Hi all,
Can someone help me with some advice?
I moved in my house a 1 year ago. Before moving in I called EON, told them Im moving and sent them the Übergabeprotokol so that they can register the new meter reader.
Everything was fine for about 6 months. I was paying the agreed amount every month, no issues.
After 6 months I recieved another mail, that they opened a brand new contract for me. It turned out that colleague has messed up some details in contract.
In short the contract had different meter readers for day and night electricity, but our house has only a single meter reader, therefore they had to open a brand new contract (dont ask me why, I never authorized this).
Afterwards no issues again.
Until January... They sent us a bill for the whole usage of the previous year (750 euro), under a totally different contract number.
I explained them multiple times in english and in german (I speak around B1) , via emails and phone calls that I was making payments the whole year. To prove this I sent them the bank statements, the bank statements contained the deposited amount, the contract nunber, customer number. I also sent them multiple times my Übergabeprotoll (which contains the meter ID and the previous owners name and EON contract number, as she was customer of eon). With this I also calculated my yearly usage, which was 50 euro more than I paid, so I officially owe them 50 euro.
Once there was a colleague who finally seemed to understand they are trying to bill us 2x, but he also didnt solve the situation. Its like I am talking to a brick wall.
What should I do? I told them I will not pay this amount as its incorrect, of course I also gave them every time the proof.
Rhis have caused me countless lost hoirs and stress.
What can happen If i dont pay this amount? I told them I have legal insurance, so I am more than happy to go to court, but lets be honest, nobody really wants to waste hours for this kind of nonsense.
I would appreciate some advice, i am quite desperate at this point.
Thanks all.

24F, independent - I live alone in a 1 bedroom apartment, $900 a month. I pay utilities, approx. $50 for gas and $100 for electric a month. I have my own car that I’m financing (hoping to get it refinanced before the summer), currently paying $300 insurance and $400 a month for financing. Groceries and house expenses cost me about $250 a month (including food and necessities for my cat). I have a credit card at about 50% utilization, I owe about $200 minimum a month on it. Good credit score (~720). Other expenses I pay for are internet ($60 a month - they recently increased this rate), Hulu/spotify ($12 a month), apple care (~$11 a month), a yoga studio membership ($109 a month), and an ID Theft protection on my credit card ($15 a month). I also have medical bills that I’ve been putting off because I had a medical emergency earlier this year (total bills come to about $2300 after insurance kicked in. I have not set up a payment plan yet). I work full time plus OT as a social worker, babysit for cash on the side, and drive for doordash occasionally (usually for gas money or small expenses) - income comes to approx. $2600 a month. I am enrolled in a masters degree for my career path that should help be get close to 6 figs before i’m 30, if I stay on track.
It never feels like enough, but all the bills get paid at the end of the month and I’m never late, so I guess I can’t really complain. But I can’t comfortably afford to go out with friends often (maybe once a month) and I put away only about $100 a month into savings. Depending on whether or not I can score OT, I can’t always keep that $100 in savings (OT is not guaranteed at my job, but I can usually get an extra 8 to 10 hours a month added in). Is there anything I could be doing better? Am I on a good track for maintaining stability? Should I be worried? I usually only have $50-ish of spare cash at the very end of the month.

Where to start. It's going to get long so the people who do read it all fully, I truly appreciate you and thank you for reading my hurt.
I met this girl at work back in December and things were not good from the start. She said she didn't want to be in a relationship cause she had just got out of one 3 months prior to me talking to her. The very 1st day I meet her at work I ended up coming to her house. We didn't do nothing but smoked, drinked. talked and watched Rick and morty, it was awesome and I knew then that I really wanted to pursue this women since I only desired to know her as a person. Things went good after that we talked more and hung out more times. It was building into something.
Move forward a month she starts to get cold feet tells me that she wqsmt ready for a relationship and ended things. Well to my surprise a week later she wanted to work it out and told me that she's never been with a real caring man before and she was scared it was too good too be true and ran away from me and our relationship. We talked about it and I told her to not give up on me cause I would never give up on her. Things went good after that. Until I started to see some changes in her behavior.
A couple months passed and during those months she would hangout with a friend who was a bad influence on her. Her friend always wanted to go out to the club and would put her in some fucked up situations where then she would call me to come fix or just come pick her up. This happened more times then I could remember. One time I was getting shit faced with some buddies and she called me at 2 am to come pick her up since she was too drunk with her friend. It was a 3 hour drive and I went to help her knowing it was a horrible choice due to me being drunk but I loved her and cared about her way too much so the answer was quite easy to go and help her. Another time she was with her same friend and I caught her going live on tiktoc with her friend and she was in bathtub in her bikini with hwr friend and in the mirror I could see another man standing there mid 40s close to 50 without a shirt on asking them if they needed more drink and towels. I commented on the live and she immediately took it down and blocked me. Th3 next day she said she didn't know who that guy was and proceeded to make excuse after excuse. She told me she was sorry and that it won't ever happen again that she wanted to be with me and only me. we dont talk for about a week after this cause i couldnt believe she would do such a thing to me. That was betrayal to me, trying to be sneaky behind my back getting caught then lying to me about it. She came to my house unexpectedly and gave me a letter professing her love and commitment to me something she's never done before. It showed me change and effort, so I took her back (stupid I know but I really wanted her and gave her every chance to change into a better person) a couple weeks if not a month after that incident, she goes to a casino with that same friend. At this point I told her that it wasn't a good idea to keep contact with this friend cause she doesn't care about our relationship and puts her in some fucked up situations all the time. But it was hard for her since this friend was someone she knew since they were 10 it was hard for her to hear my words. So she calls me at 5 am the night she went with the casino with her friend and tells me that she absolutely needs me that she was kidnapped and needed me to come save her. Sp that's what I did. Drove over an hour and 30 min to get to her. She was walking with her friend when I found her and she couldn't remember where she parked her car she said it had to be in the casino parking lot but we couldn't find it. Where was her car? Just a block away from the people who "kidnapped her" at this point I was done. She done lied to me so many times and took advantage of my heart. I told her that after I help her that we are done. She goes to an extreme and says she's going to kill herself and to just drop her off wherever. I lost a friend due to suicide so this one hit at home and I couldn't let her go thru with it, also cause I loved her and still cared for her, of course. We end up taking a trip the day after for 3 days to get away and help her balance her life again. It seemed to work fine. She was so into me and said she wanted to marry me and have kids and start a family. I was excited yet felt it was too much of a rush. So we waited.
Just last month in April she really wanted a kid and by this time things have gotten much better she wasn't hanging out with that bad friend anymore and she would always come over to stay the night or I would go to her place. It was perfect and everything I ever dreamed off to be honest. So we try to have a kid. To complete us and our relationship. She missed her period in the beginning of May and she was pregnant. Something she thought she couldn't become cause she said she tried many times before with her past partners and it never worked. We were both excited. Just last week she told me she wasn't ready for a kid and wanted an abortion. I asked her why since this was the very thing we had hoped for for some time and she simply said it was due to money and not having insurance the bills would be crazy expensive and that she wasnt ready. I supported her decision since we could always have another baby down the line if she wasn't ready then she wasn't ready. I can respect that. A couple days after that she tells me that she doesnt see herself with me and that she doesnt love me anymore. Just out the blue. After everything we have been through. All the times I forgave her and took her back just to be left out in the cold without her giving me a chance to fix whatever the problem may have been. When she told me she didn't love me anymore and that she lost feelings it made me very confused and lost. Why try to have a baby then just a week ago? Why come back to me asking for forgiveness all those times if you were just gonna play me in the end? I asked her these things and she could only say sorry. That's it. That's all I got. I kept asking why how could you do that out of nowhere was it the baby? She just said she lost feelings a long time ago and doesn't love me anymore. Okay then why try to have a baby with me if that was true? why did she make me believe that she was really down for me and committed to me. These answers I'll never know. Since she just tells me sorry and to move on. But real love doesn't work that way. I'm finding it hard to cope with. Last thing she asked me was if I was going to help with the abortion cost. I told her yes cause it was also my responsibility and not just hers. The abortion is the 21st of this month and I dread each day closer to that date.
Thanks for reading.

Had a Danny dream about 2-3 years ago but I didn’t know about the subreddit back then, in the dream Danny didn’t go missing but he had a daughter who did, she wasn’t like a baby or anything but was about toddler age and in the dream I had just believed this daughter was always there and it made total sense he had one. Danny had sent me on a quest to find and save his daughter from kidnappers so I had to break into this medical facility that, thinking back on it, I think just had normal doctors, no like obvious criminals. I snuck around the medical building occasionally fighting and killing people to help find her (I was always the one instigating it), and after searching every room his daughter was nowhere to be found. The only clue I could find is a note that read something along the lines of “who killed Danny” written in a very scratchy handwriting with large letters. I have no idea what this means or why I had to kill so many doctors for that but my best guess is that dream means Danny is antivax and/or just hates doctors

I started stim on 5/2/24, which was the second day of my cycle/period. Here are some stats: * AMH 1.48 and AFC 32 (12 on the left and 20 on the right) at baseline bloodwork and ulttasound in February. * I had alcohol until 2 days before my cycle started. I didn't drink once my period started. * I stopped lifting weights once I started stim. I didn't do much cardio either.
This was my protocol (Day 1 means "day 1 of stim", which is the second day of my cycle):
Day 1-Day 4 * Gonal F 225iu * Menupur 75iu
Symptoms: Slightly more emotional. Belly felt like I might be pregnant and I felt the need to be extra careful when getting out of bed etc. Overall felt my usual self.
Sex: Non penetrative. Orgasm caused no discomfort. At certain times, sucking in my tummy felt a bit like I might be pushing down on something inside me.
Tests: bloodwork and ultrasound on Day 1
Day 5-Day 9 * Gonal F 225iu * Menupur 75iu * Centrotide .25mg
Symtoms: Not much.
Tests: bloodwork and ultrasound on Day 5 and Day 8. I think they said the follicular count was 6 on the left and 16 on the right.
Sex: Non penetrative maybe around Day 5 or 6. Orgasm caused no discomfort.
Day 10 * Gonal F 225iu * Menupur 75iu * Centrotide .25mg Trigger shots at 9:45pm * HCG (Novarel) 5000 is * Lupron (Leuprolide Acetate) 80 units (4mg)
Tests: bloodwork and ultrasound on Day 10. Follicular count (that were large enough) had increased to 8 on the left and 18 on the right. Most of them were around 16mm to 17mm. I think there was one that was like 19mm. This is from memory so the numbers might not be exact.
Day 11
• 11am Azithromycin 1g (two 500 mg tablets)
I was asked to take this on Day 10 at night, but I misread the instructions and took it in the AM on Day 11. I was told this is fine.
Hydration: I drank a lot of water throughout the day in preparation for surgery the next day. I didn't eat or drink anything after 11pm that night.
Symtoms: Woke up on Day 11 with pelvic discomfort and cramps which I figured was from the trigger shots the night before. I was waddling a bit when walking. Driving over small bumps caused discomfort. After taking the Azithromicin at 11am, I felt a bit feverish. I had to lay down. I fell asleep for a couple of hours. I woke up around 3pm feeling perfectly fine. The pelvic cramps were gone as well. The rest of the day was smooth sailing, except for this feeling like my stomach was stretched beyond normal. It almost felt like I was constantly holding in my stomach because of the way it was stretching my tummy.
Tests: bloodwork on Day 11
Day 12
Retrieval in the morning. The IV stung throughout the procedure until they put me under. This was probably the most uncomfortable part of the entire procefure. I was out of the clinic in almost exactly 2 hours. It almost felt like I just went in for a blood draw and walked out. It doesn't feel like anyone did anything down there.
Before leaving the hospital they told me they were able to retrieve 30 eggs. Later in the day they left a message in the online portal saying they were able to freeze 27.
I spent the day on the couch drinking gatorade. Took a nap. Overall I'm felt great, other than for a very slight headache which started around 6pm. I had a Tylenol extra strengh which helped. It kind of felt like I drank a bit the night before and I was hungover. I'm prescribed Letrozole two times for 7 days a day and Cabergoline at night for 16 days.
Costs\ My insurance didn't cover anything related to fertility. Out of pocket cost was around $13300 ($8100 for procedure, $650 anesthesia, $35 initial tele visit, $4500 medication). I might have spent an additional $150-$300 in bloodwork.
I did have an additional $760 added to my cost because I visited a different hospital initially (Penn medicine in Philly) - they were not upfront about all the costs and ended up charging me $380 for the initial visit with the doctor (which was a bit like a sales pitch) and another $380 for the baseline ultrasound even though they told me it would be covered by my insurance. It was also really hard to get a call back from their billing team (they rarely return your calls).
Scheduling\ Main Line fertility in Philly worked with my cycle. Since I already had the baseline ultrasound and bloodwork done, they were able to get me started on stims with my upcoming cycle.
They required me to call them on Day 1 of my period to schedule to come in and get bloodwork on Day 2. I started stim on Day 2 of my period. I had my retrieval on Day 13 of my period.
End to end, starting from my first consult with them, I had my eggs retrieved in 21 days.
The hospital I was working with previously (Penn Medicine), had me going around in circles for months. It was extremely stressful. I'll write a separate post about red flags to look out for when choosing a clinic/hospital.

I had to go to the ER in October 2023 and had a small bill (few hundred dollars) to pay for the visit.
I never received a billing statement from the hospital, and I tried multiple times in late 2023 to access the hospital's website portal to pay the bill, but was unable to find or create a login. The hospital did not answer my calls.
In December, I did receive a call from a spam-like number that tried to collect on the bill from me, but wanted payment over the phone. Between that and the fact that I never received a bill from the hospital itself, I asked them to send me a written copy of the billing notice before I would act. I never received anything. They called a couple more times but never left a message.
Fast forward to now: the hospital is now telling me that my bill was sent to collections in early/mid March, and gave me a number to call.
I called the collections agency to clear this bill but they could not find any record for me.
I am not sure what to do now:

1. Is it worth calling the hospital again? In theory I shouldn't be paying them anymore since they sold the bill to the collections agency, right? But they never even sent me a bill in the first place.
2. How long does it usually take a collections agency to process a bill and contact someone after buying their medical bill? In my case, it's been more than two months...

I could have paid this bill the day I received treatment, so it is really frustrating that I have never received a billing statement and now the debt was sent to a collections agency which also doesn't seem to have it. I want this paid off so it doesn't come back to bite me or anything.
Appreciate any information or advice!

(Initial case post done by another Redditor)
Recording an open verdict on the case, State Coroner Adam Nakhoda said that the identity of the man who died of coronary artery disease and an enlarged heart in his Geylang Bahru flat on 5 Aug 2022, remains unknown.
What is known about this man?
It has been established previously that the name “Abdul Rahman Bin Majid” was not the real identity of the deceased man and the name was likely to have been stolen at some point, since the real Mr Abdul Rahman was revealed to have been residing at an assisted care facility in Buangkok since 1994 following a chronic schizophrenia diagnosis
The State Coroner also noted that Mdm Seri and Mr Iskandar (the deceased's wife and son respectively) have stated that they did not know or see the real Mr Abdul Rahman before. Mr Abdul Rahman had also previously indicated he did not recall the deceased man, although his schizophrenia prevented him from providing further details
Reasons for the identity theft remain unclear, with the following comments from the State Coroner:

“Why the deceased chose to use the name “Abdul Rahman Bin Majid” and the NRIC (National Registration Identity Card) number is unclear and to try to formulate reasons in the absence of evidence would be speculative."

Additionally, 3 of the deceased man's sons (Mr Iskandar, Mr Baharuddin and Mr Razef) had all highlighted that their father (the deceased) did not seek medical attention at either clinics or hospitals, did not speak of his relatives, and that they had always known their father as “Abdul Rahman Bin Majid”
An old construction pass and a bank card was found in the unit, both of which had the name “Abdul Rahman Bin Majid”, or its shorter form, printed on them
The pass also bore the identity card number that the man had assumed as his own
Did taking fingerprints help?
While fingerprints were taken from both the real Mr Abdul Rahman and the deceased man, they only helped to confirm the previously-mentioned fact that the identity was stolen, without giving any further clues to the deceased man's identity. The fingerprints taken from the real Mr Abdul Rahman matched the ones linked to his identity card, while those taken from the dead man could not be found in the local database
With the local database being a dead end, the fingerprints were sent to Malaysian and Indonesian authorities for comparison with their national databases, however both jurisdictions replied that there was no match in their databases either
The fingerprints were also sent to Thai authorities for comparison on Aug 15, 2023, but as of 8 May 2024, the Thai authorities had not replied despite multiple reminders
The State Coroner added on the possibility of the case being reopened should there be fresh information from the Thai authorities

“If a reply is subsequently received which positively identifies the deceased, this case will be reopened.”

Possible answers?
However, there was some indication from one of the deceased's sons, Mr Farizal, that their father had come to Singapore from Malaysia
The deceased also had a close friend from Malaysia. This friend had addressed the deceased as “Kassim”, with Mr Razef recalling that he was last seen during Hari Raya in 2019
In addition, several other individuals, including Mdm Seri’s younger sister, had told investigators that her family also addressed the deceased as “Kassim”
“As such, it was possible that the deceased’s real name was Kassim... Without a valid name or NRIC number, the deceased would not have been able to avail himself of services, including medical treatment at polyclinics or restructured hospitals.” the State Coroner commented
The State Coroner also noted that the deceased had been suffering from chronic illnesses but they remained undiagnosed as he was unable to seek medical attention
Sources
Identity of man found dead at home still a mystery even to his sons after coroner’s inquiry

so l just graduated, spring 2024 with my bachelors in psychology
I had a bit of a rough start in undergrad, and my gpa suffered bc of it. I currently sit at a 2.7, and fau requires a 2.5 for their masters program in mental health counseling. l've seen a lot of advice to get a job in the field or a paid internship (i have bills to pay so unfortunately just an internship wouldn't be enough for me). Currently l've applied to a couple jobs in the field, and l've been to two consecutive interviews for a position as a nuero technician assistant. I know technically I have the gpa, but should I apply in September to start the school year in August? Would my job, and a couple of letters of recommendation be enough?

Schaffer, A. E., D’Alessio, D. A., & Guyton, J. R. (2021). Extreme elevations of low-density lipoprotein cholesterol with very low carbohydrate, high fat diets. Journal of Clinical Lipidology, 15(3), 525–526. doi: 10.1016/j.jacl.2021.04.010
Case study: Extreme elevations of low-density lipoprotein cholesterol with very low carbohydrate, high fat diets
Patient 1: 65M, lost 84lbs but LDLc went from 185 to 345 in spite of statin. Felt heaviness in arms while running, found 90% stenosis in LAD. Now on modified low-carb with additional medications and LDLc at 76.
Patient 2: 47F, LDLc goes to 360+ and 440+ from 110-126 when she restarts keto. They found 2.2mm mild plaque in carotid. Shifted to plant based diet.
Patient 3: 47F on statin. LDLc from 92 to 600. ApoB to 364. Disagreed with diet change. 8 months later new xanthelasmas (cholesterol deposits on skin) were found but CAC score of coronary arteries was 0.
Author conclusions:

These cases provide further evidence that caution is needed for patients considering VLC diets. Lipid monitoring should be performed in all patients who follow them. Tissue cholesterol deposition and atherosclerotic plaques in our patients are consistent with the hypothesis that such LDL elevation may not be benign. We agree with Goldberg et al. that VLC diets may not be right for everyone.

ETA: 2 more Cases
Houttu, V.; Grefhorst, A.; Cohn, D.M.; Levels, J.H.M.; Roeters van Lennep, J.; Stroes, E.S.G.; Groen, A.K.; Tromp, T.R. Severe Dyslipidemia Mimicking Familial Hypercholesterolemia Induced by High-Fat, Low-Carbohydrate Diets: A Critical Review. Nutrients 2023, 15, 962. https://doi.org/10.3390/nu15040962
Two brother, 33 and 28, with LDLc 570 and 690 on Carnivore diet for 1 year. Muscular physique, BMI 26 and 27. Both rejected doctor's advice on diet and statin. However, both brothers had plaque in carotid arteries with CIMT thickness of 90 and 97 percentile for their ages. Carotids are one of the the first arteries where soft plaques appear.

So, I've come up with a topic for a systematic review of diagnostic accuracy on acute cholecystitis. After running a search strategy on PubMed, I retrieved 644 results, which seems a bit lower than expected. In my experience, other free databases like Cochrane tend to yield fewer results than PubMed. Given that I've typically obtained over 1000 results from PubMed for previous reviews. I wonder if this topic is under researched. Nevertheless, do you think 644 results would be ok for a systematic review?
Also, my institute doesn't provide access to databases like Embase and CINAHL. Are there any good free databases that index an adequate number of medical journals and allow you to run proper search strategies like that in PubMed, Cochrane, or Embase?
Lastly, I understand that many may feel hesitant about this, but if anyone has institutional access to Embase and CINAHL and can execute a search strategy based on the terms I provide, I would greatly appreciate reaching out to me. You can even collaborate in this review and be a co-author if it gets published.
Regards.

https://www.thecrimson.com/article/2024/5/14/garber-protesters-running-out-time/
It is disappointing to see the continued journalistic bias from the Crimson. For example:

"While the disciplinary actions have outraged many faculty...."

Something like 10% of the faculty signed the letter the reports reference and it is a stretch to say that all of the signatories were "outraged".
This could just as easily have been written "while only a small fraction of the faculty have opposed disciplinary actions..." especially since a dueling letter was issued by other faculty members.

"Despite widespread backlash, at least 64 other colleges and universities across the country have asked local authorities to arrest or detain student protesters."

As a percentage of the student bodies, the protestors and their supports are generally in the single digits.
This could just as easily have been written: "At least 64 other colleges and universities across the country have asked local authorities to arrest or detain student protesters, with only minor opposition from the vast majority of their students."

This blog post serves as your one-stop guide to MBBS admissions in India for 2024, providing accurate and up-to-date information gathered from multiple sources. It covers essential aspects and addresses queries about management and NRI quotas.
Eligibility for MBBS Admission 2024:

• Educational Qualification: Applicants must have passed Class 12 with Physics, Chemistry, and Biology (or Biotechnology) as mandatory subjects.
• Entrance Exam: NEET (National Eligibility cum Entrance Test) is the sole entrance exam for MBBS admissions in most Indian medical colleges.
• Age: Applicants must be at least 17 years old by December 31st, 2024.

Key Dates (as of May 14, 2024):

• NEET Exam: May 5, 2024 (already conducted)
• NEET Result Declaration: Expected in June 2024

MBBS Admission Process:

1. Appear for NEET: Scoring well in NEET is crucial for securing a seat in a reputed medical college.
2. Counselling: Based on NEET rank, applicants participate in counselling sessions conducted by the Medical Counselling Committee (MCC) for 15% All India Quota (AIQ) seats and by respective state authorities for 85% state quota seats.
3. Seat Allotment: Seats are allotted based on NEET rank, preferences, and seat availability.
4. Reporting to Allotted College: Once a seat is allotted, applicants must report to the assigned college within the stipulated timeframe and complete admission formalities.

Important Points to Consider:

• Management Quota: Some private medical colleges reserve a limited number of seats under the management quota. Admission through this quota typically involves higher fees compared to government colleges. However, selection might not solely depend on NEET scores. There could be additional criteria or entrance exams set by the college itself.
• NRI Quota: This quota is meant for Non-Resident Indians (NRIs) and Persons of Indian Origin (PIOs) who wish to pursue MBBS in India. Eligibility and selection criteria vary depending on the college and state.

Additional Resources:

• National Testing Agency (NTA): https://www.nta.ac.in
• Medical Counselling Committee (MCC): https://mcc.nic.in

Disclaimer: This blog post provides a general overview. It is advisable to refer to the official websites of NTA, MCC, and preferred medical colleges for the latest updates and specific details on admission procedures, including management and NRI quotas.
*Remember: A high score in NEET increases the chances of securing a seat in the desired medical college.

TLDR: GP gave insurer medical records about me without asking.
Background: I was involved with several incidents last year, which really impacted my health. I was paying for it out of my own pocket, but after some persuading by my mates I decided to go through workers comp. The specialist bills and rehab start to add up fast! So mostly just wanted help with that as I get back to normal. So I went to the GP and got him to fill out some paperwork.
As part of the application, you have to agree to let the insurer contact your doctors. I assumed that the process would be like: 1. Insurer writes to my GP 2. GP let's me know (in general terms) what they want. 3. I can say yes or no. Or, at least my GP would tell me shortly after the fact.
Sure, it might be better if the insurer has access to information. Otherwise it might look like I'd just made stuff up. But I still would've liked to be asked, or know it'd happened.
I wasn't asked. The insurer got a letter from my GP, a list of medications I take, and patient records about me. Some were related to the claim, and some weren't.
This all has me feeling a bit uncomfortable. I'm no longer seeing this GP. But I guess I wanted to know if it's normal? I have no idea because I've never been through anything like this before.
Things you might be wondering: My claim got accepted. Insurer said it wasn't because of my GP's letter. They said it was because of the independent medical exam I had to have.
Now seeing a new GP. But kind of wondering if I should be more careful about what information I share with GPs in future? Nothing to do with the claim, it was all above board. But like all people, I occasionally see doctors for things that are embarrassing.
I found out by accident. I got a call from an allied health professional I saw, asking if I was happy if they reply to the letter they got. I asked my GP if he also got a letter. He said yes, but only provided 'limited information' in response to it. I wasn't convinced so contacted the insurer to see copies of the correspondence, which they recently gave me.

Hi, I’m (20) and I live with my dad (75) and sister. My sister and I share a room she’s (15). Every year before I turn 18 my dad would receive $500 dollars from the government for me and another $500 for my sister. I started working when I was 17 and I cover all of my expenses, my dad used all the money and bought a house where we don’t feel at home since he had rent most of the space leaving my sister and I having to share rooms. Last year my dad started asking me for rent, I had to pay him $400. Again I don’t have my own room, he expects me to come home before 11, and has a couple more rules. I got in a lot of debt because I was only making $1500 a month and I pay all of my expenses including gas, bills, car insurance ($250), and my groceries. But apart from that I was going through some medical issue and had a lot of medical debt.
My dad didn’t care and he keeps asking me for rent, even though every year when we do taxes they put my sister as my dependent so he can get tax money ( my dad is retired and he doesn’t work) I’m not sure what to do here because I don’t feel like is fare for me to pay so much rent while I don’t have privacy, my own space or can’t even come home late. I currently make 2,500 which is much more than before but rent is very expensive and I don’t think I can’t afford it.
I want an apartment with bathroom and kitchen since I will bring my mom here hopefully by next year, but they rent those for about 1,700 to 2,500 a month… what could I do in this situation? Do you think I’m being difficult and should just pay the $400 dollars?

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[REQ] (45€) - (#Moenchengladbach, NRW, Germany) (55€ on May 1, 2024) (Paypal)

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Wrongly calculated myself a bit this month because of an extra bill which I have to pay once per year.
Also, first time borrowing. If you need anything to be sure that I' pay back, please tell me so.

AITAH for giving up my dream job for my Fiance
For context me and my fiancé have been struggling financially and behind on rent/bills/etc (all of which are in my name so it’ll be on my record if we get evicted). I recently got fired from my job due to calling off too often for medical reasons (was/am working on getting a diagnosis for my seizures). I have been looking for a job since early March, he has a stable high paying job (21.50 USD per hour). I decided to apply for my dream job as a coffee barista and get accepted on April 25. this is where it starts getting tricky. I can’t start until the end of May due to the job trainer being on vacation. So i start applying for a new job. Our close friend tells us her job is urgently hiring so i apply. Fiancé decided to apply for the same job right after i did. He gets a call back and gets the job. I hear nothing back. This is where it gets even trickier. We don’t have a car, all we have is my bike. His high paying job has a free bus that takes him to work and back. My new job is about an hour and a half walking distance from us, so I’d need to take the bike to it. He decides he wants to quit his high paying job to work at the new job, which is about an hour walking distance so he also needs the bike. The bike is mine, it was a gift from someone so i wouldn’t have to walk everywhere (i live in a terrible neighborhood and they wanted me to be safe). He starts his job earlier than i will so he’s decided he gets the bike. Now i have to give up my dream job because i’ll have no safe transportation (it’s across multiple highways so i’d have to bike) I feel selfish and like an asshole because i’m not happy for him getting that job AITAH because i’m mad about it.

2.3.5 Controversial views and perceptions of the clinical picture of MCAS
2.3.5.1 Alternative diagnostic criteria ("Consensus-2")
In 2011, the group of authors led by Gerald Molderings from the Institute for Human Genetics at the University Hospital Bonn and Lawrence Afrin published their own approach to the diagnosis of MCAS (51). In contrast to the diagnostic criteria of Valent et al. (1), the focus here is more on clinical symptoms. In 2016, Afrin et al. published a list of the most common symptoms that could indicate MCAS (52). Furthermore a questionnaire was developed and published on a website (53), after the answers to which the suspected diagnosis of MCAS could be supported or ruled out depending on the scores obtained. In a recently published publication, the working group referred to their diagnostic criteria as "Consensus-2" and compared and discussed them with the criteria of Valent et al. from 2016 (so-called "Consensus-1") (51). An important difference to the criteria Valent et al. 2016, the authors consider the symptoms not only as the main main criterion, but also a much wider range of previously unexplained symptoms (111 unexplained symptoms (111 possible symptoms (44)) as the most important indication of a a mast cell-mediated cause (14 symptoms in Valent et al. (1)). As The diagnosis of MCAS is considered confirmed if the main criterion is present together with a secondary criterion and possible alternative diagnoses have been excluded. The secondary criteria, in turn, are based on observations made at the time of the 500 people with suspected MCAS at the time of the first publication (44). Further differences between the two consensuses can be found in the laboratory parameters to be determined. For example, the researchers from different disciplines, which according to their own statements can draw on a wealth of experience of of over 10,000 MCAS patients (diagnosed according to their own criteria, nota bene), consider CgA to be specific for mast cells in addition to tryptase, among other things (44). The counterargument of the lower specificity compared to serum tryptase is granted a certain validity in the addendum to the "Consensus-2" published in 2020 (44), however the differential diagnoses with elevated CgA values should be easy to rule out and other markers are also never 100% specific. However, another group was already able to show in 2017 that CgA should not be used as a marker for mast cell disease(49). Furthermore the group of authors of the "Consensus-2" counts heparin as an important marker for MCAS, which should be determined after venous congestion using a blood pressure cuff (54). This maneuver was reported to cause irritation of excessively activatable mast cells with release of heparin in the congested area. Interestingly, the following section mentions markers such as IL-6 or tumor necrosis factor (TNF) which, due to their lack of specificity, are not used in diagnostics, but only in the evaluation of a successful therapy. The authors of "Consensus-2" criticize "Consensus-1" for, among other things the lack of definitions for a treatment response, whereby the "Consensus-2 does not provide any concrete proposals for evaluating or monitoring the response to therapy. Another point of criticism is the lack of exclusion of other comorbidities or differential diagnoses, such as CFS, EDS and irritable bowel syndrome, as clinical indications of MCAS. [...] In return, the AAAAI expressly points out that there is no evidence to date of a connection between CFS or EDS and MCAS. Overall, the clinical picture of MCAS is so complex and heterogeneous that a precise definition of a diagnostic algorithm is not possible at the present time. Molderings et al. therefore propose the acceptance of both the "Consensus1" according to Valent et al. and their "Consensus-2" until more precise findings are available through research. The resulting disadvantages, such as the the poorer comparability of patient populations in scientific studies would weigh less heavily than those resulting from the rejection of "Consensus-2" (an underdiagnosis due to criteria that are too restrictive according to the authors). On the other hand, the large number of non-specific complaints that are supposedly associated with MCAS harbors the risk of inflationary diagnosis.
2.3.5.2 Presentation in the lay press
An expansion of the MCAS definition with the use of non-validated clinical and laboratory chemical parameters for diagnosis is frequently found in the lay media, above all on websites, but also in the specialist literature. Increasingly, patients with (suspected) MCAS are organizing themselves with commitment and are increasingly organizing themselves into interest groups such as MCAS Hope e.V., which campaigns for the recognition of MCAS "as an independent disease". In addition They also network those affected and their relatives and carry out public relations work, which aims to make the clinical picture known to a broader public. This expansion of the diagnostic criteria described above increases the risk of a misdiagnosis of MCAS and overlooking the underlying disease, which may be easily treatable. On the other hand, such an erroneous diagnosis can also lead to the use of unnecessary or potentially harmful therapies for MCAS and supposed comorbidities (20). Shortly after publication of the review paper "Doctor, I Think I Am Suffering from MCAS: Differential Diagnosis and Separating Facts from Fiction" by Valent et al. a self claimed affected person started an online petition in which she demands the authors and the publishing Journal of Allergy and Clinical Immunology to remove the article (55). Among other things, they criticize the criterion of the tryptase increase, which is too harsh and would therefore prevent many patients from being diagnosed. The clinic also does not typically manifest as anaphylaxis, contrary to what is described in the paper, since mediator release in anaphylactic degranulation differs from that in piecemeal degranulation. Finally, the author of the petition, who sees herself as a "patient spokesperson", reports on personal experiences of frustration and feelings of frustration and rejection that were conveyed to her by doctors in the course of her medical history. The petition has so far reached just under 3,000 of the targeted 5,000 digital signatures (as of December 2020) and shows in particular how emotional the issue of the topic of MCAS is being observed and discussed not only in professional circles, but also among patients. Apparently, some patients find the diagnosis of MCAS to be the last explanation for their multiple non-specific symptoms and hope for more acceptance in scientific circles.
2.3.5.3 Difficulties in making a diagnosis
In recent years, despite the existence of consensus criteria, a (suspected) diagnosis is often made in practice, even though these criteria are insufficiently fulfilled. In some cases, the MCAS diagnosis is also increasingly used for otherwise inexplicable conditions that cannot otherwise be explained. The evaluation of symptoms without a known direct connection with the release of mast cell mediators, for example from the neurological or psychiatric spectrum, as a manifestation of the disease leads to a further dilution of the MCAS diagnosis (43). In the "Bonn" questionnaire, the vast majority of the items asked are not based on the consensus criteria formulated by Valent et al. for example they see the sonographic evidence of an enlarged liver as an indication of the disease (53). The measurement of a tryptase elevation in acute relapse, as required by the diagnostic criteria is difficult to implement in practice, whether for reasons of time, capacity or billing. Targeted therapy trials with maximum specificity with regard to all possible decisive mediators are not possible without prior measurement of urinary metabolites and, in the absence of criteria or measuring instruments often do not produce satisfactory results (43). Last but not least, the wide range of possible differential diagnoses, such as for example from the endocrinological, neurological, psychiatric or cardiovascular area, further complicates the diagnosis (43).
Translated with deep.l
https://refubium.fu-berlin.de/bitstream/handle/fub188/32749/diss_s.gu.pdf;jsessionid=A575C43E11977D2F576404BF69D6469C?sequence=3