Island doctors of new smyrna beach
2008.08.15 16:32 Georgia, USA
A subreddit for news and discussion about the state of Georgia in the Southeastern United States.
2010.12.07 19:57 NickStaton Brevard county and surrounding areas
A subreddit dedicated to 'The 321' - Brevard County, Florida - The Space Coast! Home to Titusville, Cape Canaveral, Cocoa Beach, Rockledge, Viera, Melbourne, Satellite Beach, Indialantic, old Eau Gallie, Palm Bay, and plenty more.
2016.10.04 10:27 Long Island Serial Killer
The Long Island serial killer (LISK) is an unidentified suspected serial killer who is believed to have murdered at least 10 people. Most of the bodies were left in areas on the South Shore of Long Island, New York. Also known as the Gilgo Beach Killer.
2023.06.04 18:46 bunderways I don’t know how to do this. I need help.
I’ve been married 23 years. Some of you may recognize me as someone who comments a lot from a perspective of a healing marriage with a great guy who gave up porn.
Well, I’m sitting at my moms with a lot of SH because I went through his phone yesterday. He made a big production about how he had deleted FB and IG because they were garbage. It raised teeny flags for me, but we speak openly about how mad social media is and so I figured it was that. But the hairs on the back of my neck stood up in that moment and never came back down. Then Mothers Day happened. I’m chronically I’ll and I’m in pain all the time. On the Thursday before I realized no one had planned anything? So I called my mom and said hey do you want to do breakfast and she said sure, and on Saturday I had a flare and spent most of the day in bed. That meant by the time I was even remotely able to move, I had a big job in front of me. The kitchen/house was filthy, like it always is until I can get to it. He puts canes on dirty dishes in the dishwasher sometimes, when I asked him to rinse first he just made sure there were no chunks of food,, but it’s still caked in dirty food. So I redo his dishes and reload it. And the dishes in thr sink. The garbage by his chair, etc. he works all the time but at this point I don’t know if he’s working or just fucking around in his models on the laptop to make it look like work. He does very very little without being specifically asked,and then he does the half way or poorly. It feels like weaponized incompetence, at the same time it’s likely he was never taught any of it. Whenever I try to give hm tips or help he gets…offended I guess? Like he’s capable of [random household chores]. When we were separated because his therapist told him I had no right to police his porn use and he leaned into that hard-his house was trashed. The whole time. My son didn’t want to bring people over there. Anyway, he finally “quit” in Oct 2021. His personality changed back to the sweet and caring guy I knew before porn ruined h him. So here we are Mother’s Day Eve and he’s acting. Just weird. He asks if he can help and I say yes!!! Can you just fill the breakfaat burritos while I make an egg? And he says sure, but with this look that devices his words. He immediately goes to the bathroom (to look up boobs maybe? Idk it took awhile) then immediately up to bed. I spent the next 4 hours doing it myself and ended up in some of the worst pain I’ve had in quite some time. After I dragged myself through the day, I was basically bed bound for 10 days. In that time I came to the realization that if I hadn’t remembered, planned, invited, and cooked, not one person would have so much as said Happy Mothers Day to me. He didn’t. I think he got me two presents that sit in boxes by the door unopened that came well after MD. He likely ordered them that day.
Anyway, it planted the seed for me. The callousness was reminiscent of when he was using before. So now for the last few weeks I’ve been on edge I’m worried about wanting to be intimate with him because I’m worried he’s going to not want me. I’m worried about telling him what I need because I don’t wanna hurt his feelings, I can’t have an orgasm anymore even by myself sexual contact makes me feel nervous. I’m like I could have a mental break down. And in all this, I am feeling bad for my husband. I’m feeling sorry for him and what I can’t give him.
So he goes up to take a shower yesterday and I don’t know why but his phone was right there and I started looking and it wasn’t much. There wasn’t really anything. I went through every single one of his tabs of 500 of them. A couple theory, random that may or may not be anything like Nicole Scherzinger in a Keeney, but more like a story or a story about a may December relationship. There was also pages of the new drug up which made me feel like oh that’s nice but they were way back. and then I went in to his history. Just a few days back it was him searching my old coworkers from the yoga studio and viewing them on Facebook and Instagram but via the browser I know you can imagine exactly what people who do yoga full-time have for pictures. these are women who are younger than me and prettier than me. Women who I worked with for years and now I know that he was looking at some whole time to. I tried to talk myself out of it like we all do like maybe maybe this is just him looking at people I worked with because a picture of all of us popped up and he didn’t know who they were. I know how stupid I know I feel so stupid. But when I kept opening these searches it mean, there was one that was just huge fucking boobs zoomed in is a profile picture, and he searched it, and there is no way around that. I don’t know if there’s actual porn on there anywhere in there probably is
I don’t know what to do. I can’t take care of myself because I can’t work with disability and my disability happened after my stitches failed from my hysterectomy, and my husband and I were being intimate. The trauma we both have. is insane. it’s ruined my life I can’t work. I am only marginally mobile with mobility aids. He makes all the money and I try to pay people to come and do the things that I can’t anymore but sometimes it sometimes it gets too much and I just wish I had one of those husbands I read about, who just do things around the house without being asked or nagged. He said I was nagging and so I just stopped asking completely. He is the king of Weaponized incompetence. This man who is an upper level white-collar worker with an insane paycheck somehow doesn’t know when the house is dirty needs to be picked up.
I left last night when I found out I don’t know what to do now he wants to talk. He keeps talking his answers are all clipped like he’s not gonna let me in he’s not gonna admit, he’s not gonna call himself an addict. He’s trying to blame it on the fact that it’s just everywhere and I can take away his phone if that would work I don’t know what to do. I need help from you guys. This is the first slip up. I told him I was gone if it happened again. I feel like I almost have to pick up but selfishly. I don’t know how I’m not well I can’t take care of my spot. I have no way to make him come. I am seriously considering I don’t live in myself because I have nothing. State care won’t allow me to continue with my doctors or my medic medicines, which are the only thing they give me any quality of life whatsoever. I’m trapped in his income and his insurance.
What do I do? Can I save him? Can he be saved if I gave him another chance? What do I have to insistent what we have to do right now he’s being very short and clipped and not owning up to his wrongdoing and when he’s faced with guilt, he gets really angry, that’s why he left in the first place. He felt guilty and his therapist told him he didn’t need to his therapist told him it was fine for him to watch as much porn as he wanted and I was the unreasonable one. I just need help. Tell me what to do.?
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2023.06.04 18:46 EmployPractical In resting period....
I had a injury on my chest area a week or two ago. Didn't gave a sh*t and continued my routine. But the pain got worse. I had inflammation on that area. Doctor recommended a week of rest from strength training especially on chest area.
Now my injury is almost healed and new week is going to start. Not completly healed, so I might take some more days off. Just wanted to ask if my strength and muscle loss will be significant? I was doing 22 push up, 6 straight pull up and 40 squats before injury.
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2023.06.04 18:45 ApprehensiveFault743 43M [chat] looking to meet new people
Hi there. I enjoy meeting new people, but most of my days I’m stuck at work and spend a lot of time alone. So I’ve decided to put myself out there and see if I can make new chat friends.
I enjoy getting outdoors, working in the soil, going hiking and going to the beach. Work has been a bit busy lately and I’ve fallen off a bit with my fitness. I’ve got to get back to running and working out.
Do you like to get outdoors? Did you watch Succession? Any idea of what to watch next? If not, what do you do for fun?
That’s not a whole lot about me, but it’s a start. I’m looking for someone to chat about pretty much anything. So if that sounds like you and any of this catches your attention, feel free to message me.
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2023.06.04 18:41 StarWarsNerd7 Sublease - July 1st through October 1st (3 months) in Huge DTLA Penthouse Loft w shared Bathroom and rooftop access
[Housing] Large Private Room in Massive Spacious Loft - $1200 - Westlake near DTLA Hello, we had good luck finding our last roommate on here a year ago, so let’s give it another shot! Looking for a sublease to fill my room in our massive (4000 sqft) 5bedroom penthouse loft in Westlake, available from July 1st to October 1st. Please consider reaching out even if the dates don't match up perfectly, the constant roommate search is inevitable. Rent for the available room is $1200, comes with a massive bedroom (fully furnished - bed, couch, tv, iMac), and an isolation booth for recording VO/vocals. Utilities averaging $50/mo. Security deposit is $600.
We're four roomies ranging from mid twenties to mid thirties. One is an actor, one is in law school, one is a podcast/livestream engineer, one works retail in vintage clothing, and I am a freelance producer and recording artist. I built a small professional studio in my room that you would have full access to (see pics). My room is especially friendly to recording artists and producers.
Pics here: https://imgur.com/a/8va3BII
From our two private patios, we have a panoramic view of Los Angeles from the Hollywood Sign thru DTLA down to LA Live and everything in between. There's a stage in the living room where my roommate hosts bi-weekly shows under the instagram handle: thelullabyloft
These events take place in the common area, they are professionally recorded and live-streamed, and we have a cap of 30 people in attendance (typically we average 15 people). I strongly encourage you to get involved with these events! They are great networking opportunities, and my roommate is always looking for an extra hand to help run them if you are available/interested
Important facts: - Shared bathroom Parking is included, but not in-building. It's one block away in an underground lot by the Home Depot with a security patrol. - Internet is $10 a month - Our work habits are a mix of WFH and not. The apartment is big enough where everyone has their own space to isolate, but also collaborative if you come out into the common area. - Laundry is in-building on the 3rd floor, paid via app - We have both men and women as roommates; just no couples or pets please. Other fun facts: - We have a ping pong table. - The loft is so large I can forget people are home for hours at a time. - Nearby Food: - The best Indian spot in LA is two blocks away (Bombay Beach) and also will deliver you groceries if you want. - Two of the best taco tents you'll ever visit are within a block. If you get tired of those there's another four to choose from that are also great. - Langer's is a short walk down the road. - There is a Metro bike-share kiosk directly outside of the building. bus stop right outside our spot and closest metro is 8 min walk - You can walk to the grocery store on 6th/Union. - It's Westlake, so manage your expectations about the area. We've never felt unsafe in the 4 years we've lived here. - The room is available for 3 months from July 1st - September 1st. However, even if your availability ranges outside of these dates, I still encourage you to reach out! If I can’t find anyone for next month - - I’ll still be looking for August. Also, with 5 roommates at the loft - new rooms open every so often… so I could keep you in mind for a later date if something opens up! Pics here: https://imgur.com/a/8va3BII
If you're interested, please PM me with a little about yourself (work, hobbies, etc). I will contact you to schedule a video chat and or phone call, and then set up an in-person tour if it seems right. Thanks, and looking forward to hearing from you.
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2023.06.04 18:41 barodablues My experience with Dr. Usman Khan
I did a one-month rotation in March 2023 with Dr. Usman Khan at HCA Houston Northwest and EPIC Heart and Vascular Center and got total exposure to cardiology in all its aspects. Dr. Khan is a beautiful human being and a great mentor with a passion for teaching and helping IMG doctors. The office staff was really kind and helpful. Everyone was friendly and easy to get along with.
I was exposed to a wide diversity of common cardiac and peripheral vascular presentations seen in an inpatient and an outpatient setting and learned how to manage these patients in an acute setting and their long-term management.
In the outpatient setting, a typical day consisted of visiting patients one after another and working on EMR, which made me aware of my weakness and developed my strengths. Seeing patients independently at the clinic helped me develop my history-taking, physical examination, and communication abilities. The patient population I was exposed to ranged from patients with hypertension, hyperlipidemia, sarcoidosis, and diabetes to patients with chest pain, shortness of breath, and lower extremity pain. I developed my counseling skills by advising patients on lifestyle modification, diet, exercise, and smoking cessation. I also learned how to emphasize the importance of medication adherence to patients by educating them on the mechanism of action of their medications in simple terms. I was also exposed to patients presenting with vascular pathologies. I performed a complete examination of the lower extremities, counseled patients on the conservative management of varicose veins, and observed novel procedures such as Varithena, VenaSeal, and Radiofrequency ablation.
In the inpatient setting, I also got the chance to watch interventional cardiology procedures performed, such as peripheral vein angiography and cardiac catheterization, and I learned how to recognize when procedural intervention or medication treatment is necessary. Dr. Khan appreciated how I carefully examined each process and asked intelligent questions. Dr. Khan always took the time to thoroughly explain the procedure's indications for each patient, the observations made during the intervention, and the results obtained. During these procedures, I also learned about a method used in interventional cardiology that measures the degree of stenosis in affected vessels using FFR.
Throughout the externship, I had the chance to improve my ECG reading abilities by discussing several ECGs with Dr. Khan each day. Under Dr. Khan's guidance, I could also recognize the outcomes of echo scans and nuclear stress tests. In addition, I gave a talk on "Short-term risk stratification of nonflow limiting coronary stenosis by angiographically derived radial wall strain" and "Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): a multicentre, randomized, sham-controlled trial." During that talk, I explained how patients with high radial wall strain can be diagnosed early from the risk of myocardial infarction and the role of quantitative flow-guided ratio.
By the last week of the externship, I had the opportunity to strengthen my mentoring skills by guiding the new batch of medical students. I guided them on how to use the EMR, organize their notes, and approach patients in a cardiac setting. In the cardiac catheterization lab, I mentored them on critical anatomical landmarks, pressure measurements of the heart chambers, and the indication for intervention while the doctor was performing the procedure. I reflected on what Dr. Khan taught me regarding ECGs, echos, arterial and venous ultrasounds, and nuclear stress tests, and I taught them how to read and correctly identify pathologies on each test. Overall, the experience was comprehensive and well-rounded, and by the time it was through, I felt highly secure in how I would treat a cardiac patient. I improved my clinical and teamwork abilities and medical knowledge and expertise.
It was a comprehensive experience that covered all aspects of a top-notch externship. Dr. Khan will ensure you get the most out of your rotation, improve any weaknesses, and prepare for the residency. Dr. Khan shows a strong interest in not just responding to your questions and clarifying your thoughts but also providing helpful advice on applying for residencies, doing well in interviews, and other aspects of being a practicing physician.
He would also ensure that you have a fun time in Houston. You will know the details when you go!
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2023.06.04 18:40 Bharath_Sundararajan My May Read Pile
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A bit late posting my May read pile, but here goes: submitted by Bharath_Sundararajan to UKcomicdiscussions [link] [comments]
Doctor Aphra was fun, collecting all of her appearances. I think it’s a fun run, though a lot of it was familiar ground for me. Some of the plot twists are fun and unpredictable, while the others were visible a mile away. Consistently very good artwork and pacing is pretty good. It packs a lot more issues that I initially thought. Ends in an interesting way and I’m looking forward to the next volume.
Deluxe Gimenez reminded me a lot of Metabarons (it’s the same artist, if you’re wondering). Fourth Power was interesting and intriguing, but as much as Gimenez was trying to carve new ground, I felt he had to fall back to Metabarons for storytelling style. The second story, Starr Conspiracy, was meh and I didn’t enjoy it.
Station 16 is one of the hidden gems that I remember seeing in one of NMC’s old videos. It’s very reminiscent of classic horror and time paradoxes. Short read with good art.
The Essex County was a good slice of life story. Quite grounded story with Lemire’s trademark artwork style. There are three stories which overlap mildly, but give interesting perspective on characters. Good drama, if you’re in the mood for one.
2023.06.04 18:40 Reddivak And then I'll...! (1085 Spoiler)
TLDR; Luffy's dream is creating a Pirate Kingdom, which is the same goal of the Ancient Kingdom and the People of D.
Just a (I hope) short theory about what Luffy's dream could be and why it connects the One Piece story altogether. I'll try to be brief and explain as clearly as I can, with reference images. Without further ado, let's start. Luffy’s Dream and his significance for the entire story
The first time we hear about Luffy’s dream is in Marineford, when Ace is on the verge of death and is speaking his last words to his little brother. Then we jump into Luffy’s childhood flashback (chapter 585) and we have an hunch of what it could be. But most of all we get to see Ace and Sabo’s reactions to it. https://preview.redd.it/6xadvwcm214b1.png?width=873&format=png&auto=webp&s=06873113a2d1ca7c3e1edffd4a6379db430c7b29 https://preview.redd.it/19ydcywn214b1.png?width=881&format=png&auto=webp&s=43380f79b3af157ad17da6b2e6948a5d49320328
At this point we as readers understand that it seems to be something weird, childish and almost impossible to achieve. Now let’s move to Chapter 966, during the fateful meeting between the man who will be known as the Pirate King, Gol D. Roger, and Kozuki Oden. In this istance, Roger reveals his dream to Oden and Whitebeard, just like Luffy did to Ace and Sabo. But this time pay attention on how Roger’s full statement is presented. https://preview.redd.it/zpbm00us214b1.png?width=898&format=png&auto=webp&s=a69c754e43bb95f4fc0874731aa6dfd2d4cd7d09
Roger talks about reaching the very last island, becoming the greatest pirate crew in the world and AFTER THAT Roger talks about carrying out his dream. To me, this means that you need to be the Pirate King to achieve this dream, although Roger would be called like that only after he finds the treasure. Becoming the greatest pirate crew pretty much carries the same meaning.
Let’s stay on the same track and jump forward to Chapter 1060, when Luffy reveals his dream to his crew for the very first time. https://preview.redd.it/1mnu2tax214b1.png?width=1004&format=png&auto=webp&s=e75e8006715c4369e488ed6b18241a34d82c6822
The crew obviously looks amazed and somehow amused, but what is of the most importance is following the trail left by Roger’s words. Luffy states that he will have a shot on achieving his dream IF he BECOMES Pirate King. Not long after that, Franky confirms that Luffy needs to be Pirate King to make his dream possible.
So now we have all the info we needed to try to figure out what Luffy’s dream could be. The key of it all lies in the title of Pirate King. And what would a Pirate King be without a Pirate Kingdom? That’s it. Luffy’s dream is creating a Pirate Kingdom. It may sound pretty straightforward but it makes so much sense for the entire story. Let me explain! What is a Pirate to Luffy
We know from page one that Shanks and his crew inspired Luffy to be a pirate. But what of course inspired Luffy the most is the fact that Pirates have freedom!
He then proceeds on remarking that concept to Rayleigh, when asked.
So, knowing all this, we can assume that Luffy’s Pirate Kingdom is not your average Kingdom, but one in which the iron rule is freedom, since a Pirate, according to Luffy, is a being who is completely free. In his childish mind, he may expect that all the “citizens” of this Kingdom will become pirates and chase the freedom. After all, the D. people, whose letter Luffy carries, belong to freedom themselves. Blackbeard’s dream
Speaking of D., there’s one individual whose dream was revealed to us recently and is similar, if not the same, of Luffy’s one, although the meanings are completely different from one another. https://preview.redd.it/p5qqb4dp314b1.png?width=934&format=png&auto=webp&s=1ee0c6630abac35dc58c8c739313a12dc57487a6 https://preview.redd.it/cu3ylq0q314b1.png?width=1004&format=png&auto=webp&s=4f9a3daf59d8a9586ba7ffa8976067cc2984f6d5
We learn that Blackbeard’s dream is to make Pirate Island a full-fledged nation, thus creating a Pirate Kingdom. Sounds familiar? While most people at this point would discard this theory since Blackbeard’s idea is the same of the well concealed dream of Luffy, I think that the fact that both have almost the same idea should strengthen the theory.
They have the same dream, they just look at the opposite side of the coin. Just like the both of them ate the very same cherry pie back in Mock Town but their reaction to its taste was completely the opposite. Blackbeard, having most likely inherited Rocks’ will, is chasing the goal of becoming the King of the World, and the first step is making Pirate Island a nation affiliated with the government and creating the Blackbeard Kingdom. Luffy, on the other hand, will create a Pirate Kingdom which will involve the entire world and where the absolute ruler is freedom itself. The Ancient Kingdom
It is indeed time to tie the Ancient Kingdom and Joyboy himself to the theory.
The immense kingdom which existed in the past could very well be a Kingdom which comprehends the whole world united under the same flag, pretty much like what Luffy in my opinion intends to do: they’re the same Pirate Kingdom! Joyboy must’ve been a citizen of that kingdom, thus a pirate, with a specific purpose to carry out. More about this later tho.
Of course, the top of the world, the absolute rulers aka the World Government finds the very existence of a Pirate Kingdom who chases freedom to be very threatening to the status quo. Eventually, the will of Joyboy would be inherited by Roger first and then Luffy. Then Clover also states that, while the nature of the threat that the Ancient Kingdom poses is still unknown, the key lies in the name of the Kingdom itself. But what could it be? The Will of D.
In the latest chapter, we learn a lot of things. Nefeltari Lili’s blunder and her real name, Nefeltari D. Lili. D., the same letter which Imu indeed confirms to be carried by his/her ancient enemies. The most important piece of information related to this theory lies in the letter left by Lili to future Arabasta’s rulers. We can hear Cobra speaking few words of that very letter, although they carry the utmost importance.
“The Poneglyphs must be protected. Fly the flag that heralds the world’s eventual Dawn.”
Could the name of the Ancient Pirate Kingdom be the same of D? Could this name be Dawn? The Dawn Kingdom and the will of Dawn! The word dawn that by coincidence, sure, carries the almost same sound of DON. The will of Dawn is the will of pirates to chase freedom and to be united under the same Kingdom, the same Flag. Now obviously, every pirate crew needs its flag, which would eventually be the same of the Kingdom. And what could it be?
Nothing’s better that an old-fashioned goofy ass Strawhat crew’s flag. Or maybe the one that Bellamy is designing? Who knows. That leaves us with just one question. What was Joyboy’s purpose? The Binks Sake
What I think was Joyboy’s purpose is delivering the Binks’ Sake to all the Pirate Kingdom, just like the song states, thus making everyone brothers. But at some point, he was forced to interrupt this mission, thus leaving it all in one place. Sounds familiar? That very place is Laugh Tale, and the treasure itself could be Binks Sake. Why the treasure would be sake of all things. Let’s head back to chapter 585, which at this point I think is one, if not the most important of the entire series. https://preview.redd.it/zne6ms3m414b1.png?width=873&format=png&auto=webp&s=b2d6f796385f19b0b45403a4ed24550fa8b93242
Right after mentioning Luffy’s mysterious dream, the next page is the one above, the one in which the three kids exchange the Sake cups and officially become brothers. In short, Chapter 585 might be telling us that Luffy’s dream is to create a Pirate Kingdom, thus using the Treasure to exchange Sake cups with every pirate, or “citizen” of the Kingdom, making everyone brother. Just like Joyboy was supposed to do but couldn’t, waiting for Luffy to do it in his place. Furthermore…
This may be the biggest hunch, but the key could lie in the titles of chapter 999 and 1000. It doesn’t seem right to me that every time a new chapter goes out we get pretty much straightforward titles that anticipate what is supposed to happen in the same chapter. EXCEPT for this two chapters in particular. I believe this to be an hidden message of what the treasure is. It is to be read as a sentence. It’s like Joyboy speaking: “The sake I brewed to drink with you, Straw Hat Luffy.” Conclusion
This is it. As you can see it is not a brainy and fanciful theory, but more a connection of some dots scattered in the story. Let me know what do you guys think about it!!!
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2023.06.04 18:40 RazTheExplorer Part 11.5 - Closure
“Hey Raz, I got one!” Raz’s voice was cut by static as he called back, “Great! …at quarry …die.” Well, that wasn’t ominous at all, I thought to myself as I adjusted the rear-view mirror to check on the operator I had just blown past. They were doubled over coughing, their gas mask swayed side to side on the ground next to their feet. I don’t know what compelled me to not flatten what I had thought to be an AQ soldier, but I’m glad I didn’t.
I slammed my hummer in reverse, coming to a stop next to the helpless operator. “Hop in bud, we can get you to final exfill yet.” He slowly hauled himself into the bed of my hummer, landing with a dull thud and a groan as he fell onto his back. We cleared the gas, and I was immediately put on edge as my passenger started to gain consciousness. If he was planning anything nefarious, there wasn’t much I could do about it now. “You good back there? Normally I’d stop to send an invite but given the situation that might have just caused more problems.” He leaned through the non-existent rear window, “Nah, I understand man. When we get further from the gas we can stop and squad up. Don’t need to risk lighting each other up if things get hot at the exfill.” I couldn’t help but chuckle, “I don’t think that would be much of an issue regardless. Hey, we didn’t leave any of your friends back there, did we? I know we peeled out pretty quick.” I saw him shake his head and point to our left in the rear-view mirror. “We got split up, but they were running for a car, so I wasn’t too worried.” I followed his finger, a white hatchback cruised along parallel to us, swerving through buildings trying not to eat too many AQ bullets. “Hey boys, Dutch here is gonna roll with us to final. We’ll squad up when we get there.” I was barely able to make out one of his squad mates call out “Tight!” over his earpiece.
“Hey, listen, I’ve got friend I’m rolling with. His name’s Raz, he’s gonna meet us at final. If you see a red, white, and blue LTV, don’t shoot alright.” Raz chimed in, his radio finally clear of the static, “That’s very kind of you to tell them not to shoot me Dutch.” Before I could respond, a black turreted LTV slid out of Said City ahead of us. “Is that your boy Dutch?” I wanted to give my passenger the benefit of the doubt, it is windy in the box after all, he might not have heard me. “Nah man, wrong colour, and he didn’t have a turreted LTV last I saw.” The black LTV continued North along the main road as we cut away into the quarry proper. “Raz, company is headed your way. Looks like it’s just a solo in that truck but you can never be too careful.” “Thanks for the heads up Dutch.”
I rolled to a stop at the base of the helicopter ramp, gently flattening a couple of AQ who were getting a little to close to the bird for comfort, just shy of the battery running dry. The other two operators in the hatchback slid to a stop just down the hill from us. I got out of the hummer, a tad worried that my good fortune was about to come to an end at the hands of these fellas. As they ran up the hill, the notification finally popped. I accepted and ran down the hill to grab the hatchback, breathing a sigh of relief. “Wait, where you goin’ Dutch?” One of my clients called out. “Raz and I will run interference while we wait for the chopper to take off. Any AQ or unfriendly operators are gonna have to go through us.” “You keep talking about this Raz guy, but I’ve yet to see anyone other than that black LTV.” Almost on queue, a black LTV flew up the hill narrowly missing my hatchback. My clients went into a frenzy. “Operators pushing us! Take ‘em down!” The LTV spun in the sand in front of me, a glorious and perfectly oiled moustache glinting in the Al Mazrah sun. “Hold your fire! It’s Raz!” I called from below my clients. I sent an invite to him which he had hopped out and accepted faster than any of these guys could pull the trigger. “You see the operator that was in that earlier?” Raz shook his head, “No, I pulled up on it and they were gone. Must be out on foot somewhere.”
With 5 seconds left on the clock, there wasn’t enough time to go find them, our clients now panicking as they realized we weren’t on the bird. “What are you two doing?!” They shouted from the air as we waved goodbye. “Al Mazrah is our home gentlemen. That bird was never meant for us.” I gave Raz a pat on the shoulder as the gas rapidly approached, another successful day had come to a close.
The clack of a Kastov charging handle was almost unmistakable. We both turned to see the operator from the LTV standing there, rifle honed on us. “Well shit.” Their rifle dropped towards the dirt as they looked back over their shoulder at the nearly out of sight exfill chopper. They pushed through us, wandering towards the North side of the quarry. Raz and I locked eyes, shrugging in unison. That was one of those moments where we really wouldn’t have blamed them for their decision, whatever it might have been. “We better get back to HQ, Compton said I.T dropped off something for you.” Raz said as the gas engulfed us.
“I’m going back to the island boss.” My hands were shaking as I gripped the file folder that I.T had left for me. “Twitch.” “He’s back, it took him a bit, but he’s managed to re-take the castle and hunker down since we last saw him. And if he’s back then we might finally be able to get some proper intel on those blue tracers, direct from the source.” I handed the folder to Raz. He took it, turning to no doubt address the rest of the crew. I grabbed his shoulder, stopping him before he could speak. “Not everybody, not this time. They’ve doubled the defences; we’d be walking into a slaughterhouse.” “Well, you can’t go in there alone, we look out for our own Dutch, you know that.” Raz’s brow tightened, I could tell he was already trying to figure out what my plan was. “I’m bringing Maze and Alex. They’ll provide sniper cover while I infiltrate the castle. I still have my old uniform. As long as they haven’t drastically changed up their callsigns, I should be able to get in undetected.” I could tell Raz wasn’t convinced. “Dutch, like you said, you’d be walking into a slaughterhouse. How does you going in solo make that any better.” “After what happened in the complex…I’m not putting anyone else at risk, I can’t. The Bomb Maker…Twitch, I’ve gotta face him myself. Look him in the eyes so he knows I crawled out of Hell to drag him back down there.” “Alright, I couldn’t really stop you if I wanted to, could I?” Raz shrugged. “No, not unless you shot me, and honestly, I’d take those odds.” I punched his shoulder and started heading for the breakroom to grab Maze and Alex. “You keep that up I’ll be moving you back out to that sea can of yours.” Raz smirked.
The locks took a bit of fighting to get open. While this footlocker had only been on Ashika Island for a few months, the constant spray of salt water had worn away what little integrity it once had. The black uniform, emblazoned with the Rook and Spade of Shadow Company, was still in excellent condition, save for a bullet hole just under where the plate carrier would sit. I paused for a moment, holding it up in the air, memories of the past flooding in. “Not a lot of fond memories in that uniform I take it.” Maze called out from the catwalk in our home away from home. “I think part of the problem is that there are good memories. It’s a little concerning that such fond memories can hide out amongst so much evil.” “We’ve all done things we aren’t proud of. Some of us just did things other people also wouldn’t be proud of either.” Alex chuckled to himself as he cleaned his rifle on the cot next to me. I grimaced, mostly because he was right. I slipped into the old black fatigues and strapped on my old plate carrier. My weapons were all still intact too, I pulled my Taq-56 out of the footlocker, running my fingers over the engraving in the side, ROOK-XLIV. I cycled the charging handle a few times before loading in a fresh magazine and setting it on the cot next to me. I pulled out a pistol belt, two pearl handled revolvers, one with an ebony Rook on the grip, the other, an ebony Spade. Umbra Catavae engraved along each barrel. Maze had come down from the rafters now, a look of mixed intrigue and concern on her face, “I take it those don’t invoke fond memories.” I had done a poor job of hiding my look of disgust. “No, unfortunately they do.” I felt a wave of guilt wash over me. “Each of these was given to me for completing outstanding performance in the field. I did things I’m not proud of, and I was rewarded for it, handsomely. Holding these in my hands, I feel the same pride I had felt when they were first handed to me. It makes me sick.” I strapped the belt around my waist. The pearl handles shining against my all black silhouette. Alex piped up again, “Hey, at least you are trying to make amends for your sins, not many can say the same.” I let out a long sigh, “I suppose you’re right. You both remember the plan?” “Get to the radio towers and start lighting the place up when shit inevitably hits the fan.” Maze grinned. “Close enough.” I pulled my balaclava up and headed for the door.
The guard at the gate didn’t immediately shoot me which gave me some spark of hope that this might work. “In position!” Alex and Maze called out almost simultaneously. “Jinx, you owe me a beer!” Maze rejoiced. “What? Why would I give you a beer for that?” Alex sounded genuinely confused. “Hey, cut the chatter you two, don’t need to give them any reason to not let me in alright.” The guard held up his hand. “I don’t recognize you, let’s see your I.D.” I held up my old I.D card. “Well I’ll be damned, look who crawled out if his grave.” He pulled my mask down to confirm. “You look pretty good for a corpse, though your I.D card is out of regulation. You might want to stop by the I.T guy to get a new one made.” “Thanks, I’ll head right over.” The first thought that came to my mind was Bob. There’s no way he still worked for these assholes, is there.
“You used your old I.D?! You mad man!” Maze cackled over the radio. “Ok, I’ll admit, this wasn’t my greatest plan. I honestly thought they’d just capture me after seeing who I was.” Alex cut me off, “Go with the flow I suppose.” “Spade-499 up one-two.” The local radio channel began to drown out my squad’s comms. “Rook-3468 down one-one” “This is some odd radio traffic Dutch.” Alex quipped. I watched as a Shadow Company mercenary approached a stairwell, each step primed and ready to pop a leg off whichever unfortunate soul chose to ascend. “Spade-5454 up one-two.” “It’s how they know to deactivate the traps.” I whispered into our secure line. I approached the same stairwell. “Rook-44 up one-two.” I could hear the traps audibly click off. The guard at the to put his hand out as I reached the top step. “Sorry, no ghosts allowed on the second floor.” “Ghost? What…” He bent over laughing. “I’m just messing with you man. They said you died holding off the ULF while Bob and Twitch escaped, going out in a blaze of glory. Clearly, they didn’t have their facts straight. Glad to have you back.” I’m glad I had the balaclava on because I was struggling to hide my confusion. Last I checked I was the scape goat for the largest backstab in Shadow Company history, not a hero. I was never a hero when I worked for them. “I take it you are going to see the boss, call up two-zero, we don’t want people to be just guess on the fly, just in case someone tries to sneak in.” If only he knew.
“We don’t have eyes up there Dutch. Whatever happens, you’re on your own.” I could hear a tinge of worry in Alex’s voice. “Just make sure whoever is in here doesn’t get reinforcements.” “You got it!” Alex and Maze both called out in unison. “Jinx, you owe me another beer.” “There’s free beer at headquarters, why would I owe you a beer for that.” Alex called back clearly still confused. “Radio silence please. I’ve got a rat to kill.” I took a deep breath, pulling my Bryson from its sheath, the chrome exterior brushed over with a dull grey to blend in. “Rook-44 up two-zero.”
“Well, well, well. I was wondering when I’d see you again after our last encounter. Urzikstan and Al Mazrah clearly hadn’t kicked your ass enough so you decided to come crawling back to me for another round.” The traps clicked off. “Come on up, I’ve been looking forward to this.” I slowly ascended, keeping my Bryson trained at the top of the stairs, my eyes scanning each stair for an actual trap. As I crested the stairwell, my eyes were immediately drawn to him. His back turned to me, Trophy Systems whirring and clicking around him. “I missed you Dutch. Well, the old you. The one that would shoot through a hostage just to prove a point, the one that would dangle captives from buildings by their collar until they squawked like a bird, and then still dropped them anyways. I miss the Dutch that smoked Keller because his gas mask worked and yours didn’t when we those crazy Russian’s tried to hit us with mustard gas. I still get a little nauseous when I think about you peeling his face out of there.” “I’ve changed Twitch, I’ve moved past all that. I found a calling that doesn’t require me to be a conniving bastard.” Twitch laughed as he turned around, his hands empty. I kept my Bryson trained on him. “That’s what you think I am huh? I prefer shrewd businessman, but if that’s what helps you sleep at night.” He walked to one of the barred windows. “You really think what you and those taxi driving hooligans are doing matters?” “Clearly it does, or you and the Chemist wouldn’t be working so hard to sabotage us.” I took a few steps towards him. “Well, I suppose it matters to one of us. The Chemist and Raz go way back, but you know that. What I care about is the money, and I get a lot of money for helping that crazy bastard try to wipe out your little band of Merry Men.” “And Women. This guy just loves the sound of his own voice. Can I remove his head already? He’s looking right at me, practically begging me to pull the trigger.” I could hear the contempt in Maze’s voice. Twitch always did love a monologue. “You can still fix your mistakes Twitch. Gives us what info you have on those tracers of yours and I might consider not killing you.” I snarled. “When you went soft Dutch, you lost any respect I might have had for you. We are long past the point where you can intimidate me. Besides, any info I did have, is with the Chemist. He paid a handsome sum to get the formula, and really, it was becoming a logistical nightmare to ship enough of those little blue gems across the sea. Better for everyone to have it made close to the front lines.”
“Spade-101 up two-zero.” Bob’s voice cut through the tension. “Well I’ll be, it looks like we are gonna have a little family reunion.” Bob’s head poked up the stairs, “Hey boss, another server bank has shorted out from the sea air, I told you we should invest in better waterproofing the housings but if you still…” He trailed off as I dropped my Bryson, the sling catching it just before it hit the ground, and drawing my two revolvers. “Oh, hey Dutch. Nice to see you too.” Bob stammered. I cocked the hammer on each one, keeping one trained on each of my old squad mates. “Really Bob? Really! I understand you sticking around the day of the heist. But now? After everything that Shadow Company has done to these countries. To its own people.” Before he could respond, a siren blared over the intercom system. “Defensive positions! Hostile operators have breached the perimeter.” “Dutch you’ve got six operators approaching the castle, I think it’s time to bounce.” Maze was drowned out by her own gun fire, her Signal .50 raining death into the courtyard. “Looks like our time is up here Dutch. Since you clearly don’t have los cojones to pull the trigger, you might as well see yourself out, and let me and my men handle this.”
“Fuck it.” The hammer of the first revolver slammed down, dropping Bob instantly. I turned to face Twitch, his face a mix of surprise and pride. “Maybe I was wrong, the old Dutch still lives.” I charged forward, tackling him through the window and off the roof. Both of us lay on the ground, groaning as the chorus of gunfire roared around us. He dove for one of my pistols, but unfortunately for him, I had managed to hold on to the other, putting a round through his arm just before he could grab the gun. He rolled out of the way of the second round, bringing his one working hand up to the radio on his chest. The explosion from the castle threw both of us across the courtyard, debris raining down around us. I felt like I was reliving one of the worst days of my life all over again. I hauled myself to my feet, Shadow Company mercenaries and operators wandered aimlessly through the ashes. Everyone seemed too disoriented to fight. “I think it’s time to leave Dutch.” “I second that.” Maze and Alex were barely audible over the ringing in my ears. “Regroup at the boat. If I’m not there in 5, go without me.” I never heard a response, even if they tried, they wouldn’t have convinced me to leave, not with him still breathing.
I combed through the smoke and fire, carefully checking every nook and cranny I came across but the slippery rat was nowhere to be seen. “Looks like you 3 aren’t thick as thieves after all, eh Dutch. Poor Alex here was left all alone on the beach, no boat to be seen.” Twitch was sucking in air between words, no doubt kept standing by adrenaline. “You lay a finger on him, and I’ll make you wish you had died in that explosion.” I spat into my mic. “Don’t make me wait too long.”
I limped over a hill towards the beach where we were supposed to regroup. “Alex! Where’s Maze?” I called out as I stumbled down the sand bank. Alex didn’t respond, his head held in a tight headlock by Twitch, my second pistol against his temple. “She abandoned you both, and now I get the pleasure of killing you both after yet another betrayal. When will you learn Dutch. This world is a cruel place. Only the strong survive, clearly Maze knew that.” Twitch cut me off before I could retort. “Save the fight me with honour B.S that I know you are gonna spew.” I’m gonna kill you and your buddy and salvage what little I can of this operation. Then maybe retire to Cuba. I do love a good cigar.” “Adios, pendejo!” Alex brought his arm down, the knife concealed in his hand connecting with Twitch’s thigh. Twitch let out a high-pitched yelp, letting loose a round from the revolver which narrowly grazed Alex’s hair. Alex dove into the sand right as Twitch’s shoulder exploded in a pink mist followed shortly by the unmistakable crack of Maze’s Signal .50. I squinted trying to see where the shot came from, all I caught was the glint from her scope in the sun, the boat hardly visible in the rolling surf.
I limped forward, Bryson in hand, chrome starting to show through the worn grey paint. I kicked the revolver away from Twitch, placing a boot on his chest and the barrel of my Bryson against his forehead. He began to mumble and cry, hardly able to string together an understandable sentence. “Save it, you’re gonna need your energy for what comes next.” Our boat slammed into the shore, Maze hopping off, rifle raised and ready. “Oh shit I actually hit that!” “I’m not gonna lie, I thought you’d actually just bailed.” I laughed as she helped Alex to his feet. “You still go those claymores?” I asked Maze as Twitch continued to writhe in panic under my boot. “You wanted the old Dutch, eh Twitch. Ask and you shall receive.” Maze handed me the claymores, while Alex kept sidearm pointed at Twitch. I planted 4 around him, just far enough away that they wouldn’t go off unless he moved. I drew one of my revolvers, popping the cylinder out and emptying all but one round. I gave the cylinder a spin before flicking it closed. I tossed the revolver at Twitch. “Don’t waste that on me. You’ll only regret it in about an hour.” I took my other revolver, and hurled it towards the sea, the pearl grip glinting in the sun as it spun through the air, disappearing into the crashing waves. “Good riddance.” I sighed, that chapter of my life finally ended. Twitch was silent, his whimpering now just deep, laboured breathing. I turned back before I stepped onto the boat, watching as his hand slowly moved to the pistol in the sand next to him. “Well played Dutch, well played.”
submitted by RazTheExplorer
to AlMazrahTaxiService [link] [comments]
2023.06.04 18:40 Ok_Macaroon_6912 Just diagnosed with hiatal hernia
I’ve been having a lot of GERD symptoms (chest pain, upper abdominal pain, upper back pain) with a new symptom that randomly popped up over the past week of feeling a tightness in my throat; almost like my throat is closing up. Along with the feeling of a HUGE lump in my throat and feeling as if food is trying to come back up. I went to the doctor, he sent me for blood work and a barium swallow study and the barium swallow showed a 3cm sliding hiatal hernia at the GE junction and some acid reflux. My doctor prescribed pantoprazole twice a day for 2 weeks the once a day there after. My question is: when will I fee relief, if ever? The most distressing of the symptoms is the throat symptoms. Constantly feeling like I’m going to choke and it being hard to swallow even water scares me so bad. My anxiety is at an all time high. Besides the prescription, what else can I do to help?
submitted by Ok_Macaroon_6912
to HiatalHernia [link] [comments]
2023.06.04 18:39 bobbywws People of Reddit who have been to New Zealand & Australia, is it worth visiting both on the same trip if I can only spend a few days at each city?
I'm flying into Auckland in March and I'll be there for two weeks. My wife.and I were thinking of flying to Australia to visit Melbourne and Sydney. My question is: is it smart to split my time up between NZ and Australia? NZ looks like it has some gorgeous hiking trails and I could spend weeks doing that, but I'll have my 4 YO toddler with me so I'll likely be focusing on touristy stuff and easier site seeing. I also think I might want to go to the South Island. Should I spend my whole two weeks in New Zealand? Or fly to Australia and spend 3 ish days in Melbourne, and 3 ish days in Sydney?
submitted by bobbywws
to travel [link] [comments]
2023.06.04 18:39 carmen2408 How long for MS diagnosis?
55 year old female, 130 lb, 5' 2". I fell down for the first time in May 2020. My legs give out, I have numbness and tingling constantly. I feel faint every day in the shower. Doctors have done MRI of the brain, blood work and lumbar puncture December of 2021. Also EMG was negative for Lou Gehrig's disease. I still have the same issues 3 years later also face numbness and balance problems and dizziness. I can't go to the grocery store on my own anymore. I can't walk more than 2 blocks without a cane. The only thing the MRI shows is white matter hyperintensities. Could this be multiple sclerosis? Or how long does it take to know if you have it or not? The third Neurologist I see now ordered a new MRI with and without contrast at the end of June. Thanks in advance.
submitted by carmen2408
to AskDocs [link] [comments]
2023.06.04 18:39 chaoticliving New here - New Family Doctor - confusing results
I’m a 32f with family history hereditary hemochromatosis diagnosis. Before getting a new family doctor I had a virtual doctor who sent me for an abdominal ultrasound as well as blood work. The abdominal x ray had the following findings:
Moderately increased echogenicity. Benign cyst in segment 7 measuring 1.8 cm.
Moderate diffuse hepatic steatosis and/or hepatocellular disease. New proposed local guidelines indicate ultrasound elastography in NAFLD patients with a FIB-4 score >/= 1.3.
The TIBC and Ferritin results were:
March 31st, 2023
Iron: 23 umol/l Iron saturation index: .40 Total iron binding capacity: 58 Ferritin: 234 ug/l
Once I finally had a family doctor he sent me for a work up on May 16th 2021 which showed ferritin levels of 408 ug/l so he sent me for TIBC again.
As of June 02, 2023 my TIBC was:
Iron: 11 umol/l Iron saturation index: .21 Total iron binding capacity: 53
I also had these tests done in 2021 and results were:
Iron: 17 umol/l Iron saturation index: .29 Total iron binding capacity: 59 Ferritin: 247 ug/l
As there was only 1 real high level of ferritin and most other results being in range I am thinking it may not be hemochromatosis but because of the family history I wanted to get some information for those more experienced.
Symptoms include: Stomach discomfort and pain Brain fog ( increasingly worse during the time ferritin was <400) Nausea Weakness and shakiness especially in mornings
I have not had genetic testing yet - however I have done 23 and me (not sure how much this can confirm) which resulted in the following result:
1 variant detected in the HFE gene
Tests for the C282Y and the H63D variants in the HFE gene linked to hereditary hemochromatosis.
Does not test for all possible variants linked to HFE-related hereditary hemochromatosis. Does not test for variants in other genes linked to hereditary hemochromatosis. The interpretation of your genetic result depends on the sex you reported in your account settings.
Just curious if anyone has anything similar or any advice on questions, or where to proceed the next time I meet with my doctor.
Thank you for your time.
submitted by chaoticliving
to Hemochromatosis [link] [comments]
2023.06.04 18:38 Prestigious-Till-633 appointment help
A few months ago I got a new doctor who then told me they would not continue to prescribe my meds unless I passed a drug test. I knew this was procedure at my old office so I wasn’t surprised but then the test showed I use mari*****, which my old office had been okay with. She told me I had a month to come back for a second test that had to be smoke-free. I am in college and my dad grows, I am of legal age in my state. I can say with 100% confidence that I will not pass this drug test (I am on no other drugs besides that!)
Questions: Do I bother showing up to the appointment? What do I say to them? Should I get another doctor and would they prescribe me medication? I’m even okay not being on my medication for a while as I’ve been trying to quit a little bit anyway, I’m just not sure how to talk to them without getting in trouble or something
submitted by Prestigious-Till-633
to ADHD [link] [comments]
2023.06.04 18:37 davenkz Ozempic and Wegovy Revolutionize Weight Loss Strategies for Companies
The advent of the widely popular obesity and diabetes drugs, Wegovy and Ozempic, has prompted weight-loss companies to undergo significant transformations in their business models.
Traditionally, weight-loss companies like WeightWatchers and Noom have emphasized diet and exercise as the primary means of shedding pounds. However, both companies have recently introduced new plans to include prescriptions for Wegovy and similar medications, recognizing obesity as a chronic disease.
WeightWatchers made this significant shift in March by acquiring Sequence, a telehealth company specializing in prescribing obesity drugs. In the coming months, WeightWatchers plans to launch a program catering to members who are taking these medications. Likewise, Noom, the subscription app founded in 2008, recently launched its telemedicine platform called Noom Med, providing access to weight-loss drugs. Noom has built its reputation on offering psychological tips and helping individuals track their eating and exercise habits.
The decision to expand into prescription medications was driven by an evolving scientific understanding of obesity and the increasing number of customer requests seeking medication options to enhance their weight-loss efforts.
Dr. Linda Anegawa, Noom's chief of medicine, stated, "We have always followed the science, and as the medical community has transitioned into this concept of obesity as a disease, we would be remiss in not joining as well." Dr. Gary Foster, the chief scientific officer at WeightWatchers, echoed this sentiment, noting that offering medication was a natural next step for the company. He emphasized the strong scientific evidence and consumer interest in the use of GLP-1 agonists, the class of weight-loss drugs that includes Wegovy.
The demand for Wegovy has skyrocketed since its approval by the Food and Drug Administration (FDA) in 2021 for weight loss in adults with obesity or those who are overweight with at least one weight-related health condition. Ozempic, a related drug that relies on the same formula but at a lower dose, was approved for individuals with Type 2 diabetes in 2017. Both medications, brand names for semaglutide, work by mimicking a hormone that signals fullness to the brain, effectively suppressing appetite and reducing blood sugar levels. Clinical trials have shown an average weight reduction of 15% with semaglutide.
In contrast, studies have found that diet, exercise, and behavioral counseling alone typically result in a 5% to 10% weight loss at best.
Dr. Eduardo Grunvald, an obesity medicine physician at UC San Diego Health, highlighted the significant impact of these drugs on understanding obesity as a metabolic biological problem. He emphasized that lifestyle interventions alone are often insufficient in overcoming obesity, and medications like Wegovy and Ozempic play a crucial role.
Weight-loss companies that fail to integrate medications into their business models may face challenges. Linda Bolton Weiser, an analyst at D.A. Davidson Companies, pointed out that Jenny Craig, a company that solely focused on prepackaged food and did not offer prescription drugs, recently closed its doors.
Weiser explained, "For companies that cannot strategically figure out how to do the drug thing, and if you offer a food product, those companies may suffer. That would be Medifast with their Optavia, that would be Jenny Craig, that would be Nutrisystem."
Dr. Fatima Cody Stanford, an associate professor of medicine at Massachusetts General Hospital, highlighted the potential benefits of weight-loss companies providing access to prescription drugs. With a shortage of obesity medicine doctors and a growing demand for their services, individuals with obesity could benefit from accessing prescription drugs through these companies. Dr. Spencer Nadolsky, medical director at Sequence, mentioned that some individuals face difficulties obtaining weight-loss drugs due to general practitioners' discomfort in prescribing them.
The introduction of telemedicine platforms like Noom Med and Sequence addresses these challenges. These platforms employ board-certified clinicians who evaluate patients' health and weight history, offer prescriptions, monitor side effects and weight loss progress, and provide access to fitness coaches and dietitians. By integrating prescriptions into their programs, WeightWatchers and Noom ensure compliance with FDA guidelines that recommend combining medication with diet and exercise.
However, concerns regarding the availability and appropriate use of these medications remain. Dr. Stanford noted the current shortage of Wegovy and the potential for over-prescription by for-profit companies focused on volume rather than individual needs.
While weight-loss medications show promising results, their costs present a drawback. Noom Med and Sequence programs come with additional fees on top of existing subscriptions, and the medications themselves can be expensive without insurance coverage.
Dr. Grunvald raised the question of whether the additional costs associated with these programs are necessary, considering that weight-loss medications alone often lead individuals to adopt healthier habits. It remains to be seen how customers will perceive the value of these comprehensive programs and whether they will opt for alternative options.
As weight-loss companies continue to evolve and adapt to the latest scientific advancements, the incorporation of prescription medications like Wegovy and Ozempic marks a significant shift in their strategies. The rise of these drugs underscores the recognition of obesity as a complex medical condition requiring a multifaceted approach to treatment. With ongoing developments and innovations in the field, individuals seeking to lose weight now have access to a wider range of options tailored to their specific needs and preferences.
submitted by davenkz
to weightlossmedication [link] [comments]
2023.06.04 18:36 burkechrs1 [Historic] Help with sideboard UW Control
Been piloting the below list in bo1, want to transition to bo3 but don't have a sideboard for the deck. I added what I think might be a decent sideboard as the deck seems weak vs planeswalkers and greedier control but I'd like to learn what the proper sideboard cards are and why. I play mobile so don't have a tracker but got to plat 1 last night and anticipate pushing into diamond today in bo1. Once I get into diamond I'd like to start doing bo3 instead. The deck does very well against aggro and midrange but loses to control, super friends variants and mill decks. Looking for some suggestions to help me build a sideboard that will help us the losing matchups, especially the control mirror vs a greedier deck. Thanks in advance.
2 The Wandering Emperor (NEO) 42
3 Teferi, Hero of Dominaria (DAR) 207
4 Calim, Djinn Emperor (HBG) 33
4 Fragment Reality (Y22) 4
4 Seek New Knowledge (HBG) 36
4 Archmage's Charm (MH1) 40
4 Divine Purge (Y22) 4
2 Shark Typhoon (IKO) 67
4 Leyline Binding (DMU) 24
1 Island (AKH) 258
4 Glacial Fortress (XLN) 255
1 Hall of Storm Giants (AFR) 257
4 Deserted Beach (MID) 260
2 Breeding Pool (RNA) 246
2 Spara's Headquarters (SNC) 257
2 Steam Vents (GRN) 257
1 Raugrin Triome (IKO) 251
2 Watery Grave (GRN) 259
4 Hallowed Fountain (RNA) 251
2 Raffine's Tower (SNC) 254
1 Otawara, Soaring City (NEO) 271
1 Jace, Unraveler of Secrets (SIR) 77
2 Farewell (NEO) 13
3 Dovin's Veto (WAR) 193
3 Fateful Absence (MID) 18
1 Lyra Dawnbringer (DAR) 26 1 Nezahal, Primal Tide (RIX) 45
2 Sphinx's Revelation (AKR) 262
3 March of Otherworldly Light (NEO) 28
2 Torrential Gearhulk (KLR) 70
submitted by burkechrs1
to spikes [link] [comments]
2023.06.04 18:35 impavidoutlet 27 [F4M] est/usa - genuine connection
Hey! I'm looking for some new people to talk to. I work from home and I'm fairly new to the state so my social life is almost nonexistent. 🙃 Which I'm cool with most of the time since I'm really introverted, but it'd be nice to have someone to talk to sometimes hahah. I'm really looking for genuine connections, ideally something long term.
I'm very independent and hard working. I'm pretty successful for my age and I'm very grateful. I meditate daily. I have a little dog son who does everything with me! We're always at a new park or the beach. I bought a house last summer and I've been doing a bunch of projects on it! My house is definitely a ~vibe~ haha. Speaking of vibes, I'm very 420 friendly. 🍃 I love stand up comedy and seem to go to a show or two a month lately. Who is your favorite comedian of all time?
Just want some cool people to talk to. I'm single and typically prefer talking to those who are single as well. Share your favorite music with me, exchange recipes, complain about your boring work day, anything.
I look forward to talking to you!
submitted by impavidoutlet
to r4r [link] [comments]
2023.06.04 18:34 ComicsAreGreat2 Are we overestimating Luffy’s current level right now? Does he have anymore physical challenges to face?
I’ve been sitting back and reading all the discussions about luffy and what the rest of the series will look like at the end.
Many people seem to believe that Luffy has no more major obstacles to overcome in terms of power? Many tier list’s already place him equal or above Admirals and Yonkou.
Personally I have doubts about this. Strictly from a narrative standpoint, it seems unreasonable that Luffy at this stage won’t struggle to defeat new opponents. We all know that he wouldn’t have defeated Kaido without significant help from his allies.
And If we were closer to the end of the story, I might agree that IMU could be the only challenge left for Luffy to face…But many characters are still left for Luffy to challenge and overcome. We clearly have a few arcs left before the finale. I can’t imagine Luffy easily dispatching every antagonist that he meets on these islands…
Shanks (just as a test of his strength)
The conversations around Luffy’s current power actually reminds me of back when Naruto in the manga first learned to control the Nine-Tails with KCM 1. Many people thought he was strong enough to fight evenly with the main antagonist. But that was eventually disproven when the major villains took to the stage. He had more evolving to do.
I believe Luffy still has quite a few more skills necessary to learn before he becomes “the strongest.”
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2023.06.04 18:34 kawaiixxx June 10th (Sat) Tin Hau pub crawl, bar hop
Weather's been really hot. Fancy some icy cocktails, cold beer, and refreshing sodas?
This is a completely new bar-hopping route. Each stop is literally just a minute away from each other so well within stumbling distance even with the heat wave we are experiencing. There will be beer, wine, spirits, soft drinks, and food sold at all the locations. Also cheap eats and street food in the area for the hungry people.
Taking advantage of the happy hour, we start at: 7:30pm
at underpass G/F, 18 Tsing Fung St, Tin Hau 9:00pm
we go across the street to Hong Kong Island Taphouse 1a, 1b Tsing Fung Street Flyover, Causeway Bay 10:30pm
at Drunkerland Shop B G/F, 27 Ngan Mok St, Tin Hau
Finish at around midnight or so at Ares (optional) G/F, 11 Lau Li St, Causeway Bay
They have dart boards. Those who are keen can drink and throw darts at each other til late.
As per usual we will be wearing Reddit t-shirts, with a Snoo stuffed toy so we would be easy to spot.
Everyone including myself will be paying for their own drinks.
See you there! meetup post
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2023.06.04 18:34 leftywrites Help Me, Hive Mind...
Please read my novel...
I've been having vulva issues for more than three months and I've been to the gynecologist five times. I'm starting to really not want to be alive anymore.
I went on vacation to Disney World, came back, and all of this started. My vulva/labia/clit area felt really irritated. I went to the Urgent Care because I was pretty scared to go to a gyno, I'd never been before. They had me do a urine culture, they said it was BV (can you tell that from a urine culture?), and gave me antibiotics. These didn't really help but they for sure gave me a yeast infection. I called back and they gave me a fluconazole. It didn't help. They give me 4 more fluconazole taken 3 days apart, those did not help. At this point, I figured I needed to woman up and see a gyno.
I go to the gyno, terrified. I get a NP who is very nice and does my first ever exam. She does swabs and cultures, it all comes back negative for UTI, whatever else. Just yeast. She gives me ointments and terconazole that is supposed to kill different types of yeast. I do that for three days. After the three days, right back to yeast city. She also told me to take probiotics, so I started taking Nordic Naturals probiotic.
I go back to her again. She says, OK, now try boric acid suppositories. I have never put anything like that up there and struggled to do so. Did that for two weeks. I start seeing red, watery discharge and the area still hurts, maybe more so now. I go back to the gyno. She sees sores up there now, right where I was putting in the boric acid. I think I wasn't pushing it in far enough honestly. She says, no it's herpes. Let me clarify- I've never had sex, I've never had a cold sore, nothing. She swabs the open sore and sends it off. She also sends me to get tested for herpes at Quest.
Results come back- swab negative, blood work positive. They put me on valacyclovir for a month. The sore heals but nothing else changes. At this point, I've changed to unscented/ hypoallergenic products and detergent, wearing dresses with no underwear or cotton, white underwear, stopped eating sugar and carbs, everything the interest tells me to do. Still yeast, still pain and redness, starting to get little cuts up there. I go to my GP because I'm sure I have oral thrush too. She says yes I do, and gives my an oral antifungal rinse and MORE fluconazole. My feet start swelling and stinging. Apparently, now I am allergic to fluconazole and am told to stop taking it. My feet go back to normal.
I go back to the NP. She starts acting like I'm crazy, saying its just going to take time and to take probiotics. Gives me more steroid creams. Says I may need pelvic floor therapy. At this point, I demand to see an actual gyno. They say the doctors don't see you unless you need surgery. I say I'm finding a new practice if I can't see a doctor. Finally, they agree.
I go back in, see a doctor's assistant who says, "Look, let's start over." She says the sores may not have been herpes related at all, not to continue with the valacyclovir. We need to take skin samples and do a full exam and a pap. I'm completely freaked out by all of this. They said they can put me under to do it, in a month and a half because they're busy. The thought of living like this for a month and a half is INSANE.
So 10 days ago, I decide maybe I need to be way for aggressive with the probiotics. I started taking two Smidge Optimal probiotics in the AM and two RePhresh probiotics in the PM. I start taking grapefruit seed extract, garlic supplements, multivitamins. Then I have my period. Now it's three days after my period, and I have no white discharge. That's huge. But it's still really red and raw and it stings.
Am I missing something? Am I not saying the right thing to these doctors? Help a sister please.
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2023.06.04 18:33 whinywino89 Awaiting diagnosis- colonoscopy Q
Hello, everyone. Bummed I have to be posting this, but, here we are.
I had a scope last September for extreme constipation, bleeding, and mucus. Came back perfectly clean with the exception of some bad internal hemorrhoids and a re-diagnosis of my IBS-C. I was relieved as I’m terrified of IBD.
Fast-forward to the past two months, things have gotten progressively worse (a LOT of blood). Last night/today was the first time I’ve had multiple bouts of bloody diarrhea (so, I assume it’s all downhill from here). I saw my GI last week and he’s ordering another scope. They book a month out 🙄 so, I’m looking at a hot minute before I get an official diagnosis. (But I’m 99% sure it’s UC — as is my GI.)
I’m insanely bummed out for all of the reasons — medication side effects, not feeling attractive or good in my body, life being a fraction of what it once was, money (my oop max is $8k a year so I guess that’s just my new normal spend annually now? Cool cool cool) — but I’ll be bummed about all of that when I hear, “you have UC” from my doctor.
For now, I have one main question:
I’m so scared of the prep. If you’re pretty much passing blood every single time you go, is that what you pass during prep, too? I didn’t have bleeding like this last time so it was the standard, “until it runs clear” situation. My doctor hasn’t been particularly helpful with answering my questions. I’m just really scared of the blood loss due to the prep. Going to ask my doc yet again but I figured I’d ask here, too.
Thanks in advance!
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2023.06.04 18:30 SparkOfLore Why I believe One Piece is an overrated and bad manga
EDIT: Keep on going with the ad hominem attacks. It's quite sad, but laughable more accurately.
One Piece might possibly be the most overrated shounen series of all time, and Oda is a bad writer.
First off, the plot. The plot in One Piece is incredibly formulaic. Most of the arcs have the exact same structure to them. Go to an island, meet allies, split up, find out that the island is either being terrorized by a bad guy, or it's about to be taken over by a bad guy. Then, the straw hats have to battle against the bad guys. After saving the day, they feast and proceed to the following island, where the same thing occurs. The entire stretch from the Sabaody Archipelago to Marineford is the only part of this series where the plot deviates from this same formula. Other than that, most arcs adhere to the same pattern. The plot is largely devoid of any originality.
A few arcs in the series have little to no relevance on the overall story, and do little to help the Straw Hats accomplish their goals. Skypiea was almost completely filler, aside from the last part where it's revealed that Gold Roger went up there. The entire conflict with Enels regime and the Shandians was completely filler. Same thing with Fishman Island. The New Fishman Pirates are fodder filler characters, and the entire conflict revolving around them had zero relevance to the story. Given that they aren't even significant characters in the One Piece world, the Straw Hats defeating them didn't progress the story whatsoever. The arc had some relevant parts to it, but the conflict revolving the New Fishman Pirates was not one of them. Long Ring Long Land is another irrelevant arc, but that's not even worth talking about. There are probably more than 100 chapters/episodes in all three of these arcs combined. That many chapters with little to none story progression.
Now onto my second reason as to why One Piece sucks. It's terribly cliche and shallow. People frequently criticize Fairy Tail for having the power of friendship, however One Piece does the exact same thing. One Piece has an excessive quantity of plot armor and friendship power-ups. In some cases, the author writes himself into a corner and is forced to resort to deus ex machina to correct his error. For example, the end of the Enies Lobby arc. Even though it was previously established that the Going Merry cant set sail anymore, they somehow got saved by it during a buster call. Even though the Aqua Laguna was happening. Even though a random pirate ship shouldn't be able to sail directly towards one of the three world government powerhouses. This, as well as other comparable events frequently occur in One Piece.
The conflicts in One Piece are very superficial and cliche. Most of the villains are only evil for the sake of being evil. They pursue things like power and influence, which is quite stereotypical and generic. The conflict is extremely straightforward, as well as black and white. Once you can identify an antagonist as pure evil with no justifications for why he does what he does, that throws any hope of ethical complexity out the window. There is no sort of clashing of ideals in One Piece, and the characters are never placed into any sort of ethical dilemmas. Again, the conflicts are very straightforward, black & white. One side is objectively good, while the other is objectively bad. Because of the lack of ethical complexity, the character dynamic between Luffy and pretty much every villain is relatively simplistic and generic. This is very evident based on the lack of complex dialogue in the series. Why do you think the only thing Luffy said during Alabasta is "I'm gonna kick Crocodile's ass". Again, if there's no sort of ethical complexity then there's also no room for a clashing of ideals. At least Naruto and Bleach had some sort of ethical complexity regrading Byakuya Kuchigi and Pain. The ethical complexity lead to an ideological clash between Ichigo & Byakuya, as well as Naruto & Pain. One Piece has none of that. Ethical complexity is also a great way to develop characters, and force them to think more deeply/self reflect. Constantly putting characters in black and white conflicts is one of the main reasons the characters in One Piece never develop.
Next up, the characters. This is probably the worst aspect of this story. Lets take Luffy for starters. Zero character development whatsoever. He has no introspection. He has no psychological or ethical complexity. He has no internal characterization. He has no internal dialogue. Writing a manga for 26 years and not giving a single thought to character development is shockingly sad. Overall, I find Luffy to be an incredibly boring character. Besides all of the problems I just mentioned, he has one aspect about him that I absolutely despise. Almost every conflict he gets embroiled in has complexities that he is completely unaware of. He only gets engaged in conflicts when his friends are hurt, which is extremely superficial and cliche. In certain situations, even minor characters are more relevant to the conflict than him (Waiper, Vivi). I find it very weird how the protagonist, the most important character in the story, barely has any sort of connection to the conflicts of the story. He was inside the stomach of a snake most of the Skypiea arc, not understanding any of the nuances of the deep conflict surrounding him. His importance in the conflict is minor or sometimes even non-existent until his final battles, and most of the villains he fights have no idea who he is, or don't know much about him. Because neither of them knows much about the other, this results in a rather uninteresting protagonist/antagonist character dynamic. However, even if Luffy understood the nuances of the conflicts he's involved in, not even that would make him more interesting. This is due to the earlier statement I made about how the conflicts are quite simplistic, clear-cut, and devoid of any ethical complexity. As long as one side is objectively good and the other is objectively bad, the dialogue and character interactions between Luffy and the villains will always be generic. "I'm gonna beat your ass", "You hurt my friends", "You're a bad person". That's all it really boils down to, and that's all that it'll ever be. Zero complexity.
All of the conflicts he's engaged in are never because he thinks it's the right thing to do to be engaged in these conflicts. It's never because his ideals differ from the villains ideals. He's always engaged into conflict because he just always happens to make friends with people who are on the morally right side of the conflict, and he makes those friends very quickly. That's bad characterization, and that's bad writing. That's a terrible way to make your main character get involved in conflicts. It's also the reason why we never see Luffy undergo any sort of moral reflection. When you're always placed onto the morally right side of the conflict by coincidence, then that leaves little to no room for moral reflection.
As for the other Straw Hats, all of them remain stagnant throughout the entire series. They are merely given tear bait backstories, and once that's over, they remain the same throughout the rest of the series. They're gimmicks have already gotten stale a long time ago. Brook has been making the same joke since he's been introduced. Same thing with Chopper, Franky, Usopp, Nami, etc. They've been acting the exact same way ever since they introduced. None of them receive any psychological or ethical complexity whatsoever. The lack of character development makes the characters so boring.
I have other reasons, but I'm not in the mood to type them out right now. I'll just summarize them quickly: terrible pacing, shitty art, ugly character designs, straw hats become side characters after the time-skip, ridiculously long arcs full of too many subplots, too many garbage arcs, and a few more I cant remember. Terrible series overall.
It gets insanely annoying when One Piece fans try to overcomplicate this series. I've heard people making the claim that Luffy is a complex character. Absolutely absurd. The people that make this claim obviously don't know what it means to be a complex character. A complex character would be someone like Toguro from Yu Yu Hakusho. Not only is he a psychologically complex character, but he's also an ethically complex character. That's a perfect example of a complex multi-dimensional character. One Piece has pretty much no complex characters. Again, if you want to see good writing, then read or watch Yu Yu Hakusho. Both of the major villains, Sensui and Toguro, are incredibly complex and well written. One Piece on the other hand has only one-dimensional villains. There's a very clear intellectual difference in Togashi and Oda's writing. One is better than the other. They're both intellectually dissimilar pieces of work.
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2023.06.04 18:28 XegrandExpressYT M17 , Turning Bald at an alarming rate , need Guidance
I don't know where this should be posted , if this isn't the place , then am sorry
Hi , to understand my situation , let me expand on my current state.
I am from India and 17 years old , still in +2 . I have been experiencing hair loss since I was in 7-8th grade or so , but I didn't give it much attention at that time even though it was shedding at an alarming rate . I must have been like 12 to 13 then . Whenever I had got to seen doctors usually for other illness like cough or cold , we used to ask them why am shedding so much hair and they always used to dismiss us by saying cuz I am fat . Yes I am fat . I probably weight above 80kg right now .
That's also around the time I stopped applying hair oil which I used to do once a week , as I used to see lots of hair falling . But since last year Its becoming pretty visible that my head's coming bald .
I do spend a lot of time in front of the computephone . Also its always extremely hot here , even as am writing this its above 35 degree celcius .
I also am stressed all the time to study and get good scores for exams . I have been in this study hell for the past 4 years but I understand its for my future and yes I need to study well . But the pressure is always unbearable.
I have applied countless shampoos which claim to reduce hair loss or which help to strengthen hair etc etc . Nothing works
I am also losing my hairline now .
As a socially introverted person , its very scary . I love my hair .
I researched about hair transplant but it looks painful , and also costly , which we cannot afford.
And so I recently came across this medicine called Minoxidil . Does it really result in Regrowth of new hair ? Will it have any affect on my body ?
I must also mention I am very short for my age , just 5 foot 5 inch . Everyone in my class way taller than I am .
Is there like any medicine that will help me in this situation ? What can I do ? Will I have to spend rest of my days as a bald guy ?
submitted by XegrandExpressYT
to HaircareScience [link] [comments]