#myotonic muscular dystrophy

[invodka-veritas]

Just learned that Gilbert Gottfried passed away from the same disease I have :c

Muscular Dystrophy is rare enough that I was surprised to hear about another person who had this. I'm shocked that I hadn't heard about our shared disease sooner than when I looked him up to show my partner a clip of his voice acting

#vodka says stuff #muscular dystrophy #myotonic muscular dystrophy #muscular myotonic dystrophy #spoonie #tw #tw death #i wish i knew he had it sooner cause i respect the man so much more now #MD is brutal

[helthcareheven]

Embryo Enhancement Strategies: Preimplantation Genetic Diagnosis

What is PGD?

PGD, or preimplantation genetic diagnosis, is a procedure performed on embryos prior to implantation in the womb. During in vitro fertilization (IVF), embryos are created through fertilization in a laboratory dish and are allowed to develop for a few days. At this early stage, one or two cells are gently removed from the embryo and tested for genetic abnormalities and conditions. Only healthy embryos, as determined by PGD, are selected for implantation. The History of PGD

The first baby born through PGD was in 1990 after testing for cystic fibrosis. In the years since, the technique has improved and can now test for hundreds of genetic disorders. Initially, PGD was used for serious hereditary conditions like cystic fibrosis, Tay-Sachs disease, sickle cell anemia, and muscular dystrophy. Today, it is also applied to detect chromosomal abnormalities like Down syndrome and gender selection for X-linked disorders. PGD has helped many couples avoid passing on serious genetic diseases to their children. The PGD Process

The general steps involved in PGD are:

1) IVF treatment is performed as normal to collect multiple eggs from the female patient. 2) Eggs are fertilized with sperm in the lab to create embryos. 3) Typically on day 3 of development, when the embryo contains 6-10 cells, one or two cells are gently removed for biopsy without harming embryonic development. 4) The biopsied cells are analyzed using techniques like fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR) to detect abnormalities. 5) Only healthy embryos, as confirmed by PGD results, are selected and implanted back into the woman's womb. Diseases Screened by PGD

Some of the more common genetic disorders for which PGD is often used include: - Cystic fibrosis: A lung disease caused by mutations in the CFTR gene. PGD can detect affected embryos. - Huntington's disease: A neurodegenerative condition caused by CAG repeat expansions. PGD finds embryos free of expansions. - Fragile X syndrome: The most common form of inherited intellectual disability caused by mutations in the FMR1 gene. Embryos can be tested. - Myotonic dystrophy: A muscular dystrophy caused by CTG repeat expansions that PGD can identify in embryos. - Beta thalassemia: An anemia caused by mutations in the HBB gene. PGD selects unaffected embryos. - Sickle cell anemia: Another anemia caused by a mutation in the HBB gene. PGD accurately diagnoses embryos. How Accurate is PGD?

As the techniques used for PGD continue to improve, the tests have become highly accurate. FISH analysis has an accuracy rate of about 95-99% while PCR-based methods detect abnormalities with over 99% accuracy. However, there is still a small chance of diagnostic errors. PGD is not currently able to test for all known genetic disorders and conditions either. While it has helped many couples, PGD is not perfect and misdiagnosis is still possible in a small number of cases. Continued clinical testing and experience will help further enhance the accuracy and reliability of PGD. Overall, when performed by experienced centers, PGD provides an effective method for screening embryos. Limitations and Ethical Considerations

While PGD addresses the desire to have healthy, genetically related children, it is not without limitations and ethical concerns. Aside from occasional misdiagnosis risks, PGD is not accessible or affordable for all couples and families affected by genetic disorders. The procedure is also limited to testing only those disorders with a known genetic cause and diagnostic test. There are ongoing debates around the widening scope of what conditions PGD is used for, including gender selection for social reasons alone. Some argue this could eventually lead to selecting embryos for traits like intelligence or athletic ability. Most experts agree PGD should only be offered for preventing medical disease or conditions. Overall, PGD is an advancing technology that provides benefit but also responsibility in its application. In conclusion, through the advances of preimplantation genetic diagnosis, modern science now offers new hope for couples at high risk of passing on life-altering genetic disorders. When performed carefully by trained professionals, PGD has proven an effective tool for pre-implantation diagnosis of embryos. Continued progress is still needed to further increase accuracy, expand testing options, and ensure judicious application in line with ethical standards. Looking ahead, PGD promises more couples the ability to have healthy children free of devastating genetic diseases.

#GeneticInsightPGD #EmbryoScreening #PreimplantationGenetics

[iamd-dystrophy-treatment]

Muscular Dystrophy Symptoms In India

 The muscular dystrophy symptoms in India are similar to those observed globally, as MD is a genetic disorder that affects muscle function and can manifest in various ways. The most common types of muscular dystrophy include Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), and myotonic dystrophy.

Common Muscular Dystrophy Symptoms In India

Progressive muscle weakness, typically starting in the legs and pelvis

Difficulty with motor skills, such as walking, running, and climbing stairs

Waddling gait and frequent falls

Enlarged calf muscles (pseudohypertrophy)

Muscle contractures (shortening of muscles, restricting movement)

Progressive difficulty in breathing and heart function as the condition progresses

Becker Muscular Dystrophy Symptoms in India (BMD):

Similar to DMD but with a later onset and slower progression

Muscle weakness and wasting, usually starting in the teens or early adulthood

Difficulty with running and jumping, but often able to walk into adulthood

Cardiac involvement, leading to heart problems in some cases

Symptoms of Myotonic Dystrophy:

Muscle weakness and stiffness, especially in the face, neck, hands, and feet

Difficulty relaxing muscles after contraction (myotonia)

Fatigue and muscle pain

Progressive muscle wasting and weakness over time

Cardiac arrhythmias and respiratory issues in some cases

It's important to note that muscular dystrophy symptoms in India and their severity can vary widely among individuals with MD, even within the same family. Early diagnosis and intervention, along with a multidisciplinary approach to care, can help manage symptoms and improve quality of life for individuals with muscular dystrophy in India.

Visit to know in Detail about muscular dystrophy symptoms in India.

[rockydolittle]

Q&A with Leyla, Part 2: Vitamin B12

Any supplement recommendations for Myotonic Muscular Dystrophy Type 2?; How much B12 should a senior male take? In what form?; I’m 83 and having to take blood pressure meds every day. Any advice?; More comments on HgbA1c and blood glucose disparities.

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[chloesunit4]

Spinal cord injury:

Damage to any segment of the spinal cord or nerves at the end of the spinal canal (cauda equina) can result in persistent alterations in strength, sensation, and other bodily functions below the site of the lesion. If you've just suffered a spinal cord injury, it may appear that every element of your life has been impacted. You may have psychological, emotional, and social consequences as a result of your injury. Many experts believe that breakthroughs in research will one day allow spinal cord damage to be repaired. Around the world, research projects are being conducted. Meanwhile, medicines and rehabilitation enable many people with spinal cord injuries to live productive and independent lives.

Epilepsy:

Epilepsy is a common neurological disorder that produces recurrent seizures. Seizures are brief bursts of electrical activity in the brain that disrupt its normal functioning. They can induce a variety of symptoms. Epilepsy can begin at any age, although it most commonly begins in childhood or in persons over the age of 60. It is frequently permanent, however it can occasionally improve gradually over time. Seizures can have various effects on people depending on which section of the brain is affected.

Symptoms

Uncontrollable jerking and shaking, known as a "fit" losing awareness and looking blankly into space becoming rigid weird feelings, such as a "rising" feeling in the abdomen, peculiar odours or tastes, and tingling in your arms or legs collapse

Muscular dystrophy:

Muscular dystrophies (MD) are a collection of inherited genetic diseases that cause muscles to deteriorate over time, resulting in increased disability. MD is a progressive disease, which means it worsens with time. It frequently begins by affecting a specific set of muscles before spreading to the rest of the muscles. Some kinds of MD eventually impair the heart or breathing muscles, and the illness becomes life-threatening. Although there is no cure for MD, medication can help control many of the symptoms.

Some of the more common types of MD include:

Duchenne MD – one of the most common and severe forms, it usually affects boys in early childhood; people with the condition will usually only live into their 20s or 30s

myotonic dystrophy – a type of MD that can develop at any age; life expectancy isn't always affected, but people with a severe form of myotonic dystrophy may have shortened lives

facioscapulohumeral MD – a type of MD that can develop in childhood or adulthood; it progresses slowly and isn't usually life-threatening

Becker MD – closely related to Duchenne MD, but it develops later in childhood and is less severe; life expectancy isn't usually affected as much

limb-girdle MD – a group of conditions that usually develop in late childhood or early adulthood; some variants can progress quickly and be life-threatening, whereas others develop slowly

oculopharyngeal MD – a type of MD that doesn't usually develop until a person is between 50 and 60 years old, and doesn't tend to affect life expectancy

Emery-Dreifuss MD – a type of MD that develops in childhood or early adulthood; most people with this condition will live until at least middle age

[missionwalk]

Muscular Dystrophy: What You Need To Know?

If your or your child’s muscles are becoming weak and less flexible over time, you better get a check-up done by a doctor for muscular dystrophy.

A muscular dystrophy is a group of diseases that affects the muscles, and only if you lack this problem in your genes will your muscles continue to be strong. The condition may show symptoms early in childhood for some people, while others do not have symptoms until they reach their teenage years or their middle age.

There are various types of muscular dystrophy, and each is distinct according to the following:

The genes that create it,

The affected muscles,

The person’s age when the first symptoms appeared,

How quick is the progression of the disease?

Here are 9 of the major forms of this disease:

* Duchenne muscular dystrophy is the most common type and mostly affects boys. The symptoms start between ages 3 and 5.

* Becker muscular dystrophy is the milder form of Duchenne, with symptoms starting between ages 11 and 25.

* Myotonic is the most common form in adults.

* Congenital muscular dystrophy occurs at birth or early infancy.

* Limb-girdle muscular dystrophy causes weakness and wasting of the muscles in the arms and legs.

* Facioscapulohumeral muscular dystrophy affects the muscles of the face, shoulders, upper arms and lower legs.

* Distal muscular dystrophy is characterised by wasting and weakness of voluntary distal muscles, which are farther from the centre of the body, such as lower arms, hands, legs and feet.

* Emery-Dreifuss muscular dystrophy affects the skeletal muscles and the heart.

Muscular dystrophy symptoms usually appear either during childhood or in the teen years. Generally, a child with this disease:

- frequently loses balance and collapse

- have weak muscles

- experience muscle cramps

- have difficulty rising from the bed, climbing stairs, jumping or running

- walk with short steps and in clumsy, swaying motion; walk on their toes

- have curved spine (scoliosis)

- have eyelids hanging down limply

- have heart problems

- experience difficulty in breathing or swallowing

- have vision problems

- feel weakness in the muscles of the face

Currently, no clear muscular dystrophy treatment is yet to cure the disease. However, many treatment plans and interventions could help the patient improve their symptoms, thus making life easier for the child and the family.

Here are some doctor-recommended treatments, the application of which should be based on what type of muscular dystrophy a person is suffering from.

1. Physiotherapy (physical therapy) uses different exercises, including stretches, to keep the muscles strong and flexible.

2. Occupational therapy teaches the patient to make the most use of what their muscles can do. Also, they will learn to use wheelchairs, braces and other devices to aid them in their daily functions.

3. Speech therapy trains the person with speech and language problems due to a weak throat and facial muscles to speak more clearly.

4. Respiratory therapy helps restore or improve lung functions; helps with difficulty breathing.

5. Medications to help ease symptoms, such as:

* injection medication to help increase dystrophin production

* anti-seizure drugs to help lessen muscle spasms

* medications for blood pressure to help with heart problems

* immunosuppressant drugs to slow down the damage to muscle cells

* steroids to slow down damage to muscle cells; also help the patient to breathe easily

6. Surgery can help with various muscular dystrophy complications, like trouble swallowing or heart problems.

Although MDs of any type cannot be fully cured, any of the above lists can be successful treatments of muscular dystrophy (therapies, injections, medications, surgery). They can help lengthen the time a child or adult with the disease can remain mobile. They also help strengthen the patient’s heart and lung muscles.

It is quite difficult for parents to see their child lose their muscle strength and be unable to do things other children can. Managing muscular dystrophy is challenging, but don’t let it stop your child from enjoying life.

If you have questions or need more information about muscular dystrophy, please contact Mission Walk today. You need to fill out our online contact form and send it, and one of our team members will be happy to get back to you.

#Muscular dystrophy symptoms #Muscular dystrophy treatment #Successful treatment of muscular dystrophy #muscular dystrophy

[lakannada]

Entrada hit with clinical hold on Duchenne drug - Endpoints News

Entrada hit with clinical hold on Duchenne drug – Endpoints News

When Entrada Therapeutics unveiled its shiny new alliance with Vertex days ago surrounding myotonic dystrophy Type I, CEO Dipal Doshi took the opportunity to spotlight a separate program in Duchenne muscular dystrophy — which he was hoping to put into the clinic in 2023.But a clinical hold from the FDA now threatens to delay those plans.Entrada disclosed late Monday that it received a clinical…

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[worldvoiceleague]

Becoming the Mom and the Caregiver with Ann S. Woodbury

Becoming the Mom and the Caregiver with Ann S. Woodbury

“My journey was figuring out what fed my core needs so I could be what I needed to be for my family.” ~ Ann S. Woodbury Becoming the Mom and the Caregiver What does it mean to step up as a mother when the unpredicted happens? Some mothers have to endure and overcome pain and ridicule from society just so they can love and protect their children. In this episode of the SpeakEasy Podcast,…

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#Ann S. Woodbury #caregiving #Myotonic Muscular Dystrophy

[chronicallymom]

Will my marriage survive my disability, and inability to be a housewife?

I can’t tell if this is just, annoyance because of outside factors & he’s taking it out on me... or if its because of everything I ask of him because I can’t.

Somedays I just think I would be better off on my own. Maybe he deserves better than this.

#personal #myotonic muscular dystrophy #muscular dystrophy #myotonic dystrophy #chronic illness #spoonie

[mcatmemoranda]

Huntington disease is characterized by choreoathetoid movements of the face and extremities, progressive dementia, and early death. Huntington disease has autosomal dominant inheritance, not X-linked dominance or autosomal recessive inheritance. Huntington disease is one of the trinucleotide repeat disorders (others include a number of the spinocerebellar ataxia diseases and Fragile X syndrome) and is due to a mutation on chromosome 4 that results in excessive nucleotide CAG repeats, which result in a longer than normal string of glutamine residues (polyQ expansion) in the N-terminal region of the protein huntingtin. Huntingtin plays a role in vesicle and organelle transport along axons, and increasing the length of the polyQ region disrupts this function. In addition, polyQ expansion has also been implicated in disrupting transcription of a number of genes. Expansion of these repeats over successive generations leads to earlier manifestations of the disease in affected offspring, a phenomenon known as anticipation. Above is a table of the common trinucleotide repeat disorders. The table misspelled "Friedreich!" "I" before "e!"

In Friedreich ataxia, you get inability to regulate iron-> free radical damage.

Bottom Line: Huntington disease is an autosomal dominant disease caused by an inherited mutation in chromosome 4 in which trinucleotide repeats result in impaired axonal transport and decreased and ineffective transcription of a number of genes.

I remember in B&B, he said that glutamate binding to NMDA receptor-> excessive Ca2+ influxe-> neuronal death.

From Medscape:

The most striking neuropathology in HD occurs within the neostriatum, in which gross atrophy of the caudate nucleus and putamen is accompanied by selective neuronal loss and astrogliosis. Marked neuronal loss also is seen in deep layers of the cerebral cortex. Other regions, including the globus pallidus, thalamus, subthalamic nucleus, substantia nigra, and cerebellum, show varying degrees of atrophy depending on the pathologic grade.

The extent of gross striatal pathology, neuronal loss, and gliosis provides a basis for grading the severity of HD pathology (grades 0-4).

No gross striatal atrophy is observed in grades 0 and 1. Grade 0 cases have no detectable histologic neuropathology in the presence of a typical clinical picture and positive family history suggesting HD. Grade 1 cases have neuropathologic changes that can be detected microscopically but without gross atrophy. In grade 2, striatal atrophy is present, but the caudate nucleus remains convex. In grade 3, striatal atrophy is more severe, and the caudate nucleus is flat. In grade 4, striatal atrophy is most severe, and the medial surface of the caudate nucleus is concave.

The genetic basis of HD is the expansion of a cysteine-adenosine-guanine (CAG) repeat encoding a polyglutamine tract in the N-terminus of the protein product called huntingtin.

The function of huntingtin is not known. Normally, it is located in the cytoplasm. The association of huntingtin with the cytoplasmic surface of a variety of organelles, including transport vesicles, synaptic vesicles, microtubules, and mitochondria, raises the possibility of the occurrence of normal cellular interactions that might be relevant to neurodegeneration.

N-terminal fragments of mutant huntingtin accumulate and form inclusions in the cell nucleus in the brains of patients with HD, as well as in various animal and cell models of HD.

The presence of neuronal intranuclear inclusions (NIIs) initially led to the view that they are toxic and, hence, pathogenic. More recent data from striatal neuronal cultures transfected with mutant huntingtin and transgenic mice carrying the spinocerebellar ataxia-1 (SCA-1) gene (another CAG repeat disorder) suggest that NIIs may not be necessary or sufficient to cause neuronal cell death, but translocation into the nucleus is sufficient to cause neuronal cell death. Caspase inhibition in clonal striatal cells showed no correlation between the reduction of aggregates in the cells and increased survival.

Furthermore, postmortem studies reveal that NIIs are quite rare in the striata of patients with HD as compared to the cortex, and most of the aggregates within the striatum are observed in populations of interneurons that typically are spared in individuals with HD.

#Huntingtons disease #Huntington #Huntingtons #dementia #neuro #fragile X syndrome #friedrichs ataxia #friedrich ataxia #freidrich #myotonic dystrophy #spinocerebellar ataxia #Kennedy disease #spinobulbar muscular atrophy #genetics #trinucleotide repeat #glutamate

[speakeasypodcast]

Becoming the Mom and the Caregiver with Ann S. Woodbury

#advocacy #ann #author #best-seller #caregiver #children #dystrophy #educator #empowerment #endurance #family #mom #muscular #myotonic #protect #rejection #relationships #stigma #surviving-myotonic-dystrophy #woodbury

[proffbon]

Schlatt - At War With Body and Mind

c!Schlatt is one of if not the only character that is not only portrayed as being at odds with his mental health but also with his physical health, so I thought that it would be interesting to try to figure out what exactly is wrong with the man.

Keep in mind that most things in this post will be speculations, almost headcanons because we can’t actually run any diagnostics on the man and I am not yet a qualified professional, so let’s get started.  (Everything in the post is /rp /dsmp unless stated otherwise)

Physical Health

First and foremost, a lot of Schlatt’s health issues can be glimpsed from Fundy’s diary. Fundy believed that Schlatt had some sort of “muscle atrophy” that made his body ache. Schlatt drank and smoked to numb it.

Schlatt probably suffered from some type of muscular dystrophy that he couldn’t just control or fix by exercising meaning it was most likely genetic. It is very unclear what type of dystrophy Schlatt had as we don’t know which muscle groups were affected, at what age the condition manifested or what are the symptoms exactly. It is also unclear which level of severity the condition was at as Schlatt was able to do quite heavy exercises but wasn’t able to swim at the same time. My best guess for the exact type of condition would be myotonic muscular dystrophy (MMD), one of the most common for young adults. One of the things Schlatt is famous for is his “Schlatt-walk” and while it is sort of a meme and a way to avoid getting hungry in-game I like to add it to my speculations. So Schlatt apparently suffered from some sort of muscle pain. But at the same time, we could see him doing quite heavy labor (buildings demolition, gardening) although he refused to sprint and couldn’t seem to swim properly. Schlatt also worked out a lot by using dumbbells but canonically skipped leg day, Schlatt in general refused to do cardio (as seen by the Big Man Gym dialogue). So this makes me think that the main cause of this laid in Schlatt’s legs or at least that was the site of the most severe pains which caused Schlatt to intentionally and unintentionally reduce the strain on them. Intense pain in the lower back and legs is a common symptom of MMD. A lot of types of muscular dystrophy can also lead to heart diseases and breathing problems which would fit into Schlatt’s clinical picture.

We actually have something that Schlatt said about his health himself. We all know about his almost iconic panting/shortness of breath. During the presidential rally, he was resting on a bed and had another episode of those. In-between the pants he said “I have COPD”. Schlatt didn’t really like discussing his health and often said that he’s “right as rain” when asked. But at the time Schlatt was actually half-hungover/half-already-drunk and the alcohol might have loosened his tongue a bit. COPD also fits really well in the narrative as Schlatt showed symptoms of it (coughs, shortness of breath, physical activity limitations) and also smoked (smoking being one of the primary causes of COPD).

Now we can’t be so sure about two other instances of Schlatt speaking about his health as he was sober while telling that and also tried to find an excuse for the situation. The stream at which these events occurred was also a really casual one.

1) Schlatt claimed to have Alzheimer's during his call with Pogtopians because Tubbo almost revealed that he was actually at Pogtopia. In character it could have been done to make Pogtopians believe that Schlatt would forget about that or excusing his general forgetfulness. Out of character it might have been Schlatt trying to preserve the plot and playing into his sick-old-man stereotype. (Possible conditions: early-onset Alzheimer’s, early-onset dementia, memory issues due to alcohol abuse/decreased blood flow - the last one is the most probable)

2) While talking with Fundy Schlatt mentioned suffering from multiple strokes already so his brain wasn’t working that well. This might be Schlatt finding an excuse to not knowing things Fundy does and yet again playing into the stereotype. (Possible conditions: several strokes, more likely TIAs, due to alcohol abuse)

Let’s get back to the deduction. One of the complications of COPD that is quite relevant to our discussion is chronic heart failure - due to complications in the lungs it becomes very hard for a heart to pump blood properly so it gets weaker, blood starts flowing slower and there are a lot more chances of random blood clots forming (this could have worsened the muscle pains as symptoms like intermittent claudication are common for chronic heart failure). Tubbo’s comment about Schlatt’s hand discoloration being possibly caused by blood flow problems (which Schlatt tried to adamantly deny) can also play into the narrative of some sort of vascular problems caused by the mentioned condition (although it could’ve been just discoloration caused by nicotine). This also will play the part in Schlatt’s cause of death.   We’re getting to the good stuff. During his final minutes, Schlatt was playing out the symptoms of a stroke (”Does anyone smell toast?”) while we already know that his death was written as a heart attack. Even though it was probably just cc!Schlatt confusing the symptoms I like to use it for my speculations as well. There is indeed a chance of having a heart attack and a stroke at the same time (or have a heart attack that manifests in stroke-like symptoms). It is called cardio-cerebral infarction. It starts with a heart attack (mostly caused by a blood clot or an atherosclerotic plaque in the heart’s arteries), as heart tissue starts to die the production of more blood clots increases and one of them may end up in the brain causing damage there. Alternatively, the brain tissue may start to die because of the general decrease of blood going into it as the heart starts dying and can’t work properly.

It is unknown what triggered this vicious cycle of conditions: it could have been Schlatt taking up drinking and smoking (just as a fun/cool thing to do or due to some psychological issues in his life) and then progressively increasing the substance use as his health suffered from it or it may have been the muscle condition which caused him taking up those. Either way, as Schlatt was trying to right what was wrong with his body the only way he knew how he just made everything worse and suffered fatal consequences as a result.

Addictions

The most common description of Schlatt that is used by the fandom and the characters alike is “an alcoholic”. Now, alcoholism is not just an unfortunate personality trait. It is a disorder. And considering that Schlatt used alcohol as a way to deal with physical (and sometimes emotional) pain and drank almost constantly we can assume that the addiction was already not only psychological but a physical one. Also, there are a couple of possible instances of him mixing it with the whey protein he used for his workouts. As was said above this was only worsening the state he was in.

Post-Festival Schlatt also had a problem with anabolic steroids overuse. He injected himself to the point of his mouth and hands "vibrating" and him becoming hyperactive and hyperaggressive. Knowing cc!Schlatt, he was probably playing out the so-called “roid-rage” during the White House argument. Schlatt possibly kept on using the anabolics even after the said incident so we can assume that Schlatt might have suffered from prolonged anabolics abuse side-effects which would include aggression, mania, delusions and even depression (or at least it would worsen his already existing psychological problems). It also could have contributed to his heart problems.

This is a minor thing compared to others but after the Festival Schlatt has been consuming extreme amounts of things (laxatives, creatine, whey protein) that often result in digestive problems like belching, stomach upset, diarrhea and bloating so Schlatt’s guts took a toll from his exercises as well.

Even if not as prominent as his alcoholism Schlatt also suffered from tobacco addiction to the point that he would smoke 10 bundled up cigarettes in 30 seconds at one point. As I said before it could have been the cause of his COPD and the possible cause of vascular problems following it but as he kept using cigarettes as a way to alleviate pain and stress the effects only worsened.

Psychological Health

A lot of Schlatt’s psychological issues are linked to his physical health or substance abuse.

Firstly Schlatt was aware of his conditions but wouldn't admit to having any most of the time and was too prideful to get himself checked out. Instead, he turned to self-medication through alcohol and smoking. The first time we see Schlatt working out (aka actively trying to get stronger) is after the festival. As his body got progressively weaker Schlatt got more afraid of people perceiving him as weak not only physically but mentally. Instead, Schlatt tried to overwork himself by working out, injecting himself with anabolics to try and MAKE his body not weak even though it just caused more damage. As more people left Schlatt’s side the more he felt the need to be stronger by himself.

Overall Schlatt showed signs of a typical product of “boys don’t cry” treatment/mentality. Schlatt equated “being a man” to being strong (physically and mentally), not showing vulnerability, not being a coward and getting your way. People who “cried about it”, complained and couldn’t achieve peak physical form he considered “low T soy boy betas”. Not only he applied this standard to others but also to himself, which became a great detriment to his overall health. It can be seen even in something as small as crying. In the story, Schlatt is seen crying only two times. The first time it happens, he locks himself in Casa de Putas, hiding from the rest of the cabinet and begins to drink excessively. When he comes out and is questioned by his cabinet about crying earlier he pretends not to hear it and changes the topic. The second time is just seconds before Schlatt’s death, while he desperately tries to continue working out while his heart finally gives out. It is very telling that Schlatt begins to preach the “manly man” rhetoric after the Festival, the same time he starts his workouts and his descent.

Schlatt also probably suffered from some form of paranoia or was just constantly under huge amounts of stress. Even though he rarely showed it Schlatt knew that people wanted him dead from day one. This and the fact that everyone around him could be a spy might have put a toll on him, might have even increased the amount of alcohol and tobacco he was consuming. One of Schlatt’s biggest flaws (not paying enough attention/not caring enough/being bad at reading people) might have been worsened by him simply drinking his problems and worries away. As a result, he not only didn’t care about what his enemies thought of him but about his allies too.

The Festival was surely part of the rapidly increasing speed of Schlatt’s descent. He might have his suspicions about Tubbo but still felt extremely betrayed when everything about his right-hand man was uncovered (or at least he was very annoyed/angry at Tubbo for trying to trick him for such a long time while pretending to be loyal to Schlatt). Since the Festival, Schlatt started developing trust issues and ultimately decided that he needs to focus most of his power on himself as no one could be trusted (he already had these issues from the start but Tubbo’s betrayal (and possibly Schlatt losing a canon life) only made it worse). The next betrayal put an even bigger toll on him as Quackity was arguably the person he trusted the most and who he considered his “partner in crime”. By the point of the Pogtopia vs Manberg war, the only ones Schlatt knew were on his side were Karl and Fundy. He faced the cruel truth about the latter just mere minutes before his death.

This one may seem like quite a stretch but Schlatt has developed a fear of death. I already said that his first death at the festival played into his complex of being perceived as weak and the unhealthy need to prove to everyone and himself that he’s not. Not only that but at this point Schlatt had to face his own mortality, realize that death is something permanents and painful. He didn’t initially react to his second death but it might have been due to him still being under the influence of an ungodly amount of anabolics which kinda dampened his fear and clouded his judgment. During the war Schlatt is seen to be putting on his bravado of a strong fighter but becomes very antsy and jumpy when seeing the enemies coming near him, this is probably one of the reasons he prefers to use ranged weapons. This might be the reason he escaped in the middle of the battle when long-distance fire exchange ceased and Pogtopia entered direct combat, to drink, smoke and work out – to do things that made him feel like he wasn’t weak or scared. During the Camarvan confrontation, when Tommy aimed a crossbow at Schlatt we can hear Schlatt saying “Don’t kill me, I’m scared of that”. Considering in what state he was (drunk and nearing his death) it could have been genuine fear increased by the fact that the second death he suffered from was a shot by the arrow from his most trusted man.

Bonus round!

This one might be the most headcanony one of all. So. You know how Glatt says his own name randomly throughout conversations. Some people actually interpreted this as a verbal tic. And while tics can be manifestations of genetic disorders and inherited neurological conditions it probably wasn’t the case with Schlatt. After all, such a noticeable tic developed only after his death. But some tics can develop after a person experiences something that causes damage to certain parts of the brain. And I’d like to remind you according to my interpretation Schlatt died while having a stroke, in other words, he experienced ischemic brain damage which sometimes can be a cause of motor and verbal tics. Thus that could have residually affected his dead self.

#i don't know what conclusion to put there #dream smp #dsmp #jschlatt #c!jschlatt #schlatt #c!schlatt

[yogurtberrywrites]

“Schlatt Attack”

Warnings: Drug use, Smoking, Violence, Swearing, Death, Ghosts, and Angst (Recommended to readers over 14). 

Summary: What if Schlatt survived his heart attack?

Notes: None of this is canon, this is my take on the DSMP. Let me know if there are any other warnings I should put, or if I should change the recommended reading age.

“What the fuck happened?” Schlatt groaned, sitting up in a hospital bed rubbing his head. Ponk was beside him monitoring his health. “You had a….cardio-cerebral infarction. In other words you had a heart attack.” Ponk explained hesitantly. “Wait was it from-” Schlatt was cut off by Ponk. “The alcohol.” Ponk said, setting one of the bottles he had been holding before he passed out on his bedside. “Yeah….” Schlatt said, ashamed looking down at his sheets. “Schlatt, what were you thinking?” Ponk fully aware that Schlatt should be dead. “It just all hurts.” Schlatt mumbled putting his hands to his face. “Schlatt, I understand that you suffer from myotonic muscular dystrophy and Chronic obstructive pulmonary disease.” “Yes yes that’s right.” Schlatt confirmed. “Have you tried to take any medication for it?” Ponk asked. 

“Do drugs count?” Schlatt replied with hesitation. “Schlatt!?” Ponk questioned, knowing he was probably drinking more than he could handle. “Look, you know I’m an alcoholic! Everyone knows that! And where am I supposed to get fucking medicine!” Schlatt said aggressively. “Schlatt! You can’t use Drugs and Tobacco and expect them to fix you!” Ponk shouted trying to get it through his thick skull. “THEY DID FIX ME!” Schlatt screamed, grabbing Ponk by the shirt as his breath became unsteady. Schlatt let go of Ponk only to cough uncontrollably into his arm.

 Ponk was a bit frightened, but it was his job to help all his patients, no matter how difficult they were. “Here.” He said as he tried to hand a bottle of water to Schlatt. “Get that the fuck away from me. I don’t need that.” Schlatt said, reaching for the bottle of alcohol. “Ah ah ah.” Ponk wagged his finger at Schlatt blocking his hand from the glass bottle. “Asshole.” Schlatt muttered. “Schlatt, I’m not letting you leave till you agree on taking medication and withdrawing drugs.” Ponk threatened. “Oh come the fuck on! You can’t be serious?” Schlatt said, astonished. “Okay, well I bet you can’t last a week without it.” Ponk teased. “Are you challenging me?” Ponk only looked down on him smiling. “If you're gonna bet there's gotta be something in it for me.” Schlatt said pissed off that Ponk was in control now. “I’ll give you a thousand dollars if we can improve your health by the end of the year.” Ponk said. “Ten thousand.” Schlatt stated. “Let’s make it five thousand, or I shave that off.” He said pointing at Schlatt’s facial hair. “Deal!” Schlatt said, pleased as he shook Ponk’s hand. (Also his facial hair is at risk lmao).

“Take it easy, okay. I’ll hook you up with an inhaler for your COPD. Come visit me next week.” Ponk said as he hulled Schlatt to his feet. “Thanks.” Schlatt said as he grabbed the water bottle from before. He guzled it down and threw it into Ponk’s hands. Which only caused a proud smile to form across Ponk’s face. Schlatt smiled back waltzing out the door. His little ears perked up as he walked out of the building with his new found confidence. 

                        .    .    .

Schlatt arrived at where L’Manberg once was. He looked off to where his great nation once stood. Now only being occupied by a huge crater. He was stunned. “Who the hell pulled this off?” He whispered, impressed. He wasn’t mad because he knew he’d never really cared about the nation itself, but the power he gained from it. He just wanted to know what all went wrong. He knew he didn’t govern the nation right, but he didn’t think someone would go and fucking blow it up. Off in the distance he saw a small figure. It was Tubbo.

“Tubbo!?” Schlatt called as he ran up to him. Tears were running down Tubbo’s face as he looked off to Schlatt. “S-Schlatt?” Tubbo says, his voice trembling. Schlatt came to a halt in front of him, confused. “You look like you’ve seen a ghost?” Schlatt said still not understanding why Tubbo was surprised. “I-We thought you were dead.” Tubbo responded, backing away from him. “What….” Schlatt trailed off in fear. “When you had your heart attack we thought you’d died. We called Ponk t-to take care of you.” He said, staring down at the ground. “You didn’t think to check my pulse!” Schlatt said, chuckling nervously. “Look, we were in a hurry. Trying to stop a war you helped cause!” Tubbo was still upset that he had killed him. Schlatt, noticing the pain, reached out to touch one of the many explosion scars on his face from the execution. “Don’t touch me.” He cursed, pulling Schlatt’s hand away from him. “I-I’m sorry.” Schlatt apologized. “Why did you do it?” Tubbo asked. “Do what?” Schlatt questioned. “Why did you make me your right-hand man?” “I-I…. Fuck, Tubbo! It’s because you reminded me of myself. When I was….a better man.” Schlatt said, looking off to the L’Manhole. “I didn’t want you to become me, so I thought if I kept you close…. You’d be a better man than I ever was.” Schlatt looked back at Tubbo. 

Tubbo didn’t know what to say. Schlatt never seemed to care for anyone, but himself. He never thought out of all the people Schlatt wanted to protect…. it would be him. “Hey, but it turns out Manberg really did take the L right?” Schlatt laughed trying to up the mood. “Yeah, Wilbur had a denanator room under Manberg. H-He couldn’t take it anymore-and he blew it up.” Another tear rolled down Tubbo’s face. He quickly wiped it away. “Umm, how long was I out.” Schlatt asked. “It’s been a long time Schlatt.” “Oh….” Schlatt said. “What do we do now?” He asked Tubbo. “We move on.” Tubbo said, turning from Schlatt and walking away. 

              .    .    .

Schlatt wandered the server for a few days not knowing what was the next step for him. Manberg was gone and he accepted that, but that meant his purpose was gone. Everyone hated him anyhow. Whatever he did next he had to make sure it wouldn’t hurt anyone else. If it were, no one would ever forgive him. They probably would kill him and make sure he was dead this time. He felt like no matter what he did he’d just push them further away. Was this his purpose to hurt everyone he ever came into contact with? There were so many If’! His true fear was being alone, but he just denied it.

He couldn’t take it anymore! All he heard in his head was his sins, his wrong doings! He couldn’t even remember who he used to be before L’Manberg. He needed to drown out the pain. He didn’t care what Ponk said! It all hurt too much.

He dug up one of the many drug stashes he’d hidden on the server. He opened the chest to find only a few bottles left. He must have gotten drunk the other day and didn’t remember. He didn’t care, this would be enough. He reached for one of the bottles, before hearing a rustle in the brush behind him. 

“Okay! Who the fucks is there!” Schlatt said wearily, being completely defenseless. Out of the brush sat up a very confused Wilbur. He just stared at Schlatt puzzled. “A new friend!” He shouted with glee, hugging Schlatt. “W-Will!?”  Schlatt also became very confused and uncomfortable. “Yeah?” He said letting go of Schlatt thinking he’d done something wrong. Schlatt hadn’t realized it, but something was wrong with Wilbur. He was discolored and pale. He wasn’t wearing his usual leather jacket and glasses. And was that a yellow sweater? It was freaking Schlatt out. Wilbur was his enemy, but once his friend. Seeing him like this only brought more and more questions.

“Will, what happened to you before L’Manberg blew up?” Schlatt asked. “I-I can’t remember.” Wilbur said, pushing his hands into his forehead, which made zero difference. “A-And why do you keep calling me Wilbur? I’m Ghostbur.” Now Ghostbur was asking the questions. “Um G-Ghostbur are you de….” Schlatt stopped, afraid that Ghostbur wouldn’t be able to handle it. “What? What is it new friend?” Ghostbur asked, concerned. “Never mind. Um, do you know Phil?” Schlatt changed the subject. “Yeah! I love Phil! Can we go see him?” Ghostbur said with new found excitement. “That’s where we're headed!” Schlatt said, only causing Ghostbur more cheer. “Wait, here.” Ghostbur smiled and handed him some sort of blue stuff. “What's-” Ghostbur cut him off knowing just how to answer his question. “It’s blue! It takes the pain away….” “Thanks.” Schlatt said seeing the blue stuff glow as he breathed heavily. ”I saw those bottles you had. I remember Phil said that they were bad for me. I felt funny whenever I ate them, so I stopped. Is that why you're sad?” Ghostbur said with guilt. 

“I-I don’t know. Wait, but did you say you remembered?” Schlatt said realizing Ghostbur could remember Wilbur. “I remember before….before h-he,” Ghostbur stopped hugging Schlatt, before crying into his arms. Schlatt knew he must have remembered what happened to his living self. “I know I know.” Schlatt rubbed him on the back, letting Ghostbur cry into him. He wasn’t very good at comforting people, but this was the best he could do. Ghostbur let go of Schlatt and wiped away his tears. “Sorry.” Ghostbur sniffled. Schlatt could see where the tears had rolled down his cheek now had left burning scars on his face. “Ghostbur, you don’t have to be sorry. But are you okay?” Schlatt said, pointing to the scars. “Yeah. It doesn’t hurt much.” He said, his tone more gentle than energetic. “Come on. We gotta get going if we wanna find Phil.” “Wait! Can I hold your hand?” Ghostbur said nervously. “Yeah.” Schlatt smiled, feeling like he was holding a five year old’s hand. 

                                                             .    .    .

Schlatt thought if Tubbo still had been at L’Manberg then Phil must have been. He arrived at the crater. Ghostbur was horrified. He may not have remembered much of L’Manberg, but it was Wilbur’s home. “Did I do that….” “No, you didn’t. The past you may have, but he wasn’t in the right mind, okay.” Schlatt said his hands on Ghostbur’s shoulders. “You-He was a good man.” Schlatt said, staring Ghostbur in the eyes. Ghostbur smiled, then caught something out of the corner of his eye. “Phil!” Ghostbur shouted, running towards him. Schlatt, being unable to run due to some of his complications, tried his best to catch up to Ghostbur. 

Phil was up in the denantor room which was more visible now from the explosion. He could see a sword in Phil’s hands as he sat there frozen. Dried up blood laid on the blade of the sword. As Schlatt approached he pulled Ghostbur behind him. He could see Phil was thinner and exhausted. He just stared at a button in the middle of what remained of a wall in front of him. “Looks like you’ve aged.” Schlatt laughed hesitantly. “Go away.” Phil muttered. “Phil what happened here.” Schlatt asked. “Why did Will do it. H-He had everything and he just threw it away.” Phil said, looking down to the diamond sword. Tears rolled down his face falling onto the blade. “I hope he’s happy. He’s happy that this is all gone.” The anger was in Phil’s voice, but he still missed him. Schlatt was speechless. He didn’t know what to say.

But Ghostbur was growing too impatient. He couldn’t wait on Schlatt anymore. He pushed past him wrapping his arms around Phil. Phil was about to point the blade at him before realizing who it was. “Will!?” He said dropping the sword to the ground. Phil stood up and embraced him. “How are you here?” He said, staring at Schlatt. “Um, Ghostbur, could you wait outside for us?” Schlatt really asked as more of an order than a favor. Ghostbur nodded understanding. He looked up at Phil, his eyes sparkling a deep blue. Tears of joy rolled down Phil’s face as he parted Ghostbur’s curly mess of hair out of his face. Schlatt directed him to where he could wait as they talked and he cheerfully made his way over to where L’Manberg used to stand.

“Phil, what’s wrong with him?” Schlatt said with worry. “I think he’s a ghost. He’s different now….he’s happy.” Phil smiled watching Ghostbur roll down a hill over and over again. “He acts…. younger. Why’s that?” Schlatt asked Phil. “I think he was happier as a child, so it’s in his nature to be his younger self.”  “Phil, why were you here, not taking care of yourself.” Schlatt confronted. “H-He asked me to-” Phil looked down at the sword. “Phil I-” Schlatt connected the dots. “It’s for the best. It worked out in the end, right?” Phil had more tears falling from his face. “Phil, you did the right thing. It might not have been the best choice for-Wilbur, but he asked you to take the pain away.” Schlatt said feeling the same pain.  

Meanwhile, as Phil and Schlatt conversed Ghostbur laid in the grass hanging his legs over the blown up crater. He crest his hand around the white clouds in the sky. He’d imagined what it would feel like to touch one. He mindedly pointed out shapes he saw in them as he thought. He hummed the L’Manberg Anthem as he tried to remember what the huge pit once was. He watched as the sky grew darker and the clouds blocked the light. A little toddler-like whine came from his mouth, upset that the sun had disappeared. He closed his eyes listening to all around him. It felt so….peaceful. Ghostbur would have never been able to enjoy this without Wilbur’s destruction of L’Manberg. 

A stinging came to his face as he suddenly opened his eyes. He wiped at his cheek where a raindrop had soaked into his skin. He had not yet experienced rain and didn’t understand that it could hurt him. The sky started erupting with rain. Ghostbur got up in fear, feeling it burn his skin. He tried to run towards Phil and Schlatt, but slipped on the wet grass. Everything burned and in a moment of agony he screamed for Phil. 

Back by Schlatt and Phil they were just finishing their talk. Schlatt had noticed the storm that had rolled in, but thought nothing of it. Schlatt wasn’t sure why Ghostbur’s face burned from his tears, but he didn’t think water was the problem. Suddenly they both heard someone scream. “PHIL!” Ghostbur cried out stuck to the ground like a magnet. “Wilbur!” Phil yelled in distress. “Fuck I forgot! Water must hurt him!” Schlatt shouted, ripping off his suit’s jacket. He rushed over to Ghostbur’s aid. Phil stood there frozen in fear. Schlatt used his jacket like an umbrella over his head. “Come on Ghostbur!” Schlatt reached his hand out. “I-I can’t!” Ghostbur sobbed covered in mud. 

“Wilbur couldn’t Ghostbur! But you can!” Schlatt shouted, grabbing Ghostbur’s hand. Ghostbur pulled his feet out of the mud one by one. He winced in pain being covered in the wet muck. Schlatt started dragging Ghostbur behind him, forcing Ghostbur to keep up the same pace. Schlatt ran through the pain as his legs cramped up. Ghostbur now had his jacket wrapped around him. Phil reached out his arms to Ghostbur as he melted into Phil’s arms (Not literally). Schlatt fell to the ground exhausted. “I-Is he okay.” Schlatt panted out. “He’s got a lot of burns, but I can patch him up.” Phil smiled amused by Schlatt’s act. Ghostbur didn’t say a word, only whimpering and sobbing into Schlatt’s jacket. Phil hushed him quietly to calm him down. “Schlatt?” Phil asked kindly. “Yeah?” Schlatt sat up. “You need a place to stay right?” 

                 .    .    .

Schlatt came out of his room with his Yankees hat on and his favorite Obama T-shirt. His eyes drooped with exhaustion. “Hey, Phil.” Schlatt greeted, grabbing his morning coffee. Schlatt had been living with Ghostbur and Phil since their chat. Ghostbur was still a little bandaged up from his burns. He’d also had some neighbors, Techno and Ranboo. He was still mad with Techno, but was charmed by Ranboo. He joined Phil and Ghostbur at the table watching them eat their stupid biscuts. “Did you sleep well?” Phil asked, munching on a jam filled crumpet. “Could've been better.” Schlatt sighed. “Another nightmare?” Phil said concerned. “Yeah.” Schlatt looked down at his plate where his food was getting cold. “I’m gonna go take a smoke.” Schlatt said heading out the door without a single bite of breakfast. 

Schlatt sat out in the cold, smoke rings being blown from his mouth. He may not have been allowed to drink, but Ponk didn’t say anything about cigars. He was changing. The change scared him. He couldn’t even remember the last time he’d cursed out someone’s name. He felt like he was getting too soft. And now he had an inhaler that made him look like some kind of asthma kid. He was afraid that if others looked down upon him like this they’d think he was weak. He was mad too. He was stuck in this arctic desert. He couldn’t go back, not after what he did. 

Then he heard a sound all too familiar. He barrel rolled to the side as an arrow wished past him, cutting the side of his ear. He screamed in agony grabbing at the bleeding cut on his ear. It had torn through his flesh leaving a missing chunk out. Another arrow then cut through his hat nailing it into the back porch. He then heard a crack of a twig from behind. He spun around to face his attacker. “Quackity!?” Schlatted shouted in surprise. Quackity dropped his crossbow running up to Schlatt only to pull him back into the brush. “Quackity what are you d-” Schlatt yelped before Quackity covered his mouth. 

“Schlatt! Schlatt!” Phil shouted, stumbling around the porch trying not to step on any arrows. “You gotta be quiet or they’ll hear you.” Quackity hissed. Schlatt mumbled trying to get Quackity’s hand off of him. “I’m gonna let go okay. And then you're gonna shut up alright.” Quackity said sternly. Schlatt nodded before licking Quackity’s hand. “Ah god dammit! You fucking whore!” Quackity yelled trying to shake Schlatt’s spit from his hand. 

Schlatt then ran from his killer. The last time they’d talked he got shot by him. He wasn’t gonna make the same mistake twice. “Schlatt, wait! Come back!” Quackity called chasing after him. They raced through the forest. Schlatt made sure to smack every tree branch into Quackity’s face for good measure. But the wood was really dense and filled with roots. Schlatt had to swerve through the trees and try to lose Quackity. He didn’t know if his legs could handle it any longer. A log was approaching ahead of Schlatt. He was gonna have to jump it. He pushed one of his hands off of the log as he landed on the other side. Unfortunately the more athletic Quackity jumped off of the log and onto Schlatt, pinning him to the ground. 

“Let go of me!” Schlatt squirmed underneath Quackity’s hold. “Not until you give me some answers!” Quackity ordered. “Hmm… No.” Schlatt said like a little toddler. “What the fuck do you mean no!?” Quackity laughed. “I mean why should I tell you anything!” Schlatt said in hatred. “Well you could have told me that you weren’t dead! It’s been three months since L’Manberg and your hiding out in the middle of nowhere!” Quackity said, pushing his crossbow in Schlatt’s face. “Easy with that thing!” Schlatt quived. “You left me when I needed you most! You left me with a blown up country!” Quackity roared. “And you killed me!” Schlatt screamed, flipping Quackity over and pushing into the ground. “And I wish you stayed that way.” Quackity muttered tears rolling down his face. 

 Schlatt got off of Quackity as his eyes widened. He was right. Everyone did want him dead. He may have hated Quackity, but they were friends once. Even his own friend wanted rid of him. “You didn’t mean that. Right?” Schlatt looked at Quackity, not a word coming out of him. “Tell me you didn’t mean it!” He shouted tears outlining his face. “I did mean it, okay!” Quackity screamed looking up at Schlatt. Schlatt gasped, turning away from him. “I wish I stayed that way too….” Schlatt whispered, running from Quackity yet again. “Schlatt! No!” Quackity yelled, his voice getting softer and softer the further Schlatt ran. 

“Phil! Phil!” Quackity called, running out of the forest with a stream of tears coming down his face. “Quackity!? Where’s Schlatt?” Phil said with confusion, pulling out his sword. “I-I didn’t know he was alive…. look I’m sorry, but you’ve gotta help me get him back.” Quackity sobbed, wiping the tears from his face. “What did you do!” Phil shouted nearing Quackity. “We got into an argument…. And he’s headed for the docks!” Quackity said, running towards Schlatt’s direction. “Wait for me!” Phil said, taking off after him. Poor Ghostbur peered out the window with worry, not understanding that Schlatt’s life was at stake. 

Schlatt finally arrived at the docks. He had found a bottle of whiskey as he sat at the edge of the wooden bridge. He stared at the bottle seeing his reflection in it. “I’m sorry….” He whispered as he chugged the bottle down. He shattered the bottle in his hands making him bleed. But it didn’t hurt. He didn’t care. He didn’t care as he threw it into the murky water below. He covered his face crying into his blood and tear soaked hands. “I want it to stop! I want the pain to stop!” He cried out. He stood up looking down into the sea. Bloody handprints tattooed his face. He told himself that he didn’t deserve it. That he didn’t deserve any of it. That no one cared. That no one fucking ever gave a single damn about him! And then he jumped. Splashing into the ocean as all the pain and misery was washed away by the cold stinging water. 

“Schlatt don’t!” Quackity shouted seeing his friend splash into the water. “Schlatt!” Phil shouted about to jump in after him before Quackity stopped him. “You can’t swim with your broken wings.” Quackity said with his sadness engulfing him. “But I can!” Ghostbur shouted, jumping in after him. “Wait, What!? Wilbur!?” Quackity shouted in surprise. (“How many god damn people are coming back to life” - Probably Quackity). “WILBUR!” Phil screamed, trying to grab him, but only catching air within his hands. “He’ll melt!” Phil screeched, unable to do anything.  

Ghostbur felt everything around him burn, but he had to save Schlatt. He drove through the pain and opened his eyes. In the dark depths below he could just make the outlines of schlatt. He tried to call him, only to have bubbles erupt from his mouth. He covered his mouth in shock not knowing. His skin kept burning more and more, so he tried his best to hurry and get to Schlatt. Finally, reaching him he grabbed Schlatt by the waist, lifting him up through the water. Schlatt was unconscious, so it was up to Ghostbur to find the strength to save him in time. He’d remembered how kindly he had treated him. His love, his companion. Alivebur may not have taken a liking to Schlatt, but Schlatt had changed. And Ghostbur thought that was mostly due to their uncanny friendship. But he knew eventually that everything had to come to an end and as they reached the surface the world around him went to black. 

Schlatt felt someone haul him out of the water as he tried to open his eyes. He looked around as everything became clearer. Blood still dripped from his hands as Phil wrapped them in some sort of cloth. He winced feeling the ok pressure being applied to his hands. He coughed up some of the sea water he had inhaled. “Quackity.” He called out mindlessly searching for him. “I’m here. I’m here.” Quackity cried softly cupping Schlatt’s hand. Schlatt rubbed away Quackity’s tears as his senses slowly returned. 

“Wait, where’s Ghostbur!?” He asked in a panic. “Ghostbur!” Schlatt cried out, crawling over the edge to where Ghostbur once was. Nothing was left of the innocent ghost. Schlatt stared into the water hoping he would emerge. For a time they all waited quietly, quietly waiting for their friend. “Schlatt, this is your fault.” Phil broke the silence. “What?” Schlatt said, confused. “I said this is your fault!” Phil grabbed Schlatt by the collar. “I let you into my home! I trusted you! Will, trusted you ....” Phil mumbled his last sentence realizing what he said. “Oh, so now you're blaming me! You're the one who killed him in the first place!” Quackity gasped hearing Schlatt’s words. 

Then a fist was met with Schlatt’s face. Followed by another and another. “Phil! Stop!” Quackity cried trying to pull him away from Schlatt. “You took him from me!” Phil screeched holding Schlatt over the water. “Now you’ll join him.” Phil scoffed, hatred in his voice. “Phil, don't do it! Please!” Quackity sobbed practically begging. Schlatt looked at Phil, his own blood fogging his vision. “Phil….is this what Ghostbur would have….wanted.” Schlatt asked weakly. “No….but this is what Wilbur would have.” 

Phil’s grip loosened on Schlatt, letting him fall into the sea.

Myotonic muscular dystrophy (MMD): A lot of types of muscular dystrophy can also lead to heart diseases and breathing problems which would fit into Schlatt’s clinical picture. It also affects Schlatt’s use of his legs.

COPD: One of the complications of COPD that is quite relevant to our discussion is chronic heart failure - due to complications in the lungs it becomes very hard for a heart to pump blood properly so it gets weaker, blood starts flowing slower and there are a lot more chances of random blood clots forming (this could have worsened the muscle pains as symptoms like intermittent claudication are common for chronic heart failure). There is indeed a chance of having a heart attack and a stroke at the same time (or have a heart attack that manifests in stroke-like symptoms). It is called cardio-cerebral infarction. It starts with a heart attack (mostly caused by a blood clot or an atherosclerotic plaque in the heart’s arteries), as heart tissue starts to die the production of more blood clots increases and one of them may end up in the brain causing damage there. Alternatively, the brain tissue may start to die because of the general decrease of blood going into it as the heart starts dying and can’t work properly.

Withdrawal syndrome (Discontinuation syndrome): Occurs in individuals who have developed physiological dependence on drugs or alcohol and who discontinue or reduce their use of it.

Source: 

#schlatt #jschlatt #tubbo myct #dsmp au #philza #philza minecraft #fanfic #ghostbur #wilbur soot #story

[calicojack1718]

Gilbert Gottfried Dies and Burnout

Gilbert Gottfried would've wanted it this way. He wanted us to laugh. Laughter is the best medicine, & what ails us now is prolonged chronic stress. We need all the laughs we can get to help relieve it. It's all explained right here & links to his best.

Nanci Griffith Dies and My Friend, Grief, Comes in for a Visit Gilbert Gottfried died at age 67 from a rare genetic disorder called type II myotonic dystrophy, a kind of muscular dystrophy. He was quite young to have died. He was much older than I had imagined him to be. He always seemed old to me, so when I saw that he had died and his age, I was surprised. I always liked Gottfried. I thought…

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#Aladdin #Aristocrats Joke #Burnout #Celebrity Roast #Death #George Takei #Gilbert Gottfried #Obituary #Rolling Stone #Tribute #Type II Myotonic Dystrophy

[doctorfoxtor]

I got 25% of my questions correct today so who's the winner in all of this? The people I paid for their question bank, probably

100 days of productivity

Day 10

RS/CVS

endocarditis prognosis: viridans = good prognosis (overall strep mortality ~5%); staph/culture-negative = poor prognosis (overall staph mortality ~30%); prosthetic valves and low serum complement also assoc. w/ poor prognosis

prosthetic valves = gent + RIF + fluclox if known MSSA source + vanc if unknown MSSA or suspected MRSA or PCN allergy

native valves = fluclox if MSSA; benzylpenicillin if strep + low-dose gent if less PCN-sensitive; vanc + RIF if PCN-allergy or MRSA; amox/(vanc if PCN-allergic) + low-dose gent if neither

latent TB in HIV → INH x9 mos

AV block: MILD RASH: myotonic muscular dystrophy, IHD, Lyme, digitoxicity (often +atrial tachy), RHD, aortic abscess/aortic root dilation, sarcoid, hypo/hyperkalaemia

CNS

NCS: ↓compound muscle action potential amplitude → axonal neuropathy

NCS: reduced velocity/conduction blocks → myelin disorders; reduced amplitude → axonal disorders

dizziness + absent corneal reflex = acoustic schwannoma

mumps meningitis causes low CSF glucose! however, other CSF stigmata point to viral disease (normal to mildly elevated protein, lymphocytes, negative stains/cultures) (differentiate from TB by acuity of mumps vs subacuity/chronicity of TB + cobwebbing in TB + *markedly* elevated protein in TB; PCR is 75% sensitive for TB)

GIT

best single-marker indicator of severity in acute pancreatitis is CRP; good predictor of necrosis

mucoid diarrhoea + very mild anaemia + hypokalaemia → villous adenoma (IRL, anaemia → r/o ca colon; but a colonoscopy will catch the adenoma anyway)

inducing Crohn's remission: 1. glucocorticoids + salazines 2. add-on azathioprine/6-mercaptopurine or MTX if cannot use aza/6-MP 3. add-on infliximab (I am unsure why aza/6-MP are used for inducing remission as they take upwards of 2-3 months to take effect; they are generally excellent for *maintaining* remission, not inducing it, but them's the guidelines I guess)

Endo/Repro/Infections

9am cortisol between 100-500 → inconclusive; proceed to cosyntropin test (but as long as levels <500 you will proceed with cosyntropin stimulation test)

urethritis NAAT-neg for gono/chlam → doxy x1 wk or azithromycin (NAAT will only be positive 2 weeks after likely transmission event)

malaria: sensitivity of QBC is greater than than of thick smear for parasite burden estimation, but less than that of thin smear for species identification

Onc/Haem

AIHA: in warm, the haemolysis occurs *extravascularly* (hence haptoglobin and peripheral smear will NOT show stigmata of haemolysis); in cold, the haemolysis occurs *intravascularly* (so hapto/smear WILL reflect haemolysis)

myelofibrosis = V617F JAK2 mutation (asso. w/ teardrop poikilocytosis)

Renal/Biochem/Toxo

MDRD equation for eGFR: CAGE: Creat, Age, Gender, Ethnicity

ADPKD assoc. w/ AR (aortic root dilation), MVP/MR, TR

warfarin × azathioprine interaction → ↓warfarin effect → impaired thromboprophylaxis in immunosuppressed (mechanism unknown)

atorvastatin (only) × digoxin → digitoxicity (inhibition of digoxin transport by the p-glycoprotein efflux transporter)

all statins interact with fibrates, but fenofibrate has the least potential for precipitating the myotoxic interaction and should be preferred when both statins and fibrates must be prescribed

thiazides cause impotence in up to 33% of patients???

if VICKO STUMBLED, luckily for him those toxins are dialysable: Valproate, Isoniazid/Isopropyl alcohol, Carbamazepine, Kerosene/Ketones, Organophosphates, Salicylates, Topiramate, Urea, Methanol/Methylxanthines (caffeine, theophylline etc), Barbiturates/Benzos, Lithium, Ethylene glycol/Ethanol, Dabigatran

#100 days of productivity #studyblr #studying #medblr #medicine #mine #long post

[globalstemcellcare]

The different types of muscular dystrophy are Myotonic, Duchenne, Becker, Limb-girdle, Facioscapulohumeral, Congenital, Oculopharyngeal, Distal, and Emery-Dreifuss.The treatment of stem cell therapy by Global Stem Cell Care, it is possible to treat this condition.

To know more about #musculardystrophy  visit, www.globalstemcellcare.com

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