Primary care physicians north port fl

>**What will you be doing with this PC? Be as specific as possible, and include specific games or programs you will be using.**
Gaming (Elden ring and fromsoft games in general, Counter-strike, apex legends, Resident evil village, God of war, Hogwarts legacy etc) and light microsoft office usage.
>**What is your maximum budget before rebates/shipping/taxes?**
Maximum £2400 before shipping including tax (UK so tax should be included in the price)
>**When do you plan on building/buying the PC? Note: beyond a week or two from today means any build you receive will be out of date when you want to buy.**
ASAP
>**What, exactly, do you need included in the budget? (ToweOS/monitokeyboard/mouse/etc\)**
Case, CPU (and cooler if necessary), GPU, Memory, Motherboard, PSU, Case. Don't need storage (see extra info)
>**Which country (and state/province) will you be purchasing the parts in? If you're in US, do you have access to a Microcenter location?**
England
>**If reusing any parts (including monitor(s)/keyboard/mouse/etc), what parts will you be reusing? Brands and models are appreciated.**
BenQ ZOWIE XL2411 24 Inch, G pro superlight mouse, Keychron K2 Wireless Mechanical Keyboard
>**Will you be overclocking? If yes, are you interested in overclocking right away, or down the line? CPU and/or GPU?**
No and not interested down the line
>**Are there any specific features or items you want/need in the build? (ex: SSD, large amount of storage or a RAID setup, CUDA or OpenCL support, etc)**
No specific features
>**Do you have any specific case preferences (Size like ITX/microATX/mid-towefull-tower, styles, colors, window or not, LED lighting, etc), or a particular color theme preference for the components?**
Function over form, airflow then noise are the most important to me. I looked at the Fractal meshify 2 and the white Fractal design North (I've read this can be noisy)
>**Do you need a copy of Windows included in the budget? If you do need one included, do you have a preference?**
Windows 11 home edition
>**Extra info or particulars:**
First off thank you in advance for taking the time :) .
I had something like this in mind: https://pcpartpicker.com/list/W7t4Kp .
In general I'm function over form the only visual I care about is I'd like to avoid RGB unless there is no reasonable alternative.
I have already purchased Samsung 970 Evo Plus 2 TB M.2-2280 since it was on discount. The budget I've listed already takes this into account.
The 7800X3D + 7900XTX combo is of interest because longevity is important to me, and I'm not too bothered about ray tracing (I was also looking at the sapphire nitro+). But if you strongly feel there are better alternatives I am open to that.
I will be using an ethernet port so the motherboard doesn't need integrated Wifi so I figured I would get more value out of one that didn't have integrated wifi - Happy to be told otherwise though.
I looked at the Fractal North case, but saw reviews saying it was quite noisy so went for the meshify 2 as it reportedly has excellent cooling.
I've already purchased the storage drive as it is on discount.

[crosspost from minneapolis] Recently moved up North. Looking for a primary medical care doctor to guide me in my search for answers for a chronic ailment. Have done a lot of medical tests already, so I’m looking for a doctor who’s open minded and not afraid of a challenge. Not looking for homeopathic doctors. Thanks!

Recently moved up North. Looking for a primary medical care doctor to guide me in my search for answers for a chronic ailment. Have done a lot of medical tests already, so I’m looking for a doctor who’s open minded and not afraid of a challenge. Not looking for homeopathic doctors. Thanks!

We here at Friend Corp are seeking individuals between the ages of 25 and 45 to come join us at our wonderful company. There are many benefits for when you join Friend Corp. We are a social and talkative company who enjoys listening to our employee's feedback
Alright, dropping the charade.
As the title states I'm looking for a best friend first and maybe the connection evolves into something more. The friend-connection matters more to me than anything else. I want to look forward to coming home and hearing about your day just as much as you want to hear about mine while we eat homemade tacos in front of the tv. To me, the best long term connections are those born from friendships.
It seems kind of crazy these days to think like that but what can I say? I'm a bit of a romantic. I like to take my time to get to know someone.
About Me
I'm 6'4" living in the north of Canada. I can practically see Santa's Workshop from my window. I'm an outgoing introvert - very outgoing around friends and family, sort of introverted around new people until I get to know them for an hour and then I warm up. I've been on a new health plan and working on getting fit to lose the covid pounds I've racked on. I've got an adventurous sense of humor that likes to dabble in all the different types. I've got black hair and blue eyes. French is my primary language but I mostly speak English these days. I'm a big hockey fan but I unfortunately go for the Toronto Maple Leafs. Might as well dump any hopes for a championship in my lifetime down the toilet. A few of my interests are collecting "old" books, camping at the family cottage home in the middle of nowhere (on a nice lake), and spending some quality dad time with my 12 year old daughter. "Old" is in marks because we don't get actual old books at the old book store but rather "gently used" ones. I've got a book shelf and a half worth of various ones. Like everyone else, I like music and movies and tv shows and what not but so does everyone. Plus, my crap is better than your crap. That's just the way it is. :P I've got a Bachelor's degree from a university and certified in some IT fields. A Random Fact and a Hot Take: I've never travelled outside of Canada before and winter is better than summer.
About You
You live somewhere on Earth. That's a good starting point. Sorry aliens. You're also outgoing but have some introverted streaks. You like both going out and staying in. You are social and friendly, you like to laugh. Bonus point if you laugh at my bad jokes even if they aren't funny even if I know you're laughing at my unfunny jokes that aren't funny. Your someone who shares some common interest or traits with me but not all because that's boring. Two halves make a whole. I don't care about appearances or nationality or body type or whether you were actually born on mars. That stuff doesn't matter to me. I am attracted to a person's personality much more so than anything about their physical or immutable characteristics.
This is long enough I think. Congrats if you've read this far. You, behind the screen right now reading this, are probably the first to do so. Most just skim the first sentence or two or see how long this is and skip. But I feel like to make sure people are compatible, you need to know about them. I'd personally much rather respond to something of this size than "I like music movies, hiking, camping. Anything else just ask" I want to be able to have conversations longer than 3 word sentences back and forth.
Shoot me a message if you got this far and are interested in some friendship. In your message, tell me anything you know about canada. The weirder the better but anything at all is fine. That way I know you've read this far.
Take care of yourself and live a happy life.

Company Name	Title	City
Hartford HealthCare	Registered Nurse (RN) - GI Endoscopy	Botsford
Middlesex Health	Medical Assistant	Cromwell
Middlesex Health	Hospital Assistant	Durham
Middlesex Health	Medical Assistant	Durham
Middlesex Health	Hospital Assistant	Essex
Middlesex Health	Medical Assistant	Essex
Middlesex Health	Medical Assistant	Hartford
Five Guys	Crew Member - starting at 14.50	Middletown
Middlesex Health	Family Physician	Middletown
Middlesex Health	MD Family Physician	Middletown
IntelyCare	Licensed Practical Nurse (LPN)	New Haven
Middlesex Health	Medical Assistant	New Haven
IntelyCare	LPN	New Haven
VillageMD	Medical Assistant - Westerly	North Stonington
Middlesex Health	Medical Assistant	Old Saybrook
UniFirst	Route Service Manager - UniFirst	Stratford
Hartford HealthCare	Physical Therapist - Career Advancement Opportunities	Waterbury
PureRED	Copywriter - Haddad and Partners (Part of the PureRED family)	Bridgeport
US Navy	Bomb Technicial (EOD)	Bridgeport
US Navy	Cryptologic Technician	Bridgeport
US Navy	Electronics Engineer	Bridgeport
Masonicare	Nursing Assistant	Danbury
PureRED	Copywriter	Fairfield
PureRED	Copy Writer	Fairfield
PureRED	Copywriter - Haddad and Partners (Part of the PureRED family)	Fairfield

Hey guys, here are some recent job openings in ct. Feel free to comment here or send me a private message if you have any questions, I'm at the community's disposal! If you encounter any problems with any of these job openings please let me know that I will modify the table accordingly. Thanks!

This situation happened several years ago, but I would like some clarity on the situation and the opinions of medical professionals on how this situation should have been handled.
Age at the time: 22
BMI at the time: 14.6
Medications at the time: None, no drugs/alcohol, occasional laxative abuse
Relevant Diagnoses: Anorexia nervosa, restricting subtype (however, I had purging episodes with no accompanied binging around once a week); Major Depressive Disorder, Severe; PTSD
I sought out medical treatment for the first time in my life (parents were extremely neglectful growing up and never took me to the doctor) at my university’s counseling center, upon the urging of my best friend, as she was concerned regarding my eating disorder. I was referred to my university’s eating disorder program, where students with eating disorders meet with a psychologist, primary care physician, and registered dietitian once a week.
While this was the first time I had officially been diagnosed with anorexia, I had suffered with clinically significant symptoms since the age of 8. Before making contact with my university’s ED program, I had been attempting to weight restore on my own (went from BMI of 12.9 to 14.6).
I met with the ED treatment team weekly for two months. During those two months, my BMI remained steady at 14.6.
Relevant bloodwork: High cholesterol (193 LDL), low vitamin D, all other values within normal limits
Vitals: Resting HR was consistently in the range of 140-170 bpm, BP averaged around 100/50, HR increased with changes in orthostatic positioning (Ex. Went from 143 bpm to 178 bpm), BP remained stable with changes in orthostatic positioning
Relevant testing: Echo was completely normal, EKG was normal other than the tachycardia, DEXA scan showed moderate osteopenia in spine and both hips
I made it clear at the onset of my treatment that I had no health insurance, did not qualify for medicaid (in state with no medicaid expansion), and did not have stable housing. The ED treatment program at the university was the only treatment I could afford, as it was provided for free to students.
At the two-month mark, I was told by the primary care physician that I was a liability and was too sick to be treated there. This had never been brought up prior. She told me I would die without intensive treatment, and then she promptly terminated her treatment with me.
The psychologist I was seeing agreed with her and said I needed residential. I told him I could not afford it and didn’t know how to enter residential treatment without having health insurance, especially since there were no residential treatment centers in the area (closest was one state away). He told me to “figure it out”, and within the last 10 minutes of the session, informed me that this would be the last time I’d see him.
The dietitian cancelled all of my appointments with her (without an in-person or telehealth visit) after being informed of the psychologist and the physician’s decision.
I was devastated, to put it lightly. Basically, I want to know whether this situation was handled appropriately, what could or should have been done differently, and whether it meets a subjective or objective standard of patient abandonment.
Thank you for reading! I appreciate any insight.

I work in primary care (internal medicine) as an FNP with 2+ years experience. I love primary care and have a great rapport with staff and patients.
My current role is as a support to physicians- I see urgent/sick visits, hospital follow ups, and routine follow ups. Sometimes I see physicals and Medicare wellness visits when their schedules are booked.
I am salary only, without any productivity or quality incentives. There is $0 of additional income potential.
However, it recently came to light that the physicians in the practice (regardless of whether they’ve been designated a collaborative physician) are paid out a large bonus for having APPs working in the office. It is “APP income” on their contract and comes from the RVUs we generate. This, of course, is in addition to their own RVUs and quality income which amounts to at least an additional $100k/year.
We have asked for our own patient panel to assist with a significant primary care shortage in the area. This would also allow for productivity incentives to help increase income. The system said no.
We have asked for compensation model overhaul because we are very underpaid and the system is losing multiple APPs/month. The system said no.
How can we get over the resentment that docs are paid extra for the work we do, when we aren’t even paid fairly for the work we do?!

I've been dealing with varying degrees of abdominal pain and discomfort for a couple of weeks now.
For context, I'm autistic and one of the sensory issues I struggle with sometimes is related to skin touching skin (ex: my stomach rolls touching when I'm sitting, my under boob touching my chest when I'm not wearing a bra), and so I thought at first I was just dealing with a flare up of hyper awareness of my stomach rolls and was maybe sucking my stomach in too much, causing the discomfort and tension. I thought if I could just focus on breathing out and relaxing, it would go away.
But it's been going on for far too long, not getting better no matter what I do, and I've noticed some other things. It's not just discomfort, it's a near constant burning gnawing pain, almost like hunger pain. It gets worse when I sit, especially when I'm driving (which has made doing anything outside of the house these past two weeks just SO much fun 🙃). I feel empty, because I'm not eating much because eating makes it more uncomfortable, but I also feel inexplicably full/bloated at the same time. Occasionally I'll get a brief sharp pain in my lower abdomen on my waist line, but those are infrequent. The middle abdominal pain, the burning, the tension...I feel that pretty much all the time now, especially for the last couple of days.
My bowel movements are somewhat irregular, but they are still happening so I don't think I'm constipated? I thought it could be a build up of gas, so I've taken some Gas-X a few times and noticed no change.
I've set up an appointment with my primary physician, but barring any cancellations, the soonest they can see me is the 20th of next month. I'm considering going to my local urgent care tomorrow to see what they can find out, but I'm worried I'm overreacting. One of my biggest fears, silly as I know it to be, is that my doctors are silently judging me, like I could have dealt with this on my own at home.
So idk...what do y'all think? Does it sound serious enough to see a doctor ASAP? Honestly, I'm miserable LOL

Introduction: In the field of medical science, interventional radiology plays a crucial role in the diagnosis and treatment of various conditions. One prominent interventional radiologist in Delhi is Dr. Ajit Yadav. With his expertise and experience, Dr. Yadav has made significant contributions to the field, particularly at Sir Ganga Ram Hospital in Delhi. Let's delve into his background, accomplishments, and the areas of interventional radiology he specializes in. Background and Education: Dr. Ajit Yadav pursued his MBBS and DNB (Radiodiagnosis) from Pt BDS PGIMS in Rohtak, Haryana. After completing his medical degree, he served as a medical officer at a rural government hospital for six months. He further underwent residency training in radiodiagnosis at Sir Ganga Ram Hospital, New Delhi. In 2011, he obtained national board certification and went on to complete a fellowship in Interventional Radiology at GRIPMER in Delhi. Dr. Yadav also attended a short-term fellowship program at MD Anderson Cancer Center in Houston, Texas, USA, in 2013. Moreover, he participated in a training program on Transarterial Chemoembolization (TACE) at Seoul National University Hospital, South Korea, in 2014. Dr. Yadav’s clinical interests include uterine artery embolization for minimally invasive treatment of uterine fibroids and post-partum hemorrhage, Bronchial artery embolization for hemoptysis, minimally invasive oncologic interventions (including transarterial chemoembolization, radioembolization, and radiofrequency tumor ablation), and percutaneous interventions. In addition, he offers minimally invasive procedures for various diseases like Benign prostatic hyperplasia, Varicose veins, Liver diseases, and traumatic bleeding. His research interests include the interventional treatment of liver malignancy, a topic on which he has written peer-reviewed publications. He has authored more than 15 papers in the field of interventional radiology. He has also presented his work at numerous national and International meetings. In addition to clinical activities, he is an active teacher of residents including Interventional Radiology fellows. He is a member of several professional organizations, Indian Radiological and Imaging Association (IRIA), the Indian Society of Vascular and Interventional Radiology (ISVIR), and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). He is actively involved in the Delhi chapter of ISVIR. Professional Experience and Specializations: Currently, Dr. Ajit Yadav serves as a consultant at the Department of Interventional Radiology at Sir Ganga Ram Hospital in Delhi. He has a broad range of clinical interests and expertise in interventional radiological procedures. Some of his specialties include:

• Uterine artery embolization: Dr. Yadav offers minimally invasive treatment for uterine fibroids and post-partum hemorrhage through uterine artery embolization.
• Bronchial artery embolization: He performs this procedure for the management of hemoptysis (coughing up blood from the respiratory tract).
• Minimally invasive oncologic interventions: Dr. Yadav specializes in various minimally invasive oncologic interventions, including transarterial chemoembolization (TACE), radioembolization, and radiofrequency tumor ablation. These procedures are used in the treatment of liver malignancies and other types of cancer.
• Percutaneous interventions: He offers minimally invasive procedures for conditions such as benign prostatic hyperplasia, varicose veins, liver diseases, and traumatic bleeding.

Contributions and Research: Dr. Ajit Yadav has actively contributed to the field of interventional radiology through his research work and publications. He has authored more than 15 papers in various reputed national and international journals. His research interests primarily revolve around the interventional treatment of liver malignancies, and he has conducted studies on factors affecting the survival of patients undergoing transarterial chemoembolization for unresectable hepatocellular carcinoma. Dr. Yadav has also presented his work at numerous national and international conferences and Continuing Medical Education (CME) events.
Professional Affiliations and Teaching: Dr. Ajit Yadav is an esteemed member of several professional organizations, including the Indian Radiological and Imaging Association (IRIA), the Indian Society of Vascular and Interventional Radiology (ISVIR), and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). He actively participates in the Delhi chapter of ISVIR. Besides his clinical activities, Dr. Yadav is also involved in teaching residents, including Interventional Radiology fellows, at Sir Ganga Ram Hospital.
Who we are (Interventional Radiologists)An interventional radiologist (IR) is a medical specialist who performs minimally invasive curative or palliative treatments using radiologic imaging for procedure guidance. Interventional radiology treatments have become the primary method of care for a variety of conditions, offering less risk, less pain, and less recovery time, compared to open surgery. Interventional radiologists are trained physicians who specialize in minimally
Conclusion: Dr. Ajit Yadav is an accomplished interventional radiologist based in Delhi, currently serving at Sir Ganga Ram Hospital. With his extensive training and experience, he specializes in various interventional radiology procedures, including uterine artery embolization, bronchial artery embolization, and minimally invasive oncologic interventions. Dr. Yadav has made significant contributions to the field through his research work and publications, focusing on the interventional treatment of liver malignancies. As an active member of professional organizations and a dedicated teacher, he continues to advance the field of interventional radiology and provide high-quality care to his patients.
Name: Interventional Radiology India Address: Sir Ganga Ram Hospital, Old Rajendra Nagar, Delhi - 110060 India Phone: 011 42251897, +91 - 9958474870 Website: www.interventionalradiologyindia.com

Hello everyone, Today, I (female, 35 years old) went to the emergency room due to severe abdominal distension and a throbbing pain on the lower left side that had persisted for the past five days. A few months ago, I tested positive for hydrogen. During my hospital visit, my blood levels showed high inflammatory markers, leading the docs to suspect a bowel infection. They prescribed me Metronidazole for treatment. Due to concerns from all of you, I expressed my reluctance to take the medication, as I didn't want to temporarily resolve one issue only to face another problem later. The doctor advised me to take the prescription, consider it, and consult my primary care physician for further advice. He also kind of made a threat that my condition could worsen if I don’t take it and that it’s all really a gamble. He said that it was not broad spectrum and would only stay in my bowel. I also questioned how the doctor arrived at the diagnosis of a bowel infection without conducting any specific tests, to which he responded that it was based on my pain location and symptoms.
Now, I'm wondering how I can recover without taking Metronidazole. The Facebook Rifaximin dude said he could get it to me within three days. I'm curious if Rifaximin would be effective against a potential bowel infection. I also asked the doctor about the risks associated with treating a possible infection without a confirmed diagnosis, and he explained that in emergency situations, the priority is to do what appears to be the most likely treatment to prevent any life-threatening complications.
I also asked the doctor about potential issues with my gallbladder, liver kidney or a pancreas function due to fat malabsorption and issues with my stool and he said that none of those organs have anything to do with fat malabsorption?? so I really question everything he said. I will bring these things up with my primary care physician.
I'm so worried about the prospect of the IV medication wearing off by morning- it was SO PAINFUL. I would greatly appreciate any guidance or advice you can offer to help me make an informed decision. Thank you.

What will you be doing with this PC? Be as specific as possible, and include specific games or programs you will be using.

Primarily gaming from all gens, from emulating old ps1 games through to modern releases PC and RPCS3.
Specifically looking forward to Dragons Dogma 2 coming out at some point (using RE engine so I've been roughly looking at RE4 as a guide there with some wiggle room for DD2 being open world), but also Elden Ring which I can't run on my current rig, and Forgotten City which I barely meet the requirements for. As well as heavily modded minecraft with shaders.
I'm aiming for 1440p 60fps, as I mostly game on a TV in the same room connected via HDMI. The TV is 4k capable, but I don't really have the budget to make that my primary goal and I'm happy with 1440p. I also don't mind dropping back down to 1080p if things get too intensive, I'm really not fussy.
Side uses would be photoshop, though not heavily, and I would like to get back into 3d modelling though I don't really touch the rendering side of things so I'm not too worried about AMD/Nvidia differences there. Minor use of Stable Diffusion is the last point which I know AMD suffers on with windows, but I could install linux if I really wanted or just run the limited install of it. It's still going to be better than my current 1060 6gb.
I also don't care about raytracing

What is your maximum budget before rebates/shipping/taxes?

I had originally planned on just getting a new case and moving my parts so some parts I would have needed for that are already brought, as well as peripherals I've already decided on, so while I have a total budget of $3000 AUD, the functional budget left is:
~$2100 AUD for internal parts + monitors

When do you plan on building/buying the PC? Note: beyond a week or two from today means any build you receive will be out of date when you want to buy.

Within the month, but pretty much as soon as I can get it finalized and am comfortable with it all and stop stressing about this or that thing

What, exactly, do you need included in the budget? (ToweOS/monitokeyboard/mouse/etc)

Everything except an OS and perhaps PSU
Mouse/Keyboard/Monitors all have various issues so I'm just going to do a complete refresh at once.

Which country (and state/province) will you be purchasing the parts in? If you're in US, do you have access to a Microcenter location?

Victoria, Australia. Local pickup from Scorptec, PCCaseGear, BPCTech, and CentreCom

If reusing any parts (including monitor(s)/keyboard/mouse/etc), what parts will you be reusing? Brands and models are appreciated.

I do plan on reusing my EVGA SuperNOVA 750 G2 750 W 80+ Gold Certified Fully Modular ATX Power Supply that I brought in 2016 as it's still within its warranty period of 10 years, unless it's recommended not to.

Will you be overclocking? If yes, are you interested in overclocking right away, or down the line? CPU and/or GPU?

Highly unlikely as I think that would just make me anxious more than anything

Are there any specific features or items you want/need in the build? (ex: SSD, large amount of storage or a RAID setup, CUDA or OpenCL support, etc)

Motherboard - At least 2 M.2 slots that won't throttle the PCI-E lanes of the GPU or other slots if both filled. At least 5 USB-A slots on the back, a USB-C for the case front
Other then that not particularly. I would prefer to stick with intel, sorry AMD, just because it should handle the single core stuff that little better

What type of network connectivity do you need? (Wired and/or WiFi) If WiFi is needed and you would like to find the fastest match for your wireless router, please list any specifics.

Ethernet and Bluetooth 5. I'm sick of dealing with bluetooth dongles

Do you have any specific case preferences (Size like ITX/microATX/mid-towefull-tower, styles, colors, window or not, LED lighting, etc), or a particular color theme preference for the components?

Case already brought, yes I'm one of the many people on the Fractal North train. I have a lot of wood and black furniture already haha.

Do you need a copy of Windows included in the budget? If you do need one included, do you have a preference?

No, going to move my license from my previous build

Extra info or particulars:

As I already have a rough build so along with a general review and cost cutting if possible, these are mostly my main points of concern:

• CPU Cooler - Noctua is expensive and doesn't seem to cool that much more than say a AK620 or Dark Rock Pro 4. But I would like some consideration for noise levels, quieter is better, and I also hear the be quiet mounting systems are painful to use. Or I could drop down to a Noctua U12S if it would be enough given I have no plans of overclocking for now? Really have no idea here and I've looked at so many reviews trying to figure out which is the best temp/noise that my head is spinning (note: The Assassin line of coolers is not available in Aus). And I am quite noise sensitive which is why I went the expensive noctua case fans instead of arctic, didn't want to even take the risk of the whine people report from arctic fans.
  
• Motherboard - Seems like overkill, but it's on a huge sale, looks nice, MSI's problem is the least of the three major ones lately, and unless there's something better and cheaper out there it seems fine? (Avoiding ASUS, and Gigabyte have an alarming amount of refurbished boards on aus sites at the moment)
  
• EVGA PSU being reused from my current build, 7 years old within its 10 year warranty (though I don't know where the invoice for it is), is a problem or would it be better off to just bite the bullet and get a brand new one?
  
• GPU - The one I picked is a 2 fan MSI 6750xt for $619 (asus and gigabyte models of the 6750xt have reports of coil whine, which is why I went this), but I also have the option for a 3 fan Gigabyte 6700xt for $529, and I'm not sure if that's a good trade off for cost/performance as well as quiet operation, as they seem very close in performance but not sure about noise values. Seems like it would be but just doubting myself
  

https://au.pcpartpicker.com/useNazenn/saved/64JNpg
Any and all help welcome, thank you so much

Hello everyone, so I'm new to the whole health system here in the US.. I have a primary care physician that didn't prescribe HRT for me (I went to another clinic to get it).
But what I have noticed that in the papers they always give me (PCP clinic), taking testosterone isn't mentioned at all. All other medications are (either they prescribed it or not) except HRT.
So I'm a bit confused, is this usual or should I discuss it with them? And isn't HRT considered under medications? P.S: They know I'm on HRT, but isn't written down only.

My dad was recently released from the hospital and 5 of his 11 medications were modified. One of the modifications was to take his Ozempic dose from a 1mg/week injection to a 05mg/week injection. He currently has 2-3 pens labeled 1mg. Can he achieve a 0.5mg injection from those pens, or do I need to contact his primary care physician about prescribing 0.5mg pens sooner rather than later? Thanks for any help, it's been a challenging week.

Credit to u/bluefishcake for writing the original SSB story and building the sandbox for us to play in.
And a big thanks to the authors and their stories that inspired to get off my ass and put my fingers to keyboard. RandomTinkerer (City Slickers and Hayseeds), Punnynfunny (Denied Operations), CompassWithHat (Top Lasgun), Rhion-618 (Just One Drop), UncleCieling(Going Native), RobotStatic (Far Away), Kazevenikov (The Cryptid Chronicle), Also to the editor # Fan Beta Readers and KLiCkonthat .
As always comments, complaints, and suggestions are welcome.
This is a fair use notice. Any and all aspects of this may be used on and within this subreddit only, with attribution. All other uses are exclusive to the author.
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Nanorix took the news from the advocates in stride, better than Linda. They had spent the night mutually venting at the injustice of the situation while putting away bottles of gin. Max sounded almost broken by the news while Nora the optimist in the family, firmly held to the belief that things would work out. Rufus was, well, Rufus. Intuitively compassionate, which is why he was laying in the front seat of the truck with his head on Linda's lap as they drove up to Flagstaff.
Linda was trying to sleep off her hangover, her eyes closed but not asleep. Alila had been honest that the only reason Garquile was not tied up in this was that he had her direct protection as a territorial governess. Tommy did not have that level of security and without it, he was in more danger than Robert. From what Alila had said, elements in the Interior wanted Robert dead, other interested parties wanted him alive because of his potential. The situation was so bad the Planetary Governess had stepped in and ordered the house arrest of six high-ranking members of the Interior and let it be known that if anything happened to young Mr. Pierce they would die publicly.
Neither Alila nor the planetary governess knew why the Interior wanted Robert dead, she did. After she heard that the pod found the children and what was being done to them. Her lieutenant had completely lost it, she rounded everyone operating the orphanage and lined them against the wall, and had them shot. The Interior had come in and had done what they always did, cleaned up the mess, and protected those who were important and connected. Before the interior got there one of the girls found a large data server and they made copies. There were four full copies still on Earth and one that she knew was off-world, and she had one of them. It had been too dangerous to keep at home so she had setup a remote server that would once a week send out a heartbeat signal. There were major safety measures in place to prevent access.
She had managed to go to Flagstaff for brunch about once a month to establish a pattern of behavior. Those trips with Robert and sometimes Tommy had always been good, nothing special just good days. She and Linda would have brunch and she would trigger a download to her server buried under the barn. When they had spoken with Alila, Max, and Nora, Max had commented that if anybody could stack the deck and pull inside straight now was the time to do it. She did not tell Linda why they had to come, just that she needed to come up and check on something.
She and Linda had a quiet brunch on the patio of the restaurant to allow Rufus to join them. As they ate she triggered the data transfer. The data transfer would take at least thirty minutes to complete, so they would have a nice long brunch and talk about anything but the boys, she even took a couple of selfies of the two of them to cover what she was doing. Rufus camped out under the table but never relaxed, she was not sure if he sensed her unease or something else was going on that she could not see.
They stayed and chit-chatted until Linda finished her third cup of coffee. She did not want the third cup but they needed the extra time to let the data transfer complete, and by that time Linda's hangover had started to subside. The drive home was uneventful, but traffic was horrible due to the festival of colors going on, it was the 4th of July after all.
/*******************************/
Ishani was tired and hungry but had little interest in eating. She and Ensign Tha'xur had been up half the night working to translate the new equations that Robert had created yesterday, with a new understanding of how the translation needed to work. Thoughts of Robert consumed her mind, and she had to fight the urge to look over and watch him, the singular human male. His name seemed to roll off her tongue, lingering from her dreams the previous night as she drifted off to sleep. Those dreams had been far from innocent, filled with exotic and seductive images of him, even in his baggy exercise clothing.
Returning her attention to her food, Ishani shifted uncomfortably. She would need to change her underclothes if she continued dwelling on him like this. Taking another bite of the fruit, nut, and sauce mixture, she tried to enjoy it, but it did little to distract her from watching him. He moved slowly, almost as if dancing, though she couldn't grasp the purpose behind his movements. Ensign Tha'xur's timely arrival saved her from making an obvious fool of herself by staring at a boy nearly two years her junior. It always felt like she was the only one looking.
Ensign Tha'xur sat down with a tray of food and jokingly said, "Ground control to Crewwoman Vevreix, are you awake?" Ishani returned her gaze to her food and responded, "Yes, ma'am, I am awake, just..." Before she could finish her sentence, Ensign Tha'xur interrupted, "Distracted?"
Signing without looking up and absentmindedly playing with her food, Ishani replied, "Yes, ma'am, horribly. It's just... he's just one boy. I have enough common sense to know that there is no way I should even consider... why couldn't he be old, wrinkled, and fat..."
Ensign Tha'xur completed Ishani's thought, saying, "Instead, he's young, fit, and I would even go as far as to say he's attractive in a very unmasculine way, with that wounded, sad boy aura."
Looking up, Ishani was taken aback and asked, "What do you mean 'you could call him attractive'? Are you blind? I mean, he may be a little short, but other than that, he is..." She trailed off, unable to find the right words.
Smiling and taking a bite of her burrito, Ensign Tha'xur replied, "He is desirable, and deep down, I believe you could take away all his pain and sadness... but please don't go there." Shifting into a serious tone, she continued, "I overheard Cmdr Norroe and Lt Cmdr Ashix talking about him the day we arrived. What caught my attention was Cmdr Norroe mentioning his thousand-yard stare that is measured in miles. There are significant parts of his life that we don't have access to because they've been redacted by the interior."
Ishani looked over at Robert, who appeared to have finished his morning workout and was heading towards the mobile kitchen. She murmured, "No one is ever so lost in the deepest of caves that they cannot be found by the beating of their heart. There is always hope and always a way out."
Ensign Tha'xur wiped her face clean of the red sauce that had dripped from her burrito and commented, "You, Crewwoman, are an optimist."
"With all due respect, ma'am, have you looked?" Ishani responded quizzically.
With a wry smile En. Tha'xur replied smoothly "I am technically a married woman and my husband and kho wives are going to be here in three days. I am hoping that my leave request will be honored, we were supposed to go to Tel Aviv for 14 days." Frowning slightly with the last statement.
Ishani gave an understanding smile "Well, that explains why you are not interested. You know, if you want to get the time off then ask for help. What is the worst he can do to say no?"
En. Tha'xur almost laughed at that, "So what should I do ask him over here for you to ogle him and for me to get a chance to go on leave, I do not think he would like that, being that he is here under guard."
Ishani took another bite of her food, ‘alright girl put up or shut up’ she thought to herself, before standing. "Ma'am if you never ask for help you will never get any." This is not a good idea, turning to find Robert who was looking for an open table to eat at. "Robert, can you join us over here, please?" Blessed Nest mother, that sounded so bad she inwardly cringed.
/************************/
Robert had gotten his food-laden tray and was looking for an empty place to sit. It felt a little weird not having a personal shadow always with him. The petty officers had told him last night that he would be given some space and an opportunity to interact with the people here. "Go out, mingle, talk to people, that's a winning idea," he thought sarcastically. Yup, everything was normal again. Alone in a room full of people and completely clueless about how to do the most basic of things, like talking to anybody.
Now, the people he could talk to were a problem. Being the only male and the only human, he received looks. The looks could be categorized into three groups: lust, curiosity, and pity. Dealing with lust was easy; he just chose not to care, and thankfully, they were discreet about it for now. Pity, on the other hand, infuriated him because most of the time, it was fake. Whenever someone expressed their sympathy for all the things he had been through, he wanted to scream. At best, it was a polite social convention, and at worst, it was a selfish and internalized burden of guilt that had nothing to do with him.
Just as he spotted an empty table at the far end, somebody called out his name. "Can you join us over here, please?" Shit, it was Ishani, the one person in the whole damned place who had a very unsettling effect on him. She was the only one here who scared the shit out of him. Taking a breath to collect himself, he acknowledged her with a nod and proceeded to join her and the Ensign at their table.
He noticed that when he acknowledged her, she just beamed and got all bubbly. That was the best word for it. Her glowing tattoos seemed to brighten for just a moment before she sat down, leaving him to wonder what those tattoos looked like on the rest of her body. He made it to the table and sat down on autopilot while his mind indulged in a little fantastical daydream, leaving him noticeably flushed and uncomfortable in ways that only men could be.
Setting his tray and bottle of maple syrup down on the table and taking a seat, Robert tried to say thank you, but neither Ishani nor the Ensign had their translators running.
En. Tha'xur noticed him stop trying to use hand speak and realized that they had just messed up a little. "I am sorry, that was rude of us," she said as she tried to get her translation app up and running. Meanwhile, Ishani was no help; she was head down in her food, blushing and trying very hard not to be noticed. "There, we're set."
Robert was relieved when En. Tha'xur got her translation app running, so he wouldn't have to stare at Ishani across the round table from him. He returned his attention to En. Tha'xur. "I was trying to say thank you for asking me to join you, and it's okay. You at least figured it out."
Ishani looked up from her half-eaten food when En. Tha'xur's translator started speaking. Fuck, she thought, this is so embarrassing. Inviting a boy to come over and eat with you only to ignore him when he gets here. Idiot. Turning to face him, her brain failed as she smiled stupidly and took another bite. "Hungry?"
En. Tha'xur couldn't help but cringe. The situation unfolding before she seemed straight out of a cliché "coming of age" story, where a girl meets a boy and the universe seems to pause just for them. It reminded her of the sentimental videos her older brother and his friends would tear up over. Poor Ishani, the other girls around her would roast her mercilessly, yet she remained oblivious to the fact that she was being watched. En. Tha'xur couldn't decide if it was cute or tragic. Determined to intervene and save Ishani from herself, she spoke up, "Robert, the reason Crewwoman Vevreix invited you over is that I need your help."
"Hungry?" Robert was caught off guard by Ishani's question. Did she even understand what she was doing? He found her confusing, and he just wanted to finish his meal quickly and GTFO. En. Tha'xur was speaking, but he had missed what she said. He decided to play dumb and replied, "OK."
En. Tha'xur thought to herself, "This is good." She then explained, "Well, my husband and my three kho wives are going to be arriving on Earth in three days. I had scheduled a 14-day leave, but then I received an emergency assignment here, and I don't know if they will honor my leave request."
Robert had managed to pay enough attention to understand that she needed a favor. He had two basic choices: give a hard no and explain that the advocates wouldn't allow him to help until they gave the go-ahead, or try to answer her questions. His best option was to listen and see if he could offer some hints. "I am quite restricted by what my advocates have told me to do, but I will try to point you in the right direction."
Finally, Ishani managed to gather her thoughts and interjected, "See, I told you, all you need to do is ask."
En. Tha'xur rolled her eyes, silently expressing her frustration towards Ishani. She replied, "Thank you, can you help?"
Talking with his mouth full wasn't polite and attempting to gesture while eating proved to be a challenge. Robert sighed as he reluctantly set down his fork, his stomach growling in protest. "Yes, I will genuinely help you. And if you're wondering why," Robert paused, trying to understand his willingness to assist, "it's because you asked. Now, the big question is, do you even know what you want to ask?"
Ishani eagerly jumped in, unknowingly giving En. Tha'xur some time to formulate a proper question to ask. "Okay, if I can ask one too, please?"
Robert held up one finger as he obeyed the demands of his stomach and shoved a load of runny fried eggs and hash browns in his mouth. "Sure, since you saved me from eating alone." Robert swallowed hard after he finished speaking, realizing he had just unintentionally flirted with her. Thinking inwardly, "Shut up, dumb ass. You are going to get yourself in trouble."
Ishani sputtered like Joe Pesci for just a couple of seconds before getting to her real question. "Ok, ok, ok, ok." Pointing to the work area where the Charger was, she asked, "Why is the car so important? Why did you build it?"
Robert shoveled another load of eggs and hash browns into his mouth. "Why would a human boy on Earth, living in North America, want to build a fast car and one that could fly?" Pausing to inhale the bite of his eggs and hash browns, he continued, "Because it was fun, and it would have been cool to have a hotrod and be the only one to fly. Well, that would be a show-off, a little, and to have a shitload of fun flying around in it."
En. Tha'xur cluelessly responded, "What is a 'hotrod,' and why would a flying car be 'cool'? I guess that means good?"
Robert had to roll his head back before responding, to the idea of attempting to explain custom car and motorcycle cultures. "Humans like to personalize cars and other things as expressions of their personalities and rolling pieces of art in some cases. For a human boy to be able to build a car and go fast is a dream. Hotrods are the result of those builds."
Taking another break to move the French toast in front of him and pour on the maple syrup, he continued, "Back to the first part of your question, 'Why is it important?' Other than a personal attachment to the memories connected to it... it is not, in the grand scheme of things, it was a mistake. A very valuable mistake, it disproved one of my approaches to a bigger challenge."
En. Tha'xur and Crewwoman Vevreix just looked at each other and mouthed the same words, "It was a fucking mistake!!"
Robert tried to hide his smug satisfaction. Nobody ever considered just how much of his work was critical and applied to his big challenge. Ishani looked at Robert as he dug into his French toast. "If that was a mistake, what is the prize?" Robert just smiled and shrugged in response to the question. En. Tha'xur sat dejected, "Well, that did answer one of the big questions. The car is a stepping stone to the bigger thing."
Watching the Ensign sit dejected and look a little lost made Robert feel like a little shit. Flipping the bird to the bureaucratic machine that was the Imperium always felt like a "fuck yes," but trolling a person was different. She had asked him for help, and he had used it to be petty and spiteful. "You don't need to ask right now, and if you loan me your data slate, I will give you a couple of hints," he said, reaching out for the device.
En. Tha'xur handed over the data slate wordlessly. Robert opened a new document and wrote:
"If you have 'The Right Stuff,' you can connect the dots."
"Space-Time Gravity is not the same as Gravity Space-Time."
When he finished, he handed the data slate back to the ensign and returned to his food. En. Tha'xur picked up the data slate, read the hints, and found the first line to be of no use other than some devotional wisdom that would be preached in a temple. However, the second line held interesting possibilities. Grabbing the data slate, Ishani quickly scanned the text and handed it back to En. Tha'xur. "Thank you, I think we can work with this," she said. Turning to En. Tha'xur, she added, "Ma'am, I think we need to work in conference room 2 today. It has the other digital whiteboard, and I think we need the space."
En. Tha'xur picked up the data slate and looked right at Robert. "I don't get the first one. The second one could be applied in a dozen or more places."
Finishing his first piece of French toast, Robert tried to remember the order of the equations to point her in the right direction. "Show me my work from last night, and I will show you the one to work against. Don't try to finish it, just try to understand it."
En. Tha'xur handed the translated copy of Robert's work back to him, and he looked at it with a mixture of fascination and difficulty. It was strange to see his work presented so neatly, but it was also challenging to read. He had to mentally retranslate it to the original version he had written. Working through the problem brought his headache back in full force, making the surroundings too bright and diminishing his appetite. Robert tried to hide his discomfort, squinting his eyes and taking deep breaths.
Concerned, Ishani noticed his strained expression and asked, "Are you alright? You don't look well."
With a weak smile, Robert replied, "I shouldn't have done that. I usually take a couple of days off after my little flying trips. It's like working out too hard and feeling extremely sore the next day, then trying to work out again. Not fun."
En. Tha'xur felt uneasy knowing that Robert was enduring pain to help her. She thought of her father and how he would be disappointed in her. "Are you sure you don't need a doctor?" she asked, genuinely concerned.
"I'll be fine, I just need some sleep," Robert reassured them, pushing his plate of food away. "If either of you wants to finish this, go for it. At the very least, don't waste the bacon."
Ishani reached for the plate and admitted, "I've heard about bacon, but I'm a little afraid to try new foods. I don't want to be disappointed."
En. Tha'xur reached for a piece of bacon, saying, "I love bacon. I'll even taste-test it to make sure it's okay." She smiled at Ishani and took a bite.
Robert observed as En. Tha'xur's eyes widened in shock. Oops, he remembered that he had coated the bacon in maple syrup. However, she didn't spit it out, which was a good sign. His mom loved crispy bacon dipped in maple syrup. Sometimes, she would devour an entire package of bacon if there was maple syrup in the house, and then she would try to conceal the fact that a pound of bacon had disappeared. She would even do her dishes, a chore that was usually Robert's.
En. Tha'xur bit into the bacon, expecting a salty taste but experiencing the combination of sweet and salty. The flavor was incredible. She paused to savor the taste before chewing again. "You have to try this!" she exclaimed.
Ishani, with anticipation in her eyes, sniffed the remaining piece of bacon. "Here goes nothing." She cherished this moment, as it was the closest she had come to tasting her nest mother's nectar. Grabbing the plate, she declared, "I'm finishing this!" and devoured the last piece of French toast without bothering with utensils.
Despite his throbbing headache, Robert couldn't help but smile as he rose from the table. "Enjoy. I need some sleep."
/*******************************/
Tommy had to roll his eyes at Valenlina's latest attempt to "improve" his wardrobe with a purple satin shirt with a matching sea green scarf. No matter how many times Valenlina tried to have Tommy dress like a proper male, Tommy always simply said no. Early on in the dating, Valenlina had gotten so frustrated that she also broke up with him, not that she ever told him. Her father and kho mother Tearhart had stepped in and explained that she could not make a human be like a Shil. The Imperium still tried, and the Humans resisted more. There were several semi-celebrities on the data-net that advised Shil’vai women on dating human males and females. The most common rule for dating a human male is not to try and change them to be acceptable in your circle because they will resent you for it. You have attracted a human male for a reason, embrace it.
Their walk through downtown Prescott was a moment the Tommy did not have to think about the meeting tomorrow. Early this morning he and his mother had gotten almost an hour of one on one time with Advocate Roskin and she was able to explain in greater detail what was expected of him tomorrow and how things could go right or wrong. Withholding information was one of the worse things he could do. After the meeting, Valenlina noticed the additional stress in Tommy. It was so bad that physical affection had no effect. There was only one thing other than sex that could distraction, window shopping.
Their window shopping trip started as a serious attempt to make him presentable in Shil’vati society, ow her attempts to help him look more presentable were just something they did to have fun. In many ways, it was closer to foreplay now, as Tommy now attempts to have Valenlina dress like a human girl. Tommy did have one big win, a pair of 4-inch-high heels, he had said they improved the view coming and going. Her big win last year was a shirt and tie set for his tailored charcoal suit, he was finally willing to wear formal attire with a splash color.
Valenlina could see her best effort to pull Tommy out of what his mother called a 'funk' were not working. He was still not willing to talk to her about it, she could understand that he was pissed but his silence bothered her. While he had not pushed her away, he still felt distant. Last year's fireworks had been the warmup act for what had followed. She could never look at Mr. Scott's old Ford pickup without blushing just a little bit.
Tommy smiled with a wicked little smile, "Thinking dirty thoughts again I see." he said holding up a pair of women's cowboy boots in hot pink.
Playfully Valenlina put on her pouty face, "What would you wear with them?"
Taking his turn to think dirty thoughts and hoping to see her turn dark blue Tommy put on his most innocent face, "First this is a girl's color, and they would be for you, but what would I wear if you wanted me to try them on? Nothing?" Emphasizing the last word.
With a facade of indignation, "Why Mr. Sandoval, are you implying that the Governess's daughter would be involved in anything so uncouth as to make a respectable male present himself for inspection with only what the Goddess endowed him with?"
Tommy returned the boots to the display and stepped forward to steal a kiss."My Dear Miss Seskie, you know dammed well that you would take full advantage of that situation."
Returning the kiss, Valenlina smiled. "Yes, Mr. Sandoval I would." She bent down to whisper into his ear. "I think we both need to cool off or we will never make it to the fireworks show."
Tommy took her by the hand." Looks like I'll have to settle for mint chocolate chip ice cream."
Valenlina put on a hurt expression. "You are so cruel."
They left the window shopping and continued walking back to the courthouse square. The roads around the court were closed for three days for Frontier Days and the Festive of Colors. This opened the court square up for a giant art show and sales venue. This was the change for local artisans to show off their wares in the hopes of making one or selling to a noble patron and then getting follow-up commission work. The north side of the courthouse was dedicated to custom motorcycles and the east side was for classic custom cars. The west side, known as "Whiskey Row" is where the food vendors and their destination Jacksons Ice Cream was set up right in front of the Palace Restaurant and Saloon.
Turning the corner to walk up Whiskey Row Tommy could not help but feel he was being watched. Tommy had to keep Valenlina from heading off to go look at this or that. He had to remind her, that ice cream was first or he would have to give her a spanking. Valenlina would always retort with, "Promises, promises".
When they were getting their ice cream Valenlina nudged Tommy and told him to look across the street. Standing in front of a face painting booth was a short portly balding human male with a puggy round face. He wearing a well-made black suit, the only thing missing from the 1930s gangster getup was a fedora hat.
Taking their ice cream and heading off to a wood sculptor's booth Tommy kicked himself mentally for not seeing him earlier, he was the only person wearing a business suit. He should have stood out like a sore thumb, but he just seemed to blend in. The booth was impressive, boasting several pieces commissioned by various members of the nobility. Tommy ate his ice cream and kept an eye on the gangster while Valenlina inspected the various pieces and got sticker shock.
Tommy tried to get Valenlina's attention when the gangster entered the booth and proceeded to the cane rack. By the time Valenlina noticed, the gangster was already paying for the cane he had selected.
When the gangster finished his transaction, he turned to Tommy and Valenlina." Well if it isn't the young man of the hour, Thomas Sandoval. It's a pleasure to meet you. As well as you, Miss Seskie."
Flustered, Tommy stuttered out, "Who the fuck are you? Have you been watching me?"
The man smiled, but it felt unnerving, maybe a little malicious, too., "My name is Mr. Rojo and I watch everybody. It's my calling, but I will admit that you and your brother have piqued my interest. I go through life watching the world go by, I enjoy the shifting mosaic of peoples' lives, and how they interconnect. For example, the car that you and your brother build was a 69 or 70 I could not tell with what is out on the news media.”
Tommy waited to tell this to go pound sand, but he need to talk and tell Mr. Rojo what even he needed, Tommy forgot Valenlina was listening as he spoke.” It is a 69, why is that important?”
The gangster slowly dropped part of his smile as he replied, ”It is not important, it is merely a curiosity just like why not use the Confederate battle flag and why the name Valkirey?”
Eagerly Tommy responded, “The Betsy Ross over the Stars and Bars, because it is more appropriate at this time and the Shil’vati Imperium has no idea what it means, instead of erasing human history maybe the Shil’vati could try learning from it.” almost quoting Sean Connery about goose stopping morons and burning books. “ Now for Valkire over General Lee, that is easy, Valkire’s are sexy and cool. and General Lee would get us in trouble, just like the Stars and Bars.”
The gangster's smile was completely gone, and his expression and tone had changed to serious but neutral almost professorial, “But I have a simple question for you, and I'd greatly appreciate it if you would give me an honest answer, Thomas what is gravity?"
Thomas could not stop himself and replied without hesitation. "Gravity is a higher dimensional construct. When projected from a higher dimension it appears to be a force, but to use it as a dimensional construct the space-time gravity interpretation must be inverted to be the first-dimensional construct so that space-time gravity becomes gravitational space-time with an indeterminate number of dimensional constructs between gravity and space."
The gangster looked surprised, while Valenlina looked utterly confused. "Is that your brother Robert's words or yours?"
Thomas hesitated only slightly before he replied. "Mostly Robert's, I can't dream up the shit he does but once he explains it, I can see it. He uses me as a sounding board." Tommy suddenly realized what he was saying. "Who the fuck are you?"
The gangster took Tommy's hand to shake it. "Mr. Sandoval, I told you I am a watcher and now I get to watch you. Have a glorious life Mr. Sandoval" nodding to Valenlina, "and you too, Miss Seskie."
Tommy watched as the gangster walked out of the booth noting that nobody noticed his passing.
Valenlina had been too engrossed in Mr. Rojo and Tommy's conversation to say or do anything, but now that Mr. Rojo was no longer there she angrily turned to face Tommy."Thomas, you have some explaining to do!"
Tommy would not realize until much later, that the gangster had placed the cane in his has as he left.
/*******************************/
First:
Janissary: The Joy Ride Ch1 : Sexyspacebabes (reddit.com)
Previous:
Janissary: The Joy Ride Ch7 : Sexyspacebabes (reddit.com)
Next:
Chapter 8
Extra:
Janissary: The Son Of War : Sexyspacebabes (reddit.com)
Janissary: Vision from Zy'Verila : Sexyspacebabes (reddit.com)

My PCP retired and his practice has been doing the round-robin thing (sometimes you get a Dr, sometimes you get a PA) with his former patients who've yet to pick a new PCP.

Some of my stats before I start: I am 17m, 190lbs, 6'. Typical athlete, including heavy lifting. I live in the greater Seattle area.
I would also like to give a ton of thanks to u/ThatYoungBusinessGuy for being very informative and supportive throughout my journey, providing me information that I would never have been able to obtain otherwise, even through extensive research online.
Discovery of varicocele:
Found out I had varicocele years ago, when I was about 12-14. I had a sudden pain in my left testicle that would only go away when I lifted my legs above my head. I looked online and had an inkling that it might be varicocele, but the pain just would not go away. Unfortunately, after I told my parents they panicked and took me to the ER, as we thought it might've been something like torsion. They gave me an US, confirmed that it was varicocele, and sent me home.
Progression of varicocele:
It started out G1/G2, only able to be felt. It soon progressed to G3 over time, yet it never really gave me any problems. Very infrequent pain (once every month for a few minutes at most), even after lifting. I would mention my varicocele every annual visit with my primary care doctor, yet they would mention each time that if it wasn't giving me any pain, it would be fine as its main effects were decreased fertility.
My varicocele would always be there, though. A huge constant bulge when standing up/showering/going to the bathroom, and a soft, squishy mess when lying down. Last year, in Fall 2022, my primary physician did give me the information of a urologist she recommends that works at the University of Washington, an amazing hospital/health center in Washington near Seattle. However, because my varicocele wasn't giving me many problems, I just went on with my life.
Urgency in fixing:
In March/April this year, it started giving me pain. Like, really bad pain, 6-7/10, which I've never felt from my varicocele before. My job included standing for long periods of time, so it made my time hell. This persisted for a week or so, and because I was going out of state for college in September 2023, I started to want to get my condition fixed as fast as possible. I scheduled a meeting in March/April with the urologist at UW my primary care doctor gave me. However, I was going out of town in late June and leaving for college in mid August, and because my first consultation could only be scheduled in late June with him, I scheduled a meeting with another urologist at another hospital, Virginia Mason.
Virginia Mason meeting:
I had my meeting in early April. Coming in, I wasn't set on whether I wanted surgery or embo. I knew I had a tight schedule, but I was willing to hear what my uro had to say.
He mentioned how he does the operation around 15 times a year, which was a cause of concern for me (you can check my post on my profile). On one hand, I wanted to get this over with, but on the other hand, I didn't really trust 15/year that much.
After having some doubts and wanting some clarification on the procedure (because he was kinda vague during our meeting), I scheduled a phone meeting with him on a Tuesday in mid April. He cleared up some specifics, but I still had a few concerns. I eventually decided to ask for a referral to an IR at UW to see if I could get embo.
IR meeting:
My meeting was scheduled for mid May. The IR explained it extremely clearly and was very kind. However, he kinda strawmanned the surgical approach (he claimed that the surgery would litigate the symptomatic veins in the scrotum, which is one type of procedure, but isn't the microsurgery which is what most urologists do).
He explained that he would embolize the entire gonadal vein (which is the ISV in males). He would do it with the sandwich method, where he would use coils and then a sclerosant foam, which would irritate and close of the vein while also trickling down into side veins and also irritating them. He mentioned that it would be more painful than using only coils, but might be more effective. I was extremely confident in him as although he only did this varicocele embolization surgery around 15 times a year, he does IR embolization in other body parts many many times per year. Very collected, calm, and experienced. We scheduled my embo for June 8th, which was just yesterday.
Operation day:
Checked in at 6:00am, got called in to prepare at 7:00am. They set up an IV, got me in a gown, and took my blood pressure. I met the nurse and IR before he went off to a 7:30 meeting. The nurse debriefed me, told me about the procedure/healing, gave me antibiotics through the IV, and told me that I would be given some calming medication and fentanyl for pain.
At 8:00am, I was wheeled into the operation room. There were two techs and two nurses at first. They got me prepped and hooked up to monitors, moved me onto the operating table, and hooked up my IV. They were all friendly and energetic people, joking around the entire time. The lead tech shaved my incision site (right groin area) and they set up all the radiation protection. I kept bringing my head up to look around (which was not something I was supposed to do, as it flexes the abdominal muscles) so the nurse gave me a thick cloth to prop my head up.
At around 8:30 the IR came in with a resident and a 4th year med student, they numbed the incision site, and set up a screen next to me which showed what the IR was seeing. I'm not 100% sure, but I think I was under a fluoroscopy machine (kinda like XRay?) where I could only distinguish my spine.
The screen next to me was meant for the doctors to look at when they turned around. I was able to watch the entire thing on the screen next to me. They first maneuvered the catheter to my gonadal vein, then guided a straight metal rod through the catheter. Once they reached what I assumed was the end of my ISV before it branched into the pampiniform plexus. There, they started coiling up the metal rod into coils. In the end, there were three large clumps of metal which consisted of all the coils (overall, there were 10-12 coils), with space in between where they put the sclerosant foam. Halfway through the procedure I could feel pain in my lower abdominal area, so the nurse gave me an extra dose of fentanyl.
Recovery:
I was scheduled to be in recover for 2-3 hours until 12:30pm, but I stayed there until around 3:00pm. When I was supposed to be discharged at 12:30pm, my heart rate dropped considerably (high 30s to low 40s) and my blood pressure dropped to 100 something. However, these issues were mainly due to hydration, and after hooking me up to saline for a few hours I was able to leave. The entire time, I was told to keep my right leg straight to prevent the entry vein from rupturing.
When I first left, pain on my left side was around a 2-3, while my incision site was around a 3-5 in pain level. The pain in my left side was mainly due to the sclerosant foam, which would leak from my ISV and cause general pain and irritation in the area. When I got home, I just lay down on my couch/bed the entire day.
As I'm typing this in my chair the next day, pain is 0-1 for both my left and right side. The incision site is still giving a bit of a problem when I walk around/stretch the area, but my left side is giving me the most problem. The pain on my flank/lower abdominal area is 0-1 normally, but a 1-2 when walking or coughing.
Varicocele status:
I feel so much better. It might just be placebo, but my left testicle is feeling much cooler than before. When standing, the varicocele is considerably smaller and feels hard. Considering that it takes 3-5 months for my body to adjust and redirect blood flow, the improvement after one day is incredible. No more fat ugly bulge when going to the bathroom, no more distant, aching pain. I was even surprised at how I am able to subconsciously notice a difference - I was used to feeling my underwear against my scrotum on the left side as a result of my enlarged veins, but with the reduction in size, I'm surprised at how much empty space there is and how much smaller my veins are.
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Sorry for the long story/poor grammar. I quickly typed this up and just wanted to share my story here, especially because this subreddit (and especially YoungBusinessGuy) was a huge source of support and information for me. I'll provide updates after a few months (I have an ultrasound scheduled for Aug 8), but for now, I feel much better. I'm feeling possibly dilated veins on my right side, so I might be back, but hopefully I'll be able to put this in the past.

firstly thanks for reading
I recently started as an MA at an understaffed primary care center (upgraded from scribe) and currently am not doing MA things, instead working operatoscheduling and EHR. I had minimal training for both of these and can barely handle the workload. It is exhausting and I cried all day during work due to how stressed I was trying to do two positions. I’m hoping once I actually start as an MA it will be easier as the others don’t seem as stressed out but I hate where I’m at currently. I’m supposed to start the real MA training in two weeks and can’t back out at that point. Also, I’m not paid (need over 500 hours training before being paid). Once I do end up getting payment, it will be near minimum wage. I believe if I give it up I could continue being a volunteer scribe.
I also just got my CNA license and the school’s hospital is fantastic, and I also have contacts there so I believe I could pretty easily land a job working as a patient care assistant (essentially a CNA) on PRN time meaning just working when I want to. I have friends who do this and they enjoy it. This position pays very well for my area.
Is it worth it to keep the MA position? If I keep it I’ll have a job through my gap year (going into senior year now). I know MA positions are very favorable and I could get a great rec letter from the doctor I work with but it was killing me inside this past week. I don’t know how everyone else is handling the job just fine, maybe I’m just too sensitive for it? I have a headache the full next day just from stress while working :(. Ofc CNA positions are also good but I won’t have as good of a connection with a physician.
Is there a difference in these two clínica positions??
I think at this point it’s just hard for me to give up one position after trying for years to get anything
Please help

I convinced my primary care physician to order a testosterone lab test and I just got the results in today. Unfortunately he did not get the specifics like free t and total but at least I know for sure that I’m low. I’ve had Lyme disease for several years after a tick bite in Connecticut 10 years ago and have struggled with many symptoms, mainly fatigue, pain, memory loss, brain fog. I look from the outside like I’m in good shape though and at 5’10” weigh anywhere from 165 - 180lbs. I’ve always been an athlete but recently it’s been harder to get motivated.
Ive suspected for awhile that my testosterone was low but never expected my test results today to be this low!! I did “prepare” for the test by limiting my sleep last night and eating this morning.
I’m hoping to get treatment covered by my insurance. What are my next steps for finding a doctor? Should I checkout a clinic or try using an endocrinologist? I’m in the Charleston South Carolina area.

demographics: 5’7” female 19 yo currently taking no meds tried Valsalva maneuver
So after recovering from a really nasty cold in December 2022, I started to suffer from this clogged feeling in my right ear which caused partial hearing loss. It wasn’t painful or anything, just uncomfortable.
In January, I went to a primary care physician, and he told me there was fluid behind my eardrum and gave me OTC DayQuil. The DayQuil did nothing unfortunately.
I kept the fluid in my ears for 2 months after that, thinking it’d eventually go away until I went to another physician (wish I went to an ENT specialist instead) and they told me the same thing basically, instead this time they told me to take OTC Zyrtec (allergy meds) because I had an allergic look up my nostrils. They also told me my fluid was probably solid-like/sticky or something and that a myringotomy (puncture ear drum and insert tube to drain out fluid) would be in the books for me if the allergy meds didn’t work.
Now it’s June, and my ENT appointment isn’t until the 25th of this month. So my question is, is a myringotomy absolutely necessary for me at this point or are there any home remedies or things I can do to help?
I really hope I don’t have to go through a surgical procedure because my insurance sucks and I don’t have the money for it, but if that is what I’ll have to do then I guess it is what it is. To anyone who’s done this procedure, how much does it cost typically?

My son has a dark line on his chest, I thought originally it was a bruise, but has been there for at least 3-4 weeks. He has 2 older siblings 3 and 7 and they are always rough housing I assumed he fell on a toy or something. I figured if it was a bruise it would be gone by now, but now it kind of looks like more are appearing. What is this? Pictures in comments below. We are currently switching primary care physicians due to an insurance change, and won't be able to get him in till August at the new DR. I'd really like to know if this is something I need to take him to the ER for. Thanks in advance.