My GP mentioned her concerns re over-diagnosis in the private sector and specified the assessment should be done by a psychiatrist. Her exact words on my NHS record were then "you need an ongoing shared care agreement with a Psychiatrist on the GMC register if we are to prescribe medication here".
I then found out about Right To Choose and decided to go through that route as felt more aligned with the NHS and so it's free.
I now finally have an assessment date with Dr J & Colleagues. However I noted the assessor is a 'Neurodevelopmental clinical nurse specialist', rather than a psychiatrist.
I e-mailed them to explain the convo I had with my GP. The response just said they provide shared care. Nothing else - didn't really respond to what I was actually asking. So I asked again who the psychiatrist would be who would provide the shared care, given my GP wouldn't accept otherwise. They said the shared care would be authorised by a Psychiatrist available at their service.
The responses were quick but vague and my gut is saying their lack of addressing my questions in full feels evasive and uncaring. Some of the reviews on Google also aren't great.
I'm now wondering whether to switch to ProblemShared who provided a much more comprehensive answer when I asked about who undertakes the diagnosis, where they explained the NICE guidelines and how they're regulated by CQC - though still wouldn't be with a psychiatrist. But it felt like they were thorough, reassuring and knew what they were talking about. However this means that I'd probably need to wait another 4 months or more to get my GP to write another referral and be back at the bottom of a waiting list.
I also feel like I can't raise this with my GP incase they refuse shared care if I do go ahead with Dr J. It just all feels a bit dodgy.
My current thinking is to go ahead with the assessment, and if I get a diagnosis, the medication will soon demonstrate if the diagnosis is accurate or not. I guess I'm just worried that a) Dr J might be difficult to work with including how they manage securing shared care with my GP based on interactions so far and Google reviews and b) my NHS ICB will be paying for this so I feel like it's my one shot - surely they're not going to pay for another RTC provider if this goes wrong somehow?
Note - I am still on waiting list for NHS assessment, but that's 2+ years away, and that's if they even accept my referral case which is still yet to be reviewed. I wonder if I'll be knocked off the waiting list if my ICB pays for this private assessment too?
I'm really worried about getting this right so any guidance would be HUGELY appreciated. Is it worth me reaching out to ADHDUK the org for advice? Do they provide that?
Thanks so much in advance. I may delete this post after a week or so as I'm scared Dr J might see it and treat me differently...

I work in complex care disability recently my physio mentioned I have hypermobility, I don't think my GP is taking me seriously 😒. I've just returned to GP after 5 months of GP and physio still with a. Severely stiff neck and tingles on one side which is possibly a pinched nerve.
Anyway I really want to get into nursing and go back to uni to make this happen. I've been working towards this, I also have ADHD diagnosis last year. I'm 41 F.
Is nursing going to be viable for me? It took me a really long time to decide what I want to do but nursing fits all my boxes. I know it's a career with lots of different options and maybe later I could do a postgrad in something else but I'm not exactly sure the other paths to consider at this stage. So I'm just wondering if any any nurses out there breaking with hypermobility issues in mid-life what kind of nursing are you doing and how does it affect your day-to-day?

I’m 27F got diagnosed with diastolic heart failure a couple weeks ago. I work as a CNA in a nursing home. I’ve always struggled to keep up but have always pushed through. Sometimes when working hard I feel faint and I’m always sweating profusely. I switch to third shift because the workload is a little lighter but in the beginning of shift and the end (the busiest) I feel terrible. I can’t keep doing this forever but I’m only 27 so I’m trying to go for as long as I can. The doctors says I’m not damaging anything by working hard it’s just a difficult task to push through especially when on night 3/3. Tonight I hurt my back while trying to tranfer a 130lb lady who was not helping stand at all.
I’m aware I need a new career but this diagnosis kinda caught me off guard. I’ve always had a wonky heart and have been going to the cardiologist since I was 19.
Any tips for physical work like this? I drink a lot of Gatorade while at work because sometimes I sweat so much I get salt crystals on my face and body.

In your journey to diagnosis, who was the first person to mention the possibility of Bipolar. Did you stumble across it and think, "Hmm that sounds familiar!" Or was it a family member maybe? Perhaps your therapist or a Doctor, a nurse in the ER?
Mine was a walk-in family doctor. He said, "I'm not a psychiatrist, but that sounds like a Bipolar episode.". It was at least six years after that before I got an actual diagnosis of Bipolar.

So I started in a new area at work recently so I have new colleagues and they made this statement once that everyone has a but of autism and adhd. I am honestly amazed at the lack of education as they are all Nurses, but I have to hold my tounge before I respond with “oh you didn’t have friends in school ?” Or “oh you didn’t understand that you could get to know a person without asking their favourite animal or colour until the age of 16 like me?” Or “oh you cried over the line of the socks touching you toes every morning? Or did you spend an hour before bed every night for a whole year getting rid of the creases in your bed before you just pinned the fitted sheet in place and taught yourself to lift your whole body off of the bed when rolling over so you wouldn’t cause more crease?
Or that people without knowing you for some reason just don’t like you unless they are also autistic and have adhd and you could never figure out why because you didn’t do anything to them or even talk to them?
Honestly it’s sad the lack of knowledge that they have on autism and adhd to think everyone has it because if I listed these issues too them which is only a small amount of sensory issues too them or communication issues, they would think I was exaggerating and say Im doing it to discredit them or something. No Im not but I didn’t spend 24 years not knowing why I didn’t fit anywhere or into anything, and finally find out why and feel like I belong somewhere for you to come along and discredit my diagnosis and my experience. It’s actually sad and If I get to do an in service one day I honestly think I will do it on autism and ADHD to make a point

I work up to 60 hours a week on night shift as a nurse. I have been dx with RA. Also, neuropathy and Raynauds. All three of these diagnosis FLARE SOO BAD when I lack sleep. I know I NEED the sleep to help my flair ups, but it’s simply impossible. What CAN I do?

Hi! I got my diagnosis of hEDS about a year and a half ago and my symptoms have recently started to really make themselves prominent within the last year. The main issue at this point in time is my lower body specifically my legs. Between my hips and my knees there are days when I truly cannot leave my bed because of the pain. Does anyone have any ideas to combat this since I’m a nursing student and having 2 bum hips and knees consistently in pain isnt exactly ideal. both my hips and my knees also frequently pop in and out of place especially during the bad days. Any advice would be incredibly appreciated!!

i went to the er with my parents because my speech was extremely slurred and not understandable the night before last and the hospital said it shouldn't be anything too serious, so i was went home. and then, yesterday, when i left the nurse's office at school and noticed my face was asymmetrical and i started to freak out and went back and my parents were called to rake me back to the er. i was rushed there and the medical team said it could be be bell's palsy, so i was put one stroke status one and rushed to a ct scan. they saw there was a couple dark spots and took me to a room to stay in before they took me to an mri scan. then they wheeled me to the scanning room and then to a room to stay the night in. about an hour later, they gave me the diagnosis. and then i stayed the night while getting infused with some kind of steroid medicine in the hospital and got back home earlier today. i go back tomorrow for my third and final dose while i recover.

Hi y’all! It was my dream to become a nurse since I was little. I started nursing school, then was diagnosed with POTS & now am in the process of a lupus diagnosis. This is on top of 2 other chronic illnesses too.
I switched my major to psychology & thought about becoming a counselor cause I could still help people, but I’m realizing that I really love the field of healthcare — especially the hospital setting.
I don’t think going back to nursing is possible, so I was hoping to find a career with less bending/lifting possibly? That’s still interacting with patients.
Any thoughts?
Thanks so much!!

I had DI w/ free Nip Grafts at Reformkliniken in Malmö on 18th April! Dr Tuve was my surgeon. I wanted to leave a review here since a few things happened that I wasn't prepared for and maybe this'll help anyone else!
I am from the UK and decided to have surgery privately with Dr Tuve as it was much cheaper than the UK. The cost of the surgery was 65000 SEK which is about £4800.
I flew from Manchester to Copenhagen, and then took a train to Malmö. It wasn't that expensive and very easy to figure out directions in person.
I went for 2 weeks and 4 days so I could go to in person appointments before and after the surgery. I'm also autistic and felt I needed the extra time to ground myself in a new country. I stayed at the Scandic St Jörgen hotel which was only a 5 minute walk from the clinic. Hotels are quite pricey and it has it's pros and cons. Pros - close to clinic, hotel cleaners, free wifi, close to food shops and restaurants, easy to get to train/transport. Cons - more expensive than airbnb, no fridge so had to have takeout a lot, they did a laundry service but it was VERY expensive.
In the end I do think the hotel was right for me and my needs, but I know many others are not as privileged to be able to stay that long in a hotel.
I had my pre op appointment on the 16th, which I was dreading but it went a lot better than I thought it would. Dr Tuve asked me a lot of questions about my gender, how long I've wanted top surgery, is my family accepting, etc. He then examined my chest and asked what kind of results I'd like. He let me get changed before he stepped in which I was grateful for. They asked if I had picked up my prescription (meds needed before surgery), however I hadn't had any notification about this prescription at all. They were very quick to give me a new one, which I collected the next day.
The 18th was surgery day, and I was told to arrive at the clinic at 7am. My partner walked me there, and we said goodbye outside the clinic doors. I had to fill in some paperwork, have an anti bacterial shower, and pee before surgery. I was really nervous for the anesthetic and going under, plus the IV, but it was a lot better than I thought it'd be! The nurse who did my IV was very kind and did it quickly, and it wasn't painful at all. I was called into surgery at around 8:20am. I had to lay on the surgical table, which was honestly the scariest part. The anesthetic took a few minutes and then it all kinda hit and once. It felt like a very deep long nap. I was out of surgery and awake by 12:20pm.
I was very sleepy for a few hours and apparently I sent a lot of videos of me to my partner but I don't remember taking them! They are funny to watch back! I was feeling quite nauseous so out of the food options I had some granola and apple juice. I was offered a sandwich too but that was too much for me. I kept falling in and out of sleep for a bit. The nurse was encouraging me to try go to the toilet, but I was really nauseous. I did end up being sick a lot, it was whenever I sat up. We ended up wheeling me in a wheelchair to the toilet to try pee (which was a success!). I was given some anti nausea meds. Before I left the clinic, the nurse took off my post op binder, nips dressings, and large dressing, and I felt a lot better. I got to see my chest for the first time (my nips were still covered by gauze). It looked really good for the first day! The nurse showed me how to wrap the binder myself and what to do with the nip dressings. He then wrapped me back up, but I immediately threw up which he realised was from the pressure of the large dressing. He decided to take off the large dressing so I was just wrapped with the nip dressings and binder. He only allowed this because I wasn't that swollen!
I left the clinic at 7pm, and my partner picked me up. I was able to walk easily, just sore on top, and I was on a lot of painkillers so it wasn't that bad.
The instructions from my dr was to have a shower daily, antibiotics twice a day, pain meds twice a day, more pain meds can be taken if needed (I did for the first few days). My partner helped me shower the first 3 days as I couldn't really reach anything, but after that I was slowly more independent. We had a shower head we could take off the wall which was very handy and made it a lot easier. I had to sleep on my back, which is quite painful since I had a curved spine, but I found ways to cope with it (pillow under lumbar region, pillow under feet for elevation). I brought a travel pillow and a mastectomy pillow with me. I honestly didn't use the mastectomy pillow for what it was made for, as it hurt to put my arms in the side holes. I used it more to stop myself rolling to the side. The travel pillow is a must. It helped stop a lot of neck pain, and I could fall asleep a lot easier laying on my back with my head surrounded by the travel pillow.
Unfortunately I got really ill on my 4th day post op. I track my periods, and knew one was coming up, so I was already expecting pain the week before (normal for me). This pain was a 10/10, I couldn't move and threw up a lot. We called the clinic and apparently it is normal for surgery to affect periods and cycles. I wasn't expecting anything quite this intense, so I thought I'd leave this in here in case anyone else experiences it! No-one else that I knew that was having top surgery experienced this, but I know I have a lot more intense symptoms of periods normally so this may have contributed to it. Luckily this only lasted 1 day.
The rest of the week was a lot better, and I managed to eat a lot more and do a few more things. I went on daily walks as advised by Dr Tuve, but nothing too far.
On my 9th day post op I had a random allergic reaction. My body really went through it! My face was swollen and red, and I had hives all over my body. We had no idea where it had come from since I was just doing the same stuff as normal, however I am almost certain it is linked to my autism/stress levels (I have had random intense illness related stuff flare up from overstimulation and stress a few times). I was given some antihistamines and they worked slowly over a few days.
On my 12th day I had my post op appointment where a nurse removed the gauze from my nips and any visible stitching from them. I was super nervous going to this appointment as my nips smelt really bad and I was worried they were infected. Luckily all was good ! Apparently I had a small hematoma, but it didn't have fluid so no need to drain. I was instructed to wash my nips 2-3 times a day, have my daily shower as per usual, and change the tape on my insicions once a week. I also had a small bandage gauze I taped to my nips which I had to do til they were dry. My nips were dry by 2 days after this appointment, but I used the small bandages for about a week as I was nervous of the binder causing irritation on my nips. I also had to keep wearing the binder, which I have to do til 4-6 weeks after surgery (depending on how swollen I am).
I flew back home on 2nd May, and it was all good health wise.
Since then, recovery has been good! I'm very happy with my chest. My insicions look super thin and the nips look great too.
Overall, my experience with Dr Tuve and his team was great! Here are my main pros and cons:
Pros - Cheaper and high quality results! - Very lovely nurses and Dr. I felt I was in good hands. - They are happy to answer any questions, post op and pre op. - The clinic is very nice. Felt like I was in a hotel! - You do not need to be on T or have a gender dysphoria diagnosis. These things can help the process, but are absolutely not necessary.
Cons - Most documents were in Swedish and I had to translate them using Google Translate. You can call up the clinic to ask questions, but I am not good with phone calls! - The documents/help sheets aren't super clear on post op care, it is mostly for pre op information - Sometimes a lack of communication, such as with the lost prescription.
I hope this helps anyone!

Repost from MedicalMalpractice [link]
So about half a year ago while I (27 AFAB at the time) was at work my arm began tingling. It happened while I was crocheting so I attributed it to poor posture but took note of the time (just after 3pm) and continued working until 5pm. By the time I got off work my pinky and ring finger on my right hand became difficult to use. I drove home (hindsight this was really stupid of me to do) and an hour later when it hadn't gotten better I asked my brother to take me to the ER.
While there I told them that given the symptoms I was having (numbness on one side, and partial paralysis) and that I had started a new birth control a month prior that I was worried about the possibility of a stroke. They checked for the more obvious signs of stroke (facial droop, delayed eye dilation, blood tests, etc.) and noted that I had weakness in my right arm as well as tachycardia. They asked my brother about my behavior and if I was acting off, which he said I was not.
When the blood tests came back they informed me that my d-dimer was elevated. I wasn't told how much it was elevated. They referred me to CT to check for a pulmonary embolism. CT showed a normal healthy chest and I was sent home with a diagnosis of pinched ulnar nerve.
Over the next two days I proceeded to be incapable of eating or drinking anything, if I slept it was not for more than an hour at a time and I woke up in a cold sweat. My arm went from tingly and partially paralyzed to dead meat attached to my body. I could not move it, and could only lift at the shoulder. I woke my brother up at 3am to take me back to the ER. I informed them of the new symptoms, as well as the worsening of the previous symptoms.
This time it felt very dismissive. I was not being heard. I got sent to MRI to check again for a pulmonary embolism which again showed nothing. I told them I felt like I had really bad brain fog and my arm felt like it was in ice water. I was told this was normal for a pinched ulnar nerve. They gave me nerve glides to do, a prescription for 600mg of ibuprofen, and a referral to a neurologist. I asked them before I left if it was a good idea to fly as I had a vacation starting the next day, I was told it was fine.
So I went on my vacation, flying from one coast of the US to the other. It was 7hrs after I landed and was picked up from the airport where it started to go downhill and rapidly.
I still couldn't eat, and I knew I wouldn't be able to sleep so I bummed a gummy off a friend and started getting ready to go to bed. After this is a complete haze for me but I will list the events as I was later told:

• While walking to bed I blacked out. This was me dropping while I had my first tonic-clonic seizure of the night. My friend miraculously caught me and made sure I didn't hit my head, while my other friend took charge of the situation.
• My seizure lasted approximately 2 minutes, and when it looked like I was coming out of my postictal state pretty quickly they decided to drive me to the ER
• At the ER I had another seizure while they were taking me to get a CT scan of my brain. After this I was taken to MRI. I was considered medically confused and was incapable of staying still. I was given two doses of Ativan to try to keep me still long enough to get something from the MRI
• MRI was sent to a neurologist at another hospital who was able to see on the VERY blurry images that I was having a stroke. She teleconferenced in to assess my state, asking the nurse to essentially check if I was brain dead. My friend who was with me the entire time was the one to actually wake me up.
• I was then transferred to a bigger hospital's ICU for care when I was stable.

I dropped on Tuesday night. I remember bits and pieces of Tuesday night, and the following Wednesday, but I was not conscious and aware until Thursday morning. I woke up, realized I had a catheter, and I was P\SSED*.
In the few hours after the medical staff learned I was actually with it. I was informed not only that I had a stroke, but that I had a rare form of stroke. It was a Cerebral Venous Sinus Thrombosis. They were shocked that the previous hospital had not continued to look for something and dismissed me. I was then informed that my d-dimer was 1.03 (where a 0.50 was the maximum threshold for a normal d-dimer), my glucose upon being admitted was severely elevated, and they didn't know how bad it was because they had not yet been able to get a clear image of my brain. They later did and most of the damage was surface level and I came out pretty good for a CVST.
Throughout my ICU stay I learned I was extremely lucky to be alive, you can't trust every doctor, and to always be accompanied by someone who will advocate for you. Also birth control sucks and my friends are amazing.
I spent my 28th birthday in the ER.
I now live in the state where I was finally diagnosed properly and I am communicating with a lawyer for a malpractice lawsuit. I have had up to 20 appointments a month just for things related to my stroke and am coming to terms with things that just might not get better. I'm taking 4 different medications for the after affects of the stroke, and I might just have to remain on 3 of them as it's possible I now have an epileptic disorder. We wont know for sure until my brain is given more time to heal but my recent EEG still shows abnormal brain activity.
I think overall I have a pretty solid case, especially given the shock of the paralegal as I explained what happened. But sometimes I second guess it and it worries me. I'm still waiting on their Nurse Expert to look at my file.
Additional notes: they were told both times I had a migraine with aurora. It took 2 months for me to regain usable function in my right arm. I have reduced feeling in my entire right side (I can feel if things are touching me, but not temperature or if it's sharp). I have noticeable memory issues, I can't remember appointments on my own, if I don't write down something that happened that day I will forget it by the next day. It's also a gamble what I remember on my own and how I remember it.
I'm 28. This shouldn't be an issue I have to face and I probably wouldn't be facing it to this degree if it was originally diagnosed the first two times I went to the ER.

Last year at this time I was an active 38-year-old mother, wife, and registered nurse who was halfway through a master's program and took long walks most days. Over the summer I randomly developed spasticity to my legs, arms, torso, and bladder which worsened quickly. In November I started using a walker and working mostly remote. In January I had to stop working entirely. I'm currently waiting to be approved for a power wheelchair. Everything is so hard now. Every single aspect of my life is worse, a lot of aspects are MUCH worse. I pee my pants. I can barely walk. I've had many falls and last week earned myself a concussion. I can't pick up my small child. I don't leave the house most days. I can't put in my own earrings or don my own bra.
I am lucky to have a supportive husband, family, and community. I have a great medical team even though I don't have an official diagnosis (the thought now is HSP vs PLS). I have a psychiatrist and a therapist, plus a great PCP, PT, OT, genetic counselor and neuromuscular specialist. But everything is so hard! Everything sucks. I don't see how this will be ok. Performing my own ADLs takes so much time and effort. I cry all the time.
To those of you who have been dealing with a physical disability for longer than I have-- does it ever get easier or better? If so, when? How?!

Bank of America Health Care Conference 2024 Presentation
Exact Sciences' Mission is to help eradicate cancer by preventing it, detecting it earlier and guiding treatment. In the early innings of how genomics will transform cancer prevention, diagnosis and treatment
Exact Sciences' Cologuard and Oncotype DX are two of the top brands ever in cancer diagnostics. They are helping to build a platform company through which other innovative cancer diagnostics will help patients.
Guided to 15% growth (CAGR) through 2027. Projecting over 20% adjusted ebitda margins by 2027.
Near-term growth drivers - Cologuard and Oncotype DX globally. Future drivers - pipeline.
Reiterated 2024 Revenue and EBITDA guide.
60 million Americans not up to date with colon cancer screening - huge unscreened population
Q4 2023 - highest dollar growth in screening in history. Sequential decrease in Cologuard screening revenue due to normal Q1 seasonal weakness. Despite sequential screening revenue decline, screening revenue still increased 7% YOY, and management confident in achieving 2nd Quarter and 2nd Half Guide revenue guides.
Cologuard will have steady predictable growth based upon # of sales calls to primary care physicians and increasing Health System Orders.
New Cologuard business opportunity starting last year - screening in Medicare Advantage population and gap closure programs in large health systems.
CEO Kevin Conroy: "We are confident in our ability to meet our 2nd quarter and 2nd half sales guidance."
Q1 2024 was in-line with expectations. Q1 of 2023 was an anomaly.
Sales and Marketing Spend - Spent about $800 million in sales and marketing in 2023 (sales force a relatively small component of this, sales force being brought back to levels of 2022) - High ROI from investment in additional sales people.
Last 5 quarters added 50,000 new primary care providers - docs, pa’s and nurses
As docs order more, amount of orders increases. As sales calls increase in frequency, pcp’s order more.
Calling on a doc once per quarter will result on average in six orders. Calling on a doc six times per quarter will result on average in 24 order. Sales reps provide pcp's tools, education, motivation to increase colon cancer screening numbers.
Priorities for CFO - Maintain Growth Engine not only of CG and Oncotype, but also new product pipeline - Flywheel of innovation needs to keep spinning. Will expand over 300 basis points of leverage in 2024. Increasing leverage in G&A going forward. Clear and credible pathway to adjusted ebitda margins of 20% in 2027
CFO Aaron Bloomer: Exact Sciences will show FCF growth and positive FCF delivery for each of the next three quarters in 2024.
17% CG growth embedded in 15% CAGR through 2027. (Compound Annual Growth Rate)
Impressive CAGR over the past few years. Seeing increasing opportunities to enhance the use of Cologuard as a frontline screening tool.
Over a billion dollars invested in EXACT NEXUS - Electronic Ordering, Result Delivery, Prior Authorization, Reimbursement embedded into physician's EPIC electronic record. Huge amount of customer satisfaction - makes using Cologuard easy.
Long arduous process of including Cologuard into the Quality Measures (2-3 years from being included in USPSTF guidelines), which can help health systems and plans increase their star rating in order to get quality bonuses, which is a key to their success.
130,000 new cases/year, 50,000 deaths/year from Colon Cancer, with 60 million people in U.S. not current with CRC screening guidelines.
Colonoscopy capacity in US is 12,000,000. Half screening, half diagnostic. Cologuard is helping health system and GI’s getting more people screened.
Re-screening now mid 20's as a % of revenue - aiming for 50%
Because of Covid, for two years in a row, only 1.2 million people have been eligible for re-screens. This year 1.6 million eligible for re-screen, and that number will increase annually. Also, 20 million new prospective customers in the 45-49 age group - want them to be happy customers for next 30 years. The 45-49 age group rescreens are starting to kick off this year (USPSTF guideline to include that age group updated in 2021).
Cologuard Plus - 10 Years of R&D and Clinical Trials - Improved False Positive Rate, Cancer Detection, Advanced Adenoma Detection. Improvement on all levels, and Cologuard 3.0 already in development.
Looking for a modest price increase for Cologuard Plus rolling in over a couple years period of time. Because false positives are lower - 30% fewer false positives - more people will stay in Cologuard Testing Family
Cologuard Plus also benefits from 5-7% Lower COGs = margin expansion.
20th Anniversary for Oncotype in US. 1 billion cumulative investment in Oncotype infrastructure. Quality of Science and Clinical Evidence behind it is unmatched. Company is deeply rooted in being patient and customer-centric.
Question to Brian Baranick, General Manager of Precision Oncology - How are you gonna catch up in MRD?
With respect to MRD, have never seen such a fast developing market - real clinical unmet need - enthusiasm among patients and physicians - excited to be apart of this market. Exact Sciences will catch up in MRD due to the following:
1) World class commercial capabilities - precision oncology reps are experienced, know physicians/territories, how to sell and how to get access to leverage these relationships to launch CRC MRD next year.
2) Exact Sciences' Nexus Platform - IT infrastructure to help providers save time obtaining prior use authorizations. This billion dollar company investment will allow providers to obtain prior use authorizations and order MRD tests more quickly and easily.
3) Better Performing Product - Partnering with West German Study Group and NSABP (National Surgical Adjuvant Breast and Bower Project) To build out evidence around MRD tests - Goal is for Exact Sciences' MRD tests to have best in Class Evidence. Exact Sciences' MRD tests measure more mutations in blood than some of the first mover companies in space, and will have best in class evidence. Investors will hear more about performance of MRD assays and evidence in the back half of this year.
Blood-based screening assets - crowded marketplace - Use case for Cologuard Blood will be limited.
Great idea in concept - Bert Vogelstein is a pre-eminent researcher in the field and wrote a 2005 paper on the subject of CRC screening blood test. He concluded that detecting circulating tumor dna from precancerous lesions/polyps is impossible - you can’t find what’s not there. According to Kevin Conroy, if you’re not finding pre-cancer, you don’t have a true screening test.
The real power of colon cancer screening is finding and removing pre-cancerous polyps which may result in Stage 1 disease - that is the goal. As a result, it is highly unlikely that blood tests to screen for CRC will end up in the USPSTF guidelines and quality measures b/c they are unable to detect precancer. CRC screening blood test will end up being more of a niche market. Commercial payers will not be too excited to pay for something which is not in the quality measures. Probably won’t find out if blood CRC screening will be in the quality measures until 2028-29 (After likely USPSTF in 2027). Howver, fee for service medicare advantage has agreed to pay for blood based crc. USPSTF meets every 5-8 years on CRC screening (August, 2014 - May, 2021). Predict next Meeting in 2027. This cycle think 6 years until USPSTF and then quality measures 2-3 years later
Management expects two or three blood tests to be approved by the FDA, including Cologuard Blood. Don't believe blood tests will ultimately be a big overhand for investors as Cologuard will still grow market share even with other FDA approved CRC blood tests as it is the most effective CRC screening test. GI societies recently weighed in - not recommending blood tests for frontline CRC screening. The growth of Cologuard over the coming years will be what excites investors, not CRC blood test.
Question to CFO Aaron Bloomer: What is most underappreciated or misunderstood about the company?
CFO is excited about pipeline. The company has spent many years developing these pipeline products, a number or which are slated to launch over the next few years. Don’t think investors appreciate the impact these pipeline products will have on patients, on revenue and the Company's growth profile, as well as on margins.
Excited about mid-teens growth in Cologuard and along with MRD and other new products coming online in the next few years which will provide both the Company with both leverage and diversification.

DAY: MAY 15, 2024

• 5-15-2024ALZHEIMER’S DISEASE PROCESSES WITHOUT SYMPTOMS. HOW IS THAT POSSIBLE? Everyone experiences aging in their own way, and factors such as genetics, lifestyle and environment play a role in this process. Some individuals reach the age of 90 or even 100 in good health, without medications or brain disease. But how do these individuals maintain their health as they age?
• 5-15-2024COULD A LOW-CAL KETO DIET HELP EASE ACNE? In a small pilot study, some young women looking to lose weight on a low-calorie keto diet got an unexpected benefit: Their acne began to clear up. “These findings represent an opportunity to control a skin disease that affects most teenagers and many adults at some point in their lifetimes, causing distress, embarrassment, anxiety and low self-confidence among sufferers, robbing them of their quality of life,
• 5-15-2024FIGHTING FAT AND INFLAMMATION: SCIENTISTS DEVELOP NEW COMPOUNDS The menthyl esters of valine (MV) and isoleucine (MI) are multi-faceted molecules with enhanced anti-inflammatory and anti-obesity activities. The discovery and development of such molecules can result in newer classes of therapeutic drugs to treat a wide range of metabolic disorders. Credit: Gen-ichiro Arimura from Tokyo University of Science Modified derivatives of natural products have led to significant therapeutic advances and commercial success in recent times. Menthol is a naturally occurring cyclic monoterpene alcohol found in various plants,
• 5-15-2024TREATMENT OPTIONS INCLUDE ALTERNATIVES TO CHEMOTHERAPY, EXPERT EXPLAINS Chemotherapy is usually the first treatment doctors try to treat lymphoma, including the two most common forms: non-Hodgkin and Hodgkin. But alternatives to chemotherapy are developing, as first-line treatments and as backup options, explains Stephen Ansell, M.D., Ph.D., hematology chair and hematologic oncologist at the Mayo Clinic Comprehensive Cancer Center. Lymphoma is a blood cancer that begins when a germ-fighting white blood cell, called a lymphocyte, mutates and rapidly multiplies
• 5-15-2024CHECKING YOUR BELLY BUTTON CAN TELL YOU A LOT ABOUT YOUR HEALTH Navels, belly buttons, innies or outies … whatever term you use, your umbilicus may have plenty to tell you about the state of your health. For some, they are the thing of nightmares—omphalophobia (the fear of belly buttons) is a real condition. For others, they are a fashion accessory to be shown off in a crop top, or decorated with a body piercing. Whatever your feelings about belly buttons, one thing’s for sure—it once joined you to your mother
• 5-15-2024STUDY FINDS H5N1 VIRUS FROM 2022 MINK OUTBREAK CAPABLE OF INEFFICIENT AIRBORNE TRANSMISSION Direct contact transmission, weight loss, and survival for ferrets infected with A/mink (H5N1). Four donor ferrets were inoculated with A/mink (H5N1) and 24?h later each donor was paired with a contact in the same cage. Nasal wash samples were collected every other day for 13 days, and weight loss and clinical signs were monitored. A, B display viral titers from donor and direct contacts,
• 5-15-2024STUDY SHOWS COMBINING JOYFUL ACTIVITIES WITH ‘SAVORING’ THERAPY SHOWS POSITIVE MENTAL HEALTH RESULTS AMONG YOUNG PEOPLE With rates of depression rising among young people on university campuses, a team of SMU researchers found that combining two different therapeutic approaches demonstrated effectiveness in improving students’ overall mental health. Their findings show that students receiving behavioral activation (BA) therapy augmented with savoring (S) experienced improvements in positive and negative mood. Behavioral activation is a therapeutic approach that alleviates depression by increasing engagement in meaningful activities,
• 5-15-2024AI-BASED SURGICAL PREDICTION MODELS HAVE LIMITS Prediction models generated by machine learning are being increasingly used in medicine to identify risk factors and possible outcomes, especially for total joint replacements of knees and hips—although researchers warn that machine-generated predictions are currently being drawn from a limited data pool. “Machine learning has great potential for processing ‘big data’ and has proved its undeniable capability, although it is not free of issues,
• 5-15-2024STUDY FINDS FRONT-OF-PACKAGE NUTRITION LABELING RESULTS IN HEALTHIER PRODUCTS A study finds that a food labeling system introduced by the French government in 2017 resulted in healthier products. The study of Nutri-Score, a voluntary labeling system that assigns a simple letter grade based on nutrition, is believed to be the first to examine how food manufacturers responded to the change. Using detailed product and nutrition data from 2014 to 2021,
• 5-15-2024EXPERT EXPLAINS PUBLIC HEALTH CONCERNS ON AVIAN FLU Using genetically engineered mice expressing a specific variant of HLA, researchers uncover the instrumental role of this protein in the development of drug eruptions. They found that when HLA binds to an antiviral drug, abacavir, it can lead to the formation of defective proteins, which trigger a stress response in the endoplasmic reticulum, ultimately cascading into drug eruption. This implies that HLA is involved in previously unknown signaling pathways and processes that go beyond its traditionally accepted role within the immune system.
• 5-15-2024EXPLORING THE MECHANISM BEHIND DRUG ERUPTIONS IN THE SKINUsing genetically engineered mice expressing a specific variant of HLA, researchers uncover the instrumental role of this protein in the development of drug eruptions. They found that when HLA binds to an antiviral drug, abacavir, it can lead to the formation of defective proteins, which trigger a stress response in the endoplasmic reticulum, ultimately cascading into drug eruption.
• 5-15-2024STUDY PROVIDES BLUEPRINT FOR HYBRID-VIRTUAL HOME VISIT MODEL TO SUPPORT PATIENTS WHO DO NOT LIVE CLOSE TO A HOSPITAL a team developed and successfully tested a hybrid-virtual home visit model that provides care to veterans who do not live close to a VA health care facility.
• 5-15-2024HOW SCIENCE IS CHANGING THE GAME IN SPORTS Digital twins of athletes allow athletes and coaches to evaluate performance and trial technique changes. It’s an open secret that the countries that win the most medals in the Olympics and Paralympics combine talent and technology. Athletes are preparing for the next three Olympics and Paralympics in Paris in 2024
• 5-15-2024STUDY REVEALS HOW PRACTICE FORMS NEW MEMORY PATHWAYS IN THE BRAIN The effects of optogenetic inhibition on WM task performance. a, The experimental set-up. b, The delayed-association WM task trial types; licking was assessed during the 3?s choice period, with early- and late-delays periods noted. c, Learning progress across eight sessions, measured on the basis of the percentage of correct responses. d, Learning session example
• 5-15-2024A MEDITERRANEAN DIET CAN EASE SYMPTOMS OF STRESS AND ANXIETY, SAYS STUDY It’s no secret that the Mediterranean diet is good for your health. Already recommended to reduce the risks of bowel cancer, heart disease, and dementia, new research shows that the Mediterranean diet can also reduce symptoms of stress and anxiety.
• 5-15-2024ENHANCING PATIENT RESPONSE TO CANCER IMMUNOTHERAPY
• 5-15-2024LONGER SPRINT INTERVALS CAN IMPROVE MUSCLE OXYGEN UTILIZATION COMPARED TO SHORTER INTERVALS
• 5-15-2024NEW EVIDENCE FOR USE OF ANTI-INFLAMMATORY THERAPY FOR PREVENTION OF RECURRENT VASCULAR EVENTS IN STROKE
• 5-15-2024STUDY PAVES THE WAY FOR AN ACTIVE AGENT AGAINST HEPATITIS E
• 5-15-2024RESEARCHERS DEVELOP METHOD TO MONITOR PATIENTS WITH SPINAL MUSCULAR ATROPHY USING SOUND WAVES
• 5-15-2024INFERTILITY TREATMENT FOUND TO DOUBLE THE RISK OF POSTPARTUM HEART DISEASE
• 5-15-2024A PROMISING APPROACH TO INTRAOPERATIVE CANCER DIAGNOSIS
• 5-15-2024HOW ROGUE NEUTROPHILS HELP LUNG CANCER SPREAD
• 5-15-2024WOMEN PHYSICIANS ARE UNDERREPRESENTED AND FEEL LESS IMPACTFUL IN CANCER TREATMENT PLANNING VIRTUAL MEETINGS
• 5-15-2024ONLY 20% OF U.S. NONPROFIT HOSPITALS INVESTED IN HOUSING AS PART OF THE FEDERAL COMMUNITY BENEFIT MANDATE
• 5-15-2024NEW STUDY LINKS AUTISM SPECTRUM DISORDER TO DISRUPTED DEVELOPMENTAL DOPAMINE
• 5-15-2024STUDY FINDS SEVERE ISCHEMIC STROKES ARE RARE IN PATIENT POPULATION
• 5-15-2024CYCLIN D1 EXPRESSION MAY BE A BIOMARKER FOR PENILE CANCER
• 5-15-2024GUIDELINE ISSUED FOR PEOPLE WITH EPILEPSY WHO MAY BECOME PREGNANT
• 5-15-2024NEW CARDIAC RESEARCH COULD SAVE WOMEN’S LIVES BY IMPROVING DETECTION OF HEART FAILURE
• 5-15-2024PATIENTS REPORT SIGNIFICANT SYMPTOM REDUCTION WITHIN A SINGLE INTEGRATIVE MEDICINE ENCOUNTER
• 5-15-2024STUDY LINKS PROTEIN SECRETED BY BLOOD VESSELS TO DRUG-RESISTANT CANCER
• 5-15-2024RESEARCHERS EXPLORE THE ROLE OF OF TRANSPOSABLE ELEMENTS IN MYOCARDITIS
• 5-15-2024STUDY REVEALS IMMUNOTHERAPY’S POTENTIAL IN BOOSTING IMMUNE SYSTEMS OF OLDER INDIVIDUALS
• 5-15-2024CANADIAN HOSPITAL DATA SHOW LONGER, COSTLIER STAYS FOR PATIENTS EXPERIENCING HOMELESSNESS
• 5-15-2024SCIENTISTS WANT TO KNOW HOW THE SMELLS OF NATURE BENEFIT OUR HEALTH
• 5-15-2024STUDY FINDS TWO GENES OF THE GERMLINE ARE ESSENTIAL FOR THE DEVELOPMENT OF BRAIN TUMORS IN DROSOPHILA
• 5-15-2024EVALUATING A NEW GROUP TRAINING TOOL FOR THE PREVENTION OF DEMENTIA
• 5-15-2024RESEARCH CHALLENGES LINK BETWEEN MOTOR IMPAIRMENT AND BRAIN INJURY
• 5-15-2024RESEARCH CHALLENGES LINK BETWEEN MOTOR IMPAIRMENT AND BRAIN INJURY
• 5-15-2024CHIROPRACTIC ASSOCIATED WITH LOWER LIKELIHOOD OF TRAMADOL PRESCRIPTION IN ADULTS WITH SCIATICA
• 5-15-2024UNVEILING THE IMPACT OF JOB LOSS ON THE HEALTH OF IMMIGRANTS IN GERMANY
• 5-15-2024HEALTH CARE INTERPRETERS IMPORTANT FOR HEART ATTACK REHABILITATION, SAYS STUDY
• 5-15-2024RESEARCHERS FIND MICROPLASTICS IN CANINE AND HUMAN TESTICULAR TISSUE
• 5-15-2024ANTISEIZURE MEDICATIONS CAN PRODUCE LIFE-THREATENING REACTIONS
• 5-15-2024ADULTS WHO HAD DIFFICULT CHILDHOODS ARE NOT RECEIVING SUFFICIENT MENTAL HEALTH CARE, FINDS CALIFORNIA STUDY
• 5-15-2024AI MAY IMPROVE DOCTOR–PATIENT INTERACTIONS FOR OLDER ADULTS WITH CANCER
• 5-15-2024BLOOD PRESSURE DRUGS MORE THAN DOUBLE BONE-FRACTURE RISK IN NURSING HOME PATIENTS
• 5-15-2024PREVENTING PEDIATRIC FALLS
• 5-15-2024I’M PREGNANT. DO I NEED A MULTIVITAMIN?
• 5-15-2024TREATMENT-RESISTANT DEPRESSION LINKED TO BODY MASS INDEX: STUDY
• 5-15-2024HOW DID THE COVID-19 PANDEMIC AFFECT OLDER ADULTS’ TECHNOLOGY USE?
• 5-15-2024STUDY FINDS LINK BETWEEN BMI TRAJECTORIES AND FRACTURE RISK IN LATE ADULTHOOD
• 5-15-2024STUDY FINDS REDUCED RISK OF BREAST CANCER FOLLOWING BARIATRIC SURGERY IN WOMEN WITH HYPERINSULINEMIA
• 5-15-2024FEWER US OVERDOSE DEATHS WERE REPORTED LAST YEAR, BUT EXPERTS ARE STILL CAUTIOUS
• 5-15-2024PRE- AND POST-SURGICAL IMMUNOTHERAPY IMPROVES OUTCOMES FOR PATIENTS WITH OPERABLE LUNG CANCER, PHASE III STUDY FINDS
• 5-15-2024NEW METHOD USES TAU PROTEIN DEPOSITION PATTERNS TO PREDICT ALZHEIMER’S SEVERITY
• 5-15-2024OLDER NATIVE AMERICANS MAY EXPERIENCE HIGHER LEVELS OF COGNITIVE IMPAIRMENT THAN PREVIOUSLY THOUGHT
• 5-15-2024RESEARCHERS DEVELOP INNOVATIVE PLATFORM FOR MODELING HUMAN MUSCLE DISEASES IN WORMS
• 5-15-2024CLIMATE CHANGE IS LIKELY TO AGGRAVATE BRAIN CONDITIONS, STUDY FINDS
• 5-15-2024NEW STUDY SHOWS CONTINUED HIGH EFFECTIVENESS OF HPV VACCINATION IN ENGLAND
• 5-15-2024FAT-ENLARGED AXILLARY NODES ON MAMMOGRAM MAY INDICATE HIGHER CVD RISK
• 5-15-2024NOVEL INHIBITOR INSIGHTS OFFER PATHWAY TO PREVENTING PXR-ASSOCIATED DRUG RESISTANCE
• 5-15-2024THE DOCTOR IS IN… BUT WHAT’S BEHIND THEM? STUDY REVEALS IMPACTS OF TELEHEALTH BACKGROUND SETTINGS
• 5-15-2024HIGH TELEHEALTH USE TIED TO INCREASED HEALTH CARE UTILIZATION, COST
• 5-15-2024NEW BIOMARKER IDENTIFIED TO DIAGNOSE ALZHEIMER’S IN ASYMPTOMATIC STAGES
• 5-15-2024U.S. DROWNING DEATHS RISING AGAIN AFTER YEARS OF DECLINE
• 5-15-2024STUDY FINDS ASTROCYTIC PH REGULATOR CAN REPAIR BLOOD-BRAIN BARRIER, REVERSE BRAIN DAMAGE CAUSED BY ISCHEMIC STROKE
• 5-15-2024DISPARITIES SEEN IN CARBAPENEM-RESISTANT ENTEROBACTERALES BLOODSTREAM INFECTION OUTCOMES
• 5-15-2024WHY IS WHOOPING COUGH SURGING IN THE UK? FALLING VACCINATION RATES MAY BE THE ANSWER
• 5-15-2024CARDIAC REHAB IS A PROVEN BUT UNDERUSED THERAPY IN WOMEN, BUT TAILORED RESOURCES AIM TO CHANGE THAT
• 5-15-2024IRON FUELS IMMUNE CELLS—AND IT COULD MAKE ASTHMA WORSE
• 5-15-2024NEW POSSIBILITIES FOR CELL THERAPIES AND PERSONALIZED MEDICINE
• 5-15-2024HIGHER INCOME REDUCES STROKE MORTALITY RISK BY A THIRD, NEW STUDY SHOWS
• 5-15-2024SOME FORMS OF AUGMENTED BRAIN STIMULATION RECOMMENDED FOR MAJOR DEPRESSION
• 5-15-2024LOW TESTOSTERONE IN MEN ASSOCIATED WITH AN EARLY DEATH
• 5-15-2024WEARING FACE MASKS DID NOT REDUCE RISK OF COVID INFECTION AFTER FIRST OMICRON WAVE, RESEARCH SUGGESTS
• 5-15-2024BLUETOOTH TRACKING DEVICES PROVIDE NEW VIEW INTO CARE HOME QUALITY
• 5-15-2024RACIAL DISPARITIES IN CHILDHOOD OBESITY ON THE RISE IN STUDY OF NYC PUBLIC SCHOOLS
• 5-15-2024TWO DECADES OF STUDIES SUGGEST HEALTH BENEFITS ASSOCIATED WITH PLANT-BASED DIETS, BUT CAUTION URGED
• 5-15-2024TRANSCATHETER VALVE REPLACEMENT OUTCOMES SIMILAR TO SURGERY FOR SEVERE AORTIC STENOSIS
• 5-15-2024RECOGNIZING THE PHYSICAL AND EMOTIONAL TOLL THAT CARING FOR A LOVED ONE WITH A CHRONIC CONDITION HAS ON THE CAREGIVER
• 5-15-2024DIFFICULT WORK ARRANGEMENTS FORCE MANY WOMEN TO STOP BREASTFEEDING EARLY—HERE’S HOW TO PREVENT THIS
• 5-15-2024DAY-LONG WORKSHOP IN COGNITIVE BEHAVIORAL THERAPY FOUND TO EFFECTIVELY REDUCE DEPRESSION IN 16- TO 18-YEAR-OLDS
• 5-15-2024REPORT HIGHLIGHTS BIG GAPS IN CANCER OUTCOMES BASED ON RACE
• 5-15-2024NEW BLOOD TEST COULD HELP SPOT PREECLAMPSIA IN FIRST TRIMESTER
• 5-15-2024HALF-MATCHED FAMILY DONORS OFFER BEST OUTCOMES FOR HISPANIC PATIENTS UNDERGOING BONE MARROW TRANSPLANTS: STUDY
• 5-15-2024SCIENTISTS UNRAVEL GENETIC BASIS FOR NEURODEGENERATIVE DISORDERS THAT AFFECT VISION
• 5-15-2024INCLUDING MORE WOMEN ON HOSPITAL TEAMS YIELDS BETTER SURGERY OUTCOMES, NEW STUDY FINDS
• 5-15-2024RESEARCH SHEDS LIGHT ON HOW PROTEINS LINKED TO ALZHEIMER’S DISEASE INFLUENCE NEURONAL GROWTH
• 5-15-2024RESEARCHERS IDENTIFY NEW MARKER FOR BREAST CANCER PROGNOSIS
• 5-15-2024GETTING OUT AND ABOUT IN THE COMMUNITY MAY BE LINKED TO COGNITIVE FUNCTION
• 5-15-2024NOVEL TECHNIQUE HELPS PREDICT RISK OF A MENISCUS TEAR IN THE KNEE
• 5-15-2024CAN ROBOT-INSPIRED COMPUTER-ASSISTED THERAPY BENEFIT CHILDREN WITH AUTISM?
• 5-15-2024RESEARCH FINDS EXERCISE HAS A SIGNIFICANT IMPACT ON IMMUNE CELLS THAT SUPPORT BRAIN FUNCTION
• 5-15-2024CARDIOVASCULAR DISEASES KILL 10,000 EUROPEANS A DAY: WHO
• 5-15-2024NEW TOOL CAN HELP SURGEONS QUICKLY SEARCH VIDEOS AND CREATE INTERACTIVE FEEDBACK
• 5-15-2024SCIENTISTS DISCOVER BLOOD PROTEINS THAT MAY GIVE CANCER WARNING SEVEN YEARS BEFORE DIAGNOSIS
• 5-15-2024HOW THEY IMPACT LIFESPAN IN VERTEBRATES
• 5-15-2024UN AGENCY AUTHORIZES SECOND VACCINE AGAINST DENGUE AMID OUTBREAKS IN THE AMERICAS
• 5-15-2024IF YOU’VE TRIED MEDITATING BUT CAN’T SIT STILL, HERE’S HOW—AND WHY—TO TRY AGAIN
• 5-15-2024RESEARCHERS DETERMINE THE MUTATIONS THAT PROTECT MICE FROM B-CELL CANCERS
• 5-15-2024UP TO 246 MILLION OLDER PEOPLE MAY BE EXPOSED TO HEAT RISK BY 2050 DUE TO GLOBAL WARMING
• 5-15-2024MORE RESEARCH SUPPORTS ANDROGEN TREATMENT FOR BREAST CANCER
• 5-15-2024UNDERSTANDING THE ROLE GUT MICROBIOME–BRAIN INTERACTIONS PLAY IN SOCIAL DECISION-MAKING
• 5-15-2024NEW STUDY IDENTIFIES MECHANISM OF IMMUNE EVASION OF SARS-COV-2 AND VARIANTS
• 5-15-2024RESEARCH SHOWS RECENT RELEASE FROM JAIL A BIG RISK FACTOR FOR SUICIDE
• 5-15-2024RESEARCH COLLABORATION DEVELOPS LIFESAVING ‘ARK’ TECHNOLOGY FOR CHRONIC KIDNEY DISEASE PATIENTS
• 5-15-2024FOUR IN 10 ADULTS WITH DIABETES REPORT TAKING A GLP-1 RECEPTOR AGONIST
• 5-15-2024NEIGHBORHOOD INEQUITY TIED TO MORE PEOPLE LIVING WITH VISION DIFFICULTY, BLINDNESS
• 5-15-2024CHILD MALTREATMENT LINKED TO EXTERNALIZING, INTERNALIZING BEHAVIOR
• 5-15-2024MOST SLOW RESPONDERS TO TIRZEPATIDE DO LOSE CLINICALLY MEANINGFUL WEIGHT
• 5-15-2024RESEARCHERS IDENTIFY CAUSATIVE GENE IN MOUSE MODEL OF INHERITED LETHAL ARRHYTHMIA
• 5-15-2024TECH ALONE CAN’T REPLACE HUMAN COACHES IN OBESITY TREATMENT, STUDY FINDS

Hi everyone. I made a post regarding pre-lab anxiety and wanted to give an update.
My surgical report states “stage II-III endometriosis with deep implants in pelvic sidewalls” and “significantly dilated vasculature noted throughout the bowels”. I didnt speak directly with the doctor, she visited me in recovery but I dont remember anything that was said. It seems that because there was so much endo, she terminated the lap and didn’t remove the endo. I guess I will wait to speak with her at post op in two weeks
The anesthesiologist did not give me anything for anxiety, or extra fluids for pots despite me asking (I waited 3 hours to get called back and was panicking the whole time).
I had a very hard time waking up from anesthesia, and kept nodding off. The time was approaching 7pm and it felt like the nurse was rushing me out and told me to “sleep it off”. I don’t remember much from this part since I was so out of it, and I couldn’t walk or turn my head from wooziness. My heart was also racing, then slowing, then racing whenever I shifted my body.
Today is the morning after, and the gas pains are HORRENDOUS. So bad it brings me to tears but then crying hurts too. I can’t move. I’m trying to walk but it is so incredibly painful. I’ve taken 4 Gas-x so far and going to try to keep walking.
Oh and the top of my right thigh is numb in one spot.
Despite all this, I can’t put into words how a diagnosis makes me feel. I’ve had 12 years of painful painful periods and I was told to exercise, eat leafy greens, manage my stress/anxiety, etc.
It feels good.
TLDR: didn’t have a great experience at hospital, and gas pains have me in tears, but I am so happy to have a diagnoses. Also did anyone experience numbness in their right upper thigh after their lap?

I worked my ass off doing research and selling a bunch of my stuff to get the plane tickets because I'm pretty broke. I was excited for this trip because I was accepted into a German university for graduate school and figured I'd get a good introduction to living in Germany, and to be honest, Berlin itself has been great, all the locals I've met have been very nice to me, but my professors and everyone working from my university have been really unprofessional and tricky and now I'm in an unsafe position.** EDIT to add that when I say Friday I mean tomorrow, so I have about 1 day until getting kicked out of the hotel. I also didn't need a visa to get here, though I will be getting one for my graduate program in September, but this current program was less than a month long so it was counted as group tourism basically.
Long explanation, skip to the bottom for the TLDR:
Before I even got on a single plane, I found out customer service for my phone carrier and I had a misunderstanding a month ago when I bought my international plan and found out about 3 days in advance that my phone would be a brick here. I told the professor immediately and she said worse case scenario she would help me get a working phone when I landed, since it's kind of needed for basic safety. Just half a day before the first flight, I got bitten by a few deer ticks and said I might also need help scheduling a doctors appointment when I land, because our travel insurance required a working phone number and it was too late for me to make an appointment before my flight. The professor said that was fine and I would be helped with that as well, so I got on the first plane in full confidence.
When I landed, a day passed without either thing being handled, and that was fine by me, but then multiple days passed and the professor kind of just waved it off. I'd started to feel a little unwell and asked the professor to help me find a doctor and she said it was just jetlag.
One of the first days of the program we went to a restaurant, and the seating was a very small reserved room with our entire 20+ cohort in it. I have CPTSD and am claustrophobic and knew immediately that I did not want to sit there, so I asked the professor if she could help me ask the staff request a seat for me in the outside dining area, or, if one wasn't available, that I could just sit outside on a nearby bench and skip dinner. She told me the room was reserved for us and this was on the itinerary so I HAD to sit there, and when I again said I didn't think I could, she demanded I sit there again and condescendingly asked me if I really couldn't or just didn't want to. I started to cry as quietly as possible and then that suddenly made her understand, so we went outside and I explained that, in my opinion, trying to force any adult to do something they're uncomfortable with and have said "No" to is bad enough to me normally, but since I have a disability, it's also ableist. I tried to frame that sentiment in a "I'm sure you didn't mean it this way" kind of way but she still took offence to the criticism and I think that led to the rest of this.
After that happened I was feeling more ill and the professor said, "Oh, do you think it's lyme? Because if it was lyme you'd have a rash. It's probably still jetlag". At this point I said again that I needed some help getting a working phone number and medical advice from a doctor and she told me to take responsibility for myself. I'd bought myself a SIM card but it needed some unexpected trouble shooting and everything was in German (I know some German but only around A2 level and absolutely none is required for this program), so I'd already tried to help myself, and again could not schedule myself an appointment without a working phone.
I asked the professor if she could put her phone number in just to let the appointment scheduling process complete and she said no. I asked if she had any other ideas and she again told me to figure it out. I wound up walking 20 minutes through Berlin alone with no working phone to a doctor's office unannounced, barely able to fill half the sign in sheet and navigate the language barrier, and successfully got the antibiotics I needed and a lyme diagnosis. The nurse even asked why I came alone. Thankfully for me everyone in the doctors office including the doctor was very very nice to me despite the curveball I through them.
Not long after all that the professor sent an email with me cc'd in to the office of international affairs at the university, and the email said, in effect, "This student said they have a disability and can't stick to the itinerary and therefore I think they're not a good fit for this program and should go home." I immediately responded that that wasn't accurate, that I just could not sit inside a restaurant or other very cramped space, etc. Then I figured while I was at it I'd tell them about the total lack of care for my safety or wellbeing here. After sending that email the professor confronted me and tried to pretty much intimidate me into admitting everything was all my fault or something, I honestly have no clue, I think she was just upset and trying to make me feel better somehow. I think my criticism really got to her and made her kind of just hate me and that she wanted to make me make her feelings make sense. No clue honestly.
Anyway, after that the office of international affairs reached back out to me and were acting way nicer than they were when I first enrolled in this program, which felt sus, but I was haggard and miserable and wanted to be able to trust them so I did. They told me if I was considering coming home early for my own health and safety, that I could unenroll that night to make sure the alum who gave me a scholarship would at least be refunded, but that I had to do it that night since it was the last day to drop for a refund. I said I wasn't sure if I wanted to leave the program, and they said if you're considering it unenroll and if you want to stay after further discussion then we can probably just go ahead and re enroll you.
So I did it. The next day I'm scheduled to meet with someone who told me the day or so before that she would be my advocate and that she was there to listen to and represent me, and when I join the zoom meeting, it's her, but also two other people from the international affairs office. They're telling me my return flight has already been scheduled and everything and that they were sending out a person to chaperone me on the flight, because, though it was totally ignored on my flights here, I'd mentioned at the very start of the application process that I'd been a human trafficking victim before and ideally wanted to fly with someone instead of alone. All of this had less than a 24 hour turnaround from me unenrolling.
I realized hours after unenrolling that I don't want to leave the program, I just want to actually be allowed to engage in the program as it was advertised and as it was promised, and that leaving the program, to me, feels like capitulating to the professor being an asshole to me and like removing liability from the university. In short I think I pretty much got tricked into unenrolling. I told them I didn't want to leave early and they told me they already scheduled everything and got a refund for my hotel room, so if I don't take the flight back Friday, I will be homeless on the streets for 2 weeks until the flight that I personally purchased for the 31st, and that since I hit the unenroll button, my housing, health, or safety will no longer be the universities problem after Friday.
So, the fuck do I do with this, ya'll got any life advice? Or know any cheap hostels or something? Or even just some moral support haha.
TLDR: Got tricked into hitting unenroll button after damaging professors ego, most likely purposely tricked to absolve the university of responsibility because how the profs were treating me and everything I described probably did make me a liability even if not my fault, but I'm mad and I'm enjoying Berlin and don't want to leave early or let the university get away with risking my health and safety multiple times with no apologies.
Sidenote: The professor also said a lot of things insinuating that, because she didn't like me, neither would any of my professors in my grad school program will, and as much as I think she said it in a vindictive way, I will admit it has me second guessing if I want to actually pursue that in September. After all this I just feel like running from academia in general.

I'm currently in Berlin, Germany, and about to be homeless for 2 weeks on the streets. I signed up for a study abroad program from my university, which I just graduated from last semester. I paid the application fee, got picked, paid for my own flight here and back, and then got a scholarship from an alumni couple in the department I got my degree in, and that scholarship paid for the rest of the trip.
I worked my ass off doing research and selling a bunch of my stuff to get the plane tickets because I'm pretty broke. I was excited for this trip because I was accepted into a German university for graduate school and figured I'd get a good introduction to living in Germany, and to be honest, Berlin itself has been great, all the locals I've met have been very nice to me, but my professors and everyone working from my university have been really unprofessional and tricky and now I'm in an unsafe position. **EDIT TO ADD, when I say they're trying to make me go home Friday I mean tomorrow, so I have like 1 day until I'm kicked out of the hotel.
Long explanation, skip to the bottom for a TLDR:
Before I even got on a single plane, I found out customer service for my phone carrier and I had a misunderstanding a month ago when I bought my international plan and found out about 3 days in advance that my phone would be a brick here. I told the professor immediately and she said worse case scenario she would help me get a working phone when I landed, since it's kind of needed for basic safety. Just half a day before the first flight, I got bitten by a few deer ticks and said I might also need help scheduling a doctors appointment when I land, because our travel insurance required a working phone number and it was too late for me to make an appointment before my flight. The professor said that was fine and I would be helped with that as well, so I got on the first plane in full confidence.
When I landed, a day passed without either thing being handled, and that was fine by me, but then multiple days passed and the professor kind of just waved it off. I'd started to feel a little unwell and asked the professor to help me find a doctor and she said it was just jetlag.
One of the first days of the program we went to a restaurant, and the seating was a very small reserved room with our entire 20+ cohort in it. I have CPTSD and am claustrophobic and knew immediately that I did not want to sit there, so I asked the professor if she could help me ask the staff request a seat for me in the outside dining area, or, if one wasn't available, that I could just sit outside on a nearby bench and skip dinner. She told me the room was reserved for us and this was on the itinerary so I HAD to sit there, and when I again said I didn't think I could, she demanded I sit there again and condescendingly asked me if I really couldn't or just didn't want to. I started to cry as quietly as possible and then that suddenly made her understand, so we went outside and I explained that, in my opinion, trying to force any adult to do something they're uncomfortable with and have said "No" to is bad enough to me normally, but since I have a disability, it's also ableist. I tried to frame that sentiment in a "I'm sure you didn't mean it this way" kind of way but she still took offence to the criticism and I think that led to the rest of this.
After that happened I was feeling more ill and the professor said, "Oh, do you think it's lyme? Because if it was lyme you'd have a rash. It's probably still jetlag". At this point I said again that I needed some help getting a working phone number and medical advice from a doctor and she told me to take responsibility for myself. I'd bought myself a SIM card but it needed some unexpected trouble shooting and everything was in German (I know some German but only around A2 level and absolutely none is required for this program), so I'd already tried to help myself, and again could not schedule myself an appointment without a working phone.
I asked the professor if she could put her phone number in just to let the appointment scheduling process complete and she said no. I asked if she had any other ideas and she again told me to figure it out. I wound up walking 20 minutes through Berlin alone with no working phone to a doctor's office unannounced, barely able to fill half the sign in sheet and navigate the language barrier, and successfully got the antibiotics I needed and a lyme diagnosis. The nurse even asked why I came alone. Thankfully for me everyone in the doctors office including the doctor was very very nice to me despite the curveball I through them.
Not long after all that the professor sent an email with me cc'd in to the office of international affairs at the university, and the email said, in effect, "This student said they have a disability and can't stick to the itinerary and therefore I think they're not a good fit for this program and should go home." I immediately responded that that wasn't accurate, that I just could not sit inside a restaurant or other very cramped space, etc. Then I figured while I was at it I'd tell them about the total lack of care for my safety or wellbeing here. After sending that email the professor confronted me and tried to pretty much intimidate me into admitting everything was all my fault or something, I honestly have no clue, I think she was just upset and trying to make me feel better somehow. I think my criticism really got to her and made her kind of just hate me and that she wanted to make me make her feelings make sense. No clue honestly.
Anyway, after that the office of international affairs reached back out to me and were acting way nicer than they were when I first enrolled in this program, which felt sus, but I was haggard and miserable and wanted to be able to trust them so I did. They told me if I was considering coming home early for my own health and safety, that I could unenroll that night to make sure the alum who gave me a scholarship would at least be refunded, but that I had to do it that night since it was the last day to drop for a refund. I said I wasn't sure if I wanted to leave the program, and they said if you're considering it unenroll and if you want to stay after further discussion then we can probably just go ahead and re enroll you.
So I did it. The next day I'm scheduled to meet with someone who told me the day or so before that she would be my advocate and that she was there to listen to and represent me, and when I join the zoom meeting, it's her, but also two other people from the international affairs office. They're telling me my return flight has already been scheduled and everything and that they were sending out a person to chaperone me on the flight, because, though it was totally ignored on my flights here, I'd mentioned at the very start of the application process that I'd been a human trafficking victim before and ideally wanted to fly with someone instead of alone. All of this had less than a 24 hour turnaround from me unenrolling.
I realized hours after unenrolling that I don't want to leave the program, I just want to actually be allowed to engage in the program as it was advertised and as it was promised, and that leaving the program, to me, feels like capitulating to the professor being an asshole to me and like removing liability from the university. In short I think I pretty much got tricked into unenrolling. I told them I didn't want to leave early and they told me they already scheduled everything and got a refund for my hotel room, so if I don't take the flight back Friday, I will be homeless on the streets for 2 weeks until the flight that I personally purchased for the 31st, and that since I hit the unenroll button, my housing, health, or safety will no longer be the universities problem after Friday.
So, the fuck do I do with this, ya'll got any advice? I could really use some. Or even just some support haha.
TLDR: Got tricked into hitting unenroll button after damaging professors ego, most likely purposely tricked to absolve the university of responsibility because how the profs were treating me and everything I described probably did make me a liability even if not my fault, but I'm mad and I'm enjoying Berlin and don't want to leave or let the university get away with risking my health and safety multiple times with no apologies. Currently will probably be homeless in Berlin for 2 weeks.

Hi everyone! My baby is 10 months old and I’m wondering for those of you with similar aged babies how much your little one eats?
I feel like maybe I’m not offering my baby enough food lately. She’s very petite (10th percentile) but drs not concerned because she was 5 weeks premature and is still showing gradual growth. However she hasn’t been eating a whole lot. I’m new to blw and we have free purees from Wic. So we do both. She was not finishing the jars but I realized she definitely preferred blw and feeding herself and would eat bettemore those days. When I spoon feed her she fights a little lol. I just am in over my head as far as what to offer her and am new to being a stay at home mom (was working up until about a month ago) so it’s hard sometimes to prep and give “real” food.
I recently got reusable baby pouches so I could at least put the purées in there and she can have some control over feeding herself and today she loved that and ate way more than usual!
I also want to say I still breastfeed but throughout the day she would only eat 1-2 jars of baby puréed fruits/veggies/meat, nurse a couple times mostly for naps, have a couple small snacks (think yogurt melts/cereal puffs) then overnight she’s waking up constantly to nurse. Today she had like 4.5 jars worth of food in the pouches as well as nursing. (Of course mix in the days of blw where she eats more but this is just an example of a worse and more typical day)
I googled and realized woah! It seems like she should be having wayy more solids. So wanted to hear a sample of what a day’s menu looks like for your little ones! Please share any tips regarding blw/meal and snack ideas etc! Especially because I plan on weaning off the breastmilk around 12 months. To be noted for any tips as of right now baby can’t have milk/dairy products possible allergy still working on diagnosis but bad reactions.

In order to guarantee the health and wellbeing of expectant mothers and their unborn children, an obstetrician-gynecologist (OB-GYN) with competence in pregnancy and maternity care is sometimes referred to as a Pregnancy & Maternity Specialist. The following are some important duties:
1. Prenatal care : It is the provision of all-inclusive prenatal care to expectant mothers, which includes routine check-ups, fetal development monitoring, and screening for issues like preeclampsia, gestational diabetes, and anomalies in the fetus.
2. Identifying and managing risk factors and issues that may occur during pregnancy, such as multiple gestations, advanced mother age, pre-existing medical conditions, or past pregnancy complications, is known as “managing high-risk pregnancies.”
3. Labor & Delivery: Tracking the progression of labor, offering alternatives for pain relief, and helping with baby delivery, including vaginal births, C-sections, and instrumental births (using forceps or vacuum extraction) as needed.
4. Postpartum Care: Providing new moms with postpartum care that involves observing their physical and mental recuperation, addressing difficulties with nursing, and managing complications such as infections, bleeding, or mood disorders.
5. Family planning : It includes helping women make decisions about birth control and fertility counseling, as well as providing counseling and contraceptive services to them during the postpartum period.
6. Diagnosis and Treatment : Identifying and managing reproductive problems and gynecological conditions, such as endometriosis, uterine fibroids, recurrent miscarriages, and infertility, that may have an impact on pregnancy.
7. Patient education : It refers to educating and counseling expectant mothers and their families on topics such as breastfeeding, postpartum recuperation, newborn care, pregnancy, and contraception.
8. Cooperation : Working together to guarantee comprehensive and well-coordinated care for expectant mothers and their unborn children with other medical professionals, such as midwives, nurses, pediatricians, and specialists.
9. Advocacy : Promoting pregnant women’s health and rights, such as their ability to obtain evidence-based maternity care practices, reproductive healthcare services, and prenatal care.
10. Research and Education : Participating in clinical trials and medical research, keeping abreast of the most recent advancements in obstetrics and gynecology, and teaching medical students, residents, and other healthcare professionals about pregnancy and maternity care.
All things considered, pregnancy and maternity specialists are essential in helping women through the adventure of becoming pregnant, giving birth, and recovering from the postpartum phase.

Hi. You guys might remember that I posted in here and the cancer family support group not long ago looking for some advice about looking ahead at my dad's treatment and care. Please let me know if I should change the flair, but support and advice is definitely wanted.
To revisit, he was diagnosed with stage 4 squamous cell lung cancer, metastases virtually everywhere in his body except brain and spine. We found out at the end of March/maybe very beginning of April. They told him 4-6 months without treatment, up to 18 months with treatment. So.. what happened?
I flew out to be with him and got here on the 15th of April. I took over his full time care. He declined so fast. Tuesday the ​30th, we had an interview with a home based palliative care nurse and he recommended that we send my dad to the hospital. Dad had been getting more and more foggy mentally and having a lot of difficulties communicating, tremors, etc. I questioned this very much and was told throughout the two weeks that I was here that it was probably the pain medication and we alternated through a couple options for pain management up until Tuesday. When the nurse was asking him questions, my dad couldn't remember the date or his address. So we made the call to send him to the hospital because the nurse thought it was more than just the pain medication. He was a complete angel on earth, he stayed with me the entire time until after the EMTs left with my dad and he made sure I was okay.
The doctors found out my dad had hyper calcemia, high calcium levels, which can happen in cancer patients. He had every single symptoms. They tried to give him a bunch of fluids and he got a bit better on day 2. But day 3, Thursday, he was much worse. The physician said, in the kindest way possible, that he didn't think my dad would get better. He tried one more option for a diuretic to help get fluid flowing because dad was having very wet/rattling breathing by that point. It didn't work. I had to make the hardest decision of my entire life to switch my dad to comfort care. It was what he would've wanted and made clear he would've wanted in his advanced directive/polst/etc. He told me for my entire life that if he ever was incapacitated, he wouldn't want to be a vegetable or prolong his suffering, he'd want it to end. Over the past ~month since his diagnosis, he made it clear through his legal forms and telling me/his other family that he would not want to suffer longer for no reason. He was a DNR and he chose "limited intervention" for his preferences. So I did what he wanted, I didn't prolong his suffering since it didn't look like it would help. The doctors and nurses were the most incredible I could've asked for and they gave him a lot of pain medication and meds to help him relax and be comfortable. They were wonderful to me and brought m​e and my family food and water and were just there the whole way through. He passed around midnight Friday morning. He was peaceful and at rest.
I know that I was true to what he wanted. But I'm struggling so fucking much. My heart hurts beyond words. I don't know how to live the rest of my life without him. I'm mourning that he will never get to see my boyfriend and I get married, that he'll never be able to do a first look with me or walk me down the aisle, that he'll never see my boyfriend and I finish our advanced degrees or see my boyfriend's son graduate high school. I had dreams of getting to have an inlaw suite at our future house to have him with us. Even after getting his diagnosis, I had thought we had so much more time. I feel so lost. What do I do now? How do I cope? I already got his ashes back because he wanted to be cremated, having a celebration of life this weekend. Waiting on death certificates to close out accounts and get things taken care of. I don't know what to do with myself. I felt like I was treading water before, barely staying afloat. Now I feel like I'm at the bottom in the silt, running out of air. It hurts so much. Please share any advice or even words of comfort. I'm trying to make sure I have a list of everything that needs to get done. Thank you. So sorry you're along for this journey too ❤️🫂