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Tagging System
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#dusk oc writing — my writing
#dusk rambles — Casual rambling and fandom-related thoughts
#dusk answers — Ask box and reblog responds
#dusk translation — English translations of media I enjoy (outside of Genshin Impact)
#genshin translation — English translations of official and unofficial Genshin Impact media. Mostly my Chinese to English translations, but other languages and other people’s posts might also show up
#dusk analysis — (Multi)media analysis. Might overlap with #dusk rambles
#dusk fan writing — Fan fiction (dialogue, poems, short stories, vignettes, etc)
#dusk lyrics — English translyrics (may overlap with translation. I will link the original work and translation referenced, if applicable. If there’s no link to a translation, it means I translated it myself.)
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Kinda funny that it turned out this way, but I suppose I do have Unprocessed Things after all if I had That sort of reaction as an audience to what’s otherwise a pretty fun and lighthearted production
It feels unreal that the reaction(s) happened, but the show was mesmerizing still
I started a new medication four days ago. It dramatically improved symptoms within 24 hours.
I just hyper focused on a project for a few hours for the first time in almost two years.
And yesterday, I realized partway through a client session that I was clear-headed, not fighting through brain fog, and was able to hold the client’s whole history in my head while working with them. I haven’t been able to do that in … I don’t know how long. Years.
I haven’t had brain fog for the past three days. I haven’t had a migraine for the last two days. I haven’t had to take a triptan / migraine rescue med all week.
My face is noticeably, dramatically less puffy with inflammation. My ears haven’t turned bright red with vascular pressure in three days, when that has been a near-daily occurrence since late 2021.
I can think. My mind is moving fast like it used to instead of sluggishly churning. I haven’t lost words partway through a sentence in three days. I’ve been able to access words reliably instead of groping for super common language and failing to find it.
My joints don’t hurt nearly as much, and don’t feel nearly so “floppy”/“loose”. A few days ago, my physical therapist confirmed that the inflammation around my joints is remarkably reduced, less swollen to the touch. My head isn’t hot to the touch. I slept on my side for a little bit last night and it didn’t immediately mess up my neck. The tinnitus isn’t quite gone, but it’s definitely less intense.
I had given up on ever being my old self or having my brain back. This is… this is wildly hopeful.
I started on 2.5mg zepbound. (I wanted vials to microdose with, buuuut insurance only covered the 2.5mg auto injectors. Hopefully this is tolerable. If the side effects are too much, I’ll resort to paying out of pocket for vials.) I was already frighteningly, intimidatingly hopeful about it before starting it, from the research papers and case studies and personal stories I’d read.
Here’s the paper that started me down this rabbit hole: Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.
“Among 47 cases (mean age 39, range 15–71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.”
Some more resources:
A possible new treatment for MCAS - roundup of research, case studies, etc.
Article sourcing interviews with practitioners/specialists who are prescribing it
Emerging roles of glucagon like peptide-1 in the management of autoimmune diseases and diabetes-associated comorbidities - This goes over a number of things that this med helps with, including PCOS, psoriasis, IBD, and Alzheimer’s.
Many of the studies on this with various conditions are relatively small and preliminary, but very promising. Hashimoto’s, multiple sclerosis (it seems to lead to re-myelination??), OCD (?!), rheumatoid arthritis, fibromyalgia, lupus, and … well, basically any condition that involves chronic inflammation. It’s also thought to have immunomodulation effects. Some folks are even reporting that it helps their c-ptsd symptoms and adhd symptoms. Obviously it also helps histamine-elevated anxiety, but that goes with the mcas treatment bit.
There’s currently a large trial (n=1000) in progress for its impact on long covid.
Also, iirc, no one in the MCAS study became underweight. Just symptom relief.
I did … way too much reading before getting on one of these myself. Lots of browsing forums where people share complications and experiences, trying to deduce a pattern in the problems. Here’s what I found (not scientific at all, just me looking for patterns in personal stories). Disclaimer: none of this is medical advice, I’m just sharing stories and observations, I am not a doctor, etc.
Sometimes people have reactions to the injection site. This may be due to nickel allergies and is sometimes cleared up by switching to a nickel-free needle (which aren’t terribly common, weirdly?).
Tirzepatide (which acts on GLP-1 and GIP) seems to be better tolerated than semaglutide. When semaglutide doesn’t work or causes intolerable side effects, people sometimes have better results when they switch to tirzepatide. But semaglutide does seem to improve symptoms for a significant subset of people.
Tirzepatide from a compounding pharmacy (which is more budget friendly and easier to get ahold of) is more likely to have complications than tirzepatide from the original manufacturer. Probably due to consistency issues. I also wonder if some people are having a reaction to the B-12 that compounding pharmacies frequently include in the tirzepatide solution. (I have no data to corroborate this suspicion, just speculating based on how mcas sensitivity can be with various components/additives of medication.)
People have more issues on higher doses. Currently this stuff’s only usually covered by insurance (in the u.s. at least) if you’re prescribed it for obesity or type 2 diabetes. The starting dose for diabetes (for tirzepatide anyway) is 2.5mg a week (injected). The starting dose for obesity is often 4-5mg/week. If you have mcas/are medication sensitive, this can be Way Too Much. Microdosing is not FDA approved, but i read mostly of people starting microdosing at 0.25 - 0.5mg a week. Microdosing generally causes fewer issues.
The other time people have issues is when they don’t hydrate enough, don’t eat enough protein/fiber, or try to eat larger meals instead of ~6 tiny meals through the day. (On day 2-3, I ran into the consequences of not eating frequent small meals quite enough. The slowed gut motility is obnoxious. Still figuring out the best rhythm for that and hoping it improves, as i’ve heard it often can. I’ve basically had one side effect per day, and each side effect goes away after a day, and then I get the next one.)
As for getting prescriptions: Rheumatologists are getting increasingly aware of this and willing to prescribe, so that’s a possible route if you’re already seeing someone who stays up on research. Otherwise… it’s hard to get on without a 27+ bmi and an additional condition (sleep apnea is a common one, but others are high bp, high cholesterol, fatty liver, and I’m sure there’s others). Possible, but more difficult.
Anyway, I can’t possibly sit on this. Obviously I’m only on day 5, haven’t even taken my second shot yet, but. The positive effects have been unreal. I didn’t think I was ever going to feel clear headed again, I’d nearly given up hope of more than marginal improvements. I’ve been dealing with severe symptoms for nearly five years. (And less severe symptoms for many years before that.)
Two week update…! I tallied up my migraine days / severities / etc over the past 6 weeks.
The 1 month before starting tirzepatide:
4 severe migraine days
9 moderate migraine days
14 mild migraine days
3 migraine free days
The past two weeks on tirzepatide:
1 moderate migraine days (had the migraine before taking the first shot so this might not count)
6 mild migraine days (concentrated around the couple days before the next dose, and/or the couple days before my menstrual cycle began)
7 migraine free days
All while maintaining a fairly stable weight. (Been hyper-vigilant about getting enough protein and hydration as neglecting those are the biggest pitfalls people fall into with this medication.) Actively trying to maintain a stable weight for now just to make sure I can manage caloric needs on this med; I dont want to lose muscle, that would be bad on so many levels.
And my neck was pretty badly misaligned for a good portion of the last week, which historically would mean severe migraine time… but instead I just had the neck discomfort without hardly any migraine. And minimal fluid backup/inflammation. (Confirmed by my physical therapist who was very surprised by how bad my neck was yet how low my pressure/inflammation was.)
But also my joints are more stable overall, and go back into place easier, and stay there for longer once they’re where they should be. Everything is less wobbly since there isn’t so much swelling. AndI mean everything - neck, wrists, fingers, hips, knees, ankles.
Haven’t noticed any worsening in POTS symptoms either. Haven’t noticed POTS symptoms at all, now that I think about it. Haven’t been tracking those like I’ve been tracking inflammatory symptoms / migraine / mast cell stuff though.
Also I haven’t taken an antihistamine in two weeks??? and barely taken any anti-inflammatories / NSAIDs, and only one dose a day when I do take an NSAID???? I was taking waaay too many NSAID’s prior to this just to function. (and in the past few months I started feeling fairly prompt, sharp negative reactions to NSAID’s - cramping and abdominal pain - so I knew the 15+ years of 600-800mg ibuprofen, sometimes multiple times a day, was finally catching up to me and something needed to change.)
My body feels better. I feel better in my body. My brain feels better, I don’t feel like I’m walking with a concussion all the time. I haven’t lost words partway through a sentence in 2 weeks. I’m in less pain.
My mood has improved. I’m down to my pre-quarantine summer dose of my antidepressants do the first time since 2020 (and realizing I may have been using the higher dose to brute force my way through the cranial pressure brain fog). There’s bit of extra somatic anxiety, but I’m not sure if that’s situational/environmental/related to deadline stresses, or if it’s chemical. Will have more clarity on that in a week or so.)
Oh and the digestive side effects have improved dramatically. Whew. That’s the one I was most nervous about. I can tolerate a lot of side effects if it means I get to be *me* again, but my understanding is that certain severe levels of slowed gut motility are as debilitating and life-interfering as the kind of migraine stuff I was dealing with. I’d rather not just trade one problem for another of equal severity. But it’s looking like I’m gonna be okay on that front. (Keeping fingers crossed but overall relieved there.)
The 3 inches (7.6 cm) of fluid/inflammation/?? that disappeared from my waist after the first few days has not returned. Hasn’t gone down any further, so I suspect that was the amount of pure… puffiness/inflammation/fluid-retention I was dealing with. Was briefly worried it was fluid loss from digestive issues but the measurement hasn’t changed after my digestive stuff improved. And I have been hydrating sooo much. So that’s fascinating and a bit wild.
getting lost in boston is fun because I turned around on a street corner three times and some guy yelled "hey stupid! the bus is that way!" very helpful interaction and accurate insult, 10/10 no notes
one time I walked around a building a couple times looking for a bathroom and this guy went "this bitch thinks she's on a merrygoround, where the fuck are you tryna go? bathroom? one floor down to the right behind the door that says bathroom."
My very first time in Boston. I was absolutely miserable, trying to drag my giant suitcase up a lengthy set of stairs in the pouring rain. This guy who had already reached the top looked back at me with the most pure expression of disgust I’ve ever seen in anyone’s eyes, marched back down the stairs, grabbed my suitcase, carried it to the top, left it there for me, and walked away without ever saying a word. I think about him often.
For the people in the notes going "why is Boston like this": a) the insults are a way to show you have no ulterior motives when helping someone (and don't need to be thanked or repaid), and b) Boston was settled by the Irish
also the Italians. mixing Irish and Italian sociocultural attitudes had the effect of multiplying the Sass Levels by the power of infinity, in the sense that you get all of the clever dry wit of the Irish and all of the bitchy gossipy condensation of the Italians rolled into one very stereotypically overly-friendly American package.
also worth noting that who you are to them doesn’t matter. they’ll talk to strangers like that and will also talk to their best friends like that. they’re just Like That.
By and large, Bostonians do not help you because they are secretly kind. They do it because they refuse to suffer fools. When they see someone do something they think is stupid in public, they are angry because they have to witness people being idiots. The only way they can get rid of the problem -- someone being an idiot -- is to fix that person's problem so they don't have to watch your bullshit anymore. So they help you, and they berate you for it. They will go tell their friends how you ruined their morning and wasted their time for being a fucking idiot. If they help you dig your car out in winter because you don't have a shovel, they may even gift you a shovel. This is not an act of generosity. They do it so they never have to endure your incompetence ever again. From the bottom of their hearts, they hate you and never want to see you again.
However, the "well, someone's gotta do it, and this idiot won't, so I will" mentality secretly betrays that they have extremely strong values about caring for a community. If people can't take care of themselves, someone else has to do it, and if you're the one seeing it happen, that someone is you.
Through this process, there is a random chance that the angry Bostonian will adopt you like you are a helpless puppy. This is especially true if they see you make the same mistake on a routine: every day, this person does not take the bus even though a reasonable person would; they don't know how to care for themselves, I must watch out for them. If every day at 8pm you drop your bag, you may be an idiot, but you're an incurable idiot. You can’t help it, you need ongoing assistance, so they will show up at 8pm every day and insist that they carry your bag whether you like it or not. They'll give you a hard time, because you've given them a new job, but it evolves into a secret affection and extremely strong protective instinct. They will not let anyone fuck with you. They will throw down for you. They will be sad if they don't get to see you anymore, but they will never admit that or even that they like you. They will give you a $100 gift card to dunkin instead.
This response is much more likely if they realize you're not an idiot, you are just physically unable to Do The Thing. In this case, they have nothing to berate you for, but The Job Still Has To Be Done, so they silently carry your suitcase up the stairs. This also happens with moving heavy stuff on and off the train. They will not ask permission and they probably won't speak to you or even look at you. And they'll shovel the snow out of the 80 yr old neighbor's front yard because someone's gotta do it, and grandma can't. Unless you look out your window at the right time, you may never know who plowed your driveway. They may even outright deny it because they don’t know how to accept affection.
A defining characteristic of the Bostonian psyche is their deep commitment to care for those who cannot care for themselves, the bitterest hatred for anyone who can but doesn't, and a compulsive need to fix problems (real or imagined).
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to everyone in the notes asking for a translation:
panel 1: "weigh your heart" (the suffix pronoun for heart should be .k not .ti i think but i see what you are going for. also, my copy of faulkner doesn't have a copy of the word but it's pretty clear from context what it means)
panel 4: "what"
anyway op good job this is really funny and better than 99.9% of hieroglyphs on the internet
xAa is 'to throw/dispatch/abandon' because fAj is the verb 'to weigh' (this can be checked on the Thesaurus Linguae Aegyptiae), .tj should be =k as already pointed out.
Thus with xAa as the imperative 'dispact/throw', the scales determinative doesn't belong to that word and is thus a word in and of itself the 3-consonant jws.w (the .w is just a plural, it's still 3-consonants), and then .tj which should be =k.
It's more: xAa jws.w ib=k 'chuck your heart on the scales' *ma'at gets obliterated* ptr 'what'.
As an aside; it's not good practice with Middle Egyptian to go 'we can infer this from context' when you can't find that word in one dictionary. You should be consulting at least three. Also, because my ass has been doing this for nearly 20 years, just so you're all aware xAa is in Faulkner:
This is page 183 of my personal copy of Faulkner's Concise Dictionary of Middle Egyptian. xAa is right there! You'll see that the picture of the entry for the TLA also cites it as FCD 'Faulkner's Concise Dictionary' 183.
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realizes wearing my necklace helps me feel like myself
Not unlike wearing clothes I like but the necklace’s slight weight and texture feels nice
Also, nothing like drawing a persona(?) and realizing he’s got a similar hairstyle as my other persona (?) whose design I really like (who also has a necklace, albeit his is of the Little Dipper which includes Polaris—which is also associated with my other other persona(?)), maybe from a gender perspective
Anya is live and ready to show you everything. Watch her strip, dance, and perform exclusive shows just for you. Interact in real-time and make your fantasies come true.
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Was driving with my grandmother and in broken English she says “no eyes… no nose… no face. Don’t trust.” To which I looked around wildly in search of this omen of ill portend.
