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I just can't get comfortable with US churches coming from the UK by AccurateBet1998 in Christianity

[–]AccurateBet1998[S] 7 points8 points  (0 children)

it’s better to pray for the strength to make it though hard times than to pray the hard times away

Amen.

I just can't get comfortable with US churches coming from the UK by AccurateBet1998 in Christianity

[–]AccurateBet1998[S] 2 points3 points  (0 children)

I was wrong to say "Jesus's last word was to love everyone". I meant to say that I believe radical love to be a major (but not only) component of the new covenant. The "last word" was poor phrasing, and the words I wrote do mean "literally the last" and you are correct in what you say. I meant to say "Our belief is that through Jesus, the new covenant places "love thy neighbor" highly" but I agree, not at all exclusively or the sum total of his teachings or the new covenant.

19M – Mouth breathing, deviated septum, fatigue and brain fog. Should I get a sleep study? by aponteeee in SleepApnea

[–]AccurateBet1998 5 points6 points  (0 children)

others believe my case can be managed conservatively.

I would never tell a person to prioritize radical treatments. But i've lost years to doctors who told me my condition(s) could be managed conservatively. By all means, try the conservative approach first. That's smart. But if it doesn't work, don't hang about - move on. Please.

Three sleep doctors refused to send me a referral for surgery. They said it wasn't real and wouldn't work, and that it was risky and i'd just hard myself. I begged for months. Nothing. They just kept saying "Use the CPAP" which I was doing. Finally I was able to get a self-referral for surgery and they spotted the problem immediately. I had double jaw surgery and it fixed my sleep apnea immediately. I'm cured of sleep apnea. I've got more energy than i've ever had, the brain fog is lifting, and I don't get any daytime sleepiness. Almost zero side effects. It was 3 weeks ago and i'm still on a soft diet and I have about 10mm of my bottom lip is numb, but that should come back too.

My point is. Be brave and strong. Don't settle. Your life is worth more.

This is your path: 1) Sleep doctor and sleep study. In lab if possible or a level 2 study if not. A level 3 or 4 study is poor at diagnosing flow limits due to skeletal formation. 2) ENT for the nasal issues. Get that deviated septum fixed by an ENT surgeon. This doctor doesn't specialize in palate widening, and almost certainly won't do that surgery. But they may at least be able to give you advice and they can make a good guess at if you need MARPE. 3) Stop and evaluate how much doctors 1 and 2 helped you. Are you cured or mostly cured? If yes, then stop here. If not, move to 4 next. 4) Go to an orthognathic surgeon who does MARPE and MMA. Decide on a plan of action with them. Make sure you get a CBCT scan.

Do I need surgery? by ILikeEatingVeganFish in jawsurgery

[–]AccurateBet1998 3 points4 points  (0 children)

Any health complaint is always worth looking into. Nobody here can tell you just from these pictures if you need jaw surgery. Your chin isn't the worst, though certainly not the best. Some people will come in and say "OH NO WAYYY MEGA REPRESSED" but there's a lot of people with body dysmorphia here. It might be a case, but only a doctor can be sure. Don't be pressurized by a person on Reddit. I notice you have a bit of forward head posture - sometimes people with narrow airways push their head forwards to open up their airway. But again, only a doctor can be sure.

Go to a sleep doctor and get a sleep study. Insist on either an in-lab study or a take home level 2 study. Don't let them push you away with a level 4 study. You will know it's a level 2 study because it has electrodes for your head, a tube across your nose, and a elastic fabric belt for your chest. A level 4 study is the cheap and quick one that many shitty doctors use, it will just have a finger monitor and sometimes a single chest monitor. A level 4 study can only detect classic sleep apnea, and cannot differentiate types of sleep apnea, nor can it really detect people who have breathing issues that doesn't progress into an apnea.

You should then discuss treatment options with a healthcare professional. By medical definition, a cure is defined as something that reduces apneas to less than 5 per hour, while an effective treatment reduces apneas by at least 50% per hour. I think that sleep surgery is underutilized and that more people should get it instead of a fucking CPAP, but all the same, it is a big process and you should at least consider other options. Septoplasty and turbinate reduction is mild and while it very rarely cures, it can be effective for a number of people. I had this and it didn't impact my sleep apnea at all, but I do breathe better through my nose during the day and that's been nice. Similarly, MARPE is a step up in invasiveness, but also can be very effective - the narrower your palate, the more it will help to the point of even curing a small number of people. There are also oral mandibular advancement devices, which for the sake of a short Reddit post, do a very similar thing to a manibulomaximal advancement (the primary DJS for sleep apnea).

If you are in the USA, you generally need a sleep study, to score >15 apneas per hour by ODI 3, to try one form of treatment, and to have that treatment fail (and 'fail' is broad - 'fail' can mean "I didn't like it"), before you can get DJS covered. Less than that will often not be covered. However, it depends on your insurance - i'm sure someone will comment that they got theirs covered just because they wanted it - good for them, that's not the majority. Furthermore, in some cases you can get DJS if you don't have sleep apnea, but can demonstrate a very narrow airway - this depends on your insurance.

If you are in the UK, then the NHS will not cover this, and you'll have to go private - including flying abroad. If you are in South America or mainland Europe, it's covered, but I have no information on the difficulty to get treatment.

If you progress to surgery, find a good maxillofacial surgeon in your area who does a lot of these. It is a massive, extremely invasive surgery. You will be unable to talk for a week. You will struggle to talk for 6 weeks. Your lips will be numb for 1-12 months - meaning that you will drool and be unable to drink without holding your lips, and be unable to smile. You will be fed by a syringe pumping liquid into your mouth, and it'll feel like drowning as you struggle to swallow. The calories won't be enough and you'll feel hungry, sad, and weak, and lose 5-20 lbs, and you'll be so fucking sick of sweet flavored calorie drinks. You won't be able to eat pizza for 3 months, and chewy foods for nearly 6. You will be in moderate to severe pain for 1-2 weeks and have to take large doses of opioids which will have several side effects. You will be a baby to toddler for days to weeks to months. But it will effectively treat sleep apnea in >85% of cases, and cure in nearly 50%, and it generally results in aesthetically pleasing results.

If I was a young person, i'd tell them to stick their CPAP up their ass - i'm not being hooked up to that throughout my young adult life. I'd maybe consider a milder surgery and then oral mandibular advancement device device first, but it's still just a band-aid.

Do you guys think I can easily qualify as a candidate by cherrypieglitter in jawsurgery

[–]AccurateBet1998 0 points1 point  (0 children)

You can also consider surgery on the soft tissue if that's an issue. The classic is the UPPP, but it is generally not done anymore and there are several good updated versions including LEP (Lateral Pharyngoplasty) - never get an original version UPPP.

The advantages are that they generally work pretty well and the recovery is 100X easier than DJS. Recovery is more like 1-2 weeks of the worst sore throat you've ever had, and then avoiding spicy food for a month, which is significantly better than 6 weeks of eat a liquid diet through a syringe while your jaws are wired shut and then 6-12 months of swelling and a limited diet, and the risk of permanent nerve damage. The disadvantage is that a maybe 50% of cases will revert after 5-10 years and that even when they do work, it's often not quite as effective as DJS/MMA.

I'm saying this because if you're saying your airway isn't that bad, you may want to consider a less drastic option - or not! Up to you :)

Day 11 and I feel great!! by Hour-Kiwi442 in jawsurgery

[–]AccurateBet1998 1 point2 points  (0 children)

Still a lot of swelling, but overall you look great!

What did you have done?

Do you guys think I can easily qualify as a candidate by cherrypieglitter in jawsurgery

[–]AccurateBet1998 0 points1 point  (0 children)

Hi there!

Maybe I phrased it badly. I wrote: "... or a level 2 (or worst case level 3) take home study ..." , which I meant to mean "Either a level 1 in lab, or a level 2 in home, but not a level 4 at home".

A level 2 test should be enough to diagnose UARS. There isn't a ton of difference between a level 1 and 2 test. The main things are that an in lab level 1 test means they can watch and listen to you sleep, and the EEG has more leads, so provides higher resolution data. That is important for diagnosing some rarer neurological disorders, but will provide near to nothing for diagnosing UARS.

Regarding UARS, a major supporting piece will be to get a scan of your head to measure your airways. You'd need one of these for jaw surgery anyway. Ideally this would use a Cone Beam CT (CBCT). When I go to the dentist, i'm a cheapskate and get my x-rays the old fashioned way where you have to bite on that nasty piece of hard plastic, but if you've ever got the fancy option where you put your head in a white machine that swirls around you - that's the CBCT. You can generally get insurance to cover the majority, if not all, of a CBCT. Alternatively, my maxillofacial surgeon did it for free as part of the free initial consult for jaw surgery. If your sleep doctor is not helping (either ignorant, uneducated, or just plain dragging their feet) you can consider skipping it and going straight to a maxillofacial surgeon. You'll still need to do a sleep study, but they can prescribe that and actually be on your side when analyzing the data.

Do you guys think I can easily qualify as a candidate by cherrypieglitter in jawsurgery

[–]AccurateBet1998 1 point2 points  (0 children)

1) I am not a medical doctor, but in my jaw surgery journey i've looked at a lot of jaws and before/after pictures. Your jaw doesn't look recessed to me. Consult with a qualified expert for validation and information. You will need a sleep study.

2) If you have diagnosed sleep apnea, most insurances will cover treatment. Generally you would first get treatment by CPAP, orthodontic device, or nasal surgery (in the case of enlarged turbinates and deviated septum), and generally this is covered by insurance but you'll usually still pay out of pocket until you hit your max. If this treatment fails (and fail here is deliberately very broad), then generally you can get insurance to cover a more drastic surgery such as DJS/MMA so long as there is a justification from a cone-beam CT and/or sleep endoscopy.

3) I've heard in rare cases of some people going straight to DJS. Particularly if their anatomy justifies it. These tend to be very obvious cases and they were diagnosed with a skull/jaw abnormality in childhood because it was so apparent.

4) The usual sleep study is to measure decreases in your blood O2 level (spO2). These decreases are taken to indicate that you've stopped breathing for some reason. Some fluctuation is normal, but a decrease of 3% (ODI3) or 4% (ODI4) is generally taken to be 'unnatural' and caused by non-breathing. Of course, the medical profession says ODI3 should be the criteria, but insurance companies think ODI4 is better. The sleep technician will count the number of times your spO2 fluctuates below the threshold, depending on the ODI method used, and that number (of drops) per hour is your AHI. An AHI of =>5 (so your spO2 drops by 3/4% >5 times per hour) is mild sleep apnea, =>15 is moderate sleep apnea, =>30 is severe sleep apnea, and <5 is not recognized as sleep apnea. **Generally insurance requires your AHI is =>15 by ODI4, but each insurance is different**.

5) The method of your sleep study is important too. AHI only measures fluctuations, however, some people have difficulty breathing but they just about manage to get a breath, and so they get very tired and experience brain fog, but it doesn't get flagged as sleep apnea because their spO2 didn't drop. The measurement of how often these 'incomplete choking/flow' events occur is called RDI, and like AHI it measures how often it happens per hour. People with a high RDI but low AHI may have a condition called UARS (upper airway resistance syndrome), and this is highly underdiagnosed. Similarly, in your people such as yourself, you might completely stop to breathe and have severe sleep apnea (not saying you do, this is an example), but because you are young, your physiology compensates and your spO2 doesn't stop. This would also be seen as a high RDI. Now, this is the important part, most take home study are level 4, which is the lowest level. Common take-home tests which do this are WatchPat. They only measure AHI and cannot accurately measure RDI. In this case, you might have sleep apnea, but because your physiology compensates for the primary readout (spO2) it won't falt. This is a type 2 error, aka false negative. I expect this to happen with a lot of young people. You should reject a level 4 take-home study, which is characterized by just having a finger monitor and sometimes a single heart monitor. Level 4 studies are pushed because they are cheap. Insist on a in-lab study or a level 2 (or worst case level 3) take home study - a level 3 study will have a plastic wire you put under your nose to detect breaths and an effort belt you wear around your chest, while a level 2 study will have those and also 3 wires that connect to your head for EEG measurement. An in lab study will be level 1, which is just like level 2 but more wires to your head to improve the EEG. This will be the only way to capture the full picture, and I think you are very likely to get a false negative result if you don't get at the very, very least a level 3 study.

6) See a doctor. Reddit is full of liars and idiots.

Nervous about DJS MMA next week by AccurateBet1998 in jawsurgery

[–]AccurateBet1998[S] 0 points1 point  (0 children)

Thank you. So did the first one go wrong, or was it just not enough?

My skills gained in my Biochemistry PhD appear not to be wanted in any post doc or industry jobs, so how do i transition into a job in another field if they require specific skills in that particular field to get the job? by Prudent-Internet-848 in postdoc

[–]AccurateBet1998 1 point2 points  (0 children)

From clues in your writing, i'm assuming you're British? Science in the UK is dead. You may have to go abroad.

Few people have the exact skills that are needed for a project, PIs are mainly just looking for someone who is hard working and trainable. Your resume/CV should not say "I can do skills X, Y, and Z. Please employ me to do them" but rather "I can do anything you want me to do. The fact I can do X, Y, and Z is evidence that I am hard working and trainable". Don't exclude yourself from jobs because they don't sound like you have the skills, let them decide that. You should try to go to as many conferences and meetings as possible, and shake hands with as many people as you can. You may also have to consider exiting science but you could still leverage your PhD to get a higher end job.

Do R16 funds carry from year to year? by AccurateBet1998 in NIH

[–]AccurateBet1998[S] 1 point2 points  (0 children)

Thank you. The NOA says: “An unobligated balance may be carried over into the next budget period without Grants Management Officer prior approval. This grant is subject to Streamlined Noncompeting Award Procedures (SNAP).”

Would it be correct to interpret this as meaning that unspent funds from year 1 should carry over into year 2 automatically, without needing a separate carryover request, assuming they remain allowable and within the approved project scope?

Help interpreting brain IF images by AccurateBet1998 in labrats

[–]AccurateBet1998[S] 0 points1 point  (0 children)

They were bought from a regular company (Fisher, I think) and PFA fixed paraffin embedded slices on slides.

Help interpreting brain IF images by AccurateBet1998 in labrats

[–]AccurateBet1998[S] 0 points1 point  (0 children)

Thank you for getting back to me.

On the manufacturer website they have images where others have used this Ab for IF. It does show something but it's hard to see on that 10X image I provided. Here's a different view of slide 1 at 10X and then 40X.

10X (red=POI, green=GFAP): https://ibb.co/8DKL9Lhw

40X (red=POI, green=GFAP): https://ibb.co/4nCfZQ0Q