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scientia-rex · 10 months

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Hysteria isn't a fucking thing

ok fun fact: I'm rapidly becoming a cult favorite doctor among our local privileged elderly white ladies, which I have mixed feelings about, but the #1 reason is that I just don't leap to "anxiety" as an explanation for symptoms unless the patient tells me "I am anxious, and then I feel these symptoms, and when I am not anxious, I don't feel these symptoms."

The sheer number of women I've seen who've been told for years to decades that the only thing wrong with them is anxiety is fucking staggering, in this Year Of Our Lord 2023, and I just keep digging. We checked a basic lab panel, sure. CBC. No anemia. CMP. Kidneys are fine. (Electrolytes are basically always going to be fine if someone is well enough to walk into my office under their own power to talk to me. Exception is mild chronic hyponatremia.) And we check thyroid. TSH and free T4. We check blood sugar. A1c, if the fasting is a little weird. Fasting insulin, if I'm still suspicious. We check cortisol. Inflammatory markers--ESR and CRP.

And eventually, if the symptoms support it, or right away, depending on my level of suspicion, we check rheumatological labs for abnormal autoimmune function. Anti-nuclear antibody. Rheumatoid factor. There's at least a dozen you can check, and which ones you should check is always a matter of debate and also of expertise that I 100% lack. We are out in the sticks. There are no "local" rheumatologists for me to send people to.

But a couple of weeks ago I found a woman--she has bipolar disorder and has been told for decades that's all that's wrong with her--who has an anti-centromere antibody titer that's fucking through the roof. I found an anxious 19-year-old with an ANA of 1:1380. And yesterday I found out why a sweet elderly woman I've seen for a year or two now started feeling crappy months ago: her rheumatoid factor is over 90.

Rheumatological disorders are always difficult. Our understanding of them varies from "pretty good, actually, and here are useful treatments" to "Well I Guess That Exists." Labs aren't always a slam-dunk and even labs plus symptoms can give you misleading impressions. Your immune system can decide that virtually any short chunk of protein is an enemy, and the problem with that is that your body is made up of many, many, many short chunks of proteins, so the odds that you'll develop some kind of antibody against yourself just keeps going up over your lifetime. Immune disorders tend to travel in packs; there's a clear genetic element to it, so the more first-degree relatives (parent, sibling, child) you have with any kind of autoimmune disorder (including Type 1 diabetes), the higher your risk of any kind of autoimmune disorder is, and if you already have one autoimmune disorder, you're at higher risk for developing another one.

But I think it's precisely because they're difficult that a lot of mainstream primary care prefers to pretend they don't exist, rather than try to sift through the utter fucking mess that is Mixed Connective Tissue Disorders, a title that has fallen out of favor since I learned it in my third year of med school. And women are at higher risk for autoimmune disorders than men. And older women are at higher risk than younger women.

So if I, as a family doc, just keep digging, just keep poking at the tangled knot of symptoms, there's a decent chance I will uncover something interesting. Hopefully something treatable. Sometimes we have nothing to treat with, and I just get to offer someone more understanding of their disorder, which feels pretty paltry but is better than the casual dismissal of "You're just anxious."

Never, ever, ever take anxiety as a diagnosis for a symptom other than anxiety. Not even as a rule-out. Keep those symptoms as an open question mark on the patient. Don't say "anxiety" just so you can close the door. And damn sure don't do it to women.

I'm actively working on learning more so I can be more helpful, in our Rheum-less community, so if you have good lectures or books, please drop me a lead.

#the attending dr. kristophine

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chronicallyuniconic · 1 year

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"You don't look sick"

I shouldn't have to display physical symptoms for you to believe I am sick. I shouldn't have to display physical symptoms for you to believe I need care/your help. I shouldn't have to be bleeding. Or fainting. Or vomiting. Or screaming (nobody hears me).

The words "I am exhausted" should be enough. Saying that I have chronic fatigue should be enough. Explaining how tired I am is not an invite for competition. I am just tired. To my fucking bones.

I can sleep for 21 hours 7 days a week & still feel like I've had no sleep at all. Because of chronic fatigue. Not out of choice. I'd love some restorative sleep. It never comes. It might never? (who knows, nobody seems to care enough about M.E/Fibromyalgia/CRPS/PoTS to help us)

I'm just so tired of this shit.

Uniconic

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wishful-seeker · 3 days

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I have 0% tolerance for doctors anymore, if they treat me shitty once they will again, thus I'll either drop them or file a complaint.

Before my CRPS was diagnosed i was too scared to stand up to doctors. The pain made me SO DESPERATE i was willing to deal with anything. Now that i have this new undiagnosed illness i realized my body and mind PHYSICALLY cannot do that anymore.

The second to last time i didn't stand up for myself with a doctor i punched the medical bed as soon as she left the room, the last time i couldn't even hear what he said because i was busy restraining myself from punching HIM. i was seeing red, face twitching and everything. My body literally cannot take being quiet anymore. I do not care if i make things more difficult. I don't care if it takes longer to get diagnosed because im pushing for better treatment. I would rather stand up for myself and physically suffer more than let these doctors believe they are allowed to treat me like a dog. They don't treat me like a HUMAN, they don't see us as HUMAN. They see us as pests. A burden, a problem to solve. And if they can't solve you THEY FUCKING HATE YOU. but i think i hate them more.

Doctors are in a gross position of power over their patients, they decide if you live or die, your existence is in their hands, you beg them for help because they are your God and they spit in your face. Even if you literally cry and beg them to help they will give you NOTHING and i know this because thats what i did. I literally BEGGED these people sobbing to help my pain and they did nothing. They do not care about you. They never will. We are not people to them. Nurses are often the same way. I've had nurses and doctors lie straight to my face, make faces when i tell them my story, and do other horrible things.

I can't do it. I can't deal with it anymore. I will fight tooth and nail and be the biggest Karen in existence to these doctors the SECOND they treat me wrong.

I have found two. TWO doctors out of over 50 that i actually like. 2 that treat me appropriately and not like im a bug. 2 that treat me like a human being.

#tw medical trauma #tw medical gaslighting #cripplepunk #cripple punk #physical disability #chronically ill #doctors are scum

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the-s1lly-corner · 7 months

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Knubbler hcs (Fluff alphabet edition)

Ik I just posted a fluff list to do with CRP characters last post but I also wanna do it with Knubbler because this fucker has been on my mine for WEEKS and I gotta feed my fellow dick enjoyers

Obvious heads up on heavy hc stuff since we don't have much on this dude RAAAAAAAH + still developing my hcs

Long since its A-Z, not proof read and I wrote this in one sitting I need to be put down

Attraction-

Torn between wanting to say he has high standards but I'm a dickface shipper sooo (/lh)

I can't explain it but I feel like he'd be into the feistier people; more dominant and outspoken, that sort of thing, ballsy. Also balancing with being chill so it's not just. Constant energy

Balance, you know

Appearance wise? I'm stumped tbh so maybe I'll revisit this later some day

Bonding-

While he enjoys dragging you around and spoiling you (getting into that for D + G), he does enjoy time spent at home with you! Knubblers always been the type of person to sit by a fire reading a book with a glass of wine; in a robe of course

At least he does to me

Calm stuff like that is a must

Oh how I crave domestic life hcs with this man

Cuddling-

I don't have PDA on this list so imma let it be said, this man loves affection, giving and receiving. Absolutely adores being all over you at all times and not at all afraid to show you off

Going to the actual prompt he doesnt care if you're larger or smaller than him, if you sprawl yourself over his chest he will melt!!!! Hold each other!!!

Dates-

This man is going to pour so much money into these dates

Could just be because we saw him take Abigail out to dinner but my brain defaults to restuarant dates, but otherwise I feel he's also a museum enjoyer (historical, art, ect)

Emotion-

Of course since this for reader insert stuff I can't exactly say who's more emotional so we're relying on Knubbler

I feel like. He's moderate, based on his interactions with Dethklok

He's patient by a considerable amount but has his limits

Absolutely pours his heart and guts out to you when hes drunk, though, not that he doesnt already shower you with compliments and affirmations

Wanna put him at a 6.5/10 when sober, and solid 8/10 when drunk

Family-

He doesn't strike me as the type to want kids, honestly, not that he has anything against them though, it's simply not what he wants

I saw someone hc a while back that he would have a bunch of siblings and I'm HARD agreeing on that + adding my own thing that hes an uncle

Need to write a silly fic where he's assigned as babysitter for a day (I desperately need more solo/knubbler centered stuff)

Gift Giving-

Nearly every week or so he will buy you something from flowers to jewelry to stuffed animals to fancy chocolates to really anything

If you so much as mention vaguely wanting something hes pulling out his wallet

This dude is likely loaded (based on working for Dethklok and being successful prior judging by the newspapers at the end of episode 2) so he's not afraid to drop some cash for you

As for receiving gifts he doesn't hold you to the same standard regardless of your income but he would be thrilled with anything you give him, I feel like hes a jewelry guy but maybe that's just because I like drawing him with rings

I feel like he'd go bonkers for baked good though

Harsh-

You guys may butt heads but you guys probably wouldn't argue too much outside of the basic disagreements that happen in every relationship!! Usually apologies for lashing out (if he does that in that particular argument) but will refuse to apologize if there's an actual problem that needs to be addressed (if said problem is on your end)

King of compromises (learned trait from working with bands me thinks)

Injury-

Depends on the severity

Knows very very basic first aid (cleaning, applying pressure if it's an open bleeding wound, cool water if it's a burn, ect) but more than that he's lost

Swearing and a bit of panic if it's something more serious, this is true for if hes the one hurt as well

If you're the one hurt hes going to hover all over you. Oh nooo please dont tell him hes your savior/hero, please don't make him reel good for pampering you oh NOOOOOOO (stares)

If hes the ome hurt hes going to bask in the attention if he needs to be taken care of, hypes up splinters/j

This stuff also applies to sickness

Jealousy-

Oh this is one jealous motherfucker. He will *glare* with those red pin prick robotic eyes of his

If someone's flirting with you he will saunter over and wrap an arm around you, loudly and sharply calls you babe to get the point across

^Kinda cliche but I feel like this man is a sucker for tropes

But if you're like actively uncomfortable I think he might have to intervene

See: his criminal record and the fact he "knows people who can 'take care of someone'", whether he'd actually follow through depends

Kisses-

Recieving he loves when you kiss his face; mouth, cheeks, nose

Giving, really everything is fair game if you give the go ahead; has a particular fixation on your hands (backs and knuckles), cheeks, and neck

Love anything from quick pecks to full on make out sessions

Love Language-

Physical touch and gift giving! Sometimes the gift giving can get intense since hes so ready to treat you like royalty but he doesnt mean anything malicious by it

As for receiving he has a soft spot for affirmations

Marriage-

He goes either way I think, but leans further to no marriage

That doesn't mean hes any less committed to you, though

You guys probably get matching rings even if there isn't a ceremony or legal thing, I think

No-

A deal breaker is like. If you're genuinely a bad person or a threat to his career

Like theres a difference between the shit Dethklok gets into and what you would have to do for him to cut you off full stop

Though I'm stumped on what exactly would call for that outside of being a genuinely horrible person, maybe I'll revisit this later

Oddity-

His laugh is the first thing I can think of. While I think the original is silly and cute in its own way, I'm kinda glad they changed it in the movie

He laughs at his own jokes and has a killer hair routine he follows religiously. Shitty innuendos, too. I am not going to let this man live down the hot dog thing and I KNOW it ain't a one off thing there is no way, this man gets no bitches (using Nathan's "you're horrible with women" comment as leverage)

Outside of that I dont think there's many quirks or habits that are worth mentioning

Petnames-

By law he has to call you Baby/Babe but I can also see him saying Hon/Honey, maybe even Sweetheart

Loves being called things like Dear and Darling

Question-

Loves coming to you to ask if you wanna give a second opinion on something hes working on, work related or not! Hes more than confident in his skills regarding sound engineering, but he likes getting the attention and time from you

Risk-

Skipping this because I'm truly stumped on trying to figure out how far hes willing to go in a relationship in terms of taking risks

SHH-

Has a few secrets, ranging from personal stuff to things that ultimately don't concern you

And that's okay, as long as it's not anything that can screw you or the relationship over, privacy is necessary

Probably has a lot of secrets surrounding dumb or embarrassing stuff hes done before and during the relationship

Tunes-

Obligatory I have a funky sense of music and while I want to choose a song that fits the time period of the main show to the decades before I'm a bit lost. Also I dont generally listen to love songs/songs that can be passed off as ones if you squint. So you guys get 2 songs that give me knubbler x (reader/oc insert) vibes

youtube

And

youtube

Upset-

When Knubbler is upset he shuts himself off and tries to get over whatever funk hes in, usually a glass or two is involved

Occasionally he'll seek you out for comfort or validation

If you're the one upset he's already lending you an ear and offering a shoulder to lean on (metaphorically and literally), gets mad on your behalf if someone upset you and offers solutions if it was something else

I like to think that you guys dedicate nights for venting and unloading on drama and bullshit. Like two gossiping moms

Valentine-

He is not holding back

You wake up to breakfast and gifts. He takes you out all day for shopping, you guys come home to get ready for dinner and a movie

Things definitely get.. intimate

But this is a SFW blog so I am not going to elaborate

Wedding-

If there is a wedding you guys make sure it's straight out of a storybook; dream wedding basically

Since he's not too worried about getting married I'd assume it makes sense that he lends most the power to you when it comes to decorating

Xray-

Urges you to communicate your feelings outwardly and verbally since hes not a mind reader, but he does pick up on certain behaviors to give him a general idea of how you're feeling

He doesn't want to push too hard, though, so he tries to offer an environment where there's open communication

Yearning-

Stealing this from my friend but hc that Knubbler actually would not know how to react to someone genuinely having an interest in him, at least in the beginning

Like he knows he's not the ugliest or the most horrible person but he doesnt think hes a heartthrob

So when you come along and actually get him to sit and settle down with someone he kinda. Doesn't know how to feel about being on his own/seperated

Like he can still function but hes finding himself thinking about you a lot; from wondering how your day is to things he wants to tell you when you guys are reunited

Zzz-

As mentioned before he loves cuddling so be ready for him to hold onto you

Prefers soft and light covers compared to heavier ones

Probably yoinks the blanket while he's sleeping

Probably snores

Bonus hc I think his robo eyes can be taken out, like for charging and he has a lil case for them. Has a sleeping mask so nothing gets into his sockets + he understands how it looks to others (especially if they wake up half asleep in the dark and arent used to the empty sockets yet)

#metalocalypse x reader #knubbler x reader #dick knubbler x reader #knubbler x you #dick knubbler x you #self indulgence at its finest #dick knubbler #knubbler #Youtube

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lavcommunicatez · 8 months

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about me:

lavender/lav

they/them

white Jew

nonspeaking since birth , full-time AAC user.

multimodal communicator. Sometimes I write posts with picture based AAC , sometimes text based AAC , sometimes type on computer keyboard with support person/friend help , sometimes type independently on phone with accessible keyboard app , sometimes use physical letterboard and communication & regulation partner (CRP) translates into typing and post for me.

I’m disabled. autistic epileptic and apraxic, have dysmotility or cyclic vomiting syndrome.

I’m non-binary/genderqueer and a lesbian.

I love plants / botany , lavender ( name checks out ) , surrealism , cats , folk music, Welcome to Night Vale, queer history and being in water.

Things to know about me / boundaries:

I’m a multimodal communicater and my writing style varies. in real life I try hard to type "properly" , use good grammar and punctuation to " prove that smart/competent " and "compensate" being nonspeaking. can vary a lot depending on what app / method I'm using , whether I'm typing independently or with support, level of language processing , motor control , lots of factors. I generally can process and use “correct” grammar when I have to but the language norms are very different on DD side of tumblr and am experiment with letting myself not correct everything I write. My style on here is also echolalic thing from other blogs that have seen.

please don’t involve me in debates about who can use what word or ask for my opinion about these debate. official position is I call myself nonverbal or nonspeaking in different context depending on what will piss people off more. (like in Spellers and RPM communities will call myself nonverbal, on tumblr will use nonspeaking more because nonverbal is more used term.)

please don’t call me low functioning or severely / profound autistic.

just as personal preference prefer not being on "lists of autistic people with high support needs" or "nonspeaking nonverbal people to follow." makes me feel like being used as a token and like being see as “ voice ” or represent group and not as full person. also don't like demand to translate mysteries of autism or whatever. will not do that.

related: not project “ single stories ” about nonspeaking experience on me. I don't have an intact mind. I'm not trapped inside. I love the nonspeakers I know who use these scripts because they easy to explain or because they resonate. But my dyspraxia and motor issues not The One Thing can sum everything to, neither is my language issues or co ocurring medical stuff or whatever else. please don’t reduce all of my experiences to one thing based on the labels and identities I carry.

I have trouble writing image descriptions because of visual processing problems and usually write a not very good one at first and then edit it.

I want to make my blog cognitively accessible to everyone. If you need plain language " translate " or summary for long post tell me and I will try!

(get most of these user boxes from Wikipedia. but others got from @dreamdropsystem. )

#autism #aac #aac user #nonspeaking #disability #intro post #about me #lav talkz

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