Still trying to figure out what to put in a pinned post that isn't a million pages long. Take three, I guess. (ADHD brain is terrible at being succinct.)
About me: Fandom-focused introduction
AO3: liminalpsych
Sideblogs
@onceandfuturecourt: Arthuriana, Arthurian medieval literature, queer readings of Arthurian medlit
What just happened in Hungary has a huge positive impact far beyond Hungary. For Ukraine, for the EU, for the future of authoritarianism internationally......
Also, celebrating with a parliamentary techno rave sounds absolutely perfect and I'm jealous of everyone who got to attend. Also, to live in a country with an ousted dictator? Doesn't that sound nice.
I started a new medication four days ago. It dramatically improved symptoms within 24 hours.
I just hyper focused on a project for a few hours for the first time in almost two years.
And yesterday, I realized partway through a client session that I was clear-headed, not fighting through brain fog, and was able to hold the client’s whole history in my head while working with them. I haven’t been able to do that in … I don’t know how long. Years.
I haven’t had brain fog for the past three days. I haven’t had a migraine for the last two days. I haven’t had to take a triptan / migraine rescue med all week.
My face is noticeably, dramatically less puffy with inflammation. My ears haven’t turned bright red with vascular pressure in three days, when that has been a near-daily occurrence since late 2021.
I can think. My mind is moving fast like it used to instead of sluggishly churning. I haven’t lost words partway through a sentence in three days. I’ve been able to access words reliably instead of groping for super common language and failing to find it.
My joints don’t hurt nearly as much, and don’t feel nearly so “floppy”/“loose”. A few days ago, my physical therapist confirmed that the inflammation around my joints is remarkably reduced, less swollen to the touch. My head isn’t hot to the touch. I slept on my side for a little bit last night and it didn’t immediately mess up my neck. The tinnitus isn’t quite gone, but it’s definitely less intense.
I had given up on ever being my old self or having my brain back. This is… this is wildly hopeful.
I started on 2.5mg zepbound. (I wanted vials to microdose with, buuuut insurance only covered the 2.5mg auto injectors. Hopefully this is tolerable. If the side effects are too much, I’ll resort to paying out of pocket for vials.) I was already frighteningly, intimidatingly hopeful about it before starting it, from the research papers and case studies and personal stories I’d read.
Here’s the paper that started me down this rabbit hole: Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.
“Among 47 cases (mean age 39, range 15–71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.”
Some more resources:
A possible new treatment for MCAS - roundup of research, case studies, etc.
Article sourcing interviews with practitioners/specialists who are prescribing it
Emerging roles of glucagon like peptide-1 in the management of autoimmune diseases and diabetes-associated comorbidities - This goes over a number of things that this med helps with, including PCOS, psoriasis, IBD, and Alzheimer’s.
Many of the studies on this with various conditions are relatively small and preliminary, but very promising. Hashimoto’s, multiple sclerosis (it seems to lead to re-myelination??), OCD (?!), rheumatoid arthritis, fibromyalgia, lupus, and … well, basically any condition that involves chronic inflammation. It’s also thought to have immunomodulation effects. Some folks are even reporting that it helps their c-ptsd symptoms and adhd symptoms. Obviously it also helps histamine-elevated anxiety, but that goes with the mcas treatment bit.
There’s currently a large trial (n=1000) in progress for its impact on long covid.
Also, iirc, no one in the MCAS study became underweight. Just symptom relief.
I did … way too much reading before getting on one of these myself. Lots of browsing forums where people share complications and experiences, trying to deduce a pattern in the problems. Here’s what I found (not scientific at all, just me looking for patterns in personal stories). Disclaimer: none of this is medical advice, I’m just sharing stories and observations, I am not a doctor, etc.
Sometimes people have reactions to the injection site. This may be due to nickel allergies and is sometimes cleared up by switching to a nickel-free needle (which aren’t terribly common, weirdly?).
Tirzepatide (which acts on GLP-1 and GIP) seems to be better tolerated than semaglutide. When semaglutide doesn’t work or causes intolerable side effects, people sometimes have better results when they switch to tirzepatide. But semaglutide does seem to improve symptoms for a significant subset of people.
Tirzepatide from a compounding pharmacy (which is more budget friendly and easier to get ahold of) is more likely to have complications than tirzepatide from the original manufacturer. Probably due to consistency issues. I also wonder if some people are having a reaction to the B-12 that compounding pharmacies frequently include in the tirzepatide solution. (I have no data to corroborate this suspicion, just speculating based on how mcas sensitivity can be with various components/additives of medication.)
People have more issues on higher doses. Currently this stuff’s only usually covered by insurance (in the u.s. at least) if you’re prescribed it for obesity or type 2 diabetes. The starting dose for diabetes (for tirzepatide anyway) is 2.5mg a week (injected). The starting dose for obesity is often 4-5mg/week. If you have mcas/are medication sensitive, this can be Way Too Much. Microdosing is not FDA approved, but i read mostly of people starting microdosing at 0.25 - 0.5mg a week. Microdosing generally causes fewer issues.
The other time people have issues is when they don’t hydrate enough, don’t eat enough protein/fiber, or try to eat larger meals instead of ~6 tiny meals through the day. (On day 2-3, I ran into the consequences of not eating frequent small meals quite enough. The slowed gut motility is obnoxious. Still figuring out the best rhythm for that and hoping it improves, as i’ve heard it often can. I’ve basically had one side effect per day, and each side effect goes away after a day, and then I get the next one.)
As for getting prescriptions: Rheumatologists are getting increasingly aware of this and willing to prescribe, so that’s a possible route if you’re already seeing someone who stays up on research. Otherwise… it’s hard to get on without a 27+ bmi and an additional condition (sleep apnea is a common one, but others are high bp, high cholesterol, fatty liver, and I’m sure there’s others). Possible, but more difficult.
Anyway, I can’t possibly sit on this. Obviously I’m only on day 5, haven’t even taken my second shot yet, but. The positive effects have been unreal. I didn’t think I was ever going to feel clear headed again, I’d nearly given up hope of more than marginal improvements. I’ve been dealing with severe symptoms for nearly five years. (And less severe symptoms for many years before that.)
Two week update…! I tallied up my migraine days / severities / etc over the past 6 weeks.
The 1 month before starting tirzepatide:
4 severe migraine days
9 moderate migraine days
14 mild migraine days
3 migraine free days
The past two weeks on tirzepatide:
1 moderate migraine days (had the migraine before taking the first shot so this might not count)
6 mild migraine days (concentrated around the couple days before the next dose, and/or the couple days before my menstrual cycle began)
7 migraine free days
All while maintaining a fairly stable weight. (Been hyper-vigilant about getting enough protein and hydration as neglecting those are the biggest pitfalls people fall into with this medication.) Actively trying to maintain a stable weight for now just to make sure I can manage caloric needs on this med; I dont want to lose muscle, that would be bad on so many levels.
And my neck was pretty badly misaligned for a good portion of the last week, which historically would mean severe migraine time… but instead I just had the neck discomfort without hardly any migraine. And minimal fluid backup/inflammation. (Confirmed by my physical therapist who was very surprised by how bad my neck was yet how low my pressure/inflammation was.)
But also my joints are more stable overall, and go back into place easier, and stay there for longer once they’re where they should be. Everything is less wobbly since there isn’t so much swelling. AndI mean everything - neck, wrists, fingers, hips, knees, ankles.
Haven’t noticed any worsening in POTS symptoms either. Haven’t noticed POTS symptoms at all, now that I think about it. Haven’t been tracking those like I’ve been tracking inflammatory symptoms / migraine / mast cell stuff though.
Also I haven’t taken an antihistamine in two weeks??? and barely taken any anti-inflammatories / NSAIDs, and only one dose a day when I do take an NSAID???? I was taking waaay too many NSAID’s prior to this just to function. (and in the past few months I started feeling fairly prompt, sharp negative reactions to NSAID’s - cramping and abdominal pain - so I knew the 15+ years of 600-800mg ibuprofen, sometimes multiple times a day, was finally catching up to me and something needed to change.)
My body feels better. I feel better in my body. My brain feels better, I don’t feel like I’m walking with a concussion all the time. I haven’t lost words partway through a sentence in 2 weeks. I’m in less pain.
My mood has improved. I’m down to my pre-quarantine summer dose of my antidepressants do the first time since 2020 (and realizing I may have been using the higher dose to brute force my way through the cranial pressure brain fog). There’s bit of extra somatic anxiety, but I’m not sure if that’s situational/environmental/related to deadline stresses, or if it’s chemical. Will have more clarity on that in a week or so.)
Oh and the digestive side effects have improved dramatically. Whew. That’s the one I was most nervous about. I can tolerate a lot of side effects if it means I get to be *me* again, but my understanding is that certain severe levels of slowed gut motility are as debilitating and life-interfering as the kind of migraine stuff I was dealing with. I’d rather not just trade one problem for another of equal severity. But it’s looking like I’m gonna be okay on that front. (Keeping fingers crossed but overall relieved there.)
The 3 inches (7.6 cm) of fluid/inflammation/?? that disappeared from my waist after the first few days has not returned. Hasn’t gone down any further, so I suspect that was the amount of pure… puffiness/inflammation/fluid-retention I was dealing with. Was briefly worried it was fluid loss from digestive issues but the measurement hasn’t changed after my digestive stuff improved. And I have been hydrating sooo much. So that’s fascinating and a bit wild.
3-4 moderate migraine days (1 was the day of the first shot, beginning before taking the first shot, so I don’t know if it counts) - usually in the day before taking next dose, or the day before menstrual cycle began. Or in one case, the day after eating multiple migraine trigger foods as an experiment.
11 mild migraine days
14 migraine-free days
As a comparison point, the 30 days before beginning tirzepatide, I had:
4 severe migraine days
9 moderate migraine days
14 mild migraine days
3 migraine-free days
- side effects have almost completely calmed down. Still getting the cold feeling within an hour of the injection, but it lasts less long and is less pervasive / intense (as of last week’s shot, it’s down to fingers/nose/toes for the first night and then it goes away). Digestion stuff has vastly improved.
- Inflammation remains SO MUCH better. Normally the couple days before my Emgality shot (monthly anti-migraine peptid that was the most effective treatment I’ve had before the tirzepatide), I will start having more symptoms, worse migraines, more brain fog, etc. I didn’t even notice it this time. Almost missed my Emgality injection day because I didn’t have the symptom cues to remind me. I felt *great* the past few days despite it being the few days before my Emgality injection *and* the few days before my tirzepatide injection.
- It does not *cancel out* mcas, I can’t just… eat whatever I want and be fine. I had one day where I ate bread and dairy as an experiment, and the next day had brain fog / migraine / achey / fatigue all day. Still only a moderate migraine but it’s the worst I’ve had all month. So I still have to avoid histamine triggers. But it significantly reduces severity and frequency of flares. (And makes it easier to avoid eating trigger foods.) my metamour described it as a “blanket on top of the mcas symptoms” - she’s microdosing semaglutide and finds it prevents severe flareups though she still experiences mild to moderate flareups/symptoms. just doesn’t get knocked flat like she was before, which is huge (it’s been *debilitating* for her in a whole-body way, more so than for me, and more sensitive).
- weight talk: Losing weight a little faster than I’d prefer (2lb/wk week, or 0.9kg/week). I’m hoping some of that was just the inflammation/fluid weight and that it’ll thus slow down soon. Making sure I’m getting 60-80g protein/day, fiber, lots of hydration, and enough calories per day. Almost as many calories a day as I was eating before the meds, but still shedding weight faster than I’m comfortable with. So that’s fascinating and I don’t quite understand the mechanism there.
- I continue to feel less… swollen? Bloated? Puffy? felt like my skin was tight for so long. Uncomfortably so. Like yes some dysmorphia feelings because my body didn’t feel/look like it used to, but also it was like feeling swollen over my whole body which involved physical discomfort. Disconcerting experience. That’s gone and I feel like I can feel my skin again. I don’t know if that makes any sense. It’s just like there was …. Fluid or cotton beneath my skin and made everything hard to sense/perceive? and messed with proprioception. (This is also visible visually; I have been taking daily pictures of my face to evaluate this, and it looked significantly less puffy within a few days of the first injection.)
- joints continue to be way more stable. Except my shoulders, they got more unstable, my right shoulder feels like it keeps “dropping” out of place unless I actively engage the muscles. physical therapist confirmed it’s not fully in socket when I have that “dropping” sensation. Very uncomfortable. But my neck / ribs / wrists / ankles / knee / hips are soooo much better.
- I haven’t experienced worsened POTS symptoms, but I know it’s common for POTS to worsen on a GLP-1. The GLP1+GIP like tirzepatide seems to be somewhat better for POTS (there’s some evidence suggesting that worsening POTS symptoms are associated with increased GIP secretion) but reports on how POTS patients respond to it are mixed.
I started a new medication four days ago. It dramatically improved symptoms within 24 hours.
I just hyper focused on a project for a few hours for the first time in almost two years.
And yesterday, I realized partway through a client session that I was clear-headed, not fighting through brain fog, and was able to hold the client’s whole history in my head while working with them. I haven’t been able to do that in … I don’t know how long. Years.
I haven’t had brain fog for the past three days. I haven’t had a migraine for the last two days. I haven’t had to take a triptan / migraine rescue med all week.
My face is noticeably, dramatically less puffy with inflammation. My ears haven’t turned bright red with vascular pressure in three days, when that has been a near-daily occurrence since late 2021.
I can think. My mind is moving fast like it used to instead of sluggishly churning. I haven’t lost words partway through a sentence in three days. I’ve been able to access words reliably instead of groping for super common language and failing to find it.
My joints don’t hurt nearly as much, and don’t feel nearly so “floppy”/“loose”. A few days ago, my physical therapist confirmed that the inflammation around my joints is remarkably reduced, less swollen to the touch. My head isn’t hot to the touch. I slept on my side for a little bit last night and it didn’t immediately mess up my neck. The tinnitus isn’t quite gone, but it’s definitely less intense.
I had given up on ever being my old self or having my brain back. This is… this is wildly hopeful.
I started on 2.5mg zepbound. (I wanted vials to microdose with, buuuut insurance only covered the 2.5mg auto injectors. Hopefully this is tolerable. If the side effects are too much, I’ll resort to paying out of pocket for vials.) I was already frighteningly, intimidatingly hopeful about it before starting it, from the research papers and case studies and personal stories I’d read.
Here’s the paper that started me down this rabbit hole: Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.
“Among 47 cases (mean age 39, range 15–71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.”
Some more resources:
A possible new treatment for MCAS - roundup of research, case studies, etc.
Article sourcing interviews with practitioners/specialists who are prescribing it
Emerging roles of glucagon like peptide-1 in the management of autoimmune diseases and diabetes-associated comorbidities - This goes over a number of things that this med helps with, including PCOS, psoriasis, IBD, and Alzheimer’s.
Many of the studies on this with various conditions are relatively small and preliminary, but very promising. Hashimoto’s, multiple sclerosis (it seems to lead to re-myelination??), OCD (?!), rheumatoid arthritis, fibromyalgia, lupus, and … well, basically any condition that involves chronic inflammation. It’s also thought to have immunomodulation effects. Some folks are even reporting that it helps their c-ptsd symptoms and adhd symptoms. Obviously it also helps histamine-elevated anxiety, but that goes with the mcas treatment bit.
There’s currently a large trial (n=1000) in progress for its impact on long covid.
Also, iirc, no one in the MCAS study became underweight. Just symptom relief.
I did … way too much reading before getting on one of these myself. Lots of browsing forums where people share complications and experiences, trying to deduce a pattern in the problems. Here’s what I found (not scientific at all, just me looking for patterns in personal stories). Disclaimer: none of this is medical advice, I’m just sharing stories and observations, I am not a doctor, etc.
Sometimes people have reactions to the injection site. This may be due to nickel allergies and is sometimes cleared up by switching to a nickel-free needle (which aren’t terribly common, weirdly?).
Tirzepatide (which acts on GLP-1 and GIP) seems to be better tolerated than semaglutide. When semaglutide doesn’t work or causes intolerable side effects, people sometimes have better results when they switch to tirzepatide. But semaglutide does seem to improve symptoms for a significant subset of people.
Tirzepatide from a compounding pharmacy (which is more budget friendly and easier to get ahold of) is more likely to have complications than tirzepatide from the original manufacturer. Probably due to consistency issues. I also wonder if some people are having a reaction to the B-12 that compounding pharmacies frequently include in the tirzepatide solution. (I have no data to corroborate this suspicion, just speculating based on how mcas sensitivity can be with various components/additives of medication.)
People have more issues on higher doses. Currently this stuff’s only usually covered by insurance (in the u.s. at least) if you’re prescribed it for obesity or type 2 diabetes. The starting dose for diabetes (for tirzepatide anyway) is 2.5mg a week (injected). The starting dose for obesity is often 4-5mg/week. If you have mcas/are medication sensitive, this can be Way Too Much. Microdosing is not FDA approved, but i read mostly of people starting microdosing at 0.25 - 0.5mg a week. Microdosing generally causes fewer issues.
The other time people have issues is when they don’t hydrate enough, don’t eat enough protein/fiber, or try to eat larger meals instead of ~6 tiny meals through the day. (On day 2-3, I ran into the consequences of not eating frequent small meals quite enough. The slowed gut motility is obnoxious. Still figuring out the best rhythm for that and hoping it improves, as i’ve heard it often can. I’ve basically had one side effect per day, and each side effect goes away after a day, and then I get the next one.)
As for getting prescriptions: Rheumatologists are getting increasingly aware of this and willing to prescribe, so that’s a possible route if you’re already seeing someone who stays up on research. Otherwise… it’s hard to get on without a 27+ bmi and an additional condition (sleep apnea is a common one, but others are high bp, high cholesterol, fatty liver, and I’m sure there’s others). Possible, but more difficult.
Anyway, I can’t possibly sit on this. Obviously I’m only on day 5, haven’t even taken my second shot yet, but. The positive effects have been unreal. I didn’t think I was ever going to feel clear headed again, I’d nearly given up hope of more than marginal improvements. I’ve been dealing with severe symptoms for nearly five years. (And less severe symptoms for many years before that.)
Two week update…! I tallied up my migraine days / severities / etc over the past 6 weeks.
The 1 month before starting tirzepatide:
4 severe migraine days
9 moderate migraine days
14 mild migraine days
3 migraine free days
The past two weeks on tirzepatide:
1 moderate migraine days (had the migraine before taking the first shot so this might not count)
6 mild migraine days (concentrated around the couple days before the next dose, and/or the couple days before my menstrual cycle began)
7 migraine free days
All while maintaining a fairly stable weight. (Been hyper-vigilant about getting enough protein and hydration as neglecting those are the biggest pitfalls people fall into with this medication.) Actively trying to maintain a stable weight for now just to make sure I can manage caloric needs on this med; I dont want to lose muscle, that would be bad on so many levels.
And my neck was pretty badly misaligned for a good portion of the last week, which historically would mean severe migraine time… but instead I just had the neck discomfort without hardly any migraine. And minimal fluid backup/inflammation. (Confirmed by my physical therapist who was very surprised by how bad my neck was yet how low my pressure/inflammation was.)
But also my joints are more stable overall, and go back into place easier, and stay there for longer once they’re where they should be. Everything is less wobbly since there isn’t so much swelling. AndI mean everything - neck, wrists, fingers, hips, knees, ankles.
Haven’t noticed any worsening in POTS symptoms either. Haven’t noticed POTS symptoms at all, now that I think about it. Haven’t been tracking those like I’ve been tracking inflammatory symptoms / migraine / mast cell stuff though.
Also I haven’t taken an antihistamine in two weeks??? and barely taken any anti-inflammatories / NSAIDs, and only one dose a day when I do take an NSAID???? I was taking waaay too many NSAID’s prior to this just to function. (and in the past few months I started feeling fairly prompt, sharp negative reactions to NSAID’s - cramping and abdominal pain - so I knew the 15+ years of 600-800mg ibuprofen, sometimes multiple times a day, was finally catching up to me and something needed to change.)
My body feels better. I feel better in my body. My brain feels better, I don’t feel like I’m walking with a concussion all the time. I haven’t lost words partway through a sentence in 2 weeks. I’m in less pain.
My mood has improved. I’m down to my pre-quarantine summer dose of my antidepressants do the first time since 2020 (and realizing I may have been using the higher dose to brute force my way through the cranial pressure brain fog). There’s bit of extra somatic anxiety, but I’m not sure if that’s situational/environmental/related to deadline stresses, or if it’s chemical. Will have more clarity on that in a week or so.)
Oh and the digestive side effects have improved dramatically. Whew. That’s the one I was most nervous about. I can tolerate a lot of side effects if it means I get to be *me* again, but my understanding is that certain severe levels of slowed gut motility are as debilitating and life-interfering as the kind of migraine stuff I was dealing with. I’d rather not just trade one problem for another of equal severity. But it’s looking like I’m gonna be okay on that front. (Keeping fingers crossed but overall relieved there.)
The 3 inches (7.6 cm) of fluid/inflammation/?? that disappeared from my waist after the first few days has not returned. Hasn’t gone down any further, so I suspect that was the amount of pure… puffiness/inflammation/fluid-retention I was dealing with. Was briefly worried it was fluid loss from digestive issues but the measurement hasn’t changed after my digestive stuff improved. And I have been hydrating sooo much. So that’s fascinating and a bit wild.
I started a new medication four days ago. It dramatically improved symptoms within 24 hours.
I just hyper focused on a project for a few hours for the first time in almost two years.
And yesterday, I realized partway through a client session that I was clear-headed, not fighting through brain fog, and was able to hold the client’s whole history in my head while working with them. I haven’t been able to do that in … I don’t know how long. Years.
I haven’t had brain fog for the past three days. I haven’t had a migraine for the last two days. I haven’t had to take a triptan / migraine rescue med all week.
My face is noticeably, dramatically less puffy with inflammation. My ears haven’t turned bright red with vascular pressure in three days, when that has been a near-daily occurrence since late 2021.
I can think. My mind is moving fast like it used to instead of sluggishly churning. I haven’t lost words partway through a sentence in three days. I’ve been able to access words reliably instead of groping for super common language and failing to find it.
My joints don’t hurt nearly as much, and don’t feel nearly so “floppy”/“loose”. A few days ago, my physical therapist confirmed that the inflammation around my joints is remarkably reduced, less swollen to the touch. My head isn’t hot to the touch. I slept on my side for a little bit last night and it didn’t immediately mess up my neck. The tinnitus isn’t quite gone, but it’s definitely less intense.
I had given up on ever being my old self or having my brain back. This is… this is wildly hopeful.
I started on 2.5mg zepbound. (I wanted vials to microdose with, buuuut insurance only covered the 2.5mg auto injectors. Hopefully this is tolerable. If the side effects are too much, I’ll resort to paying out of pocket for vials.) I was already frighteningly, intimidatingly hopeful about it before starting it, from the research papers and case studies and personal stories I’d read.
Here’s the paper that started me down this rabbit hole: Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.
“Among 47 cases (mean age 39, range 15–71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.”
Some more resources:
A possible new treatment for MCAS - roundup of research, case studies, etc.
Article sourcing interviews with practitioners/specialists who are prescribing it
Emerging roles of glucagon like peptide-1 in the management of autoimmune diseases and diabetes-associated comorbidities - This goes over a number of things that this med helps with, including PCOS, psoriasis, IBD, and Alzheimer’s.
Many of the studies on this with various conditions are relatively small and preliminary, but very promising. Hashimoto’s, multiple sclerosis (it seems to lead to re-myelination??), OCD (?!), rheumatoid arthritis, fibromyalgia, lupus, and … well, basically any condition that involves chronic inflammation. It’s also thought to have immunomodulation effects. Some folks are even reporting that it helps their c-ptsd symptoms and adhd symptoms. Obviously it also helps histamine-elevated anxiety, but that goes with the mcas treatment bit.
There’s currently a large trial (n=1000) in progress for its impact on long covid.
Also, iirc, no one in the MCAS study became underweight. Just symptom relief.
I did … way too much reading before getting on one of these myself. Lots of browsing forums where people share complications and experiences, trying to deduce a pattern in the problems. Here’s what I found (not scientific at all, just me looking for patterns in personal stories). Disclaimer: none of this is medical advice, I’m just sharing stories and observations, I am not a doctor, etc.
Sometimes people have reactions to the injection site. This may be due to nickel allergies and is sometimes cleared up by switching to a nickel-free needle (which aren’t terribly common, weirdly?).
Tirzepatide (which acts on GLP-1 and GIP) seems to be better tolerated than semaglutide. When semaglutide doesn’t work or causes intolerable side effects, people sometimes have better results when they switch to tirzepatide. But semaglutide does seem to improve symptoms for a significant subset of people.
Tirzepatide from a compounding pharmacy (which is more budget friendly and easier to get ahold of) is more likely to have complications than tirzepatide from the original manufacturer. Probably due to consistency issues. I also wonder if some people are having a reaction to the B-12 that compounding pharmacies frequently include in the tirzepatide solution. (I have no data to corroborate this suspicion, just speculating based on how mcas sensitivity can be with various components/additives of medication.)
People have more issues on higher doses. Currently this stuff’s only usually covered by insurance (in the u.s. at least) if you’re prescribed it for obesity or type 2 diabetes. The starting dose for diabetes (for tirzepatide anyway) is 2.5mg a week (injected). The starting dose for obesity is often 4-5mg/week. If you have mcas/are medication sensitive, this can be Way Too Much. Microdosing is not FDA approved, but i read mostly of people starting microdosing at 0.25 - 0.5mg a week. Microdosing generally causes fewer issues.
The other time people have issues is when they don’t hydrate enough, don’t eat enough protein/fiber, or try to eat larger meals instead of ~6 tiny meals through the day. (On day 2-3, I ran into the consequences of not eating frequent small meals quite enough. The slowed gut motility is obnoxious. Still figuring out the best rhythm for that and hoping it improves, as i’ve heard it often can. I’ve basically had one side effect per day, and each side effect goes away after a day, and then I get the next one.)
As for getting prescriptions: Rheumatologists are getting increasingly aware of this and willing to prescribe, so that’s a possible route if you’re already seeing someone who stays up on research. Otherwise… it’s hard to get on without a 27+ bmi and an additional condition (sleep apnea is a common one, but others are high bp, high cholesterol, fatty liver, and I’m sure there’s others). Possible, but more difficult.
Anyway, I can’t possibly sit on this. Obviously I’m only on day 5, haven’t even taken my second shot yet, but. The positive effects have been unreal. I didn’t think I was ever going to feel clear headed again, I’d nearly given up hope of more than marginal improvements. I’ve been dealing with severe symptoms for nearly five years. (And less severe symptoms for many years before that.)
I will add this: a downside of this medication is that every time you look up “[side effect you’re experiencing] medication-name”, most discussion you’ll find on forums is tainted with diet culture awfulness. It just feels gross every time. Sometimes you’ll get lucky and find a discussion thread on a medical condition board instead of a medication-specific forum, but even then, people will still make icky weight loss comments.
On the other hand, it’s the only way I was able to learn that the bizarre, bone-deep cold/chills I was experiencing on day 1 (starting within an hour of taking the shot in the late morning and getting worse until they finally cleared up in the evening) are a not-uncommon side effect that … isn’t listed on any medication guides as a side effect.
I started a new medication four days ago. It dramatically improved symptoms within 24 hours.
I just hyper focused on a project for a few hours for the first time in almost two years.
And yesterday, I realized partway through a client session that I was clear-headed, not fighting through brain fog, and was able to hold the client’s whole history in my head while working with them. I haven’t been able to do that in … I don’t know how long. Years.
I haven’t had brain fog for the past three days. I haven’t had a migraine for the last two days. I haven’t had to take a triptan / migraine rescue med all week.
My face is noticeably, dramatically less puffy with inflammation. My ears haven’t turned bright red with vascular pressure in three days, when that has been a near-daily occurrence since late 2021.
I can think. My mind is moving fast like it used to instead of sluggishly churning. I haven’t lost words partway through a sentence in three days. I’ve been able to access words reliably instead of groping for super common language and failing to find it.
My joints don’t hurt nearly as much, and don’t feel nearly so “floppy”/“loose”. A few days ago, my physical therapist confirmed that the inflammation around my joints is remarkably reduced, less swollen to the touch. My head isn’t hot to the touch. I slept on my side for a little bit last night and it didn’t immediately mess up my neck. The tinnitus isn’t quite gone, but it’s definitely less intense.
I had given up on ever being my old self or having my brain back. This is… this is wildly hopeful.
I started on 2.5mg zepbound. (I wanted vials to microdose with, buuuut insurance only covered the 2.5mg auto injectors. Hopefully this is tolerable. If the side effects are too much, I’ll resort to paying out of pocket for vials.) I was already frighteningly, intimidatingly hopeful about it before starting it, from the research papers and case studies and personal stories I’d read.
Here’s the paper that started me down this rabbit hole: Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.
“Among 47 cases (mean age 39, range 15–71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.”
Some more resources:
A possible new treatment for MCAS - roundup of research, case studies, etc.
Article sourcing interviews with practitioners/specialists who are prescribing it
Emerging roles of glucagon like peptide-1 in the management of autoimmune diseases and diabetes-associated comorbidities - This goes over a number of things that this med helps with, including PCOS, psoriasis, IBD, and Alzheimer’s.
Many of the studies on this with various conditions are relatively small and preliminary, but very promising. Hashimoto’s, multiple sclerosis (it seems to lead to re-myelination??), OCD (?!), rheumatoid arthritis, fibromyalgia, lupus, and … well, basically any condition that involves chronic inflammation. It’s also thought to have immunomodulation effects. Some folks are even reporting that it helps their c-ptsd symptoms and adhd symptoms. Obviously it also helps histamine-elevated anxiety, but that goes with the mcas treatment bit.
There’s currently a large trial (n=1000) in progress for its impact on long covid.
Also, iirc, no one in the MCAS study became underweight. Just symptom relief.
I did … way too much reading before getting on one of these myself. Lots of browsing forums where people share complications and experiences, trying to deduce a pattern in the problems. Here’s what I found (not scientific at all, just me looking for patterns in personal stories). Disclaimer: none of this is medical advice, I’m just sharing stories and observations, I am not a doctor, etc.
Sometimes people have reactions to the injection site. This may be due to nickel allergies and is sometimes cleared up by switching to a nickel-free needle (which aren’t terribly common, weirdly?).
Tirzepatide (which acts on GLP-1 and GIP) seems to be better tolerated than semaglutide. When semaglutide doesn’t work or causes intolerable side effects, people sometimes have better results when they switch to tirzepatide. But semaglutide does seem to improve symptoms for a significant subset of people.
Tirzepatide from a compounding pharmacy (which is more budget friendly and easier to get ahold of) is more likely to have complications than tirzepatide from the original manufacturer. Probably due to consistency issues. I also wonder if some people are having a reaction to the B-12 that compounding pharmacies frequently include in the tirzepatide solution. (I have no data to corroborate this suspicion, just speculating based on how mcas sensitivity can be with various components/additives of medication.)
People have more issues on higher doses. Currently this stuff’s only usually covered by insurance (in the u.s. at least) if you’re prescribed it for obesity or type 2 diabetes. The starting dose for diabetes (for tirzepatide anyway) is 2.5mg a week (injected). The starting dose for obesity is often 4-5mg/week. If you have mcas/are medication sensitive, this can be Way Too Much. Microdosing is not FDA approved, but i read mostly of people starting microdosing at 0.25 - 0.5mg a week. Microdosing generally causes fewer issues.
The other time people have issues is when they don’t hydrate enough, don’t eat enough protein/fiber, or try to eat larger meals instead of ~6 tiny meals through the day. (On day 2-3, I ran into the consequences of not eating frequent small meals quite enough. The slowed gut motility is obnoxious. Still figuring out the best rhythm for that and hoping it improves, as i’ve heard it often can. I’ve basically had one side effect per day, and each side effect goes away after a day, and then I get the next one.)
As for getting prescriptions: Rheumatologists are getting increasingly aware of this and willing to prescribe, so that’s a possible route if you’re already seeing someone who stays up on research. Otherwise… it’s hard to get on without a 27+ bmi and an additional condition (sleep apnea is a common one, but others are high bp, high cholesterol, fatty liver, and I’m sure there’s others). Possible, but more difficult.
Anyway, I can’t possibly sit on this. Obviously I’m only on day 5, haven’t even taken my second shot yet, but. The positive effects have been unreal. I didn’t think I was ever going to feel clear headed again, I’d nearly given up hope of more than marginal improvements. I’ve been dealing with severe symptoms for nearly five years. (And less severe symptoms for many years before that.)
Their mom notices, at the dinner table. She sees no nagging children, no stupid fights. She sees Lucy eating and speaking with perfect manners, Edmund analysing the economy and war with concerning skill, Susan being gracious but poised, like a diplomat.
Their father sees it in Peters eyes the first time they get into a fight. When he moves to punish Edmund for speaking out of turn, Peter calls him out on it. When his gaze meet his eldest son's, he's leveled by the war he sees behind it, the tensed muscle in his arm, the knuckles white around his knife. He's seen that before, in other soldiers. He doesn't know how to react.
Other children notice, too. Talking to all the Pevensie kids at the same time is like being the only one left out of a secret, and the way they touch and tease each other speaks of a history far deeper than their polite demeneor lets on. And when they walk they fall in line, as if there is a natural hierarchy between them.
The first time anyone picks a fight with Edmund, Peter comes home with a three week suspension and blood around his mouth. He looks more alive than you've seen him in weeks.
When Susan gets back in the pool after Narnia, she wins all the contests. Coaches can't explain how to beat her, because they don't understand how she's doing it, either. She seems to almost disappear when underwater.
Lucy, always gay and golden-haired, starts dancing, and never misses a step. She moves with an elegance that no 10 year old should have, and all the girls want to be friends with her
Edmund soon becomes the best student in his faculty. He always seems to know the right thing to say, and teachers laud his ability to think through complex problems. His mouth does get him in trouble sometimes, but the boy seems uncatchable, always talking his way through the cracks. And if not?
No one actively fears Peter, but everyone is a little scared of him sometimes. He's tall for his age, sure, but there is something else, some other air that seems to give him an authority far beyond what's normal for a teenage boy. He's nice enough, but teachers can't stand it, and bullies learn very quickly that pissing him off means missing teeth and black eyes.
The Pevensies are not quite inhuman, but not fully mortal, either
COULD you talk about ways to socially manipulate your doctor though? i've been trying to get evaluated for endometriosis for the better part of a decade but keep getting blown off. meanwhile my OBGYN is complaining that i've been on depo for a decade. yeah, because it makes me stop having a period. the period i keep telling y'all is unbearably painful. imagine that
So I will try.
I will give an example of what I did with my ADHD.
I was on stimulants and was miserable about it. I wanted to try new meds but I tested as "excellent response" when I took stimulants. So they were going to leave me on Adderall forever.
I did my research and based what I was reading on how I felt and my ways of reacting to things and determined that I should try a "dopamine reuptake inhibitor". Basically ADHD is about dopamine being poorly regulated in the brain, for a number of reasons. Your brain in proper function, has a stimulus responds with neurotransmitters (dopamine, serotonin, norepinephrine, epinephrine, histamine are all called monoamines but that is just one class) and then after a while it absorbs them so that the feeling passes. You want to stay scared/happy/sad ect then you need continued stimulus. Well I am bad at feeling happy, I am bad at getting things right with a normal amount of practice, I am clumsy... all of this points to dopamine specifically. It tells you good job when you get something right, it allows you to feel happy, it aids in coordination and not knocking into things because you get rewarded for not doing that and dodging.
But I DO feel these things, but just for fleeting moments. So I figured, that is probably the reuptake. I looked into what drugs are like that for ADHD and I found two candidates. I cant remember their names so lets call them chemX and chemY. Chem X had a cool sounding name but nothing else was remarkable about it. Chem Y is used in like everything and also lowers your blood pressure.
HERE IS THE BIG SECRET
Your doctor does not have an inexhaustible amount of time knowledge and research they have done about everything. They have to look shit up. Your research is probably just as valid as theirs. You have endometriosis and depo for 10 years. you have the motivation to look in vetted sources and come up with treatments and methods that you have spent 6+ hours finding and your doctor isnt interested in doing 6+ hours of research when the AMERICAN HEALTHCARE SYSTEM is telling them "look look look I know we officially say 20 mins, and we only give you 15, but if you could take only 10, you might actually get home on time tonight".
So just go a few steps backwards in your research, explain your well reasoned way you got there in a minute or less ( yes practice this part beforehand) and then sort of leave off before they get to the suggested solutions. They will look it up, see the solution as low hanging fruit RIGHT THERE and they will snag it.
I told my doctor about the dopamine reuptake inhibitors, I told him that they sounded right for me as a new classification of drugs to try, and I mentioned that my blood pressure was getting a bit high and that stimulants made that problem worse... so was there anything he could try with me... and low and behold the doctor found Chem Y the one that also lowers blood pressure!
He even had a smug grin on his face because he was proud of himself for solving the puzzle.
It is like the trick parents use with toddlers. if you pick an outfit and say "put this on!" they fight you the entire time. but if you lay out 2 outfits and say "which outfit would you like to wear today?!" they will jump at the option for the red shirt or the yellow shirt.
trick #2
STAY FOCUSED
You have a goal for going to the doctor.
Stay on target. My leg is broken.
"Hello doctor I am here about my broken leg."
"your blood pressure is a bit higher than I would like"
"after we talk about that we will talk about my leg?"
go along with whatever they want to do or talk about, be agreeable but keep bringing up that you came there for a reason, paid the copay for a reason and would like to have a resolution to that issue.
"I would like to see you lose some weight that should bring down your blood pressure and reduce the strain on your leg"
"Okay what steps are we going to take to reduce my weight?"
If they bring up **alternative health problems** They are usually a dismissal of the health problem you brought along to showcase. The doctor probably doesn't even realize nor believe that they are doing it. So the uno reverse card on this one is to ask them how to solve it. "yes I have tried diet and exercise and they did not have the desired results, so what else do you have to try?" If they have no suggestions for you then ask them to say that they had no suggestions to solve that issue in your chart. (we will come back to this)
Then when they are done with that ask what we are doing about the health problem itself. SO now they can fall back on the throw away solutions that they gave no actual pathways to, or an outright refusal to address your health concern. If they do either of these ask to have it noted in your chart.
At the end summarize the visit. Know the words prognosis diagnosis and treatment. I came in with leg pain, the prognosis is the 3 stairs I fell down and landed on my leg, the diagnosis is a minor fracture of the fibula and the treatment is a walking cast that I will go get at the pharmacy on my way home.
If you cant say all of that then go as far as you can and what you are doing about it. I cam in with leg pain, the prognosis is that I fell down 3 stairs, we suspect a diagnosis of a broken leg and we will confirm the diagnosis with an x-ray which is I will schedule on my way out at the front desk, and in the mean time I am prescribed a walking cast that I will get from the pharmacy on the way home.
If you cant go through steps like that or they just sort of stop somewhere it points out how unfinished the office visit is. I have told friends to bring in a notebook and write down these steps to keep it straight. Assure the doctor this is to help you keep it straight because you want to make sure you understand your own health and what you need to do. Write it all down, it isnt to keep tabs on the doctor that is what the state medical board is for, I just want to make sure I get the correct information down.
After the appointment when you go to the front desk, IF you had to ask that something gets noted in your medical chart THEN ask for a copy of your medical chart. Under HIPPA Federal statute 45 CFR § 164.524 you have "The Privacy Rule generally requires HIPAA covered entities (health plans and most health care providers) to provide individuals, upon request, with access to the protected health information (PHI) about them in one or more "designated record sets" maintained by or for the covered entity" So if you run into them not wanting to provide it just quote that at them and they should either comply or commit such a federal violation that you can go to the state medical board with your complaints then the media and watch your bank account explode with your litigation earnings.
Story time. I had a doctor and she was my new Primary Care Physician. I was trying to get an appointment to go see the ADHD specialist. I spent 8 months from first day picking up the phone and asking how I get ADHD meds to that appointment. At the appointment she REFUSED to acknowledge any mental health issues. I was there for a mental health referral and she acted like I had not said anything any time I brought it up. After the appointment I went to my car and cried. Then I took my evidence that showed that I was there for an ADHD referral, and my after visit summary that said nothing about any referral and I researched how to submit a complaint to my state medical board... and 6 months later I received a letter that that physician had their medical license revoked in my state. I thought I was just going to be a black mark on their record, I was stunned they got "you have to move to a new state" level of fucked.
So if you ask for something to be noted on your chart and they dont do it... turn their ass in and make them answer the question to an inquest. "was the patient aggressive at all? were they demanding? Did their request make sense? Did they seem threatening? Did they make any irrational demands? So why exactly did you fail to fail to note a failed prognosis on their chart? What treatment options did you give when the patient said the current regimen wasn't working?"
Defensive medicine is a dual edged sword. Make them spend company money lavishly on you and your problems. Take a hunk right out of the healthcare exe's yacht fund.
If it’s possible (with your finances, insurance, and region)… search for a social media group of people *in your area* with the issue you have (or think you might have). Eg “endometriosis Cleveland Ohio” or something. Yes this will probably lead you to Reddit or Facebook; you don’t need to use it beyond this resource, but static websites are just not as up to date or comprehensive. You want crowdsourced recommendations.
Look through the group for recommendation posts. There might be some pinned ones (the local Ehlers Danlos Facebook group I’m in is fantastically organized with specialist-specific recommendations threads all indexed in a pinned post), or you might have to search the group/forum for the kind of doctor you need. If all that fails, you can make a post asking for recommendations. But it probably already exists.
Go through the recommended specialists. Some will be warnings against them, some will be recommendations for them. Often people will provide additional details like “he’s great and helpful, but he is always 1-3 hours late so plan for that, and take copious notes because his chart notes are not helpful” (like one of the top recommended rheumatologists in my region. Who was indeed super helpful and thorough. And was 3 hours late to my first appointment). Useful guidance.
Then, if the specialist meets your various needs and insurance/financial requirements, go to a medical professional you’re already seeing and ask for a referral to that specialist. Or go directly to the specialist, if that’s an option (sometimes it is).
I have had so much success with this strategy (and I’ve had to see so many different specialists). Really minimizes the amount of M.Deity complexes you have to manage/work around.
(This especially applies to getting diagnosed with something complex/chronic/systemic, like Ehlers Danlos or MCAS or such. It won’t work to go to a general physician and ask what’s wrong with you. You have to figure out what you might have, then go directly to a specialist for that thing, in order to get fairly and competently assessed.)
I'm in an RP. Said RP involves a character who has compulsive sex as a way of validating and distracting himself from untreated depression and PTSD. As part of his storyline, we're doing a series of scenes where he gets help and moves to a healthier relationship with his body and partners, so sex is enjoyable again and not just compulsive. We like referencing real-world materials as part of the fun. How tf do I find good sex therapy resources that aren't implicitly conservative...
Start with AASECT’s list of yearly book awards! (American Association of Sexuality Educators, Counselors and Therapists. They’re quite the opposite of implicitly conservative.)
Their continuing education classes aren’t going to be what you’re looking for but the class summaries might have links, names, and books/articles that’ll get you closer to what you’re looking for.
They also have a list of member books and publications.
Sexual Health Alliance also has some decent resources. (They mention Nagowski’s Come As You Are, which is is phenomenal but focused on women’s sexuality, so probably not quite so relevant to your roleplay. Still, I’ve found the dual control model relevant for everyone. Also, worksheets!)
ok but roadrunners are so cool, I can seldom think of a bird more velociraptor-like
more people need to know they’re real because look at this, this is some real walking with dinosaurs shit
they have powerful legs allowing them to run up to 20mph and leap to impressive heights with ease
they are extremely swift and fearless, quick enough to take down a sizable rattlesnake and other large prey animals like lizards and mice
they have several unique adaptations to thermoregulate, such as the dark patch of feathers on their back which acts as a solar panel to absorb heat, or its crest that either releases or absorbs heat by exposing its skin
they have these long, stiff tailfeathers that they use as a counterbalance when running, very reminiscent of the rod-like tail of a dromaeosaur
and they are capable of bursts of flight/gliding with incredibly beautiful plumage
I’m genuinely shocked how many people think they’re made up, they are real and they are AWESOME
Cannot emphasize enough that the statistical likelihood of you exclaiming “IS THAT A FUCKING ROADRUNNER?!” the first time you see one in the wild is close to 100%.
Welcome, welcome! You’re reading Feel Good News with Erica — the little corner where we collect reasons to smile.
1. Green Sea Turtles No Longer Endangered in Conservation Win
The green turtle, once classified as “endangered,” has been reclassified as “least concern” on the IUCN Red List of Threatened Species. This positive outcome is the result of decades of sustained conservation efforts, including protecting nesting females and their eggs, reducing unsustainable harvest, and implementing measures to reduce accidental capture in fishing gear. While this is a major win for turtle conservation, some subspecies remain threatened, and the IUCN’s latest update also highlights the ongoing biodiversity crisis, with declines in bird populations and the extinction of several species. Conservation efforts must continue to ensure the green turtle’s recovery and protect other threatened species around the world.
2. ISPs angry about California law that lets renters opt out of forced payments
California Governor Gavin Newsom has signed a new law that aims to increase broadband competition in apartment buildings. The law, which takes effect on January 1, requires landlords to allow tenants to opt out of paying for any internet service provider subscription offered through a bulk-billing arrangement. The law was opposed by the cable and real estate industries, who argued it would undermine the cost savings of bulk billing. However, the bill’s author, Assemblymember Rhodesia Ransom, said it was a first step to ensure tenants are treated fairly and would boost competition from smaller internet service providers. The law fills a gap in federal rules, as it gives tenants more choice in their internet provider.
3. Autistic man axed by Waitrose after working for free for four years offered paid job at Asda
Tom Boyd, a 28-year-old autistic man, had been working unpaid for over four years at a Waitrose store in Cheadle Hulme. When his family asked if he could be given a few paid hours to recognize his hard work, Waitrose reportedly gave a “dismissive” and “cold” response, stating that Tom could not “do the full role.” This decision sparked national outrage. However, rival supermarket Asda has now offered Tom a paid role with two five-hour shifts per week, providing him with the opportunity to have a paid job and the sense of belonging and independence he had enjoyed during his unpaid work. The story has highlighted the challenges faced by disabled people in the workplace, particularly concerning the fairness of volunteering arrangements, and the need for greater inclusivity and support from employers.
4. Advice to feed babies peanuts early and often helped 60,000 kids avoid allergies, study finds
A decade after a study showed that early introduction of peanut products can prevent peanut allergies in children, new research finds that the change in medical guidance has led to a significant decline in peanut allergies in the U.S. The rate of peanut allergies in young children fell by more than 27% after the initial guidance was issued in 2015, and by over 40% after the recommendations were expanded in 2017. This means that about 40,000 children have avoided developing peanut allergies since 2015. Despite this progress, food allergies still affect around 8% of children, including over 2% with peanut allergies. The research highlights the importance of early introduction of peanut products, which was previously not recommended, as it can significantly reduce the risk of developing peanut allergies. However, implementing this new guidance has been slow, with only about 29% of pediatricians and 65% of allergists following the recommendations as of 2017.
5. Russia’s Coal Collapse Marks The End Of Fossil Fuel Post-War Illusion
Russia’s coal industry is facing a deep crisis, with prices plummeting and over half of producers losing money. Sanctions, soaring logistics costs, and the decline of the global coal market have led to the collapse of this once-vital sector. In parallel, the U.S. coal industry is also struggling, with federal lease auctions attracting minimal bids as the market prices coal out of the future energy mix. These events are part of a broader global transition away from fossil fuels towards renewable energy and storage technologies. Clean energy has now surpassed coal in global electricity generation for the first time, marking a major turning point. Batteries and other clean technologies are rapidly scaling up, becoming cheaper and more reliable than fossil fuels.
6. Breakthrough Vitamin K Compounds May Reverse Alzheimer’s Damage
Researchers in Japan have developed enhanced versions of vitamin K that could help the brain repair itself by generating new neurons. These redesigned molecules, created by combining vitamin K with retinoic acid, showed three times the ability to turn stem cells into neurons compared with natural vitamin K. The study found that the novel vitamin K analogues exhibited potent neuronal differentiation-inducing activities, suggesting they could serve as regenerative agents to help replenish lost neurons and restore brain function in neurodegenerative diseases. The researchers also uncovered a previously unknown mechanism through which vitamin K promotes the formation of neurons, involving metabotropic glutamate receptors (mGluRs), particularly mGluR1. Further analysis demonstrated that the novel vitamin K compound could efficiently cross the blood-brain barrier and produce higher levels of the active form of vitamin K in the brain compared to the standard form.
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That’s it for last week :)
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I remember an interaction that happened to my husband. A Christian evangelist - pretty, young, female, American - stopped him urgently on a street in England, and asked, "what makes you happy?"
Clearly any answer at all would be an excuse for her to suggest Jesus, and aggression or denial would be taken as evidence of the unrighteous nature of unbelievers.
But he - not thinking of much at all - just smiled pleasantly and said, sincerely, "autumn."
And she was like. yeah. actually. and she smiled, and thought about it, and nodded, and they thought together about autumn, and then he went on his way.
This is a true story, but - if you look at the content - you'll note that it's barely a story.
I wrote it up in response to seeing a post where someone told a reasonable, believable small anecdote, but wrote it while using an exciting framing. The OP was challenged by people saying "it didn't happen / wouldn't have happened that way." But the only "exciting" part of the story was the framing. I challenged myself to tell an equal-level true story in the plainest possible way I could, and got the above.
When we put on our Reading Comprehension Goggles, we see that what actually happens in these anecdotes is usually incredibly mundane. It isn't the action in the story that's unbelievable, it's that the storyteller used craft in telling it. Using the craft and conventions of fiction can cause some readers to believe - like overly reactive antibodies attacking the body's own tissues - that the content must be fiction too.
Attention tends to follow framing, craft and skill - not the relative excitement of the content. A masterful communicator can wrench thrills, jokes and drama from making a cup of tea. A poor communicator can't even rally interest in a moon landing.
The point of the story above is miniscule: someone asking a stranger "what makes you happy?" and the "main" character answering "autumn." Those two lines of dialogue are barely a story by themselves - utterly believable, and not really meaning much. The context, how it's presented, the very sparse framing, and the fact that there is an "ending" (a final reflection) are what make it a story.
In writing it, I conveyed a decent whack of information, such as who the characters are, the location, and nationalities (skilled and attentive readers could gather additional information from this - the American was probably a Mormon). I created a very small buildup of expectation, and a very small reversal of expectation. It possibly makes the reader think, for a moment, of autumn - leaving them with a pleasantly elegiac feeling. I could have pushed this, but did not. The sentences have some varying structure and a pleasant cadence, but are not beautifully tuned. I did not use any particular tricks or craft to embellish the post. I could have rallied the readers at the end with a call to action ("let's all think about autumn together"), but that would have been additional craft, so I didn't. It's just a story.
Still, I spotted that it could be a story, and gave it the elements it needed to be a story. It's believable.
Synthesis
I sometimes see people disagreeing with or disliking a post, by myself or by others, because it was written too much like a story. People will often get exceptionally cross that readers like stories. It's fair enough, but step back and think of the criticism: it was written to be too interesting. Too accessible. Too in-touch-with-tumblr-trends. The writer used too much craft. They connected with their audience too well. People liked them too much.
I often see people complaining that their perfect, accurate, graduate-paper-quality, correcting-the-tide-of-misinformation posts about Important Things don't get as much attention.
They blame the Ignorant Public for this (not a great way to make the Ignorant Public like you more) citing the Ignorant Public's poor taste.
Early on in my comms-to-change-the-world career, I discussed the Terry Pratchett quote, "a lie can run around the world before the truth can put its boots on," with an experienced and famous person who pointed out that the truth is also perfectly capable of moving quickly. And if it isn't, the truth can certainly be made (crafted? bred? engineered? given slip-on running trainers? woken up earlier?) to be faster. It's just that there are few high-quality storytellers in the business of quick truths.
It's tempting to berate the Ignorant Public for failing to appreciate our best-beloved messages. However, this is neither kind nor useful, and achieves the opposite of the intended effect. (It's also not our most self-aware belief; even if we are an expert in something, in other spheres, we are someone else's Ignorant Public - where we behave exactly as the Ignorant Public does, because that is what we are there.)
Instead of trying to bring "exciting but flawed" material down, we could be better storytellers who raise better-quality material up.
Instead of complaining about how engaging material gets more engagement - a sort of toddler-level argument - we could attempt to raise the standards of how people read, and encourage excellent taste in the public.
We don't even have to do that much. I didn't do any tricks with this one - I physically stopped myself from making it "better" - but it is still a nice little story, that can be admired for a moment, like an acorn.
Assignment
Your assignment, should you choose to accept it, is to create a small story about a similar real moment in your life - something that's barely a story, but still rather nice, like an acorn. The one above is 102 words. Consider the ending of the story, and what lingering afterimage of emotion you would like the reader to feel.
Stretch challenges
If you normally tell an elaborate story, try a very simple one. If you normally tell a simple story, try to elaborate it.
Make it so a reader on tumblr wouldn't believe it, because it's told too well.
I was walking home once late in the afternoon. I don’t remember much about it beyond a few things:
I was tired. The sun was in stages of dusk already. It was before 6pm. I had no music playing. I was walking on a pavement where the only crossing was the back of the large store area needed for lorries to come in and out. I saved someone’s life.
It’s a real story. Though the life that was saved was less of a self-proclaim but more because they told me it themselves.
I heard a lorry move, the rumble of the engine, the drive of wheels turning on tarmac. I stopped as one does at the edge of the pavement, and I waited. At the same, the lorry came out. At the same time, someone on a bike stopped right by me.
“You saved my life,” he said, a stranger, who I realised might not heard or seen the lorry appear in time.
When the tail end of the lorry left the opening, 2 seconds later, the stranger left, already biking away. A bit fast, a bit loose—no helmet. And I was standing there stunned, until I remembered I had to go back home too.
I think about it all the time. It’s my answer I come back whenever my depressions demands to know why I should keep on living.
Someone else might need me to stop by the pavement, someone else might need help realise they were about to bike straight into a lorry they didn’t see coming.
The author’s writing choices show how they’re still turning the moment over. We are not such much invited in as given a pile of information - short staccato points of data - and then the writer turns to us, like the Ancient Mariner or Ishmael - and says suddenly, this is real. HWAET! That’s a very good storytelling choice, and one you could make again.
This is an interesting series of movements because it’s tremendously small and nearly-pointless. A lorry, a bicycle, one moment. But it shifted something in the writer.
This kind of story is, weirdly, exactly the ones that Redditors get the most annoyed about. They’re out there measuring the angle of the sun, accusing the OP of exaggerating their role (in stopping for a moment) because curbs in Australia are ten centimetres different from what OP described. The precise movements of the items and their velocities are not important - it doesn’t matter if they’re true, false, out-of-order, reported unclearly, misremembered, irrational or unbelievable. It does not matter if the bicyclist would have actually been fine, if it didn’t happen like that, if it seems too small. That is not the point of the story; the point is the shift they caused in the writer. Nobody in the moment of a life shift can expect their brain to imprint information that a Redditor would judge truth-worthy. OP remembers, as the moment crystallises, that the cyclist was careless - no helmet - that they probably did save a life.
A very nice contrast between small movements and big shifts. And well done.
As more and more people are being forced to switch to Windows 11, Microsoft's most AI-malware-ridden OS yet, I've been putting together articles and links for how to undo the damage and save your battery, your RAM, your disk space, your privacy, and your sanity from this bullshit.
FIRST:
The easiest way to get rid of the majority of the bullshit that Windows is forcing on us, as of October 2025, is this one-stop-one-click debloat solution from a modern day hero:
A simple, lightweight PowerShell script to remove pre-installed apps, disable telemetry, as well as perform various other changes to customi
It's very easy, even if you're not tech savvy or get scared of pop up windows saying "ARE YOU SURE?" Yes, you are sure, I promise. This program takes maybe two minutes and will save you SO MUCH pain, time, and money (and exploitation).
Now that you've done that, here's the cleanup, to catch the little shit that the debloat might have missed (most of this will already be done by debloat, but hey, it's good to double check).
Microsoft wants to put AI everywhere on your PC, but you can take back control.
Even just reading about some of these features makes me angry. Fucking Copilot and "Discover" AI scrapers are in Notepad. NOTEPAD. And then there's this uncanny valley garbage:
No uncanny valley video calls for me, thanks! (Also, what else is it doing while it scans your face and listens to your calls? What else, microsoft? Because there was a lot of memory being assigned to this program for a simple "smooths your skin" add on).
Tired of Microsoft pushing ads throughout Windows 11? Here are the settings you can tweak to turn them off and reclaim some privacy.
The truly insane number of places they have stuck ads on your own home computer is sickening. Become Unmarketable.
Bonus:
Some background programs you probably don't need that are taking up space and how to remove them (Microsoft forums, 2024)
Your Samsung Galaxy Phone comes with 22 apps you don't need (Android Police, 2025)
How to disable the AI in firefox (still the only browser that lets you do this permanently) (Windows Report, 2025)
turns out i wasn't making that up, his name is Dr. Toru Miyazaki! he also wrote a book called "The Day Cats Live To Be Thirty", so cats are kind of his thing.
apparently, cats' kidneys tend to be the thing that takes them down, something about their bodies being unable to self-clean their kidneys, and the vaccine is supposed revitalize the body's ability to do just that. It would be very VERY fucking cool to have cats suddenly reaching 30 years of age be the normal thing.
As they age, almost all cats develop kidney disease, from which they eventually die. Just as in humans, kidney disease i
Dr. Toru Miyazaki’s AIM injection for cat kidney disease enters trials in 2025, aiming for a 2027 release. Greycoat Research supports the sc
whoa wait i actually read the articles and it's so much cooler than just that!!
dude cracked the case about WHY kidneys fail, across the board as far as i can tell. turns out there's a specific molecule whose job it is to attach to waste and signal macrophages to come eat it. it remains inactive in cats for some reason, but the molecule is still there. basically what he's done is found the switch to activate them. this will be profound not only for our domestic babies, but for big cats too - especially cheetahs!
although his research was focused on cats, it's already being used to develop drugs for humans too!
on top of that, since these molecules are tags for waste, this could also dramatically lower the rate of fatty liver disease, liver cancer, urinary crystals, rheumatoid arthritis, and even some neurological cases! like, they're hoping it may have an impact on parkinson's and alzheimers, but it DOES have an impact on stroke recovery. like. holy shit.
furthermore, he's insisting that the feline drug be affordable if and when it rolls out onto the market. he wants this to be something anyone can get for their cat!! idk how much sway he'll have over the human drug, but hopefully enough that it, too, won't be that expensive.
annnnnd in his research that he's still doing for the human side of things, he's found a potential link between this molecule and estrogen. in the 20,000 samples he's tested, women between ages 10 and 29 had the highest amount of this molecule present in their blood (a higher amount means Something Fucky is going on, essentially. There's a higher amount of waste the body is trying to clean out) but it drops down to be almost equal amongst men and women after menopause. it hasn't been looked into yet, but fuck, just the fact it's noted and known and probably WILL be looked into soon??? imagine if this is what leads to figuring out all the various ways the ovaries and uterus fucks with people and how to fix it. or even like, maybe there's something about estrogen that makes it work better. who knows! but it's rad the link is there to be researched :D
man just think, not only could our kitties start living longer, healthier lives, but just maybe dialysis will become as rare and obsolete as the iron lung is for people. what a badass Dr. Toru is!
It also looks like the second link might be a Supplement Company (ie snake oil) trying to piggyback on his research without actually being part of it. But the actual research in the first link looks really solid! If it's proven to work and gets approved, my kitters are going to get started as soon as possible!
Time to start taking vitamin d and using my light therapy lamp every morning for the next six months so I don't completely lose it before spring rolls around 🙃
If you too live a stone's throw from the Arctic circle this is your cordial reminder to start taking your vitamin d and dust off your light therapy lamp before the SAD sets in! Vitamin d and light therapy lamps are most effective when you start using them beginning early in the fall, before your SAD gets too bad. Don't let the SAD set in and get too bad, start now!
Well this little post I made over my morning coffee is gaining quite a bit more traction than I expected (which I'm happy for, remember to take your vitamin d!)
Here's a few more reminders for the upcoming winter darkness:
- Vitamin d is fat soluble, meaning you need to consume it with fat for your body to absorb it properly. This is why a lot of vitamin d capsules contain Omega-3 and/or other oils. If you aren't eating or drinking something rich in fat when you take your vitamin d, take it with a spoonful of something like Omega-3 oil. In the Nordics it's popular to have a spoonful of fish oil in the mornings because fish oil is rich in Omega-3, which helps with SAD especially when taken alongside vitamin d.
- Check with a doctor or local healthcare provider what they think is an appropriate amount of vitamin d to take at your latitude. I just found out from my doctor last winter that I wasn't taking nearly enough vitamin d for how far north I am, and she told me to actually quadruple my dose. It sure made a difference and last winter was noticeably less miserable for me.
- When using a light therapy lamp, it's best to try to position it as close to eye level as possible, and ideally around 60cm / 2 feet away from your face.
- Try your best to still go out and be physically active, I promise it really does help with SAD! I know, trust me I know how much harder it is to make yourself go out and still be active when it's so dark and cold and miserable out. But if you make an effort to still go out and meet your friends at a cafe you will feel better. If you still make an effort to move your body you will feel better. Last winter I actually bought a DDR gamepad and got back into DDR so I could still move and get some exercise over the winter. It really does help, I promise!
This doesn't just apply to people near the Arctic Circle, but places where the number of sunny days drops significantly during the winter months due to Winter = All The Rain. I'm looking at you Oregon, Washington, & SW British Columbia. A doctor told me once that she'd never seen an Oregonian who *wasn't* vitamin D deficient.
A Lot Of Germans are vitamin D deficient, too. Guys, we are not nearly as far South as we tend to think. The Gulf Stream is tricking you.
Generally speaking, this country is actually on the same latitude as (southern) Canada, not the US. And at least in North Germany, the sky also has the unfortunate tendency to turn into one greyish-white mass with no chance of sun.
