#in your face to all the shitty doctors and specialists I’ve seen throughout the years who have just written me off as a hypochondriac

[oliveasaltylife]

I got a celiac diagnosis on Thursday after having unresolved GI issues for my entire life that pediatric specialists just labeled as “overweight.” The pediatric specialists (at UCLA nonetheless) told me I was anemic and then didn’t run any further diagnostics. And now, 20-some odd years later, I have confirmation with my celiac gene and extreme response to gluten!

My current doctor said it’s also still possible I go on to develop (or have already developed) Crohn’s Disease because of the damage that gluten has done to my gut! Wow! Fun!

Also my on/off lifelong butt and thigh rash is likely dermatitis herpetiformis from my autoimmune response to gluten. Which makes a lot of sense as it tended to clear up when I periodically went gluten free. Funny how that works.

Don’t get me wrong, I’m glad I have more information, but fuuuuuuck I was not really prepared for a celiac diagnosis. And because I’m so sensitive, my husband and I have to replace basically everything in our kitchen to avoid any cross contamination. I’m talking new pots & pans, silverware, knives, bakeware, Tupperware containers, baking sheets, glassware, cutting boards, and utensils—everything that’s scratched and can trap gluten, which is like 90% of our kitchenware. We can’t afford this shit so we’re going to have to put it on my credit cards.

If anyone is able to help out at all with the cost of making our kitchen celiac friendly and totally gluten free, my Venmo is linked at the bottom. I also have ko-fi and buymeacoffee but I haven’t started using them yet.

[pip-n-flinx]

yup, it all goes below the cut

So I’ve been seeing a resurgence of ME content following the trailers for ME4 and MELE, which makes sense. But I’m a salty m-fer and I honestly am sick and tired of Mass Effect getting shit on for things that other game studies (looking at you fromsoftware) get praised for. So we’re going to unload a little.

The underpinnings of the mass effect universe is this huge extinction cycle, designed and perpetuated by the Reapers. As sufficiently advanced civilizations reach a tipping point, not unlike the great filter theory of space travel, these AI come in and wipe anyone out. This sort of cyclical storytelling, with pieces of the previous cycles being dribbled in throughout the trilogy, seems pretty similar to progression of Dark Souls. At the end of the Mass Effect Trilogy, many fans were upset by the ending choices: Destroy, Control, and Synthesis.

What are your choices in Dark Souls? At the end of the first game, the cycle ends and you, the player, get to choose how the world enters the next era. Does they cycle of undeath continue, or do you shatter the world and hope something new rises from the ashes?

How, pray tell, is that really any different a decision? And why is it when fromsoftware does this its groundbreaking storytelling, but when bioware does it we decide collectively its ‘just a shitty recolor of the same ending?’

I agree, there are some flaws in how they chose to animate the climactic moments of ME3. For one, the fleet assembly and space combat with the reapers above Earth doesn’t change much no matter how many/which allies you bring to the final fight. And of course, the ‘garbage recolor’ ending. And I agree with the premise that more than the color should have changed. We should not have had to wait for the still flawed Extended Cut ending to be released to see how Shepard’s final choice changes the end of the game.

We can also comment on what the crucible actually does. If it is some incredible power-source in need of direction - the citadel - it is a strange choice of weapon to design for your battle against the reapers. We could speculate endlessly on why the writing team chose this, but the real issue here is that there is very little in game context for how this comes about. We get a few lines from Hackett and Liara explaining the Crucible, but that’s about it. Surely there could have been more discoverable codex entries about it, perhaps on Eden Prime with Javik?

To be clear, I don’t actually have a problem with the end of the Trilogy. Sure, it has its plot holes, but I’m not actually too fussed about it. It felt like a fitting end to the series to me. Graphically a little disappointing, to be fair, but otherwise a fine capstone to the story.

I’ve actually read some comments and posts explaining that they ‘won’t buy the legendary edition because they won’t fix the ending’ and I.... Do you even know what a remaster is? I’m not buying the remaster because I think many of the new lighting choices detract from the story, and a reskin won’t ensure the graphics stand the test of time any better than the old ones. I’m perfectly happy replaying the original trilogy without a fancy graphics package that adds nothing to the artistic vision nor sets out any distinctive art style. A few years will see even these HD 4k graphics obsolete/dated, and I’ve spent enough money on Mass Effect as it is.

Moreover, I really hate what speculation and rumor I’ve heard about Mass Effect 4. First, I hate that it will be a ME4 and not an MEA2. This will take some explaining so bear with me.

I’ve seen videos of the original graphics and animations that caught so much flak for Mass Effect Andromea. Unpopular opinion: I don’t think they were bad, and I certainly don’t think they were bad in the context of Mass Effect. None of the games prior had flawless rotoscoping or anchoring. Even watching stock sheploo in the original trilogy is painful if you’re hoping for realism. If y’all want to play this game we can start sharing clips but suffice to say I’m personally convinced we can go tit-for-tat on awkward animations.

Moreover, I think Mass Effect Andromeda is the best Mass Effect game. Best gameplay, by far. It has all the hallmarks of a great sci-fi: new aliens, new planets, new villains. And while I understand some people felt the switch from overcompetent supersoldier Shepard to young-kid-with-daddy-issues-and-more-than-a-few-bad-bosses Ryder was jarring, I absolutely loved playing a plucky hero who lost their mentor before they’d even properly started training. It gave the game an urgency I loved, and to me Ryder felt like a much more relatable protagonist than Shepard.

The story itself is a fucking masterstroke. Hear me out:

So in Mass Effect, the twin plot drivers are infighting with council/alliance/cerberus ‘allies’ while facing down the threat of and advanced AI wiping out all organic life to preserve diversity and make way for the next ascendant race. In Andromeda, we’re met by the same bickering and infighting amongst our own faction, and the Kett. The Kett, for whom nothing is cyclical. Everyone must assimilate. Who shun technology and seek to eliminate biodiversity by ensuring all civilizations end with Kett. And instead of a well trained military commander and a ship of soldiers, mercenaries, and specialists in the sciences who grow to be respected players on the galactic stage, we get Ryder. Ryder and their crew of misfit nostalgia-driven rock-licking rule-breaking cereal-smuggling culture-vulture heart-broken multiple-amputee nervous-doctor neophiles who meet one alien and have to save all their races from genocide by a rogue Kett Archon. And the Jaardan? the long gone artificial life-forms who had the technological capability to be reaper analogs? They’re the life-givers, the gods of the Andromeda galaxy, seeding species and hope into the galaxy for the player to find.

It’s such a perfect inversion of the original trilogy while still preserving the genre and the universe they had already built. It’s fucking brilliant. And I’ll never forgive them for abandoning it, nor will I forgive the fans whose vitriol stopped the project in its tracks, and killed any hope of a second trilogy.

Honestly, I don’t care if you agree about MEA, or the ME3 ending. I know this isn’t a common take among bioware fans. I just... I’m so fucking done with this franchise and this fandom. I’d like to think my mutuals and the other blogs I follow have level headed positions on this stuff (possibly more level headed than my own salty takes these days) but I honestly wonder why I’m even on this platform some days. It doesn’t spark much joy anymore. I hope no one takes this personally, I certainly don’t mean this as an attack or criticism of any of my followers but damn, I’ve got a lot of feelings tonight and almost all of them are negative...

[paumeranian]

Interview #2

11/3/19

Tell me about a time where you started feeling symptoms. What did you do? How did you feel in that moment

Looked a bit bewildered when I started to ask the question – mouth open, blinked hard to start thinking about question

“Symptoms for sickness?”

“Previous experiences demotivated me to go to the doctor”

Go back to instincts if it’s something I’ve experienced before. If not, I turn to Google to get an idea of what it might be

Gets concerned if symptoms persist after 1-2 weeks

*fidgets with hand while talking* lead to talking about finger infection

Effect of googling symptoms – sometimes can lead to anxiety, but generally calms my nerves down if what I’m reading isn’t too alarming. An example was getting a finger infection and got scared thinking it would need to get amputated but Google suggested to take antibiotics which relieved my anxiety

I usually mention symptoms to my mum or a friend, I generally go to doctor with my mum since she pays for my check-ups ($40 students, $50 adult)

I’m in between child and adulthood in terms of taking responsibility for my health

I take into account if my friend is concerned after hearing my symptoms as a sign to visit the doctor

*talks with hands a lot*

Tell me about your healthcare provider. Is your doctor/GP available via booking an appointment or is it a walk-in clinic?

Recently switched to a new GP due to dissatisfaction with previous GP e.g. waste of money, wasn’t proactive with symptoms, didn’t talk through what could be happening with body and just gives medicine

Mum got recommendation from a friend to see a Chilean doctor, helps to talk to GP who speaks Spanish

All members of my family go to the same GP now, have been going for the past 5 months with 3 appointments

“Not sure why we need to see the same doctor as we live in different areas but it’s easier for mum to have one point of contact”

Generally satisfied although was worried about the distance from home at first

“$40 for students, $50 for adults is still a lot”

Feel obligated to come with a list of things to get checked out to get most out of time and money - “It’s kinda sad that I have to do that”

Solution would be to move but not considering it at the moment maybe in a few months

Poor service from receptionist

15-20 minutes appointment

Book a few days prior

Get recommendations from friend when “shopping around” for healthcare providers, considered  going to (Grey Lynn) centre but talked with mum about going to the same GP’s - mum took action and enrolled to same GP

Regularly, go twice to three times a year to the doctor (laughs), would only go if it’s necessary

Talk me through your usual process of allocating a day and time to see your doctor/GP? How easy or difficult is it to schedule an appointment at a time that suits you? (if it’s a walk-in clinic, how long do you have to wait to see your doctor/GP?)

Appointments done through phone calls, and potentially through “a computer system”

Busy clinic so booking can be difficult

Clinic gives recommendations and you work around them

“Would be nice to have an online platform for you to see when you can go”

Not open on weekends, e.g. calls Wednesday then would end up seeing GP the following Monday or Tuesday

“I could be seeing another GP during the waiting time, if I went to a less busy GP and possibly open during the weekend”

Would wanna be seen sooner rather than later

Is it important for you to get seen by the same GP each time?

Yes as there would be more understanding/connection with GP for recurring check-ups

Doctor would know your history better

Talk me through your most recent visit to the doctor or GP. What were you thinking and how were you feeling from waiting in reception through to going home?

Personal reflection: Had to explain this question further, perhaps I could’ve planned to word this differently. Wanted to have interviewee think about the question for a few seconds as it’s about “feelings”

Most recent visit was about a month ago

Anxious about what would happen next

Actual clinic looks like a home that’s been transformed to a clinic, doesn’t look like a clinic though

Generally packed waiting room

I read magazines while waiting, appointments usually run late so I make sure to allocate a lot of time throughout the day

*rubs face/eyes a lot, talks slowly in a relaxed manner, take into consideration that the interview was done in their home*

Felt relieved when GP was seen and given prescription meaning they could start “trialling” medication and felt like there was “more progression”

GP was quick, informative, gave notes - this was nice

Understands that the 15-20 min duration is to not make other patients who’ve booked wait

This is enough as GP is active in asking questions and finding things out

Compared to previous doctor who just listened instead of steer the conversation = “hard to know what to talk about when you don’t understand what you’re going through”

Goes same time as mum - one after the other so they sit in each other’s appointments, feels that there’s enough time to ask questions in case anything was forgotten before leaving

Can you tell me roughly how long you were seen by the doctor for?

15-20 minutes

Talk me through how you were feeling during the actual check-up.

FEEL during appointment: trusts GP but still anxious about “how” to explain feelings, concerned how to express what they’re going through but GP asks questions like “are you experiencing this” and replies with “yes” “no” etc. - anxiety subsides when they start to feel like the GP understands what they’re saying

GP asks other questions like how long it’s been persisting, etc

Start off anxious but depends on GP and how they act which is a huge factor that would leave them relieved/satisfied

Tell me about how your provider explained potential diagnoses and solutions.

Give brief explanation of what’s going on to GP

“GP analyses it in her mind probably”

GP talks through symptoms e.g. if it is this, have you been feeling ___, reply

Question and answer method until they reach a point of possible/actual diagnosis

GP explains why it’s happening e.g. environmental effects, immune system, chemicals = understand in a “more scientific level”

GP explains actions to take, gives timeframe for when it should get better with medication and if not come back

GP is informative, gives names and writes them down for patient to read through later

Medication/prescription explanation (benefits, side effects)

If concerned with side effects, GP “wholeheartedly” says what they are e.g. for taking antibiotics it’s good to compensate for what’s lost with probiotics (so far, interviewee always gives examples of personal experiences)

Test fees

E.g. blood test - take paper from GP to Labtest which is included in the appointment fee

Current GP informs them of results whether positive or negative unlike previous one who never followed up, turns out they are iron deficient but found this out from another practitioner - mum took action and got results from Labtest then

FEEL: angry that interviewee paid $40 and GP didn’t follow up when they said they will “bad service”

Tell me about a significant clinical experience you can recall (either positive or negative). Why was it significant? How did you feel in that moment? Why did you feel that way? Do most check-ups with your provider turn out like this?

Took longer to think about this situation which is understandable

E.g. with previous GP, interviewee consulted about a cyst which their mum had before at a young age (similar area) and needed to get surgically removed. GP however said to just take antibiotics - cyst didn’t get better, infection went away but it was still there, started to get inflammed, went back to GP and gave them more antibiotics

Wondered why GP wasn’t concerned about it especially with how long it was persisting

IMPROMPTU section of interview

Topic: Recommending surgery to patient

Added interviewee/participant: Shannon in the background

Following up from the cyst situation - moved to new GP in the first appointment that they had a cyst, GP brought up taking antibiotics but also surgery if it doesn’t get better

GP said it would be quick “right then and there”

“Could be that they’re just lazy about it”

Shannon: Are we just talking about GP’s or other specialists? *proceeds to tell her story about a surgery*

Consulted own GP about a freckle on lip and got referred to a dermatologist

Was monitored for 6 months, couldn’t see anything serious about it e.g. cancerous. Advised interviewee to come back if it changes colour or size and it did

After seeing it for the third time, within 10 minutes of the appointment specialist said to “cut it out” next week

Interviewee was shocked as they didn’t sign a consent form to the surgery, wasn’t told how it was going to be done and what to do

Hesitant as it was too sudden, felt like specialist was just trying to fit interviewee in the list before Christmas holidays

Quoted specialist “yo we’re gonna cut this out” was very casual while telling the story

Worried upon hearing that - “what? This is my face”

“Looking back that was really bad” - didn’t explain complications

Expressed feedback as they asked for it “doctors were shitty but the nurses were nice” *Cat laughs*

30-40 minutes surgery where interviewee was conscious and nervous

Assumed it was going to be a small cut, kept asking doctor what they were going to do

Appalled at doctor taking it so casually when explaining where they were going to do the cut

“I think they do hold back on surgeries because they’re expensive and they want to explore other options (first), But if they do surgery they’re gonna try fit it around them.”

E.g. asked doctor if surgery had to be next week and replied with “Well you know, I’ve got a very tight schedule and we don’t want it to get better” “Now or never”

Next time “I would take a support person with me or make sure I question it”

Doctor made it seem like surgery was the obvious way to go - interviewee (may have) felt like they weren’t in control of the situation

“I was just SHOCKED” which prevented them from asking questions

“I don’t care what it looks like I just want to know if I’m healthy”

Question: did they tell you what it could be or what it was caused by? Answer: Not really, said biopsy would have a look and explain what it was

“Doctor didn’t do a good job of stitching me up” as there was a mark left

Cat: I think doctors in NZ are generally lazy

Shannon: Not necessarily lazy but everything is kind of against them a little bit. Doctors are under-resourced, stressed, they’re trying to fit a 30 minute operation “next week” because they can and they need numbers. Like oh we’ll do it now I think they do just think of you as a number. Other family members have experienced this too where doctors are like “well you gotta do it now. There’s a long waiting list. Almost like guilt you into it”

Cat: Well then I guess maybe not lazy but just uncaring *uses hand to try get to a word*

Shannon: Bad bedside manner.

Me: Or not empathic?

Both: Yeah!

Shannon

First thing doctor said after sitting on computer not talking to interviewee before surgery was “Oh you nervous?”

“I’m sitting there trying not to cry” “Yo that’s not what you should say first thing”

Convinced self that “the worst is in your head” but after surgery was convinced that that was the worst and doesn’t want another procedure again without getting knocked out

Has accepted that that happened now, it’s “algood”

Back to script

Can you comment on the quality of care you typically receive in relation to the cost of a check-up? Rate the cost from:

Cat: Private provider hence why it costs more

“I feel like I shouldn’t pay $40, should be $30 max”

In the end, I still think it worth it due to GP being good and they still have to pay other staff, the space, resources etc.

Shannon: “$40 for a student though. That’s expensive”

On uni clinic: busy, under-staffed

Scale of 1-5, 1 being extremely unfair to 5 being extremely fair - Cat gave me a 3.8

Always see the same doctor and having been with them for 5 months, interviewee is certain they prefer it over previous doctor

Shannon: “I pay $15” and there’s a certain amount of free appointments for students. Not privatised.

Group reflection: On different healthcare prices

Free but walk-in so longer wait times

E.g. Central City Clinic is walk-in but costs $50 for a citizen and about $70 for a non-citizen

Fees can depend on location

Cat: “I wish it was easier to find information. I didn’t know that there was a Union (Health Centre). I thought all doctors were like $40. Never heard of an $18 doctor before.”

Shannon: “Also as students we’re all eligible to get a Community Service Card which gives you $5 prescriptions and discounted doctors. Even if you have a job. Normally sent to you during your first year of study […] There’s so much stuff that isn’t made aware.”

Cat: “Yeah! All the stuff I’ve learned are from Shannon or overhearing it. I never see it on a website or a pamphlet. I don’t know why it’s so hard to find really useful information, it’s like they don’t want you to use it.”

Doorknob moment

Poor customer service example: One time a doctor had overdosed her with steroids for a chest infection

Didn’t weigh her and she couldn’t stop trembling so had to go to the doctor

Another example: Doctor/GP had no bedside manner and told interviewee to “lose some weight” at age 14 (felt alone) and was intrusive when asking about family medical history

Receptionist told them that they needed their New Zealand Passport to apply in a condescending manner

Then after seeing it, receptionist changed attitude all of a sudden

Personal reflection:

Overall, I got a lot of insights from that interview and I really benefitted from changing the method. Sitting across Cat while asking her questions without typing away on my laptop to record her answers made it feel like a normal conversation with a friend. Before Shannon stepped into the picture, Cat seemed like she was a bit tired due to her rubbing her eyes a lot and talking slowly. However knowing her she does talk like that naturally anyway. I knew she had plans afterwards so I also didn’t want to drag the interview too long.

Interestingly, having another person contribute to the conversation changed the atmosphere. Once Shannon was able to talk about her own medical experiences, particularly more on the negative side, they both sounded enthusiastic to be talking about our topic which is healthcare. The reason why I chose it was because it seemed to always elicit conversation and it continues to do so.