u/orthoprof

I know this is a lot, but I am desperate.

41 year old white male
5'11", 200lb

Current medications:
Quilipta 60mg
Ubrelvy 100mg prn
Zolmitriptan 2.5mg prn
Indapamide 2.5mg
Amiloride 5mg
Mounjaro 15mg
Chorionic gonadotropin 500u 3x/wk
Omnaris
Potassium citrate 30 mEq K+/day
Potassium chloride 48 mEq K+/day

Medical history:

\- Hx Nephrectomy 8 years ago (aquired IPJ stricture due to frequent kidney stones, current solitary kidney, GFR stable but being monitored, no stones in past 3 years)
\- Hypogonadotropic hypogonadism (diagnosed 3 years ago)
\- Mostly normal neuro-imaging (some radiology reports mention "mild prominance of optic never sheaths," "slight posterior scleral indentation."), no vascular abnormalities in brain/neck on MRV/CT-V.
\- Opening pressure on lumbar punctures varied between 29-31cm H2O (no noticeable change on acetazolamide treatment)

Main pain issue: Chronic daily migraine/headache. I woke up 6 years ago with a headache and one-sided blurry vision, and haven't had a headache-free day since (vision has mostly resolved).

Initial diagnosis after LP was IIH, but after over a year of treatment with acetazolamide, opening pressure did not decrease. Notably, I weighed 312lb previously, lost over 100lb on tirzepitide in the past three years with no change in symptoms.

Acetazolamide was discontinued after >1 year due to issues with hypokalemia and no apparent improvement of symptoms nor opening pressures. During one LP, fluid was drained to an optimal range, however my headache did not improve. I have spondylitis/spodylolisthesis in my lumbar spine which makes lumbar punctures difficult even with fluoroscopic guidance, so the sample size for those is small, with many dry taps. Since pressure did not respond to acetazolamide (or topirimate), nor did my symptoms improve with theraputic draining, ICP was determined to be unrelated.

Currently being followed by a prominent headache clinic, and the current assumed diagnosis is chronic/refractory migraine. I have tried every CGRP, gepant, and triptan medication under the sun, botox, ketamine infusions, stellate gangion blocks, you name it. No change. My neurologist says we just need to keep "trying" things, but at this point we are essentially out of options.

I have seen a psychologist for CBT/pain management strategies with limited benefits.

I was a successful professional, now I am disabled with pain, fatigue, and exercise intolerance.

\-----

If you are still with me, here is my main issue:

I know some things that help. 4 years ago I had my appendix removed. While on narcotics in the hospital, my headache was much more tolerable. Ironically, I actually felt better immediately after surgery than I had in the previous 2 years of my life.

\~3 years ago I had another kidney stone that needed to be urgently dealt with due to my solitary kidney. The 3 days of hydromorphone around the surgery meant that, even though I had an obstructing kidney stone, I was actually a "functional" human being for those 3 days.

I have what I have been told is "atypical asthma" where I get symptoms only during/after a respiratory infection. A few years ago, I was prescribed a course of steroids when it was particularly bad, and my head actually felt much better while on the steroids, however returned to baseline once i stopped.

So my issue is: I know these things work. I also understand that there are issues with being on narcotics and/or steroids long term. At this point, I don't care though. I need my life back, and literally nothing else is working. What is the ethical basis for me being in chronic pain, disabled, unable to work, unable to contribute to my family, in order to prevent a theoretical risk on a long term pain treatment?

To reiterate, I don't drink (at all), I don't do recreational drugs, I never had any issues with addiction/misused with previous surgeries/kidney stones. I am not some junky looking for a fix. I am just desperate, in pain, and want my life back.

Any advice, guidance, or suggestions would be immensely appreciated.

p.s. if anyone has any ideas about the etiology/treatment of the underlying issue, that of course would be preferable to needing any pain meds at all.

My business and multiple other people (reports on social media, both business and residential customers) are having the same issue. Can call out but unable to receive calls. Call doesn't connect and just drops (tried calling from multiple carriers).

Frustrating part: Nothing on the Shaw/Rogers outage map, and when you try and call their business support it says they are busy and won't take the call, and to call back later.

Literally losing business because of their service incompetence.

UPDATE: nearly 7PM ET and still no phone service. Still no outage being reported on their website. Still nobody answering the phones at Rogers business support. >7 hours of lost business due to Shaw/Rogers not providing their contracted services, nor ANY form of customer support.

Is this normal?

My services were canceled as of June 24th (I have the confirmation). I packed up and dropped off all of the equipment at FedEx using the shipping label Shaw/Rogers provided me on June 25th (I also have confirmation). Tracking says it is still in transit. Today (Sunday, June 28th) I got a bill for over $800 for not returning equipment.

I am hoping they always pre-emptively do this and credit it out when they receive the equipment? Is this normal procedure?

Is it just me, or is customer service dead? Every interaction I have had with a business the past year or so has been absolutely brutal, whether it is on a local or even national level. (For background this is in Canada).

Few highlights:

1. Snow removal backed into the deck on the front of my house this winter, promised to fix it promptly in the spring. It is now almost July, and I still have a smashed deck on the front of my house for the neighbours to admire. Multiple contacts and I still don't have any idea when it will be fixed.

2. Six weeks ago had a company come (after many positive recommendations) to give me an estimate to replace all of the windows and doors in my upper-middle-class house. Guy came, took a million measurements, never heard anything. Last week called again for an update, was told they were very behind, and he would have it to me that day or the next. Still nothing.

3. Contract for my internet/tv came up with a national company I have been with for \~14 years. Agents were rude, unhelpful, and essentially offered me less for more money. Cancelled and moved to a company offering more for less money (another national company). Literally nothing worked right at setup (last week). The past week I have spent 12 hours on the phone and taken two days off work to wait around for a tech to come and fix it who never showed up. Been hung up on multiple times by agents who didn't know how to fix the problem so just decided to hang up on me.

4. Alarm company at my business: Had multiple false alarms after 14 years of no issues, resulting in having to pay police service fees for call-outs. Alarm company said to just disable the sensors that are giving the false alarms. Since that is obviously not reasonable, they offered to send a tech to check the system but it would be at least 2 weeks, and if we don't want false alarms we can just not set the alarm until then.

Honestly there are so many other examples, and it seems like everyone I talk to has had multiple similar issues. Am I just putting something out into the universe to get crapped on? Or is this just the way business operate these days?

Is it just me, or is customer service dead? Every interaction I have had with a business the past year or so has been absolutely brutal, whether it is on a local or even national level. (For background this is in Canada).

Few highlights:

1. Snow removal backed into the deck on the front of my house this winter, promised to fix it promptly in the spring. It is now almost July, and I still have a smashed deck on the front of my house for the neighbours to admire. Multiple contacts and I still don't have any idea when it will be fixed.

2. Six weeks ago had a company come (after many positive recommendations) to give me an estimate to replace all of the windows and doors in my upper-middle-class house. Guy came, took a million measurements, never heard anything. Last week called again for an update, was told they were very behind, and he would have it to me that day or the next. Still nothing.

3. Contract for my internet/tv came up with a national company I have been with for ~14 years. Agents were rude, unhelpful, and essentially offered me less for more money. Cancelled and moved to a company offering more for less money (another national company). Literally nothing worked right at setup (last week). The past week I have spent 12 hours on the phone and taken two days off work to wait around for a tech to come and fix it who never showed up. Been hung up on multiple times by agents who didn't know how to fix the problem so just decided to hang up on me.

4. Alarm company at my business: Had multiple false alarms after 14 years of no issues, resulting in having to pay police service fees for call-outs. Alarm company said to just disable the sensors that are giving the false alarms. Since that is obviously not reasonable, they offered to send a tech to check the system but it would be at least 2 weeks, and if we don't want false alarms we can just not set the alarm until then.

Honestly there are so many other examples, and it seems like everyone I talk to has had multiple similar issues. Am I just putting something out into the universe to get crapped on? Or is this just the way business operate these days?

So just switched from Rogers (Shaw) to Bell.. I tried to record the Jay's game so I can fast forward through commercials, but it says the recording isn't available on the device until the game is over. Is this normal? That is HORRIBLE functionality... Typically with Rogers I would record at the start of the game, wait half an hour to an hour, and then start watching so I can fast forward. Is there a setting or something to make this work, or is it just a terrible system?

Just signed up for Internet, TV, and home phone. I am technically inclined. I have multiple devices and architectures to troubleshoot. Most people aren't and don't. When I installed the modem, there was an error 2001 authentication error. When I log in to the web portal for the modem using the credentials provided by the LCD screen, I see that the internet is "down" and the TV and Phone are active. The Internet says it needs a login/password. The login field is filled, the password is not. It says the information is found on my "Welcome Letter" which I did not receive.

Tech support chat is able to provide me the credentials eventually. I go in the Bell Wifi app, and it is stuck in a loop trying to set up pods and will not proceed. I do not have pods. I did not order pods. I was not sent pods. Tech says he needs to reset the account, which he does, but the same error persists. I try on multiple devices to access the app, same issue. It won't let me go past and set up wifi before the pods are installed. Tech says he needs to send in a ticket to get it resolved, and it will take at least 48 hours. So I guess I just won't have internet access for days after set-up?

Well at least I have TV, right? Log in to the TV app and it says there are no TV subscriptions associated with my account. Back to tech support. Apparently they never bothered to activate my account, so it had to be manually activated.

Literal hours with tech support trying to resolve their incompetence in setting up my account on their end, and I still don't have a resolution. Not exactly a good first impression.

UPDATE: I was trying to access the WiFi app because I needed to configure ports/DHCP for my networking setup. When the modem wasn't connecting, the options didn't appear to be there on the modem configuration page, and the Bell agent made it sound like the Wifi app was needed for them. I pushed him to try a reset a second time, and low and behold, it worked--only to find out that the app is essentially useless if you know how to configure a router. Either way, the whole thing is a mess on their back end.

I have a 2020 Rav4 Limited Hybrid and, given the age, I wanted to take a peek at the actual fan that cools the hybrid battery and clean it out if necessary. I do know how to check the filter, but I don't see the fan when I am in there, and I know from other Toyota models it isn't necessarily even close to where the filter/air intake is.

The Car Care Nut seems to have videos about this for other models but I can only find the video where he checks/replaces the filter for Rav4s.

I don't want to remove the whole back seat just to find out there is an easier way to access the fan itself. Anyone know?

TIA

EDIT: Typo in title, should be "even exist any more"

My contract is up next month for internet/cable. I was a previous Shaw customer, which is now under the Rogers umbrella. I called to renew my contract and see what they offered, and all they offered was literally the plans on the website. My current plan:

Popular TV + 1GBit internet $200/month

Bell is offering a TV plan (not as many channels but has the sports channels that I care about, literally the only reason I have cable), plus 1.5 Gbit internet for $120/month.

I told the Rogers phone agent I was considering that, and after putting me on hold, they came back and said that the best they could do is $195/month plus a $100 credit for my existing plan.

I asked to speak to the loyalty/cancellations team, and the person told me she would be the one to handle a cancellation if I wanted to cancel today, and wouldn't transfer me to anyone.

Is this just where we are at right now? I previously had very bad experiences with Bell and never thought I would go back there, but I have been with Shaw/Rogers for 10+ years now and the difference in price is if I switch back to bell is $1700 over the 2 year term.

I just submitted the supporting documentation last week because my medical expenses were audited (they were quite high, I would have been surprised if they DIDN'T audit them). Any idea how long I should expect for an ETA? I am having an unreasonable amount of anxiety about it, and would like to know when to expect the all clear.

I am currently running seerr/prowlarr/sonarr/radarr. I have 6 paid usenet trackers, and a handful of free ones. I would love to know which of my trackers I am getting most of my grabs from, but I don't see anywhere to do this natively in my setup. I see that sonarr/radarr have this information if I manually look in the history and check each grab individually, but I was wondering if there is a way to get this info in a more useful/compiled form? Preferrably for past grabs, but if not that then at least for future grabs.

Thanks in advance!