The fricking cwowld metwl slid owor my skin like silk sliding dwown a fricking banyister. It dwoesn't take much pwessure wen u have a fricking sharp razwor. Bwood came pwouring immediatewy. That's a fricking gwood sign - the fricking deep cuts are fricking bwight white and take a fricking minyute two start bleeding. I am onye with the fricking pain because I deserve it fwor being worthless and a fricking piece of shit and a fricking bad perswon.

Am I bwoken that my mind cwonstantwy instwucts mwe two self-mutilate, b-word? It feels like there's a fricking gwoblin in my head (the Gwueswome Gwoblin) cwonstantwy egging mwe on two dwo the fricking nyeedfwl and start slicing. Can anyonye relate, b-word? I knyow I'm gwoing two dwo it again twomworwow and it's gwoing two be wose. The fricking cycle's begun again.

Patient presents with severe anemia pulse Ox 89%, neutropenia and possible pancytopenia upon blood work. Final diagnosis was stage 4 bladder cancer so how did we end up at that diagnosis?

69 y/o male presents after multiple bruises and bone pain, neuropathy and paraprotein general screening. Further testing showed non IgM paraprotein. There are only 2 diagnoses that makes sense so start asking questions for this very obvious guided answer.

Patient presents to PCP with swelling of the left clavicle persistent for 3 months. Hx of schizoaffective disorder, depression, hypertension and active multiple myeloma. Case goes into consult with multiple physicians. What are considered treatment plans?

For consideration

Heterogenous enlarging left clavicle mass (3.8cmx3.2cm)

Bone marrow suggests plasmacytoma with skewed kappa/lambda ratio, CD138 positive cells (value not reported due to conflicting lab results)

FISH showed 17p deletion.

Labs consistent with previously diagnosed multiple myeloma

Prior treatment included radiotherapy 1 month post initiation of a combination of lenolidomide, bortezomib and dexamethasone

Helping out with my friends special needs kid and faking not being drunk. He is annoyed I have to look up specifics on gluconeogenesis like I remember proteins from 20 years ago.

Abraham lincoln won a presidential election in civil-war-torn America in 1864, and fdr secured his fourth term in 1944 while American troops were in action across the globe. Winston Churchill, by contrast, avoided the electorate until the war in Europe was over in 1945, at which point he was turfed out.

Ukraine's constitution is confusing. Article 103 states that the president is elected for a five-year term; but Article 108 says that he or she exercises power until a new president is inaugurated. A longstanding law (though not a constitutional provision) says that elections cannot be held when martial law is in force, as it has been in Ukraine since Russia began its full-scale invasion in February 2022.

I love how they ignoring that martial laws ends on 19 May and that Ukraine is parliamentary country where parliament has more power and there should been parliament election in October or November 2023 and now parliament can't prolong the martial laws that they extended for 3 months in February because Parliament lost its power in March. So ignore that detail that doesn't suit them.

As the war drags on, Mr Zelensky's popularity will be tested further. Already his star power is waning. Some Ukrainians wonder if a different leader could have fought more effectively, or found a way to negotiate some kind of peace. The president insists his aim is still to recover all of Ukraine's lost land, which seems unachievable. The government is under fire for alleged corruption and the centralisation of power in the hands of a tiny circle. It has bungled the mobilisation of fresh troops: many front-line units are down to 70% or so of their strength. After a long delay, a new conscription law is in place, but it will take months for its effects to be felt on the battlefield.

It's hilarious how they trying to end every paragraph with a positive note

Khohols don't want to fight the mobilisation is their 24/7 whole year. Sending men more notes won't fix it. All who wanted to fight already joined the army. You don't see men returning from west to blast their bussy for Zelenskyy. And 70% soldiers are saying they will leave Ukraine after this conflict ends. Yet homosexual end the pragraph with “it will take months for its effects to be felt on the battlefield” like it ever will be felt.

Ukraine should be able to resist, and in the coming months it will be bolstered by a new package of military and financial aid approved by America's Congress in April. But still, Mr Zelensky needs to address rather than evade the questions raised by the end of his formal presidential term. He should acknowledge that he needs eventually to hold an election, and lay out plans for how one might be organised. It will be hard: Russia will doubtless bar voting in areas it occupies and bomb polling booths in areas it doesn't. But a country as ingenious as Ukraine can surely find ways to give its people a proper say in how they are governed. One of the many reasons why they don't want to be swallowed by Russia is that Russians under Mr Putin have no such choice. Rather than suspend democracy indefinitely, Mr Zelensky should lay out plans to strengthen it. ■

Ukraine already getting help, they launched couple hundreds ATACMS since February when they didn't had officially aid but Biden “secretly” pushed it. So there won't be any wunderwaffel. This bs is more pathetic than epic spring counteroffensive and leopards. Khohols are saying they preparing new counteroffensive for 2027. By that time they won't have any men left. Zelenskyy told by lowering age from 27 to 25 he will mobilise 300k while there literally ain't that many men in Ukraine in that age barracks and age Barack 18-20/21 don't exist anymore since people were underage 2 years ago and left the country. So even if he lowers to 18 there won't be 300k to mobilise

Just deport all of them.

Source account: https://instagram.com/tkk220/

It's 5, I'm allowed to drink now. (Ignore the fact I was drinking this morning those in the group chat)

Had to spend the majority of the day filling out paperwork that literally should not be my problem. Some nurse was being bitchy because I used shorthand instead of printed English even though she should have known what I wrote. Now I'm just trying to put the past couple days behind me and enjoy Belvedere.

!boozers

Figured I'd help out last second and fly back to California. Flight connection got cancelled so offered to do telehealth but said I'd be a couple hours late and have to cancel some appointments. Apparently the response is cancel 5 more appointments and just be a peepee to somebody with privileges trying to help out? We didn't even agree on payment outside of the flight they got fully refunded for. I know we're not exactly on good terms given I've fired their best friend, hated her and responded negatively to her getting the job behind her back but she reached out to me and shit just didn't work out. Life happens sometimes.

In all honesty there are no correct answers and only incorrect answers. Possibly a pentad combination could work, you could adjust or go for removal of lenalidomide, change to a two factor drug, initiate differing cycles of dexamethasome could be beneficial due to refusal of ASCT by patient. This is how medicine works, there's no one size fits all and all we can do is attempt to help.

This was a case I worked on with people from MD Anderson, John Hopkins School of medicine, Mt Sinai, New York and unfortunately the patient refused all forms of treatment and expired.

🇩🇰🇺🇦 Journalist of the Die Zeit Joerg Lau deleted his tweet and clarified that the F-16s will be in Ukraine within monthS.

So, not soon ... https://t.co/lxBaKtXpWW pic.twitter.com/zV3pkrVaAd

— Lord Bebo (@MyLordBebo) May 14, 2024

https://rdrama.net/post/268676/f16s-from-denmark-will-be-in

@Szia_uram

I can't keep getting away with this

Also a future video from volchansl got posted

Dvinatsate nole patu = 12/05

Everything is fine in volchansk

Neighbor got me worried I was like “frick did I just sleep a whole day ?”

>hihi haha but not hihi haha to me ! Da frick I should guard that object, that object has max 30 person. Ok this object will get hit and ? 30 people will be gone, that's just 30 and not minus 100 so no big deal lol kek

She gives reason why she walks far away from object she suppose to protect

To me the actually fun part was that some of my black guy friends liked this post

Frogs soldiers won't come with new weapons since Ukraine already got 60% of frogs artillery so they are there just to fill the numbers. No matter what macron is planning it will end up being reputation damage to France especially in Africa. Frogs can max give Ukraine 20k men and that's literally nothing. Of course he is smart like smartest person in empty room. Side effect will that it will instantly rise Russian moral since they will now not only fight western tanks that they were supposedly afraid of and would run away from them but also legendary superior frog warriors that won't have exp in that fight and will be short on ammo

Macron hypothesis are

A: Russian won't cross the line and won't touch frogs soldiers

B: killed frog soldiers will anger frogs and start supporting sending more frogs to Ukraine and NATO countries will be very sad of dead frogs so they decide to also send their soldiers

This is 2 ideas. They have solid if you have no background info

But answer will be C: frogs will ask macron defack he send frogs to Ukraine and his and his bf (pm) ratings will go down and his bf will lose the next election