Tacky Cardi A ✡️

This is important to listen to. He is spot on.

@OilCoIntern @financedystop Nothing beats arguing Descartes cogito ergo sum or studying history and literature.

@BuggerWoolly @financedystop Why liberal arts? Critical thinking can be learned through business school and manual labor, don’t you think?

The most regretted college majors according to a 2024 survey: Performing Arts: 51% Sociology: 47% Communications: 45% Liberal Arts: 43% Music: 42% International Studies: 41% English: 39% Psychology: 38% Environmental Science: 36% Exercise Science: 35% A lot of people were told to “follow your passion” when they were 18 and then found out the job market does not care.

@OilCoIntern @financedystop We actually, desperately, need to bring back the liberal arts education. Have you worked with Gen Z? Critical thinking skills are horrible!!!

@financedystop You could study whatever you wanted in the 70s and the degree itself would land you a great career. Now you have to specialize in something beneficial or you’re wasting money.

@LBFlyawayhome Read it as a child! There were so many wonderful covers back then

What a cover! I mean, how could a child pick up this book and not want to read it?

@TweetHearts72 @sechildress1985 @jeremyct Medicaid is horrible. You only get 35 a month do buy personal items. Yeah, you have care but what if you want a new sweater or to buy a present for someone. You have no idea what your future holds…..

@sechildress1985 @jeremyct So, essentially Medicare does pay. Unload your assets. Duh.

My grandmother’s nursing home costs $9,200 a month. Medicare covers none of it. My mom is paying out of her own retirement to keep her there. Which means my mom won’t have enough saved when she retires. Which means in 20 years I’ll be doing the same thing for her. Nobody plans for this. The system just assumes someone in the family will absorb it. It’s usually a daughter.

@muheediva01 You can put veggies in the sauce you know. Eggplant and zucchini are my favs but I’ve also added carrots and broccoli.

If you grew up in a "vegetables at every meal" household, what went wit spaghetti?

@afshineemrani My liver produces LDL just for fun. Diet and exercise don’t matter for me but all other labs are good and calcium score is zero and blood pressure would make you weap at how good it is. I’m holding off on statins for as long as I can. No thank you.

I'm a cardiologist. I prescribe cholesterol-lowering drugs every single day. They save lives. That science is settled and I will never tell you otherwise. But I'm going to say something that will make a lot of my colleagues uncomfortable — because someone needs to say it, and your doctor probably won't. Too many physicians make you feel crazy when you bring up statin side effects. You walk into your appointment and say "my muscles ache constantly" — and you're told it's in your head. You say "I'm exhausted all the time" — and you're told it's your age. You say "my sex drive disappeared" — and you get an awkward silence followed by a subject change. You say "I don't feel like myself anymore" — and you're told the benefits outweigh the risks, take the pill, stop reading the internet. I've watched it happen in my own field for twenty years. The conversation gets shut down. The patient gets dismissed. And then they do the one thing we should be most afraid of — they stop the medication entirely, without telling us, and lose the cardiovascular protection that's keeping them alive. That is the real cost of not being honest. Not the side effects themselves — the silence that drives patients away from treatment. In my practice, I see statin-related complications in at least 25% of my patients. Muscle pain. Fatigue that doesn't resolve with sleep. Reduced sexual drive. Brain fog. Cramping. Joint stiffness. Weakness that makes exercise — the very thing we tell them to do — feel impossible. Some of these improve with CoQ10 supplementation and optimizing vitamin D. Many do not. I wrote about the diabetes risk of statins in a New York Times op-ed in 2012. The backlash from the cardiology establishment was immediate. I was told I was undermining trust in a life-saving drug class. Fourteen years later, every major guideline acknowledges the risk I warned about. It's in the prescribing information. The physicians who attacked me for saying it now teach it to their residents. The truth doesn't care about professional comfort. It never has. Now a paper published this week in Science Advances has finally explained the mechanism behind statin myopathy — and the finding validates what millions of patients have been telling their doctors for years. Researchers discovered that statins activate the NLRP3 inflammasome in muscle cells — triggering an inflammatory cascade that causes muscle cell death, activates atrophy pathways, and disrupts muscle metabolism. This is entirely independent of the drug's cholesterol-lowering effect. The muscle damage isn't caused by lowering cholesterol. It's caused by a completely separate pharmacological action through a different pathway. The critical implication: the side effect can potentially be separated from the benefit. Blocking NLRP3 or restoring isoprenoids prevented muscle cell death without interfering with cholesterol reduction. Future therapies could preserve the cardiovascular protection while eliminating the muscle toxicity. Even more striking — the researchers found that background systemic inflammation significantly lowered the statin dose needed to trigger muscle damage. Patients with chronic inflammation, gut dysbiosis, or metabolic syndrome may be experiencing myopathy at doses their doctors consider "too low to cause problems." They're not imagining it. Their inflammatory state is priming the pathway. The muscle pain was never in their heads. It was in their NLRP3 inflammasome. And we finally have the molecular proof. Here's what I actually do in my practice — because I refuse to choose between protecting the heart and respecting the patient. Whenever possible, I avoid statins as my first-line approach for eligible patients by using alternatives that lower LDL through entirely different mechanisms with no muscle toxicity: PCSK9 inhibitors — Repatha and Praluent. Injections every 2-4 weeks that dramatically lower LDL without touching muscle tissue. No myopathy. No fatigue. No brain fog. For patients who can access them, these are transformative. Inclisiran — Leqvio. An siRNA injection I administer twice a year in my office. It silences the PCSK9 gene in the liver. Two shots a year. LDL drops roughly 50%. No muscle side effects. No daily pills. Now approved as first-line monotherapy. This is the future of lipid management and I use it aggressively. When statins ARE clinically necessary — and sometimes they are, especially post-heart attack or in combination therapy — I choose hydrophilic statins like rosuvastatin or pravastatin. These do not easily cross the blood-brain barrier. The cognitive complaints — the fog, the memory issues, the feeling of "not being yourself" — are substantially less common with these formulations because the drug stays out of the central nervous system. I never prescribe a statin without CoQ10. 100-300mg daily. Statins deplete the cellular energy molecule your muscles and heart depend on. Replenishing it reduces muscle symptoms in many patients. It should be standard practice. The fact that it isn't is a failure of our field. I check vitamin D and optimize it aggressively. Low vitamin D — which is epidemic — worsens muscle symptoms independently and compounds whatever the statin is doing. Target 50-80 ng/mL, not the bare minimum of 30. Bempedoic acid — Nexletol — for patients who can't tolerate any statin. Works upstream in the cholesterol pathway and is not active in muscle tissue. Specifically designed to avoid myopathy. Ezetimibe added to a lower statin dose. Cut the statin intensity, add ezetimibe to maintain the LDL reduction, and halve the muscle exposure. There is no excuse in 2026 for telling a patient "just deal with the muscle pain." The toolbox is deep. The alternatives exist. The only barrier is a physician's willingness to listen and adapt. I want to speak directly to every patient who has been dismissed. Your muscle pain is real. Your fatigue is real. Your cognitive changes are real. Your loss of drive — in every sense of the word — is real. A paper in Science Advances just proved the mechanism. You were never crazy. You were experiencing a documented inflammatory response in your muscle tissue that your doctor didn't have the science to explain — until this week. And I want to speak directly to my colleagues. We have to be honest. Not just about the benefits — which are enormous and undeniable — but about the side effects, the mechanism, and the alternatives. Patients who feel heard stay on treatment. Patients who feel dismissed stop their medications in silence — and die from the heart attacks we could have prevented if we'd simply been willing to have an honest conversation and switch the approach. The cardiologist who tells you statins are flawless is not protecting you. The wellness influencer who tells you statins are poison is not protecting you either. The truth lives in the middle — where it always has. Statins save lives. The side effects are real. The mechanism is now proven. The alternatives exist. And you deserve a doctor who holds all four of those truths at the same time. Both things can be true. They always could. Now we have the science to prove it.

@samslamdunk Get off the internet. Know that these are just thoughts and they will pass. Talk to someone or do what I do….go to sleep. Listen to a boring podcast to distract your mind as you settle into bed Keep telling yourself “I will be fine”. ❤️❤️ the world needs you.

@peppypatty64 @BracketNky @FreddyLA7 It’s the good fun rhe world needs right now!

@BracketNky @FreddyLA7 Although apparently he didn’t take it & American Airlines and JJ Watt came to save the day. This is Just so funny, this whole story lol. And the fact that he won’t show any pictures of himself is also funny. Such a wonderful story.

My man @FreddyLA7 is getting the VIIIIIIP treatment in America. Private jet now🤣🤣🤣 Good for him.

@Local12 Social security is not facing a crisis because of illegals. It’s facing a crisis because both parties have raided it and never replaced what they took. Illegals getting aid? Yes bad. But not the major issue with solvency.

"We could be talking about a catastrophic hit." A report is raising fresh concerns about the future of Social Security, warning that the program's financial outlook has deteriorated and that millions of Americans could face automatic benefit reductions: bit.ly/4ez68ur

The best moment in all of Widows Bay!

@RachelLeishman That must have been so fun to do!! And now it is the best meme ever.

me walking into any crowded place

@WhoDey_UK Even better at night.

When you're driving in from CVG you soon turn a corner on the interstate and... there it is. Like some Ohio El Dorado... the view of dreams.

@BeTraumaFree I have and thank you. I enjoy your posts.

@BuggerWoolly grief and loss is not a mental illness. It is a human experience. Sorry for your loss. Sounds like you are doing some grief work now. Most places have grief groups. There are also many online grief groups. Have you looked into that type of support?

A few days ago something happened and I realized I was feeling sadness, loss and disappointment. I was able to name those emotions, which was good. However, I noticed I wanted to dissociate into my head so I would not have to actually feel them. Instead I used gentle breathing...

@sethdanie1 I don’t look Jewish at all. When I saw some Chabad guys in an elevator I said Shabbat shalom and they looked at me and I said I’m Jewish!! 🤣🤣🤣🤣

I'm always perplexed when someone says "you don't LOOK Jewish!"... like what do you expect me to look like?

@peppypatty64 @CincyShirts We are tired. lol

@CincyShirts 🙏🏼🙏🏼 need a Cincy shirt of everyone hiding in their showers with sleeping bags and snacks. 🤦‍♀️

Crazy storms last night. Y’all good?

@AngryCitizenxx It’s a mess but totally worth it. Get in the mud yourself! Play!

Day 13 of being sober off of alcohol. It's a rainy day today, thinking of bringing the kids to play in the mud and puddles. Momma is going to hate me🤣

@DrDoyleSays But I’m tired, so tired of being the only person to rescue myself…..

It's not true that "nobody cares about our problems." But I'll tell you, my trauma recovery only leveled up when I adopted the mantra, "Nobody cares, work harder." Part of me was hell bent on waiting on an external rescuer that would never come. We (only, ever) rescue ourselves.

@peppypatty64 I used to have my best friend loving below we and we would gather at every warning and laugh and watch The Very Local News channel and imagine that guy was in the back yard. But he’s moved to west side now and I am not comfy with new neighbors to knock in their door

@peppypatty64 I e been exhausted feom dealing with some grief issue and when I heard the sirens I looked at my phone to check the radar and just went back to sleep. 🤣🤣

@BuggerWoolly you doing OK? did you make it in your second floor condo/apartment?

@BeTraumaFree So I am new on this path. My absent father died and I am letting the emotions come and go but how to stop going down rabbit holes? Meditate and bring myself to the front? I’m also just trying to feel the feels and no ignore them.

For hours I used gentle, conscious breathing every time the emotions showed up. I noticed those emotions were attracting similar emotions of sadness and loss from my past. I did not allow those old emotions to create a spiral. I sent them away. A few hours later, I was OK.