelvic floor sufferers. Along with swimming, people also use an elliptical at a low resistance to help provide a cardio workout that is safer for your pelvic floor.
Fix your posture. Pelvic floor issues and hard flaccid syndrome are closely associated with Anterior Pelvic Tilt and other postural issues. Get evaluated by a physical therapist so that they can give you exercises and stretches to fix it. You could also look into the Postural Restoration institute and see one of their providers and try to implement some of their exercises. In the meantime, here is one video playlist on how to fix APT. Another video to fix APT says to stretch the hip flexors, lower back, while focusing on strengthening the abs, glutes, and hamstrings. Make sure that you sit and walk with good posture - watch this to learn how to walk correctly - activate your glutes during each step and push off with your back foot!. I also recommend getting a standing desk to try to avoid sitting for long periods of time.
Weight training can be effective for boosting active androgen receptors in the body to increase testosterone and DHT levels. However, you need to make sure that it isn’t making your pelvic floor symptoms worse which defeats the purpose. If you are going to lift weights with pelvic floor issues, don’t lift heavy, do any intensive ab workouts, or any other exercises that can put extra strain on your pelvic floor. Do lifts where you can sit down instead of standing up. Start with yoga, stretching, and gentle body exercises to relax your pelvic floor and strengthen surrounding muscles before incorporating consistent weight training. I highly recommend, however, just sticking with yoga and pelvic floor safe body weight exercises to build strength instead. Remember to see a pelvic floor therapist to get evaluated first before starting any weight lifting.
Work on your mental health. Anxiety can worsen pelvic floor issues. Just as dogs tuck and tense their tails when stressed, we tense our pelvic floors which are directly connected to our tailbone where we used to have tails ourselves in our evolutionary history. As we are impacted by sexual dysfunction and pelvic floor dysfunction symptoms, we become anxious along with other negative emotions which leads to more pelvic floor tension symptoms due to the fight or flight mode response causing even more anxiety leading to more symptoms. It is a vicious cycle that needs to break by not becoming anxious and negative when we experience pelvic floor symptoms or hard flaccid and instead let go, accept, and realize that it is a normal process when trying to heal because sometimes our muscles that are used to that tightness don't want to let go of the tension we hold in our pelvic floors. Daily yoga, meditation, stretching, and walking will help with anxiety. I would also see a mental health therapist because all of these issues are deeply traumatic and we cannot go through this alone. We often hold tension in the form of emotions and trauma in our bodies, especially our pelvic floor and genital areas. By openly talking about these issues with a therapist, it will help us process and release our emotions and trauma that we are holding inside our bodies to improve our anxiety, relax our pelvic floor, and to let go of all of our tension. Many people who healed their hard flaccid and pelvic floor issues said that solving their anxiety and negative thoughts by talking to a mental health counselor was vital in recovery. The mind-body connection is so powerful, and it directly impacts our pelvic floor. Those who are stuck in the cycle of experiencing pelvic floor symptoms leading to anxiety and negative thoughts will also benefit from Cognitive Behavioral Therapy you can do by yourself like in this video or preferably with a trained therapist. Here is an informative mini lecture on how stress impacts the pelvic floor.
I would also definitely go on a healthy anti-inflammatory diet. Avoid caffeine, alcohol, marijuana, and other substances. Avoid foods and liquids that can trigger pelvic floor inflammation such as highly acidic fruits and veggies, carbonated beverages, very spicy foods, and artificial sugars. To maintain a healthy gut to reduce inflammation in your body I recommend trying a low-histamine probiotic supplement along with eating healthy. You should also work on preventing or fixing constipation; eat a lot of soluble fiber to not get constipated - take a supplement such as metamucil if you have to. Check the Bristol stool shape chart to identify if you are constipated because even mild constipation can contribute to pelvic floor tension. This is because the constipation leads to a lot of pressure being put on your rectum and pelvic floor leading to the muscles becoming weak and dysfunctional. I am willing to bet many of you are constipated and don’t know it because it isn’t just whether you go regularly, it is also how your stool is shaped. People with pelvic floor disorders are at a high risk of constipation which makes their tension and dysfunction worse which then worsens the constipation, another cycle to fix. I recommend getting a Squatty Potty to reduce strain on the pelvic floor during elimination.
Sexual health advice:
This is a good reddit guide on how to reverse kegel.
However, I will also give a shot at explaining how to reverse kegel because it is one of the most confusing things for people about this healing pelvic floor issues, and many people unfortunately do it wrong. This is why visiting a pelvic floor therapist would be helpful.
If you know how to do a kegel, the reverse kegel is the opposite feeling of that. I describe the kegel as a pull feeling, while the reverse kegel is a pushing out feeling. The reverse kegel helps to lengthen the pelvic floor through the front using the penis (front rk) and the back (back rk) using the perineum behind the testicles near the anus, but not the anus itself. I learned to reverse kegel by diaphragmatically breathing down into the belly and pelvic floor. On the inhale, inflate your diaphragm and belly, breathe down into your pelvic floor area and feel a gentle pushing movement out the front of the penis and out the back of the perineum. You can then gently release this pushing feeling on the exhale. Never force any movements - it should be a gentle process guided by the diaphragmatic breath. You can also try to do the front rk and back rk separately to try to concentrate on each better. To give another perspective, one person described the reverse kegel as like blowing up a balloon in the whole front area between the perineum and pubic bone inside out - so to me this means blowing up the balloon with your diaphragmatic breath into your pelvic floor and making a pushing feeling out the front of the penis and out the back of the perineum. You should also reverse kegel during sexual activities to help keep your pelvic floor relaxed and prevent involuntary kegels that lead to a tight, imbalanced pelvic floor and premature ejaculation. Reverse kegeling when erect may be difficult at first, but it will become easier to understand during sexual stimulation when you get the feeling of wanting to involuntary kegel, but doing the opposite of that and gently doing the push feeling through the front reverse kegel.
I would stay away from regular kegels when dealing with pelvic floor and hard flaccid issues - it will only lead to contraction and tightening. The kegel (BC) muscle works plenty involuntarily on its own without us needing to exercise them. Once again, the reverse kegel helps to counterbalance the pelvic floor that has been overusing regular kegels leading to hypertonic pelvic floor dysfunction. Positions that I am most able to feel the reverse kegel the most in are the wall happy baby pose, lying flat on my back while spreading my knees apart, child’s pose, and the yoga/malasana squat. Do not be discouraged if you have no awareness of your pelvic floor or the concept of reverse kegeling just yet. Your pelvic floor is tight and dysfunctional giving you little to no feeling of the proper movements. Once your pelvic floor becomes relaxed and lengthened through pelvic floor stretches, you will have an easier time gaining awareness. Learning how to reverse kegel is often the hardest part of recovery for men. It may take many months, so have patience with your body while it is healing.
To help heal pelvic floor and hard flaccid issues, never watch pornography again (this is vital). Go on NoFap for 90+ days to help heal your brain and body from any unhealthy pornography and sexual habits you have partaken in. Pornography leads to involuntary kegels, a tight pelvic floor, desensitizes you, and messes up the dopamine and arousal circuitry in your brain. Don’t climax too often. Use lube and a very gentle gliding motion if you are going to self-pleasure, no more tugging on your penis that is then pulling on your pelvic floor muscles, and avoid masturbation positions that puts you into an anterior pelvic tilt - stick to neutral/posterior pelvic tilt positions. Sex is much healthier compared to masturbation for the penis and pelvic floor muscles because the head of the penis is stimulated by the vaginal walls which creates a reflex that helps activate the ischiocavernosus (IC) muscle, which is vital for erection health and is likely in a contracted state causing hard flaccid - thank you to this thread for this information. If you do have a partner, only climax through sex. Make sure you have proper erection quality during sexual activities - take supplements or medications if you have to. Climaxing flaccid or semi-flaccid is what causes many people to develop hard flaccid and pelvic floor issues in the first place. This is likely due to a complicated process of the IC muscle being improperly activated due to flaccidity during climax leading to a cramping of the muscle leading to hard flaccid and causing dysfunction across the pelvic floor muscles causing a cascade of inflammation. Only partake in sexual activities when you have relaxed your pelvic floor enough through stretching and the rest of the techniques. Again, I do recommend abstaining from masturbation as long as possible while healing and preferably after as well.
Remember that you are not alone. So many people have pelvic tension, muscle imbalances, sexual deficits, posture issues without realizing it and never will heal due to their lack of awareness. Since we now have the great gift of awareness over our issues, we can start to heal our whole body and minds to become healthier than ever before, including our pelvic floor! Everyone’s journey is different due to our unique bodies and needs so that is why I gave you all the information I had regarding stretching, strengthening, supplements, nutrition, mental health advice, etc. to empower you to form your own plan to heal.
You can and will heal. Stay strong and never give up. Thank you for reading.
submitted by EasyFlaccid to PelvicFloor [link] [comments]

2023.08.27 19:19 EasyFlaccid The link between Hard Flaccid Syndrome, Pelvic Floor Dysfunction, Chronic Pelvic Pain Syndrome, Post-SSRI Sexual Dysfunction, Post Finasteride Syndrome, and advice on how to start your healing journey based on 8 years of research and personal experiences

Here are all my thoughts and advice based on my personal experiences, other people’s insight and helpful experiences, and research I have done on and off about pelvic floor issues from the past eight years or so. There is still a lot left to learn, but I am putting everything I know currently here. I am not claiming that any of this is revolutionary, but I hope it can help some of you out there to give you a headstart on healing and advance our understanding of these conditions. As I am a 27 year old male with previous major problems with pelvic floor issues and hard flaccid, some of my advice may be biased towards my condition. However, I believe everyone can benefit from a lot of this because I really do think that all of these conditions that I mentioned are linked in at least some way, especially by pelvic floor dysfunction and sex hormone desensitization. I try not to come to these forums because it increases anxiety and negative emotions which leads to worse pelvic floor symptoms, so my apologies if I do not respond to your questions. For hard flaccid and pelvic floor affected people, follow my advice and I am confident you can heal and reach a place where your symptoms barely affect your life, if at all, which is where I am at now. The mentality of trying to find a 100% “magic cure” solution just leads to anxiety and catastrophic thinking if you have a set back which will only worsen your symptoms. You can and will heal. I know this is a lot of information, but try to implement just one or two things at a time. Focus on the present, and take it one day at a time. Don’t get overwhelmed.
Post Finasteride Syndrome (PFS), Post-SSRI Sexual Dysfunction (PSSD), Hard Flaccid Syndrome (HFS), Pelvic Floor Dysfunction, and Chronic Pelvic Pain Syndrome all can have some similar symptoms. I believe that they are all either caused or can be exacerbated by androgen and estrogen receptor insensitivity and are triggered by medication, genital injury, and pelvic floor inflammation and dysfunction. The pelvic floor is rich in androgen receptors and estrogen receptors. However, without proper androgen receptor activation and sensitivity, the pelvic floor muscles don’t have enough DHT which line the tissues of the pelvic floor, genitalia, and lower urinary tract. DHT is vital for healthy sexual functioning in both sexes - it provides an anabolic effect to tissues to provide strength, stability, healing, and relaxation to tissues. As a result of androgen receptor insensitivity and lack of DHT, the pelvic floor can become chronically weakened, tight, and inflamed which reduces blood flow to the region leading to even more androgen receptor insensitivity and thus less DHT. These symptoms can cause psychological stress to the individual which tightens the pelvic floor further leading to more symptoms and less blood flow. One study found that androgen sensitivity has raised the possibility that androgens can be used to rebuild the weakened and/or damaged muscles comprising the pelvic floor - source. Some people may also have normal sex hormone levels in the blood when tested, but these hormones cannot reach or be effective in the pelvic floor tissues or brain due to sex hormone insensitivity and the lack of the blood flow in the region caused by pelvic floor tightness and dysfunction.
Desensitized estrogen receptors leading to decreased estrogen levels in local pelvic floor and genital tissues may be causing a similar mechanism of dysfunction in some people like androgen receptor insensitivity and DHT because estrogen is important for pelvic floor and sexual health in both sexes. This study says that “Estradiol in men is essential for modulating libido, erectile function, and spermatogenesis. Estrogen receptors, as well as aromatase, the enzyme that converts testosterone to estrogen, are abundant in brain, penis, and testis, organs important for sexual function. In the brain, estradiol synthesis is increased in areas related to sexual arousal. In addition, in the penis, estrogen receptors are found throughout the corpus cavernosum with high concentration around neurovascular bundles.” Steroid users report that low estrogen causes decreased or numb penile sensitivity, shrunken flaccid penis, dull orgasm, urinary hesitancy, urinary frequency, low sex drive, and erectile dysfunction. Here is a paper from a PSSD community member that hypothesizes, as do an increasing amount of people, that the main issue of PSSD, PFS, and Post-Retinoid Sexual Dysfunction is estrogen receptor insensitivity. PSSD and PFS sufferers often have similar hard flaccid and pelvic floor issues, so if those conditions are caused by estrogen insensitivity, then perhaps our pelvic floor dysfunction, HFS, and CPPS, is also impacted by a lack of estrogens in the pelvic floor tissues, not just androgens. The most important element to remember to help start the healing process for these disorders is to boost blood flow through supplements, stretches, and exercises which will increase both androgen and estrogen receptor sensitivity over time.
Post Finasteride Syndrome (PFS) caused by Finasteride, a 5-alpha-reductase inhibitor (5-ARI), plummets DHT levels in the body to try to help hair loss causing sexual dysfunction and pelvic floor issues. Androgen receptors that surround the pelvic floor, genitals, and brain become desensitized due to the Finasteride leading to less DHT binding to these receptors causing dysfunction and a tight, weak pelvic floor. The tight, dysfunctional pelvic floor now restricts blood flow which impacts healing and the delivery of testosterone to this area that further exacerbates androgen insensitivity leading to less DHT in these tissues. Since androgen receptors are found in the brain and androgens have neuroprotective effects, this could be one reason why some PFS and PSSD sufferers are also impacted cognitively. An herbal supplement called Saw Palmetto has also been reported to cause a disorder similar to PFS because it is also a 5-ARI that blocks the conversion of testosterone into DHT. Another disorder called Post Accutane Syndrome (PAS) is also similar to PFS and it reduces DHT as well through being a 5-AR.
For Post-SSRI Sexual Dysfunction (PSSD), SSRIs are also known to decrease androgens and down regulate androgen receptors. This study shows that SSRIs can have an anti-estrogenic effect as well and can even reduce the expression of estrogen receptors (ER), including in the hypothalamus.. As androgen and estrogen receptors get desensitized in the pelvic floor, genital region, and brain, it causes localized DHT and estrogen levels in these tissues to decrease causing emotional blunting, sexual dysfunction, pelvic floor issues, hard flaccid syndrome, and more. The pelvic floor dysfunction can then prevent the sex hormone receptors from being reactivated and sensitized in this area due to restricting oxygen and sex hormone rich blood flow to the tissues. SSRIs can cause androgen receptor insensitivity and estrogen receptor insensitivity by severely inhibiting the serotonin transporter (SERT) leading to increased serotonin levels which desensitizes those receptors throughout the body. It is also interesting that some PSSD community members are trying to restore estrogen receptor sensitivity via boosting estrogen in various ways including by taking hops extract which is a potent phytoestrogen. Check out the PSSD Network for more information on this condition as they are helping to give a voice to the unheard..
Hard Flaccid Syndrome (HFS) - There are many men suffering from HFS and pelvic floor issues due to PSSD, PFS, heavy weight lifting, excess kegeling, or in the case I’m presenting here, physical damage to the genitals from excessive, vigorous sexual activity (my case) or penis enlargement exercises. When the genitals get damaged, an inflammatory process starts and the pelvic floor contracts to protect itself. Since the pelvic floor is now in a chronic, contracted state, it limits oxygen and sex hormone rich blood flow to the genitals and pelvic floor which leads to sex hormone insensitivity and negatively impacts healing, muscle relaxation, and DHT production in these tissues. Finasteride, Accutane, and SSRIs also desensitize sex hormone receptors in the genitals and pelvic floor tissues leading to hard flaccid and pelvic floor dysfunction. Since the pelvic floor tightness restricts blood flow, it is difficult for hard flaccid sufferers to reactivate and sensitize their pelvic floor muscle androgen receptors again to regain relaxation and strength in their pelvic floor muscles, including the ischiocavernosus (IC), bulbocavernosus (BC), and pubococcygeus (PC) which are in a contracted state; the IC muscle in particular is thought to be the most implicated in the cause of hard flaccid. We first need to promote relaxation in the pelvic floor by boosting blood flow through supplements and stretches because tight muscles are weak muscles. Once the pelvic floor is in a chronic state of tension, it is hard to heal from pelvic floor issues because you likely already had bad habits such as poor posture, unhealthy sexual practices, stiff muscles, sedentary lifestyle, unchecked anxiety, and other negative lifestyle factors. Along with supplements, exercises, and stretches, correcting these bad habits is necessary to heal to have an even healthier pelvic floor than you ever had before because it likely was already tight and dysfunctional to begin with before developing obvious issues, but it was more subtle and you had no awareness of your pelvic floor muscles until now. You have the potential to now become a much healthier person overall than you ever would have been without being affected by pelvic floor dysfunction and hard flaccid.
What I see in all these conditions is that sex hormone receptors become desensitized in the pelvic floor and genital tissues either from a drug, pelvic tightness, or inflammation from injury leading to less localized sex hormones causing sexual and pelvic floor dysfunction. The pelvic floor now goes into a chronic tightened state as a response, leading to more inflammation and less oxygen and testosterone rich blood flow to the genital and pelvic region which leads to more androgen insensitivity and subsequently less DHT. This all explains why many people who have these conditions are helped by supplements that improve androgen receptor sensitivity and blood flow, and why pelvic floor therapy and exercises are so helpful to many of them. Estrogen receptor insensitivity in the pelvic floor also appears to have a similar mechanical negative effect by leading to less estrogen levels in the pelvic floor and genital tissues. It is also possible that some people with PSSD/PFS may have subtle or no pelvic floor symptoms, but the medication still desensitizes sex hormone sensitivity in their genitals and pelvic floor tissues that is leading to sexual dysfunction.
Another study linking androgens and the pelvic floor: Levator ani and other muscles of the pelvic floor and lower urinary tract are sensitive to the anabolic effects of testosterone. Androgen receptors are also expressed in the pelvic floor and lower urinary tract of both animals and humans. Anabolic effects of androgens may play an important role in the female pelvic-floor and lower-urinary-tract disorders. The action of androgens in the lower urinary tract and pelvic floor is complex and may depend on their anabolic effects, hormonal modulation, receptor expression, interaction with nitric oxide synthase, or a combination of these effects.
My solution to help heal and improve the well-being of people with these issues is to try to improve sex hormone receptor sensitivity and pelvic floor function through supplements, stretches, exercises, and boosting blood flow which will hopefully restore normal levels of estrogens and androgens in pelvic, genital, and brain tissues. The body has a tremendous capability of self-healing, but we need to support it through active recovery methods.
We will first start with supplements (this is not professional medical advice - talk with your doctor before taking):
L-citrulline - This is the precursor to l-arginine, and it will improve blood flow and levels of nitric oxide to help get oxygen and testosterone rich blood to the pelvic floor and genital tissues to increase androgen sensitivity. Nitric oxide can also induce smooth muscle relaxation which is important for relaxing the pelvic floor. Herein we report on a young man affected by PSSD who regained sexual functioning after 3-month treatment with EDOVIS, a dietary supplement containing L-citrulline and other commonly used aphrodisiacs.. I recommend taking at least 6000 mg daily by taking 2000mg three times throughout the day. The max dose is 10,000mg. Even potentially better, people report great results using Cialis to improve blood flow and healing rather than L-citrulline and some doctors will even prescribe it to women if you show them the evidence - talk with your doctor. “Tadalafil (Cialis) reversal of sexual dysfunction caused by serotonin enhancing medications in women”. L-Citrulline and Cialis are not recommended to be taken together.
L-Carnitine - This will improve the number of androgen receptors and their sensitivity to testosterone to increase levels of DHT in the pelvic floor, genital tissues, and brain. I recommend taking 2000mg daily. Acetyl-L-Carnitine can pass through the blood-brain barrier, while Propionyl-L-carnitine has a high degree of interaction with testosterone. Propionyl may be better for sexual and pelvic floor dysfunction, while Acetyl might help people suffering from the mental effects of PSSD. This study used each at 2000mg daily to improve erectile dysfunction along with Viagra.. I would work up to 2000mg each of Acetyl and Propionyl L-Carnitine along with Cialis instead of Viagra as it lasts in the body for much longer (36 hours) for increased blood flow healing purposes. You can also use L-Citrulline instead of Cialis as mentioned earlier. Discuss with your doctor before taking them.
Vitamin D - This vitamin, which acts more like a hormone, works directly with the endocrine system. It has its own receptors throughout the body and they are often in close proximity to androgen receptors. Deficiency in vitamin D is associated with a stunting of testosterone's effects on androgen receptors and a decline in testosterone levels. Vitamin D will encourage androgen receptor resensitization. One study found that higher vitamin D levels are associated with a decreased risk of pelvic floor disorders in women, and The levator ani and coccygeus muscles are skeletal muscles that are critical components of the pelvic floor and may be affected by vitamin D nutritional status. I recommend 4000IU of vitamin D daily or whatever gets your levels to 60 - 80 ng/ml. I would also take 100mcg of vitamin K2 to ensure that any excess calcium from vitamin D is deposited into the bones and not arteries.
Magnesium Glycinate - This will help relax your pelvic floor muscles to help restore function and blood flow. I recommend starting with 300mg.
If you have inflammatory issues or pain due to pelvic floor dysfunction, I recommend a fish oil supplement daily. I take fish oil, and I find that it helps limit pelvic inflammation. Take quercetin and bromelain as needed if you experience pelvic inflammatory flare ups, pain, and bladder issues, but just be careful as quercetin can also inhibit the production of DHT from testosterone as well. Some say fish oil blocks DHT too, but experiencing chronic pelvic floor pain and inflammation will do more harm to you than minimal DHT blocking.
I also recommend doing some form of yoga or pelvic floor stretches daily to improve blood flow for pelvic floor relaxation and sex hormone receptor sensitivity. You also need to request to see a pelvic floor therapist for an evaluation and treatment. Learn how to do reverse kegels. Doing reverse kegels will be difficult at first because your pelvic floor is tight and you have little to no awareness of these muscles, so just focus on lengthening and relaxing the pelvic floor through stretches for now. Do not do regular kegels for pelvic floor issues. Learn how to diaphragmatically breathe in 360 degrees to create expansion in your rib cage and abdomen to encourage pelvic floor relaxation. Do not breathe through your chest, and “belly breathing” isn’t the right term because the ribs need to expand as well. You can learn how to diaphragmatically breathe through an exercise such as 4-7-8 breathing. Here is a great video on diaphragmatic breathing and another video. Retraining yourself to properly breathe diaphragmatically is the single most important thing that you can do to heal from pelvic floor issues.
Stretches/Yoga poses I recommend:
Hold the Malasana/hindi/yoga squat pose for at least 5-10 minutes at least twice a day, but doing it morning, mid-day, and at night would be the best. Some get great results holding it for 15-20 minutes.This is one of the most important things for your pelvic floor because it will help lengthen and release it. Doing them barefoot is also very beneficial to strengthen your ankles and feet which are connected to your pelvic floor. Again, remember to breathe deeply down into your belly and pelvic floor for all these stretches.
Begin your stretching routine with an Exercise ball ab stretch and Upward-facing dog/cobra pose. This will help stretch your lower abs and psoas muscles so that you can get more breath deeper down into your pelvic floor for the rest of your stretches. Some people say that these types of stretches aren’t great for people who have Anterior Pelvic Tilt, which we should fix, but I still do them as it is important to stretch the lower abs that are hard to get to. You can experiment with doing them sporadically instead of every time you stretch.
This is my current personal complete stretch routine I do in order 3+ days a week:
Myofascial release on my glutes with an orb massage ball but you can use any small hard ball (don’t do this if glutes are currently sore) > Calf stretch against a wall or a yoga block which is what I use > exercise ball ab stretch > upward facing dog > (optional) Do a handful of cat cows > Supine hamstring stretch with yoga strap or an IdealStretch tool which is what I use > Kneeling hip flexor stretch > flat on back supine single knee to chest stretch > then bring knee to opposite shoulder stretch > supine figure four > I do this stretch next right after figure four > Reclined bound angle pose > (optional) butterfly stretch > (optional) A little bit of downward facing dog to stretch the calves > (optional) Lizard Pose) > (optional) Half split stretch/Half monkey pose with yoga blocks > Half-pigeon pose > Child’s pose > Wall quad hip flexor stretch > Wall figure four stretch > Wall straddle pose > Wall happy baby pose > Flat on back while pulling knees apart > kneeling with one leg, other leg out to side for adductors > (optional) Frog pose with feet together > regular Frog pose with feet separated in line with the knees > Yoga squat/malasana > Corpse pose
All these stretches are the ones I found most useful in a routine. See what works for you and develop your own routine. Consistency is the most important. This long stretching routine may not be possible for you to complete regularly so make adjustments, but doing this routine at least 3 days a week is ideal. Stretches such as the yoga squat, supine hamstring stretch, hip flexor stretches, and wall stretches are vital and should be done most days to help relax the pelvic floor. For how long you should hold each stretch, just go by how you and your body feels. Really let go, breathe, and sink into every stretch. On rest days, doing some deep breathing in child’s pose, reclined bound angle pose, flat on back while pulling knees apart, and the happy baby wall pose is really great while trying to do gentle reverse kegels.
You can also work on more individualized stretches for posture to correct anterior pelvic tilt, muscle imbalances, and to release other tight muscles, such as the upper body. Listen to your body if you need to give yourself a rest day from stretching. Adding in a 30-60 minute walk/swim on rest days is incredibly beneficial as well. Eventually, you can also try to learn isometric PNF stretching to incorporate it into some of the stretches such as the kneeling hip flexor stretch and hamstring stretch.
Exercises I recommend:
After working to relax and lengthen your pelvic floor through yoga and stretches, I would begin gentle body strengthening exercises that are pelvic floor safe. The pelvic floor is a master compensator. So, if the glutes, adductors, deep hip rotators, transversus abdominis, and other supportive muscles are weak, then the pelvic floor is in the prime position to pick up the slack which leads to a lot of strain on the pelvic floor which results in tightness and dysfunction. You need to strengthen the surrounding muscles to relieve tightness in the pelvic floor. This is where working with a pelvic floor therapist would be helpful to point out safe individualized exercises for you. Yoga will help strengthen your muscles in a safe way too.
The glutes and transversus abdominis in particular are very important to strengthen. Glute bridge, single glute bridge, side lying leg raises, lateral band walks can help build up glute strength. Deadbugs, Bird Dog, 8- point planks, or planks with pelvic floor-friendly modifications, can help to strengthen the transversus abdominis (TVA). Abdominal work may be triggering to your pelvic floor symptoms, especially the 8 point plank, so you can instead look into hypopressive exercises to work the TVA without overworking the pelvic floor. These exercises will help you bring more awareness to your breathing, diaphragm, TVA, and pelvic floor which are all important for recovery. Here is how to find and become aware of the TVA. Do side planks for your oblique ab muscles.
For hip/abductors do the side lying hip abduction exercise, fire hydrants, and the shinbox lunge. For the adductors, do Copenhagen adductor exercise, cossack squats, and an exercise where you squeeze a soft ball between the knees just don’t do any crunch movements with pelvic floor issues. For hamstrings, Nordic hamstring curl/glute ham raises, and single leg bridge. For the back, do supine pelvic tilt. One person even reported that dorsiflexion exercises and stretches were one important element to solve his pelvic floor issues; this is most likely because the ankle bone, like everything else including even our jaw, is connected to the pelvic floor.
Like with anything, do all these exercises in moderation and stop if you sense your pelvic floor is not responding well to them - do them one at a time to see which ones your pelvic floor can handle for now. Here is an exercise routine from another poster that has helped many people. Just be careful of the ab exercises such as the ab wheel and 5 minute planks with your pelvic floor issues - don’t over do it or avoid it if they cause too many symptoms.
Myofascial release and foam rolling to release trigger points also helps a lot of people to relax their pelvic floor muscles and improve blood flow. The glutes are the most important area to target for pelvic floor issues when foam rolling in my experience if you only had limited time. Using a soft ball to lay on and breathe deeply can help release trigger points in the abdominal muscles and psoas which can help you breathe better and relax the pelvic floor. I haven’t done it, but you can also try out a massage gun for myofascial release; just be careful and don’t use it in sensitive pelvic areas. Some men and women also report success using a therawand to release internal trigger points that are causing them pelvic floor dysfunction symptoms.
Walking and swimming for 30-60 minutes are some of the best exercises to lengthen, relax, stretch, and release your pelvic floor, boost blood flow, and help to retain and build strength in muscles that give support to the pelvic floor. Walk or swim for 5+ days a week for the best results. The breaststroke and freestyle are very helpful for pelvic floor sufferers. Along with swimming, people also use an elliptical at a low resistance to help provide a cardio workout that is safer for your pelvic floor.
Fix your posture. Pelvic floor issues and hard flaccid syndrome are closely associated with Anterior Pelvic Tilt and other postural issues. Get evaluated by a physical therapist so that they can give you exercises and stretches to fix it. You could also look into the Postural Restoration institute and see one of their providers and try to implement some of their exercises. In the meantime, here is one video playlist on how to fix APT. Another video to fix APT says to stretch the hip flexors, lower back, while focusing on strengthening the abs, glutes, and hamstrings. Make sure that you sit and walk with good posture - watch this to learn how to walk correctly - activate your glutes during each step and push off with your back foot!. I also recommend getting a standing desk to try to avoid sitting for long periods of time.
Weight training can be effective for boosting active androgen receptors in the body to increase testosterone and DHT levels. However, you need to make sure that it isn’t making your pelvic floor symptoms worse which defeats the purpose. If you are going to lift weights with pelvic floor issues, don’t lift heavy, do any intensive ab workouts, or any other exercises that can put extra strain on your pelvic floor. Do lifts where you can sit down instead of standing up. Start with yoga, stretching, and gentle body exercises to relax your pelvic floor and strengthen surrounding muscles before incorporating consistent weight training. I highly recommend, however, just sticking with yoga and pelvic floor safe body weight exercises to build strength instead. Remember to see a pelvic floor therapist to get evaluated first before starting any weight lifting.
Work on your mental health. Anxiety can worsen pelvic floor issues. Just as dogs tuck and tense their tails when stressed, we tense our pelvic floors which are directly connected to our tailbone where we used to have tails ourselves in our evolutionary history. As we are impacted by sexual dysfunction and pelvic floor dysfunction symptoms, we become anxious along with other negative emotions which leads to more pelvic floor tension symptoms due to the fight or flight mode response causing even more anxiety leading to more symptoms. It is a vicious cycle that needs to break by not becoming anxious and negative when we experience pelvic floor symptoms or hard flaccid and instead let go, accept, and realize that it is a normal process when trying to heal because sometimes our muscles that are used to that tightness don't want to let go of the tension we hold in our pelvic floors. Daily yoga, meditation, stretching, and walking will help with anxiety. I would also see a mental health therapist because all of these issues are deeply traumatic and we cannot go through this alone. We often hold tension in the form of emotions and trauma in our bodies, especially our pelvic floor and genital areas. By openly talking about these issues with a therapist, it will help us process and release our emotions and trauma that we are holding inside our bodies to improve our anxiety, relax our pelvic floor, and to let go of all of our tension. Many people who healed their hard flaccid and pelvic floor issues said that solving their anxiety and negative thoughts by talking to a mental health counselor was vital in recovery. The mind-body connection is so powerful, and it directly impacts our pelvic floor. Those who are stuck in the cycle of experiencing pelvic floor symptoms leading to anxiety and negative thoughts will also benefit from Cognitive Behavioral Therapy you can do by yourself like in this video or preferably with a trained therapist. Here is an informative mini lecture on how stress impacts the pelvic floor.
I would also definitely go on a healthy anti-inflammatory diet. Avoid caffeine, alcohol, marijuana, and other substances. Avoid foods and liquids that can trigger pelvic floor inflammation such as highly acidic fruits and veggies, carbonated beverages, very spicy foods, and artificial sugars. To maintain a healthy gut to reduce inflammation in your body I recommend trying a low-histamine probiotic supplement along with eating healthy. You should also work on preventing or fixing constipation; eat a lot of soluble fiber to not get constipated - take a supplement such as metamucil if you have to. Check the Bristol stool shape chart to identify if you are constipated because even mild constipation can contribute to pelvic floor tension. This is because the constipation leads to a lot of pressure being put on your rectum and pelvic floor leading to the muscles becoming weak and dysfunctional. I am willing to bet many of you are constipated and don’t know it because it isn’t just whether you go regularly, it is also how your stool is shaped. People with pelvic floor disorders are at a high risk of constipation which makes their tension and dysfunction worse which then worsens the constipation, another cycle to fix. I recommend getting a Squatty Potty to reduce strain on the pelvic floor during elimination.
Sexual health advice:
This is a good reddit guide on how to reverse kegel.
However, I will also give a shot at explaining how to reverse kegel because it is one of the most confusing things for people about this healing pelvic floor issues, and many people unfortunately do it wrong. This is why visiting a pelvic floor therapist would be helpful.
If you know how to do a kegel, the reverse kegel is the opposite feeling of that. I describe the kegel as a pull feeling, while the reverse kegel is a pushing out feeling. The reverse kegel helps to lengthen the pelvic floor through the front using the penis (front rk) and the back (back rk) using the perineum behind the testicles near the anus, but not the anus itself. I learned to reverse kegel by diaphragmatically breathing down into the belly and pelvic floor. On the inhale, inflate your diaphragm and belly, breathe down into your pelvic floor area and feel a gentle pushing movement out the front of the penis and out the back of the perineum. You can then gently release this pushing feeling on the exhale. Never force any movements - it should be a gentle process guided by the diaphragmatic breath. You can also try to do the front rk and back rk separately to try to concentrate on each better. To give another perspective, one person described the reverse kegel as like blowing up a balloon in the whole front area between the perineum and pubic bone inside out - so to me this means blowing up the balloon with your diaphragmatic breath into your pelvic floor and making a pushing feeling out the front of the penis and out the back of the perineum. You should also reverse kegel during sexual activities to help keep your pelvic floor relaxed and prevent involuntary kegels that lead to a tight, imbalanced pelvic floor and premature ejaculation. Reverse kegeling when erect may be difficult at first, but it will become easier to understand during sexual stimulation when you get the feeling of wanting to involuntary kegel, but doing the opposite of that and gently doing the push feeling through the front reverse kegel.
I would stay away from regular kegels when dealing with pelvic floor and hard flaccid issues - it will only lead to contraction and tightening. The kegel (BC) muscle works plenty involuntarily on its own without us needing to exercise them. Once again, the reverse kegel helps to counterbalance the pelvic floor that has been overusing regular kegels leading to hypertonic pelvic floor dysfunction. Positions that I am most able to feel the reverse kegel the most in are the wall happy baby pose, lying flat on my back while spreading my knees apart, child’s pose, and the yoga/malasana squat. Do not be discouraged if you have no awareness of your pelvic floor or the concept of reverse kegeling just yet. Your pelvic floor is tight and dysfunctional giving you little to no feeling of the proper movements. Once your pelvic floor becomes relaxed and lengthened through pelvic floor stretches, you will have an easier time gaining awareness. Learning how to reverse kegel is often the hardest part of recovery for men. It may take many months, so have patience with your body while it is healing.
To help heal hard flaccid and pelvic floor issues, never watch pornography again (this is vital). Go on NoFap for 90+ days to help heal your brain and body from any unhealthy pornography and sexual habits you have partaken in. Pornography leads to involuntary kegels, a tight pelvic floor, desensitizes you, and messes up the dopamine and arousal circuitry in your brain. Don’t climax too often. Use lube and a very gentle gliding motion if you are going to self-pleasure, no more tugging on your penis that is then pulling on your pelvic floor muscles, and avoid masturbation positions that puts you into an anterior pelvic tilt - stick to neutral/posterior pelvic tilt positions. Sex is much healthier compared to masturbation for the penis and pelvic floor muscles because the head of the penis is stimulated by the vaginal walls which creates a reflex that helps activate the ischiocavernosus (IC) muscle, which is vital for erection health and is likely in a contracted state causing hard flaccid - thank you to this thread for this information. If you do have a partner, only climax through sex. Make sure you have proper erection quality during sexual activities - take supplements or medications if you have to. Climaxing flaccid or semi-flaccid is what causes many people to develop hard flaccid and pelvic floor issues in the first place. This is likely due to a complicated process of the IC muscle being improperly activated due to flaccidity during climax leading to a cramping of the muscle leading to hard flaccid and causing dysfunction across the pelvic floor muscles causing a cascade of inflammation. Only partake in sexual activities when you have relaxed your pelvic floor enough through stretching and the rest of the techniques. Again, I do recommend abstaining from masturbation as long as possible while healing and preferably after as well.
One interesting and strange thing that I also want to mention is that a person with hard flaccid and pelvic floor issues reported significant improvements after changing the position in which they masturbated and climaxed in to an elevated glute bridge position while reverse kegeling, some commenters also reported improvements - here is the thread. Another post here said that using a squatting position while sitting at the edge of a chaibed with feet flat on the ground and not touching himself during climax helped him. Another reminder, I would only attempt this if you have gotten your pelvic floor to a relaxed state through stretching and learned how to reverse kegel when erect during sexual activities. Going gentle and using lube is necessary. During all sexual activities you should be erect as possible to support proper pelvic floor function.
The reason why masturbating in a posterior pelvic tilt along with glute muscles activated likely worked for them is that we have been masturbating and climaxing in an Anterior Pelvic Tilt (APT) all of our lives. This is unnatural and goes against our evolutionary biology because during sex throughout all of our human history, thrusting and climaxing puts us into more of a posterior pelvic tilt position with a lot of activation of our glutes. Men are often self-pleasuring with an APT while edging for sometimes hours at a time throughout their lives while sitting on a chair, couch, bed, etc. which has put unnatural pressure, or improper activation,on their pelvic floors that has likely caused dysfunction with our BC, PC, and especially IC muscles. By switching to more of a natural sex position during masturbation that puts us in a posterior pelvic tilt state, such as during an elevated glute bridge, it is reactivating and counter correcting the function of our pelvic floor muscles, such as the IC muscle in particular, that has been dormant or dysfunctional due to our bad sexual habits. This of course isn’t a miracle cure, but it could be worth a try if you first applied the rest of the recommendations.
You can and will heal. Stay strong and never give up. Thank you for reading.
submitted by EasyFlaccid to hardflaccidresearch [link] [comments]

2023.08.27 16:24 EasyFlaccid The link between Post-SSRI Sexual Dysfunction, Hard Flaccid Syndrome, Post Finasteride Syndrome, Pelvic Floor Dysfunction, Chronic Pelvic Pain Syndrome and advice on how to start your healing journey based on 8 years of research and personal experiences

Here are all my thoughts and advice based on my personal experiences, other people’s insight and helpful experiences, and research I have done on and off about pelvic floor issues from the past eight years or so. I am not claiming that any of this is revolutionary, but I hope it can help some of you out there to give you a head start on healing and advance our understanding of these conditions. As I am a 27 year old male with previous major problems with pelvic floor issues and hard flaccid, some of my advice may be biased towards my condition. However, I believe everyone can benefit from a lot of this because I really do think that all of these conditions that I mentioned are linked in at least some way, especially by pelvic floor dysfunction and sex hormone desensitization. I try not to come to these forums because it increases anxiety and negative emotions which leads to worse pelvic floor symptoms, so my apologies if I do not respond to your questions. For hard flaccid and pelvic floor affected people, follow my advice and I am confident you can heal and reach a place where your symptoms barely affect your life, if at all, which is where I am at now. The mentality of trying to find a 100% “magic cure” solution just leads to anxiety and catastrophic thinking if you have a set back which will only worsen your symptoms. You can and will heal. I know this is a lot of information, but try to implement just one or two things at a time. Focus on the present, and take it one day at a time. Don’t get overwhelmed. All of this is my opinion and not professional medical advice. Talk with your doctor before starting anything.
Post Finasteride Syndrome (PFS), Post-SSRI Sexual Dysfunction (PSSD), Hard Flaccid Syndrome (HFS), Pelvic Floor Dysfunction, and Chronic Pelvic Pain Syndrome all can have some similar symptoms. I believe that they are all either caused or can be exacerbated by androgen and estrogen receptor insensitivity and are triggered by medication, genital injury, and pelvic floor inflammation and dysfunction. The pelvic floor is rich in androgen receptors and estrogen receptors. However, without proper androgen receptor activation and sensitivity, the pelvic floor muscles don’t have enough DHT which line the tissues of the pelvic floor, genitalia, and lower urinary tract. DHT is vital for healthy sexual functioning in both sexes - it provides an anabolic effect to tissues to provide strength, stability, healing, and relaxation to tissues. As a result of androgen receptor insensitivity and lack of DHT, the pelvic floor can become chronically weakened, tight, and inflamed which reduces blood flow to the region leading to even more androgen receptor insensitivity and thus less DHT. These symptoms can cause psychological stress to the individual which tightens the pelvic floor further leading to more symptoms and less blood flow. One study found that androgen sensitivity has raised the possibility that androgens can be used to rebuild the weakened and/or damaged muscles comprising the pelvic floor - source. Some people may also have normal hormone levels in the blood when tested, but these hormones cannot reach or be effective in the pelvic floor tissues or brain due to sex hormone insensitivity and the lack of the blood flow in the region caused by pelvic floor tightness and dysfunction. It is also likely that there is a problem with desensitized estrogen receptors causing a similar mechanism of dysfunction because they are also found in the pelvic floor, genitals, and brain and are important for pelvic floor health, sexual functioning, cognition, and emotions in both sexes. The most important element to remember to help start the healing process for these disorders is to boost blood flow through supplements, stretches, and exercises which will increase both androgen and estrogen receptor sensitivity over time.
Many males with PFS, PSSD, and Pelvic Floor dysfunction are affected by the hard flaccid condition.
Post Finasteride Syndrome (PFS) caused by Finasteride, a 5-alpha-reductase inhibitor (5-ARI), plummets DHT levels in the body to try to help hair loss causing sexual dysfunction and pelvic floor issues. Androgen receptors that surround the pelvic floor, genitals, and brain become desensitized due to the Finasteride leading to less DHT binding to these receptors causing dysfunction and a tight, weak pelvic floor. The tight, dysfunctional pelvic floor now restricts blood flow which impacts healing and the delivery of testosterone to this area that further exacerbates androgen insensitivity leading to less DHT in these tissues. Since androgen receptors are found in the brain and androgens have neuroprotective effects, this could be one reason why some PFS and PSSD sufferers are also impacted cognitively. An herbal supplement called Saw Palmetto has also been reported to cause a disorder similar to PFS because it is also a 5-ARI that blocks the conversion of testosterone into DHT. Another disorder called Post Accutane Syndrome (PAS) is also similar to PFS and it reduces DHT as well through being a 5-ARI: “Isotretinoin, used to treat severe acne, has been shown to induce hormonal changes, especially to reduce 5 alpha-reductase in the production of the tissue-derived dihydrotestosterone (DHT) metabolite 3 alpha-Adiol G.”. PFS, PAS, and PSSD are thought to cause not only androgen receptor desensitization, but likely estrogen receptor desensitization as well.
For Post-SSRI Sexual Dysfunction (PSSD), SSRIs are also known to decrease androgens and down regulate androgen receptors. This study shows that SSRIs can have an anti-estrogenic effect as well and can even reduce the expression of estrogen receptors (ER), including in the hypothalamus.. As sex hormones get desensitized in the pelvic floor, genital region, and brain, it causes localized DHT and estrogen levels in these tissues to decrease causing emotional blunting, sexual dysfunction, pelvic floor issues, hard flaccid syndrome, and more. The pelvic floor dysfunction can then prevent the sex hormone receptors from being reactivated and sensitized due to restricting oxygen and sex hormone rich blood flow to the tissues. SSRIs can cause androgen receptor insensitivity and estrogen receptor insensitivity by severely inhibiting the serotonin transporter (SERT) leading to increased serotonin levels which desensitizes those receptors throughout the body. One key to help heal from PSSD is increasing androgen production, androgen receptor sensitivity, and blood flow to boost BDNF, SERT, and DHT levels to hopefully allow any estrogen receptor desensitization recover on its own over time after everything else is normalized. Once androgen levels in local tissues (pelvic floor, brain, genitals) are normalized again through androgen receptor activation and sensitivity, it will encourage the conversion of androgens into estrogens in these tissues via aromatase. It is also worth to mention that some community members are trying to restore estrogen receptor sensitivity via boosting estrogen in various ways including by taking hops extract which is a potent phytoestrogen. This is also interesting: Estradiol represents another important natural ligand for androgen receptors that may play an essential role for the androgen receptor function and the development of the male reproductive system.
As mentioned earlier, people with PSSD and other disorders might have normal looking hormone blood tests (testosterone, DHT, estrogen, etc), but the issue is that these hormones are not functioning in the brain, pelvic floor, and genitals properly due to androgen and estrogen receptor insensitivity. An important thing to also recognize is that the medical community still has no official explanation how exactly SSRIs cause all of these debilitating side effects, but they are still being readily prescribed without informed consent about the risks of PSSD. It is unfortunate that it is people like us on the internet leading the charge to investigate and inform. We all need to continue to do our part to spread awareness of these iatrogenic disorders to warn people about the risks of taking these medications because their medical providers aren’t likely going to. Thank you to the PSSD Network for helping to give a voice to the unheard.
Post-SSRI Sexual Dysfunction (PSSD): Biological Plausibility, Symptoms, Diagnosis, and Presumed Risk Factors
Androgen receptor (AR) inactivation in mice led to reduction in hypothalamic neural nitric oxide synthase (nNOS), indicating the regulatory sexual function of this neurotransmitter. Furthermore, activation of the pre and post-synaptic 5HT1A receptors was found to be correlated with inhibitory effect on erectile function. All of these factors are speculated to be involved in this symptom and might be related to epigenetic alteration of androgen receptor (AR) and estrogen receptor (ER) densities due to influence of SSRIs on the epigenome.
In male PSSD sufferers, the penile shaft can be rigid during erection, yet the glans of the penis remains flaccid.This symptom may arise from hypo-activation of the dopaminergic and oxytocinergic pathways. The glans of the penis, in particular, receives its blood supply from the deep dorsal artery. Perhaps this points to a selective arterial malfunction relative to pelvic floor dysfunction which usually accompanies PSSD.
Here is another interesting study that gives support to the importance of increasing blood flow to help heal:
If SSRIs produce sexual side effects by impairing vasocongestion to the genital region, it would be expected that pharmacologic agents that increase blood flow to the genital region would improve sexual functioning. Indeed, several anecdotal reports and studies have found that sildenafil (a drug designed to treat erectile failure by increasing blood flow into the penile tissue) was successful in reversing SSRI-induced sexual dysfunction in both men and women [8,9,87,88,109]. Sildenafil acts to increase blood flow into the genital tissue by facilitating c-GMP activity that is initiated by nitric oxide [19] and preliminary evidence suggests that the SSRIs may cause sexual difficulties by inhibiting nitric oxide synthase [39,118].
Here is a paper from a community member that hypothesizes that the main issue is lasting estrogen receptor insensitivity just to give another interesting perspective on Post-SSRI Sexual Dysfunction, Post-Finasteride Syndrome, and Post-Retinoid Sexual Dysfunction
As the body is starved of DHT, ARs upregulate in response. At the same time, ER activation is significantly increased as a result of the increased production of Estradiol during treatment (due to higher Testosterone availability by reduced 5a reduction to DHT) - eventually leading to ER downregulation.
Hard Flaccid Syndrome (HFS) - There are many men suffering from HFS and pelvic floor issues due to PSSD, PFS, heavy weight lifting, excess kegeling, or in the case I’m presenting here, physical damage to the genitals from excessive, vigorous sexual activity (my case) or penis enlargement exercises. When the genitals get damaged, an inflammatory process starts and the pelvic floor contracts to protect itself. Since the pelvic floor is now in a chronic, contracted state, it limits oxygen and sex hormone rich blood flow to the genitals and pelvic floor which leads to sex hormone insensitivity and negatively impacts healing, muscle relaxation, and DHT production in these tissues. Finasteride, Accutane, and SSRIs also desensitize sex hormone receptors in the genitals and pelvic floor tissues leading to hard flaccid and pelvic floor dysfunction. Since the pelvic floor tightness restricts blood flow, it is difficult for hard flaccid sufferers to reactivate and sensitize their pelvic floor muscle androgen receptors again to regain relaxation and strength in their pelvic floor muscles, including the ischiocavernosus (IC), bulbocavernosus (BC), and pubococcygeus (PC) which are in a contracted state; the IC muscle in particular is thought to be the most implicated in the cause of hard flaccid. We first need to promote relaxation in the pelvic floor by boosting blood flow through supplements and stretches because tight muscles are weak muscles. Once the pelvic floor is in a chronic state of tension, it is hard to heal from pelvic floor issues because you likely already had bad habits such as poor posture, unhealthy sexual practices, stiff muscles, sedentary lifestyle, unchecked anxiety, and other negative lifestyle factors. Along with supplements, exercises, and stretches, correcting these bad habits is necessary to heal to have an even healthier pelvic floor than you ever had before because it likely was already tight and dysfunctional to begin with before developing obvious issues, but it was more subtle and you had no awareness of your pelvic floor muscles until now. You have the potential to now become a much healthier person overall than you ever would have been without being affected by pelvic floor dysfunction and hard flaccid.
32% of women will develop a pelvic floor disorder in their lifetime which is double that of men. While childbirth and pregnancy plays a role in this discrepancy, women also have far less testosterone and DHT levels than men which I believe plays a major factor. Since women have less testosterone, their androgen receptors that line the pelvic floor don’t make enough DHT to adequately support these tissues compared to men. This makes them more prone to pelvic floor dysfunction that causes them a disparate amount of pain, tightness, and inflammation. Androgen receptors and their ability to convert testosterone into DHT play such a vital role in pelvic floor health and sexual functioning. This is mentioned in a research study: Prevailing scientific literature has indicated the presence of androgen receptors in the levator ani muscle and pelvic fascia. The existence of androgen receptors in the vaginal wall can play an essential role in the development of pelvic floor disorders in women.Thus, androgen-related disorders may interfere with the function of pelvic floor muscles. Many people mistakenly believe that androgens are only important for male sexual health: increase libido by providing the fuel for a woman’s psychosexual stimulation, (2) increase sensitivity and blood flow to the external genitalia, and (3) increase the intensity of sexual gratification.
What I see in all these conditions is that sex hormone receptors become desensitized in the pelvic floor and genital tissues either from a drug, pelvic tightness, or inflammation from injury leading to less hormones being produced causing sexual and pelvic floor dysfunction. The pelvic floor now goes into a chronic tightened state as a response, leading to less oxygen and testosterone rich blood flow to the genital and pelvic region which leads to more androgen insensitivity and subsequently less DHT. This all explains why many people who have these conditions are helped by supplements that improve androgen receptor sensitivity and blood flow, and why pelvic floor therapy and exercises are so helpful to many of them. Estrogen receptor insensitivity in the pelvic floor also appears to have a similar mechanical negative effect by leading to less estrogen levels in the pelvic floor and genital tissues. It is also possible that some people with PSSD/PFS may have subtle or no pelvic floor symptoms, but the medication still desensitizes sex hormone sensitivity in their genitals and pelvic floor tissues that is leading to sexual dysfunction.
Another study linking androgens and the pelvic floor: Levator ani and other muscles of the pelvic floor and lower urinary tract are sensitive to the anabolic effects of testosterone. Androgen receptors are also expressed in the pelvic floor and lower urinary tract of both animals and humans. Anabolic effects of androgens may play an important role in the female pelvic-floor and lower-urinary-tract disorders. Furthermore, the interactions between androgen and nitric oxide synthase and arginase have been demonstrated, suggesting that androgens may also participate in modulating the physiological functions of the lower urinary tract through nitric oxide. The action of androgens in the lower urinary tract and pelvic floor is complex and may depend on their anabolic effects, hormonal modulation, receptor expression, interaction with nitric oxide synthase, or a combination of these effects.
My solution to help heal and improve the well-being of people with these issues is to try to improve sex hormone receptor sensitivity and pelvic floor function through supplements, stretches, exercises, and boosting blood flow which will hopefully restore normal levels of estrogens and androgens in pelvic, genital, and brain tissues. The body has a tremendous capability of self-healing, but we need to support it through active recovery methods.
We will first start with supplements (this is not professional medical advice - talk with your doctor before taking):
L-citrulline - This is the precursor to l-arginine, and it will improve blood flow and levels of nitric oxide to help get oxygen and testosterone rich blood to the pelvic floor and genital tissues to increase androgen sensitivity. Nitric oxide can also induce smooth muscle relaxation which is important for relaxing the pelvic floor. Herein we report on a young man affected by PSSD who regained sexual functioning after 3-month treatment with EDOVIS, a dietary supplement containing L-citrulline and other commonly used aphrodisiacs.. I recommend taking at least 6000 mg daily by taking 2000mg three times throughout the day. The max dose is 10,000mg. Even potentially better, people report great results using Cialis to improve blood flow and healing rather than L-citrulline and some doctors will even prescribe it to women if you show them the evidence - talk with your doctor. “Tadalafil (Cialis) reversal of sexual dysfunction caused by serotonin enhancing medications in women”. L-Citrulline and Cialis are not recommended to be taken together.
L-Carnitine - This will improve the number of androgen receptors and their sensitivity to testosterone to increase levels of DHT in the pelvic floor, genital tissues, and brain. I recommend taking 2000mg daily. Acetyl-L-Carnitine can pass through the blood-brain barrier, while Propionyl-L-carnitine has a high degree of interaction with testosterone. Propionyl may be better for sexual and pelvic floor dysfunction, while Acetyl might help people suffering from the mental effects of PSSD. This study used each at 2000mg daily to improve erectile dysfunction along with Viagra.. I would work up to 2000mg each of Acetyl and Propionyl L-Carnitine along with Cialis instead of Viagra as it lasts in the body for much longer (36 hours) for increased blood flow healing purposes. You can also use L-Citrulline instead of Cialis as mentioned earlier. Discuss with your doctor before taking them.
Vitamin D - This vitamin, which acts more like a hormone, works directly with the endocrine system. It has its own receptors throughout the body and they are often in close proximity to androgen receptors. Deficiency in vitamin D is associated with a stunting of testosterone's effects on androgen receptors and a decline in testosterone levels. Vitamin D will encourage androgen receptor resensitization. One study found that higher vitamin D levels are associated with a decreased risk of pelvic floor disorders in women, and The levator ani and coccygeus muscles are skeletal muscles that are critical components of the pelvic floor and may be affected by vitamin D nutritional status. I recommend 4000IU of vitamin D daily or whatever gets your levels to 60 - 80 ng/ml.
If you have inflammatory issues or pain due to pelvic floor dysfunction, I recommend a fish oil supplement daily. I take fish oil, and I find that it helps limit pelvic inflammation. I also take Magnesium Glycinate to relax the smooth muscle that lines the pelvic floor and genital tissue. I recommend it for people with clear pelvic floor dysfunction, but others should be careful as research says magnesium is a 5-alpha-reductase inhibitor. Take quercetin and bromelain as needed if you experience pelvic inflammatory flare ups and pain, but just be careful as quercetin can also inhibit the production of DHT from testosterone as well. Some say fish oil blocks DHT too, but experiencing chronic pelvic floor pain and inflammation will do more harm to you than minimal DHT blocking. I recommend staying away from all DHT inhibiting foods and supplements for people with PSSD, PFS, and PAS unless you are experiencing pelvic pain and inflammation.
As always, discuss these supplements with your doctor to see if they are okay for you. Lower your supplement intake based on side effects. These aren’t a magic cure, but a tool to help you on your journey to recovery. Don’t do anything without doctor supervision, but this thread gives more evidence for the “cure” for PSSD/PFS being resensitizing androgen receptors and estrogen receptors along with enhancing blood flow as it details how some men recovered through taking high doses of androgens, post cycle therapy, and Cialis. This at least gives hope that a hormonal cure can be created one day by medical professionals. I would of course recommend trying to heal yourself naturally for a long time before doing any hormone treatments under the supervision of a doctor.
I also recommend doing some form of yoga or pelvic floor stretches daily to improve blood flow for pelvic floor relaxation and sex hormone receptor sensitivity. You also need to request to see a pelvic floor therapist for an evaluation and treatment. Learn how to do reverse kegels. Doing reverse kegels will be difficult at first because your pelvic floor is tight and you have little to no awareness of these muscles, so just focus on lengthening and relaxing the pelvic floor through stretches for now. Do not do regular kegels for pelvic floor issues. Learn how to diaphragmatically breathe in 360 degrees to create expansion in your rib cage and abdomen to encourage pelvic floor relaxation. Do not breathe through your chest, and “belly breathing” isn’t the right term because the ribs need to expand as well. You can learn how to diaphragmatically breathe through an exercise such as 4-7-8 breathing. Here is a great video on diaphragmatic breathing and another video. I cannot overstate it enough: retraining yourself to properly breathe diaphragmatically is the single most important thing that you can do to heal from pelvic floor issues. Be a student of breathing: study and take notes on how to breathe better.
Stretches/Yoga poses I recommend:
Hold the Malasana/hindi/yoga squat pose for at least 5-10 minutes at least twice a day, but doing it morning, mid-day, and at night would be the best. Some get great results holding it for 15-20 minutes.This is one of the most important things for your pelvic floor because it will help lengthen and release it. Doing them barefoot is also very beneficial to strengthen your ankles and feet which are connected to your pelvic floor. Again, remember to breathe deeply down into your belly and pelvic floor for all these stretches.
Begin your stretching routine with an Exercise ball ab stretch and Upward-facing dog/cobra pose. This will help stretch your lower abs and psoas muscles so that you can get more breath deeper down into your pelvic floor for the rest of your stretches. Some people say that these types of stretches aren’t great for people who have Anterior Pelvic Tilt, which we should fix, but I still do them as it is important to stretch the lower abs that are hard to get to. You can experiment with doing them sporadically instead of every time you stretch.
This is my current personal complete stretch routine I do in order 3+ days a week:
Myofascial release on my glutes with an orb massage ball but you can use any small hard ball (don’t do this if glutes are currently sore) > Calf stretch against a wall or a yoga block which is what I use > exercise ball ab stretch > upward facing dog > (optional) Do a handful of cat cows > Supine hamstring stretch with yoga strap or an IdealStretch tool which is what I use > Kneeling hip flexor stretch > flat on back supine single knee to chest stretch > then bring knee to opposite shoulder stretch > supine figure four > I do this stretch next right after figure four > Reclined bound angle pose > (optional) butterfly stretch > (optional) A little bit of downward facing dog to stretch the calves > (optional) Lizard Pose) > (optional) Half split stretch/Half monkey pose with yoga blocks > Half-pigeon pose > Child’s pose > Wall quad hip flexor stretch > Wall figure four stretch > Wall straddle pose > Wall happy baby pose > Flat on back while pulling knees apart > kneeling with one leg, other leg out to side for adductors > (optional) Frog pose with feet together > regular Frog pose with feet separated in line with the knees > Yoga squat/malasana > Corpse pose
All these stretches are the ones I found most useful in a routine. See what works for you and develop your own routine. Consistency is the most important. This long stretching routine may not be possible for you to complete regularly so make adjustments, but doing this routine at least 3 days a week is ideal. Stretches such as the yoga squat, supine hamstring stretch, hip flexor stretches, and wall stretches are vital and should be done most days to help relax the pelvic floor. For how long you should hold each stretch, just go by how you and your body feels. Really let go, breathe, and sink into every stretch. On rest days, doing some deep breathing in child’s pose, reclined bound angle pose, flat on back while pulling knees apart, and the happy baby wall pose is really great while trying to do gentle reverse kegels.
You can also work on more individualized stretches for posture to correct anterior pelvic tilt, muscle imbalances, and to release other tight muscles, such as the upper body. Listen to your body if you need to give yourself a rest day from stretching. Adding in a 30-60 minute walk/swim on rest days is incredibly beneficial as well. Eventually, you can also try to learn isometric PNF stretching to incorporate it into some of the stretches such as the kneeling hip flexor stretch and hamstring stretch.
After working to relax and lengthen your pelvic floor through yoga and stretches, I would begin gentle body strengthening exercises that are pelvic floor safe. The pelvic floor is a master compensator. So, if the glutes, adductors, deep hip rotators, transversus abdominis, and other supportive muscles are weak, then the pelvic floor is in the prime position to pick up the slack which leads to a lot of strain on the pelvic floor which results in tightness and dysfunction. You need to strengthen the surrounding muscles to relieve tightness in the pelvic floor. This is where working with a pelvic floor therapist would be helpful to point out safe individualized exercises for you. Yoga will help strengthen your muscles in a safe way too.
The glutes and transversus abdominis in particular are very important to strengthen. Glute bridge, single glute bridge, side lying leg raises, lateral band walks can help build up glute strength. Deadbugs, Bird Dog, 8- point planks, or planks with pelvic floor-friendly modifications, can help to strengthen the transversus abdominis (TVA). Abdominal work may be triggering to your pelvic floor symptoms, especially the 8 point plank, so you can instead look into hypopressive exercises to work the TVA without overworking the pelvic floor. These exercises will help you bring more awareness to your breathing, diaphragm, TVA, and pelvic floor which are all important for recovery. Here is how to find and become aware of the TVA. Do side planks for your oblique ab muscles.
For hip/abductors do the side lying hip abduction exercise, fire hydrants, and the shinbox lunge. For the adductors, do Copenhagen adductor exercise, cossack squats, and an exercise where you squeeze a soft ball between the knees just don’t do any crunch movements with pelvic floor issues. For hamstrings, Nordic hamstring curl/glute ham raises, and single leg bridge. For the back, do supine pelvic tilt. One person even reported that dorsiflexion exercises and stretches were one important element to solve his pelvic floor issues; this is most likely because the ankle bone, like everything else including even our jaw, is connected to the pelvic floor.
Like with anything, do all these exercises in moderation and stop if you sense your pelvic floor is not responding well to them - do them one at a time to see which ones your pelvic floor can handle for now. Here is an exercise routine from another poster that has helped many people. Just be careful of the ab exercises such as the ab wheel and 5 minute planks with your pelvic floor issues - don’t over do it or avoid it if they cause too many symptoms.
Myofascial release and foam rolling to release trigger points also helps a lot of people to relax their pelvic floor muscles and improve blood flow. The glutes are the most important area to target for pelvic floor issues when foam rolling in my experience if you only had limited time. Using a soft ball to lay on and breathe deeply can help release trigger points in the abdominal muscles and psoas which can help you breathe better and relax the pelvic floor. I haven’t done it, but you can also try out a massage gun for myofascial release; just be careful and don’t use it in sensitive pelvic areas. Some men and women also report success using a therawand to release internal trigger points that are causing them pelvic floor dysfunction symptoms.
Walking and swimming for 30-60 minutes are some of the best exercises to lengthen, relax, stretch, and release your pelvic floor, boost blood flow, and help to retain and build strength in muscles that give support to the pelvic floor. Walk or swim for 5+ days a week for the best results. The breaststroke and freestyle are very helpful for pelvic floor sufferers. Along with swimming, people also use an elliptical at a low resistance to help provide a cardio workout that is safer for your pelvic floor.
Fix your posture. Pelvic floor issues and hard flaccid syndrome are closely associated with Anterior Pelvic Tilt and other postural issues. Get evaluated by a physical therapist so that they can give you exercises and stretches to fix it. You could also look into the Postural Restoration institute and see one of their providers and try to implement some of their exercises. In the meantime, here is one video playlist on how to fix APT. Another video to fix APT says to stretch the hip flexors, lower back, while focusing on strengthening the abs, glutes, and hamstrings. Make sure that you sit and walk with good posture - watch this to learn how to walk correctly - activate your glutes during each step and push off with your back foot!. I also recommend getting a standing desk to try to avoid sitting for long periods of time.
Weight training can be effective for boosting active androgen receptors in the body to increase testosterone and DHT levels. However, you need to make sure that it isn’t making your pelvic floor symptoms worse which defeats the purpose. If you are going to lift weights with pelvic floor issues, don’t lift heavy, do any intensive ab workouts, or any other exercises that can put extra strain on your pelvic floor. Do lifts where you can sit down instead of standing up. Start with yoga, stretching, and gentle body exercises to relax your pelvic floor and strengthen surrounding muscles before incorporating consistent weight training. I highly recommend, however, just sticking with yoga and pelvic floor safe body weight exercises to build strength instead. Those with PSSD without pelvic floor dysfunction may benefit a lot from lifting weights, high-intensity interval training, and doing bodyweight exercises such as squats regularly to boost androgen receptors and DHT. Remember to see a pelvic floor therapist to get evaluated first before starting any weight lifting because many people have pelvic floor issues without even realizing it.
Work on your mental health. Anxiety can worsen pelvic floor issues. Just as dogs tuck and tense their tails when stressed, we tense our pelvic floors which are directly connected to our tailbone where we used to have tails ourselves in our evolutionary history. As we are impacted by sexual dysfunction and pelvic floor dysfunction symptoms, we become anxious along with other negative emotions which leads to more pelvic floor tension symptoms due to the fight or flight mode response causing even more anxiety leading to more symptoms. It is a vicious cycle that needs to break by not becoming anxious and negative when we experience pelvic floor symptoms or hard flaccid and instead let go, accept, and realize that it is a normal process when trying to heal because sometimes our muscles that are used to that tightness don't want to let go of the tension we hold in our pelvic floors. Daily yoga, meditation, stretching, and walking will help with anxiety. I would also see a mental health therapist because all of these issues are deeply traumatic and we cannot go through this alone. We often hold tension in the form of emotions and trauma in our bodies, especially our pelvic floor and genital areas. By openly talking about these issues with a therapist, it will help us process and release our emotions and trauma that we are holding inside our bodies to improve our anxiety, relax our pelvic floor, and to let go of all of our tension. Many people who healed their hard flaccid and pelvic floor issues said that solving their anxiety and negative thoughts by talking to a mental health counselor was vital in recovery. The mind-body connection is so powerful, and it directly impacts our pelvic floor. Those who are stuck in the cycle of experiencing pelvic floor symptoms leading to anxiety and negative thoughts will also benefit from Cognitive Behavioral Therapy you can do by yourself like in this video or preferably with a trained therapist. Here is an informative mini lecture on how stress impacts the pelvic floor.
I would also definitely go on a healthy anti-inflammatory diet. Avoid caffeine, alcohol, marijuana, and other substances. Avoid foods and liquids that can trigger pelvic floor inflammation such as highly acidic fruits and veggies, carbonated beverages, very spicy foods, and artificial sugars. To maintain a healthy gut to reduce inflammation in your body I recommend trying a low-histamine probiotic supplement along with eating healthy. You should also work on preventing or fixing constipation; eat a lot of soluble fiber to not get constipated - take a supplement such as metamucil if you have to. Check the Bristol stool shape chart to identify if you are constipated because even mild constipation can contribute to pelvic floor tension. This is because the constipation leads to a lot of pressure being put on your rectum and pelvic floor leading to the muscles becoming weak and dysfunctional. I am willing to bet many of you are constipated and don’t know it because it isn’t just whether you go regularly, it is also how your stool is shaped. People with pelvic floor disorders are at a high risk of constipation which makes their tension and dysfunction worse which then worsens the constipation, another cycle to fix. I recommend getting a Squatty Potty to reduce strain on the pelvic floor during elimination.
To help heal hard flaccid and pelvic floor issues, never watch pornography again (this is vital). Go on NoFap for 90+ days to help heal your brain and body from any unhealthy pornography and sexual habits you have partaken in. Pornography leads to involuntary kegels, a tight pelvic floor, desensitizes you, and messes up the dopamine and arousal circuitry in your brain. Don’t climax too often. Learn how to reverse kegel by yourself and during sexual activities. Never edge or regular kegel - it leads to pelvic floor tightness and dysfunction - just relax your arousal through a reverse kegel. Keep your pelvic floor relaxed during sexual activities.
Stay strong and never give up. You will heal. Thank you for reading.
submitted by EasyFlaccid to pssdhealing [link] [comments]

2023.08.27 15:50 EasyFlaccid The link between Post-SSRI Sexual Dysfunction, Hard Flaccid Syndrome, Post Finasteride Syndrome, Pelvic Floor Dysfunction, Chronic Pelvic Pain Syndrome and advice on how to start your healing journey based on 8 years of research and personal experiences

Here are all my thoughts and advice based on my personal experiences, other people’s insight and helpful experiences, and research I have done on and off about pelvic floor issues from the past eight years or so. There is still a lot left to learn, but I am putting everything I know currently here. I am not claiming that any of this is revolutionary, but I hope it can help some of you out there to give you a head start on healing and advance our understanding of these conditions. As I am a 27 year old male with previous major problems with pelvic floor issues and hard flaccid, some of my advice may be biased towards my condition. However, I believe everyone can benefit from a lot of this because I really do think that all of these conditions that I mentioned are linked in at least some way, especially by pelvic floor dysfunction and sex hormone desensitization. I try not to come to these forums because it increases anxiety and negative emotions which leads to worse pelvic floor symptoms, so my apologies if I do not respond to your questions. For hard flaccid and pelvic floor affected people, follow my advice and I am confident you can heal and reach a place where your symptoms barely affect your life, if at all, which is where I am at now. The mentality of trying to find a 100% “magic cure” solution just leads to anxiety and catastrophic thinking if you have a set back which will only worsen your symptoms. You can and will heal. I know this is a lot of information, but try to implement just one or two things at a time. Focus on the present, and take it one day at a time. Don’t get overwhelmed. All of this is my opinion and not professional medical advice. Talk with your doctor before starting anything.
Post Finasteride Syndrome (PFS), Post-SSRI Sexual Dysfunction (PSSD), Hard Flaccid Syndrome (HFS), Pelvic Floor Dysfunction, and Chronic Pelvic Pain Syndrome all can have some similar symptoms. I believe that they are all either caused or can be exacerbated by androgen and estrogen receptor insensitivity and are triggered by medication, genital injury, and pelvic floor inflammation and dysfunction. The pelvic floor is rich in androgen receptors and estrogen receptors. However, without proper androgen receptor activation and sensitivity, the pelvic floor muscles don’t have enough DHT which line the tissues of the pelvic floor, genitalia, and lower urinary tract. DHT is vital for healthy sexual functioning in both sexes - it provides an anabolic effect to tissues to provide strength, stability, healing, and relaxation to tissues. As a result of androgen receptor insensitivity and lack of DHT, the pelvic floor can become chronically weakened, tight, and inflamed which reduces blood flow to the region leading to even more androgen receptor insensitivity and thus less DHT. These symptoms can cause psychological stress to the individual which tightens the pelvic floor further leading to more symptoms and less blood flow. One study found that androgen sensitivity has raised the possibility that androgens can be used to rebuild the weakened and/or damaged muscles comprising the pelvic floor - source. Some people may also have normal hormone levels in the blood when tested, but these hormones cannot reach or be effective in the pelvic floor tissues or brain due to sex hormone insensitivity and the lack of the blood flow in the region caused by pelvic floor tightness and dysfunction. It is also likely that there is a problem with desensitized estrogen receptors causing a similar mechanism of dysfunction because they are also found in the pelvic floor, genitals, and brain and are important for pelvic floor health, sexual functioning, cognition, and emotions in both sexes. The most important element to remember to help start the healing process for these disorders is to boost blood flow through supplements, stretches, and exercises which will increase both androgen and estrogen receptor sensitivity over time.
Many males with PFS, PSSD, and Pelvic Floor dysfunction are affected by the hard flaccid condition.
Post Finasteride Syndrome (PFS) caused by Finasteride, a 5-alpha-reductase inhibitor (5-ARI), plummets DHT levels in the body to try to help hair loss causing sexual dysfunction and pelvic floor issues. Androgen receptors that surround the pelvic floor, genitals, and brain become desensitized due to the Finasteride leading to less DHT binding to these receptors causing dysfunction and a tight, weak pelvic floor. The tight, dysfunctional pelvic floor now restricts blood flow which impacts healing and the delivery of testosterone to this area that further exacerbates androgen insensitivity leading to less DHT in these tissues. Since androgen receptors are found in the brain and androgens have neuroprotective effects, this could be one reason why some PFS and PSSD sufferers are also impacted cognitively. An herbal supplement called Saw Palmetto has also been reported to cause a disorder similar to PFS because it is also a 5-ARI that blocks the conversion of testosterone into DHT. Another disorder called Post Accutane Syndrome (PAS) is also similar to PFS and it reduces DHT as well through being a 5-ARI: “Isotretinoin, used to treat severe acne, has been shown to induce hormonal changes, especially to reduce 5 alpha-reductase in the production of the tissue-derived dihydrotestosterone (DHT) metabolite 3 alpha-Adiol G.”. PFS, PAS, and PSSD are thought to cause not only androgen receptor desensitization, but likely estrogen receptor desensitization as well.
For Post-SSRI Sexual Dysfunction (PSSD), SSRIs are also known to decrease androgens and down regulate androgen receptors. This study shows that SSRIs can have an anti-estrogenic effect as well and can even reduce the expression of estrogen receptors (ER), including in the hypothalamus.. As sex hormones get desensitized in the pelvic floor, genital region, and brain, it causes localized DHT and estrogen levels in these tissues to decrease causing emotional blunting, sexual dysfunction, pelvic floor issues, hard flaccid syndrome, and more. The pelvic floor dysfunction can then prevent the sex hormone receptors from being reactivated and sensitized due to restricting oxygen and sex hormone rich blood flow to the tissues. SSRIs can cause androgen receptor insensitivity and estrogen receptor insensitivity by severely inhibiting the serotonin transporter (SERT) leading to increased serotonin levels which desensitizes those receptors throughout the body. One key to help heal from PSSD is increasing androgen production, androgen receptor sensitivity, and blood flow to boost BDNF, SERT, and DHT levels to hopefully allow any estrogen receptor desensitization recover on its own over time after everything else is normalized. Once androgen levels in local tissues (pelvic floor, brain, genitals) are normalized again through androgen receptor activation and sensitivity, it will encourage the conversion of androgens into estrogens in these tissues via aromatase. It is also worth to mention that some community members are trying to restore estrogen receptor sensitivity via boosting estrogen in various ways including by taking hops extract which is a potent phytoestrogen. This is also interesting: Estradiol represents another important natural ligand for androgen receptors that may play an essential role for the androgen receptor function and the development of the male reproductive system.
As mentioned earlier, people with PSSD and other disorders might have normal looking hormone blood tests (testosterone, DHT, estrogen, etc), but the issue is that these hormones are not functioning in the brain, pelvic floor, and genitals properly due to androgen and estrogen receptor insensitivity. An important thing to also recognize is that the medical community still has no official explanation how exactly SSRIs cause all of these debilitating side effects, but they are still being readily prescribed without informed consent about the risks of PSSD. It is unfortunate that it is people like us on the internet leading the charge to investigate and inform. We all need to continue to do our part to spread awareness of these iatrogenic disorders to warn people about the risks of taking these medications because their medical providers aren’t likely going to. Thank you to the PSSD Network for helping to give a voice to the unheard.
Post-SSRI Sexual Dysfunction (PSSD): Biological Plausibility, Symptoms, Diagnosis, and Presumed Risk Factors
Androgen receptor (AR) inactivation in mice led to reduction in hypothalamic neural nitric oxide synthase (nNOS), indicating the regulatory sexual function of this neurotransmitter. Furthermore, activation of the pre and post-synaptic 5HT1A receptors was found to be correlated with inhibitory effect on erectile function. All of these factors are speculated to be involved in this symptom and might be related to epigenetic alteration of androgen receptor (AR) and estrogen receptor (ER) densities due to influence of SSRIs on the epigenome.
In male PSSD sufferers, the penile shaft can be rigid during erection, yet the glans of the penis remains flaccid.This symptom may arise from hypo-activation of the dopaminergic and oxytocinergic pathways. The glans of the penis, in particular, receives its blood supply from the deep dorsal artery. Perhaps this points to a selective arterial malfunction relative to pelvic floor dysfunction which usually accompanies PSSD.
Here is another interesting study that gives support to the importance of increasing blood flow to help heal:
If SSRIs produce sexual side effects by impairing vasocongestion to the genital region, it would be expected that pharmacologic agents that increase blood flow to the genital region would improve sexual functioning. Indeed, several anecdotal reports and studies have found that sildenafil (a drug designed to treat erectile failure by increasing blood flow into the penile tissue) was successful in reversing SSRI-induced sexual dysfunction in both men and women [8,9,87,88,109]. Sildenafil acts to increase blood flow into the genital tissue by facilitating c-GMP activity that is initiated by nitric oxide [19] and preliminary evidence suggests that the SSRIs may cause sexual difficulties by inhibiting nitric oxide synthase [39,118].
Hard Flaccid Syndrome (HFS) - There are many men suffering from HFS and pelvic floor issues due to PSSD, PFS, heavy weight lifting, excess kegeling, or in the case I’m presenting here, physical damage to the genitals from excessive, vigorous sexual activity (my case) or penis enlargement exercises. When the genitals get damaged, an inflammatory process starts and the pelvic floor contracts to protect itself. Since the pelvic floor is now in a chronic, contracted state, it limits oxygen and sex hormone rich blood flow to the genitals and pelvic floor which leads to sex hormone insensitivity and negatively impacts healing, muscle relaxation, and DHT production in these tissues. Finasteride, Accutane, and SSRIs also desensitize sex hormone receptors in the genitals and pelvic floor tissues leading to hard flaccid and pelvic floor dysfunction. Since the pelvic floor tightness restricts blood flow, it is difficult for hard flaccid sufferers to reactivate and sensitize their pelvic floor muscle androgen receptors again to regain relaxation and strength in their pelvic floor muscles, including the ischiocavernosus (IC), bulbocavernosus (BC), and pubococcygeus (PC) which are in a contracted state; the IC muscle in particular is thought to be the most implicated in the cause of hard flaccid. We first need to promote relaxation in the pelvic floor by boosting blood flow through supplements and stretches because tight muscles are weak muscles. Once the pelvic floor is in a chronic state of tension, it is hard to heal from pelvic floor issues because you likely already had bad habits such as poor posture, unhealthy sexual practices, stiff muscles, sedentary lifestyle, unchecked anxiety, and other negative lifestyle factors. Along with supplements, exercises, and stretches, correcting these bad habits is necessary to heal to have an even healthier pelvic floor than you ever had before because it likely was already tight and dysfunctional to begin with before developing obvious issues, but it was more subtle and you had no awareness of your pelvic floor muscles until now. You have the potential to now become a much healthier person overall than you ever would have been without being affected by pelvic floor dysfunction and hard flaccid.
32% of women will develop a pelvic floor disorder in their lifetime which is double that of men. While childbirth and pregnancy plays a role in this discrepancy, women also have far less testosterone and DHT levels than men which I believe plays a major factor. Since women have less testosterone, their androgen receptors that line the pelvic floor don’t make enough DHT to adequately support these tissues compared to men. This makes them more prone to pelvic floor dysfunction that causes them a disparate amount of pain, tightness, and inflammation. Androgen receptors and their ability to convert testosterone into DHT play such a vital role in pelvic floor health and sexual functioning. This is mentioned in a research study: Prevailing scientific literature has indicated the presence of androgen receptors in the levator ani muscle and pelvic fascia. The existence of androgen receptors in the vaginal wall can play an essential role in the development of pelvic floor disorders in women.Thus, androgen-related disorders may interfere with the function of pelvic floor muscles. Many people mistakenly believe that androgens are only important for male sexual health: increase libido by providing the fuel for a woman’s psychosexual stimulation, (2) increase sensitivity and blood flow to the external genitalia, and (3) increase the intensity of sexual gratification.
What I see in all these conditions is that sex hormone receptors become desensitized in the pelvic floor and genital tissues either from a drug, pelvic tightness, or inflammation from injury leading to less hormones being produced causing sexual and pelvic floor dysfunction. The pelvic floor now goes into a chronic tightened state as a response, leading to less oxygen and testosterone rich blood flow to the genital and pelvic region which leads to more androgen insensitivity and subsequently less DHT. This all explains why many people who have these conditions are helped by supplements that improve androgen receptor sensitivity and blood flow, and why pelvic floor therapy and exercises are so helpful to many of them. Estrogen receptor insensitivity in the pelvic floor also appears to have a similar mechanical negative effect by leading to less estrogen levels in the pelvic floor and genital tissues. It is also possible that some people with PSSD/PFS may have subtle or no pelvic floor symptoms, but the medication still desensitizes sex hormone sensitivity in their genitals and pelvic floor tissues that is leading to sexual dysfunction.
Another study linking androgens and the pelvic floor: Levator ani and other muscles of the pelvic floor and lower urinary tract are sensitive to the anabolic effects of testosterone. Androgen receptors are also expressed in the pelvic floor and lower urinary tract of both animals and humans. Anabolic effects of androgens may play an important role in the female pelvic-floor and lower-urinary-tract disorders. Furthermore, the interactions between androgen and nitric oxide synthase and arginase have been demonstrated, suggesting that androgens may also participate in modulating the physiological functions of the lower urinary tract through nitric oxide. The action of androgens in the lower urinary tract and pelvic floor is complex and may depend on their anabolic effects, hormonal modulation, receptor expression, interaction with nitric oxide synthase, or a combination of these effects.
My solution to help heal and improve the well-being of people with these issues is to try to improve sex hormone receptor sensitivity and pelvic floor function through supplements, stretches, exercises, and boosting blood flow which will hopefully restore normal levels of estrogens and androgens in pelvic, genital, and brain tissues. The body has a tremendous capability of self-healing, but we need to support it through active recovery methods.
We will first start with supplements (this is not professional medical advice - talk with your doctor before taking):
L-citrulline - This is the precursor to l-arginine, and it will improve blood flow and levels of nitric oxide to help get oxygen and testosterone rich blood to the pelvic floor and genital tissues to increase androgen sensitivity. Nitric oxide can also induce smooth muscle relaxation which is important for relaxing the pelvic floor. Herein we report on a young man affected by PSSD who regained sexual functioning after 3-month treatment with EDOVIS, a dietary supplement containing L-citrulline and other commonly used aphrodisiacs.. I recommend taking at least 6000 mg daily by taking 2000mg three times throughout the day. The max dose is 10,000mg. Even potentially better, people report great results using Cialis to improve blood flow and healing rather than L-citrulline and some doctors will even prescribe it to women if you show them the evidence - talk with your doctor. “Tadalafil (Cialis) reversal of sexual dysfunction caused by serotonin enhancing medications in women”. L-Citrulline and Cialis are not recommended to be taken together.
L-Carnitine - This will improve the number of androgen receptors and their sensitivity to testosterone to increase levels of DHT in the pelvic floor, genital tissues, and brain. I recommend taking 2000mg daily. Acetyl-L-Carnitine can pass through the blood-brain barrier, while Propionyl-L-carnitine has a high degree of interaction with testosterone. Propionyl may be better for sexual and pelvic floor dysfunction, while Acetyl might help people suffering from the mental effects of PSSD. This study used each at 2000mg daily to improve erectile dysfunction along with Viagra.. I would work up to 2000mg each of Acetyl and Propionyl L-Carnitine along with Cialis instead of Viagra as it lasts in the body for much longer (36 hours) for increased blood flow healing purposes. You can also use L-Citrulline instead of Cialis as mentioned earlier. Discuss with your doctor before taking them.
Vitamin D - This vitamin, which acts more like a hormone, works directly with the endocrine system. It has its own receptors throughout the body and they are often in close proximity to androgen receptors. Deficiency in vitamin D is associated with a stunting of testosterone's effects on androgen receptors and a decline in testosterone levels. Vitamin D will encourage androgen receptor resensitization. One study found that higher vitamin D levels are associated with a decreased risk of pelvic floor disorders in women, and The levator ani and coccygeus muscles are skeletal muscles that are critical components of the pelvic floor and may be affected by vitamin D nutritional status. I recommend 4000IU of vitamin D daily or whatever gets your levels to 60 - 80 ng/ml.
If you have inflammatory issues or pain due to pelvic floor dysfunction, I recommend a fish oil supplement daily. I take fish oil, and I find that it helps limit pelvic inflammation. I also take Magnesium Glycinate to relax the smooth muscle that lines the pelvic floor and genital tissue. I recommend it for people with clear pelvic floor dysfunction, but others should be careful as research says magnesium is a 5-alpha-reductase inhibitor. Take quercetin and bromelain as needed if you experience pelvic inflammatory flare ups and pain, but just be careful as quercetin can also inhibit the production of DHT from testosterone as well. Some say fish oil blocks DHT too, but experiencing chronic pelvic floor pain and inflammation will do more harm to you than minimal DHT blocking. I recommend staying away from all DHT inhibiting foods and supplements for people with PSSD, PFS, and PAS unless you are experiencing pelvic pain and inflammation.
As always, discuss these supplements with your doctor to see if they are okay for you. Lower your supplement intake based on side effects. These aren’t a magic cure, but a tool to help you on your journey to recovery. Don’t do anything without doctor supervision, but this thread gives more evidence for the “cure” for PSSD/PFS being resensitizing androgen receptors and estrogen receptors along with enhancing blood flow as it details how some men recovered through taking high doses of androgens, post cycle therapy, and Cialis. This at least gives hope that a hormonal cure can be created one day by medical professionals. I would of course recommend trying to heal yourself naturally for a long time before doing any hormone treatments under the supervision of a doctor.
I also recommend doing some form of yoga or pelvic floor stretches daily to improve blood flow for pelvic floor relaxation and sex hormone receptor sensitivity. You also need to request to see a pelvic floor therapist for an evaluation and treatment. Learn how to do reverse kegels. Doing reverse kegels will be difficult at first because your pelvic floor is tight and you have little to no awareness of these muscles, so just focus on lengthening and relaxing the pelvic floor through stretches for now. Do not do regular kegels for pelvic floor issues. Learn how to diaphragmatically breathe in 360 degrees to create expansion in your rib cage and abdomen to encourage pelvic floor relaxation. Do not breathe through your chest, and “belly breathing” isn’t the right term because the ribs need to expand as well. You can learn how to diaphragmatically breathe through an exercise such as 4-7-8 breathing. Here is a great video on diaphragmatic breathing and another video. I cannot overstate it enough: retraining yourself to properly breathe diaphragmatically is the single most important thing that you can do to heal from pelvic floor issues. Be a student of breathing: study and take notes on how to breathe better.
Stretches/Yoga poses I recommend:
Hold the Malasana/hindi/yoga squat pose for at least 5-10 minutes at least twice a day, but doing it morning, mid-day, and at night would be the best. Some get great results holding it for 15-20 minutes.This is one of the most important things for your pelvic floor because it will help lengthen and release it. Doing them barefoot is also very beneficial to strengthen your ankles and feet which are connected to your pelvic floor. Again, remember to breathe deeply down into your belly and pelvic floor for all these stretches.
Begin your stretching routine with an Exercise ball ab stretch and Upward-facing dog/cobra pose. This will help stretch your lower abs and psoas muscles so that you can get more breath deeper down into your pelvic floor for the rest of your stretches. Some people say that these types of stretches aren’t great for people who have Anterior Pelvic Tilt, which we should fix, but I still do them as it is important to stretch the lower abs that are hard to get to. You can experiment with doing them sporadically instead of every time you stretch.
This is my current personal complete stretch routine I do in order 3+ days a week:
Myofascial release on my glutes with an orb massage ball but you can use any small hard ball (don’t do this if glutes are currently sore) > Calf stretch against a wall or a yoga block which is what I use > exercise ball ab stretch > upward facing dog > (optional) Do a handful of cat cows > Supine hamstring stretch with yoga strap or an IdealStretch tool which is what I use > Kneeling hip flexor stretch > flat on back supine single knee to chest stretch > then bring knee to opposite shoulder stretch > supine figure four > I do this stretch next right after figure four > Reclined bound angle pose > (optional) butterfly stretch > (optional) A little bit of downward facing dog to stretch the calves > (optional) Lizard Pose) > (optional) Half split stretch/Half monkey pose with yoga blocks > Half-pigeon pose > Child’s pose > Wall quad hip flexor stretch > Wall figure four stretch > Wall straddle pose > Wall happy baby pose > Flat on back while pulling knees apart > kneeling with one leg, other leg out to side for adductors > (optional) Frog pose with feet together > regular Frog pose with feet separated in line with the knees > Yoga squat/malasana > Corpse pose
All these stretches are the ones I found most useful in a routine. See what works for you and develop your own routine. Consistency is the most important. This long stretching routine may not be possible for you to complete regularly so make adjustments, but doing this routine at least 3 days a week is ideal. Stretches such as the yoga squat, supine hamstring stretch, hip flexor stretches, and wall stretches are vital and should be done most days to help relax the pelvic floor. For how long you should hold each stretch, just go by how you and your body feels. Really let go, breathe, and sink into every stretch. On rest days, doing some deep breathing in child’s pose, reclined bound angle pose, flat on back while pulling knees apart, and the happy baby wall pose is really great while trying to do gentle reverse kegels.
You can also work on more individualized stretches for posture to correct anterior pelvic tilt, muscle imbalances, and to release other tight muscles, such as the upper body. Listen to your body if you need to give yourself a rest day from stretching. Adding in a 30-60 minute walk/swim on rest days is incredibly beneficial as well. Eventually, you can also try to learn isometric PNF stretching to incorporate it into some of the stretches such as the kneeling hip flexor stretch and hamstring stretch.
After working to relax and lengthen your pelvic floor through yoga and stretches, I would begin gentle body strengthening exercises that are pelvic floor safe. The pelvic floor is a master compensator. So, if the glutes, adductors, deep hip rotators, transversus abdominis, and other supportive muscles are weak, then the pelvic floor is in the prime position to pick up the slack which leads to a lot of strain on the pelvic floor which results in tightness and dysfunction. You need to strengthen the surrounding muscles to relieve tightness in the pelvic floor. This is where working with a pelvic floor therapist would be helpful to point out safe individualized exercises for you. Yoga will help strengthen your muscles in a safe way too.
The glutes and transversus abdominis in particular are very important to strengthen. Glute bridge, single glute bridge, side lying leg raises, lateral band walks can help build up glute strength. Deadbugs, Bird Dog, 8- point planks, or planks with pelvic floor-friendly modifications, can help to strengthen the transversus abdominis (TVA). Abdominal work may be triggering to your pelvic floor symptoms, especially the 8 point plank, so you can instead look into hypopressive exercises to work the TVA without overworking the pelvic floor. These exercises will help you bring more awareness to your breathing, diaphragm, TVA, and pelvic floor which are all important for recovery. Here is how to find and become aware of the TVA. Do side planks for your oblique ab muscles.
For hip/abductors do the side lying hip abduction exercise, fire hydrants, and the shinbox lunge. For the adductors, do Copenhagen adductor exercise, cossack squats, and an exercise where you squeeze a soft ball between the knees just don’t do any crunch movements with pelvic floor issues. For hamstrings, Nordic hamstring curl/glute ham raises, and single leg bridge. For the back, do supine pelvic tilt. One person even reported that dorsiflexion exercises and stretches were one important element to solve his pelvic floor issues; this is most likely because the ankle bone, like everything else including even our jaw, is connected to the pelvic floor.
Like with anything, do all these exercises in moderation and stop if you sense your pelvic floor is not responding well to them - do them one at a time to see which ones your pelvic floor can handle for now. Here is an exercise routine from another poster that has helped many people. Just be careful of the ab exercises such as the ab wheel and 5 minute planks with your pelvic floor issues - don’t over do it or avoid it if they cause too many symptoms.
Myofascial release and foam rolling to release trigger points also helps a lot of people to relax their pelvic floor muscles and improve blood flow. The glutes are the most important area to target for pelvic floor issues when foam rolling in my experience if you only had limited time. Using a soft ball to lay on and breathe deeply can help release trigger points in the abdominal muscles and psoas which can help you breathe better and relax the pelvic floor. I haven’t done it, but you can also try out a massage gun for myofascial release; just be careful and don’t use it in sensitive pelvic areas. Some men and women also report success using a therawand to release internal trigger points that are causing them pelvic floor dysfunction symptoms.
Walking and swimming for 30-60 minutes are some of the best exercises to lengthen, relax, stretch, and release your pelvic floor, boost blood flow, and help to retain and build strength in muscles that give support to the pelvic floor. Walk or swim for 5+ days a week for the best results. The breaststroke and freestyle are very helpful for pelvic floor sufferers. Along with swimming, people also use an elliptical at a low resistance to help provide a cardio workout that is safer for your pelvic floor.
Fix your posture. Pelvic floor issues and hard flaccid syndrome are closely associated with Anterior Pelvic Tilt and other postural issues. Get evaluated by a physical therapist so that they can give you exercises and stretches to fix it. You could also look into the Postural Restoration institute and see one of their providers and try to implement some of their exercises. In the meantime, here is one video playlist on how to fix APT. Another video to fix APT says to stretch the hip flexors, lower back, while focusing on strengthening the abs, glutes, and hamstrings. Make sure that you sit and walk with good posture - watch this to learn how to walk correctly - activate your glutes during each step and push off with your back foot!. I also recommend getting a standing desk to try to avoid sitting for long periods of time.
Weight training can be effective for boosting active androgen receptors in the body to increase testosterone and DHT levels. However, you need to make sure that it isn’t making your pelvic floor symptoms worse which defeats the purpose. If you are going to lift weights with pelvic floor issues, don’t lift heavy, do any intensive ab workouts, or any other exercises that can put extra strain on your pelvic floor. Do lifts where you can sit down instead of standing up. Start with yoga, stretching, and gentle body exercises to relax your pelvic floor and strengthen surrounding muscles before incorporating consistent weight training. I highly recommend, however, just sticking with yoga and pelvic floor safe body weight exercises to build strength instead. Those with PSSD without pelvic floor dysfunction may benefit a lot from lifting weights, high-intensity interval training, and doing bodyweight exercises such as squats regularly to boost androgen receptors and DHT. Remember to see a pelvic floor therapist to get evaluated first before starting any weight lifting because many people have pelvic floor issues without even realizing it.
Work on your mental health. Anxiety can worsen pelvic floor issues. Just as dogs tuck and tense their tails when stressed, we tense our pelvic floors which are directly connected to our tailbone where we used to have tails ourselves in our evolutionary history. As we are impacted by sexual dysfunction and pelvic floor dysfunction symptoms, we become anxious along with other negative emotions which leads to more pelvic floor tension symptoms due to the fight or flight mode response causing even more anxiety leading to more symptoms. It is a vicious cycle that needs to break by not becoming anxious and negative when we experience pelvic floor symptoms or hard flaccid and instead let go, accept, and realize that it is a normal process when trying to heal because sometimes our muscles that are used to that tightness don't want to let go of the tension we hold in our pelvic floors. Daily yoga, meditation, stretching, and walking will help with anxiety. I would also see a mental health therapist because all of these issues are deeply traumatic and we cannot go through this alone. We often hold tension in the form of emotions and trauma in our bodies, especially our pelvic floor and genital areas. By openly talking about these issues with a therapist, it will help us process and release our emotions and trauma that we are holding inside our bodies to improve our anxiety, relax our pelvic floor, and to let go of all of our tension. Many people who healed their hard flaccid and pelvic floor issues said that solving their anxiety and negative thoughts by talking to a mental health counselor was vital in recovery. The mind-body connection is so powerful, and it directly impacts our pelvic floor. Those who are stuck in the cycle of experiencing pelvic floor symptoms leading to anxiety and negative thoughts will also benefit from Cognitive Behavioral Therapy you can do by yourself like in this video or preferably with a trained therapist. Here is an informative mini lecture on how stress impacts the pelvic floor.
I would also definitely go on a healthy anti-inflammatory diet. Avoid caffeine, alcohol, marijuana, and other substances. Avoid foods and liquids that can trigger pelvic floor inflammation such as highly acidic fruits and veggies, carbonated beverages, very spicy foods, and artificial sugars. To maintain a healthy gut to reduce inflammation in your body I recommend trying a low-histamine probiotic supplement along with eating healthy. You should also work on preventing or fixing constipation; eat a lot of soluble fiber to not get constipated - take a supplement such as metamucil if you have to. Check the Bristol stool shape chart to identify if you are constipated because even mild constipation can contribute to pelvic floor tension. This is because the constipation leads to a lot of pressure being put on your rectum and pelvic floor leading to the muscles becoming weak and dysfunctional. I am willing to bet many of you are constipated and don’t know it because it isn’t just whether you go regularly, it is also how your stool is shaped. People with pelvic floor disorders are at a high risk of constipation which makes their tension and dysfunction worse which then worsens the constipation, another cycle to fix. I recommend getting a Squatty Potty to reduce strain on the pelvic floor during elimination.
To help heal hard flaccid and pelvic floor issues, never watch pornography again (this is vital). Go on NoFap for 90+ days to help heal your brain and body from any unhealthy pornography and sexual habits you have partaken in. Pornography leads to involuntary kegels, a tight pelvic floor, desensitizes you, and messes up the dopamine and arousal circuitry in your brain. Don’t climax too often. Learn how to reverse kegel by yourself and during sexual activities. Never edge or regular kegel - it leads to pelvic floor tightness and dysfunction - just relax your arousal through a reverse kegel. Keep your pelvic floor relaxed during sexual activities.
Stay strong and never give up on yourself. You can and will heal. Thank you for reading.
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2023.07.27 13:00 WaveOfWire One Hell Of A Vacation - Chapter 107

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The moon was rising, taking stage as the sun clung to the horizon, reluctant to abandon the sky to its lunar counterpart. The initial assault was repelled, and precious moments ticked by as Atmo ferried those needing critical care past the High Huntress’ group to the den of the Grand Hunter for treatment.
The clinic before her was little more than a stopping point for triage—somewhere the wounded were sent to be patched up and sorted. Some with lesser injuries would be mended and sent back to the defence, others would be reassigned to duties befitting their current state, and the rest would be sustained long enough for transport to the den for emergency care.
A few arrived on the cusp of the Void and needed to be given their final rites. Luckily, the priest and his mate were assigned there to do such, though neither let the wear it was taking on them show. The enfeebled male did a surprising amount, considering his disability; he was applying healroot to the wounds and otherwise caring for those who could be sent back to the front. It was quite the contribution, considering he would not be blamed for seeking shelter further away from the conflict, but every pair of paws helped, and she couldn’t help but respect his dedication.
It was only when the flow of wounded slowed did she allow herself a moment to breathe, the constant evaluation and stress straining her system. She wished to be fighting for her kin at the walls, but the fact remained that she was...lesser.
Her training was for plasma-casters and counter-intelligence, not bows and swords, and she had hardly the opportunity to train since landing. Head Jax and Head Sahari made it abundantly clear that her duty was to seek out those who would feign the seriousness of their injuries, so she had been relegated to organizing the care for them. She also acted as an intermediary for reports during the incursion—assessment of the settlement and its forces passing through her muzzle to various runners.
She could almost laugh at the absurdity of it; the ‘treadmill’ that powered their more advanced production machines had actually prepared some members of the pack for the strenuous demands of the position, though even those were exhausted after so many trips. It had her wondering how many of the Human’s strange decisions were made with these circumstances in mind, though the time to muse such was limited.
The reports came in quickly. They had confirmed that the Grand Hunter’s ‘excessive’ walls around the settlement had proven to be exactly what was minimizing casualties, funnelling the majority of the first effort into the gateway and meeting considerable resistance. Though she had watched the male propose, construct, and distribute his odd armament, it was only now that she openly admitted that his alien nature had kept them alive this long. His tools of warfare proved paramount when they lacked the ability to craft more advanced options, and it was giving them an edge in the onslaught—their foes assuming the items they possessed and numbers they touted would simply triumph over them.
That, and the Blades at his behest. They were everywhere, yet nowhere, informing the pack upon the walkways of where they should concentrate their efforts to discourage flanking.
“High Huntress,” a pack member called. Mi’low twitched her ear, motioning for the group she was instructing to continue on with rearming the front defences. They bowed before quickly leaving to distribute the arrows and bolts to the prescribed positions.
“Speak.”
The male—a member of the security force under Head Jax—shouldered their polearm, his chest heaving. “The second assault has begun in earnest. Despite our efforts, they have surrounded the settlement. Our lines are spread thin.”
She cursed. Though she had been in command during the war-games several times, the numbers were never skewed so heavily in the attacker’s favour. Even when it came close, they needed but protect several strategic locations, not the entirety of the settlement.
“Understood. I will distribute the mended evenly throughout the points.”
The male nodded. “I must inform Head Nalah.”
Mi’low sent him away with a wave of her paw, grimacing as Atmo deposited wounded in the clinic before hurrying away to give those worse off to the den. One of the insects sat itself on the ground, tired and pushed to its limits. Another relieved them of duty, allowing their other rest as it followed the distant cries for medical aid.
She clenched her jaw. She hated feeling useless. Powerless.
A Lilhun argued and pushed aside those in charge of tending to their wounds as they stomped outside, words of vitriol and venom pouring from their muzzle. They sought to avenge their kin, injury be damned. Mi’low stepped forward, her glare daring the member to strike her as she blocked their way.
“Move. I must—”
”—You must prevent yourself from hindering those around you,” she snarled. “See your wound tended. Then you might be given the chance to strike the enemy.”
“But—”
“—You. Will. Obey.”
The cold stare she delivered upon them was filled with pain and rage. She had lost a settlement to the carelessness of another, and that male now worked tirelessly to ensure they did not lose this one. Be it her pack or not, she would not be tied to the downfall of lives she sought to sustain. She took a breath to continue addressing the cowed Lilhun.
“The Guardian will not bless those who selfishly seek violence. You are defending his domain. Seek treatment so that you might continue doing so.”
She watched as they allowed themselves to be dragged back and armour removed. It was as she suspected, an arrow had broken off in their stomach—likely severed to hide the wound. They would not be fighting at the front like that; they would only be a liability.
No matter how much she tried, she couldn’t help but feel that the same helplessness in their eyes was reflected in her own.
She took a breath to steel herself as more Atmo returned. Fuelling his forces was her task.
She would perform her duty.
For the one who she once mocked. For the one who sheltered her kin. For the one who brought life to the defeated.
For the insufferable weakness that gave them strength.
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Nalah grunted as another arrow soared over the walls to slam into her shield. They would be vaulting the barrier en masse soon. It was inevitable. The stray shots may have brought hesitation, but they were naught but prodding and suppression. She simply held her shield proud to inspire her pack members to do the same.
If she didn’t, they would fear what had befallen them.
The security upon the wall were routed—injured or pushed to areas less defended. Her assigned forces were not the foremost of their combatants, but they need not be; they were to delay any that tried to flank the defensive positions which were preventing further advance—even if their own number was paltry in comparison to what sought their ruin.
Reports stated that Sahari and Jax were to their limit in what they could repel, and the number of critically wounded kept increasing—though it was thankfully still within the number that could tend. Her forces contained several who had been injured, but they were given shields and crossbows, forming a defensive wall that moved to where the Wraiths requested them.
Heads would peek above the edges of the wall, only to be met by bolt and arrow. Some completed their traversal regardless. Those were dispatched quickly with spear and blunt trauma, assuming they survived being open targets.
She just wished that the number of those successful in climbing the wall would stop surging.
“Incoming!”
The blond-furred female swallowed, brandishing her shield along with the others towards the plasma-caster that sought to mow them down from on high—the weapon poked over the top of the wall to cover the advance of others. The impacts on her defences numbed her arm. Every part of her thanked the smith that Joseph had allowed an opportunity to atone, his creation in her paws absorbing the rounds with little more than a sizzle of protest as the ironwood beneath the metal prevented the material from warping.
A crossbow slammed on the top of her shield from behind for stability, the weapon recoiling and swiftly ducking back so that her pack member could reload in safety. The shots stopped, a scream sounded, a dull thump of body on ground inside the walls ended the agony of the wounded invader. Subsequent silence signalled a moment of reprieve.
A blur of black and brown snatched the rifle of the defeated, slipping further into shadow before reappearing nearby.
“Head Nalah,” Raine voiced from her side. Nalah refused to remove her eyes from the walls, but tipped an ear to acknowledge the Wraith. The masked female presented her spoils—the very weapon used against them, as well as two spare batteries.
Nalah nodded her thanks, sliding her pike into a hasty holster forged into the back of her armour as she accepted the armament. “My gratitude, Raine. Any news of the Grand Hunter?”
The Wraith shook her head. “The stealth units he had trained are watching that section of the walls for his return, but they have been forced to engage with the enemy as they expand their area of attack. They have begun spreading out well before our forces can discourage it and are slowly encompassing the settlement.”
She grit her teeth. He was late. Soon, there would be little in the way of light as the moon rose and clouds obscured, but the most important part was that their symbol of hope was absent. Their leader wasn’t there to spur them onward, and it was taking its toll on morale.
Several of her unit shrunk at the news, their turned ears betraying their feigned lack of interest. She couldn’t blame them. Nalah took a breath, putting power into her voice.
“Rise!” The members jolted at her command, straightening their posture as they warily glanced at her. “You claim yourselves members of his pack? You who cower when not coddled by his presence? Need you his paw to hold your own when your livelihood is threatened?”
Several exchanged looks—some abashed, others bitter. A familiar red insectoid walked up from the pathways, clad in iron and every bit a warrior. She nodded at Rose, somewhat surprised that the Atmo was not guarding the den. The insect displayed a tablet that had been prepared for it.
[They wish to help. We will not lose what father has given us. Believe in him, as he does you.]
Nalah stared at the script along with everyone else. Violet was tasked with assisting the wounded at the den, yet she allowed those who were to defend her move outward. The Head laughed, gaining volume as it progressed. She spread her arms wide to grin at the other members.
“A kit has foregone her protections! A kit has given all that she has to mend those on the cusp of the Void, and has now made her own journey shorter so that yours may last past this moon. You cower in uncertainty when a kit depends on you? You bow to outside forces when our Grand Hunter has entrusted you with defending what is his? What are you!?”
The pack grimaced, none meeting her challenging gaze.
“Answer me! Who do we fight for?”
“The Guardian?” one questioned hesitantly in return. Nalah smirked.
“No.”
Her flat denial was met with confusion. Nalah gestured for Rose to cut her shield, making a shelf for her new armament and a view-port. It was done swiftly, reminding her why it would behoove them to keep the insects by their side, and thankful that the pack had become so close with them. She turned back to the members, her modifications completed.
“You do not merely fight for him; you fight for yourself, for your kin, and for the pack.” Fire lit behind their eyes as she spoke, waving her shield arm towards the red Atmo. “You fight for the chance to be proud of your own kits. Look at what his has given us! Young, yet seeks to assist in your plight! Innocent, yet steeling herself to see you safe! See what one not of our own is willing to part with so that you might fear the known! She is not scared, but proud! Be what she thinks you are—what he knows you are.”
Voices crested the walls. They vaulted in small numbers, some landing on the walkway, others barely preventing the breakage of bone as they surpassed it. She brought her shield forth, slapping the barrel of her new gun into the slot and viewing the flashes through the newly-created window. The rifle recoiled lightly as plasma was sent to dispatch the incursion, making swift work of the enemy. Continued shouts beyond the wall warned of more encroaching in but a moment.
She glared at the stunned pack as she reloaded, snarling her words.
“You fight for what he has given you! My mate—the Torch—put our lives into his paws when we made our vows. Not because he provided, not because he was going to save us, but because she saw in him what we should be. What we could have if we followed his leadership.”
She straightened her shoulders, ignoring the sounds of incoming reinforcement and doubtful murmurs from those unknowing of Sahari’s Aspect. She didn’t blame them for not being informed—the ex-Grand Huntress didn’t advertise it—but it was time for them to know why the Heads showed absolute loyalty.
“What is it you see for us when we defend our dens and continue on after this moon? Prosperity? A rise in technology? A freedom from the wars of our past—a life devoid of prejudice? A life where a defective kit is not a mark of shame, but one of pride, knowing that you have birthed one of the Guardian’s chosen?”
Growls of affirmation came from her number, the pained eyes of a female surreptitiously meeting her own. A glance to her stomach showed the subtle evidence of new life growing within. The female nodded discreetly, glaring at the first signs of successful climbing. Nalah bore shield towards the enemy, matching with her others to form a bulwark as the remaining loaded ranged weapons behind them.
“What are we fighting for!?”
This time, not one had a shred of doubt behind their answer. It roared out of them as arrow and bolt were loosed, as pad and claw gripped the ground beneath them, and as they met the charge from the opposing forces directly—those not mowed down by the rifle finally noticing the Atmo that sought to assist them as Rose charged the flank, leaving corpse and crimson in their wake.
“Fight for our kin!”
A sword clashed with shield, an arrow ending the enemy.
“Fight for our allies!”
A male kicked away one who sought to harm Rose, driving their weapon cleanly into the chest of the attacker and nodding thankfully when the Atmo deflected an arrow aimed for his head.
“Fight for our territory!”
Rose cleaved a Lilhun in two before they could harm a pack member engaging with another, buying time for two more to press forward.
“Fight for our future!”
Nalah retreated a step, lining up the barrel of her rifle with another surge of forces, smiling despite the dwindling odds. She listened to each shout their convictions, every utterance renewing the vigour of their kin. She whispered her own reason, her silent creed.
“Fight for him, for he has given us everything.”
The rifle flashed as plasma exploded forth.
= = = = = = = = = = = = = = = = = = = = = = = = = = = = = =
“Severed artery!”
“Coming!”
Harrow held down the female, the bleeding beneath her paws only slightly hampered by the force she applied. Idee ran up, accepting a needle and thread on the tray held out by one of the young Atmo. Carefully, she poured ethanol over the wound, gaining visibility long enough to see where she needed to work. Though the seamstress had not received much medical training, her sewing made short work of the hemorrhage, finalizing the task and swiftly running to another patient. Harrow applied the healroot with the Atmo’s assistance, calling over Mama for help with transporting the patient to the medbay for rest.
A morbid thought considered how pointless it would be to give them a place to recover when the pack might be slaughtered wholesale before the moon had passed. A breath gathered her thoughts, thankful when she looked up to see that there were no new arrivals.
A moment’s rest.
She crashed into a chair, her legs weakening now that the adrenaline had fallen away. Volta came forward, cleaning the ‘operating’ table that had been cleared of board games earlier in the sun, then set off to tend to her other duties. Ferra, Atrox’s mate, bandaged burns from an incendiary weapon, her experience with animals transferring over to the medical field. She was hardly qualified for any intensive care, but even the smallest overlap was appreciated.
The hub lacked its usual beams of light, instead supported by the dim glow of moonlight peering through the glass, darkened by the rolling clouds above. Not even the torches placed throughout the pathways were lit in fear of giving the enemy additional information. Lilhun night vision was excellent, true, but blinding one’s self by alternating between bright and dark was only something a fool would consider.
It also allowed them to quickly identify the source of fires that sparked on occasion—the Atmo tasked with transporting the injured equipped with a parcel of water to douse the flames.
She watched the members assigned to the den as they restocked their materials from wherever they needed. Most had barely spent time inside of their abode—save for the few that were a part of Tel’s cooking classes or Volta’s rotation—so the looks of wonder and curiosity were saved for the tiny fractions of respite afforded to them as they were given free reign to most areas.
It drew a sardonic smirk to see them express the same emotions she had felt when she was escorted here so long ago. Back when Joseph was some strange alien they should be wary of—kin of two insects she had come to treasure—instead of the honorary blood-father of her kits. A paw moved to her stomach as fondness and fear swirled in her mind. He had yet to return.
She held no delusions about the Human solving their problem by merely arriving, but she wished for him to be there—to assure her all would be well, and that Jax would return whole. That they could repair the damaged, mourn the lost, and heal the injured, then continue crafting their settlement into a place where her kits would run and play. She pictured how Violet would coo and rush to help at every cry, completely enamoured by her den-siblings, just as Harrow herself did long ago.
[Are you okay?]
She blinked off the haze, reading the English presented by the young Atmo. A genuine smile graced her tired face.
“I’m alright. Just taking a break.”
The purple insect wiped her tablet flat, pausing to watch Daisy rush out with more healroot to distribute amongst the other kits.
[Do you need something to eat?]
She snorted a laugh. Violet had been tirelessly helping wherever she could since the alarm was sounded, and even after all of that, she was here making sure that Harrow was fed. It was hard to say if the inclination was from Joseph, Pan, or Mama, but the three of them shared the desire to see the pack happy—even if the facets they oversaw were different.
Harrow reached out and scratched at the young Queen, thankful for her efforts and care. Rose and Cobalt—along with a few other Atmo who seemed confident in their combat abilities—had apparently approached her for permission to help beyond transporting the injured and tending to wounds. Somehow, seeing the den-kit forego her unofficial protectors made the whole situation feel real.
When the flare went up, it was curious. When the pack was alerted to the threat, it was strange. When she was delegated to the den to provide aid, it failed to pierce the wilful veil that all would be well. Oddly, even the first injuries coming in to be tended just floated atop her threshold. Violet painfully committing to sending those she cared about—those she was tasked from birth to lead—directly into danger?
That struck true. Everything she held dear was at risk once again, and yet, she wasn’t panicking. Not yet. She just went through the motions, identifying what needed to be done to the best of her abilities.
Joseph trusted them to manage themselves until he got back, and he had his mates with him. If anything happened to him with them around, then all was lost anyway.
Volta’s blue coat caught her eye, the female bringing out more cleaned and sterilized materials for them to use—from towels to thin quills and thread. She wore a determined look that was rare on the cleaner’s muzzle. Harrow hadn’t seen it since the newest Head had awoken to Joseph’s restful habit of cuddling with whoever happened to be near, and at the time it had been in response to Scarlet’s jests that she missed an opportunity to bed him.
The memory drew a smirk; Volta had seemed almost offended by the assertion, and more than a little abashed by the Wraith’s teasing. The two had been seen on their breaks together more often now, instead of the blue-furred female spending her time alone, while the servant simply skipped any designated rest periods. Often, the pair of them were spotted eating quietly or conversing—though Scarlet never stopped her pestering.
Harrow glanced once again at the skylights, wondering how long it would be until the Wraith returned with news. They sought assistance from the soldiers that the pack begrudgingly tolerated, but none knew how that would go. For all they knew, the ship had already been surrounded and their members disposed of in the woods.
A clamour of clicks cracked through the air, breaking the tepid silence that had established.
More Atmo burst into the hub, the Lilhun atop the flat equipment on their backs burned and bleeding, groans being the best indicator of their condition for the moment. It meant they were still alive enough to feel what was happening to them.
Harrow bolted to her feet as Violet let her tablet clack against her torso and rushed to grab another tray of materials. She hurried to assist the others pulling the wounded onto various tables, recognizing one as a male assigned directly under Jax. He murmured and groaned, clutching his ribs. Carefully, herself and another eased him onto the surface while Idee set about sealing a pouring gash on another’s throat.
“Easy, easy. You’re in the den,” she assured the male quietly, examining him for external injuries. Internal would be another issue, but luckily, most everything that had come in so far could be treated with what they had. Finding nothing seeping out of his flesh, she was forced to consider the area and the possible effects. Broken ribs could puncture organs, or just cause general havoc—Jax had experienced as much during his conflict with Joseph.
A quick pat and soft touches confirmed her fears. Two ribs had broken, a clear separation.
“Mama!”
The Hatcher appeared from the facilities wing, likely having been trying to make more splints and slapdash casts after depositing the mended; they had used far more than expected. Harrow waved her over urgently.
“Ribs snapped. We don’t have any accelerant and I need you to open him up. We need to set it and clear out any fragments.”
The massive Atmo nodded, rushing off to speak with Violet. A moment later, and her blades were wiped down with alcohol, rejoining the table while being careful not to touch anything. Violet repeated the cleansing, helping by shaving around the indicated area before heading off to assist as she could.
With practised motions, Mama set blade to flesh, Harrow steeling herself to do what she must, silently asking for forgiveness as she held the patient down. They had long since run out of painkillers.
The male cried out as his skin parted. Harrow set her jaw as she prayed for him.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Idee finished sewing up the male, one of the Atmo kits dutifully took away the blood-soaked towels to be cleaned, and Mama left to wash off her blades. Harrow just held the paw of the male drifting in and out of consciousness, speaking softly to the others so as not to disturb him too much.
Several had come through while they were occupied, but thankfully, none were in dire condition—relatively speaking, anyway. Many needed to be cauterized or sewn up. Some needed to have legs or arms set, splinted, and then bound.
Overall, the number of those requiring more advanced care was slow, but steady.
She could only imagine how many were being given less careful care before being sent back to the front. Their only solace was that the battle would eventually end, one way or the other.
Occasionally, a wounded member would inform them of how things were going. Though not all that much time had passed since it all started, the steadfast defence had given the enemy pause, and thus, the pack time to recover. It was a hectic pace set out of necessity.
And she was watching it wear everyone down to the bone.
There was a very clear line between those who had been under Joseph for a long time, and those who were recent additions. The former were determined, unbreakable defenders who shouldered their burden admirably. Countless spars and training regimes had increased their stamina in ways that their military training never accounted for.
Lilhun warfare was expected to be decided in quick, brutal conflicts that barely lasted as long as the current siege—explosives and firearms dismantling one force or the other in vicious displays of violence. From what Joseph knew of it, human warfare was often a much longer affair. Both sported brief clashes, but humans would err towards slower or more methodical approaches only described to her by Tel during the odd chance that the Wraith could be convinced to continue their lessons. Instead of waiting for your foe to slip, or bolting in claw and fang, humans would drag encounters out over many suns of peaks and lulls, peace being but a facade for silent aggression.
She questioned how their Human would react to the current situation. Would he be as weary as the ones coming through for treatment? Or would he be as spry and sharp as he was after rounds and rounds of sparring, sweat dripping between panted breaths as his eyes scanned potential foes? When did the savage violence of Lilhun give way to the unflinching vigilance ascribed to the Guardian moniker?
The pained paw she held tightened as the male gained clarity, his eyes focusing properly through flinches of pain as his heart pulsed the wound beneath the healroot. His voice was rasped and strained from the screams—enough so that she needed to lower her ear to his muzzle.
“Head... Jax...,” the male wheezed, chilling Harrow’s blood to ice. “Injured... Help...”
She waited for her breathing to free itself from the grips of horror overtaking her. Without a word, she pulled her paw away and walked to the doorway, gazing out into the settlement. There were a few flashes of fire, then smoke as Atmo extinguished them on their way to and fro. Distant yells and plasma rounds lit the sky before sending the outside into its dim normalcy, only to be replaced by more.
It itched at her. Something was wrong with the image beyond conflict that she wished had never started.
It was far closer than before.
It was inside the walls.
They had pushed the pack back.
They had gotten past her mate.
Footsteps preceded thought, her instincts screaming at her to be by his side. To assure her bond safe. What was once her den, was now the passing dens of others, her legs pushing her forward towards where he was stationed and feet gripping dirt for traction.
It was the unfamiliar voices that sent her nerves on edge; they were far too close. Far closer than where he had been. Far closer than he would have let them.
By instinct drilled into her by Tel, her steps lightened, suns and moons of agonizing training in the Wraith’s free time coming to bear despite the stress. She slipped from building to building, edging closer to where her mate might be. Her heart hammered in her chest at the prospect of him laying in the grass, broken and unmoving. Again, her innermost desires pulled for her to join his side, to snarl and fight for his well-being.
She needed to find him. There was no logic, no thought, and no way she could calm down until she saw that he was well. It was a need, not a want, and every iota of her being made that demand clear.
Plasma scorched the air in front of her as she peeked around a corner, her yip of surprise exposing her position, yet drowned out by the ever growing din of combat. Shouts, curses, and orders barking from voices both foreign and familiar.
She timed her burst across the pathway carefully, shadowed by the moonlight. The flash of a plasma-caster illuminated the pathway, the projectile whipped past, then she ran.
A glance both lightened her soul and weighed it heavily, followed by panicked breathing as she replayed the situation she faced in relative safety on the other side. The cool wood of the den drew little of the warmth her body constantly produced in its effort to supply her burning blood.
Jax was alive, but he and four of the pack were engaging in tight quarters against thrice their number. His axe had severed limb from form as soon as she found cover. She shunted her eyes closed as shouts grew vulgar and primal, declarations of violence and dominance assaulting the air.
He needed her—of that, there was no question. He faced an enemy far greater than himself for the pack. For her. For their kits.
She waited the breath it took for another set of plasma rounds, charging out to the next barrier of cover and throwing herself against the building. She cursed herself for continuing to watch the fight in fragments, compelled to simply swipe and claw at those posing threat to her bond. To take him away from the threat and nurse his wounds like she had when she first became his.
The last rational portion of her mind argued that doing it would only doom the final evidence of their pairing—their unborn progeny fading with their mother as she joined her mate in the Void. She couldn’t do it alone, nor directly. She needed an approach that would work. She needed to surprise them. It came to her through repetition—a skill that Tel had her fail and fail again until she could do it without thinking. Climbing.
The dens.
Her quick movements had her kicking off the adjacent wall and turning to grip the edge of the roof, pulling herself up in one swift motion. It was higher than she had learned to do, but adrenaline filled in the gaps. All she needed now was a way to help.
Her thoughts were interrupted by a paw covering her muzzle, an arm attempting to wrap around her throat. She forced her own claws to her neck, deflecting the arm upwards and spinning as she ducked away. Her arms brought up into the trained stance, weight spread evenly and fists clenched. Her assailant sighed, the moss-wolf skull drooping with the lack of enthusiasm. Harrow’s ear flicked.
“Raine?” she hissed through barely contained rage, her whisper coated in poison. “What are you doing!?”
The female glanced down at the fight below, pawing at her weapons below the scarce armour. “Head Jax requested you be removed from potential combat.”
Harrow stood frozen, mind clinking in the background as the connection forced itself below reason.
The female was trying to keep her from her bond. That was all she formed as a thought before she lashed out. Fortunately or not, Raine backed away out of range with her paws raised, uninterested in a full-scale fight over the matter.
“Any dispatch would require injuring you,” she explained calmly, bringing her claws to a pocket slowly. Despite the hiss directed at her, she slowly unveiled a vial and presented it. “This is a chemical smoke bomb. Kaslin procured it without Toril’s notice. You may buy time for your mate by throwing this between him and them. Do nothing foolish.”
Harrow cautiously reached out for it, gingerly grasping the fragile container. She looked at the tiny device in her paw, shooting a glare back up at empty air, Raine having slipped away. A roar of pain and rage had her head snapping towards the conflict below.
Jax stumbled back, swinging his axe to fell his foe, but struggling to pull the haft of a pike from his leg. Whatever she had missed, there was the distance between them she needed.
No thought was spared as she leapt from the roof, chucking the concoction to the dirt below. With a pop and a sizzle, the mixture combined, billowing a dark black cloud of concealment for her mate and the surviving pack. She hit the ground running, uncaring for the redirected shouts, nor the new volley of plasma rounds that singed her fur as it narrowly missed her.
She needed to get them away from him.
The attackers pursued her, though only a few. The rest coughed and sputtered as fumes reached their lungs, calls of retreat from Jax’s pained voice making her heart soar. He didn’t notice her, so he wouldn’t put himself further in harm’s way. She bought him time.
Her enthusiasm faded shortly after, the peril she placed herself in finally winning out against protective instinct. Her body—worn from near ceaseless activity since she had awoken—protested the exertion, even endorphins unable to support the constant abuse. Her legs ached, her lungs scorched her chest with each breath, and her unending strain wore on her senses.
She ducked a corner, the dull thud of an arrow impacting the wooden wall sending a jolt through her. Where else could she go? She didn’t keep track of where everyone was or what points they had decided to fall back to. Why would she? She was assigned to tending to those in need, and yet she was bringing foes she couldn’t contest wildly throughout the settlement.
Another corner brought her face-to-face with yet more enemies, a scrambling retreat forcing her paw as she blindly ran between buildings and pathways. More shouting. More footsteps. More arrows. More options closed down as she had to adapt her pathing. How far had they invaded? How many? Why did it sound like they were looking specifically for her?
Again and again, she bought precious moments, leading her pursuers away from where she thought the others might be. Blind turn after dead sprint. Stumbled step after hasty pivoting. Where was she supposed to go?
Sprinting into the main paths, she skidded to a stop, her chest heaving to supply the speech. “Mama?”
The massive Atmo clicked in relief to have found her, moving to embrace the orange-furred female. Shouting increased in volume, what little distance she had gained was eaten quickly by time. Harrow ran up to the insect, pulling her by the blade.
“Mama, we need to go. They’re coming.”
The Hatcher looked beyond her, then brought her eyes back as the evidence of their peril became louder and louder. Mama glanced at a den nearby, new and sturdy.
“Mama. What are you—”
The Atmo picked her up with the large blades, hurrying to the building. She used a leg to pull the large door open before roughly tossing Harrow inside and slamming it shut. Almost perfect blackness overtook the room, the recent construction’s windows set high into the structure—closed and out of reach.
Harrow pushed to her feet, charging the vague outline of the door, only to bring up solid. Why? It opened outwards and locked from the inside. Her ears flattened as the shouting grew distinct. More shouts to find the orange-furred female.
Her fists pounded on the door.
“Mama! We need to leave! Now!”
Soothing chitters passed through the door, close and soft. Why was she doing this?
“MAMA!”
The shouting was muffled by the material between them, but the distance was clear. They caught up. Her pounding became frantic, heart hammering in her chest as blood screamed through her ears. The scent of ash and smoke lingered in the air, the small voices of kits calling for their sister echoed through memory. Again she was powerless to reach the voices. Why couldn’t she get to her?
“MAMA!”
Two bangs resonated out, the door and floor pierced by large insectoid blades, locking the entrance to the very structure it was supposed to allow access. A chip was missing from one edge, the almost indecipherable blue colouring blending into the darkness. The shouting ceased, replaced by the discharge of a plasma rifle. The chittering and clicks continued, but slowed. Tears welled in her eyes as fear overtook her. The Atmo couldn’t fight—didn’t want to fight. She just wanted to love and care for others. Why didn’t she leave?
“MAMA! RUN!”
Her fists sent shocks of pain through her bones and her bruised tissue, each impact with the unyielding ironwood door returned with the constant purrs and comforting clicks. Each slam of flesh on the barrier bearing no progress, yet still she tried. Still she cried out for the mother of the pack. Still she begged and pleaded, her voice scratchy and hoarse, threatening to bleed as she screamed for the Atmo to heed her warning. Why won’t she listen?
“MAMA! PLEASE!”
A roar of Lilhun rage preceded sicking cracks, the insectoid language falling to but a mere pin drop amongst the blackness. It was still soft and reassuring, just painfully weak. Why was this happening?
“MAMA! PLEASE DON’T!”
Another report of weapons fire, and the clicking faded, then ceased.
She dropped to her haunches, burning trails running rivulets down her cheeks. Her cracking utterance slipped through absent sobbing, her eyes fixed on the doorway that would open at any moment to show that Mama was okay. That it was all a misunderstanding. Why was it taking so long?
“Mama...”
There was laughter. Taunting. Jeers. Calls for an orange-furred female to be brought to their leader.
She heard nothing. Felt nothing.
Just the expectation of that percussive language she had come to equate with unending love for the young, and the excitement that was voiced when the Atmo had learned more would be brought into the pack. The familiar purring and chittering from the one who helped bring her world together after so many years alone. Of the one who learned English with her so that they might communicate, but have yet to find the time to talk at length. The sound that represented the unity of three species, bound by care and compassion, always present under Joseph’s rule. The auditory evidence of the one stable certainty that all members accepted wholly.
She listened so closely—strained her ears to the point of pain to hear even one click of reassurance. For an answer to the simple question that haunted her.
Yet there was nothing.
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2023.05.30 16:24 running_a_riot Edinburgh Marathon - 30 min PB over 12 months. Redemption at last!

### Race Information * **Name:** Edinburgh Marathon * **Date:** May 28th, 2023 * **Distance:** 26.2 miles * **Location:** Edinburgh, Scotland * **Website:** https://www.edinburghmarathon.com * **Time:** 3:39:XX
### Goals Goal Description Completed? ------------------------------- A Sub 3:40 *Yes* B Sub 3:43 *Yes* C Avoid the fade *Yes*
### Splits Mile Time ------------ 1 8:09 2 7:52 3 8:21 4 8:10 5 7:58 6 8:14 7 8:19 8 8:13 9 8:10 10 8:12 11 8:12 12 8:21 13 8:13 14 8:18 15 8:47 16 8:09 17 8:05 18 8:15 19 8:19 20 8:11 21 8:21 22 8:22 23 8:27 24 8:37 25 8:54 26 8:42
### Background I started running in 2020 as a way of losing weight (38M 6’3” 220lb) and became hooked. I ran a few short distance races and soon found that I preferred the longer stuff.
I ran my first marathon which was Edinburgh in 2022 (4:09:XX) off the back of Hal Higdon and really struggled with that race. The wheels came off and I bonked hard. Up until that point, I assumed that bonking was a feeling of fatigue and was not prepared for the bleak, negative, end-of-the-world emotions that came along with it.
I did not feel proud about completing my first marathon because deep down I knew I had more to give. How could I be satisfied with a goal of simply finishing when I had invested so much mental and physical energy. I promised myself that I would learn from the experience and come back stronger in 2023. Reading your race reports has provided invaluable knowledge.
I ran two further marathons in 2022 with a modified Hal Higdon plan to increase training volume, the first one being London (3:49 - a huge PB) and the second just two weeks later setting another PB of 3:43. I felt proud of those performances and realised I could do even better if I could increase endurance and prevent my pace from dropping off after the 20 mile mark.
In 2023 (two weeks ago) I ran the Leeds marathon and treated this as my ‘B Race’ from a performance perspective. The route has around 1,500ft of elevation so not PB territory. Like everyone, I ran this race in support of Rob Burrow / Motor Neurone Disease and it was a special occasion. I ran a strong first half and then eased off finishing in 3:58 and barely reflected on my performance. This event was about so much more for everyone involved.
Two weeks later, onto Edinburgh for redemption!
### Training In January 2023 I decided to run Pfitz 18/55 and peaked around 63 miles. I lost 2 or so weeks due to illness and overall stuck to 80-90% of the prescribed mileage. I didn’t hit every LT, Vo2 and MP workout but stuck to the core principles of long/medium/short distances and fast/slow paces. My weight reduced from 212lbs to 205lbs. I saw my LT improve (according to Garmin at least) which gave a good indication that things were improving compared to my readings from the previous year.
Once again I would be running two marathons two weeks apart through circumstance rather than design. I was lucky enough to be accepted into London last year and decided to stick with my ‘backup race’ two weeks after that. This year, I wanted redemption at Edinburgh but couldn’t resist running to raise money for MND in Leeds.
Of course performance compromises are to be expected in taking this approach but there are also positives. It takes away the pressure of having to nail a single race on the back of a long training block and squeezing two performances out of a single training block gives more bang-for-buck, at least in terms of experience .
### Pre-race I slept well the night before the race and woke up around 7:30am, ate a large bowl of overnight oats, drank a coffee, applied a generous amount of lubrication, kitted up and then headed to the event. This moment always feels like Christmas Eve to me. You know what you’ve asked for but you’re not quite sure if you’ll get it.
### Race Garmin race predictor had me at 3:40 which tied in nicely with my goal of sub-3:40 so I set my watch for 3:39. I brought along 8 SiS gels (the beta variety due to their higher carb content). I had one at the start line then planned to have one every 30 mins. I’m a bigger guy and need to keep on top of fuelling. I took two electrolyte tabs and two caffeine tabs along to have 1.5 & 2.5 hours into the race.
Miles 1-5 The first 5 or so miles at Edinburgh are mostly downhill to sea-level and it’s hard not to let it fly. I hit a couple of sub 8 min/mi’s during this section (which I had no business doing) but I didn’t want to hammer my quads by braking too much.
Miles 6-13 This next section takes you out along the coast where you spend the majority of the race. Back in 2022 I really didn’t enjoy this because the crowds are smaller, there are fewer distractions etc. This time I really enjoyed it. The sun was shining with a gentle breeze and I felt as though I got the first half for ‘free’. My HR was Z2/Z3 and I had built up a useful buffer of 2-3 minutes.
Miles 14-18 At mile 15 I decided to spend 30 seconds of my buffer on a toilet break. Still out on the coast, you hit the loop-back at around mile 18 and enter the grounds of Gosford House (an old stately home). It’s a really nice part of the course but there’s a section on loose gravel which isn’t much fun. I winced at the AFs, VFs, Elites etc getting chewed up. Last year the death-march had well and truly started by this point. Today, I felt really strong and in control. My HR was now in Z3/Z4 but I had a good sense of how close to push it to the edge and was still managing the race well enough.
Miles 19-21 I usually dread this stage but flew through miles 19, 20 and 21 still feeling strong, giving out high-fives to the kids, smiling for photos etc. For the first time in a marathon I started passing lots of other runners and it felt incredible. I didn’t have any of the usual brain fog, I didn’t need to walk, I didn’t curse myself for signing up to the event. All is well.
Miles 22-26.2 I finally felt like I was working for it. Not ‘Z5-working-for-it’ but my pace had dropped off and I was fighting to get my cadence back. I felt like my feet were hitting the ground for about 3 seconds of contact time before turning over but in reality I was still good. I set a small goal of keeping all remaining miles sub 9min. In reality, I could have kicked harder in the final two miles but I was good with uncomfortably hard and didn’t want to tip it over the edge. I saw a few runners needing medical attention which was enough for me to look at my watch and realise that with a final kick down the finish line, I would achieve my goal.
### Post-race I hit 3:39 and felt a real sense of satisfaction. It wasn't like London where I ran out of my skin, pulled a PB from god-knows-where, and shouted in disbelief as I crossed the finish line. This time, I looked at my time and was left feeling as though I had claimed what was rightfully mine. I lay on the grass with my family, sipped on a beer, closed my eyes and felt a wave of endorphins flowing all over as I heard my kids playing in the background. This is why we do it, my mind is totally empty, the sun is screaming down on my face and my body is dissolving into the earth below. Job done.
### What next? I have now done 5 marathons in my first two years and have gained so much. I'm a late bloomer but I’m now a truly happy person and my family has gained the best version of their Dad/husband. I have my first 50k fell run coming up (or ultra, depending on your persuasion) and will then build towards another event in Oct-Nov.
I will run Pfitz again but need to focus on losing more weight and strengthening my posterior chain as I have noticed in race photos that when I’m fatigued, my torso collapses forwards which means I am no longer running with my hips forward and chest high. I think that 3:35 is well within my sights, 3:30 would be incredible and anything faster than that would be a dream.
Made with a new [race report generator](http://sfdavis.com/racereports/) created by herumph.
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2023.05.17 19:22 Then_Marionberry_259 MAY 16, 2023 UGD.V UNIGOLD ANNOUNCES CLOSING OF NON-BROKERED PRIVATE PLACEMENT OF $3,850,000

MAY 16, 2023 UGD.V UNIGOLD ANNOUNCES CLOSING OF NON-BROKERED PRIVATE PLACEMENT OF $3,850,000
https://preview.redd.it/2mgc5uncef0b1.png?width=3500&format=png&auto=webp&s=6e1e655074cac6265fe934368129e5fe87917e05
Toronto, Ontario--(Newsfile Corp. - May 16, 2023) - Unigold Inc. (TSXV: UGD) (OTCQB: UGDIF) (FSE: UGB1) ("Unigold" or the "Company") is pleased to announce that it has closed a second and final tranche ("Final Tranche") of a non-brokered private placement of 48,125,000 units of the Company (each, a "Unit") at a price of $0.08 per Unit for gross proceeds of $3,850,000 (the "Offering"). Each Unit consists of one common share of the Company (a "Common Share") and one-half of one common share purchase warrant (each whole common share purchase warrant, a "Warrant"). Each Warrant will entitle the holder thereof to purchase one Common Share at an exercise price of $0.30 until the date that is the earlier of: (i) one year following the date of issue, or (ii) 30 days after the date on which the Company gives notice of acceleration, which notice may be provided no earlier than four months and twenty-one days from the date of issue if the closing price of the Common Shares on a stock exchange in Canada is higher than $0.60 per Common Share for more than 20 consecutive trading days.
The Company announced the closing of a First Tranche on May 11, 2023. In the closing of the Final Tranche, the Company has issued 32,107,500 units for aggregate gross proceeds of $2,568,600. No finders were paid in connection with this closing of the Offering. The proceeds from the Offering will be used to fund the Company's continued exploration and development on its Neita Concession in the Dominican Republic, and for general working capital purposes. All securities issued under the Offering are subject to a four-month hold period. The Offering is subject to final acceptance of the TSX Venture Exchange.
The following "insiders" of the Company subscribed for Units under the Final Tranche of the Offering:
https://preview.redd.it/sitdgtzcef0b1.png?width=720&format=png&auto=webp&s=4089bc87850b9bb9a45c0692483cf60e440da943

Each subscription by an "insider" is considered to be a "related party transaction" for purposes of Multilateral Instrument 61-101 - Protection of Minority Security Holders in Special Transactions ("MI 61- 101") and Policy 5.9 - Protection of Minority Security Holders in Special Transactions of the TSX Venture Exchange. Pursuant to MI 61-101, the Company will file a material change report providing disclosure in relation to each "related party transaction" on SEDAR under the Company's issuer profile at www.sedar.com. The Company did not file the material change report more than 21 days before the expected closing date of the Offering as the details of the Offering and the participation therein by each "related party" of the Company were not settled until shortly prior to the closing of the Offering, and the Company wished to close the Offering on an expedited basis for sound business reasons. The Company is relying on exemptions from the formal valuation and minority shareholder approval requirements available under MI 61-101. The Company is exempt from the formal valuation requirement in section 5.4 of MI 61-101 in reliance on sections 5.5(a) and (b) of MI 61-101 as the fair market value of the transaction, insofar as it involves interested parties, is not more than the 25% of the Company's market capitalization, and no securities of the Company are listed or quoted for trading on prescribed stock exchanges or stock markets. Additionally, the Company is exempt from minority shareholder approval requirement in section 5.6 of MI 61-101 in reliance on section 5.7(1)(a) as the fair market value of the transaction, insofar as it involves interested parties, is not more than the 25% of the Company's market capitalization.
The securities offered have not been registered under the U.S. Securities Act of 1933, as amended, and may not be offered or sold in the United States absent registration or an applicable exemption from the registration requirements.
About Unigold Inc. - Discovering Gold in the CaribbeanUnigold is a Canadian based mineral exploration company traded on the TSX Venture Exchange under the symbol UGD, the OTCQB exchange under the symbol UGDIF, and on the Frankfurt Stock Exchange under the symbol UGB1. The multi-million ounce Candelones gold deposits are within the 100% owned Neita Fase II exploration concession located in Dajabón province, in the northwest part of the Dominican Republic. The Company delivered a feasibility study for the Oxide portion of the Candelones deposit in Q4 of 2022. The Company applied to split the "Neita Fase II" concession into an Exploitation Concession and an Exploration Concession in late February 2022. The application for the 9,990 Ha "Neita Sur" concession has moved smoothly through various permitting stages and the Company expects that a decision will be given on the application in the second quarter of 2023. The 10,902 Ha "Neita Norte" Exploration Concession was awarded to the Company in Q2 2023. Unigold has been active in the Dominican Republic since 2002 and remains the most active exploration Company in the country. The two concessions together form the largest single exposure of the volcanic rocks of the Cretaceous Tireo Formation. This island arc terrain is host to Volcanogenic Massive Sulphide deposits, Intermediate and High Sulphidation Epithermal Systems and Copper-gold porphyry systems. Unigold has identified over 20 areas within the concession areas that host surface expressions of gold systems. Unigold has been concentrating on the Candelones mineralization and is moving to bring these deposits into production.
For further information please visit www.unigoldinc.com or contact: Mr. Joseph Hamilton Chairman & CEO [jhamilton@unigoldinc.com](mailto:jhamilton@unigoldinc.com) T. (416) 866-8157
Forward-looking StatementsCertain statements contained in this document, including statements regarding events and financial trends that may affect our future operating results, financial position and cash flows, may constitute forward-looking statements within the meaning of the federal securities laws. These statements are based on our assumptions and estimates and are subject to risk and uncertainties. You can identify these forward-looking statements by the use of words like "strategy", "expects", "plans", "believes", "will", "estimates", "intends", "projects", "goals", "targets", and other words of similar meaning. You can also identify them by the fact that they do not relate strictly to historical or current facts. We wish to caution you that such statements contained are just predictions or opinions and that actual events or results may differ materially. The forward-looking statements contained in this document are made as of the date hereof and we assume no obligation to update the forward-looking statements, or to update the reasons why actual results could differ materially from those projected in the forward-looking statements. Where applicable, we claim the protection of the safe harbour for forward-looking statements provided by the (United States) Private Securities Litigation Reform Act of 1995.
Neither TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.
To view the source version of this press release, please visit https://www.newsfilecorp.com/release/166354
​
https://preview.redd.it/hem89qbdef0b1.png?width=4000&format=png&auto=webp&s=90bc47f191310960f1c6d3f8f4ffe73c7aa86951
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2023.05.11 13:31 Then_Marionberry_259 MAY 11, 2023 UGD.V UNIGOLD ANNOUNCES CLOSING OF FIRST TRANCHE OF NON-BROKERED PRIVATE PLACEMENT OF UP TO $4,250,000

MAY 11, 2023 UGD.V UNIGOLD ANNOUNCES CLOSING OF FIRST TRANCHE OF NON-BROKERED PRIVATE PLACEMENT OF UP TO $4,250,000
https://preview.redd.it/jxreryadu6za1.png?width=3500&format=png&auto=webp&s=0d77f80ac339fd05b8207ab883e96478a1a4c655
Toronto, Ontario--(Newsfile Corp. - May 11, 2023) - Unigold Inc. (TSXV: UGD) (OTCQB: UGDIF) (FSE: UGB1) ("Unigold" or the "Company") is pleased to announce that it has closed a first tranche ("First Tranche") of a non-brokered private placement of up to 53,125,000 units of the Company (each, a "Unit") at a price of $0.08 per Unit for gross proceeds of up to $4,250,000 (the "Offering"). Each Unit consists of one common share of the Company (a "Common Share") and one-half of one common share purchase warrant (each whole common share purchase warrant, a "Warrant"). Each Warrant will entitle the holder thereof to purchase one Common Share at an exercise price of $0.30 until the date that is the earlier of: (i) one year following the date of issue, or (ii) 30 days after the date on which the Company gives notice of acceleration, which notice may be provided no earlier than four months and twenty-one days from the date of issue if the closing price of the Common Shares on a stock exchange in Canada is higher than $0.60 per Common Share for more than 20 consecutive trading days.
The Company has issued 16,017,500 units for aggregate gross proceeds of $1,281,400. No finders were paid in connection with this closing of the Offering. The proceeds from the Offering will be used to fund the Company's continued exploration and development on its Neita Concession in the Dominican Republic, and for general working capital purposes. All securities issued under the Offering are subject to a four-month hold period until September 10, 2023. The Offering is subject to final acceptance of the TSX Venture Exchange.
The following "insiders" of the Company subscribed for Units under the First Tranche of the Offering:
https://preview.redd.it/fkhbraddu6za1.png?width=720&format=png&auto=webp&s=8abc894b335e180b5df13bc9b5d3f6167b2a731f

16545921 Canada Inc., a holding company of Mr. Normand Tremblay, subscribed to the Offering.
Each subscription by an "insider" is considered to be a "related party transaction" for purposes of Multilateral Instrument 61-101 - Protection of Minority Security Holders in Special Transactions ("MI 61- 101") and Policy 5.9 - Protection of Minority Security Holders in Special Transactions of the TSX Venture Exchange. Pursuant to MI 61-101, the Company will file a material change report providing disclosure in relation to each "related party transaction" on SEDAR under the Company's issuer profile at www.sedar.com. The Company did not file the material change report more than 21 days before the expected closing date of the Offering as the details of the Offering and the participation therein by each "related party" of the Company were not settled until shortly prior to the closing of the Offering, and the Company wished to close the Offering on an expedited basis for sound business reasons. The Company is relying on exemptions from the formal valuation and minority shareholder approval requirements available under MI 61-101. The Company is exempt from the formal valuation requirement in section 5.4 of MI 61-101 in reliance on sections 5.5(a) and (b) of MI 61-101 as the fair market value of the transaction, insofar as it involves interested parties, is not more than the 25% of the Company's market capitalization, and no securities of the Company are listed or quoted for trading on prescribed stock exchanges or stock markets. Additionally, the Company is exempt from minority shareholder approval requirement in section 5.6 of MI 61-101 in reliance on section 5.7(1)(a) as the fair market value of the transaction, insofar as it involves interested parties, is not more than the 25% of the Company's market capitalization.
The securities offered have not been registered under the U.S. Securities Act of 1933, as amended, and may not be offered or sold in the United States absent registration or an applicable exemption from the registration requirements.
About Unigold Inc. - Discovering Gold in the CaribbeanUnigold is a Canadian based mineral exploration company traded on the TSX Venture Exchange under the symbol UGD, the OTCQB exchange under the symbol UGDIF, and on the Frankfurt Stock Exchange under the symbol UGB1. The multi-million ounce Candelones gold deposits are within the 100% owned Neita Fase II exploration concession located in Dajabón province, in the northwest part of the Dominican Republic. The Company delivered a feasibility study for the Oxide portion of the Candelones deposit in Q4 of 2022. The Company applied to split the "Neita Fase II" concession into an Exploitation Concession and an Exploration Concession in late February 2022. The application for the 9,990 Ha "Neita Sur" concession has moved smoothly through various permitting stages and the Company expects that a decision will be given on the application in the second quarter of 2023. The 10,902 Ha "Neita Norte" Exploration Concession was awarded to the Company in Q2 2023. Unigold has been active in the Dominican Republic since 2002 and remains the most active exploration Company in the country. The two concessions together form the largest single exposure of the volcanic rocks of the Cretaceous Tireo Formation. This island arc terrain is host to Volcanogenic Massive Sulphide deposits, Intermediate and High Sulphidation Epithermal Systems and Copper-gold porphyry systems. Unigold has identified over 20 areas within the concession areas that host surface expressions of gold systems. Unigold has been concentrating on the Candelones mineralization and is moving to bring these deposits into production.
For further information please visit www.unigoldinc.com or contact: Mr. Joseph Hamilton Chairman & CEO [jhamilton@unigoldinc.com](mailto:jhamilton@unigoldinc.com) T. (416) 866-8157
Forward-looking Statements Certain statements contained in this document, including statements regarding events and financial trends that may affect our future operating results, financial position and cash flows, may constitute forward-looking statements within the meaning of the federal securities laws. These statements are based on our assumptions and estimates and are subject to risk and uncertainties. You can identify these forward-looking statements by the use of words like "strategy", "expects", "plans", "believes", "will", "estimates", "intends", "projects", "goals", "targets", and other words of similar meaning. You can also identify them by the fact that they do not relate strictly to historical or current facts. We wish to caution you that such statements contained are just predictions or opinions and that actual events or results may differ materially. The forward-looking statements contained in this document are made as of the date hereof and we assume no obligation to update the forward-looking statements, or to update the reasons why actual results could differ materially from those projected in the forward-looking statements. Where applicable, we claim the protection of the safe harbour for forward-looking statements provided by the (United States) Private Securities Litigation Reform Act of 1995.
Neither TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.
To view the source version of this press release, please visit https://www.newsfilecorp.com/release/165673
​
https://preview.redd.it/nxk0piedu6za1.png?width=4000&format=png&auto=webp&s=16f7753915f3afbe2498eaf37ce72880ea327817
Universal Site Links
UNIGOLD INC.
STOCK METAL DATABASE
ADD TICKER TO THE DATABASE
www.reddit.com/Treaty_Creek
REPORT AN ERROR
submitted by Then_Marionberry_259 to Treaty_Creek [link] [comments]

http://activeproperty.pl/