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.

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

Finishing up fixing some really shitty non-EMR personal notes because for some reason they aren't readable despite using standard acronyms and very unlikely to ever be read and just a QC thing. Only perk is they're paying me bullshit high hourly rates where realistically I'm just getting drunk, watching anime or finishing up this weeks meal prep. Knocked them all out within a few hours and will just release them slowly to see how much free money I can get.

Going through notes I was asked to fix and I don't know what the frick is wrong. One of the highlighted parts is ‘Patient is a pleasant female with prior family history of breast cancer (stage IV) in her natal sister and history of breast cancer (stage II) in adoptive sister.' I literally see nothing wrong. There were quite a few with typos that are easily fixed but is this seriously why you call back somebody that hasn't worked with you for over a year???

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.

If you aren't comfortable with Goetic Demons due to your religious background, up-ringing, etc. I'm not requiring you too.

The same techniques can be used to work with or call upon any other type of spirit such as angels.

I just want to say something from my experience, Angels and Demons aren't contradictory and you can work with both. Angels are fine if you work with demons and vice versa, and they often work together on similar goals. They aren't in opposition. My experience with demons, is that they have tended to be benevolent, and when working with Archangel Michael, I asked him about Lucifer and he told me "I consider Lucifer to be a friend". It's ideal to think beyond the religious dogma that classifies spirits as "Good" or "Evil", "Right Hand" or "Left Hand" dichotomy, but I'm not expecting someone to do something they aren't comfortable doing.

If you ask me what the difference is between Angels, Demons, Gods, etc. I would say after working with them "I have no idea", Demons were just Gods that were demonized by Judeo-Christian mythology.

https://en.wikipedia.org/wiki/Paimon

https://en.wikipedia.org/wiki/Arsu

After building a relationship with Demons, they will often let you know what God they were before they were demonized.

>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