#In good news I have two referrals and an appointment with different specialists to see what's wrong

[4rk-in-the-road]

Doctors are so funny. They'll be like "Hey you should stop doing this thing" and when I explain I'm doing that thing because otherwise I'd be dysfunctional they just give up lmao

[solitarelee]

Sol/Lee's One Stop Source For 'There Are Mushrooms Growing In My Skull' Updates

Hey guys, I'm briefly able to be upright and at the computer so I'm going to try and do a short little timeline of the past few weeks that I can just link to people. It'll be my temporary pinned post and I'll keep updating it, so check back here if you want the latest news.

Last Update 7:30pm 7/25

Current status: Pain briefly 12/10, back to 8/10, difficulty eating, difficulty sleeping, nauseous, severely dizzy, moderate to severe hearing loss, hole in both ear drums

TWs for: medical, hospital, medical malpractice, infection, fungus/parasite, suicide/suicidal ideation, body horror

The evening of Sunday, July 10th, I notice some tenderness in my right ear. I ignore it, assuming a scratch, and sleep with earplugs as usual. By the night of Monday, July 11th, the pain has worsened so I elect to go to urgent care the next day, presuming I have developed an ear infection.

Tuesday, July 12th, I go to the urgent care for the first time. My discomfort is minor, the doctor prescribes me antibiotic ear drops.

Thursday, July 14th, I return to the urgent care. My right ear is worsening and the infection has spread (I am corrected firmly that it has not "spread") to my left ear. I am concerned about the worsening symptoms but am told it's only been two days. The second nurse examines my ears and says that the right ear is an outer ear infection and the left is an inner, so I will need antibiotic pills on top of the ear drops, which I am to continue using.

Condition continues to worsen, however, I maintain course, cancelling my birthday plans and waiting for the meds to kick in. In the meantime, I am unable to sleep due to the pain, and haven't slept more than a few hours in a row since Sunday night. My jaw can't fully close and I am on a liquid diet. Near midnight July 19th, Tuesday, one week after initial appointment, I notice strange discharge. Against all good advise, I prod a q-tip gently into my ear. It comes back covered in black spores. Terrified, I check the other side. Black spores. Frantic and suspecting my ear infection is not bacterial but fungal, I make another appointment at an urgent care.

July 20th I go to see my third nurse practitioner, blackened q-tip in hand. I am concerned about the worsening symptoms but am told it's only been seven days. However, the nurse also seems concerned and does an exam. She says the blackness does not look like fungus, but like "some kind of black scabbing." She admits she's never seen a fungal infection, or this, before, and refers to me to an ENT, saying it's out of her league and I need to see a specialist right away. She takes a sample to send off for culture. She prescribes me a different kind of antibiotic ear drop to use in the meantime.

I immediately begin calling the recommended ENTs, however I am quickly informed that Medicaid does not accept referrals from urgent care and I need to see a primary care doctor in order to get a referral. At this point, I have what I believe to be wholly untreated fungus growing in my ears, and am getting frantic as both the pain and my psychological distress worsens. I call my primary's office and leave a message. They call back, and I explain the situation, however, the soonest appointment my primary has is August 1st, 12 days away. I explain the situation again and ask if she can just recommend me to an ENT without seeing me, based on the urgent care referral. I am told she cannot. Frantic and frustrated, I tell the clerk I'll just have to go to the ER instead. She hesitates, and then suggests I just see "any doctor" who can see me fast enough. I eagerly agree, having been under the impression due to previous experience that doctors at this particular practice have to have "new patient" appointments before they can see you for something like this. Mercifully, the clerk schedules me to see another doctor in the office the afternoon of the next day.

By this point the pain is excruciating, and I am unable to sleep or eat. My mother is now deeply concerned by all this and drives me to the doctor herself as I'm becoming delirious from pain, lack of food and lack of sleep, and am certainly in no condition to drive. July 21st, I arrive at the new doctor. I'm examined again; according to my appointment records both ear drums are fully obscured due to brown debris and thick white discharge. The doctor seems alarmed by the state of my ears. After leaving for a moment to look at some medical books, the doctor returns and tells me it looks like I have a fungal ear infection. She says it was likely exacerbated by the antibiotics and to stop them immediately and not start the new prescribed one (which wasn't ready due to several pharmacy delays). She tells me on no uncertain terms I need to see an ENT immediately to clean the debris and fungus out of the ear, and prescribes me antifungal ear drops. The medical assistant comes to me after a long wait and tells me that she's gotten me an August 16th appointment with an ENT, but knows it's not good enough and will continue trying, and call me when she finds something better. Thanking them both, I leave, get a bit of food, and head home.

The pharmacy informs us that they do not have the antifungal in stock and it will need to be mail ordered. That evening, the doctor's assistant (ilu Melissa) informs me she's gotten me an appointment on Monday morning with an ENT just over the state border that can accept my insurance anyway. (Finding doctors that take Unicare/Medicaid is a major struggle.)

Overnight Thursday, the pain continues to worsen. At this point it has been severe for days and is growing steadily worse. It feels like my head is full of glass shards, the pain is hot and burning and scratchy and stabby. I feel as though every canal in my head is full of acid and steel wool. The pain has spread into my throat and swallowing is becoming difficult to impossible. I briefly lose consciousness early in the morning, blacking out from the pain, and am relieved, praying that I'm either dying or entering a coma so I can escape the pain. I awaken later to even worse pain, and begin frantically calling every emergency room and pharmacy in the state, asking for help and trying to find anyone that has the drops in stock.

Around 8:30AM I make the decision to go to the ER, despite having been warned there's possibly not anything that they can do. I am afraid the fungus is in my throat as well and even if I get the ear drops, it will grow there untreated until Monday when I can go to the ENT. An increasingly frantic mother drives me to the ER on the morning of July 22nd.

I arrive at the ER slightly delirious from pain and lack of sleep. I'm checked in immediately as they have empty rooms (thank g-d) and am seen relatively quickly. The doctor is unable to tell if there's anything in my throat as he doesn't have a scope, I am informed that an ENT could tell and tell him that I have an ENT on Monday. He is relieved I managed to get in to see one so quickly. After discussing courses of action with me, we settle on giving me an oral antifungal to try and keep any possible infections from worsening before I can see the ENT.

Towards the end of the emergency room visit, the pain killers (I'd been on 600mg of ibuprofen + 500mg tylenol constantly for the past two weeks) I was on were wearing off, and I began to, for lack of a better word, "freak out," pushing and clawing at my ears as the pain worsened and worsened. I was, thank g-d, given narco (tylenol+hydrocodeine) for the pain and discharged.

Friday morning still, I stumble to the car and am driven home by my mother, who's Pretty Freaked Out as I slip in and out of consciousness, groaning in pain as I wait for the medication to kick in. Everything is a black and red, sharp haze full of barbed wire, and I hope again that I'm dying.

We manage to get me home and into bed. I lay stock still, gripping my mother's hand, as it makes the pain lessen. Slowly, the pain medicine begins to kick in, taking the sharpest edges off the pain. Some birthday presents from friends have arrived, lightening my mood somewhat, and mom manages to get me to eat. I pass out for a bit, and wake up to a call from the pharmacy. My meds are ready: all of them. I stay conscious long enough to tell my mother, and then pass out again immediately (probably thanks to the hydrocodeine lol). I wake up at 4pm to medicine, which I take immediately, and then pass back out.

At time of writing it's 5AM July 23rd. I've had two rounds of oral anti-fungals and two rounds of ear drop anti-fungals. The pain is still present but is slowly lessening. It's well below "kill me now, put me down like a tortured dog" levels, which I appreciate greatly. I've been able to stand up to get to the computer to type this. I still can't really hear out of either ear (the sound is muffled, more than when I'm wearing ear plugs. all I can hear is my own heartbeat). However, despite a bunch of pretty wild side effects (I cried for almost 18 hours straight, even while unconscious! it wasn't out of pain, the crying felt like relief), I am definitely improving, although I can't tell which medicine is doing it (it's probably all of them).

UPDATE 6PM July 23rd: I'm currently oozing a pretty insane amount out of my right ear. It is brown and disgusting but probably a good sign. It hurts more in that ear too, probably due to the oozing. Sometimes I wake up feeling pretty good and can move around, but within abt 30 minutes of activity I get very sleepy again. Think I'm continuing on the upward swing, though, and plan to just. Keep sleeping.

UPDATE 3:30AM July 24th: Currently in a rough patch because the ER doctor didn't actually give me enough pain meds to last til my doctor appt. They're every 4-6 hours; if I'd taken them every 4 I'd have run out halfway thru Saturday. Even taking them every 6, I'd run out Sunday night. It's frustrating to because there were 9 pills, you can tell he did the math to see exactly how few he could get away with giving me to "get me" to Monday. There are a lot of complicated reasons for this but they mostly come down to "legislated eugenics in the guise of fighting the 'opioid epidemic.'" So anyway I'm rationing out about 2.5 hours of agony between pills to make them stretch. I'm not very happy about it.

Anyway, in a lot of pain. Dizzy. My hearing is getting a lot worse, I can barely hear anyone anymore. Being temporarily hard of hearing is more annoying than genuinely inconvenient but it'd really suck if I had to go anywhere. I can hear inside my own head just fine so I think it's just be blocked. Did I mention I'm dizzy? So, so dizzy. Both ears expelling a lot of unpleasant brown liquid that I assume is that color bc it's dead fungus. If the doctor does clean out my ears Monday I feel like it's gonna be INSANE.

The horror of the situation has settled into an unreal sort of mundanity as the constant naps make a few days feel like a few weeks. My friends are making a lot of jokes, mostly about Resident Evil. Crow has named the infestation "Steve." I can feel it becoming just one more thing that's gone wrong with me. IDK what it says about me or my ability to cope that I can experience my biggest lifelong fear and wind up just tired about it within a few days. I guess if you almost die enough times, your brain becomes slippery to the trauma. If I try to think about the reality of it, my brain just turns into a completely smooth orb and it slips off to the side. I may be describing PTSD. Oh well.

UPDATE 4:30PM July 24th: The pain has definitely gone down in my ears. It's still present and stabby but it's getting more manageable, and just in time since I've been running out of pain pills. I think it might have been those pills that were making me so hungry, also, because now that I've been weaning off of them my appetite is shot and it's a struggle to eat again, which is worrying my mom. I'm going to try and make myself eat after I finish writing this.

My hearing is definitely getting worse, although I do hear some mysterious popping from inside my ears sometimes that is probably drainage or something. It is really hard to hear; if I'm talking or breathing or my stomach is gurgling I can't hear a damn thing coming in from the outside world. It's mostly annoying because I have to keep asking people to repeat themselves.

ENT is tomorrow morning, so the next update you guys see from me will probably have a lot of info. Pray for me or sacrifice a goat in my name or whatever it is yall do!

UPDATE 1PM July 25th: This'll be a long one so buckle up. It's also going to be kinda gross. There won't be a tl;dr but I'll try to emphasize important bits. So I went to the ENT. It was part of a huge complex and I was sent to the wrong building and had to hoof it half a mile to the right one, but it was fine other than wearing me out. The campus was very pretty and had good sidewalks, at least.

The ENT saw me basically instantaneously, took one look in the ears, and began to vacuum. Yes, vacuum. It was one of the single most bizarre and disturbing sensations of my life. I could feel liquid, yes, but also somewhat large chunks getting pulled out of my ears. Occasionally one would be too large for the vacuum and she'd have to pause to de-clog. As I expected, it wasn't exactly a one stop fix, but it was able to clear things out enough for us to at least see a bit more of what was up.

Some of it's what we already know: I have a pretty severe fungal infection. It is in there. They have set up a home base in my skull and it's going to be a long process to get them out, anti-fungals and weekly vacuuming for as long as it takes, which will probably be a while. I personally expect to be at this for at least a month.

Bad news: I have a brand new hole in my left eardrum. At some point during the infection, it ruptured (no wonder I was in such intense pain). That could (and probably already has) lead to complications such as the fungus spreading places we really would rather it not go. We'll be monitoring it closely, and I'm following up with my primary (or rather, Dr. James, since she knows what's up already) to see what I can do to keep an eye on potential infections in my sinuses, nose, or like, yknow. Blood, bones, and brain. Ideally it won't come to that. Ideally, the rupture will heal on its own, but for right now all we can do is keep an eye on it. Once the infection is fully gone, then we can talk options.

My ears are wild due to the amount that was sucked out and the amount that's still in. Things are lose in there and shifting around and blockages are changing sides and one side is clearing and then clogging and the other is clogging then clearing. It'll probably only continue to be weird as I continue to treat it with anti-fungals that will kill and knock more loose. The end result is that I'm very off-balance and extremely disoriented, unable to tell what direction any sounds are coming from.

So I guess I do have a tl;dr for you: tl;dr, I still have fungus in my head and I will probably for a while yet. I'll keep updating this post, maybe not daily, but regularly, whenever there's an update. Honestly I think it will do me good to have a place to organize my thoughts, although after this I'll start doing updates in a reblog instead of just making this top post longer and longer.

This has been a pretty traumatic experience for me, just due to it being one of my personal biggest fears, and also just the ongoing anxiety of not knowing the answers to big questions like "will my hearing come back fully" and "are there any mushrooms in very important places." I appreciate the support, and some ongoing gentleness as I continue to deal with this while also starting school back up and stuff.

[bugbyte]

Bug gets an hEDS diagnosis

So it's been a minute since I've talked about ongoing health stuff, but I learned some new things this week and I'm posting because it's possible this will help somebody else on the path of "I think I have EDS, what do I do about it?" Throwing this under a read more because it's probably going to be pretty long.

For clarity, I'm located in the US, so depending on where you are, your version of this process may be different. Also, obviously, none of this is meant as medical advice because I am not a doctor, this is just a rough retelling of what I've experienced because it is a long, frustrating process, and when I started I had no idea what I was getting into. It would have helped me a lot to read a personal account of what it's like to go through this, and I hope this can help someone else in the same position maybe.

Also, if this is you, don't give up. It is long and frustrating and hard, and not always easily accessible, but if you can, I have found it worth pursuing the diagnosis. I have so many more options to help me now than I did when I started.

So: after a year and a half of constant doctors appointments and tests and various kinds of therapy and other nightmares, I've finally got an actual official diagnosis. Like I (and several doctors) thought from the beginning, I have Ehlers-Danlos Syndrome, type 3 aka hypermobile Ehlers-Danlos aka hEDS. There are 13 subtypes of EDS that affect different types of connective tissue; type 3 is the most common, but is also the one type we do not know the gene for yet. (Although there is promising research happening currently and we might find the gene!)

The first step was explaining to my primary doctor the kind of issues that I have and just flat out stating that I've read about EDS, and it sounds absolutely strikingly like my lived experience. I emphasized that my joint pain and dislocations were impacting my quality of life and ability to work. She agreed, and referred me out to two other specialists: a physical medicine doctor, and a geneticist.

It then took about six months to get in to see the physical medicine doc, because every specialist under the sun is booked out until forever. You may have better or worse luck with this, but from what I've heard, wait times are awful everywhere. I was also sent for an echocardiogram, which is where they smear goop on your chest like an ultrasound and look at the size and shape of your heart. EDS can cause your heart tissue to stretch and potentially tear, which is bad for obvious reasons.

This doc (lucky for me) had a bunch of previous patients with EDS, and has slowly grown to pick up more over the years, which was really good news because it was easy to show and explain my problems. They set me up with physical therapy, some meds to try for the pain, referrals to a cardiologist, and sent a note to genetics to try and help expedite that process. (Spoiler: it did not help.)

At this point I should drop in this link, because there are a heap of good resources here that helped me a lot:

This person made several documents you can fill in the blanks on with your own information, which helps a) you understand what EDS is, b) explain EDS to doctors who don't know anything about it (more common than you'd think) and c) organize all the relevant information you need for appointments, bringing it up with your primary, and so forth. I discovered this a bit into my journey and it was so helpful.

Additionally, the EDS Society has a lot of information and printable stuff for taking to your doctor or other people who might need education.

Okay, link tangent over.

I spent the time from December 2021 through maybe May or June of 2022 in PT, which didn't go well because my health has deteriorated pretty badly. My joint pain was severe and out of control, and I dislocated my shoulder 3 times in PT. I also learned from a cardiologist during this time that I also have POTS syndrome, which tends to be comorbid with EDS. Basically: I stand up, all my blood goes to my feet, I get dizzy and have no stamina for walking any kind of distance. This, also, made PT very difficult because I had a really hard time doing any of the exercises without feeling like I was going to collapse. But PT is the standard treatment for EDS to strengthen the muscles around your joints so the work is distributed between them better and the pain is less over time. I'm hoping to get back to this.

So: if you're going through the diagnosis process, you might have to do PT for a while, and probably see a cardiologist.

Finally, after originally seeing my primary and getting a referral to genetics in spring of 2021, I got to see a geneticist in fall of 2023. It turns out that this is because there is only one geneticist in my state who deals with EDS, so the wait times are accordingly long. But: it was worth the wait. We tested for a whole spectrum of connective tissue disorders, to rule everything out, and I got so much information.

If you are waiting on a genetics appointment, it's worthwhile to use that time to try and gather as much family history as you can. Anything unusual neurologically, heart-wise, etc., among your siblings, parents, grandparents, if you can get that information. Even if you can't, they will still be able to help you. But it's very useful to have. It's also helpful to have a timeline for yourself: when did you start noticing your symptoms? Did you have any weird injuries? Were you weirdly flexible as a kid? Stuff like that.

Understandably, some people have different feelings on genetic testing, and it's all valid. For me, I just wanted an answer, because basically every doctor throughout my childhood and younger adulthood dismissed me when I brought up stuff that ended up being signs of EDS. I felt really vindicated by getting an answer, even if that answer means I have a lifelong illness. It just means I now have a toolkit to help it and work around it.

So, between meeting with genetics for the first time, and getting the test several weeks later, waiting for results, and finally making an appointment for a final diagnosis, took about 6 months. A lot of this was due to scheduling (again) and insurance causing a fuss because they do not like to pay for genetic testing.

Anyway, as I mentioned earlier, hEDS can't be tested for genetically (yet) but is also the most common type. So how do they diagnose it? You need a qualified geneticist to rule out other illnesses, and then they visually do some tests and ask a lot of questions. (The technical term is "clinical diagnosis.") You'll have to do something called a Beighton scale, which is a series of tests of flexibility on your thumbs, fingers, elbows, knees, and other joints. It's not difficult, and you can stop if your joints are in pain. (I also found that basically every doctor and physical therapist I saw through the year wanted me to do parts of this test for them, and they all said "yep, you're probably getting that diagnosis." So I guess I should have been more prepared to perform on command, or something.) Between my Beighton score, family history, and personal history, my geneticist determined that I fit the diagnosis to a T.

Really, this last genetics appointment was like sitting and listening to someone narrate the details of my entire life to me. So many little things I hadn't even mentioned in previous appointments came up, and I have so much more understanding of why my body is how it is. They confirmed that one of the best pain relief methods for EDS patients is cannabis, which I've been using for a month and change, and has truly made a difference in how functional I can be. I now have more ideas on what I can do to help reduce the pain I'm feeling through physical activity and other means, and diet, and so on. It will never be 100% better, and I can accept that. I can work with this.

So, essentially, it's an endurance game. I was frustrated, in pain, tired, and overwhelmed for the better part of a year. I cried a lot. I felt like no one would help me, but what I really needed was answers and information. I'm lucky to have family support cheering me on through the process, because more than once I just wanted to give up and never see another doctor again. But, knowing what I do now, I have the information I need to improve my life, and that is a lot.

It can be hard and scary and really, really frustrating, but don't give up. Your life can get better. You just have to be persistent, and if you've made it this far with pain and joints like these, you already have the persistence to do it. 💖

If this has helped you at all, and you want to help me out in return, I have a ko-fi page for tips and shop, but please take care of yourself first!

[discoveringthebible]

On Patience and Endurance

James 1:2-5, New Living Translation

2: Dear brothers and sisters, when troubles of any kind come your way, consider it an opportunity for great joy. 3: For you know that when your faith is tested, your endurance has a chance to grow. 4: So let it grow, for when your endurance is fully developed, you will be perfect, and complete, needing nothing.

5: If you need wisdom, ask our generous God, and he will give it to you. He will not rebuke you for asking. 

Galatians 5:22-23, New Living Translation

22: But the Holy Spirit produces this kind of fruit in our lives: love, joy, peace, patience, kindness, goodness, faithfulness, 23: gentleness, and self-control. There is no law against these things!

Hebrews 12:1-2, New Living Translation

1: Therefore, since we are surrounded by such a huge crowd of witnesses to the life of faith, let us strip off every weight that slows us down, especially the sin that so easily trips us up. And let us run with endurance the race God has set before us. 2: We do this by keeping our eyes on Jesus, the champion who initiates and perfects our faith. because of the joy awaiting him, he endured the cross, disregarding its shame. Now  he is seated in the place of honor beside God’s throne.

I have gone through a considerable amount of crap since Thanksgiving day. And I’m going to admit, my patience and endurance is wearing quite thin. I broke down and cried today and I may do it again later.

Here is a quick list of everything that I have been going through:

- Thanksgiving night received a call that my great aunt Bev was terminally ill (today is actually her birthday)

- Sunday after Thanksgiving Auntie Bev passed away

- Mid December received a call that my mom’s sister, Rose was terminally ill. The next day she passed away. Found out later she had been in the hospital since Thanksgiving and never knew. 

- Early January found out that my dad’s uncle, great-uncle Wade had passed away from severe health complications. 

-Because of severe weather, we were not able to attend Uncle Wade’s funeral, and ended up being pretty much the only family not there. (I am glad everyone had made it safe)

- In February, I was able to see a hip specialist for a hip condition. I waited 1 year to see this hip doctor. During his examination, I became injured and he believed I had a tear in my hip, but was told I could work on it.

-I worked on my hip for about 6 weeks, with debilitating pain. I had xrays and MRIs and then he immediately placed me on 12 week disability with my job because my hip was in much worse shape than he originally believed it to be. 

-I requested to have a second opinion by a surgeon, because the hip doctor wanted to “band aid” the situation, I wanted a reasonable solution. Physical therapy and pain injections would not fix my problem. 

-First hip surgeon called me 2 days before my appointment at the end of April and said my case was too complicated for him and he would not see me as a patient. 

-Because of the second opinion, the first doctor dropped me as a patient, before filling out the disability paperwork I needed for my job and for the state so I could get money while I was out of work. 

-I was removed from my two ministries because of a difference in theology with the Church of the Nazarene. 

-I left my church and I left the Church of the Nazarene. 

-Had to make an  appointment with my doctor to get disability paperwork and new referral. My doctor filled out paperwork for disability for my job and the state.

-Third referral for my hip was denied in mid May. I cannot even remember the reason.

-I found a new church and a new church denomination to worship in. 

-Fourth referral for my hip was denied in the beginning of June because they were full, they could not accept new patients. They didn’t have many doctors who could even see me because of my unique case. 

-Got off the phone today with the new referral. Turns out they will not see me because of the type of insurance I have. 

-I have an appointment on Monday with my doctor to do a new referral (again) and to hopefully extend my disability. My work will not allow me to return until I am cleared to work because of the possibility of injuring myself while on the job. 

Right now, I am holding onto hope. I know that all this crap is temporary. And I have felt God in every step of the way, but I am also tired. I am tired of fighting to get the aid that I need to get better. I am currently using a cane to help me walk. I cannot walk far and I cannot do what I used to be able to do at the beginning of the year. 

Until today, there was something I had read a lot in the Bible, but I didn’t fully understand, but now I do because I am in the middle of many, many trials. (Especially Verse 4, I am seeing in a new light)

Romans 5:1-5, New Living Translation

1: Therefore, since we have been made right in God’s sight by faith, we have peace with God because of what Jesus Christ our Lord has done for us. 2: Because of our faith, Christ has brought us into this place of undeserved privilege where we now stand, and we confidently and joyfully look forward to sharing God’s glory. 

3: We can rejoice, too, when we run into problems and trials, for we know that they help us develop endurance. 4: And endurance develops strength of character, and character strengthens our confident hope of salvation. 5: And this hope will not lead to disappointment. For we know how dearly God loves us, because he has given us the Holy Spirit to fill our hearts with his love. 

If you are struggling, like I am, with everything seemingly going wrong, hold on to hope. God is with us every step of the way. This is something that I am absolutely sure of. And this struggling, this pain, these problems are temporary. They will end. 

Peace, Love and Blessings

Cody Marie

[flowercrowncrip]

I want to talk about trans healthcare in England, and how it's particularly fucked if you're disabled. I think TERFS and their "think of the poor disabled girls" retorique around trans men have a lot to do with this. My ongoing top surgery saga is a pretty good example of what it's like being a disabled person seeking surgery.

My first top surgery was cancelled 4 days before it was due to happen in 2017. It was cancelled purely because I use a wheelchair. They were totally fine with me using crutches and having conditions that actually impact surgery, but using a wheelchair for a different condition was a step too far. My specialists (experts in my condition) didn't see a medical problem with me having top surgery, but my GIC doctor, (who saw the word wheelchair and googled my new condition for all of ten minutes) panicked.

I fought that clinic for three years. It got silly. Here are some real things a qualified GIC doctor told me:

"maybe you're not trans, and you're just sad you can't walk" (I became totally unable to walk age 18, and transitioned when I was 15... I'll let you do the maths)

The Daily Mail will write mean things about us they find out we let you, a poor disabled little girl trans man, have surgery (because apparently right wing newspapers are the definitive authority on trans healthcare /s)

Although my diagnosed mental health problems weren't an issue for them before I started using a wheelchair, simply being a wheelchair user and wanting top surgery was a symptom of a mental health problem so severe it alone disqualified me from surgery. This was because:

being okay with the truly microscopic chance surgery would make my disability worse is apparently "irrational", and shows a disregard for personal safety (it doesn't)

I, a person with experience of both, said that for me crushing dysphoria is a worse experience than getting round in a chair with wheels on it. And having different priorities than the ones my cis, abled doctor expected was somehow "alexithymia" because if I don't know that using a wheelchair is the worst thing that can happen short of dying, I must be totally unable to recognise my emotions (clearly bullshit).

You, a twenty one year old adult, need to bring your parents to your appointments so we can explain to them how unreasonable you're being. (Suspiciously close to TERF arguments about the age of capacity)

In the end I caused a massive schism in my GIC. The psychologists agreed that wanting top surgery while being disabled isn't a mental illness, that I had clear capacity to consent, understood the risks and benefits and that ultimately if I said I needed surgery, I should have it. The medical doctors (the ones that sign the referral) disagreed on every point. It got heated between them towards the end.

The head psychologist realised I was never going to get surgery if I stayed with that GIC, and that would obviously fuck up my mental health, so she wrote a letter to literally every GIC in England asking if they'd take me as a patient. Only one (out of like 7) agreed to take my case.

So I'm now with a new GIC. They're so far way better than the last one, but the bar is low. They re-referred me for surgery pretty much straight away, trusting that I obviously had a better insight into how my disability and my transness affect me than anyone else.

Unfortunately the surgeon they referred me to turned me down (for genuine reasons this time). Basically in the time wasted arguing with my GIC I developed a few new conditions that will actually have an impact on surgery and we've agreed that when I have surgery there has to be an intensive care bed available just in case. (To be clear, this was not the case when my first surgery was cancelled or for the majority of the fight with my previous GIC). Now I'm being referred (referral number three) to one of only two hospitals in the country that do top surgery have access to an intensive care bed

So despite having a date for my top surgery in 2017, I'm still waiting on it because doctors are transphobic, misogynistic and ableist with awful consequences.

[sapphicautistic]

every dr appointment I have I gain a new specialist or two, they’re like hydra heads, I keep thinking surely I’ve collected all the specialists I could possibly need and then I go to an appointment with another one and she’s like oh also I’m gonna refer you to Y and Z because you really need to get that addressed.

Honestly though I’m really loving being in the [redacted] system though because every doctor I’ve seen has been extremely competent and they share notes with each other and when they make a referral it’s easy to do cuz they’re all connected and my insurance is always already on file and everything.

I saw a new neurologist today and she continued the pattern of doctors expressing horror at things my doctors in Iowa really should/should not have done. I’m a little shocked at how seriously she took my pain and at the lengths she’s willing to go to to deal with it.

She said if a headache lasts a whole day I’m to use this new rescue med she’s prescribing, on day 2 I can take it again, and if the headache goes into day 3 I’m to contact her immediately and she’ll prescribe something else that day to end that particular headache.

Which like... I have to consciously pay attention to see whether I have a headache most of the time because I’m so dissociated from it I don’t notice unless something makes me think about it or unless it gets so bad it makes it hard to do stuff. I have headaches most of the time.

She said she is gonna try to get me down to 0 to 1 headache days per month and it was all I could do not to laugh at her because that seems insane. I thought I’ve been doing good that it’s like 24ish now with the meds I’m on!!

She’s prescribed me a bunch of new stuff and I passed on the q from my rheumatologist if it’s ok to go up on the nortryptyline (apparently it helps with fibro too?) and she upped it immediately. She said if I don’t like the new stuff to message her and she’ll get me in for botox next month. (I was on botox in IA and it did help some but she thinks this stuff will help more)

She had to rearrange her schedule to even get me in for a video visit next month, and in-person appointments are out to the end of September, but she was like very intense and said if I want the botox she will find a way to squeeze me in. I have NEVER had a dr that dedicated!

OH and also she seems to think my headaches are like. A very bad case? Even though I told her I don’t have vision issues with it and my nausea could be from another of my chronic illnesses. She didn’t even ask how severe they were, she was horrified that I have them like most of the time and I guess that was enough to think this is very bad?

I just keep being shocked every time I go to an appointment and the doctor takes me seriously and believes that my suffering is a problem worth attempting to solve. It’s so so different to what I was dealing with back in IA and I’m so fucking glad I moved here.

[lastoneout]

So my doctors appointment went kinda meh?

She did give me the referral I needed for the eye place I'm going to on Friday who will likely be doing the MRI I need to figure out whats up with my brain, or at least rule out a tumor anyway. And she also referred me to a new rheumatologist which is nice cuz the old one never really listened to me and talked super fast and diagnosed me in like 2 seconds which sucked. She also prescribed me a beta blocker to help with my rapid heart rate and slightly elevated blood pressure, which will also hopefully help my anxiety and manage my migraines better, which is also nice.

But she kinda wasn't really listening to me either. I told her that two doctors have recommended that I be evaluated for MS, and another one(the physical therapist that SHE referred me to) says I should be evaluated for EDS, but she was kinda squirrely about it and said that "zeroing in on a specific diagnosis doesn't make sense at this stage" which was like?? What?? If I have MS or EDS or POTS isn't it good to start at least ruling other things out, because if I have any of those, especially fucking MS, I need to know soon so I can get treatment before things progress to far??

She also gave me the "well you aren't very active" speech when I brought up my heart rate even tho I told her that I would LOVE to be more active, but one my more sedentary lifestyle is due to my debilitating chronic pain and migraines, and two I dont think me being lazy can cause me to go from 94bpm to fucking 125bpm when all I did was stand up. She also said that "well it could be caused by anxiety" even tho I repeatedly stressed that my anxiety meds have never helped my heart rate and this happens no matter how anxious I feel. I mean at least a beta blocker is supposed to help with the migraines and anxiety and is a treatment for POTS, but I def feel like she's just throwing pills at me to make me go away.

And thankfully she did refer me to a new rheumatologist because she said that MS and EDS are autoimmune conditions and so that type of specialist would be the one to evaluate me for them. So hopefully I can get that doctor to fucking listen to me about whats going wrong. I was also kinda miffed cuz she kept asking me if I've ever dislocated a joint or if my skin is really soft and tears easily when I know for a fact not all types of EDS have those symptoms, on top of the fact a friend who has EDS and studies this stuff said that you can repeatedly dislocate joints without ever noticing it with EDS. My primary also didn't listen when I told her I have a family history of hyper mobility so that was fun.

I really would have liked to be referred to a cardiologist or a neurologist but maybe if another specialist reccomends that I can get it in writing and she'll actually do it. Cuz I def think I'm going to have to be incredibly insistent on both getting a physical, paper copy of my files and that the specialists send my chart over to my primary as soon as possible. Cuz yeah I really don't think she's gonna listen to me unless I have written instructions from another doctor.

Oh she also told me to monitor my blood pressure cuz there can be interactions between my Adderall an my beta blocker but then like didn't tell me what the readings I need to look out for are. So that was fun. Gonna call them today and be like "um hello wtf are good or bad blood pressure readings??" Plus my heart rate is actually still spiking when I stand, but its more from 86bpm to 96bpm so that not as bad I guess.

So yeah, good and bad I guess. I'm honestly probably gonna find a different primary at some point, but for now I'm kinda stuck with her cuz my insurance won't pay for the ophthalmologist I'm seeing if my primary didn't refer me and she's my primary. But I'm also gonna call a physical therapist my friend knows who specializes in EDS and see if he can help either with the pain or just with getting either my primary or my rheumatologist to fucking listen to me about all this.

[informationsorter]

How can I find a therapist?

I cannot stress enough how useful a therapist is when dealing with such serious issues as DID/OSDD and trauma. I’m afraid there is no sure-fire way to find the perfect mental health professional the first time. But it's ok, don't stress too much. You don't have to stay with the first therapist you try. If you don't feel they are right for you, you can ask to see a different therapist, and even ask them for a referral to one who is better suited. It's also possible that a therapist you see will not feel that they are experienced of skilled enough to provide adequate treatment for you, in which case they should offer you a referral to someone better suited, or at least tell you what type of therapist to look for. This happened with me, I saw a new therapist for two sessions, and on the third I brought up that I didn't think she was the right therapist for me. She said she felt the same, and that she wanted to see if I was willing to see a colleague of hers who specialised in childhood trauma. A good therapist will do their job, and part of their job is making sure you are placed with the most suitable therapist possible. Healthline.com has 9 detailed tips for finding the right therapist, please click the link to see the full details. Here is an overview of their list: 1. Consult your provider directory 2. Ask someone you trust 3. Use a reliable online database 4. Explore local resources 5. Reach out to organizations that address your area of concern 6. Think about your goals ahead of time 7. Try an online therapy app 8. Ask questions about the things that matter to you 9. Pay close attention to your own responses

The basic gist of the list is to figure out what you need, before you start searching. Do you need a therapist who is covered by your insurance? What are your biggest issues, and what sort of therapist deals with those issues? - In the case of DID/OSDD you’re probably looking for a psychotherapist who specialises in, or has experience with, dissociative disorders. A childhood trauma specialist may be a very good option if you cannot find a dissociation specialist, or if you are unsure of whether you need a dissociative disorder specialist. What are your goals? (Are you desperately in need of immediate help in your day to day living skills? Are you in a safe and stable life situation, but you want to process traumatic flashbacks? Is the DID/OSDD on the backburner and you want to concentrate on a comorbid disorder? etc) Do you need your therapist to be a specific gender? Are you ok with long distance video sessions, or do you need in-person appointments? How much external support do you need from your therapist? (Are you the type who needs to send emails outside of sessions so that you ensure an important issue gets dealt with?) Defining these things will help you narrow down your search. Best of luck.

[xseildnasterces]

resentment.

Another week, another nap, another day I wish was over and I could be in bed sleeping. That, I think, it my current weekly cycle. Right now, the weather is beautiful, and I am really hoping I can pull together the motivation to actually go out this weekend and do something. Yesterday I went to see a dermatologist for the very first time ever, and it felt good! As much as it should not be the case, private healthcare does seem to be much more thorough than public healthcare. I do not believe it should be this way, and I am also certainly not advocating for healthcare in the UK to be sold off to private companies. All I am saying, is when budget is not an issue, like it is for the NHS, healthcare can be very different. I acknowledge that I am very lucky to work for an institution that provides us with incredibly good health insurance, which of course we pay for out of our salaries, but all the same, it is very good health insurance and includes a lot. I honestly do not understand how people cope living here without health insurance – well I guess I answered my own question there, they don’t.

 Anyway, as soon as the dermatologist realised that I was English the first thing she asked me was whether I watched the Harry and Meghan palaver. Of course, I had, so we chatted a little about that before actually moving onto what I was there for. She took one look at my skin, which I must admit looked better than it had in ages (typical), and she said she knew what I needed and that she could definitely help and improve my skin. I felt so relieved. I have tried so many things, both prescribed and other topical skincare and nothing has helped even a little, so I felt incredibly relived. We discussed my skin care routine, and the possible side effects of taking the medication I have been prescribed. I will go back in three months to check how things are going and she also said it could take that long to noticeably work. We talked about my other medical issues and as I expected we addressed how PCOS certainly made hormonal cystic acne worse. I have been provided with medication that is only for women and is specifically for hormonal cystic acne, which is why she said it should definitely work for me. Whilst I was there she asked what I was taking for my PCOS and I said I had never been prescribed anything before other than birth control when I was in the UK (which was not good for me). She urged me to set up an appointment with a gynaecologist to address my PCOS because she said it would be very beneficial for me to have that checked on and dealt with on a regular basis. Of course, I was diagnosed with PCOS almost ten years ago, so it’s perhaps a little late in the day to prevent any damage, but it will certainly be good to have it monitored. My insurance also allows me to set up appointments with specialists without referrals from my GP which is wonderful! I now have a dermatologist, an OBGYN, my usual GP and a gastroenterologist. Who knew I would have my own entourage of doctors and specialists? At least I feel like I am being well looked after. I have annual checks on everything and so far, all is good. I feel glad to have this amount of care. I now just need to get myself a dentist, optician, and orthodontist and then that’s the health stuff all out of the way! Along with the medication, I have also been given a medicated topical cream which I am super scared to use. I am so nervous with anything like this considering the ridiculous allergic reactions that I have had in the past. Tonight, is my first night starting both… so lets see how it goes.

 I got upset last night. Yesterday I had my usual weekly meeting with my boss and without going into all the details of it, she made a comment about how she doesn’t want me going home any time soon and how she needs me in the office. I wasn’t even suggesting going home any time soon, nor did I intend to, but as soon as she said I couldn’t, all I wanted to do was run and get on a plane. I felt really upset and sad about it and ended up crying later on once I was in bed. I expressed that my sister would be home in a week and I had not seen her in two years so I fully intend on heading home for a while during summer. As soon as I said that her mood changed and she was super pissed off with me. It’s so frustrating. I have quite a lot of leave to take yet my boss is basically telling me that I cannot take it because she knows I will have to quarantine when I get back. It’s incredibly annoying and upsetting. My intention was to head home for a short while perhaps in May or June, most likely June, but now I feel like I will not have my leave approved. If that is the case I will certainly end up having another breakdown and end up crying down the phone. By June it will be six months that I have not seen anyone, so I cannot cope with not seeing any of my family and friends for longer than that, and personally I don’t think my boss should expect me to. It’s annoying that I am literally the only person at work who lives alone and is living here without any family members, so when other people are allowed to go wherever they want and I can’t its very stressful. I took is badly last night and was very upset, but I woke up this morning feeling a little better about it. I will be going home at some point this summer whether my boss likes it or not. I’m just not quite sure how I will be able to wing it.

 I had therapy today and I had a really good session. We discussed my recent realisation and some of the regrets in my life. We talked about the progress that I had made over my time in therapy so far and how much I have developed. It made me feel good. I think I am starting to recognise and accept things about myself that I hadn’t before and although there is still work to do I feel better for it. I feel that I am no longer undergoing a fight in my head on a daily basis, nor am I constantly terrorising myself over things that I cannot change or do anything about. I know this is not permanent and I am not silly enough to think I will always feel this way. My struggles will come back, of course they will, but right now I feel more content with what is going on in my head, and that is certainly a bonus. We also discussed ‘someone I used to know’. We talked about feelings. We talked about the ‘magnetic pull’ I have always felt from them and how no matter what has happened I still feel that pull. We talked about what it was about this person that created that pulling effect and how to address and deal with that. We also talked a lot of about my feelings towards that person, both the good and bad and how things had changed for me since certain things occurred that I never believed would, and I learnt more about the person that I felt I knew pretty much everything about. It was a good session though and I felt that I was growing even during it. These are topics I have avoided a lot and it was the first time that I really opened up about my real and honest feelings towards this person in detail, and it felt like walls were really beginning to fall for me surrounding that topic in regards to discussing it.

 I also sliced my thumb open at work. Do not let anyone tell you that there are no risks associated with being an archivist. I promise you, there are many. Today I was working with a super old file that had a small metal closure. As I was trying to release the papers from the metal closure, it slipped from my hand and ran all the way along my thumb cutting right down into it. Now, I hate blood, and my god, there was blood. I was dripping all over the floor and I couldn’t find any tissues or anything to stop the blood so I just grabbed an old cardigan and wrapped my hand in it whilst I ran through to another of the girls in the office to see if she had a plaster. She didn’t, and we spent the next ten minutes running through all the offices to find a plaster or first aid kit. When we did find a first aid kit it was empty… fabulous. We eventually found a plaster in someone’s drawer and I cleaned my thumb and put it on. Before I had even made it back to my office the plaster was completing sodden with blood and it was dripping again. It’s a wonder I didn’t faint. I pulled the plaster back off, with my blood splattering all over some documents on my desk – thankfully not the old records! And I made a makeshift bandage out of tissue and tape. Thankfully it lasted until I got home where I could properly wash and dress the cut properly. It is still incredibly painful, but it has finally stopped bleeding – so that’s something.

  I am currently IN LOVE with the new ADTR album. I cannot stop listening to it, all day, at work, at home, whilst cooking, whilst walking. It is absolutely amazing. I think it’s just what I needed right now. I’ve really been into listening to Kerrang! radio again recently and after a weekend of female fronted metal bands and emo playlists, I am just loving this album. I would even go as far as saying it might actually be my favourite album from ADTR. I just adore every single song. ADTR really do make me think of Download. They are such a good festival band and so many songs of theirs are major crowd sing-a-longs. I’m so unreliable sad that I have to wait over a year to be in a field with a bunch of people singing our hearts out and dancing to our hearts content, but god damn, Download 2022 is going to be SOMETHING. And I cannot bloody wait.

[princessneleam]

hey! i just read that narcolepsy post and it mirrors my experiences scarily well. who would i talk to about looking into diagnosis and/or treatment? and what ways do you cope with your narcolepsy? my insomnia in particular is very disruptive to my life.

Hello! First off, I'm sorry you are struggling with severe insomnia because it can be debilitating.

My answers are based off my experience in the US, so keep that in mind if you are elsewhere. First, what I would do is do some research of sleep specialists in your area to see reviews as well as cross reference who is covered by your insurance. Take what you learn to your primary care physician (pcp) and ask for a referral to that specialist. There will likely be a wait of a few months, this is a long process.

When you see a specialist, if you can bring a family member or friend to assist as an advocate/witness, I highly recommend, it can often make doctors act different and give you better help. The advocate just needs to be in the room but can also second what you are saying, take notes, and speak up if the doctor does try to brush off something you say. Bring a written list of symptoms to your appointment with the specialist. Ask for a sleep study. If they don't want to do a sleep study or tell you your insomnia is caused by depression/mental health issues, go back to your pcp and ask for a referral to a new specialist.

For my sleep study, I did an overnight one where I needed a minimum number of hours of sleep during it for it to count or else I'd need to repeat it at a later date. I then did a day study where they had me lay down for thirty minutes every two hours to see if/how I would nap.

During the follow up I had to describe my experience to my doctor because the techs marked me as awake when I felt like I had fallen asleep during the naps, and that affected my diagnosis.

So now you have a diagnosis... medication time... stimulants can help you stay awake during the day, I had mixed results with them. Battling insurance is the toughest part of getting medicated. Most sleep specialists who handle narcolepsy are well versed in dealing with the insurance company and Jazz pharmaceuticals is very good at navigating the system. GHB has about a 50% success rate for narcolepsy. It helps your body get proper sleep over night. The medication is mostly how I deal with my narcolepsy. I am on disability for a combination of illnesses, so I kind of just adjust my schedule each day based on how I've slept and my level of cognitive functioning. This is incredibly frustrating, and does affer setting a regular schedule or habits. If I can't sleep, I read or do whatever I feel like, and then sleep when I can. It is a struggle, and some days are easier than others.

I hope that helps and answers your question.

[pushsilica29]

13 College Essay Examples From High-25 Universities (2022-2022) - Shemmassian Educational Consulting

My bedroom was far enough from my parents so as not to disturb them, but house to apply became a difficulty with my brother as a result of, properly, we shared a room. My parents are aerospace engineers, humble whilst their work helps our society discover new frontiers. Upon strolling to the following row of hollowed cavities, we were not contemplating the lengthy work that lay forward, however fairly, we sought to liberate the helpless lettuces, imprisoned in produce cartons that have been too small for them to develop in. To do the necessary work to change things. I couldn’t change key without my voice cracking as I switched to a head voice. I told her I couldn’t focus or keep monitor of all my materials for classes. I don’t actively give attention to focusing, however rather I observe myself internally digest the week’s events. “You don’t need to show anything to me. It was vital for me to be taught you don’t should all the time get every part proper the first time and that good issues include continuous effort. At my subsequent doctor’s appointment my mother mentioned that I had a learning problem, but the physician shook his head and said that I didn’t appear to have ADHD. Armed with information, we went to a brand new physician, and earlier than my mother could insist that we get testing or get referred to a specialist, the physician handed us a signed referral. My mother took off from her grocery store job to take me to 2 extra appointments to ask about ADHD, the term the doctor had used, but different doctors weren't willing to listen. Not like my “patriotic” peers, I used to be much less upset by her refusal to face up for the pledge of allegiance and extra upset that she didn’t share with me that she was hurting and what she was going to do to protest how she was treated due to her beliefs and the color of her pores and skin. Everyone in it to study to be a extra inclusive area for everyone. Although many see gardening as tedious busywork, I find it meditative, as I lose monitor of time whereas combining peat moss and soil within the garden’s compost mixer. I met Brian, a detailed friend of mine who also basks within the tranquility of nature, by my gardening endeavors. My love for gardening started when i moved to Georgia throughout my sophomore 12 months. Previously year two different clubs of its kind started at different local schools. In the yr that I’ve been working with him, I’ve watched him revel in planting, nurturing, and finally harvesting his veggies, particularly the grape tomatoes, which we get pleasure from eating contemporary off the vine! Within the time I’ve spent learning the way to backyard, I’ve developed an affinity for watching my vegetables develop to maturity, desperate to be harvested and sold at the Saturday market. By the point we obtained to middle school it was clear that my older brother most well-liked quiet, indoor activities, whereas I used to be a born performer who preferred the theatrical, even when off stage. While we aren’t ready to communicate verbally, we converse the language of earth, water, peat, and seedlings. After a racist alternate with a student who insulted her and refused to take a seat at the identical lunch desk, my best buddy, who was Muslim, did not stand for the pledge of allegiance in homeroom the following day. As 美国论文代写 , she seemed round on the walls lined in sticky notes, the index playing cards scattered on the computer desk, the sofa, the desk, and she mentioned, “How are your friends managing it? After rubbing the gritty soil off of my arms, I checked out Brian, a co-volunteer and nonverbal 20-12 months-old with autism, who extended his arm for a excessive-5. I held my breath as my regular hands gently nestled the crumbly roots of the lettuce plant into the soil trench that I shoveled moments earlier than. These are the phrases Brian taught me. That is what they taught me. I felt ashamed. It didn’t even occur to me to seek to know what was behind her determination in the primary place. It was troublesome at first. To the chagrin of my parents, we simply didn’t get along. I didn’t thoughts having a tense relationship with my brother as a result of I was concerned at school. My highschool wasn’t various by any requirements. This scholar was accepted to the University of Pennsylvania. This can be a school essay that labored for Washington University in St. Louis (WashU). What she wanted from me was to take a stand.

[claudeetenalson]

Financial Advice: Rebuilding A Relationship of Trust

"We can't legislate wisdom or passion. We can't legislate competency. All we can do is create the structures and hope that good people will be appointed who will attract other good people - people who will make careers and listen and see to it that never again do we go through what we have gone through."

 Connecticut senator and financial services connecticut, Chris Dodd, as quoted in The New York Times, July 15, 2010

 With the recent passage of the historic Financial Regulation Bill, the transgressions of the financial industry and new provisions designed to prevent these types of excesses in the future have once again taken center stage. The legislation comes at a time when mistrust of financial services is epidemic. Nervous investors traumatized by losses and mismanagement of their funds wonder how to go about getting reliable and trustworthy advice.

 Not long ago I came across a small column in the Business section of The New York Times Sunday edition, entitled "Beware Advice That's Generic." I thought, "What's wrong with offering advice that may have a broad general application?" I realized that if people mistake such advice as directed towards them specifically, it could end up doing them a disservice. This led me to the larger question, in relation to financial matters, whose information and advice can you trust?

 Three Suggestions financial services connecticut

 This is a big issue and one that deserves careful thought. I would like to offer three basic ideas to help put you on firmer ground when seeking and evaluating financial advice. First, become more independent. Take more responsibility for your financial well-being. Second, commit to the selective use of a number of different resources. Third, establish a relationship, or two, with trusted financial professionals.

 Taking more responsibility means educating yourself about financial subjects. Pick a topic and research it. Maybe you want to learn more about bonds or determining a good investment mix. Having more information will help you make better financial decisions. While you will probably still want to seek professional advice, the more you know yourself the better your decisions will be. The old saying is true- no one cares as much about your money as you do.

 Beware of Sound Bites and White Noise

 Choosing your resources for information selectively is extremely important. People seem to want sound bites and easy answers. But in personal finance there are few easy answers and the sound bites can lead you astray if you aren't careful. I would encourage people to avoid the television and radio. There is too much "white noise" being passed off as valuable information about the markets.

 Pare down both the quantity of information you take in, as well as the focus of your information gathering. Investigate subjects of particular interest to you. I find the personal finance articles in The New York Times, The Wall Street Journal and Morningstar to be of very high quality. And, referring back to the article I saw in The Times - be wary of generic advice that doesn't apply to your situation!

 Financial Relationships

 Becoming better informed is an important part of taking charge of our financial health. However, we recognize the need for expertise. Much as the family physician is a trusted source of advice on many important issues, he is not the one we would go to for a knee replacement. We may very well turn to him, though, for a good referral to the appropriate specialist. In much the same way, we need to cultivate those relationships we already have with trusted professionals in various areas of our financial lives. These could be personal bankers, accountants or estate-planning attorneys. Ask these professionals, as well as neighbors and friends, if they can recommend a financial planner whom they like. Many financial advisers offer free initial consultations. Subscribe to their newsletters. Get to know who they are and how they might help you.

 In conclusion, educating ourselves is really our best response to the skepticism and mistrust we may feel when looking for sound financial guidance. Seek out a few good sources of information, and begin to develop a relationship with a financial professional. Don't wait until an urgent need leaves you scrambling to find someone. Engage simultaneously in all three of the steps we have discussed. The old adage applies here: dig your well before you need it.

[thecrazyviking88]

The Crazy Viking: (00:09) Hey, it's your guy, The Crazy Viking here at good old Nissan of Greer. And I'm finally going to answer a question people have been asking me and asking me and asking me time and time again. So as you can see, it's already nice and bright about 9:30 right now already on the prowl for a car deal, already ready to raid something. As you can see, the inventory's there got us some nice weather too. Got a nice little breeze going, but nothing too crazy. So guys, how's everybody doing today? I got plenty of inventory as you can see as per usual, the Honda store across the street has exactly nothing. So you know that I love trolling my neighbors, but you know at the same time, I also try to be classy when it comes to my business dealings. So let's look at some new trade-ins. Just took in this dirty, but almost ready to rock and roll Dodge Journey, for those of you that need three rows. Got another Altima SV. For those of you that watch my stories religiously, I got this beautiful '17 Focus SEL. And over right there, I got that blue old body Pathfinder for those of you looking for something with three rows. So the inventory's there. The top level customer service is there. Right now I'm just waiting on y'all to come on in. And for those of you that want something with some great gas mileage, but still runs like it's darn near brand new. I got this beautiful, beautiful Toyota Prius. I got this beautiful Infinity that I took in. And I mean, I just can't say enough. I got some gorgeous inventory. Thanks to my amazing used car manager, Mr. Jay, wise man Willie Lewis. That's what I call him because he's always dropping knowledge bombs, just like the great Brad Lea. So guys, people keep asking me the question. A. Can you buy a car with bad credit? And B. Do I need money down? So the answer is that there's a couple of things that you need to take into account is one. Can you buy a car with bad credit? Absolutely. I've got a laundry list of outstanding lenders and I've got the great credit specialist Mr. Robert Kreiman as one of my desk managers always working on deals. Okay, guys, I've had the pleasure to work with a lot of really, really great people. I will swear up and down. Rob Kreiman in is the best desk manager I've ever had. And if anyone can get an approval for you, he can. Okay? Now the other question, do you need money down to buy a car? Well, depends on the lender, depends on the car. If you're just trying to get something done, you got to paid off trade. Guess what? You're probably good to go, but you might have to prove your income. So the sure-fire way if you're worried about your credit three months of bank statements, two most recent paycheck stubs, and a water or power bill showing that you live, where you live, that ties you to your residence. Okay? So the short answer, yes you can. And yes you can. So the big question is why aren't you guys here to see me already? Okay? Those of you that follow me on Facebook, those of you who follow me on Instagram, the underscore crazy underscore Viking underscore. Okay? You guys know I'm good to my customers. Just the other day, I just helped Mr. and Mrs. Dunn lease their first Nissan ever. They got a Sentra just as a second get around car. And you know, at first they weren't sure, but they had a great experience with me. You can see so on my YouTube channel and they were really, really great people too. So Dunn family, if you're watching, I still got your back for life. Let me know if you guys need anything. I'm here for you. And if you guys know anyone that's looking, it is the last two days of the month and I'm doubling up on referrals. Okay? The dealership pays you 50 bucks. If you send someone to me and they buy, then I give you an additional 50 bucks. Okay? That's out of my own pocket. Dealership's not paying me anything to do that. That's just me trying to be a professional and me trying to serve you at the highest level. Hey grandma, Carney. Lots of love to you. So guys, this is definitely the best time of the month and of the year right now. Okay? You're starting to have the selling season wind down and everything. So that means the deals are there right now at Nissan of Greer. The inventory's there. So guys text me 8-0-5-4-5-1-0-1-0-7. If you want me to just send you a message letting you know, Hey, I got a little bit of this, a little bit of that. If you're looking for something specific, I've got Mr. Lewis, and if you're looking at selling a car, I know you hear it all the time from various dealers. Go talk with me. I'll go talk with Mr. Lewis. If you're looking at selling something, not even buying, just selling and you want me to buy it off of you. Okay? Get with me. I'll get with Mr. Lewis. We'll give you a hookup on a great deal and we'll get you in and out. We'll get you your check in a timely fashion. And if you still owe money on it, guess what? We'll pay off the lender, pay you the difference. So guys have a blessed day. Let's rate some car deals. Okay? I got a little bit of everything for everybody. Let me serve you at the highest level. Let me treat you like family. If you let me know what time to expect you and you make an appointment with me, I'll ask you, okay, what do you want from Starbucks? Or if you're just wanting a red bull, I keep plenty of that around too. So guys call The Crazy Viking. Text me, send me a DM and have a blessed day.

[voice-oftheempire--archived-blog]

SEMI-HIATUS NOTICE

// It probably doesn’t come as any sort of great shocker to see that, given that I haven’t exactly been really active on here or @morvokk now for some time. This blog has been running on queue, in fact, due to just not having the energy and capability to actually do anything.

So let me get on that, explain what is going on, and we’ll sort of move on from there.

As any of you who have been with my blogs since they were started back in October know, my health hasn’t been in the greatest of dispositions for one reason or another. Given that I do have some new followers, I’ll retell some things, so a few bits will be old-news-moving-into-new for the veterans here, eheh. (If you want to skip to the new stuff, search for “***”)

As this story goes, I went in to the ER, primary care, and a handful of different specialists on numerous occasions and ended up basically grabbing a doctor in the ER by the lapels and screaming at him what he was going to do to my body to find out what was wrong that time.

This was how we found out I had biliary dyskinesia. Again, for those of you who have been around for a bit, you know that this was but for the new ones this is basically a huge dysfunction of the gallbladder where it produces all the same symptoms of gallbladder disease with gallstones. . .except you lack the ability to actually make stones. No stones means this can’t be picked up easily through blood tests (mine were always “good”) or through an ultrasound because there’s nothing to see. You must get something called a HIDA scan done that basically induces your gallbladder to do it’s job and measures if it does. It should perform at lowest 35%, but doctors prefer 40%. Mine was 20% when the test was done. And dropping.

Scheduled for surgery, but it was postponed numerous times while I was given a run-around by my surgeon who wanted my heart cleared because I had been having chest pains since November (mind, this was January now when I finally had this together). I had asked about that, but they had denied me, so I grumpily wore it for three days and now have five scars on my torso from the stickers, tachycardia when I have panic attacks and bradycardia when I take narcotic painkillers. Thanks, heart monitor. Gallbladder out on February 5th, have bad recovery.

***This is where the new stuff starts kicking in, for those of you who have been around here.

As I recovered from my gallbladder surgery, I noticed that it was taking me a lot longer to actually recover than what it was supposed to. Like. A lot longer. Weeks more. I was steps back from my peers. I had to order another round of painkillers because I was still in agony. I was still suffering chest pain. I was told, “It’s just built-up gasses -- you’re fine, you’re fine.” And then the images came back from my surgery and we found the cyst on my left ovary. Okay, cool, nothing huge to panic over. Made an appointment with my OBGYN and discussed it with him. Got scheduled for an ultrasound to see what kind of cyst we were dealing with and why it was pretty sizeable. Discussed and agreed to having an ablation treatment to my inner lining to hopefully fix a lot of those problems too. Schedule that after the ultrasound (because if we gotta do surgery for one, may as well do them at the same time, right? Right).

And then there were the pesky panic attacks that were keeping me up at night. Gasping, chest-crushing, sobbing, I-am-dying, screaming into pillows and begging for it to end attacks on end. Five, six, eleven times a day. All hours, always worse at night. I was staying awake instead of sleeping. My spouse was getting two hours on good nights where all he could do was try to keep me from hyperventilating and screaming. Most of the time I just sobbed and begged him to make it stop.

The muscle weakness came not long after. My arms went first, but we expected them to be a little off, especially since I had been on strict orders from my doctors to not lift beyond five pounds. But my legs? When it became almost impossible for me to stand up from sitting in a chair, or getting out of my car without help I knew something was wrong. It felt like sandbags weighed me down. Like I had done leg day for eons. Like a thousand leg presses. Whatever. It was wrong, and it got worse every day.

Then the brain bleed happened out of nowhere. That one was fun and scary. A simple trip to the ER for a headache that felt very wrong that I wasn’t willing to mess with (my aunt has a history of brain tumors, so nu-uh) revealed blood on my brain and wham I was laid up for two days in a much fancier hospital ICU. Three more CTs later, plus a cerebral angiogram I was released, and no one knew where the bleed had come from or if it would happen again.

And all the while my chest got worse and worse. And my entire body began hurting and aching. My headaches became worse, but no more bleeds (even after another ER trip to make sure). Many days I would wake up and barely be able to roll out of bed without wanting to scream. Some days I was up and okay but still not there. I was always dizzy, always a bit sick, always foggy in my brain. Given new drugs to help with the panic attacks (they did, for a bit, and then they came back).

My primary care doctor sat me down and gave me this: you will go see a gastroenterologist. The testing will ultimately probably come back clear, and when that does I can give you the referral to the best rheumatologist. You have an auto-immune disease or fibromyalgia. Maybe both at this point, but it’s not our specialty. It’s theirs. 

Then: the nail. The insurance I was riding was literally riding -- I was coasting on the fumes of my old job’s insurance -- expired. When I showed up for my ultrasound appointment they told me they had tried to bill it the day prior and it bounced back as gone and asked if I had new insurance. Well, no, not yet.

Now, this isn’t to say I haven’t been working with Medicaid here since December because of chronic illnesses and various mental/physical disabilities keeping me from having a job to be able to PAY for insurance, but they had to collect paperwork from every doctor I had seen in six months time. That was over sixteen doctors. And some...were not sending. And not sending. And not sending. As of right now there are still some who have not sent from months ago and I am screaming because they are hindering my potential.

Anyway

$400 upfront for my ultrasound and who knew how much for the actual appointment? Sorry, no could do. Guess that cyst is there to stay for now, fellas. I had to cancel my GI appointment, which also means that all my progress is now halted. I’m a dead fish in the water with no insurance. My doctor has given my prescription strength NSAIDs to see if that will help relieve some of the issues in my chest, but so far nothing. 

And, not to make this sound more Danny Downer? But each day I wake up and it’s worse. For the past two days I haven’t even gotten a whole five hours because I woke up to roll over and my heart started hammering in my chest, my entire chest cavity began hurting worse than ever, I felt like I couldn’t breathe and was dying all over again...and hours later it still feels like that? I was in the ER again last night for pain uncharacteristic for all of this and they couldn’t even diagnose it at this point. It’s just a, “You’re not having a heart attack, so you’re alright and that’s the best we have.”

The week before I was in the ER too. I’m getting very tired of hospitals.

My point here is: today, I’m doing really good to be sitting up and typing. I’m really proud I walked from my bed to my attached bathroom and back again before I started sobbing. I keep writing in my chronic illness journal and I keep waiting for something to happen with insurance. But I’m always exhausted and my creativity is absolutely gone. It’s just...zapped and gone.

For now, I’m having to take a step back, focus on just trying to get through each one of my days as I have them, and exist. Adding the responsibility of Tumblr to my life right now just isn’t quite possible. It’s too taxing right now, and I feel too much guilt looking at how many replies I owe or how many Asks I have in my box. And given that some days I can’t even sit up to type? Or even see the screen or keyboard? Maybe best not.

So, in the meantime, both Valoren (@voice-oftheempire) and Morvok (@morvokk) will be placed on a SEMI-HIATUS with an indefinite return date. I’ll be in and out as I can, when I can, and work as I can, but it will be extremely low-key, threads will be highly-selective, and I will ask for the upmost patience with my partners while I navigate good and bad days. 

As always, I love each and every one of you, and please, please do not hesitate to hit me up on Discord just to chat or whatnot. Just remembering that someone else is out there is often enough to help someone through their day. I’ve actually lost irl friends because my health bothers them -- and I would hate for that to happen here as well simply because I wasn’t writing as frequently as before.

PS: There are certain drugs that if you take them will make your urinalysis come back positive for meth, cocaine, and cannabis. If you have been in and out of the hospital as much as I have, the nurses will ask in on your Drug Cartel. This legit happened last night. I had to end this on an amusing note. <3

[pickleparade7]

Tips For Finding A Good Elder Law Attorney

Tips For Finding The Best Elder Law Attorney

Table of Contents4 Tips To Help Homeowners Choose The Right Elder Law AttorneyTips In Finding The Best Elder Law AttorneyTips For Choosing The Right Elder Law Attorney3 Tips For Finding The Right Elder Law AttorneyWise Tips On How To Choose Your Elder Law AttorneyTips For Finding The Best Elder Law AttorneyHow To Find A Good Elder Law Attorney

Getting a referral from family or a friend is a terrific way to find a legal representative. If they have a lawyer they more than happy with and would work with once again, that's a great sign. It's best to get a referral from somebody whose legal requirements were comparable to yours. But even if you need a senior care legal representative and your cousin dealt with an excellent civil attorney, that referral is still beneficial.

Similarly, financial advisors, accountants, and fiduciaries (someone legally designated to manage cash) are specialists who frequently deal with elder law attorneys. If you know and trust one of these specialists, ask for a recommendation. The National Academy of of Senior Law Lawyer (NAELA) is the expert organization for lawyers who specialize in older law and special requirements planning.

Advertisement, After getting referrals, you'll still require to select an attorney. Don't comprise your mind about working with a lawyer up until you've met them, discussed your older grownup's needs, and examined their credentials. An in-person meeting assists you get a feel for how they work and if their design works for you.

How To Find A Good Elder Law Attorney

If there is a fee for a consultation, learn how much it will be. If you can, meet a few legal representatives and present the same situation to each. Then, you can compare their responses. That assists you confirm that the general technique is genuine and prompts you to ask questions about any differences in guidance.

So, it's a great concept to search for an attorney with experience dealing with matters similar to your older adult's. For instance, if they require a Power of Lawyer, long term care preparation, and estate planning, ask prospective lawyers to describe their experience with those matters. Working with someone who is professional and responsive is essential.

Later, evaluate your notes to assist you make the decision. Before employing any lawyer, inspect the State Bar Association website for your state. Look up the lawyer's name or Bar number to ensure they're actively accredited to practice law in your state. This will likewise reveal if they've ever been publicly disciplined.

7 Great Tips For Finding A Elder Law Attorney

To learn more, see How We Earn money.

The Resilient Power of Attorney for Health Care is a legal document in which you authorize a trusted individual to make health care decisions in your place in case you are not able to do so due to illness or incapacity. The person you select is referred to as your "Attorney-in-Fact," "POA," or "Health Care Agent".

The individual you choose need to be a relied on member of the family or good friend with whom you have actually discussed your worths and medical treatment choices. A Long Lasting Power of Lawyer permits responsiveness to altering healthcare scenarios as the Healthcare Representative that you appoint expresses your dreams and will be able to respond to unexpected modifications in your condition and base decisions not just on your written desires, however also on their familiarity with you and your desires regarding your care.

Tips On Finding A Good Elder Law Attorney

Without a Resilient Power of Attorney for Healthcare, the following people, in order of top priority, are authorized to make health care decisions for you, including withdrawing or keeping care: A guardian with healthcare decision-making authority, if one has actually been designated Your partner Your adult children Your parents Your adult brothers and siblings When there is more than someone, such as kids, parents or siblings and sis, all should settle on the health care choice (Elder Law Attorney).

Our company is devoted to offering you with quality estate preparation resources. When you check out or call our office, we desire you to feel comfortable discussing such crucial concerns worrying both you and your household, and to equip you with the information you require to make an informed choice about your household's future.

I felt complete trust and self-confidence in Dan De, Bruyckere and his personnel. They have a caring, low-key technique and there is no pressure to include items to the estate strategy; rather he makes me mindful of changes in the law, etc. I constantly find out something brand-new to assist me in our preparation!.

5 Tips For Finding The Best Elder Law Attorney

COVID 19 UPDATE: Burke & Casserly, P.C. is now seeing customers on-site on a limited basis - Elder Law Attorney. However, we continue to conduct meetings by means of video conferencing or telephone whenever possible. We need all visitors to sign-in attesting to a COVID-19 health screening assessment and verify that you have actually not experienced any COVID-19 symptoms.

Click on this link for the most recent updates on how COVID-19 is impacting the law..

Click the links listed below to have your questions answered. Many methods exist to safeguard your assets into your golden years. Sometimes the biggest difficulty is just selecting the ideal one. Ettinger Law Firm attorneys are trained to first listen very thoroughly to a couple's or specific's unique set of household and/or service circumstances.

Wise Tips On How To Choose Your Elder Law Attorney

They make suggestions just after completely comprehending long term goals and the dynamics of each situation. For information on our totally free workshops about the "4 Pillars of Estate Planning" in New York City State, please click here."We were really delighted with the level of service received from Ettinger Law practice. The legal representative that helped us was extremely well-informed and assisted us through a distinct family circumstance, and established our trusts appropriately.

I would highly advise Ettinger Law office.".

This page offers short answers to numerous typical questions about our law office and our person. Please note, this page provides basic details but is not an alternative to professional legal advice. If you have a legal issue concerning estate planning, probate, or older law, it's best to to address your concern.

Choosing A Professional Elder Law Attorney

What are your practice areas? Sean J Nichols, PLLC practices in senior law, estate preparation, and probate. Elder Law Attorney. These practice locations cover practically any legal issue connected with aging, death, and inheritance. This includes guardianship, trusts, estate lawsuits, and more. Q. Do I need to visit your office to establish an assessment? Not necessarily, most customers that visit our physical area are within 15 miles of our office.

It's not uncommon for our law office to receive calls from clients who lie far away or outside the state. In these circumstances, we accommodate their requirements through the use of contemporary innovation. Q. Elder Law Attorney. Where is your law company located? Sean J Nichols, PLLC is located in Plymouth, MI.

Q. What do you charge for assessments? The expense of many consultations varies from $150-$500 dollars, depending on the case. Our assessments usually range from one to two hours and likewise consist of the time we spend evaluating the materials and consumption you supply prior to the meeting. We credit the cost of the consultation if you employ us within 7 days of the assessment date.

[kettlespot0]

4 Tips For Choosing The Right Elder Law Attorney

Advice How To Choose The Best Elder Law Attorney

Table of Contents9 Tips For Choosing The Best Elder Law AttorneyChoosing A Good Elder Law AttorneyTips On Finding A Good Elder Law AttorneyHow To Find A Good Elder Law AttorneyAdvice How To Choose The Best Elder Law AttorneyQuestions To Ask A Elder Law AttorneyTips For Finding A Elder Law Attorney

Getting a referral from household or a friend is a terrific way to discover a legal representative. If they have a lawyer they're pleased with and would work with once again, that's a good sign. It's best to get a referral from somebody whose legal needs were comparable to yours. But even if you need an elder care legal representative and your cousin dealt with an excellent civil lawyer, that recommendation is still beneficial.

Similarly, financial consultants, accountants, and fiduciaries (somebody legally appointed to handle cash) are professionals who frequently deal with older law attorneys. If you understand and trust among these specialists, ask them for a referral. The National Academy of of Senior Law Lawyer (NAELA) is the expert organization for lawyers who focus on elder law and unique requirements planning.

Advertisement, After getting recommendations, you'll still require to pick an attorney. Don't comprise your mind about employing an attorney up until you've fulfilled them, discussed your older adult's requirements, and checked their credentials. An in-person conference helps you get a feel for how they work and if their style works for you.

4 Tips For Finding The Right Elder Law Attorney

If there is a charge for an assessment, discover just how much it will be. If you can, fulfill with a couple of lawyers and present the very same situation to each. Then, you can compare their actions. That helps you validate that the total technique is legitimate and prompts you to ask concerns about any differences in advice.

So, it's an excellent idea to try to find an attorney with experience managing matters comparable to your older grownup's. For instance, if they require a Power of Attorney, long term care preparation, and estate planning, ask potential lawyers to describe their experience with those matters. Working with somebody who is expert and responsive is very important.

Later on, evaluate your notes to assist you make the decision. Prior to working with any legal representative, examine the State Bar Association website for your state. Look up the attorney's name or Bar number to make sure they're actively certified to practice law in your state. This will also show if they have actually ever been openly disciplined.

4 Tips For Finding The Right Elder Law Attorney

To learn more, see How We Generate income.

The Durable Power of Lawyer for Healthcare is a legal document in which you license a relied on individual to make healthcare choices in your place in case you are not able to do so due to disease or inability. The person you select is called your "Attorney-in-Fact," "POA," or "Health Care Agent".

The individual you select ought to be a trusted member of the family or pal with whom you have discussed your worths and medical treatment choices. A Resilient Power of Attorney permits responsiveness to altering healthcare circumstances as the Healthcare Agent that you designate reveals your desires and will be able to react to unexpected changes in your condition and base decisions not simply on your composed desires, however likewise on their familiarity with you and your desires regarding your care.

9 Questions To Ask Your Elder Law Attorney

Without a Long Lasting Power of Lawyer for Health Care, the following people, in order of priority, are authorized to make health care decisions for you, consisting of withdrawing or withholding care: A guardian with healthcare decision-making authority, if one has been appointed Your partner Your adult children Your moms and dads Your adult bros and sisters When there is more than a single person, such as kids, parents or bros and sisters, all need to agree on the health care choice (Elder Law Attorney).

Our firm is dedicated to providing you with quality estate preparation resources. When you check out or call our office, we want you to feel comfy talking about such crucial issues worrying both you and your household, and to equip you with the details you require to make an informed decision about your household's future.

I felt complete trust and self-confidence in Dan De, Bruyckere and his personnel. They have a caring, subtle method and there is no pressure to include items to the estate plan; rather he makes me conscious of changes in the law, etc. I always learn something new to help me in our preparation!.

10 Steps To Choosing The Right Elder Law Attorney

COVID 19 UPDATE: Burke & Casserly, P.C. is now seeing customers on-site on a limited basis - Elder Law Attorney. However, we continue to perform conferences via video conferencing or telephone whenever possible. We need all visitors to sign-in attesting to a COVID-19 health screening assessment and affirm that you have actually not experienced any COVID-19 signs.

Click here for the most recent updates on how COVID-19 is impacting the law..

Click on the links listed below to have your concerns responded to. Lots of strategies exist to protect your assets into your golden years. Often the most significant difficulty is simply choosing the ideal one. Ettinger Law office attorneys are trained to first listen extremely carefully to a couple's or private's distinct set of household and/or business circumstances.

5 Tips For Choosing The Right Elder Law Attorney

They make suggestions just after thoroughly understanding long term goals and the characteristics of each circumstance. For info on our complimentary workshops about the "Four Pillars of Estate Preparation" in New York State, please click on this link."We were really delighted with the level of service received from Ettinger Law office. The lawyer that helped us was very educated and directed us through an unique household situation, and established our trusts properly.

I would highly recommend Ettinger Law practice.".

This page offers brief responses to a number of typical questions about our law practice and our person. Please note, this page supplies general details but is not an alternative to expert legal recommendations. If you have a legal problem relating to estate planning, probate, or older law, it's best to to address your concern.

How To Find A Good Elder Law Attorney

What are your practice locations? Sean J Nichols, PLLC practices in older law, estate planning, and probate. Elder Law Attorney. These practice locations cover essentially any legal concern connected with aging, death, and inheritance. This includes guardianship, trusts, estate lawsuits, and more. Q. Do I require to visit your office to establish a consultation? Not necessarily, a lot of customers that visit our physical area are within 15 miles of our workplace.

It's not unusual for our law practice to get calls from customers who are located far or outside the state. In these scenarios, we accommodate their needs through using modern-day innovation. Q. Elder Law Attorney. Where is your law office found? Sean J Nichols, PLLC lies in Plymouth, MI.

Q. What do you charge for assessments? The cost of most assessments varies from $150-$500 dollars, depending upon the case. Our assessments generally vary from one to two hours and likewise consist of the time we invest reviewing the materials and intake you offer before the conference. We credit the expense of the assessment if you employ us within 7 days of the assessment date.