My post will be US-centric, because that's where I live, but obviously you're welcome to talk about your own location as well.

With this new COVID-19/Omicron surge, strange things are afoot. Specifically, those in charge of our systems and government have chose to ignore it, rather than institute more shut downs, mandates, stimuli, etc. It appears as though the plan now is to let it burn through the population and see how that shakes out.

But if you peruse r/nursing and r/teachers like I do, you can really see how deep the cracks are becoming. Infections are up, as are hospitalizations, and with more and more professionals out sick, we're seeing huge staff shortages in both education and health care. These industries in particular are essential, and the professionals in these jobs are on the front line of our problems. Health care professionals obviously need to be there to help the sick. And teachers need to be there not only to teach, but so that parents can go to work. They're being sacrificed to our economy.

But as teachers, for example, get sick or get burned out and quit, it puts continued strain on the education system as a whole. We're already seeing staff shortages in other areas of education, such as food service, bus drivers, substitutes, paraprofessionals. With how contagious this variant is, it's only a matter of time until school systems collapse in on themselves due to a lack of people running the show. And when kids have no place to go, parents will have to figure something out or stay home themselves, pulling them away from their jobs and their income.

With all help being pulled away from Americans--help such as eviction moratoriums, financial stimulus, unemployment benefits--what might happen if these things begin to cascade? There are already plenty of anecdotal reports from those in health care that hospitals are full, short staffed, and falling (and you can check here to see hospital status in your state). It can take hours, if not days, to find a bed for someone in the ER. As for education, increasingly both teachers and students are out sick with COVID, yet administrations are fighting tooth and nail against any kind of remote learning, only exacerbating the problem. Remote learning, as you know, requires a parent to be home with the child, which takes them away from work, income, and economic productivity.

And meanwhile, the media seems mostly quiet about how things are actually going. The line is that Omicron is "mild" but if you look at hospitals and schools, it seems like that might just be verbiage to reduce panic in the populace. Omicron isn't mild for the health care system. Better hope you don't get in a car accident. And in medical terms, "mild" is a pretty broad thing. It could mean you're home sick for two weeks, feeling like death, but not bad enough to be hospitalized.

And then there are other front line workers, grocery stores, supply chain, all experiencing similar sickness and staff shortages. But I haven't been keeping up with that as much lately as I have been with education and health care. If anybody has information about these sectors, I'd love to hear it.

My gut feeling is that the economy is actually on the verge of collapse, and this "let it rip!" strategy is a hail mary to see if the status quo can be maintained by sacrificing the health and well-being of a lot of people. Any other mitigation efforts could topple the economy as we know it (and as those at the top benefit from it), so the people in charge of our systems have decided that we're not going to try to fix things, we're just going to hope it works out in the end and deal with the death and illness. For me, the proverbial canary in the coal mine for this was the recent extension of the student loan payment pause. Borrowers had been blasted for months, both phone calls and emails, telling them that loans would need to be paid after January 31st, it was happening, get ready for it. And then poof... nope. Extended. The government knows. People are stretched thin as it is and restarting loan payments could be the thing that triggers the economy to tumble. Even if borrowers can pay, it sucks money out of the consumer economy which can have far-reaching effects.

Many, if not most people are absolutely fatigued by this pandemic. I am, you probably are. But it has revealed so many cracks in our flawed system and it really feels like the people in charge of things--whoever that is--are gripping on for dear life, just hoping the flaws can remain because it benefits them, praying that the system holds. I just don't see it. I don't see how we make it through this without some kind of major fall. People want to ignore it all, because it's frightening and it's negative, but it's happening right in front of our eyes. Our most important systems are broken and those with the power to fix them aren't doing it.

I'm curious as to what Tildes thinks.

A little over a week ago, I got an official diagnosis of hypothyroidism from my GP. Fair warning, this post is going to be a little bit of a rambly discussion of my thoughts and feelings surrounding my diagnosis and other circumstances surrounding it.

I'm a US American, but I moved to Germany to do my master's degree in 2018 and have lived here ever since. I've struggled with depression and social anxiety since before I moved to Germany, but my symptoms got notably worse in 2020 (perhaps unsurprisingly). In late summer of 2020 my psychotherapist finally suggested I go on an SSRI, but she wanted me to get a blood test to rule out any physical causes. I went to my then-doctor and got such a blood test. Everything was within the normal range except for my TSH.

For those unfamiliar, TSH is the hormone your pituitary gland sends to tell your thyroid to get a move on. It doesn't directly measure your thyroid function, but it's a pretty good indicator something's up, so doctors use it to screen for thyroid issues. High TSH is a sign of hypothyroidism, and low TSH is a sign of hyperthyroidism. Your average person with a healthy thyroid will probably have TSH between 1.0 and 2.0, but some variation exists. The normal range that doctors use here has 4.2 as its upper limit. In 2020, my TSH value was 4.8. My doctor then said that people with hypothyroidism have higher numbers than that, so I was fine. She wrote my a prescription for a low dose of an SSRI, which did help me to an extent.

I've been fat for a long time, to different degrees. After I first moved to Germany in Fall of 2018, I quickly lost a lot of weight. There were likely a lot of factors -- I wasn't living at home where snacks were constantly stocked, I was buying food on a student's budget, I was eating out and ordering takeout less because of my social anxiety and shitty German skills, and I was walking a lot more. When I came back to the US for family vacation in 2019, I constantly got compliments about having lost weight, which felt weird. I was still overweight according to the BMI, but more of a classic midsize chubby at that time. But it wasn't to last, and I did start gaining the weight back. For a while it, I attributed this to my getting more takeout and walking less. But a year or two ago it felt like it stopped being directly attached to my activity or food consumption. I went on medication that suppressed my appetite as a side-effect, but I continued to gain weight. Since I was already fat and had been gaining weight for a while, I didn't mention anything to my doctors because I was already getting lectures about how I needed to lose weight and exercise more. I don't know for sure what I weigh right now because I've avoided weighing myself for months, because I'm scared I weigh over 100kg and I can't handle seeing that triple digit on a scale.

I've tried and failed to become more active and start an exercise routine several times. I joined a sports course at university with some of my friends, but I quit after a couple sessions because I was hyperventilating before warm-up was over. I've tried to do some basic strength training, but I'd be sore for days after even incredibly beginner-level stuff. More recently, my wife and I tried to take regular walks through the nearby park during last spring and summer. But I'd tire out after an embarrassingly short distance, not even enough to get to where we see the ducks (the highlight of the park for me). As the weather got worse in winter I basically stopped leaving the apartment. It's a struggle to put my shoes on without an extra long shoehorn so I don't have to bend over, and anything that requires me to tie my shoelaces is basically off the table.

I've been struggling with work for the past several months. I can't seem to focus on it, even if I take my ADHD medication. I look at the computer screen and I just can't mentally handle the work. Every day of work is exhausting, even though I work a pretty cushy job as a data scientist and I work from home. I do way less than 40 hours of actual work a week but I'm still too physically and mentally exhausted all the time to do anything but the most trivial household chores. I haven't cooked dinner for myself in months (thank God for my wife).

I switched to a new GP at the beginning of 2024 bc I was having trouble getting timely appointments at my last one. We agree to do one big blood test covering everything, since I have a myriad of small complaints and it's been years since I've had one. That test comes back mostly normal, except my cholesterol is a little high and my TSH is a smidge above 5. My new GP then says we should do a follow-up blood test to look at other thyroid measurements (this would be directly measuring the hormones my thyroid produces) to see if I have hypothyroidism. I mention offhandedly the interaction I had with my old GP in 2020 and she says that's not how you're supposed to do that; high TSH means further testing even if it's not that high. A few weeks and another blood test later and I've now got a new diagnosis and a prescription for artificial thyroid hormone.

It turns out that pretty much everything I've been struggling with for years now? May be because of my underactive thyroid. Your thyroid is apparently pretty damn important and it not working right (in either direction) can result in a truly dizzying amount of things going wrong. Depression, brain fog, fatigue, and weight gain are all pretty classic symptoms, but apparently it can also cause problems with your lungs or even contribute to carpal tunnel syndrome. Everyone with a properly-functioning thyroid, take a moment to thank that lil butterfly-shaped guy in your neck.

I'm so glad to have something that's basically a "feel better" pill now. But I'm left with a sense of deep frustration that I've had so many problems that even I dismissed to myself because I assumed they were just cause I was a stupid out-of-shape Fatty. It turns out it's actually not normal for someone in their mid-20s at my age to struggle to put on their own shoes without assistance, even when they're obese. Being unable to take a short walk without needing to sit down because I'm exhausted and out of breath isn't just because I'm fat and out of shape. I've had no shortage of symptoms heavily impacting my life, but most of them I hadn't even bothered to mention to my doctor because I assumed they were just Me Being Fat and that all I'd get was (yet another) lecture.

This is, of course, coupled with a lot of anger at my old doctor for not even running any follow-up tests. I've only been on levothyroxine for about a week and I already feel like I have a little more energy. I could have been spared years of suffering if that doctor had only done what she was supposed to. Fuck that.

But at the same time, I feel such relief. This all wasn't just me being a bad and lazy person. There was actually something wrong. And, even better, hypothyroidism is pretty easy to treat. I just wish I hadn't gone through over three years of unnecessary suffering when I could have gotten this treatment then.

I very much would not be. My son had a rough birth, but it probably wouldn't have killed him or my wife.

Both my brothers had children in the last six months. Neither of the kids would have survived, and one of the mothers would definitely have died.

The better question might be: how many of you can say for sure you'd be alive without modern medicine?

So I don't know about all of you, but I'm pretty sick of terrible healthcare in the USA.

So I'm starting this thread for all of us to rant about our personal issues with healthcare. I'll be writing my rant into it's own reply later (it's a bit of a long one), but I wanted to start the thread now to give others a chance to start venting.

Rules of Rant Thread:

1. Don't argue a rant
2. Thread is likely going to be incredibly USA-centric. USA healthcare is assumed unless stated otherwise.
3. Rants should involve people no more than 2 degrees of separation from yourself. This thread is to vent about your personal experiences, not hearsay from total strangers.

In order to foster further discussion, and include those without a rant: Here are some things I personally would appreciate and expect for replies, but others might not.

• Explanation of how things would work out for you if you were in a similar situation
• Advice for dealing with any ongoing or future problems

In case you don't live in the US and don't know, it is very common for health insurance to be tied to employment.

I've held four jobs over the last twelve months. Health insurance has been the most frustrating part of it. I'm married, I have kids. I don't want to go months without health insurance. My wife is self-employed so no employer subsidized insurance for her. We live comfortably so no option for government subsidized insurance.

The cheapest plan with insanely high annual "deductible" of something like $10,000 (the money you have to pay before insurance will pay) I can get independently is around $1000 / month. For comparison, with my current employer, my part of the insurance is around $440 month with a $3000 / year deductible.

During the past year I've four different insurance companies, one of them paid entirely out of my own pocket, no coverage for dental care for a while, no coverage for eye care for a while. Really WTF? Why are teeth and eyes so different from other medical care?

I'm now three weeks into my current position, insurance coverage with this employer began on the first of the month (so after about one week of working) — another gripe, the waiting periods to start coverage; my position before this had me working six weeks before coverage began; this time I had no idea when it would begin until I spoke to HR on my first day. I finally got my new insurance cards yesterday.

So today I decided to try to cancel my out-of-pocket coverage. I have until the sixteenth to cancel for this month. Haha, no. I can't. Not only are the human operators not working today (which granted is a Saturday), but the website is shut down for the weekend. I can't make any changes until Monday.

If the cost to me was the same, or close, I'd just buy my own insurance all the time instead of dealing with the hassles of constant change. But the costs are no-where near close. And I've got college tuition costs coming up very soon, so it's not like I'll have money to spare.

I feel like health insurance in the US is the worst of all possible worlds.

I was inspired to write this after reading this reddit post. It ranted about people who attempt to disuade people from commiting suicide by telling them that they are selfish because of the impact it will have on other people (I do think it is explained better in the post if you are interested).
However I have also been thinking about how suicide prevention is handled by most governments. I am not sure of exactly what process happens in other countries, but in America if you fail a suicide attempt you can be involuntarily put into a mental health asylum for a temporary period of time, and from reading many accounts of what people have experienced in these asylums and from my ongoing experience with suicidal idealation I very much feel i would be 10x more likely to commit suicide if I was put into such a facility once i got out.
But I also wanted to talk about other ways individuals may try to disuade people from suicide which i find problematic. Before i continue, i do want to say that I am not blaming these people, they have very good intentions. But something that has bugged me for a while has been that whenever people discuss suicide/mental health problems the first thing that is done is just recommending suicide hotlines/telling the person in question to seek a therapist/psychologist. While these options can be good for many people, i want to mention that

1. Suicide hotlines (mainly 811) are known for reporting people to police and having them put in mental health asylums (often times unnecisarlly). And staff at these suicide hotlines are often uneducated or rude to callers, or will just not answer or even hang up.
2. Many people in these circumstances do not have access to trained proffesionals. Even if you live in a country with public healthcare, you may be in a situations (mainly abuse) where you cant get access to one either way.

Anyways sorry for the rambling, my brain is tired and i just wanted to get this out there. But based off of the above points, do you think that suicide prevention in society is flawed, and what could be better? While i do agree that it is flawed and there are ideas related to government on how to handle suicide prevention, i do not know what could be done on the individual level. To me one of my only resources apart from seeing other people experiences online is music (mainly Elliot Smith, Linkin park, Soundgarden and Nirvana) which I deeply relate to. But anhedonia can prevent enjoyment of such things.

Symptoms from my diagnoses of bipolar 2 and social anxiety disorder kept me from working, socializing, forming relationships, and living independently for more than a decade.

I worked my ass off to improve my wellness, and for the past 6 years I have worked as a Peer Support Specialist for 2 different public agencies. I tell my story to other people with mental health and substance issues as part of my work. If anyone’s interested, I’d love to share it here too.

I'm writing this post in the spirit of the powerful conversations that I had participated in on reddit in /r/adhd. I'm giving up reddit, after this recent fiasco. And, so, I hope to find a similar community here.

And, so, here we go.

I recently quit my job in Big Tech after 7 years in that space. Corporate America, and Big Tech in particular (among other fields) is a human meat grinder. Humans go in and husks come out. After taking a medical leave of absence from work due to complications from anxiety, and multiple medical interventions, I realized that I needed to evaluate whether my job, even my career, was sustainable for me. It only took a few weeks, after returning to work, to accept that, yes, this job and perhaps this career are actively harming me. After talking about it with my wife, at length, I found relief in quitting.

At the core of it: my career has simply been incongruent with my values.

Sure, I've always been a nerd. I was the "brainy" kid. I didn't know how to people well (though I'm told that I'm not on the spectrum or not in any meaningful way). I'd always been overweight and prone to stress. Throughout my life, I was often labeled as the "sensitive" one by people. I rarely felt as though I fit in with any group of people, save perhaps for the other misfits who would band together because they didn't with in with any group of people.

Just before the pandemic began, at the tender age of 47, I was diagnosed with ADHD Combined type. More recently, I was diagnosed with C-PTSD, that I have likely suffered for 40 of my 50 years.

Now I know where that weight comes from: self-medication to give me a dopamine hit and numb me to layers of trauma. I also know where the emotional reactivity comes from: emotional flashbacks resulting from the C-PTSD.

1. Lexapro for well over a decade. It helped to blunt the lows but, I've found, also the highs. I rarely feel poignancy with Lexapro. When I have occasionally been able to ween from it, I have felt a far greater range of emotions.
2. I've had an excellent therapist for going on 8 years who practices ISTDP. He's helped me learn to show up for my more challenging emotions instead of instantly reaching to numb them.
3. Adderall and Vyvanse both used to help until I received a stellate ganglion block (Disclaimer: I have been a client of Dr Mulvaney's practice though I link to it as his explanation is excellent; I'd make this a footnote alas tildes doesn't support that extension for markdown)
4. Ketamine (prescribed) to better address the depression and anxiety. Ketamine, as a psychedelic, combined with the skills learned in therapy has let me dig deeper into my layers of trauma, leading to better overall mental health and better self-understanding.
5. Stellate Ganglion Block mentioned above. Short version: it reduced my seemingly PTSD-driven emotional reactivity to about 10% of what it was prior to the SGB. It's like getting a new nervous system. Unexpected side effect: medications that act on my nervous system now respond differently. As a result, stimulants are now extremely uncomfortable for me whereas before they were effective. Before the SGB, I would say that fear was my primary emotion. Now, I feel things.

I know: I'm privileged. I'm an "old white dude who profited from being in Tech". Yep. True. But I can't retire yet; we don't have that kind of money. We do, however, have enough such that I have the luxury of time to figure out my next steps.

What I have right now is the plan to make a plan. The core of it: live a life congruent with my values--not just at some far off retirement but here, now.

At first, step 1 was to answer this question: "What is the minimum amount of money that I need to earn for us to not massively disrupt our lives?" But then I realized that this is a fear-based question. It means starting out by saying "no" to everything that doesn't earn "enough" money for some arbitrary value of enough.

Where I'm at now, Step 1 Mark II, poses a more inspiring question: "What does retirement look like for my wife and I?" I don't know that we truly get to retire in the sense of living a life of leisure as seemingly many Boomers and earlier were privileged to do. Besides, part of my sense of accomplishment and peace is knowing that I did something to make the world better.

So what do you struggle with?
How are you doing?
What are you doing about it?

Be well.

P.S. This is me trying to do my part, as a new member of this community, to encourage growth not in membership but into different areas of discussion.

My first memory after leaving the house to cycle was being taken by the ambulance to the hospital. I was evaluated by several medical professionals. One of them spent two hours stitching my mouth and forehead back into something that resembles a human being.

Brazilian SUS is not perfect by any means. It's unorganized and some procedures and operations can take a long time to happen. There's lots of corruption with doctors that work in multiple places at the same time.

But, a lot of the time, it freaking works. The paramedics were gentle, affectionate, and competent. Some in the street knew my mother so they when to my house and called her--she accompanied me in the ambulance.

The hospital was not pretty by any standard. There were burn victims screaming bloody hell and I'm pretty sure I saw a woman die--but hey, that's a hospital, people die there!

An actual orthopedist made sure I did not have any fracture. An actual neurologist made sure I have no neural damage. A surgeon stitched my mouth and forehead back together into something that doesn't look like a character out of Frankenstein. It still looks bad, but it'll improve with time. A very nice nurse cleaned up all my bruises and have me aftercare orientations.

On several occasions, we had to manually seek people and procedures that were supposed to happen automatically. The operation itself was a mess, but the doctors and nurses were extremely caring, competent, and dedicated.

This all cost me exactly zero dollars. I didn't even had to fulfill any absurd form or provide an excess of documentation: just my national registry (RG), something almost every citizen has unless they're a very specific kind of homeless.

This is in a very poor unstable country. It is absolutely not perfect, but on many occasions, it kinda works!

Hi everyone! I am new to Tildes and wanted to say hi to the ~Health community. I am on a 28 hour emergency general surgery call today and have a bit of downtime. I also noticed that the post on the moral crisis of America's doctors had some interest so I thought I would answer any questions about that or training to be a surgeon in the United States. I am finishing my 2nd year of a 7-year training program. Ask me (almost) anything!

I'm not very familiar with how government works in the US, and I've always had this question.

Like, if states are reasonably independent, and it seems like there are some states who lean way more into the socially liberal side of the spectrum from providing universal healthcare (or at least some better healthcare policies) on their own?

I have stage four colo-rectal cancer. It's not curable. It's not particularly treatable. I'm getting palliative care, but I'm not yet end of life. They're not offering surgery or radiotherapy (yet, that may change). They are giving me chemotherapy (capecitabine and irinotecan) and immunotherapy (cetuximab).

Prognosis is difficult, but if everything goes well I have about 18 months.

I've had 6 cycles of treatment. I had a re-staging PET CT scan and the results were very good.

But, here's the thing: chemo & immuno therapy suck. I don't just mean "I feel a bit bad sometimes", I mean "I feel awful most of the time."

We've just about got nausea under control, but those meds cause constipation and that's causing problems with my stoma. And because the nausea meds are only used for the first week it means the second week I have problems with fast output, and that's causing other problems with my stoma. My stoma team and my oncology team are not particularly joined up. In theory I can build in laxido for the first week and loperamide for the second week but that's complicated because side effects are so variable. And that's just stoma output -- there's a bunch of other stuff around pain, fatigue, skin toxicity (I'm not allowed in the sun, even on bright but overcast days. I have to use three different creams, but not too much of any of them, and they're not compatible with each other), loss of appetite, etc.

One example of how healthcare isn't joined up and I'm getting conflicting advice (there are lots of these): My stoma team want me to wear a hernia support belt to prevent my hernia getting worse, and to help my stoma work properly. But this is a tight broad elastic belt going round my lower abdomen, right where my diaphragm is, and so it makes it harder for me to breath. My physio doesn't want me to wear the belt because it's interfering with fatigue treatment (which is "do more stuff, but do it slowly, and build in breaks, and FOCUS ON YOUR BREATHING"). My oncology team have no opinion and are leaving it to the other teams.

I know some people just want more life, and they don't care about side effects. "Do anything you can to give me more life". But that's not me. I'd much rather have 3 months of mostly feeling okay and then a month of active death over a year of mostly feeling fucking lousy and then a few months of active death.

I don't know how to talk to my family about this. I have spoken to my care team and they're giving me all the options - (1) continue chemo and immuno therapy on 2 week cycles until I die or until it stops working, and try to buidl in better support meds. (2) continue chemo & immuno on 2 week cycles, but build in breaks (3) stop chemo & immuno and focus on pain relief.

Some tricky decisions to be made.