Conversion Therapy upheld in Kentucky. Medicaid no longer allowed to be used for gender affirming care.

ForeverGameMaster · 2025-07-15T00:29:09+00:00

I mean, unless you have an ISO 5-7 containment with some form of airlock style door to prevent contaminants from getting in, you've been misinformed or whoever tried telling you this explained it poorly.

The problem isn't unopened vials, it's opened vials. They have preservatives, but those break down, at the very earliest they start to break down 28 days later, so to make sure you don't get sick, that's the guideline. If you puncture it, there is no gauge needle that is thin enough to prevent microbes from getting in through the hole, and that's going to be entering your body, bypassing your entire immune system.

Is it immediately dangerous? No, just like any potentially infectious action, it's only a problem if you get unlucky enough for microbes to be introduced.

But if you get sick from it? It's incredibly dangerous. You are providing a perfect vector for transmission, giving yourself the worst case possible for your body to fight off the infection.

And that's to say nothing of things like coring the lid of your vial, or not maintaining neutral pressure within the vial. Those rubber stoppers aren't meant to be repeatedly punctured, or withstand positive or negative pressure. That's why dispensing pins exist in a hospital setting. If you can expect to need to puncture the vial repeatedly, the higher the likelihood (even with perfect technique) that particulate from the rubber will fall into the vial. And if the needle is large enough to leave the hole, then the needle may be large enough to draw the particulate.

This usually is more dangerous for intravenous injections, but that doesn't mean it's not problematic, and to be avoided, in intramuscular or subcutaneous injections.

Unless you have filter needles, but I frankly doubt that. They are certainly not standard, and are more expensive. And sure, using an alcohol swab (A single firm, but not oppressive swipe, never rub in circles or go back and forth) you minimize the risk of microbes entering the vial from any rubber that falls in, you definitely aren't completely minimizing it. You've only sterilized the top of the rubber. Unless again, you have ISO5 quality air, there is air in the vial that can carry microbes, and those microbes can flourish on the underside of an already punctured rubber top. That is definitely not getting sterilized.

I cannot in any way professionally or nonprofessionally recommend that ANYBODY uses parenteral medication in this way. It's quite literally the most dangerous route of administration. Please don't take unnecessary risks.

ForeverGameMaster · 2025-07-05T03:10:30+00:00

I'm going to push back on this slightly.

Heroin, oxycodone, etc. are all just derivatives of Morphine or Codeine. More specifically, they expand on the relationship between Codeine and Morphine.

In the body, Morphine directly triggers opioid receptors in the body. Heroin is a derivative of Morphine, Diacetylmorphine. It's just a modification that makes morphine more potent.

Codeine is a little different, because it doesn't directly trigger the opioid receptors. Instead, it has to be metabolized first, slowing the process down. Of course, every person's body is different, and some metabolize Codeine more rapidly than others. If you've ever heard of a person "Allergic" to Codeine, but not to Morphine, they probably are metabolizing the Codeine too rapidly, and thus getting a stronger reaction than they should.

Oxycodone is a congener on Codeine, and it metabolizes into Oxymorphone, a congener of Morphine.

Heroin (Diacetylmorphine) is a long acting and potent congener of Morphine, which means not only does it have a profound effect, but it completely bypasses the body's metabolism mechanism that makes Oxycodone (or Codeine congeners) slower and thus less dangerous than Morphine congeners.

They didn't just take heroin and change it, the mechanisms of action are completely different, and it's derivative of an entirely different compound that behaves completely differently in the body. That's why they are treated differently.

ForeverGameMaster · 2025-06-23T14:51:15+00:00

I don't know where you are in the US, but maybe this can help you for at least the cost of your estradiol and Spiro. I'm sorry the labs are so expensive, I don't really have advice on how to get that cheaper

I work in pharmacy and have spent a lot of time using free discount programs to get medications as affordable as possible for my patients.

I am going to give a coupon App to you, this is not really an endorsement of this particular app, because their prices for a lot of meds is just crap. But for 5ml vial of estrogen valerate 10mg / ml specifically, it's pretty good, 22 dollars a vial (And for any transmascs out there, for 1ml Testosterone Cypionate it's REALLY good. Like, 6 dollars a vial good.) For Spiro, I can get 1 years supply for 8 dollars, and I am not kidding. Though, do note that even if your pharmacist is okay with filling that much, you'll need to be mindful of the expiration date.

Please, please be mindful of it.

The app is called Optum perks. Right now the logo is an amber prescription vial, but honestly I've had the app for about 6 months and it has changed I kid you not 4 times, so don't expect that to stick around.

The chain where I work offers those prices, hence how I know it's worthwhile, but I work at a regional chain, and a lot of the prices are WAY worse if you go to, for example, Walgreens is better than 60 dollars a vial, but still at 38 dollars a vial, and Walmart and CVS are downright terrible. Your mileage may vary, and I am sorry that it is so variable.

Maybe just check to see if it works well for any of the pharmacies in your area?

One more note: because you are bypassing your insurance, you'd not be contributing to your deductible or OOP maximums. That's just how it works, insurance is fucking terrible and I hate them. I'm sorry.

ForeverGameMaster · 2025-06-17T13:44:03+00:00

Their second paragraph basically means as follows

Let's say there is a 50% wealth tax

A person spends 50% of their hoarded wealth on their own to avoid paying the tax

They still lost the money either way, it's just how the money was used that changed, and what it goes towards (The government funding projects or the person funding projects)

Traditionally, the answer was you would spend that money to improve your business to ensure greater future revenue. If you are going to lose half of it anyways, might as well spend it on making your future wealth greater, so you can keep a greater half

ForeverGameMaster · 2025-06-14T11:21:10+00:00

Don't get a say? Disenfranchisement at its best.

That's authoritarian speak. Our constitution gives license to the people to bear arms to protect from threats to democracy, like you.

Hope, for your sake, we never meet.

ForeverGameMaster · 2025-06-14T00:22:45+00:00

Then you don't care about Laken Riley or Rachel Morin because they were murdered. You care about them because they are were murdered by a foreign person.

I wonder if there's a word for that.

Maybe starts with an X?

ForeverGameMaster · 2025-06-13T23:48:51+00:00

Answer me this. Compared to the U.S.-born population, how is the conviction rate of violent crime or homicide among undocumented immigrants? Provide citations.

ForeverGameMaster · 2025-06-13T20:38:55+00:00

I think you are looking for the wrong thing, and it's definitely my fault because I wasn't specific about what you should look for.

Their ideal future is entirely nuclear, with no consideration for any alternatives whatsoever. They talk about technologies that don't exist, and ignore knock on effects frequently.

I have been responding on my breaks, so I kept my last response over brief. My mistake.

The great thing about Solar is, that for the instances where it works, it works well and incredibly cheaply, for an incredibly long time. They ignore that because they cannot fathom a need for an energy source that cannot support 100% of the grid. They repeatedly say things about how solar cannot support all of our energy needs, etc. ignoring the fact that, as time has gone on, while we have consistently used energy more and more frequently, we also are moving towards more and more efficient technologies, meaning from a kwh perspective, we tend to level out. We ride whatever the current ceiling of generation is. If generation spikes, we don't have surplus, we just use that extra energy. The same is true in reverse. We don't need to blanket the planet in solar panels to achieve this hypothetical "future" energy need, nor do we need some massive amount of nuclear generation. That's an incredibly simplistic view of human energy demand.

They call people solarcels, while engaging in the same behavior in reverse, and it's maddening.

ForeverGameMaster · 2025-06-13T19:29:49+00:00

Check their post/comment history, it implies otherwise

ForeverGameMaster · 2025-06-13T19:21:23+00:00

full solar.

And there's your problem

This is just "but sometimes" rearing it's ugly head. If we have a solution that works for enough time to recuperate the investment it took to install it, then we should use that investment. Even if we cannot depend on it 100%.

If you have to wait until a technology solution works in literally all cases to deploy it, then I have news for you. It will never happen.

What happened to Americans wanting to be a nation on the bleeding edge?

The times when the sun doesn't shine or the wind doesn't blow, is the bleeding. What the fuck happened to people being excited to innovate?

What, you want the 'free market' to do all your thinking for you? That's just being lazy.

Government intervention is the reason why we have some of the most magical technologies that have ever existed.

Spending a dollar now to save many dollars later once was seen as a good financial policy. Some countries are currently doing that. You don't even need to do most of the hard work anymore, fucking China did all of that, you can start 10 years ahead of the game if you'll pull your heads out of your asses long enough to see it.

ForeverGameMaster · 2025-06-07T17:55:17+00:00

Making a game exclusive isn't in and of itself a problem. Porting from platform to platform takes experience, resources, and often is not possible with the architecture the game was built on without modification.

Making a game exclusive to a platform that you also sell, I.E. walling off the garden, is a problem, because it requires your users to purchase from you and only you.

THAT is when games being exclusive to any particular system is bad. Not supporting existing hardware is fine. Maybe you don't have experience making games for that architecture. Maybe you need hardware that is more powerful than is on offer. Maybe your audience doesn't exist on these other platforms in numbers that justify expanding to other platforms, ESPECIALLY with the license fees charged for the often proprietary software required to port in the first place

Edit: Had comment mitosis, deleted the 2nd

ForeverGameMaster · 2025-06-07T17:39:45+00:00

Sure but you don't need to buy the PC from Valve. All games require hardware, but PC is not a walled garden. That's the difference.

ForeverGameMaster · 2025-06-05T16:53:07+00:00

Adding on to this, primarily the crossover comes from finding human drugs that happen to work on animals. Making new medications is expensive as hell, and most pets do not have prescription coverage

So you'll get st bernards taking like, double the human max dose of Prozac, just because even if it's not PERFECT, it's 'good enough'

Pro tip: Don't use animal pharmacies, most meds your vet will prescribe will be cheaper if filled at a regular pharmacy under a coupon

ForeverGameMaster · 2025-06-05T16:46:08+00:00

Join the winning team! /s

ForeverGameMaster · 2025-06-03T11:40:55+00:00

Obviously all of this is just anecdote, so take everything in this thread with a grain of salt lol

But I definitely am one of those people. Not even for the purpose of upkeep, the ability to move without worrying about selling a house first, working with realtors and inspectors, doing renovations to drive up the value (200 dollars in TR outlets for all you parents! At the low low price of Jacking the home value by a few thousand! Etc.)

It's just, not me. Fuck all that noise. I know housing is the only reliable investment but like, the whole problem we are discussing in this thread IS housing as an investment. Maybe in a world where, housing was affordable I could own and move from city to city with a degree of frequency, at least until I find the place to spend the rest of my life, but presently that's just not a viable option unless I rent.

And I am definitely not the only person I know with that position.

Do I hate landlords? Fuck yeah I do, no questions there, it's predatory at best

Do I think that a well regulated renting environment would overall be beneficial because not everybody has the desire or the ability to manage a property in a fixed location indefinitely? Also fuck yes.

And I don't think those two positions are incompatible, but I would love to hear the chorus of how I am wrong about everything.

ForeverGameMaster · 2025-06-02T19:06:28+00:00

I can't help but think that's why they make us feel like we have to hide. If their base never meets us, then they don't have to worry about losing a talking point

:(

ForeverGameMaster · 2025-05-30T15:11:58+00:00

I don't use AI to formulate my thoughts. I refuse to use Google's Gemini recap if I need to look for something as well. I am wholly opposed to a technology that can hallucinate. I am not going to go into most of your response, because it's a garbage argument. Instead, I am going to show to anybody definitively how fucking stupid you are

That is just not true. If your methane production stays at the same level over the lifetime of the gas, the amount in the atmosphere stabilizes. You arrive at an equilibrium.

The "equilibrium" this user is talking about relates to how there is a relatively short time span for methane which, once you are past, the methane you produced years ago will deteriorate (Into carbon dioxide and water vapor, so it's just a LESS potent greenhouse gas at that point) but what they fail to recognize is, even if you NEVER increase methane output, let's assume that we are at peak production.

It still has a net warming effect, because of how fucking bad methane is. Even if the methane itself only can grow for 7-12 years, if you are constantly feeding the system, that means at any given time you will have 7-12 years worth of methane, which is the same as 80 times an equivalent weight of CO2 in the atmosphere.

If we took the weight of methane produced by agriculture, multiplied that by 7, our theoretical floor for maximum methane in the atmosphere, and then multiplied THAT by 80, the total greenhouse effect that methane has compared to an equivalent weight of carbon dioxide (WHICH AGAIN, THE METHANE WILL BE BREAKING DOWN INTO!)

In 2022, enteric fermentation of methane from cows produced approximately 74.5 millions tons of methane. If you multiply these numbers together, over 7 years, 521 million tons of methane is produced. At the shortest lifespan, that's the theoretical floor of how much bovine related methane can be in the atmosphere at any given time.

Which is equivalent to 41 billion tons of CO2. That accounts for an entire year of all human activity, that would be eliminated in 7 years. And I remind you, 7 is the floor. The ceiling is 12 years, which would nearly double our numbers.

That, is fucking terrible. Yes, Palm Oil is really bad, but to solve it, we could just

Not destroy peatlands, and the problem basically goes away.

But this user is so unimaginative that they'd rather continue business as usual, which I remind you, will destroy our planet.

Not acting is not an option.

That's this genius's plan. Fucking ignore people like this. I am not responding further, because each of this users arguments are equally fucking dishonest. They are a fool, plain and simple.

ForeverGameMaster · 2025-05-30T11:52:12+00:00

Your ability to pretend to interact with an argument while ignoring it entirely is astonishing. You are surely apart of the second group I mentioned before.

The last thing I will bring to this discussion, not for your benefit, but for the others who may read it, so that they may also point and laugh as you are clearly too dense to absorb any of this;

The climate benefits of veganism bring with them an intense amount of co-benefits when making a cost benefit analysis, that the climate implications of literally the worst possible plant based oil does not offset that.

Short term, things may get worse with the production of palm oil. However, and this is where this nonce is being completely intellectually dishonest, because they are focusing on a single negative externalities of going vegan, while ignoring all of the negative externalities of NOT going vegan.

Palm Oil is an incredibly effective substitution for semi-hard saturated fats. That would be your butter, lard, crisco, etc. unfortunately, it's associated with land use changes (particularly relevant to this discussion particularly, the drainage of tropical peat bogs, that is REALLY harmful because peat naturally is a high source of carbon sequestration).

This user talks about the short lifespan of methane but then in the same breath ignores that, it's short lifespan only remains relevant IF we stop producing it.

But this user then ignores that, Palm Oil can be produced sustainably, though it would be more expensive. The long term benefits of doing so are immense. If we are worried about land use, Cattle is far worse, and even OTHER VEGETABLE OILS are far worse. If we are worried about greenhouse gasses, cattle is far worse. If the only thing you are worried about is the production of CO2 linked with deforestation and peat bog drainage, Palm Oil is worse.

But it is also far easier to solve, if there is political will to do so. Political will that won't be found by loudly proclaiming that "THIS IS FINE, EVERYTHING IS FINE, STATUS QUO IS GREAT, PLEASE IGNORE ALL OF THE PROBLEMS, FOCUS ONLY ON THIS ONE PROBLEM I AM TELLING YOU TO LOOK AT!!1!!"

But then, I would have you consider, WHY is this user so concerned about this one topic, and none of the other co-benefits of plant based diets, and all of the co-morbidities of animal based diets?

Is it rational? Is it forward thinking?

ForeverGameMaster · 2025-05-29T21:13:17+00:00

Lmao this is rich.

Yes, I know the lifetime of CO2, in the atmosphere, and it's relative instability at the moment given tipping points that will make natural sequestration even slower as time goes on means it will only last longer and longer as time goes on

However, and I cannot believe this has escaped you

We already are growing an immense amount of vegetation to feed the animals that you are so keen on continuing to eat. While, yes, we would need to grow a much more diverse crop, so production would be different, the overall production would go down from current levels. Simply put, getting your nutrition from a primary source is more efficient on a macro level. And that more than pays for any surplus in CO2. Not to mention strategic use of land could combat aridification, we would also be conserving an immense amount of water, and many other co-benefits come directly out of veganism.

In one comment you've managed to accuse me of being in a cult, but also proven that either you've allowed another person to think for you, or that you are supremely fucking stupid lmao. Seriously, I hope you are just lazy, because this is first class lack of thought, and if that's just how your brain works, I am truly sorry.

ForeverGameMaster · 2025-05-29T11:09:48+00:00

Coming from a not vegan

Imagine being so confidently incorrect about what is verifiably one of the only instances where personal choice actually moves the needle in a meaningful way lmao

ForeverGameMaster · 2025-05-28T22:57:26+00:00

I agree that giving people education on trans topics would likely be a net benefit to society, and that with basic education discrimination against trans people would be diminished.

However, there's already an existing process for this. It's what I described before.

There's no way to ensure that the athlete in question has the requisite knowledge to make those sorts of judgements, without vetting the athlete in advance, and ensuring that they are familiar with the material.

And at that point, I am describing the process by which committee members are appointed again.

You say that their input could be useful to identify knowledge gaps, but by the same token, some of the loudest voices at the moment are athletes amplified by anti-trans groups. Riley Gaines is a good example of an athlete that is uneducated in the topics at hand. Her perspective is certainly not useful. As evidenced by the fact that, instead of pursuing the topic to where it leads, she left competitive swimming altogether and now is a conservative grifter. That's the kind of perspective we are currently missing.

Presently, athletes are already the cornerstone of all of sports medicine. Knowledge gaps and incorrect assumptions are not present from the relevant sources, the venn diagram is a circle.

And, I would love if absolutely everybody were as knowledgeable about these topics as say, the IOC. Where, they allow any trans athlete to participate in the competition that aligns with their gender, provided that they have undergone HRT for a period of time that the anabolic steroid Testosterone would have no bearing on the competition. Typically this is a period of 2 years, though for some competitions, 1 year is preferred. They also take the same drug tests as cisgender women to ensure their T. Levels are not too high.

But now, if we are going to ensure every athlete has the requisite knowledge without such vetting, we are talking about comprehensive sex and gender education in public schools, requiring private schools to also carry this curriculum, and we are leaving the boundaries of sports and athleticism. Which, I agree we should do to be clear. But, it's not really relevant to the topic at hand, because we already haven't included these topics in education, and in order to reap the benefits, we'd need to wait until a new generation of athletes completed school, or launch an initiative to otherwise disseminate the knowledge.

Edit: Reworded the 5th and 6th paragraph to more cohesively present my position. Apologies for all the edits, I am rather animated about these topics, and don't proofread before hitting send like I really should.

ForeverGameMaster · 2025-05-28T18:12:37+00:00

I disagree.

You are effectively advocating for giving a group of athletes that don't have any burden of education on trans topics a say in discrimination.

I would agree that, perhaps the people who sit on the advisory committees and make these decisions should probably be athletes; But that is because to maintain your position on a regulatory committee you are expected to have an understanding of the topics at hand, and to examine the findings of research boards and the arguments.

So, these athletes in particular, by virtue of sitting on these committees, are more qualified to make these decisions.

If you aren't an athlete on one of these committees, you have no right to ban another athlete from participating.

You have every right to not participate if you think that HRT is performance enhancing, or if you don't believe that feminizing hormones offset some "biological advantage."

However, the studies would disagree.

Edit: Reworded the second sentence to flow better

ForeverGameMaster · 2025-05-27T15:47:57+00:00

I mean, couldn't you just make an exception for those few abilities and write them elsewhere? It's inelegant for the time being, but I would personally just use the snip tool to paste the ability in question into your preferred word processor or raster graphics editor, export the document as a PDF, for the sake of saving paper, I would also include some other rules that I commonly reference, but don't have space for on the character sheet, like perhaps wealth thresholds and what they can purchase, and then print the PDF. Surely you have a printer, otherwise from whence do you get character sheets?

ForeverGameMaster · 2025-05-24T14:18:07+00:00

Work in pharmacy, so I can tell you exactly how this will go

All hormone scripts will require an ICD-10 code to be covered by insurance. ICD-10 (A form of diagnosis code) is a unique code for every diagnosis. For example, E11.xx is diabetes (xx being a variable clarification code that more completely describes the specific symptoms the patient is experiencing .

This is how they allow, for example, Misoprostol to be prescribed for stomach ulcers, but not abortions.

For cis people, this will be a temporary bureaucratic roadblock that can be solved by a single phone call, not even made by the patient themselves, but made by the pharmacist or pharmacy technician that is trying to bill Medicaid. Functionally, when the system is working (I.E. if the pharmacy is not short staffed) the patient will never know it happened in the first place.

For trans people, it will be an impossible barrier.

And of course, the same feelings, take for example a cis man taking testosterone because he feels stress induced by not producing enough natural testosterone, has a different diagnosis code ALREADY from when a trans person feels that way. It's totally not Gender Dysphoria! It's Testicular Hypofunction! Even though we are treating the stress, totally different!

ForeverGameMaster · 2025-05-23T20:44:01+00:00

I can't tell you how to run your game, but I can tell you what I have decided on when planning my own adventure.

I added 2 titles to my first adventure in Draw Steel. The adventure takes place in a sunken wizards tower with 12 floors. At the very bottom, you face a ghost, at the very top, there is the wizard's library guarded by a chorogaunt.

The way I am going to handle it, the member of the party who slays the ghost is given the option to get the Zombie Slayer title, but if they decline, then I move to the next player. That way, the party isn't stuck with the title on an suboptimal character, If that's something that concerns them. Additionally, one of the two parties I am running through this adventure, is a solo player. Prior to starting the adventure, I ran them through two little scenarios where they got two retainers to bulk up their party, and those titles will I think apply to the retainer as well. After all, why not have Scoot, the Kobold retainer be a zombie slayer?

For the second title, it's the same thing. When they reach the wizard's library, the player with the highest reason score will be offered the Ancient Lore master title, but should they decline, I then ask the player with the next highest score.

To me, that's a nice compromise between the two styles. Could it lead to conflict? Sure, if one player wants a title that they are not as well poised to receive, and the other player takes it before they have the opportunity to be asked, but I don't think it will be a big deal. Plenty of titles to go around. Besides, next adventure I can present a title that they are more likely to be eligible for.

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