Aurora health care doctors
Nursing for nurses and by nurses for the care of all.
2009.10.18 21:53 davedavedavedavedave Nursing for nurses and by nurses for the care of all.
A place to discuss the topics of concern to the nurses of reddit. All are welcome.
2012.04.29 00:56 Irunongames Emergency Medicine
/emergencymedicine is a subreddit for healthcare providers in the emergency setting to discuss their encounters and find ways to improve their knowledge of various parts of EM.
2021.05.26 04:11 thekategatsby161 EndoAus
A place to talk about doctors, the health care system and living with endo in Australia. This is a Trans friendly page and know that you don’t have to be a woman to have endo.
2023.05.30 22:15 DarkDetectiveGames Privacy laws in Canada could get worse, Bill C-27 Digital Records Act/ Consumer Privacy Protection Act
Bill C-27 is a Bill in Canada that would replace the Personal Information Protection and Electronic Documents Act (PIPEDA) with the new so called Consumer Privacy Protection Act (CPPA). It has passed second reading. This new law is worse than PIPEDA.
1 The Protections (or lack thereof)
CPPA offers less protection than PIPEDA. Under PIPEDA organizations are required to give purposes must be stated in such a manner that the individual can reasonably understand how the information will be used or disclosed. Under CPPA organizations still must give purposes, however they do not have to give individuals an understanding of the information will be used or disclosed.
This law introduces vague new exceptions to consent. These are the new exceptions (note de-identified means pretty much nothing. You can still be identified):
Business Activities 18 (1) An organization may collect or use an individual’s personal information without their knowledge or consent if the collection or use is made for the purpose of a business activity described in subsection (2) and
(a) a reasonable person would expect the collection or use for such an activity; >and
(b) the personal information is not collected or used for the purpose of influencing the individual’s behaviour or decisions.
List of activities
(2) Subject to the regulations, the following activities are business activities for the purpose of subsection (1):
(a) an activity that is necessary to provide a product or service that the individual has requested from the organization;
(b) an activity that is necessary for the organization’s information, system or network security;
(c) an activity that is necessary for the safety of a product or service that the organization provides; and
>(d) any other prescribed activity.
Legitimate Interest An organization may collect or use an individual’s personal information without their knowledge or consent if the collection or use is made for the purpose of an activity in which the organization has a legitimate interest that outweighs any potential adverse effect on the individual resulting from that collection or use and
(a) a reasonable person would expect the collection or use for such an activity; and
(b) the personal information is not collected or used for the purpose of influencing the individual’s behaviour or decisions. Research, analysis and development 21 An organization may use an individual’s personal information without their knowledge or consent for the organization’s internal research, analysis and development purposes, if the information is de-identified before it is used. Information produced in employment, business or profession An organization may collect, use or disclose an individual’s personal information without their knowledge or consent if it was produced by the individual in the course of their employment, business or profession and the collection, use or disclosure is consistent with the purposes for which the information was produced. Employment relationship — federal work, undertaking or business 24 An organization that operates a federal work, undertaking or business may collect, use or disclose an individual’s personal information without their consent if
(a) the collection, use or disclosure is necessary to establish, manage or terminate an employment relationship between the organization and the individual in connection with the operation of a federal work, undertaking or business; and
(b) the organization has informed the individual that the personal information will be or may be collected, used or disclosed for those purposes. Financial abuse
34 An organization may on its own initiative disclose an individual’s personal information without their knowledge or consent to a government institution, a part of a government institution or the individual’s next of kin or authorized representative if
(a) the organization has reasonable grounds to believe that the individual has been, is or may be the victim of financial abuse;
(b) the disclosure is made solely for purposes related to preventing or investigating the abuse; and
(c) it is reasonable to expect that disclosure with the knowledge or consent of the individual would compromise the ability to prevent or investigate the abuse. Statistics, study or research 35 An organization may disclose an individual’s personal information without their knowledge or consent if
(a) the disclosure is made for statistical purposes or for study or research purposes and those purposes cannot be achieved without disclosing the information;
(b) it is impracticable to obtain consent; and
(c) the organization informs the Commissioner of the disclosure before the information is disclosed. Socially beneficial purposes
39 (1) An organization may disclose an individual’s personal information without their knowledge or consent if
(a) the personal information is de-identified before the disclosure is made;
(b) the disclosure is made to
(i) a government institution or part of a government institution in Canada, (ii) a health care institution, post-secondary educational institution or public library in Canada,
> (iii) any organization that is mandated, under a federal or provincial law or by contract with a government institution or part of a government institution in Canada, to carry out a socially beneficial purpose, or > (iv) any other prescribed entity; and >(c) the disclosure is made for a socially beneficial purpose.
or
Prevention, detection or suppression of fraud *Debt Collection *Records of historic or archival importance *Breach of agreement or contravention *2 Enforcement** CPPA's enforcement is similar to PIPEDA's but worse. At least there are penalties. The process: 1. An individual files a complaint with the OPC. There are several reasons which can the commissioner can use to not investigate but not talking to the organization first isn't one of them. 2. The OPC investigates during which the Commissioner may attempt to resolve a complaint by means of a dispute resolution mechanism such as mediation and conciliation, unless an inquiry is being conducted in respect of the complaint or try to enter a compliance agreement. There is not time frame for this. (note under PIPEDA, a report of findings must be issued within a year see my last post)). It doesn't really say what an "investigation" is. 3. If the matter is still not resolved or the commissioner believe a compliance agreement is being breach an inquiry will start. The Commissioner must make rules respecting the conduct of an inquiry, including the procedure and rules of evidence to be followed, and must make those rules publicly available. 4. After the inquiry, the commissioner must make a decision.
>(a) the Commissioner’s findings on whether the organization has contravened this Act or has not complied with the terms of a compliance agreement; >(b) any order made under subsection (2); >(c) any decision made under subsection 94(1); and >(d) the Commissioner’s reasons for the findings, order or decision.
"Compliance order"
(2) The Commissioner may, to the extent that is reasonably necessary to ensure compliance with this Act, order the organization to
>(a) take measures to comply with this Act; >(b) stop doing something that is in contravention of this Act; >(c) comply with the terms of a compliance agreement that has been entered into by the organization; or >(d) make public any measures taken or proposed to be taken to correct the policies, practices or procedures that the organization has put in place to fulfill its obligations under this Act.
This must happen within 2 years of the complaint being followed, except it might not, see my last post. 5. The commissioner may recommend a penalty be imposed. This seems irrelevant because of, 6. Appeals may be made by the complainant or respondent to the tribunal with respect to a finding made by the inquiry, an order made by the commissioner or the commissioner's decision not to recommend a penalty. You only have 30 days to go to court. Under PIPEDA you have a year. 7. The tribunal may impose a penalty for all the contraventions in a recommendation taken together is the higher of $10,000,000 and 3% of the organization’s gross global revenue in its financial year before the one in which the penalty is imposed. Those numbers are the maximum. The law sets out relevant factors. 8. You may sue for damages if a finding by the commissioner or tribunal has made a finding that the respondent has violated the act. This is done in federal court or the superior court of a province. 9. An order by the tribunal may be reviewed by the Federal Court. The judgment of the federal court may be appealed to the Federal Court of Appeal. The Supreme court may also take an appeal afterwards. This is much longer than PIPEDA and although there are fines, the protections are so weak that the fines barely matter.
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2023.05.30 22:15 SunnyPsychologica I'm supporting my partner going through the craziest time ever, and I'm tired of it.
I know Reddit can be a sesspool, but I feel like I have nowhere else to turn.
My partner and I have been together for almost five years and we're still madly in love. I'm grateful for them. They're my best friend in every sense of the word. We have ebb and flow, we teach each other different things, have healthy conflict, and have a ton of fun and meaningful growth/time/conversation together. But lately...things haven't been the same. Not because they've changed or that I've changed in ways that mean we've outgrown one another, but because they're going through something so intense that's left them burnt out and is now leaving me burnt out.
For some context here, my partner is the child of a hoarder. An abusive, neglectful hoarder. I knew about this prior to us getting together as we were friends and worked with one another for three years prior to getting together. So theoretically, I knew what I was signing up for...that one day, eventually at some point, if we were to still be together, we'd both be tasked with dealing with his shit. And well, that day has finally come.
It started last May-ish when he had a stroke and ended up in the hospital. He was in there for a couple months, and during that time, my partner and their brother started working on cleaning out and organizing their dad's house. I helped a bit, but it was mostly them at the time while I supported on the sidelines. Went to hospital visits with my partner, helped occasionally at the house, that sort of thing. Unfortunately their dad came home (I say unfortunately because they can't make any progress on the board - of both things and animals - when their dad is present), and so a lot of things got put on hold for several months. It was good in terms of energy and taking a break, but during that time, my partner found out that they're the sole executor of their dad's will and that everything of his goes to them, and so, with his end being so near and not being able to make any progress on a hoarder house and four seacans worth of stuff, it was massively stressful for them and also for me.
Their dad spent the next several months wasting away in his house. He was supposed to do rehab stuff and take care of his health. None of that happened. Instead he literally ended up almost dying in his bed and eventually, after months of trying to convince him, ended up back in the hospital. He's now been there for several months and we know for sure he is never coming out. It's either he dies in the hospital or he goes to a long-term care home and dies there.
So anyway, for the past several months, it's been all hands on deck getting shit sorted for my soon-to-be father-in-law's shit. I'm talking trying to come up with money in the tens of thousands because of bills he owes, figure out government taxes because that man hadn't done taxes in over a decade (this is being sorted by an angel of a man who's been helping us thank god, but it's been so stressful), dealing with the four seacans (we finally got ONE of the four empty thank god), rehoming animals (as I said he hoarded animals, too, so over the past year we've managed to go from over 20 animals to I believe 6 who are still there now), and getting rid of shit in his house. We've also been selling cars cause he's hoarded those, too, and going to visit him when my partner feels up to doing that since it's so emotionally intensive for them. They've also been going through so much trauma healing because being around that house and their dad so much has brought so much up for them.
And while I'm their partner and I love them and I'm happy to support them through life, I'm getting so tired...so so tired. I'm feeling burnt out to a crisp. Which part of me feels crazy for! I'm not working anymore because with my partner having a job and having to deal with their dad's shit, it's not prudent for both of us to be working. Our home gets neglected and it's not feasible with everything going on rn. I'm best at cooking, cleaning, traditionally feminine gender role stuff, so I've taken on the role of being the stay-at-home partner right now. And so my brain is like well how can I be tired when I'm not even working...but I am. I am so tired...and I feel so guilty saying this that part of me doesn't wanna say this to my partner. Because they're even more tired which is even more valid! They're working forty hours a week and on top of that trying to balance their dad's shit, our relationship, yard projects we're doing together, resting, all that jazz. And here I am doing all of that minus the conventional job - although I will say as most of you probably know - keeping a house going is also a full-time job.
I just...I don't know guys. A big part of me wants to throw in the towel and say I need a fucking break. I need a month where I don't have to deal with any of your dad's shit! Where I just focus on our home and our garden and our renovations. I feel like I'm living a life I didn't sign up for even though I DID sign up for it, but it's like anything. You don't really know what it's gonna be like til you're going through it. And now that I am, I want off this ride. But I don't want off the ride that is my partner. But...selfishly, I want my old partner back.
I want my partner back who isn't just stressed 24/7 about work and dad and dad and dad and DAD. I literally don't know how to handle this anymore. Any amount of rest I get never feels like enough and it's shitty because I get more rest than my partner. Literally I feel like I'm not allowed to be tired or burnt out because they are dealing with even more than I am right now AND they have less time to rest.
But the problem is...I get the brunt of all of their emotions and stress. I mean, we both do. It's just hard cause they have more people to vent to about all of it. They have coworkers that I don't have that they talk to all of this stuff about. I have a very small amount of friends one because I'm introverted but also because a lot of friendships have been evolving and/or dying in my life lately. I've been going through a lot of growth alongside all this shit so it's honestly for the best but that doesn't mean it isn't lonely.
I just...idk. Despite us both going to therapy, I don't feel like I have the support I need right now or the boundaries or breaks that I need right now. The shitty thing is...this isn't something my partner can just walk away from. Believe me, if they could they would. But it's either we deal with shit now slowly but surely or we let it pile up, have their dad's house foreclosed on and have services turned off, have their brother and animals who are living in the house suffer, and prolong dealing with and selling the massive amount of SHIT their fucking hoarder dad has left them.
Any words of wisdom are much needed right now because I don't know where to turn other than to screaming or crying. All I know is I'm feeling like a partner who is a bit of a caregiver right now and as anyone who has experience knows, the caregiver has a rough time with shit, too, even if acknowledging that comes with a lot of guilt...
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2023.05.30 22:15 FatherOfUniverse (First time posting here) // Health Anxiety
Hello there! Hope You all doing better everyday! Since that's gonna be my very first post in here, I already apologise for my poor English skills, as it isn't my first language. A little about me and the anxiety I have: I am a 20 year old guy from Estonia (Baltics), apparently to Your surprise I'm more of an extrovert and working a job at front desk. I smoke cannabis daily (on work-days only before bed), I also use nicotine daily (smokeless nicotine pouches) as well as the caffeine in my morning cup. I suffer under terrible health anxiety, which I haven't really talked about with my doctor. It's become pretty much daily now. Sometimes when I smoke a little too much/or randomly even while sober I'm just, all of a sudden, starting to feel my heart rate going up, getting dizzy, instantly my breathing changes as I'd need more oxygen. When things go really bad, my hands start to shake and I might even have a weird feeling in my chest for a while. And every God-damn time, I'm afraid I'm just about to have some heart-related episode. The fear of death kicks in as my thoughts are rushing faster than the speed of sound. I just hate it all so much. I'm about to go and see my doctor soon, since I already sent her a letter that I wanna check out what's up exactly. I wanna do all the blood tests, ECG for sure (to make sure my heart functions right), spirography in case it should be asthma/something lung related. Does anybody feel me? It sometimes really feels like a slow death. . .
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2023.05.30 22:14 eriiibear826 nobody understands my BPD
i feel like my friends and family don't understand how exhaustive BPD actually is.
yes, i'm fully aware everybody is going through something, but it hurts that my problems are constantly misunderstood because nobody can take the time to educate themselves about it. my family doesn't even bring up mental health, and when they do and i join in on the conversation, they instantly shut it down. when i bring it up with friends, their responses vary between "everybody struggles with something" and "take care of yourself", which, of course, are both great responses, but i never truly feel heard.
they don't understand the nausea from confrontation, the obsessiveness over sounding one way or another, the guilt, the feeling like everybody is constantly mad at you, the thoughts that leave me feeling like i can't breathe. i have been isolating myself because i'm afraid of being a burden, while they are out having fun and enjoying their summer. they get mad at me when i don't respond or when i respond in a way they don't want. it hurts, because it's exhausting for me to even pick up my phone.
i just wish they understood, or tried to understand. i feel as if bringing up my bpd makes them uncomfortable, because they truly don't know anything about it. to them, it's just mood swings. and i've tried to educate them on it, but it just feels like nobody really understands and i end up feeling more alone than i did before.
this is kind of just a vent-- i'm feeling really alone lately and i feel as if i am too tired to even exist. i want to cut everybody off and disappear, but i know that i will never get better if i do that.
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2023.05.30 22:14 bendbreakspill Suicidal mood swings
Hi there, recent lurker of this subreddit as my sleep issues have reared their ugly head again.
I’ve had short bouts of sleep issues throughout high stress periods of my life - 2015 (first serious break up I was falling asleep but waking up in the middle of the night),
2018 - when I had to take prednisone and stayed up for foufive days and a psychiatrist gave me risperdal (even though I wasn’t having psychosis) which helped me sleep again but I got off it as quickly as I could with a taper because I hated the side effects and my sleep was normal after.
2021 - I had extreme stress from college and was unknowingly subclinical hyperthyroid and had another bout of staying up for multiple nights (sleeping every other night w the help of klonopin) and then stayed up for four days again. But it just went away on its own. I also experienced suicidal ideation in 2018 from taking Ativan daily despite taking benzos occasionally in the past with no issues. I think I might have ptsd from that trauma which is effecting me now. I have had health issues I’ve left untreated because I didn’t want to take medication or supplements due to anxiety.
I’ve reached a point with my iron and b12 deficiencies that I had to take shots/get infusions and since then my sleep has been horrendous. At first I was sleeping 4-5 a night and then it turned into not being able to fall asleep again. If I do sleep on own without meds, I wake up 3-4 hours later unable to fall back asleep. Went to the doctor - they gave me Trazodone (which I tried before and didn’t work) which wasn’t helpful but also I’m not sure I took enough. She then gave me a weeks worth of Ambien 5mg which has been helpful but I’m still waking up a few hours later. I’ve also been feeling extremely depressed/suicidal - which is from the lack of sleep but I’m worried Ambien is making it worse since benzos started making me suicidal. I also am still waking up in the night
Every day I have giant mood swings/panic attacks where I say I wish I was dead and truly mean it - until I snap out of it and feel defeated but not actively suicidal the rest of the day. It’s worse days I sleep less. I envy/resent everyone who is doing fine while I feel so terrible. It’s been over a month of stress/rumination/anxiety.
If benzos made me suicidal should I assume ambien is a bad idea? It’s helping me sleep but also I feel so lethargic and spaced out. The doctor who prescribed me them knows about it. I told myself if I ever had to take AP’s again I’d kill myself because I hated the side effects so much. I feel so isolated from everyone in my life despite how helpful they’ve tried to be. Thinking about asking for Dayvigo.
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2023.05.30 22:12 Hopeful-Aerie-9727 Feeling stressed--okay to take a break from a partner?
Not sure if this is the right venue for this question, but I am in a polyamorous relationship with someone who we'll call Fern. I've been seeing them for six months and it has largely felt easy, or if there were hard things that came up we discussed them and moved on. Early on they shared that they were worried when I graduated from my grad school program in May that I would have more time and would want to give it to a more serious partner and see them less. This is because before we started dating I said I had wanted a stable longterm relationship in the longterm, but in the short term was okay dating them casually while I was in school. I quickly caught feelings and we had been seeing each other 2-3 times a week since. When they brought up this concern a few months into our relationship, I reassured them that no, I wasn't interested in seeing anyone else and that I would likely want to see them more. Well, I think things are changing.
Things in my life this past week have started to implode in my personal life--potential housing insecurity, potential job insecurity, a general sense of inner turmoil and anxiety due to other pressing deadlines and responsibilities. My partner's partner has been going through it too--having some mental health instability because of their own work burnout. They are nesting partners, have been together for 5+ years, and are essentially primaries (though my partner Fern says they're more non-hierarchical). They went on vacation together a week or so ago and when they came back I volunteered to help them both move into their new place. I was having some feelings come up about wanting a LTR and the stability and security of a nesting partner, and still excited for them. This was the day before my landlord told me he was deciding to sell the house I'm in and other things were arising in my life.
I saw my partner today and they were telling me how living with their other partner makes them feel more securely attached to their partner. I think that makes sense. I feel sad that it would be difficult for me to live near them (they live way out in the mountains, about 45 minutes from my city). They work here, and I go up there about once a week or so, so it doesn't feel terribly long distance. But certainly different than being able to spontaneously share space.
Anyways. That was probably more information than necessary but basically I'm feeling overwhelmed and not in a place to show up for the relationship the way I was previously. My partner keeps asking about ways they can support me which I appreciate but I'm not sure what to tell them. I feel hesitant to turn to them for emotional support since they usually rely on their other partner for emotional support. I feel sad about the instability in my life and worry that seeing their stability with their other partner will make me feel more insecure and confused at this time.
Is it reasonable to ask for a month long break while I figure things out (housing, work, etc.)? I'm not sure what I have to offer as I feel pretty raw and stressed with so many different moving parts right now. Before this, I haven't been in a romantic relationship for a long time, but I'm pretty sure a lot of folks look for partners to have support when things are rough. When things are rough I am lucky enough to talk to my parents, or my therapist, or a hotline, and sometimes pals. I know part of being in a relationship is being vulnerable, but I don't want to burden my partner with all the uncertainty and stress in my life right now.
I feel like part of me is afraid to go from the fun, NRE new person into a messier, longer term partner phase and worry that there won't be space for me longterm in the ways I am hoping (ie a live-in or primary partner situation). But maybe this is just the natural end to a spring fling? I care a lot for my partner but feel in a weirdly malleable place where I'm not sure if I can be the fun date I once was and I'm not sure they can be the stable support I need right now.
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2023.05.30 22:11 robmichaelfield UK - Advice for Disabled Father
Hi all, first time here so apologies if this post breaks any rules.
I'm nearly 30 now and have been living on my own for nearly 10 years and in that time my dad has been blighted by a disability causing him to lose the use of his legs. As tragic as it is, it was always manageable because he had the support of our mother.
It's been nearly half a year since she had a breakdown and was permanently hospitalized due to dementia. Her absence has been huge, and most noticeable in the care my father receives. For some context, my father has always been a very unclean man and that's been a contact all of my life. He's great, but he has never understood hygiene, even when he was well. My mum was always single factor keeping the house in liveable conditions.
Since she's been gone, I've been the only one in a position to really step up and help out financially. I've temporarily moved home to try and help him gain some independence but I'm just losing hope. It's important to remember here that he is, by nature, a very piggish man, even before the disability. So I try to approach the problem to tackle the accessibility issues: I'm trying to make cleaning as easy as possible for him and remove any barriers. I paid for a private occupational therapist who was great and fast-tracked some nursing which he now receives every morning - they come and make breakfast and give him a wash (he typically refuses the wash, but I'm sure as his confidence grows he'll do it more often). I've seen some real progress in the accessibility of the house and his outlook. I do not, however, see any progress in the cleanliness of the house. And please don't read this as me putting a disabled man down - this isn't just leaving things on the floor because he obviously can't reach it - it's the kind of mess which is a genuine health concern. I hired cleaners last month and they charged me double because they claimed the house was in such a dire state. I am not exaggerating, the house was almost back to an absolute state almost a whole week after the deep clean.
It's unsustainable. I'm trying my hardest but I just can't keep up. I cannot be his full-time nurse, and even if I was, he creates too much mess for me to keep up with anyway. He'll make a slice of toast and leave the opened bag of bread on the floor next to the bin and the butter will stay open without a lid for a week, with flies and mould around it as he continues to use it. This isn't just his disability but his mindset. I've typed too much and feel like I'm ranting now, and some of this was therapeutic for me, so thank you for taking the time to read because I'm really struggling stay calm and patient with him.
I think the ultimate point of this post is to ask for any advice - has anybody been in similar situations? What can I do not just to make it easier for him, but for him to want to do it? Full-time care is off the table as the nurses believe he's capable of looking after himself, which I believe is also true. I think having a large, accessible bin for the kitchen would work well too, maybe something electric. Just any advice would be great, thanks.
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2023.05.30 22:10 atomic_chippie Start/stop frustration
This is vent/question if you will. I live in a rural area, very few providers but have a decent enough relationship with current NP. She has a past with BED, understands weight/mental health issues, is caring but not always on the ball. Three weeks ago, I had an appt, we decided to go with Wegovy, she shows me how to do the first injection, it leaks all over, no yellow bar. Defunct, so we use another from the sample box. I go home with two .25 remaining. Take those over 2 weeks, slight nausea, no weight loss, but am absolutely excited about moving up.
Have an appt this week, a teaching appt as she's having wegovy sent from a compounding pharmacy, different administration. I call the office today, asking when/where it's supposed to arrive, the MA checks my chart, NP never sent the prescription in.
Ok, can I just pick up another box of samples since NP made a mistake, I can just stay on .25 for now? Sure, let me check. No samples here, but the rep might be coming in this week? Oh great, please call when available. Can't, NP is the only provider in the office, she's out with Covid, then on vacation for a month, she has to sign for samples.
Um, wtf? So now what? They don't know when the prescription will be called in, and the MA said it takes weeks to be filled. So, I will have nothing for weeks but am supposed to jump to .5? Has anyone else done this? Not seeing any other choice but um...how bad are the side effects going to be?
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2023.05.30 22:08 coolwali I platinummed Sly Cooper 4: Thieves in Time on VITA to get the secret ending.
Hello everyone. I recently platinummed the PSVITA version of Sly Cooper 4: Thieves in Time as my 28th platinum. It only took me 10 years, 4 weeks, 22 hours to do it. Did you know this game hides its true ending behind the platinum?
Anyway, I'd like to talk about the experience.
Sly 4 was a bit confusing and inconsistent to platinum. I get the feeling the game wants you to platinum it given how on every loading screen it shows you how much you've completed the trophies and collectibles for the game. And that there no missable trophies. But there are some decisions that don't help with that.
So I'd say there are around 3 groups of Trophies in this game.
The first group are the mandatory story trophies. Not much to say about these. There's nothing missable here and the names are quite cool. I do like looking at the percent completion to see how many players completed the PS VITA version of the game. Did you know that around 73% of players booted this game up and completed the prologue? And only around 25% of players even beat the game. The biggest drop happened around the start of Episode 2 since the completion dropped from around 60%to 48% for some reason.
The second group are the trophies for the collectibles and arcades. I'll talk about these later.
The third and final group of trophies are for miscellaneous challenges. I'll start with these first and highlight some of the notable ones that I missed on my first playthrough.
"Crazed Climber - Scale the dragon lair in under 90 seconds". This was one I missed during my original playthrough of the game. This requires you to climb a giant tower filled with traps in the mission "Mechanical Menace". And this one was really fun even though it took me like 3 attempts. Sly 4's movement and platforming is quite fun so having a mini speedrun challenge using Sir Galleth's moveset was a treat. The one criticism I have here is that the game drops a checkpoint as soon as you get to the top. If you haven't gotten the trophy by then and need to retry, you need to quit to the main menu/hideout and reselect the mission, skip through all the cutscenes and get back there which gets annoying. At least the tower is near the start of the mission.
"Ancient Warfare 3 - Crackshot 10 enemies within 65 seconds. Sly's ancestor, Tennessee "Kid" Cooper" has an ability similar to "Dead Eye" from Red Dead Redemption where he can slow down time, mark enemies and objects and then instantly shoot them dead called "Crackshot". I never got this trophy when I first played the game because there wasn't much opportunity to. There aren't large groups of enemies wandering around that you can casually get 10+ of them line up for you to shoot them. Plus, I was already good at shooting them normally. I tried running around in the open world trying to lure enemies but found it wasn't working. There's a mission in the game called "Blind Date" that throws lots of rabbit enemies that chuck TNT at you that worked better for me.
"Hubba Hubba - Don't miss a beat in the Carmelita dance game." This trophy is, without a doubt, the main reason to platinum this game on VITA instead of the PS3. So nobody can see you play this dumb minigame and call you a Furry. This trophy requires you to complete the minigame where Carmilita needs to disguise herself as a belly dancer and dance to distract guards while the Cooper gang try and open a door. You just need to hit the button prompts perfectly. So you can ignore the times the minigame asks you to shake the VITA from side to side like a champagne bottle to make Carmilita shake her ass (seriously, why does this game sexualize Carmilita so much? None of the past Sly games did it).
"Get To the Chopper - Don't take any damage during Up In Smoke." This one was actually fun. In the mission "Up in Smoke", you have to control an RC Helicopter and drop bombs on turrents while drones and mines chase you down. It was fun dodging and weaving through them. There are 3 phases to this mission and you have a checkpoint in between every phase. So if you mess up, you can just restart the checkpoint to the last phase. You don't need to avoid taking damage the whole way through which is nice.
"Unexpected Package - Place 60 bombs in enemy pockets with Bentley." When I first saw this trophy, I groaned. This would be a massive grind. And I had actually made it harder on myself. You see, normally, when you sneak up behind an enemy as Bentley and hold triangle, Bentley will try to put a bomb in the enemy's pocket. Larger enemies won't notice this but smaller enemies will. But the main issue is that I had previously unlocked the Heat Seeking upgrade for Bentley. Meaning sometimes, the bombs would "miss" and stick to an enemy guard's arms or legs instead. So it was annoying going around the hub world and planting bombs on guards.....until I remembered that I had purchased the upgrade for sleep bombs. My plan now was just to find a lone guard on a rooftop, try and place one sleep bomb into his back pocket and detonate it. He'd then fall asleep. Then I'd go to his sleeping body and try placing 5 sleeping bombs in his pocket and back away (the max you can place at any one time). When he wakes him, I'd detonate all 5 which set him to sleep and then repeat. Even if I'd "miss" a few bombs that would stick to their legs instead, I generally 3 or 4 bombs work perfectly. So it didn't take long to get all 60.
"Apollo Wins - Have the perfect workout during the Training Montage." During the mission "Getting Stronger", you have to do a training montage with Bob where you alternate through 6 minigames as you complete them with the minigames getting harder as you complete them. The trophy requires you to complete 10 randomly selected minigames without making a single mistake. If you mess up, you can restart the checkpoint to the beginning of the montage and have to play through a new set of 10 randomly selected minigames. The Minigames are "Slippery Slope" where you balance an egg on a beam using motion controls while penguins jump around on the floating iceberg you are standing on. "Penguin Popper" where Penguins are diving in front of you and you have to play baseball using them. "Sumo Slap" where you have to perform QTEs to push a giant penguin out of a Sumo Ring. "Duck and Cover" where penguins get launched at you from 4 different directions and you have to move the left stick to dodge them. "Super Sling" which requires you to use a catapult to launch a penguin at a flying pterodactyl. And "Whack a chump" which is Whack a Mole but with penguins. Some of which are fake and you should avoid.
Penguin Popper was easy. Once you get the timing down it's easy to get into a rhythm and hit the penguins since they don't vary when they dive. Whenever this popped into the rotation, I considered it a freebie. Sumo Slap was extremly easy. The button mashing was extremely generous. This was another freebie. Duck and Cover requires a bit more focus because of the timing and inconsistent patterns. It's not too challenging. Interestingly, I noticed that the VITA's speakers would reflect if the penguin was coming from the right or left but not above or below you. I guess headphones would make this easier but I had no need for it. I was generally glad when this popped up in the rotation. Whack a Chump was a bit harder than Penguin Popper because there is no set pattern and the additional challenge of not hitting the fake penguins. But it wasn't too bad. I was glad when this popped up in the rotation.
Super Sling and Slippery Slope were the 2 I dreaded and the ones I messed up the most on. Super Sling doesn't give you much indication of where your sling will go. The Pterodactyls have varied speeds so you can't rely on pattern recolonization and reactions. And there's time pressure as taking too long counts as a miss. And it kept popping up in the rotations for some reason!
Slippery Slope was stressful because of the motion controls and how wild later versions of it were.
"The Cooper Open - Have a 20 hit rally with Bentley in each hideout." There are 6 hideouts in the game. In each hideout there is a table tennis table where you as Sly can play a round of table tennis with Bentley. I question the inclusion of it but I suppose it can be a nice distraction. This trophy requires you get a sequences where both you and Bentley hit the ball back and forth 10 times each (or 20 times overall) without missing. And repeat for each of the 6 tables. I found Bentley kept messing up so I had to intentionally hold back and avoid making good shots and try and hit the ball towards him. The main issue is the fact you have to repeat it 6 times. I feel it would be better off just once and as nothing is really added by doing it 6 times. If anything, it's more annoying given the long load times to switch hideouts and Bentley's random AI.
"Hassan Would Be Proud - Pickpocket a full collection of every item in the game." Each of the 6 or so locations have around 3-4 items that can be pickpocketted from guards. The main issue with this trophy is that it doesn't keep track of which items you have already pickpocketed in any way. The game already tracks how many treasures and masks you've found per general area but not pickpocketted items.
I only got this trophy by planning on systematically going through every location in the game and pickpocketting every enemy item and noting down which ones I found.....only to get it in the first level when I used Murray's shake move on some rat enemies. Enemies that you never encounter or have a reason or opportunity to naturally pickpocket. I guess 2013 me had already gotten 99% of these items previously.
"Navigate Like Drake - Take a look at every map in every episode". I found this trophy really annoying. The way it works is that every location in the game, including linear interiors that are exclusive to missions and even the hideouts, have a map you can look at by pressing SELECT. The game doesn't keep track of which locations you've seen the map of. So I had to systamatically play the game from the first mission and press SELECT whenever I entered a new interior. Then quit out and play the next mission and repeat. It popped for me in Episode 4 so somehow, 2013 me had looked at all the maps in Episode 5 without realizing it.
I don't like this trophy. It doesn't really add anything. The player would already be looking at the maps in the hub worlds where they would be at their most useful since those are open world sections. They have no real reason to use the map in linear interiors. And even less useful in hideouts as these aren't even explorable. They are basically just menus that happen to have a 3D background. I'd be more forgiving of this trophy if the map showed collectibles at least. That way, players have more of a reason to use this feature.
Shout out to the Lazy Trunk Spa & Lounge. A secret area in the game that contains a mask collectible and counts for the trophy with a unique map. No mission ever goes here. So even if you were to play diligently and open the map for every area you encounter, you'd still miss this. I only knew this existed because the trophy guide I looked at told me about it so I decided to tag this area while doing the "Get to the Chopper" trophy.
"Hero Tech - Battle with a secret weapon" Once you collect 50 Sly masks. You unlock Ratchet's wrench from Ratchet and Clank. This weapon even turns the coins you collect into bolts. Collecting 60 Masks unlocks Cole's Amp from inFAMOUS. This can electrocute the enemies you hit. I chose to use Cole's Amp to get the trophy as a tribute to inFAMOUS. Killed by Ghost of Tsumia 😭. May it rest in peace. Gone too soon.
That covers all the miscellaneous trophies. Now for the collectibles and arcades.
Sly 4 has a bunch of different collectibles scattered in each of its 6 episodes.
Bottles: Each hub world contains 30 bottles. Collecting all of them gives you access to unlock a safe hidden somewhere in the hub world. Unlocking that safe rewards you a special treasure. Bottles make a "clinking" sound when you're near them so if you're having a hard time finding them, try going into the game's settings and turning down the music and voice sounds. If you find the safe in Episode 3, the special treasure it gives you will highlight bottles and safes in every other episode on your map which is quite nice. I wish the game did this more often. If it hides collectibles from the player, at least give the player an endgame ability to highlight them. It makes it more feasible and fun to complete these tasks instead of combing every last inch (or looking up a guide).
Treasures: Each hub world has around 11 treasures scattered all around. The gimmick here is that in order to collect them, you first need to find where they are in the hub world. Then once you pick them, you need to race back to your hideout under a certain time limit and without taking any damage. If you mess up, you need to repeat the process. The treasures generally require you to have all of Sly's costumes. And a couple require you to be playing as Sir Galleth because England has increased gravity for some reason. Some of these treasures are really well hidden. Requiring you to go to these holes in the middle of nowhere which then require you to switch between some of Sly's costumes. Like, if you open the map when picking some of these up, you'll find Sly is located beyond the borders of the area.
I found it way more fun to race back to the hideout than actually finding them. It was tedious to find many of them because of how well hidden they are. There is no tool or item in the game that can help mark them on your map. Well, I say that. Supposedly, if you have both the PS3 and VITA versions of the game and play them at the same time, you can use the VITA like a scannebinoculars to locate these treasures. And then use the Cross Save feature to nab them in both versions. I only have the VITA version so no luck for me. Again, I'd argue it would be better if there was an endgame upgrade or tool you could get that would mark the treasures like how the game does it for bottles. There isn't even a "clinking sound" or any help for these.
Anyway, collecting all the treasures for an episode unlocks the arcade machine minigame for that episode.
Also sidenote, but this game has the worst map screen that still somehow can be useful. The map gives a top down view of the area but with a blue filter. This makes it harder and more annoying to navigate and use landmarks for reference. Especially on the VITA with its smaller screen. There are also no icons on the map (aside from bottles, safes and objectives) or the ability to make your own markers. The VITA version makes it worse as you can't even use the buttons to navigate the map. You have to use the touchscreen even though that's not how it is in the PS3 version. But you can still use it to know where you are and where collectibles can be from guides. It's technically readable and useful but just barely. I've never seen a map in a game so perfectly walk the line between useful and annoying.
The next collectible are Sly Masks. There are 60 total and around 11 per Episode. Collecting them unlocks skins and some goodies. But the catch with them is that they can be anywhere. There can be a couple in the hub world. But also couple during select missions and even some in the arcade minigames. There's no way to know where any of them are. They generally tend to be really well hidden even if you are trying to scour every area.
Again, I wish there was a way to highlight them. The game's long load times make it a chore to switch episodes or missions so it's tedious to try searching for them manually.
Now it's time to talk about the arcades. Sly 4 has 3 arcade minigames that are used in both the main missions and have a harder version in the arcades in hideouts. The arcade versions of these minigames are harder, go on for much longer and can have secret paths that lead to portals that reward you with points and some of them even have Sly masks. You need to beat the high scores to get the trophies
The first minigame is "Alter Ego". This has you play this 2D auto scrolling twin stick shooter minigame where you must avoid enemies and collect these "ionic bits". Collecting 5 yellow bits levels you up so your weapons get more powerful. At level 10 you have shoot crazy fast, can launch missiles and have floating drones that can damage enemies around you. But whenever you take damage, you drop an entire level. And you get left behind as the level autoscrolls, you respawn at level 0. You can also collect blue bits which can give you a grenade explosion around you.
Personally, I don't really like this minigame. It's fine when playing casually as a change of pace but grinding the high score isn't great. Since it is an autoscroller it is entirely possible you don't have enough points to match the high score and you won't know until its too late, wasting your time. I also found the hitboxes a bit too small. Making items more annoying to pickup.
The key to success is finding the right balance between collecting yellow bits as they give points and level you up (and how high your level is acts as a multiplier for your score) and killing enemies since they give more points. As well as avoiding taking damage and maintaining level 10 as much as possible and knowing where the secret paths are so you can get more points as well as level up if you have messed up.
The second minigame is "System Cracker". Here, you guide a little space ship looking thing through 2D levels in top down twin stick shooting sections. This isn't an autoscroller. You need to explore levels looking for keys and shooting enemies. There are 3 ships you can switch between by going onto specific coloured pads and each ship has its pros and cons. The green ship you start with does decent damage and has decent health and can carry keys. So it's a jack of all trades master of none kinda ship. The pink ship literally resembles a tank. It fires slower and at a shorter range but does more damage and has more health. It's also necessary for destroying pink crystals to progress. The blue ship has floatier handling and faster speeds. Its shots also bounce off walls and it can draw a line which can activate switches and damage enemies. It is weaker than the green ship though.
I actually really enjoyed this minigame and was happy whenever it comes up. It even feels the most fleshed out of the 3. Like, I feel it could even be released as a small standalone game with some tweaking and expansion. I'd probably play a mobile version of this in my free time.
I like how varied the levels can be. You can have a lot of different threats and mini-puzzles and even scenarios where you have to keep switching between ships on the fly to damage enemies. Like, there's this one enemy that's made up of orange, blue and pink hexagons that require you to switch between all 3 ships and use their abilities to damage it. It's quite fun. Damage one ship takes is "saved" on that ship. So if you take 50% damage with the green ship and switch to the pink one, the pink one will have 100% health. But whenever you switch back to the green one, you will be back at 50% health. So mistakes have consequences requiring you to make decisions accounting for them without being too overbearing.
Beating the high scores for the associated arcades is very easy. For one, there is no time limit or pressure so you’re free to take your time and play carefully. On top of that, the mode is very generous with points. Whereas Alter Ego only gives you points for killing enemies and picking up bits (and you need to get and maintain a multiplier for decent times), System Cracker gives you points even for shooting obstacles and barricades in your way. In Alter Ego, I was scraping for points until the very end. In System Cracker, I had more than enough points by the halfway mark.
I suppose the game could have balanced this by increasing the points threshold and rewarding extra points for taking less time to complete sections but I’m not complaining.
The third and worst minigame is “Spark Chaser”. Here you must guide a little electric ball across these maze like areas with gaps that end your attempt if you fall down them and these pinball like bounce pads that bounce you really far. There’s also a time pressure. You have around 20 seconds to get as far as possible with more time added as you pick up these purple clock icons.
The biggest issue is that it’s entirely controlled by motion controls. And this makes me experience worse on VITA. Seriously, I very nearly quit playing. This post was almost titled “I gave up trying to Platinum Sly 4”.
With the PS3 version, at least titling the remote doesn’t also affect your view of the screen. You can look at the game and play it the same as you normally would. But in the VITA version, the “neutral” position where no input is registered by the system is placing the VITA flat with its screen facing up. The standard “screen facing you” position registers as down.
The end result is a frustrating experience. This minigame requires really fine precision given how easy it is to fall off and the time pressure requires you both be fast and more precise to collect time pickups. On top of that, your view is constantly being messed with due to how much you need to tilt the system from odd angles. Especially how tilting “up” really makes it hard to see. Oh, and the dialogue from Bentley as you bounce gets really annoying and repetitive.
It’s barely tolerable in regular missions since those don’t require as much precision or speed. And even then, the usage there in 2013 was suspect to begin with. I only completed this because there’s a cheese where if you can get enough time early on, you can then keep bouncing on certain pads which give around 20 points per bounce. When I played “normally”, I’d get around 300 points with the high score being 1000 points. Using the cheese, I averaged around 990 points and managed to get lucky to win with 1010 points.
Tangent Time:
I’ve said it before. Motion controls work best when they complement existing controls in an optional way or in more restrained ways. I love it when games have gyro aiming since that can help compensate when aiming with sticks with small fine corrections. It works here because the sticks do most of the work and the gyro sensors work where they are best suited.
Or in many mobile racing games, steering is often done by tilting your phone. I enjoy this because there is only one axis you need to tilt your phone, the screen often rotates in conjunction so your view is preserved and it’s more intuitive to feel the “range” of rotation and how it corresponds to steering.
Hell, even ignoring these approaches, motion can still be used in worthwhile ways. Such as by mapping an extra action that is infrequent if all other buttons are occupied. The Mario games on Wii map a “spin” when you jump and shake the remotes giving Mario a bit of grace allowing him to make slightly further jumps or correct a bad jump. Call of Duty MW1 on Wii allowed you to assign certain commands to custom motions of the controller and nunchuck. So you could map stuff like jumping, moving and shooting to buttons but map reloading to smacking the nunchuck to the Wii Mote or plunge the Wii Mote forward to do a melee attack or tilting the Wii Mote to bring out a grenade or alt fire.
Even Resistance 1: Fall of Man had a neat idea. You could quickly tilt the controller left to bring up the Scoreboard screen without needing to take your thumbs off the sticks or stop moving. The Soulsbourne games allow you to quickly do emotes without needing a menu by holding the interact button and quickly tilting the controller in certain directions.
I bring all this up to highlight how Sly 4’s use of motion controls are a failure on every level. They’re mostly used in place of minigames as the sole method of control. So all the issues of motion controls (such as the lack of broad control and feedback) are front and centre. The only place where the motion controls are understandable is when firing arrows as you can then control the arrow after it’s fired using both the sticks and gyro aiming. But even then, the lack of any ability to tune the gyro sensitivity or even invert the controls hampers any use it could have had.
I don’t mind the idea of Sly 4 having decent motion controls. There are places where I can see it being beneficial. In addition to shooting and guiding arrows, I can see it being useful when you have to use the binoculars. Especially as Bentley as you need to shoot darts precisely.
Or, here’s a gimmicky one: you can bind certain costumes or tools to also be selected by quickly tilting the system. Even though using the D-pad for a quick select would be faster, it would still be a better use of motion controls for Sly 4 than most of what’s currently there.
End Tangent.
Back to getting all the trophies, the final arcade machine, unlocked only when you’ve gotten all the treasures in every other episode, is very easy. It has “3 rooms”, one featuring every minigame thus far. But the high score requirements are really low and rooms aren’t as tough as prior versions. You can easily get the high score in the first area which is the Alter Ego one. Even if you miss it there, the second area is Spark Runner but you can keep reloading the checkpoint to preserve your score. So you can get some time clocks, reload a checkpoint when you’re close to running out of time or about to fall off and repeat until you get the high score.
You do need to get past the Spark Runner section to the 3rd and final section that uses System Cracker's gameplay in order to get a hidden Sly Mask, but it's far easier than the dedicated Spark Runner arcade minigame as the section is shorter, is more generous with Time Pickups, has easier level design and lets you reload a checkpoint if you're about to fail which doesn't end the run.
So yeah, Sly 4 Thieves in Time was....inconsistent game to platinum. I enjoyed the base gameplay, System Cracker, the various challenge trophies and the mini speedruns for collecting treasures. I didn't enjoy finding the collectibles and doing some of the other minigames. I hated Spark Runner.
If the game had more ways of tracking collectibles, fewer minigames and better load times, I'd gladly recommend it as a fun game to platinum.
As for the base game itself, I am mixed on it. The gameplay is arguably the best in the series. Sly's movement and costumes are so fun to play around with. Murray, Bentely and Sly's ancestors are also fun changes of pace during missions.
The story is lacking. My main issue is that it doesn't feel like it realizes its following up Sly 3. The story so casually undoes the ending of Sly 3 to get Sly 4's story going. I get it, that's what a sequel has to do. But the way it does it really undermines Sly 3. It's also much more lighthearted and doesn't have as much of a theme or focal point as its predecessors. Sly 1-3 explored the theme of legacy and the consequences of adhering to it so tightly. A major aspect of Sly 3 was Sly realizing the Cooper Vault wasn't worth dying for. It's what prompts him to fake his amnesia and retire with Carmilita in the end. So for Sly 4 to then have Sly have an itch to steal just for the fun of it, it's sending mixed messages here.
In addition, Sly is really casual about the fact Carmilita now knows about his betrayal and has broken up with him. Seems like that should have been a bigger deal. In fact, that kind of "casual-ness" persists throughout the story. Sly doesn't really have much of an arc or any real heartfelt moments with his ancestors. Nor do they seem to really care their decedent from the future is here with them.
If I could have tweaked the story to address these points, here's what I would have done:
I'd have the story open with Sly, Bentley and Murray enjoying their "retirement" and have no plans of thieving. I'd go so far as to have Sly even scoff at the idea of him ever wanting to be a thief. Then when the pages of the Thievus Racconus are dissapearing, Sly, Bentley and Murray have to reluctantly unretire to try stopping them. There would be dialogue during the opening mission of Sly being worried if they get caught as it would undo their happy ending. And then when Carmilita catches Sly, Sly at first is flustered and tries to explain the situation to Carmilita who isn't having any of Sly's BS. Sly is forcibly extracted by the gang and then they time travel. As they are time travelling. Sly is upset that, in order to go literally defend the Cooper Legacy, he has to give up his happy relationship and can't be repaired now. That even if they fix the problem, they'll be on the run forever now. Murray had to give up his professional career as well.
Already, I feel this introduction has a few things going for it. It respects the ending of Sly 3 and keeps the characters in more character, as well as putting more heat on Le Paradox. Sly 4 had to rip away the happy ending that was Sly 3. The characters know that and aren't happy about it. There is immediate consequences. And that heat can be directed at Le Paradox when he comes later.
I'd also like if all of the ancestors Sly met had different reactions to both him and the Cooper legacy and how it affects Sly's arc.
For example, lets say when he meets Riochi Cooper, Ricohi is initially disappointed in Sly as the future Cooper decendent as Sly doesn't act honourably or respect the legacy or something like this. Something that makes Sly start to question if it's even worth defending the Cooper Legacy. Bentely is the voice of reason here and mediator that gets the gang to work as well as they can.
Then when Sly meets Tennessee Cooper, Sly is initially expecting another traditionalist ancestor that cares a lot about the Cooper Legacy. But Tennessee is kinda the opposite of Riochi in that Tennasee doesn't care about the legacy in the same way. He adds his own spin and contributions but also uses the knowledge from it to do his own thing. Perhaps Tennessee is this Robin-Hood esque figure who uses his heisting skills to steal from the corrupt ruling class and give to the lower class. The point being that through Tennessee, Sly considers another aspect of the Cooper Legacy on how he's not that beholden to it and can potentially make it his own.
Then when Sly meets Bob, part of Bob's training is also from Sly as Sly teaches him some of the Cooper moves he knows. Since Bob is the first Cooper ancestor, he has no bias towards the legacy or any knowledge. So he's far more grateful and begins to use his new skills in helpful ways. Causing Sly to wonder if he could use the Cooper Legacy in more ways.
It's a similar situation for Sir Galleth. And for Selim, perhaps by that point, Sly has a newfound outlook and appreciation for the Cooper Legacy and ways on how he can improve it or make it his own that he encourages Selim not to retire or to retire in such a way where he could help people or something like that.
So yeah, there's this theme now of "Don't let the past define you now. You can make it your own and grow past its flaws". Which I feel would give Sly 4 more of a punch. I am basically copying Metal Gear Solid 4 and Assassin's Creed though.
I also feel it would be better if Penelope wasn't the villain of episode 4. It seems to contradict her character from past games and the explanation given for her heel turn doesn't really hold water. I feel the story would be better if Penelope had the role Dmitri has where she's their help in the present and the Knight was a new character. But if you need to have Penelope as the antagonist, have her be under mind control or something. That way the team has the conflict of how will they stop the plan without hurting their friend. But if you really insist on Penelope being a full on antagonist now by her own choice, perhaps flesh out her motivations more? Maybe something like "she sees how Bentley will never reach his full potential as the Bill Gates of the world because of his criminal past that requires him to lay low and not take public credit for his inventions. So she's trying to erase the Coopers so Bentley will have never met Sly". That would at least be more than "I want money".
Everything else, I feel works more or less.
I will note that the cliffhanger ending was a weird choice given that this game wasn't projected to sell well and kinda pigenholes any story Sly 5 would be going for. Plus, it being locked behind the platinum trophy means only a small portion of the few players that played Sly 4 would even know about it.
So yeah, that's my take on platinumming Sly 4: Thieves in Time. What do y'all think?
Next up for me is platinumming every Spider-Man game on PS VITA. See you then.
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2023.05.30 22:08 Necessary_Drawing_78 Getting Help.
So today I had a mental health evaluation with the VA due to a C&P examiners recommendation. Spoke to the therapist and basically unloaded everything that I've been through from basic training to Sept 11th 2001. It was a lot to unload and majority of the time I was crying like a little child to her and she just totally let me vent all that built up anger and hurt I had in me. If it wasn't for that C&P examiner though I would've still had it in my mind that I'm fine and there's nothing wrong with me. The therapist immediately sent in prescriptions for depression and anxiety. If you think you're fine and you have people that care for you telling you to seek help don't disregard them. Pride is a hard pill to swallow but self destruction is even worse.
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2023.05.30 22:08 6aturn Should I leave my job after my maternity leave? Is it frowned upon?
Okay so I’ve been at my site for 2 years and honestly I love my kids. I teach art so I get them to teach all students on campus and I see them year after year until they graduate.
However, when I was pregnant my work environment became really toxic due to overly involved parents complaining that I wasn’t “doing my share” when moving tables or during dismissal (I was not looking to pass out from the heat or get hit by a crazy parent while pregnant).
I had asked for disability accommodations and they were often not met or met with hesitation. I have a condition that makes swallowing food difficult or just not possible to do quickly. I had asked for my full 1hr lunch instead of breaking it up into two 15 minute breaks and one 30 minute lunch (both of which I often worked through because kids were often sent to me by “accident”). They said okay but honestly during the last trimester I was there I only got my 1hr lunch 3 times total all because they were too concerned with getting accreditation and having CDE visitors on campus.
I also had asked for restroom breaks and nobody would respond over the walkie or I would have to leave my students to run down the hallway. I would later get reprimanded for doing so but what was I supposed to do, pee myself?
I was also excused by my doctor because I had to be doing prenatal screening 2x a week early in the morning due to Gestational diabetes and other staff would often complain that I took “too much time off” even if I rushed to get back before 8am to teach my classes. My doctor also took me off on disability 2 weeks before my due date because my blood sugars were unstable due to my hectic work schedule and their lack of meeting my accommodations. When I gave them my work note they got upset that I couldn’t wait to train my sub. I also went back on campus the following Friday to return my key and laptop only to find my classroom was a disaster and all my supplies in my closet were trashed because the sub didn’t care and nobody cared to oversee what she was doing.
I just felt so disrespected and had no support from admin or other staff aside from 2 people but they also had their own work to do and couldn’t help me out. I’m still out on maternity leave but haven’t signed a new contract because I left before the renewals but I honestly don’t want to go back when I don’t feel valued. I love the kids but honestly they’re not worth it and neither was the pay but I stuck it out for them. However now I don’t want to do it anymore.
I haven’t told them I plan on leaving because I need my insurance over the summer. I have also paid all the premiums for May, June and July out of pocket or from deductions made from each paycheck as they no longer planned to cover employees during the breaks and decided to take it from out paychecks instead.
I don’t know, is it wrong or is it logical to leave?
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2023.05.30 22:07 Former-Fish4746 Looking for Venezuelan medical doctors for research project
I am working on a project regarding mental health in doctors who have emigrated from Venezuela. I really need your help with this and would appreciate it if you could DM me.
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2023.05.30 22:07 leftistmccarthyism A peek into the vileness of r-alberta: "Take a rock. Paint it blue. Use it to bash the skulls of newborn babies. Run it as a candidate. Watch it win". +30 upvotes.
Some more "respectable" comments that were upvoted by that subreddit, and "somehow" escaped the moderators.
- "teamwildfire2023"
- "Well all those rural voters. Zero sympathy from me. Enjoy wildfires destroying your belongings and enjoy dying from not having any rural doctors!!"
- "I hope that Karma gets every last one of these fucks"
- "Garbage towns, garbage people."
- "There are more nazis in Alberta than good people who want responsible government."
- "That's Alberta for you. When you're full of hate, it will always take priority to actually caring about anyone."
Canada's left has a hatred problem.
Too bad they're so addicted to their self-absorbed preening about being about "acceptance" to even admit they have a problem with vile bigotry and hatred.
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2023.05.30 22:06 PA226 Can't tell if i have costochondritis or something more serious
Hello everyone,
For context, i am 22 (m), generally healthy and fit, with the only diagnosed underlying medical condition being GERD. Around 6 months ago, i started waking up with terrible chest pain. I first thought that i was just sick, but the pain continues on until today.
The pain is unlike anything i have felt before (It's different from the chest pain i experiance due to GERD). Its usually felt around the upper and middle part of my sternum (although sometimes its felt all over my chest area) and it gets worse when touching. For the first days it was terrible and i could feel it all the time, but as time persisted i would mainly feel it when lying down to sleep (I sleep on my belly if this is important) and when i do certain movements of my upper body.
I am generally an anxious person, so it naturally triggered a kind of health anxiety. At first i let it be to see if it will subside on its own, but now it has gone to the point that its really worrying me. GERD does not help, for although chest pain on its own is usually not taken to be a serious symptom, i started having a persistent cough which i can't tell if it comes from GERD or anything else more serious and related to my chest pain.
My situation is not helped by the attitude of those around me. My parents, who due to my current circumstances i am highly depended on medically, have dismissed it as pain that stems from me working out. The closest thing that i could get to a diagnosis was getting on the call with my doctor, who after hearing about my symptoms, said that its probably costochondritis without any further explanation.
This is why i am here. I'm wondering if anyone has similar symptoms and experiances that they can share. While if things don't change, i'm probably going to be more persistent in seeking medical help, i first i need to cull my anxiety.
Thank you.
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2023.05.30 22:06 gemstonesys Please help me figure out whats hurting me. I'm desperate.
Hello there, I'm desperately searching for answers for the pain and symptoms I am experiencing. I have been going to doctors and hospitals searching for answers, but I've gotten nothing but a few tests done that have done nothing but add to the confusion.
Let me add some context.
I'm a relatively healthy 21f with no prior health issues. I started hormone therapy (Testosterone, intramuscular injections 1x a week) And started experiencing severe, debilitating panic attacks I had never had before. They tapered off after a few weeks, but then at about 10 weeks, I started to experience entire right-sided numbness and pain. I would feel aching and pins & needles down my hands and feet, my entire right side just felt weaker and heavier than the left, and attempting to lay on that side would exasperate the feeling to the point where my entire right side would feel heavy and achy, and it would become difficult to breathe.
At 12 weeks, I stopped the Testosterone, and the pins and needles, as well as the general feeling of my right side being uneven and numb in comparison to the left subsided... But since then, more symptoms have been sprouting up, and it's getting worse.
- (Shoulder pain) I have this painful area in my upper back, between my shoulder blade and spine, that doesn't go away. It is not tender to the touch, and when I am laying/sitting I mostly cant feel it, but when I stand, it becomes an intense tight ache that radiates through that area of my back and my shoulder. It subsides partially after standing for a while or adjusting my posture enough times.
- (Right-sided aches and numbness) I have been experiencing aching pain in my right hand and leg, it's typically triggered by those parts being elevated or constricted in any way (My right arm laying on a hard table would be enough to make my hand start to ache.)
- (Facial numbness and drooping) The right side of my face feels numb and droopy, the corner of my mouth visibly droops ever so slightly, and my eye feels heavy.
- (Constant headache) I have had a constant migraine in my right side that feels like its putting pressure behind my eye and one side of my neck. It is always there, but sometimes it becomes a sharp throbbing, usually with no apparent reason.
- (Blurred/worsening vision) My vision in my right eye is gradually getting worse, and its very difficult to focus my eyes on small text.
- (Ear pain, hearing loss) I've lost part of my hearing, and my right ear hurts similarly to my head, constantly aching and sometimes sharply throbbing.
- (Dizziness/Lightheadedness) I feel consistently dizzy, lightheaded and out of focus. Standing makes this worse, and the longer I stand, the more difficult it becomes to focus and balance. ANY time I take a deep breathe while standing, I get extremely lightheaded and my vision will tunnel or disappear entirely for a few seconds before returning.
- (Difficulty breathing) It feels difficult to get a full breathe of air, especially on the right side, and more prominently when standing versus sitting/laying. One lung feels like it fills unevenly.
- (Brain fogginess) I have times (that are becoming more frequent) where I find it impossible to focus, I forget words that I KNOW that I know, and I forget many things. It becomes nearly impossible to hold a conversation.
I'm sure there's more, but I'm not remembering right now.
I had a chest Xray prior to the right sided symptoms, during the panic attacks, that came back clear. I've gotten extensive blood tests that have come back clear, aside from a B12 deficiency. They've also had CT and MRI scans done on my head just the other day, completely clear. They won't do any further tests because it seems I'm "fine", and now I'm suffering without answers. I would appreciate any direction or advice, I'm scared and I want to get help before it gets even worse.
Thank you.
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gemstonesys to
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2023.05.30 22:06 bipolarity2650 Need to vent/get advice about gender roles vs in practice
I’ll try to keep this as short as possible (but it’ll probably be long). Basically, since i’ve (F) been learning about feminism, it’s made me like so upset about how women are treated and almost like angry for my women ancestors too. I am married to a man, and i’ve been learning a lot about invisible labor and stuff.
TL:DR I feel like it’s not really fair to expect him to do housework when he’s the one working. I’d feel more valid in asking for help if we had children that i was taking care of while he was gone, but since we don’t it’s a little harder to figure out for me. pls help
Our situation is basically that he works and i stay home. We only have one car, and i have some mental health struggles so it’s actually better that he works instead of me. We just have two dogs, no kids or anything. I am CONSTANTLY conflicted. In my head: he’s working so i should take care of the house stuff. reasons for this are: in the sense that i love him and don’t want him to have to worry about it, i feel guilty being at home while he’s working so i better take care of everything else, and probably also the gender roles i’ve been taught my whole life. But learning about feminism leads to me feeling resentful bc i want him to help with chores, but then i’m like “well i’m not working so why should he have to do double the work.” In an ideal situation we would both not have to work, or we both would work and then both share the chores. But it’s like we’re each doing half? Idk. One could argue that housework/taking care of dogs/paying bills etc could be more work than an actual job, or vice versa, but something in my brain is just feeling this way.
THEN i feel like it’s making my relationship tougher, almost like making myself upset about something i was fine with i guess? i don’t really know what the solution is, and it’s not like he’s making me do any of it or making me feel guilty or anything at all, it’s 100% my own brain
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2023.05.30 22:05 No_Limit_2377 Suicidal thoughts are my only guarantee in life
Ive struggled with suicidal thoughts since I was 15 years old, when I fell in love with a best friend of the same gender, who of course was not gay. I have borderline personality disorder, and a few months ago I also came out as a trans woman. I am extremely confused about my identity and sometimes it feels like I am transitioning just to guarantee myself the social role of being taken care of by a man, something that I failed over and over again to be myself. I am now in my early 20s, I have a great job, good physical health, great family, lots of close friends and I have been blessed with very high emotional and overall intelligence. Unfortunately, regardless of what I do I feel like my life only makes sense when I am in a relationship with someone who I would honestly give myself away for. I would say Im quite an attractive individual, I dont think I have insanely high standards for a partner and I am also very independent. The only thing I want is to experience the moment when I fall asleep in someones arms and I dont have to worry about anything in the world for at least a minute. For the whole entirety of my life, I have never had a partner whom Ive loved and would be receptive to such an act to the degree that I would be receptive to a crush that I fall for every now and then. I have a crush on a specific person, and its obviously not reciprocated, and it never will be. I feel like it would be much easier to just save myself future pain and kill myself already, I have thought about it many times, and I honestly regret not doing it already. Regardless of how much happiness comes my way, I will never get what I want, and the worst thing is that I know that I probably can never even have what I want. Its not good for me, the universe doesnt want me to have that, because it makes me too codependent. I have tried hard to get rid of this desire, I have tried becoming the most masculine person myself but it never works. Taking estrogen has made me crave touch and wanting to be protected even more, and regardless of how much it has helped me, I still feel this emptiness inside. Before, I wanted to kill myself every few weeks, now I want to do it every few hours, I have imagined my funeral, and to be honest it actually fills me with love and calmness thinking about shooting up half a gram of heroin into my arm, and drifting off forever. The only thing I am scared of is not succeeding.
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2023.05.30 22:05 TheFuriousCoconut Weight gain and sexual attraction
My sexual attraction to spouse isn’t what it used to be bc they have gained so much weight that they are now considered medically obese. Their weight impacts our ability to have sex the way we used to. I know I sound shallow and with time, I know looks fade. I maintain a fit and healthy lifestyle and expect my partner to care about their health as well. IMO, maintaining your health is an important thing to do for your partner. They won’t exercise bc they quit within minutes of starting. They want me to work out with them but I can’t get a good workout if I’m doing very beginner things. I’m a runner. Started in elementary school and am now almost 40. It’s as if they expect it to be easy when they’ve gained 40lbs. Maybe this is just a vent post. They are overly sensitive and have very big feelings and what I describe as “emotional come-aparts”. This is perhaps related to something they were diagnosed with as a young adult but it has never been confirmed while we’ve been married, it’s just something he allegedly has. I hesitant to discuss all of this with them but weight is a touch subject.
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2023.05.30 22:02 MonsieurVox 30M, considering TRT, wanting to understand the risks
Hey good folks. I've been reading up on TRT lately as I suspect low T may be responsible for a number of symptoms I've been having over the last few years. Specifically, low mood, anxiety, low(ish) libido, difficulty losing weight, and a general "meh" feeling in life despite everything being pretty excellent in my life on paper. I've tried antidepressants with mixed results but currently all signs point to low T.
When I had my T checked last year, my "total" number was 412. The results do not show free testosterone, which is the more important number based on my understanding (please correct me if I'm wrong).
Essentially every single post I've seen raves about TRT. I have a primary care provider who I'm almost certain would prescribe it if asked, but I want to know what some of the drawbacks are, if there are any.
The two "risks" I'm aware of are:
- Your body stops producing its own T (which could complicate life if you needed to travel abroad or couldn't find a doctor to prescribe it)
- Hair loss on your head. I've had some thinning in the last 5 years or so, and would prefer not to lose my hair, but would consider it if the benefits outweighed it
What else should I be aware of? Thanks!
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2023.05.30 22:02 kit112 Cipralex Withdrawal
Hi everyone, writing this post on behalf of my husband who does not have Reddit…
Looking for advice/support regarding SSRI withdrawals. Background story is that my husband was (in my opinion inappropriately) put on anti-depression/anxiety meds 2 years ago by his doctor after a 15 minute chat with her about how he felt stressed about his current life situation. We were in the process of buying a house and planning a wedding at the same time all while a close family member of his passed away. My husband had NEVER struggled with mental health in the past - this was just a stressful season in life and his doctor without even suggesting therapy or other methods of stress reduction prescribed him with 20mg of Cipralex daily. Over the last couple of years, my husband struggled with ED and several other issues related to the pill, and we even stopped having sex altogether because he developed a fear of being unable to perform. I was supportive of course as I knew it was out of his control. We recently decided that we want to start a family, so he was exploring the idea of tapering off of the pill to see if it would help. We went on vacation recently and he actually forgot his medication on the trip so he thought to himself, by the time I get home it’ll be over 10 days without the medication so I’ll just stop taking it altogether (DO NOT DO THIS - it is extremely dangerous). He and I both know how dumb that is but it was his decision and he was determined to get it over with.
It’s been about 13 days since stopping cold turkey and he has had some pretty irritating symptoms. Bad nausea, had diarrhea for a few days, extreme brain fog, irritated, restless leg, dizziness, etc. Since he’s not really prone to anxiety/depression, we haven’t seen any bad mental side effects yet.
Has anyone had a similar experience? And how long did it last? I know everyone is different but I’m hoping to see the light at the end of the tunnel soon..
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2023.05.30 22:01 PatientOpen1893 LSD Side effects
is there any proof or any rumor that lsd can be bad for your health? i have been microdosing weed for sometime smoked like 0.1g 3 times a week now started lsd been taking 100ug like every weekend and i want to be very careful so i want to know if i should quit.
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2023.05.30 22:01 robmichaelfield UK - Advice for disabled father
Hi all, first time here so apologies if this post breaks any rules.
I'm nearly 30 now and have been living on my own for nearly 10 years and in that time my dad has been blighted by a disability causing him to lose the use of his legs. As tragic as it is, it was always manageable because he had the support of our mother.
It's been nearly half a year since she had a breakdown and was permanently hospitalized due to dementia. Her absence has been huge, and most noticeable in the care my father receives. For some context, my father has always been a very unclean man and that's been a contact all of my life. He's great, but he has never understood hygiene, even when he was well. My mum was always single factor keeping the house in liveable conditions.
Since she's been gone, I've been the only one in a position to really step up and help out financially. I've temporarily moved home to try and help him gain some independence but I'm just losing hope. It's important to remember here that he is, by nature, a very piggish man, even before the disability. So I try to approach the problem to tackle the accessibility issues: I'm trying to make cleaning as easy as possible for him and remove any barriers. I paid for a private occupational therapist who was great and fast-tracked some nursing which he now receives every morning - they come and make breakfast and give him a wash (he typically refuses the wash, but I'm sure as his confidence grows he'll do it more often). I've seen some real progress in the accessibility of the house and his outlook. I do not, however, see any progress in the cleanliness of the house. And please don't read this as me putting a disabled man down - this isn't just leaving things on the floor because he obviously can't reach it - it's the kind of mess which is a genuine health concern. I hired cleaners last month and they charged me double because they claimed the house was in such a dire state. I am not exaggerating, the house was almost back to an absolute state almost a whole week after the deep clean.
It's unsustainable. I'm trying my hardest but I just can't keep up. I cannot be his full-time nurse, and even if I was, he creates too much mess for me to keep up with anyway. He'll make a slice of toast and leave the opened bag of bread on the floor next to the bin and the butter will stay open without a lid for a week, with flies and mould around it as he continues to use it. This isn't just his disability but his mindset. I've typed too much and feel like I'm ranting now, and some of this was therapeutic for me, so thank you for taking the time to read because I'm really struggling stay calm and patient with him.
I think the ultimate point of this post is to ask for any advice - has anybody been in similar situations? What can I do not just to make it easier for him, but for him to want to do it? Full-time care is off the table as the nurses believe he's capable of looking after himself, which I believe is also true. I think having a large, accessible bin for the kitchen would work well too, maybe something electric. Just any advice would be great, thanks.
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