u/Tilak_1028

My mother was recently diagnosed with MASLD cirrhosis — compensated, Child-Pugh A. She has portal hypertension with esophageal varices (banded), enlarged spleen, plus diabetes, hypertension and hypothyroidism.

We've been managing it seriously for a few months:

• High protein diet (albumin improved 2.96 → 3.62)
• Multigrain flour, seeds, no sugar, no juice, very low salt
• Walking 1 km daily
• Carvedilol + Saroglitazar (Lipaglyn)
• Weight recovered from 54 to 60 kg

What I'm asking:

1. Has anyone here genuinely improved or partially reversed cirrhosis (not just fatty liver grades 1-2)? What did it take?
2. Did your Fibroscan / fibrosis scores improve over time, and how long did it take?
3. Anything you wish you'd started earlier?

I know cirrhosis scarring is largely permanent, so I'm not chasing miracles — just looking for realistic experiences from people who've actually held it stable or seen improvement

Stuck on this and could use a sanity check from anyone who's shipped Play Integrity.

Setup: React Native + Firebase App Check using the Play Integrity provider (Android). Release build, installed on a real device from the Play internal testing track.

The error (logcat during getToken):

requestIntegrityToken(IntegrityTokenRequest{..., cloudProjectNumber=4955...})

E/Volley: Unexpected response code 404 for https://play-fe.googleapis.com/fdfe/integrity

E/Finsky: requestIntegrityToken() failed ... DF-DFERH-01

IntegrityServiceException: -1: Integrity API is not available (API_NOT_AVAILABLE)

What I've already verified (all correct):

- ✅ Play Integrity API enabled on the Google Cloud project

- ✅ Cloud project linked in Play Console → Play Integrity settings (responses On)

- ✅ Play app-signing key SHA-256 added in Firebase

- ✅ Request carries the correct cloudProjectNumber

- ✅ Genuine Play install (installerPackageName=com.android.vending)

- ✅ Device passes the Play Integrity API Checker app — all 3 verdicts — with its own project (so the device + Play services are fine)

- ✅ Same error even after migrating to a brand-new same-account Cloud project

The one thing that's different: this app has only ever been in internal testing — never published to production (Play Console tags it "unreviewed"). I have two other apps with the identical setup that ARE live on the Play Store, and they work perfectly.

Question: Does Play Integrity / App Check require the app to be published to production (reviewed by Google) before it issues tokens? Or should internal testing work, and this is just a provisioning delay after linking the Cloud project (if so, how long)?

The official docs say publishing only affects quota increases, not token issuance — but my real-world results say otherwise. Anyone hit this and confirm what actually unblocked it?

Stuck on this and could use a sanity check from anyone who's shipped Play Integrity.

Setup: React Native + Firebase App Check using the Play Integrity provider (Android). Release build, installed on a real device from the Play internal testing track.

The error (logcat during getToken):

requestIntegrityToken(IntegrityTokenRequest{..., cloudProjectNumber=4955...})

E/Volley: Unexpected response code 404 for https://play-fe.googleapis.com/fdfe/integrity

E/Finsky: requestIntegrityToken() failed ... DF-DFERH-01

IntegrityServiceException: -1: Integrity API is not available (API_NOT_AVAILABLE)

What I've already verified (all correct):

- ✅ Play Integrity API enabled on the Google Cloud project

- ✅ Cloud project linked in Play Console → Play Integrity settings (responses On)

- ✅ Play app-signing key SHA-256 added in Firebase

- ✅ Request carries the correct cloudProjectNumber

- ✅ Genuine Play install (installerPackageName=com.android.vending)

- ✅ Device passes the Play Integrity API Checker app — all 3 verdicts — with its own project (so the device + Play services are fine)

- ✅ Same error even after migrating to a brand-new same-account Cloud project

The one thing that's different: this app has only ever been in internal testing — never published to production (Play Console tags it "unreviewed"). I have two other apps with the identical setup that ARE live on the Play Store, and they work perfectly.

Question: Does Play Integrity / App Check require the app to be published to production (reviewed by Google) before it issues tokens? Or should internal testing work, and this is just a provisioning delay after linking the Cloud project (if so, how long)?

The official docs say publishing only affects quota increases, not token issuance — but my real-world results say otherwise. Anyone hit this and confirm what actually unblocked it?

Hi, my mother is 50, from India. I've been coordinating her medical care for 3 months and I'm completely lost. Hoping for outside perspectives.

How it started:
In March 2026, routine tests showed pancytopenia (all three blood cell lines low — red cells, white cells, and platelets). She has had Type 2 diabetes for 6-7 years, but at this same time she was newly diagnosed with high blood pressure and Hashimoto's hypothyroidism. No serious illness before this.

Key lab findings:

• ANA positive but weak (only 1:100) — and the full autoimmune antibody panel (dsDNA, SS-A/SS-B, Sm, RNP) came back completely negative. So the autoimmune markers are borderline at best.
• Complement C3 low, C4 normal. Coombs test negative (so not autoimmune destruction of red cells).
• Bone marrow biopsy: normal cellularity, only mild dysplasia, just 2% blasts (normal), no fibrosis. The report specifically said "rule out secondary causes before diagnosing MDS, cytogenetics advised" — but the cytogenetics test was never actually done. Her reticulocyte count is high, meaning the marrow IS actively producing cells.

The platelet rollercoaster (the part that confuses me most):

• She was put on an **immunosuppressant (mycophenolate) + hydroxychloroquine + steroid (prednisolone).**While on the full immunosuppressant dose, her platelets actually FELL (71K → 51K).
• When the steroid dose was increased, platelets shot up to 120K — then slowly drifted back down.
• When the immunosuppressant was stopped completely, platelets jumped to 114K within 3 days — then a week later fell back to 55K.
• The pattern: platelets spike after any treatment change, then always settle back to a ~50-55K baseline. Never hold high, never crash dangerously low. She has no bruising or bleeding.

The confusing doctor situation:

• Rheumatologist #1: said it's autoimmune → started the immunosuppressants.
• Rheumatologist #2 (senior, second opinion): said it's NOT a rheumatological disease → told us to stop the immunosuppressants.
• Hematologist: agreed to stop them, called it "secondary dysplasia" and said 50K platelets is safe — but then wrote a referral sending her back to rheumatology, labeling it "thrombocytopenia – rheumatological disorder."

So her case is being passed back and forth between specialties, and after 3 months I still don't have a clear diagnosis of what she actually has

My questions:

1. Anyone seen platelets spike after a med change, then settle low like this?
2. If it's autoimmune, why did platelets get WORSE on immunosuppressants and BETTER after stopping them?
3. Should I push for the bone marrow cytogenetics/NGS that was advised but never done?
4. Could it be drug-induced? (She took unregulated herbal diabetes medicine years ago.)

She's stable/safe now, but 3 months in with no real diagnosis. Similar experiences? Thanks.

Hi, my mother is 50, from India. I've been coordinating her medical care for 3 months and I'm completely lost. Hoping for outside perspectives.

How it started:
In March 2026, routine tests showed pancytopenia (all three blood cell lines low — red cells, white cells, and platelets). She has had Type 2 diabetes for 6-7 years, but at this same time she was newly diagnosed with high blood pressure and Hashimoto's hypothyroidism. No serious illness before this.

Key lab findings:

• ANA positive but weak (only 1:100) — and the full autoimmune antibody panel (dsDNA, SS-A/SS-B, Sm, RNP) came back completely negative. So the autoimmune markers are borderline at best.
• Complement C3 low, C4 normal. Coombs test negative (so not autoimmune destruction of red cells).
• Bone marrow biopsy: normal cellularity, only mild dysplasia, just 2% blasts (normal), no fibrosis. The report specifically said "rule out secondary causes before diagnosing MDS, cytogenetics advised" — but the cytogenetics test was never actually done. Her reticulocyte count is high, meaning the marrow IS actively producing cells.

The platelet rollercoaster (the part that confuses me most):

• She was put on an **immunosuppressant (mycophenolate) + hydroxychloroquine + steroid (prednisolone).**While on the full immunosuppressant dose, her platelets actually FELL (71K → 51K).
• When the steroid dose was increased, platelets shot up to 120K — then slowly drifted back down.
• When the immunosuppressant was stopped completely, platelets jumped to 114K within 3 days — then a week later fell back to 55K.
• The pattern: platelets spike after any treatment change, then always settle back to a ~50-55K baseline. Never hold high, never crash dangerously low. She has no bruising or bleeding.

The confusing doctor situation:

• Rheumatologist #1: said it's autoimmune → started the immunosuppressants.
• Rheumatologist #2 (senior, second opinion): said it's NOT a rheumatological disease → told us to stop the immunosuppressants.
• Hematologist: agreed to stop them, called it "secondary dysplasia" and said 50K platelets is safe — but then wrote a referral sending her back to rheumatology, labeling it "thrombocytopenia – rheumatological disorder."

So her case is being passed back and forth between specialties, and after 3 months I still don't have a clear diagnosis of what she actually has

My questions:

1. Anyone seen platelets spike after a med change, then settle low like this?
2. If it's autoimmune, why did platelets get WORSE on immunosuppressants and BETTER after stopping them?
3. Should I push for the bone marrow cytogenetics/NGS that was advised but never done?
4. Could it be drug-induced? (She took unregulated herbal diabetes medicine years ago.)

She's stable/safe now, but 3 months in with no real diagnosis. Similar experiences? Thanks.

My app has no login/account system (everything is on-device, anonymous). Premium features sit behind a Google Play subscription via RevenueCat. Rejected twice now with: "the in-app experience is behind a paywall or a subscription is required."

The "Sign in details" form in Play Console now explicitly says reviewers cannot:

- create new accounts

- use their own existing accounts

- use free trials

For others shipping no-login + paywall apps under the current (2026) policy — what actually got you approved?

1. Hidden reviewer-bypass code / "guest mode" unlock in Settings?

2. License testing setup with detailed instructions?

3. Promo codes via RevenueCat / Play Console?

4. Something else?

Specifically interested in what's working right now, since older threads recommend approaches that several devs report are no longer accepted.

Thanks 🙏

Indian indie dev here. Converted my Google Play Console account from individual to organization (GST-registered sole proprietorship, D-U-N-S sorted, domain verified). Conversion went through fine.

The payment profile verification in India runs through BillDesk (connect.billdesk.com), and I'm stuck there. They keep bouncing the application with three issues:

1. Secondary business activity proof required for the organization

2. Name on registered address proof doesn't match the declared name

3. Current address proof for the individual is incomplete

What I've already tried: uploaded GST certificate (REG-06) as secondary proof, matched the legal business name from GST character-for-character, re-uploaded masked e-Aadhaar as a clean single PDF from myaadhaar.uidai.gov.in. Still rejected.

If you're an Indian dev who cleared this in the last year, would love to know:

- What exact document combination worked for you?

- Which name went in which field (legal name vs. proprietor vs. trade name)?

- Did your registered address have to match your GST principal place of business?

- Any contact channel that actually responds, beyond the Resume link in the email?

Thanks 🙏

9 paid subs. 8 countries. Only 1 American.

🇧🇪 🇳🇱 🇳🇱 🇿🇦 🇮🇩 🇯🇵 🇬🇷 🇺🇸 🇯🇵

If I'd shipped English only like most indie devs do, I'd be invisible in local App Store search across all of these markets. Japanese users don't search in English. Neither do Greek, Dutch, or Indonesian ones.

Localizing at launch costs a few hours with AI translation + a native review pass. Skipping it costs you ~80% of your TAM.

Don't ship English-first. Ship localized-first.

https://preview.redd.it/vsiy9x28jryg1.png?width=2940&format=png&auto=webp&s=f0fd2fb042de1b0bb6db0cb7c018c14c33c5312f