chronic illness ghost

I've made great progress on my own pelvic tightness, there's exercises you can look up online to loosen your pelvic floor. There's also this sex toy specifically designed for people with tight pelvic floors. It's done wonders to loosen mine.

Back before there was more people in the medical community flagging the pelvic floor as the culprit, and it still happens sometimes with less informed medical professionals, any hint that a trans man was getting cramping was chalked up to "uterine atrophy." And trans men would be sent to get a hysterectomy, sometimes without even an ultrasound first, or a second opinion. Which disturbs the fuck out of me, for a number of reasons.

A trans dude on a local transmasc Facebook group posted a while back, about how he's been getting cramping and his doctor wanted him to get a hysterectomy just based on his descriptions of symptoms alone. I don't even think his doc even did a physical exam, and he definitely didn't send him to a [trans friendly] gynecologist, or to get an ultrasound.

So I relied being like, "woah. It sounds like your doctor isn't informed around current health care for trans men. Recommending a hysterectomy without doing a full exam, or sending you to a specialist, or at least ordering an ultrasound, is a huge red flag to me. I use to have your exact symptoms and mine ended up being my pelvic floor. Please ask your doctor for a referral to a trans informed gynecologist."

And they were really grateful because the idea of going in for a surgery just like that was scary.

The current view from medical providers I've talked to is that the relationship between atrophy and cramps is more complex than just "cramps = uterus atrophy, take it out". For example, vaginal atrophy might change the stability of the pelvic floor and make other muscles engage more to compensate. So just getting a hysto might not fully treat it.

Also, cramps aren't necessarily a result of things like endometriosis like some doctors think. A retrospective study of gender-affirming hysterectomy patients [1] found that chronic/cyclical pelvic pain was NOT a reliable endo symptom, because it had a high incidence in patients who didn't have endo. (The reliable indicator of endo was abnormal bleeding). This is important because sometimes gynaecologists can get really focussed on endo or other reproductive health conditions and might not consider pelvic muscle dysfunction as a cause of cramps.

The pelvic floor muscles mainly start at the front of the pelvis and run all the way back to the tailbone. This means that as well as trouble peeing, trouble pooing can also be a symptom of pelvic floor dysfunction (also ✨butthole cramps✨), especially if you don't have any other conditions that could be causing it or you can feel stool getting "trapped" in there. You can get a vicious cycle where straining on the toilet makes the muscles tighten up more. Definitely talk to a pelvic physiotherapist if this is a problem for you; a "squatty potty" footstool may also help.

One catch with looking up info online is that a lot of it suggests Kegel exercises, which are a strengthening move that may not help for cramps and tightness issues. My physio specifically banned me from them. Based on discussions with physios and doctors, my understanding is that the increased muscle bulking from T also applies to the pelvic floor, leaving a lot of trans people with pelvic muscles that are strong but too tight (it's possible for them to be weak and too tight). This can create new issues, or worsen existing ones; some patients don't realise they have an overtight pelvic floor until the bulking from T starts making it painful.

Other things that I tried out were:

Botox injections into the pelvic floor. I got mine done under general anesthetic but you can also get it as an outpatient procedure. Best for if you're getting pain throughout the entire pelvic floor, since they get put in the middle and it can break up "chain reactions" with muscles setting each other off.

Biofeedback. Kind of a subset of physiotherapy, you get given a machine or toy that connects to an app and shows you how your muscles are activating. I have a hard time connecting to the "feeling" of them, so this helps me actively relax them.

Medical cannabis (if you can get it). I used a low-dose 1:1 THC:CBD edible. This worked better than most other pain relief both because it's a muscle relaxant, and because my doctor was comfortable with me taking it as soon as I felt any indication of a flare (rather than waiting until I was "sure I needed it"), so it was easier to do good pain control.

Swimming (if you can) and walking. Some of the muscles in the pelvic floor start at the lower back, run down through the hips, and out the front (hip flexors). These can get super tight if you spend all day sitting. Walking and swimming (esp. front crawl and backstroke) help stretch these out.

Treating my other "unconnected" medical problems. Getting sleep apnea surgery made a HUGE difference to my pain levels even though it wasn't the "cause" of the pain. Turns out that when your body is struggling on a day-to-day basis, that can make your pain conditions worse. Wild.

this does not. they're playing world of tanks which is like the "call of duty" of tank games (casual, players only slightly bad-smelling). it also doesn't have support for tank peripherals. no game does. no trainers do afaik. which means that (assuming this isn't just a video editing) all of that shit they are fucking with translates into mouse/keyboard inputs that the game understands. that's weird/hard and perplexing, uh, and considering that "tank peripherals" aren't a thing that exist i can only guess they built them theirselves

hua mulan: hey i respect MY father so much, and also yours

belle: i would lay down my life for him in an instant, so of course when his life was on the line i didn’t hesitate to set aside whatever identity and thoughts of the future i had had to defend him

hua mulan: that’s crazy i also did that

belle: i didn’t expect that i would end up with more grandeur and authority than i ever could have accessed otherwise, but of course i didn’t forget who i was doing this for or let the power tempt me

hua mulan: 100% with you sister

belle: also the giant bloodthirsty cat creature gives insane dick like you wouldn’t even believe

If you have ever been tempted by a Paleozoic Pal, like a a stuffed trilobite or a full size eurypterid body pillow, now's the time to buy one, before they and a really lovely little museum are gone for good 😭😭😭

As stated in the article, they hold around 7 million artifacts- many of which are orphaned fossils, with the museum taking in collections that otherwise would have been trashed.

Please consider buying a Paleozoic Pal, but I'll also leave a direct donation link as well.

I JUST WENT INTO A FUGUE STATE AND BOUGHT ME A 16 INCH CUDDLE BUDDY WITH PLATED TEETH!! DUNKIE, MY BELOVED!!

HE’S HERE! MY BIG BOY IS HERE!! (And yes he is my BIG boy despite only being 16 inches, you shush!)

He took nearly a month to get here, but that’s because of ALL THE ORDERS THEY’VE BEEN GETTING! OVER 1800 ORDERS! This is why I love the online community!!

For anyone curious what's happening with the PRI they're digging themselves out! An anonymous donor gave them $1 mn which they used to secure a stay on the forclosure for the rest of the year and they're approximately a third of the way to buying their way out of the mortgage.