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2023.06.09 21:34 PoopieKitty Seeking advice: lower pelvic pain and retroperitoneal lymphadenopathy
40/F. About 6 weeks ago I started feeling pain in my lower left pelvis that I thought was an ovarian cyst. It is pretty constant and radiates to my groin and across my abdomen at times. It has gradually gotten worse over the weeks. I often get cysts that come and go, so I didn’t think much of it. However, I saw my fertility Dr and I had a transvaginal ultrasound that said everything looked normal, with no cysts seen.
Two weeks later I had a saline ultrasound that noted “nodular thickening” in several areas of my endometrial lining (6mm) and narrowing of the lower part of my uterus. They don’t seem overly concerned, because I recently had a blind biopsy that came back normal (EndomeTrio) and also ReceptivaDx that came back positive for possible endometriosis and/or hydrosalpinx. They ordered a Hysteroscopy and exploratory lap, as they suspect endometriosis or my tubes are the culprit for my pain and said they will likely remove my tubes while they’re in there. Those aren’t scheduled until August.
In the meantime, I went to my GP who said it’s probably just diverticulitis. They ordered blood work (the usual stuff) and a CT scan, but I can’t do the IV contrast, so I only did oral contrast. I can do MRI IV contrast, but they said I have to do CT for insurance purposes. They just called and said my blood work and CT were normal. I went onto my patient portal and read the CT report myself and it states everything is normal, except “borderline peritoneal lymphadenopathy with enlarged nodes no greater than 10mm in the short axis diameter”. I looked that up online and it literally keeps saying cancer and high mortality rate if spread to these lymph nodes. I left a message and they’ll “try” to call back Monday. I am convinced I have cancer and I’m dying and everyone is taking their time. :(
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2023.06.09 21:15 WagyuTheBull Zomedica Launches Revolutionary TRUVIEW(TM) Digital Microscope with Advanced Optics, Automated Slide Preparation, and Telepathology Services
ANN ARBOR, MI / ACCESSWIRE / June 9, 2023 / Zomedica Corp. (NYSE American:ZOM) ("Zomedica" or the "Company"), a leading innovator in veterinary medicine offering diagnostic and therapeutic products for companion animals, announced today the launch of the revolutionary TRUVIEWTM digital microscopy platform, featuring the proprietary TRUprepTM system that automatically prepares slides, along with LiquiViewTM liquid lens technology that provides best-in-class images.
Microscopic examination of blood and cytology fluids is the standard of care in the veterinary industry and is utilized by essentially every veterinary practice. The groundbreaking all-in-one TRUVIEW system combines LiquiView advanced optics, TRUprep automated slide preparation and tele-pathology with an easy-to-use interface to ensure consistent quality to boost veterinarian diagnostic confidence. The LiquiView advanced optics system will provide the highest quality slide images on the market, leading to better diagnostics for the pet.
Preparing cytology slides and making blood smear slides can be critically important to cellular investigation and diagnosis. However, the effectiveness and accuracy of that interpretation depend on the quality of the slide. The TRUVIEW microscope features the TRUprep automated slide preparation system, eliminating the need for manual slide preparation because all the traditional manual slide preparation steps, including smearing, drying, fixing, staining, washing and drying, are handled by the TRUprep system, assuring consistent high-quality slides, while saving 5-10 minutes of technician time for each slide to improve productivity and workflow.
TRUVIEW's digital imaging and telepathology component is an easy-to-use interface providing veterinarians with multiple diagnostic options, including reading the slide directly on the microscope, reviewing the slide digitally from a remote computer through the Company's myZomedica® web portal, or sending the image to a Zomedica pathologist for external review and consultation. This will result in boosting veterinarian confidence in providing a consistent, reliable diagnostic result.
"The innovation of the automated slide prep feature has been a critical need in the industry for years," stated Bill Campbell, VP of Imaging at Zomedica. "We have taken every step to make it easier than ever for clinics to have consistent slide quality, reduce human error and waste and deliver reliable results every time. By automating this critical step, the TRUVIEW microscope significantly improves the efficiency of veterinary practices, enabling veterinarians to save staff time and focus more on diagnosing their patients," continued Campbell.
"The development of the TRUVIEW microscope has been a project I have been following closely", said Dr. Matt Connolly of Connolly Animal Clinic. "Having a microscope that automatically smears and stains the slide produces very consistent quality, with the resulting image resolution better than manually prepared slides. With TRUVIEW in our lab we are more efficient, and it helps us provide the best medicine possible."
"The TRUVIEW microscope represents the latest innovative technology launched by Zomedica," said Larry Heaton, CEO of Zomedica. "By combining advanced optics with automated slide preparation, we are providing veterinary professionals with a powerful tool that enhances their diagnostic capabilities and streamlines their workflow.
"We're launching the TRUVIEW system at this weekend's PacVet conference and then offering it initially to practices participating in Zomedica's Customer Appreciation Program by utilizing our TRUFORMA® diagnostic platform. The microscope will be placed in practices with no upfront capital required through a monthly subscription service in addition to fees for slide interpretations that will produce high margin revenue for the Company. As we build inventory, we'll widen the launch as essentially all veterinary practices could benefit in several ways from adoption of the TRUVIEW system as they will receive quality images, professional interpretation and positive impacts on both workflow and cash flow", concluded Heaton.
Zomedica acquired the assets of Revo Squared in July of 2022 and has been actively working to enhance their product line and prepare for the launch of the TRUVIEW platform. TRUVIEW products are manufactured by Zomedica at its Global Manufacturing & Distribution Center in Roswell, GA.
To learn more about the TRUVIEW microscope and be among the first to experience its transformative capabilities, please visit Zomedica's website at
www.ZOMEDICA.com.
About Zomedica
Based in Ann Arbor, Michigan, Zomedica (NYSE American: ZOM) is a veterinary health company creating products for companion animals by focusing on the unmet needs of clinical veterinarians. Zomedica's product portfolio will include innovative diagnostics and medical devices that emphasize patient health and practice health. It is Zomedica's mission to provide veterinarians the opportunity to increase productivity and grow revenue while better serving the animals in their care. For more information, visit
www.ZOMEDICA.com.
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2023.06.09 13:40 SnooCats6607 Nurses not doing their jobs...on-call, portal messages, work notes, etc...
Is it just me, or are our practices ruled by administrators and nurses? When I say nurses are "not doing their jobs" I don't mean they are lazy a-holes (though in rare cases that also is accurate) but that an environment has been set up where their skills/authorities are not being utilized, while responsibilities beneath what is appropriate for us as physicians are pushed upon us and we have no say in it.
For example. Being on-call. 90% of these calls are useless, and most can be handled by an RN on-call. Why are we on-call at all? "Dad's (89 year old) atorvastatin was sent to the wrong pharmacy by the doctor at his appointment at 4:59PM and he is out of medication." Or the "My 2 year old has a fever and isn't breathing right, hasn't had a wet diaper all day, is throwing up." It doesn't take a doctor to handle most of this. When a prescription is needed or some advanced clinical expertise required, the call should be forwarded on to the physician, but I don't think we should be fielding this BS. They do it during the day, and sometimes they provide advice and make decisions above and beyond what is appropriate for their credentials. Then, once the clock hits 5PM, they go home and we're on call to deal with it.
Second example. Portal messages. In most cases in my practice, everything is forwarded to the provider. "I have joint aches and was bit by a tick, what should I do?" It goes first to the RN. They forward it with no inquiry for additional info straight to us. I don't have time to engage in a back and forth portal appointment.
Other examples...just exercising some clinical common sense. Person asks for an ozempic refill. Well...what was their most recent dose, when is it due to be given again, etc? And once you figure that out, why not state it in a message with the medication pended/proposed to me to sign off. Saves me a dozen clicks and mindless digging through the chart while I have 2 patients waiting in rooms.
Work notes. Someone wants one at the end of their appointment, while I have prescriptions to send and an actual chart note to write and the next patient just got into their room. Patient is at the front desk 45 seconds later asking why the note isn't done. RN comes to tell me they still need their note. How about the nurses do it? What does it need to say, what dates? And in general I don't think providers should be having to type out these work notes at all. I worked with a doc once, in urgent care, who straight refused to write the notes. The nurses wrote them, entered the dates, and he signed them. Not the case in the primary care place I am now.
Appointment intakes and history gathering. Why isn't it done the day beforehand? Why does the nurse need to spend 5 minutes asking what the patient's pain level is and whether they feel safe at home? Why do I need to search through mountains of garbage documents like PT notes and refill requests just to find their most recent colonoscopy or tetanus? Why aren't nurses doing this for us, the day before?
In general I just feel these practices are set up where we are very much employees with no control. Possibly, we have much less control compared to the RNs and even LPNs. They control the schedule, the triaging, and they forward a ton of inappropriate stuff on to us and we're left doing scut work.
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2023.06.09 10:12 Potential-South-4889 Sapphire still failing to fail - curaleaf too
Just got my latest meds. Once again, no hassle, no pain.
Go to sapphire portal, push buttons.
wait a day or two for email from curaleaf; pay. meds arrive next day or the day after.
this has been my consistant experience more or less for almost two years.
I'm sorry people report problems, but i honestly cant say i have had any real ones (slight frustration with curaleaf's payment idiocy about a year ago tbh).
just bringing a little balance, and no, i have no 'relationship' with either whatsoever other than being an ordinary fee and prescription paying patient. (if they want to pay me to be an ambassador, that would be great :)), but i would always make that clear.
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2023.06.09 09:16 AlternativeClerk5070 RPM Billing
RPM Billing Services RPM Billing Services is a leading provider of comprehensive and efficient billing solutions for healthcare professionals. Our primary objective is to streamline the billing process, optimize revenue generation, and ensure accurate and timely reimbursement for our clients. With our extensive expertise and advanced technological capabilities, we enable healthcare organizations to concentrate on delivering exceptional patient care while we handle their billing requirements.
Our Range of Services: Medical Coding:
Our team of certified
coders meticulously assigns accurate codes to medical procedures, diagnoses, and services in adherence to industry standards. Precise coding plays a critical role in maximizing revenue and minimizing claim denials.
Claims Submission: We take charge of the complete claims submission process, from verifying patient insurance coverage to submitting claims electronically or in paper format when necessary. Our professionals diligently review claims for any errors or missing information to minimize the chances of claim rejections.
Claims Follow-up: Proactive claim follow-up is a crucial aspect of our services. Our dedicated team communicates directly with insurance companies, resolving any
claim issues, and resubmitting claims if required. Our aim is to minimize the reimbursement turnaround time.
Payment Posting: Accurate payment posting is essential to ensure proper revenue recognition. Our team efficiently posts payments received from insurance companies and patients into your practice management system. We conduct detailed reconciliation of payments against billed amounts and promptly identify any discrepancies.
Denial Management: Our systematic approach to denial management involves identifying the root causes of claim denials, appealing unjustified denials, and implementing corrective measures to minimize future occurrences. By improving the first-pass claim acceptance rates, we help optimize revenue for your practice.
Patient Billing and Collections: We handle all aspects of patient billing, including statement generation and distribution. Our team is well-equipped to handle patient inquiries and resolve billing disputes promptly. Our focus is on enhancing patient satisfaction while ensuring effective collections for your practice.
Reporting and Analytics: We provide comprehensive reports and analytics that offer valuable insights into your practice's financial performance. Our reports encompass key performance indicators, reimbursement trends, and actionable suggestions for improvement. Our data-driven approach empowers you to make informed decisions to enhance your practice's financial success.
Why Choose RPM Billing Services? Expertise: Our team consists of experienced billing professionals who possess in-depth knowledge of the latest industry regulations and coding guidelines. We bring a wealth of expertise to the table, ensuring optimal revenue generation for your practice.
Technology: We leverage state-of-the-art billing software and advanced technologies to streamline the billing process, automate tasks, and minimize errors. Our secure systems guarantee data confidentiality and compliance with industry standards.
Customization: We understand that every healthcare organization has unique billing requirements. Therefore, we tailor our
services to align with your specific needs and workflow, facilitating seamless integration with your practice.
Transparency: We maintain transparent communication with our clients and provide regular updates on the billing process, payments, and financial performance. Through our secure client portal, you can access real-time billing data and stay informed at all times.
Cost-effectiveness: Outsourcing your billing needs to RPM Billing Services can result in significant cost savings for your practice. By reducing administrative burdens and optimizing revenue cycles, we contribute to the overall financial success of your organization.
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2023.06.09 03:16 kaazzzz12 Just got a VERY UNEXPECTED positive for herpes!
So I had my first ever full on lady physical and my Dr screened me for STDs among many other labs. I was checking all of my lab work I got done and seen I had a positive Herpes II result of 1.22 which is moderately high but Google says it’s still “unequivocally positive. I have only ever been sexually active with my current boyfriend of almost 3 years. I’m now worried that he has cheated on me and he doesn’t know he has it, but I know that potentially isn’t the case. I know he had sex with a few other girls before me, so I guess he could of gotten it from them and passed it to me later!? I’m trying not to freak out yet because I only seen the lab result come in on my patient portal but idk what to do! So is there a chance it could be a false positive because the number isn’t super high? I also found out I have a UTI so could that have affected those test results? I have also had cold sores as a kid but have not gotten one in 10 years probably. What do I tell my boyfriend? Or what’s the next steps?!??
Thank you
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2023.06.09 02:29 FilbertaForest Labeled high risk but not sure why... Implications?
I had an ultrasound a few days ago (at 8W1D) and just looked at my chart on the online portal. I thought it went great, but there was a line top of my chart with the reason for visit /billing code that said "Supervision of other high risk pregnancies, first trimester."
They told me everything looked good and was measuring on track. Heart rate was good. I had a blood panel and everything was normal. I'm confused why I'm high risk and they didn't tell me. I care because I want to give birth at a birth center and they don't take "high risk" patients. Anyone have insights to the label and if it can go away? Are all early pregnancies high risk?
Info: The only reason I can think of is that I'm 34, which is close to 35... No infertility struggles. I have a lowish BMI (18.5) but they haven't mentioned it. The only other thing that came up was that I stopped taking Adderall when I became pregnant and she asked me if I wanted to try Wellbutrin which is considered safe for pregnancy, as it can have some benefits for ADHD, so I said yes. No other health conditions other than ADHD.
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2023.06.09 01:38 Chronicle556 33male test results, what to expect
| Took a lab a year ago for the common symptoms. Doctor told me my levels were normal and there was no reason to treat. I decided today when I'm still feeling those symptoms, that I wanted to see my actual results. Saw my results and according to the ranges, they were low. I looked at the after car report that the doctor put in the patient portal, and IT SAID HE TOLD ME I NEEDED TESTOSTERON SUPPLEMENTAL THERAPY, and discussed injections, topical, and implant options WHICH IS ABSOLUTE HORESHIT! He told me the complete opposite! Would these results be considered low? I'm going to a clinic on Saturday instead of a urologist like last time. Are my numbers low enough to where I can expect treatment? What medications should I be hoping for and in what amounts from your experience? This is all new to me, I was really disappointed when my doctor told me my levels were good, and now that I'm finding out that's not the case, I'm hopeful! Thanks in advance for any info. submitted by Chronicle556 to Testosterone [link] [comments] |
2023.06.08 22:46 Imaginary-Tart-8829 Reactivity to Rejection and How to Regulate Emotions?
I'm undiagnosed, but I'll give a brief rundown of my background. Dad was abusive and neglectful, invalidated my feelings verbally by saying "your feelings are wrong" the sole time I expressed my emotions to him about his lack of presence in my life, he normalized and regularly sa'd me as a child up until after puberty, was very jealous of any bfs I had, lots of emotional incest, attempted to prevent me from going to college, delayed me from getting my driver's license til 20 and having a baby at 19 and escaping my subsequently abusive baby daddy was the only saving grace for me. I'm 31 now.
I've been through so much. I believe I'm hypersexual as well and I've always had issues in romantic relationships. Being a single parent doesn't exactly make dating easy and I'm not anyone's ideal partner due to that fact. I fall in love easily and care deeply, but I've been rejected so many times as an adult and every time it feels as fresh as the rejection and neglect I faced constantly as a child.
I sought therapy and attended at least 10 sessions for my last break up and then the therapist ghosted me bc I couldn't quite grasp the patient portal and how to send a message. When I finally sent her a message to set an appointment after figuring it out, she never responded to me. I'm not interested in looking into finding another therapist now. I tried Zoloft and had a genuinely horrific experience. I'm about to try Lexapro and I hope it works.
I'm going through another loss of a romantic partner and again, the wounds have been ripped back open. I genuinely want to learn better coping mechanisms than laying around all day feeling sorry for myself but this is a repetitive theme in my life and I don't know what to do anymore. I feel as if no one will ever love me properly or as fully as I would someone else. I just cry every day wishing I even had friends to turn to but I am so incredibly lonely.
How does everyone else deal with rejection? I want to feel good about myself but it's so difficult when I see people all around me with lifelong partners and I've already brought three different men to my family's yearly reunion. I know the trauma is what's wrong with me, but I don't know how to manage it and I feel helpless all the time.
Thanks in advance for any help or advice. I truly am at a loss and I don't know how much more heartbreak I can handle.
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2023.06.08 22:20 rxsangria I asked ChatGPT to pretend it was a prior authorization specialist and what it would do to get Wegovy covered. Here is the response, and it's LOADED with good information. I also asked about the appeal process and the process for a formulary exception.
I gave ChatGPT the following prompt: Pretend you are a prior authorization specialist and your job is to get a medication covered for a patient. The medication is Wegovy (semaglutide) injection. What are the steps necessary to get this medication covered and what questions would you ask the insurance company to assist the process? The answer: As a prior authorization specialist, your role is crucial in facilitating the coverage of medications for patients. To get the medication Wegovy (semaglutide) injection covered, you would typically follow these steps:
- Verify patient information: Ensure you have accurate patient details, including their name, date of birth, insurance information, and any relevant medical history.
- Review insurance policy: Familiarize yourself with the patient's insurance policy, specifically the coverage and formulary (list of covered medications). Check if Wegovy is covered under the patient's plan.
- Determine prior authorization requirements: Find out if the insurance company requires a prior authorization for Wegovy. Some insurers may have specific criteria or restrictions for approving this medication, such as a certain body mass index (BMI) range or documented weight-related health conditions.
- Obtain necessary documentation: Gather the supporting documentation needed to demonstrate that the patient meets the insurance company's criteria. This may include medical records, laboratory results, BMI calculations, and a prescription from the prescribing physician.
- Complete prior authorization form: Obtain the prior authorization form from the insurance company or their online portal. Fill out the form accurately, providing all required information. Be sure to include the patient's diagnosis, treatment history, and any other pertinent details.
- Submit the prior authorization request: Submit the completed prior authorization form, along with the supporting documentation, to the insurance company. Follow their preferred method of submission, which could be online, by fax, or through a dedicated prior authorization portal.
- Track the status: Monitor the progress of the prior authorization request. Keep a record of the submission date, any reference numbers or confirmation of receipt, and the expected timeframe for a response from the insurance company.
When communicating with the insurance company, consider asking the following questions to assist the process:
- Does the patient's insurance policy cover Wegovy (semaglutide) injection?
- Is prior authorization required for this medication? If so, what are the specific criteria or restrictions for approval?
- What documentation is necessary to support the prior authorization request?
- Are there any specific forms or templates that need to be completed for the prior authorization?
- What is the preferred method and contact information for submitting the prior authorization request?
- What is the expected timeframe for a decision on the prior authorization?
- Can you provide a reference number or confirmation of receipt for the prior authorization request?
- Are there any additional steps or information required for the successful approval of Wegovy?
Remember, each insurance company may have its own unique processes and requirements, so adapt your questions accordingly to ensure a smooth prior authorization process.
Followup question: If the authorization was rejected and I needed to submit an appeal, what would that process be? If the prior authorization for Wegovy (semaglutide) injection is rejected by the insurance company, you may need to initiate the appeals process. Here are the general steps involved in submitting an appeal:
- Review the denial letter: Carefully read the denial letter or explanation of benefits (EOB) provided by the insurance company. Understand the specific reasons for the denial, such as lack of medical necessity, formulary restrictions, or failure to meet specific criteria.
- Understand the appeal process: Familiarize yourself with the insurance company's appeals process. Review the guidelines, deadlines, and any specific requirements for submitting an appeal. Note whether the process involves a single level of appeal or multiple levels.
- Gather supporting documentation: Compile additional documentation that strengthens the case for why Wegovy should be covered for the patient. This may include medical records, physician's notes, lab results, clinical guidelines, relevant research studies, and any other evidence supporting the medical necessity of the medication.
- Draft an appeal letter: Write a clear and concise appeal letter addressing the reasons for the denial and presenting a compelling argument for why the medication should be covered. Include the patient's name, insurance information, the date of the denial letter, and any reference numbers provided by the insurance company. Use professional and persuasive language to state your case.
- Include supporting documents: Attach the supporting documentation you gathered to the appeal letter. Organize the documents in a logical order and reference them in the letter when necessary. Make sure all copies are legible and well-organized.
- Submit the appeal: Follow the insurance company's preferred method of submission, whether it is by mail, fax, email, or through an online portal. Keep a record of the date and method of submission, as well as any confirmation of receipt.
- Track the appeal progress: Monitor the progress of the appeal. Note the expected timeframe for a response from the insurance company and follow up if the decision is delayed. Keep detailed records of any communication, including dates, names of the individuals spoken to, and a summary of the conversation.
- Consider escalating the appeal: If the appeal is denied again, review the insurance company's guidelines to determine if further escalation is possible. Some insurers may have additional levels of appeal, such as a review by an independent third-party or a formal hearing.
- Seek assistance if needed: If navigating the appeals process becomes challenging or you require additional expertise, consider consulting with the patient's healthcare provider, a healthcare attorney, or a patient advocacy organization. They can provide guidance and support throughout the process.
Remember that the specific appeals process and requirements may vary depending on the insurance company and the patient's plan. It's essential to carefully review the denial letter and follow the insurance company's guidelines to increase the chances of a successful appeal.
Followup question about formulary exceptions: Is a formulary exception different than a prior authorization, and how does the process differ when requesting a formulary exception? Answer: Yes, a formulary exception is different from a prior authorization, although they both involve requesting coverage for a medication that may not be initially included in the insurance plan's formulary. Here's how the process differs when requesting a formulary exception:
- Understanding formulary exceptions: A formulary is a list of medications covered by an insurance plan. A formulary exception occurs when a patient needs a medication that is not on the formulary, but it is deemed necessary due to specific medical reasons. In such cases, a formulary exception request is made to seek coverage for the non-formulary medication.
- Check formulary status: Verify whether the medication, in this case, Wegovy (semaglutide) injection, is included in the insurance plan's formulary. If it is not listed or is designated as a non-formulary medication, a formulary exception may be necessary.
- Gather supporting documentation: Obtain supporting documentation from the prescribing physician that outlines the medical necessity of the medication. This may include medical records, clinical notes, diagnostic tests, previous treatment history, and any relevant guidelines or research articles supporting the use of Wegovy for the patient's condition.
- Obtain the formulary exception form: Contact the insurance company or visit their website to acquire the specific formulary exception request form. Some insurers may have a designated form for this purpose, while others may require a written letter.
- Complete the formulary exception request: Fill out the formulary exception request form accurately and provide all the necessary information. Include the patient's information, the name and dosage of the medication (Wegovy), the medical condition it is intended to treat, and the reasons why it is medically necessary.
- Attach supporting documentation: Include the supporting documentation obtained in Step 3 with the formulary exception request. Ensure that the documentation is clear, organized, and relevant to support the medical necessity of the requested medication.
- Submit the formulary exception request: Submit the completed formulary exception request, along with the supporting documentation, to the insurance company. Follow their preferred submission method, such as online submission, fax, mail, or dedicated online portal. Keep a record of the submission date and any confirmation of receipt.
- Track the status: Monitor the progress of the formulary exception request and keep a record of any communication. Note the expected timeframe for a response from the insurance company and follow up if necessary.
The insurance company will review the formulary exception request and supporting documentation to determine whether to grant coverage for the non-formulary medication. The process for a formulary exception generally does not involve the extensive clinical review that is often required for a prior authorization.
It's important to note that the specific requirements and process for formulary exceptions may vary among insurance companies. It is advisable to consult the insurance company's guidelines or contact their customer service for detailed instructions on requesting a formulary exception for Wegovy.
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2023.06.08 21:34 ITMAN1223 Omnicell and their infinite glory
I dont typically post anything but just want to warn those that deal with Omnicell.
Yes I will admit that their cabinets are decent, and that their over complicated software and features offer decent outcomes for pharmacy and nursing, BUT...
If you want terrible support, and only ever hear "we will look into it" and never get back to you, have to followup with (no joke 10-12 emails over 1-3 months) Omnicell is for you!!! The only semi decent thing with support are the guys that actually come out to fix the cabinets, but if you want software support... Forget it!! TAC never has the answers to simple basic questions, they take eons to get back to you, call/email when they know your not in the office, and then basically have to sell your soul in order to get them to actually help you.
You ask for a quote for a cabinet, because a facility is looking at you to be their pharmacy, and end up losing it because of Omnicell... you reach out for the quote, get no response, then try and follow up multiple times over the span of a month, and nothing. Its frustrating and sad.
Dispense authorizations are a joke. Cant dispense by QTY, the time frame of only 12/hrs sucks, and only works for SINGLE dispenses... You cant put in mutiple requests since every requests overrides the last one... for pharmacies that are not 24/hrs that take care of LTC homes have to deal with angry nurses that are trying to dispense meds and cant because they have to call for every dispense. Then because after hour pharmacies take a bit of time to get back to the nurse the poor resident/patient is suffering an agony.
Sell antiquated hardware, tell you your good for 10 years, then spring windows licenses that you can get on Microsoft licensing portal for 250-300 dollars for $6250 per cabinet...
Try and get dividers for the drawers of the cabinet, send you the incorrect ones, then have to fight with them over part numbers between tac and acute consumables, then actue consumble smakes it sound like the dividers come in a pack of a particular qty and then quote you for them all individually. You get them to try and honor what they sent and you get a oh were sorry for the confusion but there isnt anything we can do...
Pxyis HERE WE COME!! Their dispense authorizations actually allow you to have multiple requests, adjustable time frame of how long dispenses are good for. They at least for us have been straight forward with what is in their cabinets, and are willing to even customize the computer peice in the cabinets if we so desire. Omnicell wont...
This is just the tip of the iceburg of the issues we have with Omnicell. I could go on for hours of the disheartening issues we have had, the frustrations, and everything else...
Sorry omnicell that we are not a hospital that has more than our 6 cabinets. Sorry we arent good enough for you!!
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2023.06.08 20:56 SnooPandas988 I finally left - Long
I guess I am looking for support as I share my story. This may be long but stick with me here
My Q (40M) and I (39F) had been together over 6 long years. During this time I had always tried to get back the spark we once had. 6 months into our relationship a switch flipped and he was no longer the show he put on but his true self. Me - being the loving fixer upper that I am - have been trying my hardest to get that back. In that time since, I have lost myself within it and him. I have not ever dealt with an alcoholic before in my life. I had no idea what I was dealing with and honestly it took me a long time to realize. We lived 45 mins from each other and had different work schedules so we really only spent our weekends together. He always drank heavily at night ( 1/2 pint of rum, 1/2 pint of fireball and countless beers) but regardless of that and how he was a complete asshole to me, I stuck by his side and I don't even know why? I guess that's trauma bond? Co dependency? Narc hold? whatever you want to call it.. I don't know. But I did. I felt so worthless and low about myself and I though if only I did this, if only I did that - things would get better. I thought maybe it was my weight. I thought maybe it was because I didn't party or like the same things as him. I was always involved in his likes and wants and needs yet he wasn't ever there for my own. Would he be happier with me if I was a party girl? Thinner? sexier? This started to wear on me. I became a different person. someone I didn't recognize.
A year ago he moved a mile away from me. I saw things differently. How much he drank daily. How hungover and miserable he was on the weekends (that's when he drank the heaviest) It finally started to register with me. My friends were pointing things out. Things I didnt want to see or believe had anything to do with his drinking. Things I always blamed on myself. He started going to see a dr for pains he had in his stomach. They did bloodwork - high liver enzymes and sent him in for an ultrasound. His liver - double in size, spots of fat , liver enzymes at liver decease level. This was April. I showed him his patient portal and told him if he didnt stop drinking he would get cirrhosis and need a new liver or worse. He got mad at me and told me I had wished death on him (oh okay sir, whatever makes you feel better) Since then he has "slowed down". We had a very big fight on mothers day! (happy mothers day to me!) He told me he hopes I die. I left. Didnt want to talk to him anymore. My anxiety had gotten the best of me and I caved in and talked to him. He told me that he quit drinking mothers day and he wanted me back and to work on things. I was naïve enough to believe him so I went back to hang out. He was drinking. Told me it has been 10 days since he had a drink and he wanted to relax and he thought he had done well. He got HAMMERED. I mean it was the most I had seen him drink in a while. It was ridiculous. I left. I left for a week and anxiety once again won. He was drinking rum and coke. He said he bought me a bottle of wine. I didnt open it. He asked if he could have a drink and within 20 mins the entire bottle was gone. I left. I saw him Sunday at the store. He asked me to come by to talk. I reluctantly went but I did. I wasnt even there 10 minutes and we had gotten into a huge fight. I told him we needed to talk. He needed help, rehab, AA, a therapist, He told me he wasnt going to talk to me about it and he didnt need it he could do it himself and he was tired of me and my shit. So I told him we are done.. Do not contact me anymore. I havent talked to him since and I know it hasnt been long but I didnt even wish him a happy birthday yesterday. For me, thats a huge step and I am proud of it.
For a very long time I have allowed this man to gaslight me, to manipulate me. I have been trying to find myself and my happiness again. I have been enjoying my time. My kids. Myself. I will not ever speak to him again and thats a promise I plan to keep for myself and my family.
I left a relationship that was entirely 1 sided.There was no communication. There was no love . There was no intimacy. Sex was reduced to him basically using me as a human fleshlight. There was no compromise. There was no team. No respect. No honesty. No romance.
He didnt even have a relationship with his own KIDS, why would I ever expect anything??
I AM DAMANGED
There was There was nothing..... There was nothing there for me and I stayed so long and I have no idea why.
But I am proud of myself.
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2023.06.08 19:50 iambeppy Help. My provider switched practices
Hi all. I was wondering if anyone could shed light on my situation.
I have been seeing my NP for over year when she informed me she was switching to another practice. I absolutely love her so I decided to move with her even though they do not take my insurance.
My first appt. there is today and when I logged into my patient portal it says my bill is $300 which according to their fee agreement document is for a 90792 code for diagnostic evaluation with medication services.
When I called to question this they said the first appt. has to be 300 dollars and that it is because she has to imput all of my information in the system.
I've googled the code and as far as I can tell this code would not apply to this visit as I do not need a new diagnosis, eval, etc. This was supposed to be a medication management appt.
What should I do? I budgeted for the service on the fee agreement that I usually receive from her and I don't have another 150 bucks laying around. Please help!
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2023.06.08 18:01 pravasininewsblare01 How Long Does it Take to Get Selected for the Indian Army
Joining the Indian Army is a prestigious and challenging career choice that requires individuals to undergo a rigorous selection process. The duration of this process can vary depending on several factors, including the specific entry scheme, competition levels, and individual performance. In this article, we will explore the various stages involved in the selection process for the Indian Army and provide an overview of the approximate timeline for aspiring candidates. From application submission to final selection, let's delve into the journey of becoming a part of the esteemed Indian Army.
Stage 1: Online Application and Preliminary Screening
The initial step towards on
How to join Indian Army involves submitting an online application through the official recruitment portal. Candidates are required to fill in their personal details, educational qualifications, and other necessary information. After the application submission deadline, a preliminary screening process takes place, where the eligibility of the candidates is assessed based on the specified criteria. This stage typically lasts for a few weeks, after which shortlisted candidates are invited to proceed to the next stage.
Stage 2: Written Examination
Candidates who pass the preliminary screening are called to appear for a written examination. The written test assesses candidates' knowledge in subjects like General Knowledge, English, Mathematics, and reasoning. The duration of the written examination varies depending on the entry scheme and the level of the position sought. Typically, the examination can last for a few hours. Once the written test is conducted, candidates must wait for the results to be announced, which may take a few weeks.
Stage 3: Physical Fitness Tests
Candidates who successfully clear the written examination are then required to undergo a series of physical fitness tests. These tests evaluate the candidates' physical endurance, strength, and overall fitness level. The physical fitness tests include activities such as running, long jump, high jump, push-ups, sit-ups, and more. The duration of this stage can range from a few days to several weeks, depending on the number of candidates and the availability of infrastructure and resources.
Stage 4: Medical Examination
The medical examination is a crucial stage in the selection process, as it determines the overall health and fitness of the candidates. A panel of medical professionals assesses the candidates to ensure they meet the required medical standards set by the Indian Army. This examination includes a thorough physical examination, vision and hearing tests, laboratory tests, and other medical assessments. The duration of the medical examination may vary depending on the number of candidates and the complexity of the evaluations. Typically, it can take a few days to complete this stage.
Stage 5: Personal Interview and Personality Assessment
Candidates who clear the medical examination move on to the personal interview and personality assessment stage. During this stage, candidates are interviewed by a panel of experienced officers who assess their suitability for a career in the Indian Army and
How to join Indian Army. The interview may include questions related to the candidate's background, interests, leadership skills, and motivation to serve in the army. Additionally, personality traits such as discipline, confidence, and communication skills are evaluated. The duration of the interview process can vary, but it usually lasts for around 30 minutes to an hour.
Stage 6: Final Merit List and Selection
After the completion of all the aforementioned stages, the final merit list is prepared based on the candidates' performance in the written examination, physical fitness tests, medical examination, and personal interview. The list is usually published on the official website of the Indian Army. Selected candidates are then notified about their selection through a formal letter or email. The duration for the final selection can vary, but it typically takes a few weeks to several months from the initial application submission. You can read more about
best motivational speakers in India.
Conclusion
The duration to get selected for the Indian Army can vary depending on several factors, including the entry scheme, competition levels, and individual performance. On average, the entire selection process, from the online application to final selection, can take anywhere from a few months to a year or more. It is important for aspiring candidates to be patient and dedicated throughout the process, as each stage requires thorough preparation and performance evaluation. The Indian Army selection process is designed to identify the most capable and deserving candidates who possess the necessary physical and mental attributes to serve in this esteemed institution.
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2023.06.08 07:52 ramenw2eggs Combined ACL MCL Tear
(9 June 2023: most updated diagnosis is full rupture for ACL and MCL, torn meniscus. The doctor says it’s pretty much the worst one could get lol the trinity force of knee injuries!)
Hi everyone, I had a freaky accident when sparring no gi. MRI results came back today and indicates tear in both ACL and MCL. I plan to share my experience here live as I go through the injury 💔 and I also hope my experience could be of help for anyone in the community.
(It is currently the end of Day 3 as I am writing this post. I am 24, female, blue belt, living in the US, for reference)
Day 0: How it happened I was trying to take my partner’s back and they shut me down by shifting their body weight down towards me. Their butt landed on the outside of my knee - it snapped inwards followed by a pop. I collapsed in throbbing pain
Ice and compression was immediately applied when I was immobilised and on the mats. I was later sent to the urgent care. X-Ray indicates no bone damage.
My leg has no stability whatsoever. When I put minimal weight on it, it bends OUTWARDS. I cannot move without crutches (well I can skip around with one leg)
Went ahead and booked the earliest ortho availability covered by my insurance on Zocdoc
Day 1: Orthopaedic visit Doctor inspected my swelling and checked my range of motion against my healthy leg. His assessments was rupture in ACL and a tear in the MCL. They said an MRI is needed to properly diagnose the injury and to determine further actions. I.e. if surgery is needed. They ordered an MRI for me and said to wait for the insurance company’s approval.
Day 2: Insurance company approval I decided to call the insurance company to learn more about the MRI approval and it’s status. They put me on hold for over 10 minutes. But when somebody finally picked up the phone, I was told that a pre-authorisation is not needed for an MRI. Lesson learned was to be patience!! I scheduled an MRI appointment a week from then and informed the orthopaedist.
Day 3: MRI Since calling worked yesterday, I decided to call the imaging centre to see if they have any availability. They indeed have a slot today. I took it. Had some hassle removing all my jewellery but I showed up and got my MRI. The MRI itself took around 15 minutes. The imaging centre said results would be available in 24-48 hours.
Fast forward 8 hours, I already got my results via the patient’s portal. It is a ACL and MCL Tear. I am devastated. I scheduled an ortho appointment for two days later to discuss the report and next steps.
Day 4: thankfully, my job allows me work remote due to the circumstances. Not going to lie, I still am sad, but am starting to find things to do. Started doing research on tattoo and piercing places. Spending more time reading and gaming. It is really challenging going from exercising 5 days a week to 0.
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2023.06.08 05:51 Determination7 An Outcast In Another World (Subtitle: Is 'Insanity' A Racial Trait?) [Fantasy, LitRPG] - Chapter 200 (Book 5 Chapter 26)
Quick Author's Note:
For better clarity of intent, the 'worthwhile opponent' stipulation in Lifedrinker is being changed to 'non-negligible opponent' moving forward.
--
"The Gellin Empress was the catalyst for our breakthrough," a mage explained. "Tracing Lord Rob's lingering mana signature through the space between dimensions proved effective at first, yet it came with an insurmountable problem: he only attained mana after initially leaving Earth. At a certain point, there was no more of a signature for us to trace. We had found his home dimension, but finding his home world within the infinite expanses of that dimension could have taken years of aimless searching, like blind men stumbling in the dark."
He leaned forward, clearly enjoying having a captive audience. "The key, then, lay within Lord Rob's memories. Even without mana, memories have a power all their own. The Empress looked within his mind and found locations of personal importance to him. Ones that he remembers with pristine clarity. By scrying for areas within Lord Rob's dimension that matched those specific locations, we were able to narrow down the scope of our search considerably."
The mage spread his palms wide, and his voice dropped a full octave, as if he was imparting a great revelation. "The result will soon be made self-evident. You shall bear witness to the foremost magical achievement of our era: a one-way viewing window into Lord Rob's world. The first of many to come."
In respect for the man's showmanship, Rob started up a clap. Granted, he would've clapped even if the explanation was done via a mindnumbing PowerPoint presentation, because nothing in the universe could stunt his enthusiasm right now. Riardin's Ranger, the Elders, Diplomacy, and the Soul Surgeon clapped as well, although Rob was pretty sure they were just following his cues. This moment couldn't possibly hold the same gravitas for them as it did for him. They mostly were here to provide moral support and satisfy their curiosity.
While for him, this meant everything.
"Do we need the Gellin Empress here to create the window?" Rob asked. "I'd also like to thank her for the help she's given."
The mage shook his head. "I'll spare you the details, but to be succinct; she taught us how to save a mana-based copy of the necessary memories, which will allow us to attune to a subset of Earth locations. Her presence is not required. In fact, she insisted that we proceed without her, as the Gellin have gone to rest for the night."
Must be nice. I'd trade ten Levels for a consistent sleep schedule. Rob internally frowned at himself, punting the envious thoughts away. No sour grapes. If the Empress helped me see Earth again, then I hope she sleeps like a baby for the rest of her life.
"One question," Keira interjected. "In your explanation, you stated that, without the Empress' assistance, it may have taken years to discover Earth. That is hardly the weeks or months you claimed in the past."
The group of dimension mages froze, embarrassment blooming on their features. They looked to the head mage for guidance, whose veneer of showmanship was deflating like a leaky balloon. "We were perhaps...optimistic."
"By years?"
"The previous estimate I put forth was one that assumed we would develop breakthroughs as we went along." His mouth widened into a sheepish grin. "As you can see, we, um, succeeded."
Keira raised an eyebrow. "Only with the timely assistance of a Leader." Her tone was calm, yet unyielding. "Rob is too grateful to point out this contradiction, so I suppose the task falls to me. You have also told us that you should be able to 'open' the window and let Rob send a letter home within the next week – is that more unfounded optimism?"
"No." The mage straightened his posture. "Now that we have located Earth, the rest is simply a matter of refining our spells and collecting reserves of mana. We are no longer blind, nor are we fumbling in the dark, and thus our progress moving forward shall be predictable and steady. This, I swear."
After a few seconds, Keira nodded. "Then I thank you for the wonderful boon you've granted to the man I love."
From behind, Malika giggled under her breath. Rob squeezed Keira's hand, gave her a warm smile, and faced the mages. "I'm ready whenever you are."
The tent thrummed with mana as the dimension mages formed a Mage Circle with Malika. It was no different from any other time they'd done so, yet the knowledge of what they were about to accomplish heightened the tension in the air to a fever pitch. Rob's pulse quickened, his throat tightening. He'd been disemboweled by monsters, decapitated by eldritch abominations, and none of those events made him a fraction as nervous as watching the dimension mages at work.
Minutes passed. Rob forced himself to be patient. Reaching across the boundaries of space and dimensions wasn't like heading to the store to pick up a carton of milk. It involved a level of spellcasting prowess that would take Rob decades of committed study to have even the slightest chance at grasping. Frankly, the fact that it was possible at all still beggared belief.
Maybe...maybe the mages were wrong. Not lying; just wrong. They could be overeager, sharing before they were actually ready, and they'd end the circle looking contrite and ashamed.
That was okay. No biggie. Rome wasn't built in a day, or...something. He could wait–
Creak.
It was the sound of a rusted hinge, of crumpling paper, of breaking bones, and more. A combination of all the noises things made when subjected to an external force. Like reality itself was groaning under the pressure.
Creeeak.
A thin, imperceptible line appeared at eye-level, dark as the endless void. Slowly, inch-by-inch, it widened.
CREEEAK.
It had become a rectangle. Two feet wide, three feet high. With a final CREAK, reality threw in the towel. The void dissipated, as if smoke blown away by a gust of wind, revealing...
Home.
Everything was as he remembered it. The same furniture with scuffed marks of wear-and-tear. The same living room where they'd watched movies each Friday. The same kitchen with a sink perpetually filled with dirty dishes. The same tacky wallpaper that his mom refused to change, and that he secretly enjoyed.
Identical. Like a portrait had been painted straight from his memories.
A tsunami of aching nostalgia surged through him. Rob didn't realize he was extending his hand until his fingertips were already brushing against the viewing window. Its surface felt solid, and for an instant he was terrified that this really was just a painting. Something invented to give him false hope.
Then he noticed that a window had been cracked open. Not the mages' window; the window inside his house. A small breeze blew inside, jostling a curtain ever so lightly. Just enough to make it move.
"It's real." Rob's voice was hoarse. "It's my home."
No one said anything. They allowed him his silence, a gesture which he greatly appreciated. Eventually, Rob took a deep breath, clenched his hands so that they wouldn't tremble, and looked at the dimension mages. "Thank you. I owe you...so much. Even if observing from afar ended up being the limit of what you could do, just seeing my house again like this is..."
He trailed off, unable to find words that were sufficient. Thankfully, the dimension mages seemed to understand. "You are most welcome, Lord Rob." The head mage smiled. "This is far from the limit of what we can do, however. Give us time, and this window shall open."
Rob nodded, choosing not to believe them. They were probably right, but on the off chance they weren't, he didn't want to look back on this moment with bitterness. Best to assume the worst and be grateful for what he already had.
As if drawn by a gravitational pull, his eyes drifted back towards the window. It was displaying a fixed point in the center of his home. "Can you switch perspectives? I want to check other rooms." His parents were likely asleep in their bedroom at this hour. Assuming they didn't sell the house out of grief and move, that is.
"I am afraid that isn't possible. We can transpose the viewing window to other specific locations that the Empress provided, but having it 'walk around', so to speak, requires finer control than we are yet capable of."
Yet, he says. Which means that with practice, they'll be able to. Rob placated himself with that notion. This was a minor setback, and he wouldn't let it get him down.
He especially wouldn't listen to that tiny voice in the back of his head, whispering that the reason he couldn't see his parents right now was because they were–
"Got it," Rob stated, in a wooden voice. "What other locations did the Empress pick out?"
The window's perspective blurred and shifted. Rob swallowed a gasp as an extremely familiar place was displayed before him. He'd seen it many, many times, even after coming to Elatra. It used to be at the top of his nightmare rotation, only ousted from its throne when Blights started coming into play.
In front of them was a small grassy lawn, surrounded by lecture halls in the near-distance. The place that had forever altered the course of his life.
"This is where it all started." Rob pointed to an empty spot in the middle of the field. "Portal opened up. Right there. Saturated with darkness. Chains shot out, tried to grab at Jason. I pushed him out of the way, and...the rest is history."
Silence reigned once more. After a few seconds, Orn'tol stirred. The young Ranger opened his mouth, preparing to say what would undoubtedly be some platitude reassuring Rob over his noble sacrifice.
"The grass truly is green."
Rob burst out laughing. He kept going until he was short of breath, wheezing as the others looked at him with eyes full of concern. "I'm okay," he managed to cough, once the laughter had died down to snickers. "Thanks, Orn'tol. I needed that."
"You're very welcome?" Orn'tol exchanged confused glances with the rest of Riardin's Rangers. "I am unsure of what I did to assist you, yet it's good to see you in high spirits nonetheless."
"Sometimes a little silliness is just what the doctor ordered." Rob offered him a high-five, which the boy accepted with zeal. They returned their gazes to the viewing window, Rob tilting his head as he peered closer. "Hmm. That's weird."
"What do you mean?"
"There's no people. It's early evening, but college students have the worst sleeping patterns on the face of the planet. Trust me; I'm speaking from experience. Usually you'd see a dozen partygoers strung out on energy drinks racing around now."
"Perhaps this location is known as a place of danger," Keira posited. "I would certainly be hesitant to tread where a portal of darkness sprang from the aether and kidnapped a civilian."
Rob watched the viewing window for signs of life, finding none. "Could be. Parents probably pulled their kids out after what happened to me. Then either the government condemns the area, or enough money is lost that the college goes bankrupt." He snorted. "Would be the least of what it deserves, considering the tuition fees. Bloodsucking vampires."
"People on Earth drink blood?"
Normally, Rob would have played along with their confusion, but there were more important things to focus on. "Can you change this to the next location from my memories?" he asked the dimension mages. "How many are there, anyway?"
"Five in total. One moment, please."
The window's perspective blurred, shifted, and reformed. Now it was displaying a city sidewalk, its view positioned right outside the best god damn burger joint in existence. Rob didn't care what anyone else said; two greasy slabs of beef squeezed between two sesame-seed buns was the absolute pinnacle of culinary delight. So what if his palette was 'like a five-year old's?' Wasn't his fault that delicious things were delicious.
Belatedly, he realized that his memory of this restaurant had been strong enough for the Gellin Empress to choose it as a point of reference for interdimensional portal magic. That...yeah, that tracked. Aside from the burgers, he had fond memories of sitting at the outside patio with Jason and his folks, drinking Minty Fresh Phantasma and inhaling cheesy fries as they mocked his dietary preferences. Good times.
He was about to explain what this place meant to him when a human casually walked past the viewing window.
She was a normal working woman like any other. Tired eyes, a purse slung over her shoulder, and dressed for lukewarm weather. A cell phone was held in her right hand, her eyes glued to some form of social media. She strode past the window without a care in the world, visible for merely a second before disappearing from view.
To the Elatrans, it was like a horror movie jumpscare. All of them froze. Several gasped. Elder Alessia grimaced. Faelynn muttered "a world of Humans" in a hushed tone. The only exceptions were Elder Duran and the Soul Surgeon, who crept closer to get a better look, their eyes shimmering with curiosity.
In contrast, Rob let out a sigh of overwhelming relief. That bored, everyday woman was exactly what he'd needed to set him at ease. Earth hasn't completely gone to shit behind my back. People are still living their lives.
As he watched, a few more humans walked in front of the window. A middle-aged man, a young boy with his mother, and an old woman with a walking cane. The old woman pivoted straight into the burger joint, Rob internally praising her good taste.
"W-well," the head mage stuttered. He paused, cleared his throat, then started anew. "As you can see, the viewing window is imperceptible to those with low Levels of Sense Mana. Naturally, this will not be the case for a portal that can be interacted with from both sides."
"Dangerous," Meyneth commented. "I would advise that you conceal this type of spell for as long as you are able. The viewing window especially."
"Why is that?"
"If this window cannot be sensed by those with low Levels of Sense Mana, then that makes it an ideal tool for spying on non-Mages. In your haste to glimpse into the world of another dimension, you have inadvertently developed a field of magic that puts every nation in Elatra at risk of subterfuge. People have been assassinated for much less."
The mages blanched. "We are nothing more than simple researchers," the head mage protested, in a faltering voice. "Who besides a madwoman like the Dragon Queen would stoop so low as to threaten noncombatants?"
Keira averted her eyes, pointedly examining the floor.
"We can discuss matters of life and death at a later time," Duran interjected. He gestured to the viewing window with the demeanor of a child in a toy story. "There's a world of discoveries to explore! Take a look at those structures the Earth Humans have built – they resemble the buildings within Human territory, yet small differences set them apart."
Duran ooooh'd as another person walked past the viewing window. "So many humans are ambling about despite the late hour. Is this area a well-traveled location in your home city, Rob?"
"This is around the level of street traffic you should expect for early evening. If it were daytime, you'd see a hundred people per minute."
Duran aaaah'd. Before he could launch into a series of questions, Zamira beat him to it. "Pardon me if this comes across as an insult," she began, hesitantly. "But Earth Humans appear marginally...uncoordinated. It is hard for me to describe the notion, yet when I watch them move, they appear as if they're liable to fall over at any moment."
They look normal to me, Rob almost said, before remembering that Earth's normal wasn't Elatra's normal. "That's called being permanently Level 1." He shrugged. "They've all got crap stats. Except athletes, I guess."
Zamira stared at the human passerby with obvious sympathy. "My condolences."
Does Earth seem like a world of cripples to her? Rob wondered. Even Utility Class users have the option to put a couple points into Dexterity and Perception. That's not counting the natural stat boosts they gain as they grow up, either. And when combined with Vitality and healing magic, it means that people in Elatra tend to age gracefully.
Rob tried to think of the last time he'd seen an Elatran with the same frailty as that old human woman with her walking cane. The oldest person he'd met so far was the Fiend High Soulseer, and in spite of being positively ancient – and blind – the dude could get around fine. Elder Duran was having health problems, but that was only after suffering from severe Corruption poisoning for weeks on end. An incident like that would've landed an Earth human in long-term hospice care.
Actually, no, that was wrong. It would've just killed them.
"We should switch to the next location," Rob said, preempting any further questions. "There's still two more left." Maybe I can see...no. Keep your expectations in check.
He was right to do so. Rob's heart sank as the viewing window solidified once again, revealing battered, empty streets. Half the buildings had collapsed to rubble, as if visited by a wrecking crew with an axe to grind. He recognized this spot as the street leading up to his favorite movie theater on the other side of the city. There'd been good times here, as well.
Although not anymore. The theater's roof had caved in, and half the letters in its ostentatious PRIME CINEMA logo were missing. It would take years to rebuild – assuming someone was willing to invest millions of dollars into what was essentially a ghost town.
"This..." He ran his hand down his face, aware of everyone gazing at him with pity. "As you can probably infer, this isn't normal. In the past–"
Bang.
Rob practically jumped out of his skin at the abrupt sound of gunfire. At first he thought the shot had come from outside, but no, it was both too distant and too close for that. The noise also sounded different from the rifles that the Dwarven Thunder Rod wielders employed.
A series of repeated bangs swept his thoughts away. Everyone watched in astonishment as a crew of Earth military soldiers ran into view from a side street, desperately fleeing the eight-legged Blightspawn that was hot on their tails. The abomination was more of an amalgamation of flesh and limbs than anything resembling a living creature, and the way it skittered made Rob reconsider if spiders were really that bad in comparison.
"Keep firing!" one of the men commanded, his voice sounding like it was coming from the bottom of a lake. The soldiers blasted their assault rifles in a retreating offensive, peppering the abomination with a hailstorm of bullets. Their response was swift, their aim was true, and it did not matter. The Blightspawn bulldozed through the rain of bullets as if it was a light drizzle, the creature's five cavernous mouths wailing for blood and sustenance.
It was nearly upon them when an explosive rocketed in from the opposite side street, knocking the Blightspawn off its many feet. The reprieve was temporary, but it was just long enough for the soldiers to escape unharmed. Unfortunately, the creature was also mostly unharmed, sporting minor injuries despite a direct missile strike to the torso. With a chorus of screams that prickled Rob's ears, the abomination continued its chase, batting away a second missile as it resumed the chase with renewed fervor.
Then it was gone, having left the window's range of sight. Distant sounds of battle grew quieter, the gunshots and explosions becoming more faint as predator and prey ran deeper into the ruined city.
Rob closed his eyes. He said nothing for half a minute, allowing himself time to process what he'd seen.
"Okay." He opened his eyes, nodding. "This is fine."
Keira laid a hand on his shoulder, struggling with what to say. "Rob...you don't need to–"
"Hold it in? Bottle up my emotions?" A wry chuckle escaped his throat. "Honestly, I'm not as affected as I thought I'd be. The Blight dropped one too many cryptic hints for me to be surprised, anyway. At this point I'm just glad that Earth hasn't been completely overrun. Some parts of the city might be fucked up, but not all of it is."
He narrowed his eyes. "The biggest thing I'm worried about is the Blightspawn itself. You saw those weapons the humans were using, right? Think of them as substantially upgraded versions of the Thunder Rods. They should've put a real dent in a fully-grown Blight, let alone one of its spawn."
"Perhaps the creatures have gained a defensive Skill?" Duran theorized. "What we witnessed appears consistent with other damage reduction Skills such as Tough Skin or Heat Resistance. I would surmise that the Blight has learned something akin to – for example – Thunder Rod Resistance."
Rob paused. Elatra didn't have a specified 'Bullet Resistance' Skill, but that was because conventional firearms had been removed from the system for balancing purposes. The Blight wouldn't give two shits about balance. They'd cheerfully grant themselves Bullet Resistance, Missile Resistance, and whatever else tickled their fancy.
And the more Earth fought back, the more resistant they'd become.
"...This doesn't change anything," Rob eventually concluded. "Earth is a big boy planet. It'll figure something out. In the meantime, we'll clean up our problems here and be ready to help if the Blight's still around by then."
"You're sure?" Keira asked. Two words that held so much intent. 'Are you sure you'll be alright? Are you sure Elatra should remain your primary concern? Are you sure you don't want to head home the instant the dimension mages create a working portal?'
Rob gave her a thumbs-up. "I'm sure. And I know you'll worry about me regardless, but I promise I'm feeling fine."
Or maybe he was just numb, and an avalanche of emotions would bury him when he least expected it. The good news was that was a problem for future-Rob to deal with. Present-Rob had one last area to investigate.
I'd be satisfied with seeing my old bedroom intact, he thought, as the dimension mages altered the viewing window for the last time. I have strong memories there, right? It should be a candidate. Those late night Netflix binges were uh...riveting. Yeah.
The window finalized.
Rob felt the strength leave his body.
Some parts of what he was seeing were incongruous. Strange details that he'd need to figure out soon. All of it took a hard backseat to the one sight in the room that truly mattered.
Jason was alive.
He was at his house that Rob had visited so often. Alive. Surrounded by people. Alive. Chatting away. Alive. Gesturing in that exaggerated manner he often used. Alive.
Smiling.
Alive.
A dam broke. Silent tears began streaming down Rob's face. Thoughts cut out, leaving only the realization that his best friend since childhood, the sole person he'd have trusted with his life before meeting Riardin's Rangers, the man whose place he'd taken when the gods picked a new chew toy...
Was alive.
"Hey, man." Rob's smile was the most genuine it had been in a long time. "Been a while."
At that moment, almost as if he could hear him, Jason grinned.
--
Author's Note:
When I was writing Chapter 199, I was mildly annoyed that Rob didn't reach 200 Vitality on Chapter 200. That would've been hilariously coincidental. But if I had to choose between that chapter or this one for a big milestone...I think I like this better.
Happy Chapter 200, everyone. Thanks for reading and staying on this journey with me.
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2023.06.08 04:55 NRFmama High Risk Triploidy Results Question
Hello, and thanks so much in advance, this group and all the posts have been really helpful to read through and just get a better understanding of what all these words mean. So, I’m 34 (35 next month) G2P1, healthy 20 month old, uncomplicated pregnancy. This time around I have a different OB since mine retired and since I’m older we decided to do the NIPT testing (Natera, panorama) I had an 8w ultrasound for dating that was all normal, no mention of anything. Fast forward to 5/30, quick sono in office, good HR, went for the NIPT blood draw that same day, so at like 10w2d. Got a call from the doc re: results about a week later, she says “it’s flagged for aneuploidy, so there’s basically something extra or missing there, all the other test are normal, I’m going to refer you to MFM” she mentioned it could be a twin/vanishing twin situation, but they haven’t seen anything on any of the ultrasounds they have done. Then I get my results on the patient portal and everything says N/A for every result, for FF for gender, everything N/A and high risk for triploidy. Results suggesting either a vanishing twin, unrecognized multiples or triploidy. PPV for triploidy is 7.5% so I guess the main question is do the doctors get different/more results than what’s in the patient portal? And what do we think of these? A vanishing twin that was vanished before the 8w ultrasound? I havent had any spotting or cramping, just run of the mill nausea and fatigue. I have an NT ultrasound already scheduled for 6/16, The wait for MFM and what’s next is just a lot, as I know you all KNOW, and thank you for any insight
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2023.06.08 01:28 kirant Covid-19 Update for July 7 (21 day total): Hospitalized: 397 (-70 since last update), ICU: 12 (-6), 36 Deaths, 6.53% tests positive (-2.94%)
Data is taken from the
Covid-19 portal.
VACCINE ELIGIBILITY
Dose | Recommendation Booking Time |
1st | >6 months old |
2nd | 8 weeks after first shot |
Further Doses | .. |
.. 18+ | 6 months after last dose (recommended) |
.. Immunocompromised | 5 months last |
1. TOP LINE NUMBERS
- For values where "Current" and "Total" are the same, I have left results under Total
- Change is relative to the end of the 16nd and data is current to the end of the 5th (reporting day of the 6th)
Value | Current | Change | Total |
Tests | — | +10,290 (~6.53% positive) | 7,478,550 |
Hospitalizations | 397 (~46% "because of" Covid)1 | -70/-97 based on last update/portal data | 35,707 (+215) |
ICU | 12 (~42% "because of" Covid)1 | -6/-8 based on last update/portal data | 4,807 (+17) |
Deaths | — | +36 | 5,769 |
Albertans with 1+ vaccinations | — | +411 | 3,652,744 (~83.7% of eligible) |
Albertans fully vaccinated | — | +547 | 3,462,760 (~79.3% of eligible) |
Albertans with additional vaccinations | — | +801 | 1,828,362 |
Eligible Albertans not vaccinated | — | -411 | 713,472 (~16.3% of eligible) |
Albertans ineligible for vaccination | — | +0 | 50,476 |
1 Based on the last 3 days. The official definition given by Alberta Health is "with a primary or contributing cause due to COVID-19". Contrast "with Covid", where Covid was not a contributing factor to hospitalization (incidental hospitalization).
Cases Since Last Update
- Dates refer to the date of reporting (e.g. June 6 primarily consists of tests conducted on June 5)
Value | May 17 | May 18 | May 19 | May 20 | May 21 | May 22 | May 23 |
Cases | 49 | 30 | 33 | 28 | 27 | 32 | 24 |
Tests | 511 | 500 | 425 | 466 | 443 | 407 | 404 |
Positive test rate | ~9.59% | ~6.00% | ~7.76% | ~6.01% | ~6.09% | ~7.86% | ~5.94% |
Hospital usage | 496 | 483 | 482 | 460 | 446 | 457 | 452 |
ICU | 18 | 17 | 17 | 14 | 14 | 13 | 11 |
Value | May 24 | May 25 | May 26 | May 27 | May 28 | May 29 | May 30 |
Cases | 41 | 21 | 38 | 20 | 33 | 26 | 23 |
Tests | 446 | 444 | 516 | 454 | 418 | 327 | 429 |
Positive test rate | ~9.19% | ~4.73% | ~7.36% | ~4.41% | ~7.89% | ~7.95% | ~5.36% |
Hospital usage | 462 | 453 | 449 | 434 | 427 | 430 | 440 |
ICU | 13 | 15 | 14 | 12 | 11 | 12 | 13 |
Value | May 31 | June 1 | June 2 | June 3 | June 4 | June 5 | June 6 |
Cases | 39 | 30 | 25 | 30 | 22 | 21 | 20 |
Tests | 619 | 430 | 442 | 465 | 395 | 393 | 440 |
Positive test rate | ~6.30% | ~6.98% | ~5.66% | ~6.45% | ~5.57% | ~5.34% | ~4.55% |
Hospital usage | 431 | 428 | 422 | 423 | 408 | 403 | 397 |
ICU | 13 | 13 | 13 | 13 | 11 | 9 | 12 |
- A historical summary of weekly cases, hospital admissions, and ICU admissions, is given here
- Due to the last week providing no weekly update, the results for the last three weeks have been averaged for hospital and ICU admission
Dates | Cases | Hospital Admissions | ICU Admissions |
10/05/2023 - 16/05/2023 | 279 | 96 | 9 |
17/05/2023 - 23/05/2023 | 223 | 72 | 6 |
24/05/2023 - 30/05/2023 | 202 | 72 | 6 |
31/05/2023 - 06/06/2023 | 187 | 72 | 6 |
- Highest weekly hospitalization/ICU admissions:
- Weekly hospitalization: 872 (Jan 26-Feb 1, 2022)
- Weekly ICU admission: 282 (Sept 15-21, 2021)
2. AGE DISTRIBUTION
Total Cases and Deaths
Age Bracket | New Cases | Total | New Deaths | Total Deaths |
<1 | +12 | 5,501 | +0 | 1 |
1-4 | +8 | 21,965 | +0 | 1 |
5-9 | +15 | 31,876 | +0 | 2 |
10-19 | +15 | 69,819 | +0 | 2 |
20-29 | +27 | 104,052 | +0 | 25 |
30-39 | +25 | 119,383 | +1 | 52 |
40-49 | +17 | 99,432 | +1 | 119 |
50-59 | +50 | 72,496 | +0 | 316 |
60-69 | +80 | 46,181 | +5 | 762 |
70-79 | +109 | 26,332 | +10 | 1,347 |
80+ | +234 | 36,328 | +19 | 3,142 |
Unknown | +0 | 2 | +0 | 0 |
Total Hospitalizations by Age
Age Bracket | New Hospitalizations | Ever Hospitalized | New ICU | Ever in ICU |
<1 | +3 | 635 | -1 | 95 |
1-4 | +5 | 526 | +3 | 58 |
5-9 | +4 | 256 | +0 | 34 |
10-19 | +4 | 617 | +2 | 81 |
20-29 | +2 | 1,720 | +0 | 182 |
30-39 | +7 | 2,824 | +2 | 354 |
40-49 | +6 | 3,003 | +2 | 592 |
50-59 | +10 | 4,348 | +0 | 980 |
60-69 | +36 | 5,920 | +6 | 1,257 |
70-79 | +42 | 6,748 | +1 | 891 |
80+ | +96 | 9,110 | +2 | 283 |
Unknown | +0 | 0 | +0 | 0 |
3. VACCINATIONS
Summary of Vaccinations
Value | Change | Total |
Doses delivered | +13,636 | 10,076,326 (~2,210,576/million) |
Albertans with 1+ doses | +411 | 3,652,744 (~823,986/million) |
Albertans fully vaccinated | +547 | 3,462,760 (~780,420/million) |
Albertans with additional doses | +801 | 1,828,362 (~413,653/million) |
Albertans not vaccinated (eligible) | -411 | 713,472 (~161,418/million) |
Albertans not eligible for vaccine | +0 | 50,476 (~11,420 /million) |
- Vaccinations by age can found at this link
- A version of this chart with the age column repeated can be found here if needed.
4. VARIANTS AND CASE SPREAD
Current Dominant Strains
- General notes:
- XBB are recombinant viruses of two previous strains
- BQ are sublineages of BA.5 (Omicron)
- ".x" is a wildcard to designate all of the sublineages of XBB and BQ.
- Minor sublineages consist of <5% of cases
Variant | Percentage of cases identified, last 21 days (Change) |
Recombinant (XBB.x) | 56.8% (-11.4%) |
Omicron (BQ.1.x) | 0.0% (+0.0%) |
Minor Sublineages | 43.2% (+11.4%) |
5. SPATIAL DISTRIBUTION OF CASES
Zone | New Cases | Total | Cases/100k (Change) | New Deaths | Total |
Calgary | +187 | 254,720 | 2.9 (-3.1) | +13 | 1,656 |
Central | +58 | 65,079 | 5.5 (-1.4) | +5 | 747 |
Edmonton | +278 | 204,352 | 5.8 (-1.5) | +11 | 2,174 |
North | +52 | 67,845 | 3.5 (+0.0) | +3 | 654 |
South | +26 | 41,295 | 1.9 (-3.6) | +4 | 538 |
Unknown | +1 | 86 | -- | +0 | 0 |
6. CASES IN HOSPITALS/CARE FACILITIES
Spatial distribution of hospital usage:
- Hospitalization zone are where the patient is receiving care, not zone of residence
Zone | Hospitalized | ICU |
Calgary | 110 (-40) | 3 (-2) |
Edmonton | 210 (-10) | 5 (-4) |
Central | 17 (-10) | 4 (+1) |
South | 19 (-4) | 0 (-1) |
North | 41 (-6) | 0 (+0) |
Outbreaks in care facilities
Location | Calgary Zone (Change compared to last update) | Central | Edmonton | North | South | Total |
Supportive Living/Home Living Sites | 2 (-5) | 0 (-1) | 2 (-3) | 4 (+2) | 0 (-3) | 8 (-10) |
Long Term Care Facility | 6 (-7) | 3 (+2) | 6 (+2) | 0 (+0) | 0 (+0) | 15 (-3) |
Acute Care Facility | 0 (-1) | 1 (+0) | 7 (+3) | 0 (+0) | 0 (+0) | 8 (+2) |
Other | 1 (-1) | 0 (+0) | 0 (-1) | 0 (+0) | 0 (+0) | 1 (-2) |
Total | 9 (-14) | 4 (+1) | 15 (+1) | 4 (+2) | 0 (-3) | 32 (-13) |
Hospitalization intake for Covid-19 and all influenza strains
- Note: Many factors can influence the comparison of Covid-19 and influenza. For example:
- Vaccination rates
- The dominant influenza strain
- Covid-19 hospitalization dates: May 16-June 6 (21 days)
- Influenza hospitalizations dates: Apr 22-May 6 (14 days)
Age Bracket | Hospitalizations | - | ICU | - | Deaths | - |
- | Covid | Influenza | Covid | Influenza | Covid | Influenza |
<1 | +3 | +0 | -1 | +0 | +0 | +0 |
1-4 | +5 | +0 | +3 | +0 | +0 | +0 |
5-9 | +4 | +0 | +0 | +0 | +0 | +0 |
10-19 | +4 | +0 | +2 | +0 | +0 | +0 |
20-29 | +2 | +0 | +0 | +0 | +0 | +0 |
30-39 | +7 | +0 | +2 | +0 | +1 | +0 |
40-49 | +6 | +0 | +2 | +0 | +1 | +0 |
50-59 | +10 | +0 | +0 | +0 | +0 | +0 |
60-69 | +36 | +0 | +6 | +0 | +5 | +0 |
70-79 | +42 | +0 | +1 | +0 | +10 | +0 |
80+ | +96 | +0 | +2 | +0 | +19 | +0 |
Unknown | +0 | +0 | +0 | +0 | +0 | +0 |
7. ADDITIONAL INFORMATION
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2023.06.08 00:51 spookypillz questioning on patient portal
hi!
so I thought my medical exemption waiver went through, but it never did, and now I can't register for classes. I just re-uploaded it to patient portal, how long will that take?
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2023.06.07 23:59 BairischStolz Looking to transition from Product Owner to Product Manager roles
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2023.06.07 20:29 LiseEclaire [Leveling up the World] - Academy Arc - Chapter 762
Out there - Patreon (for all those curious or wanting to support :)) At the Beginning
Adventure Arc - Arc 2
Wilderness Arc - Arc 3
Academy Arc - Arc 4
Previously on Leveling up the World…
“Mage Dallion Darude and novice!” A loud voice boomed before Dallion could determine the source of the item.
Damn it! He thought. Of all the times that the archduke’s snobbishness could erupt, why did it have to be now?
Four fury guards stood to attention at the hall’s entrance. Everyone’s eyes focused on Dallion. The crowd was rather impressive, composed of several hundred people, all dressed in their most illustrious clothes. Fury guards were everywhere, giving the atmosphere a distinctly military vibe. And yet, it was obvious that everything was just a hollow façade. While still important, less than half of the people were nobles. There were no representatives of any other archduke families, even the neighboring ones. Members of high-powered guilds and merchant organizations had taken their place. Most notable of all, there was no imperial presence whatsoever.
With a diplomatically acceptable smile, Dallion made his way along the length of the hall, straight towards the elevated section where the archduke’s throne was. Power still emanated from the man, but now the sense of boredom was replaced with tiredness. The man who at one point Dallion thought capable of shattering mountains with a single punch now seemed like a wounded lion struggling to maintain the appearance of his former glory. Even worse, everyone in the hall seemed to know it. They were smart enough to know they’d never survive a direct confrontation, so instead they were patiently waiting for the moment a new archduke would emerge. The emotions of the Linatol family were especially turbulent. Several of the immediate members were considering how soon they could make a go for the position, while the rest were ashamed they had fallen to such a level.
Noble problems, Dallion thought.
A thin elderly mage in a deep blue robe stood a few steps from the throne. Dallion hadn’t seen him before, but could tell by the magic emanating from the man that he was powerful and probably important. Dark-skinned with almost entirely purple eyes, he had the Lanitol emblem embroidered on the upper right section of his robe, suggesting that he was related to the family in some fashion.
Everyone’s here, a whisper said among the crowd.
Dallion fought the urge to combat split in an attempt to find the source. He knew that it was an item, though a different one than that which had warned him moments ago. Also, this one wasn’t talking to him, but to someone else. Unless there was another empath right here, right now, that suggested that the item had an ancient guardian.
Stopping ten feet from the throne, Dallion bowed.
“Archduke Linatol,” he said. “The archmage commends you on your victory.”
The Lanitol mage snorted. It wasn’t that he found the lie amusing, but rather disapproved that Dallion was the one talking in the name of the Academy.
“Dallion Darude,” the noble said with a semi smile. “Better known as the battle apprentice. I heard you were instrumental in dealing with three rogue mages.”
That was false. Dallion had taken down six and assisted in the capture of a few more. Of course, no one counted the first three since that occurred before the mage legion was established. Also, two of those three were children.
“We learned that you went through Nerosal before joining us here,” the archduke continued. “Is there a reason for that?”
“My apologies, archduke. I was eager to try and find more about the one who got away.” He paused for a moment. “And also to claim my novice.”
There were a lot of ways the conversation could have continued from there, most of them bad. Fortunately, the archduke remained blinded by his own ego.
“Maybe you can help me as well. Seems that several mages have tried their luck going against me. Some steal from me, others come to my land to hide out, thinking that I wouldn’t notice.”
This almost sounded like a threat directed at Dallion. Thanks to his music skills, though, he got the impression that it related to someone else.
“A rogue had the gall to venture into one of my ruins and proclaim them theirs. I would have gone deal with him myself, but Nerot convinced me this is a matter for the Academy.”
“We take care of our own.” The mage nearby nodded in agreement. “Although I don’t see any reason the battle apprentice should refuse.”
My owner will take out the three by the column, an item said. From what Dallion could make out, it was a knife.
The bows in the courtyard are on our side, another voice said. They won’t hit their target.
What about the apprentice? He’s an empath?
Internally Dallion froze. This wasn’t a case of items talking to each other! The discussion was between echoes! Combining magic with music in the Nerosal vortex must have triggered something, allowing him to listen to them as well. That’s why he was only hearing bits and pieces—his ability remained underdeveloped.
“Battle apprentice?” the mage asked.
“Of course, mage Nerot,” Dallion quickly replied. He didn’t like the situation he was in one bit. Even the appearance of using magic in front of the archduke could be viewed as an insult as best and treason at worst. Why wasn’t the overseer noticing anything, though?
“Splendid.” The old man grinned. “I’ll be sure to discuss matters with you later in the evening. Maybe after the auction is over.”
You three attack the fury, Dallion heard among the echo whispers. At this point, there were so many of them that they had become a constant hiss in the background.
We must take them down at the same time. No mistakes…
“We have a rather special item tonight,” the archduke said, oblivious to what Dallion could hear. “Something from my personal collection. Priscord wanted to get her hands on it, of course. They all would. Now I’ll sell it to the highest bidder just to prove how pitiful she is.”
Dallion’s muscles tensed. The whispers kept on increasing, blocking out the noble’s words until, suddenly, they all stopped.
Crap! Dallion thought. He knew all too well what was to follow.
No longer worried that his actions would create a major scandal, he split into twenty instances. Almost simultaneously, crossbow bolts rained onto him. The attack had started.
“Ruby!” Dallion shouted, while casting an aether sphere surrounding him, Diroh, the archduke and everyone else in the immediate vicinity.
How the hell did they get a crossbow in here?! he wondered. The overseer had explicitly said that no weapons were allowed at that banquet, not even a dagger. And yet, whoever had organized this attack had brought in the heavy artillery.
Waves of wind slashes flew in the direction of the crossbow attacker, causing the bolts to shatter before they had approached the target. Unfortunately, that was only the tip of the iceberg. Dozens of attackers had engaged as well, focusing on the armed guards and any nobles that tried to put up a fight.
A wall of ice blocked off the upper part of the hall from everyone else. Diroh had been faster to react than Dallion hoped.
“Skye, Ruby, guard Di,” he ordered, while starting a portal spell to summon his harpsisword. Now that the surprise attack had failed, if anyone would get hurt, it wouldn’t be the archduke.
“Archduke, we should take this in the open,” Dallion split into instances.
To his horror, the noble had remained in his seat completely motionless, his lips half open, as if finishing the last word he was saying.
Before Dallion could figure out what was going on, magic threads shot out from the mage, forming a ten-circle spell that skewered three quarters of Dallion’s instances. Thankfully, five survived. Choosing one to become reality, Dallion quickly split again.
This was a tough one. Facing a mage of Nerot’s level was more than he could handle. His only only advantages were speed and the close distance between them.
Gritting his teeth, Dallion dashed forward with a series of slash attacks.
“I’m not trying to harm the archduke,” he quickly said, using his music skills to add as much calmness as possible in his words. “I’m trying to save him.”
Sound threads attempted to attach themselves to the mage, yet the moment one made contact, it snapped, rendering the effort pointless. It was at that point that Dallion knew: the mage wasn’t attacking him because he feared that Dallion was part of the coup; he was attacking because he had organized it.
Aether barriers emerged as quickly as Dallion could strike. While to an onlooker it might have seemed that he was dealing significant damage to the mage, in reality, the blade was stopping a quarter of an inch shy of its target.
“Ruby, attack!” he ordered.
Nothing followed. Dallion’s first reaction was to turn around with one of his instances and see what was going on. However, it was at that point that he noticed: nothing had followed. The attacks, the yells, even the screams of panic had all disappeared. It was as if everyone and everything in the room had frozen in time, leaving him and Nerot to hash it out.
Infusing his sword with spark, Dallion continued on the offensive. His opponent kept casting spells with both hands, each more intricate than the last. The speed at which this was done was passable. The technique, on the other hand, was astounding. Each spell seemed original, with so many false connections and dummy symbols that Dallion had no idea what the effects would be. In situations such as this, it was best not to find out.
Skipping between surviving instances, he consciously targeted the mage’s hands. The attacks remained inefficient as before, but nine times out of ten Dallion would sever the threads before the spell could fully form, rendering it harmless.
“Arrogant,” Nerot said once it was clear that the two were at an impasse. This was one case in which Dallion was grateful he was fighting a far older opponent. If the mage had been a decade or two younger, the fight would have long been over. “Bad at magic, so focusing on interrupting others.”
“The rules of the wilderness, mage.” Dallion attempted a multi attack in the hopes that one of the strikes would break through the defensive barriers. It didn’t.
“Only the weak don’t follow etiquette.”
Using his left hand, Dallion attempted to cast a simple aether projectile spell. The mage wasn’t able to stop him. Six bolts darted forward, striking Nerot’s torso. Similar to all previous attacks, only flashes of light followed.
There has to be a mega spell on the floor, Dallion thought.
That would explain the stillness all around him. Or was it stillness? As far as he knew, the fight between him and the mage might as well be locked within a single second of real time. Chrono-spells weren’t a popular area, mostly due to their highly impractical nature, but there were still those that dabbled. Such spells were difficult to prepare, almost impossible to execute, and seldom achieved anything. Or maybe this wasn’t time magic. There was only one instance in which time dilation occurred—when within an item, a prison item, to be precise.
“You turned the entire room into a prison item?” Dallion asked, while still attacking.
“Not a complete idiot.” The other grunted.
That was why the mage had called Dallion arrogant. It had nothing to do with his fighting style, but the fact that he had remained half an inch above the ground at all times. Unlike everyone else in the room, Dallion’s feet had never come into contact with the floor, preventing him from getting sucked into the prison item’s realm.
“If you created the trap, why the attackers?” Dallion asked.
No longer had he done so, when the answer hit him like a brick. As long as there was only one survivor, the emperor would accept any account he was given.
“You aren’t betraying the empire,” Dallion said. “You just want to replace the archduke.”
“No. I’m just severing my ties with the so-called archmage,” waves of hatred emanated from the man.
Thanks for reading! If you enjoyed this story, consider joining my patreon or check out my other stories on redditserials:
The Scuu Paradox (a Space Opera Sci Fi)
The Cassandrian Theory (a Space Opera Sci Fi)
The Impeccable Adventure of the Reluctant Dungeon (Dungeon Core Adventure Comedy)
Uncharted Waters (An Urban Fantasy Detective Noir)
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2023.06.07 20:13 new_me2023 Still bleeding a month post op scalpingectony. Can't get ahold of doctor.
So I bled for a couple days after my surgery, which my doctor said was normal. Then it stopped Then a few days later it started back up again. My doctor told me it was provably a normal period this time since it was around the time I get my usual period.
I've been bleeding way less than ZI uded" to pre op. But still bleeding for like a month now. In small amounts, but for an extended period if tine.
I'm pretty sure I'm anemic now.
I call my doctor and the option to speak with the docto nurse on the phone, just connects you to a robot that tells you to use their patient portal online. I've tried reaching out on their patient portal, but nobody gets back in contact with me.
I have no way in getting to the hospital besides calling 911, and honestly I can't afford it arm. I was just fired from my job. So with my job went my weekly wages and my insurance : /
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