I've just received the date for my next foot surgery, it's this Friday. I thought I'd be on the waiting list for months but because of my state of health etc, they gave me a much sooner appointment at a much further away hospital. My landlady angrily agreed to drive me if I pay for the petrol and parking costs. So that's the third mutual aid post I've had to make already this month. I'm always worried people are going to get sick of me but I don't know what else to do.
this post was submitted on 16 Jun 2025
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I'm glad you're able to get in to get the surgery, fingers crossed it's the last one for a while. I'm sorry landlady is such a shitty, abhorrent person. Hopefully it works itself out and you can get the help you need. Sending some positive energy your way, love.
Thanks so much. They actually offered me a cancellation for tomorrow but she said it's too short notice to drive me so Friday it is.
Good luck for the surgery, and I'm also sending you positive energy. Take care, love
Thanks you x 
choice between waiting 3 years to get an autism diagnosis and access to help i need or paying $3,000
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Considering how badly understood patient communication is, I almost want to learn to draw to make one of those "Difference between equality and equity" comics but for the difference between compliance, adherence and concordance* in medicine.
*Latest fad
But then I also realize that a great many doctors do not and have never given a shit about concordance.
It sounds like a good idea, despite the doctors being that way.
As someone who's only ever been on the patient side of things, what is concordance in the medical sense here? What sets it apart from compliance and adherence?
Warning I'm going to be simplifying things a lot with regards to medical treatment. Medical treatment obviously refers to more than just taking a pill or doing an exercise, I'm trying to keep this light and as widely applicable as possible and you can feel free to substitute any intervention as necessary and you can obviously ask me to clarify or question or correct my wording. Also a lot of the wording may seem like I'm talking about non chronic situations but it applies equally.
Compliance refers to how close a patient adheres to the agenda set by the medical professional. It's whether you take your medication as prescribed by your doctor, whether you do the rehabilitation as told, whether you do all the exercises your physio showed you. If you aren't compliant you are not doing as you are told, if you are compliant you do as you are asked.
Adherence is active participation in an agenda. So if based on guidance from a medical professional you make lifestyle changes and stick to them even when not watched you are adherent. Adherence is you making a habit of taking your pills, it's making and following an exercise plan, etc.
So in other words if you don't take a pill your doctor is telling you to take you are non-compliant, if you haven't made a habit of taking your pills as part of your regimen you are non-adherent.
Concordance is the agreement between a patient and a medical professional with regards to their agenda and their understanding of their own disease process (uhh i forget what the english name for that is). It refers in totality to the process of aligning the doctors desired agenda and the patients desired agenda, the level to which the two are in alignment and the patients engagement with the plan set forth. So in order to have concordance a medical professional must take into account the physical, social and psychological premises under which you exist and help you reach a treatment plan and a common agenda. Conversely you must as a patient be an active part of the planning of your treatment plan, advocate for your needs, and be honest about your ability to follow any plan and vulnerable enough to take it into account when making a plan and in your discussions with a healthcare professional.
So if you are actively changing your schedule to accommodate a treatment plan you think is ridiculous and which does not account for you as a person outside of the immediate list of symptoms you may be adherent, but there is no concordance. But if you helped set your schedule and as a result feel engaged in your own treatment and wish to follow it, there is concordance.
Some people point out that the framing of adherence and concordance puts a lot of responsibility on patients rather than doctors, and that it may be a way to avoid responsibility for the outcome of patient care. Others point out that a compliance based model limits patient autonomy which is supposed to be a core value of patient care and is likely to be less effacacious.
First of all, thank you so much for the explanation, I don't think I've ever had anyone explain "medical talk" this explicitly to me.
Secondly, you are really good at explaining these things even though English isn't your native language. You're doing great both linguistically and medically.
And finally, I totally see now why you would be running into a brick wall with these definitions and how doctors don't take that responsibility seriously enough. It's a difficult topic, but I think a comic could really help explain this stuff better. You should give it a try
If you ever have any questions about jargon I'm always up for explaining if I can, I think patient communication is super important and I think as patient you have the right to know what's going on (But I can't provide any kind of medical assistance through the internet, both because I am unqualified to diagnose anything, and because it would be irresponsible even if I were qualified.). Now I'm making a summer project out of learning to draw better, even if I never become good enough to draw that comic it at least gives me something to do.
I appreciate the offer, thank you! And I'll be sure to ask a local doctor for medical advice.
By the end of summer you're probably good enough to draw the compliance-adherence-concordance comic, you'll see
I don't know where else to post this.
I'm basically organizing between 4 different groups. 3 are local and one is the PSL. One group is essentially an offshoot of the local crowd from the 50501 protest last week, so basically running the gamut between lib and... radlib. Another group is mostly anarchist with me and 1-2 others that identify as Marxist. This group is very much in motion. The 50501 one is trying to figure out direction and currently want to focus on ICE rapid response. I have some tech experience and offered to help. A few of the others from the anarchist group are also involved. It's sort of a coalition, right?
Well, one member of the 50501 group is onboarding for the PSL chapter I started. Another potential member contacted the cops regarding 50501. I freaked and told PSL to no onboard that person because of the current situation with the FBI as it is. For some reason the person already onboarded decided to tell the rest of the 50501 group that I was collecting data from them and reporting it to the PSL. I do not know why they think I'd even be doing this. Why would the PSL even care or need the data? I woke up yesterday am to find that I was removed from the 50501 group and spend all day yesterday piecing together why. What I realized was that the onboarded person didn't seem to understand that since I was the person onboarding for PSL, I already have a list of potential candidates. I don't know how that got lost in communication but I guess it did. They ran off to tell 50501 group that I was collecting data wen it was literally me just saying I don't want to go forward with onboarding this particular person for security purposes.
Well, now I'm kicked from that group and still don't quite know how I feel about it. I was early in planning to do a reading group with a few of the people there to introduce them to Marxism and try to help radicalize them since a 50501 brunch lib protest isn't gonna do shit but let them wave a few flags and yell a bit. In any case, a friend in the anarchist group and I pieced together the whole story and they plan on talking to the person in charge of the 50501 group tomorrow to try and resolve things. And I'm trying to figure out how to talk with the nark that was onboarded to PSL. They literally did exactly what they accused me of doing and it's leaving a bad taste in my mouth since I considered them a friend.
Above all, I hate how high school drama this whole thing feels.
Thanks for reading my wall of text rant. I need a fucking hug.
This is so infuriating to read, but I do believed you're doing the best you can. Take a deep breath, you've got this.
As far as the nark is concerned, I do not know how I'd handle this, but if you think talking to them is a good idea, do it.
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Well my sodding foot infection is back. They aren't even going to bother trying to treat it with antibiotics this time, since my immune system is so weak it can't fight anything off. I'm going straight on the surgery list again. God knows how many months I'll have to wait this time, it'll probably spread even further by then. Why is life like this??? 
Now I'll have to make another mutual aid post for actual money which I really didn't want to do, other wise I won't be able to pay for the post-surgical supplies. So ridiculous that the NHS doesn't give them for free.
I'm so sorry you're having to go through that again, comrade. My heart goes out to you. Hope you can get the care you need soon, and that you aren't in too much pain.
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This is so frustrating to read. Why tf does the NHS still exit if it doesn't cover anything, really?
I hope you're gonna get replies on your mutual aid requests and that your foot infection isn't too painful (and stays that way). This is so unjust.
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YEA SURE LETS SHUT DOWN ALL FUCKING PUBLIC TRANSPORT IN A MAJOR CITY TO PROMOTE BICYCLING. THAT MAKES SENSE. ALSO YOU CANT WALK WE'RE LITERALLY BLOCKING YOUR ABILITY TO WALK ACROSS MAJOR ROUTES TO MAKE ROOM FOR BOTH THE BIKES.
You may have stuff you need to do, but have you considered that if we don't make it impossible to cross from one side of the city to the other it'll hurt the bikes feelings.
Anyway I'm opening these fucking barriers and if one of these security dweebs tries stopping me I'm just gonna steal the entire barrier you fucking watch me.
Went to a social event. Had a short conversation with someone who sat with me. Still hovering around generally, and then leaving after a short time.
Going up to someone feels like a bad idea, introducing myself feels like a violation of their boundaries.
Honestly, I need things on a level playing field. If I'm in a group of any kind and two people are like, clicking, or already know each other, my brain really latches onto that. I'd prefer if we were all strangers, so I don't feel like I have to play catch up. But my instinct is to back off the minute I suspect that they know or like that person better than me.
Like if we were a group of strangers plunged into a scenario or situation together. Holy shit I'm going to go on Survivor so I can make friends
I get it. I will say thought that just going to a social event and hovering is still a step up from not going.
Going up to someone feels like a bad idea, introducing myself feels like a violation of their boundaries.
I totally feel the same, and I know you've also heard the counter of "It's obviously not. You wouldn't feel it was a violation of your boundaries if someone in a social setting said hi to you, so why would they". We just gotta work at it until it feels less wrong.
finally got over the "i deserve to have things not fully work" brainworms for long enough to buy a new phone. current one is 5 years old and keeps shutting off randomly so, kinda a long time coming i guess
Yey new phone 
I'm happy you got over the brianworm for at least a bit. Did you choose a nice color?
i just got a black one cos that was the only color available. but i got a rosegold case. it's a oneplus 10 pro
Oh the case sounds lovely! and the phone too, come to think of it.
I always thought getting yourself something new when you feel like "you don't deserve it" is always a tiny bit easier if the color is nice :)
i think ill get a pretty case for it later, since i just got a cheap one for now
i am physically incapable of not spending too much social energy all at once and now im depressive again
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It's the summer solstice party at Stonehenge tonight. I want to go, so much it hurts. I've wanted to go for years. But I don't feel well enough at all and anyway the trains are too expensive. 
Maybe next year or the year after.
Yes please!
showered for the first time in a month, I can feel my health deteriorating.
I had an anxiety attack on Saturday that essentially wrecked me for the next 2 day. Now I have to go get a few cavities filled and I fucking hate needles so guess who's back? Anxiety! I'm bringing my earbuds and a stim toy with me so hoping I don't turn too much into a 42 year old baby.
The group I've been organizing with started their breakfast program this week. Yesterday not a single kiddo showed up. 
I'm checking with them now and I guess this morning 4 kids showed up. We reached out to a local community leader and he spread the word a bit. I really wanna see this program take off! It's a first step towards our Food Co-op. We still need to get the website live because people are talking about it.
I'm gonna get my food handler license done probably Friday so I can start helping directly. I want to put as much effort into this as I can because if we start getting enough money from the Co-op, I get to be the first paid employee and that's gonna be substantially more rewarding than driving a delivery van for Amazon.
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Med school is a way to redirect strivers without any sense of empathy towards places where they'll do less damage. Also the uni internal it system is designed with malice. It's literally evil. It's not just incompetent
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i got referred to a psychologist bc the therapy/medicine aint doing shit lmao. i want to be upfront about the things i usually dont mention for fear of being pathologized (like being plural), but gosh am i afraid they're just gonna go 
and turn me away for some special specialist i cant afford
Sorry the meds/ therapy aren't helping like you need, comrade. Sucks to start over with a new doc too, and all the unknowns that come with it. Hope you know there's nothing 'yikes' about you and that you're awesome 
thanks. i know im awesome, im just also SO far away from neurotypical im not sure if they'll be willing to try helping me lol
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