washingtonpost.com
Some Americans spend billions to get teeth whiter. Some wait in line to get them pulled.
You can work full time but not have the money to fix your teeth – visible reminders of the divide between rich and poor.

It’s beyond reprehensible that this is happening to anyone—let alone already vulnerable populations such as veterans and senior citizens.

To anyone getting wisdom tooth surgery:
From my experience, here’s what I reccomend.
-Choose the person who accompanies you to your appointment wisely! They are going to be taking care of you for a few hours and you need someone who is compassionate and willing to help you.
-Milk! Once you are able to drink again, I recommend drinking lots of chocolate milk! If you don’t like chocolate, try strawberry or vanilla! (Yes vanilla milk exists) Flavored milks have lots of calories, which you need to heal (especially since your diet is restricted from the surgery). If you can’t drink lactose try almond, soy, goat or any other milk substitute. Just make sure it has those calories and tastes yummy! You’ll want that yummy taste to help you feel better after the surgery.
-Don’t use too much cotton. Once you pull the cotton swab out and its not completely soaked in blood, you don’t need to replace it again. The surgical site might ooze blood for up to 24-48 hours so if you taste a little blood, don’t freak. Although if you’re profusely bleeding after three or more gauzes, call your doctor or dentist.
-DONT DRINK FROM STRAWS OR BOTTLES! The suction will cause the blood clot to come out and will cause you to bleed more. If that does happen, call the dentist and follow their instructions.
-Eat soft, mushy, lukewarm or cold foods. Avoid spicy, super salty or acidic foods. I know, that’s not much fun, but here’s some stuff I like: Eggs (cooked any way), Potatoes (again, most ways are fine), cooked veggies (so they’re soft), pasta with butter (no tomato sauce), pierogis, raviolis (again, no red sauce), soup. Remember, all your cooked foods must be cooled down before you eat them. Ice cream, yogurt, pudding, jello, milkshakes, smoothies (try to avoid having seeds in your smoothies, you don’t want them to get lodged in your surgical wound), soft fruit (peaches, mango, plum, grapes, melons, etc.), cheese, soft un-toasted breads. Overall, keep it bland and not at an extreme temperature.
-Check your mouth using a mirror and a light for extreme bleeding or anything unusual, if you see anything that looks not good, call your dentist or doctor.
-TAKE YOUR MEDS ON TIME AND CORRECRLY! Trust me, these medicines are friends, they will keep your pain at bay. They may not get rid of all the pain, but they will subdue most of it.
-A little swelling and bruising is normal. To avoid major swelling, for the first 24 hours after surgery, place ice to the outside of your cheek where the surgery was performed on for 15 minutes and off for 15 minutes. After 24 hours, switch to heat.
-Sleep and lay down with your head elevated, it will stop blood loss.
-Don’t be worried if you’re still numb for a few hours. The Novocain processes different in everybody’s body. Sometimes it wears off in a half hour, sometimes it takes a few hours. But if you get really worried, call your dentist.
-Don’t exercise for two to three days after surgery, you risk unlodging the blood clot.
-Your mouth might have limited movement range after surgery, totally okay.
-If you get IV anaesthesia, you may be nauseas or have a headache after, this happens sometimes, just tell your surgeon and he’ll tell you what to do.
-Do something nice for yourself, take a soothing bath, get into your comfiest clothes, watch your favorite movie/TV show. TREAT YO SELF.

BUT REMEMBER! I AM NOT A PROFESSIONAL! CHECK EVERYTHING WITH YOUR DENTIST/SURGEON! It’s better to be safe than sorry. Okay? Now take care of yourself, love you babies!

anonymous asked:

I just saw your post about homemade toothpaste being unhealthy so I'm just wondering ow bad are the abrasive properties of baking soda and do you know a zero-waste alternative??

Sorry for the delay, Anon, I just got this message today!

Minerals are given a hardness rating using something called the Mohs hardness scale, which goes from 1 (talc) and 10 (diamond). The harder a substance is, the more difficult it is to scratch. Tooth enamel is around 5, and baking soda is 2.5; a lot of zero waste and natural health sites have used this fact to say that baking soda is not capable of scratching teeth.

However, softer substances can scratch harder ones. For a non-dental example: iron and steel have a hardness of approximately 4 while glass is 5–despite being harder, glass is easily scratched by iron, it’s just that the iron is damaged more than the glass is in the exchange.

Baking soda crystals are less abrasive than steel, obviously, but have been shown to cause small abrasions over long-term use, which is why a number of medical professionals caution against brushing with baking soda. These tiny grooves provide the perfect habitat for bacteria to grow, and can make you more susceptible to cavities further down the line.

On the other side of the coin, a number of commercial toothpastes contain silica (hardness 7), and have been known for at least a decade to abrade enamel, the results of which are worsened by regularly drinking acidic beverages (this study has a lot of good information for those interested in reading more about the above).

The take home message of the dental literature I’ve read (disclaimer: I’m not a dentist nor a doctor, not giving anyone medical/dental advice) is that baking soda is less abrasive than some commercial toothpastes, but still too abrasive to be using on a daily basis. It has been shown to be good at removing plaque, but this is a once a month rather than daily type of requirement.

What I do personally is brush with water daily, and dissolve baking soda in a glass of water to make a mouthwash. This gives you the pH-balancing action of the baking soda while getting rid of the abrasion. I do brush with baking soda, but only once a month to once per two months, depending on whether or not I see plaque buildup. This is actually how old-fashioned tooth powders were used a century ago, on an as-needed basis. They have become popular again, but people have forgotten how to use them (and there are plenty of 1950′s and before patents and papers demonstrating their effectiveness when used in this fashion).

Hope this helps!

anonymous asked:

seafam I currently don't have a regular doctor to go to (trying to find one though) but I have pretty bad acid reflux, I've been changing my diet to more simple foods but I'm really scared of the effect this is probably having on my esophagus and teeth, do you have any advice on how to protect them from being damaged?

I tend to like pronamel and colgate’s enamel health toothpastes, and the purple listerine. Colgate is cheaper than pronamel, and I like the mineral repair version of the enamel health toothpaste best (just look for the shiny teal boxes, any kind will do really). As for your esophagus, maybe try the equate chew antiacids? They were pink, yellow, and orange, and next to the alkaseltzer brand. They aren’t the best tasting but they should be fast enough to help. At least until you can find your doctor.

-Lou the Lobster

hi guys!! i just wrapped up my first semester in college (thank the Lord), so i thought i should share some of the things i’ve learned with you.

  • make friends during the first few weeks!! 
    • participate in all the “welcome week” activities. step outside of your comfort zone and be willing to talk to anyone and everyone—everyone else is in the same position as you. find friends who have similar values as you. do not become too close with anyone who will influence you to do things that you do not want to do. befriend the people you sit next to in class—maybe they can become a study buddy. establish your friendships early on. from personal experience, it is harder to befriend people who have already formed their own friend groups. 
  • join clubs!!
    • join them early on in the semester.
    • join clubs that are specific to your major! not only will you meet people with similar interests and career goals, but you will also receive important information (opportunities, research programs, etc.) and get more hands-on experience.
    • if you are on a pre-professional track, join a club based on your program. i’m currently in the pre-dental health society club at my school!
    • join any club that interests you, but try not to join clubs that frequently overlap—it is better to attend clubs faithfully than sporadically. 
    • if you’re a person of faith, join a (or several) campus ministry/group to get connected with people who share your same faith. a majority of my friendships have come from doing this and it’s like having a second family. if you’re a christian, join cru!! cru is awesome!!!!
  • scheduling
    • only take 8 am’s if you are disciplined enough to go to sleep at a reasonable time and to wake up at or before 7 am. 
    • try to end your school day relatively early so that you have the rest of the day to do any studying that you have to do, while you’re still awake and alert. 
    • try to avoid night classes as they are very long and will probably interfere with a billion other things you want to do. 
    • if you are scheduling back-to-back classes, make sure you have enough time to get from one class to the other. 
  • coursework
    • exams are so important in college. there is homework, though, but it usually only accounts for a small percentage of your grade. you should still complete it. all of it. try to accumulate as many points as you can from homework and other assignments in case you don’t perform as well as you wish on the exams.
  • time-management is SOOO important!!
    • learn when to say no to social events. you can still do fun things, but know when you should refrain from it. 
    • managing time wisely significantly lowers academic-related stress.
    • create a skeletal schedule for your week–add your classes, when you want to wake up/go to sleep, any club meetings that you have, what time’s a good time for lunch, etc. 
    • determine what times work best in your schedule to dedicate to studying. 
    • schedule your free time so that 1. you have something to look forward to and are less likely to get distracted, and, 2. you can take a break from everything and feel refreshed.
  • dealing with professors
    • respect them (obviously). 
    • form good relationships with your professors, but, for the love of God, do not be a kiss up. they can tell when you are or aren’t being genuine. 
    • visit them during office hours for any questions you may have. make it known to them that you do care about what you’re learning and that you’re not only trying to get an A. 
  • reminders!!
    • sometimes you will try so hard and your grade will still not reflect the effort you put in.
    • learning > grades
    • grades do not always reflect intelligence. sometimes, a lower grade could be a result of something else, such as poor time-management.
    • your GPA does not define you.
    • you are here to learn.
    • rest!!
    • you can do this!!
    • i love you!!

disclaimer: this post is based on my experiences and things i have heard from people who i have interacted with. this advice might not apply to everyone who reads it. artwork by: paul antonson

i will be adding to this! just wanted to get some of it posted! feel free to message me with specific college-related questions and feel free to message/reply/reblog with any advice you think i should add. :)

love, melissa (@studenting

sadinasaphrite  asked:

I understand you have a long list of these questions, but figured I'd get in line. I want to adopt a retired greyhound racer. What health problems do you see with them? I've also heard they are especially sensitive to anesthesia due to their low body fat. Do you have a protocol you find is particularly safe for them? The rescues have too many conflicting answers. One even claims they never should be put under anesthesia ever, even for dentals, because they "just die!" Which is ridiculous.

Anonymous said: Is it ok to request another breed? If so, greyhounds? Possibly rescue racing hounds if that specification has any problems that pet raised greyhounds dont

and

Anonymous said: Hello! I was wondering if you could (or have already done) a post about greyhounds? Specifically racing-quality ones? I read something earlier that claimed they were a lot healthier than most dogs and I’m wondering if that’s true. Thanks!

and

Anonymous said: Hey there! I noticed you said recently you’d like to see more ex-racing greyhounds as pets - I’m seriously considering adopting one in the future and I was wondering what health issues you see in them? I’ve heard that they can get painful corns on their feet and that you need to be careful about their temperature, but is there anything else you see that a future adopter should be watching for? Question tax: came for the the vet stories, stayed for the refreshingly sensible advice :)

Oh vetlings, I have a lot to say about Greyhounds.

I adore these dogs, and am glad to work with them, but don’t specifically condone organised greyhound racing. Most of these dogs like to run, I would have no problem with them running around a track casually for fun, but once prize-money is involved it becomes too tempting to push limits, to cheat, to cut corners, to overbreed, and this leads to poor welfare outcomes for too many dogs.

Please note the disclaimer that these posts are about the breed from a veterinary viewpoint as seen in clinical practice, i.e. the problems we are faced with. It’s not the be-all and end-all of the breed and is not to make a judgement about whether the breed is right for you. If you are asking for an opinion about these animals in a veterinary setting, that is what you will get. It’s not going to be all sunshine and cupcakes, and is not intended as a personal insult against your favorite breed. This is general advice for what is common, often with a scientific consensus but sometimes based on personal experiences, and is not a guarantee of what your dog is going to encounter in their life.

Also please note that this will be a Long Post.

Originally posted by thegypsycob

General conditions of Greyhounds

Whatever their history all greyhounds have a few things in common. Most of them struggle to sit, they tend to either stand or lie down. Their pain tolerance is interesting, walking in with a broken bone but screaming at a tiny needle prick. They like to feel someone touching their head. There are also a few conditions common to them, regardless of their lifestyle or upbringing. They are one of the very few breeds that I think it’s not an exaggeration to say you benefit from seeing a vet with experience in this breed. We have a lot to get through, so I’ll try to keep the basics fairly short.

Bloat, (Gastric Dilatation Volvulus) is more common in the big males, but can occur in any greyhound due to their deep chest. Delicate, picky eaters seem less at risk.

Greyhounds are generally very athletic, but they can and do develop Dilated Cardiomyopathy. While they have generally reached a reasonable age before developing this condition,

Pannus can affect any greyhound, and this chronic eye condition is generally made worse by UV light exposure. Once diagnosed it’s not too hard to control with medication but it is a long term condition. This is the most likely reason you would see a greyhound wearing doggy sunglasses or ‘Doggles’.

Greyhounds can also get Progressive Retinal Atrophy, which may manifest as ‘night blindness’ first, though this seems to be less common lately.

Greyhounds, perhaps surprisingly for all the raw food they seem to get when racing, have generally poor Dental Health. Despite being big dogs that are generally pretty tolerant, most of them don’t like to chew. They’re delicate chewers and won’t necessarily gnaw a bone.

Speaking of bones, these dogs get Osteosarcoma (Bone cancer) fairly readily. This cancer has a biphasic age pattern. Basically it usually occurs in dogs around 2 years of age, and dogs around 8-10 years of age. It’s all kinds of bad, every time and there’s not much else to say about it, other than the life expectancy is short. I’ve talked about it previously.

Of purely cosmetic concern, greyhounds also commonly develop pattern baldness. Typically the affected areas are the thighs and ventral neck, and there are a few possible reasons for this. It might be genetic, it might be nutritional or stress related, or it might be due to blood vessel compression under due to large muscle groups underneath the skin. This generally bothers the owners more than the dog.

Greyhounds often have thin skin, and while this doesn’t necessarily bother the dogs most of the time it certainly bothers me as the surgeon! Some of these poor dogs will seem to tear themselves open with any little scrape, so be careful of the suture materials you choose. They are prone to pressure sores with poor bandage care too.

And associated with their thin skin, some of these dogs develop “Happy Tail,” which is basically a chronic injury on the tail tip which wont heal because the blessed dog insists on wagging it against solid objects all the time, despite the pain and injury. They can’t help it. They’re too happy, hence the name of the wound. This takes creative bandaging or the occasional partial amputation to fix.

Originally posted by emiliotheexplorer

Conditions associated with Racing

Most greyhounds are reared for the race track and it’s not until later that they’re identified as being 'unsuitable’ for the track. Some greyhounds will be 'retired’ early, before they ever get to run, but many will be retired either with injuries or because they just don’t win. Greyhounds that have been retired due to injury are not necessarily lame, they may have healed well enough to do normal dog activities, just not enough to win races.

Track leg is probably the most common 'racetrack injury’ we see. It’s basically a swelling on the inside of the tibia below the knee, caused by the greyhound continually hitting its hind leg with a front leg as it runs around the track in the same direction all the time. They’re usually not painful, and generally go away when the greyhound is not restricted to always running in a very large circle.

Corns are hard thickenings in the bottom on a footpad, either secondary to trauma, foreign objects (grit) or papilomas. They start out small but grow with time, and are painful. It’s like having a stone in your shoe all the time and many greyhounds will become footsore because of it. Affected greyhounds are often reluctant to walk on harder surfaces, and anti-inflammatories doesn’t seem to make much difference. We treat them by paring them out and waiting patiently.

Grit in foot pads can cause corns, and can cause similar lameness to corns, but will show up on Xrays if you use high enough detail. These are fragments of sand or other foreign objects that have become embedded in the foot pads while running. Greyhounds are particularly lame with this injury and often don’t respond fully to anti-inflammatories. They need surgery to remove these pieces of grit, and the surgery can result in corns.

A Fractured hock, carpus or metacarpal/metatarsal might be a racing career ending injury, but not necessarily a life ending one. Depending on the extent of the fracture the greyhound may have no lameness with a walk or light run, or may end up with a completely fused joint. Generally these dogs are only retired to pet homes if they can still get themselves around pain free.

A Split Webbing is an injury to the web of skin between toes. When this skin tears it’s nearly impossible to get it to heal if both layers are torn, so the recommended technique is to split it all the way to the base of the toes and remove the webbing. This doesn’t seem to bother the dogs at all, and prevents it from re-tearing over and over again as it heals.

Maxillary Fractures are a rare injury of long-nosed dogs who are also klutzes and trip over, slamming their nose into a fence or the ground. This upwards force can fracture the upper jaw, just in front of the canine teeth. These fractures may be non displaced, causing little more than a blood nose and needing pain relief and soft food for a few weeks, or they may be loose and need wiring. They are fairly uncommon overall, but it seems to be greyhounds that get them most.

Associated with racing greyhound husbandry, Neospora infection from raw, infected beef consumption (and similar Toxoplasma from kangaroo or sheep) is more common in greyhounds due to their high prevalence of raw meat being fed. It may present as anything from back pain to blindness, and you can lose whole litters to these parasites.

There are a number of odd Assorted Sports therapy things that greyhounds might be subjected to, from particular lineaments being used, ultrasound therapy, chiropractic treatment or 'seeing the muscle men’, some of the 'treatments’ racing greyhounds are exposed to seem more like hope and witchcraft than medicine. These dogs may also have been supplemented with all sorts of things during their racing days, including iron and B12 as the most common supplements. You don’t necessarily know what a dog has or hasn’t been given in its racing days, but most will be little consequence, if any, after a few months.

Racing greyhounds are also known for a few particular metabolic weirdnesses. Exercise associated heart conditions, exercise associated epilepsy, water diabetes (like a temporary diabetes insipidus), rhabdomyolysis and acidosis are the most well known.

Anaesthesia

Now, this is an interesting difference. Greyhounds are a bit different when it comes to anaesthetics. Most vet students will easily recall that barbituate anaesthetics aren’t recommended in sighthounds due to their proportionally low body fat (and very young or very fat dogs for the same reasons), but greyhounds also seem to have a different liver metabolism that makes handling this class of drugs more difficult. Fortunately there are many other options these days.

The whole 'they die under anaesthesia’ thing is…sort of true. If you put them under anaesthetic when they’re under 24 hours off the race track then they tend to…well… die. But when these dog’s have been at rest for at least 24 hours there doesn’t seem to be a particular increase risk of death specifically.

These dogs are prone to both hypothermia and hyperthermia under anaesthetic, and in life in general.

They are prone to rapid wake ups from anaesthesia, which is not fun when you have a 30kg dog thrashing about and freaking out. For this reason higher premed doses seem to help if you’re using an alfaxalone protocol, medetomedine/butorphanol works well for sedation and we usually use xylazine/ketamine/atropine for orthopaedics. I will not be posting dose rates on this blog, but rest assured greyhounds are perfectly able to have an anaesthetic. They’ve got to get their dental disease treated somehow!

Compared to other breeds

Generally greyhounds are considered pretty healthy. They’re not free of problems, but their common problems are different to common problems in other breeds. Greyhounds have one of the lowest incidences of hip dysplasia in purebred dogs,  and rarely develop the same common structural issues we see in other breeds.

Their blood results are often a little different. A greyhound in racing condition will have a higher PCV, and a pet greyhound may keep this in their retired life. They often have a lower platelet count,  by around 20-25% or so, and may have a relatively low T4. A low T4 can be normal for a greyhound, and hypothyroidism shouldn’t be diagnosed without a TSH level.

They are, in general a little more prone to being clingy or developing separation anxiety. This is generally because most of these dogs are raised in big groups in a kennel situation, and may not get to be truly 'alone’ until they’re in a pet home. Some dogs just need a few weeks of being spoiled with TLC to adjust, some dogs need some pharmaceutical assistance for a while. Some dogs only really relax if they have a companion, but it depends on the individual.

So that is the greyhound breed from a veterinary viewpoint in a nutshell. Some of these points are brief because I only want to give you an overview, but I do recommend vet students spend some time in a greyhound practice, even if you don’t want to work with them or the racing industry, because the musculoskeletal exam of a greyhound is so much more thorough and I understood hocks and carpi much better in greyhounds than I ever did in horses.

Phew, that took a while to write. If you would like to support Dr Ferox’s writing time you can via Patreon for as little as $1 a month!

BRUSH YOUR PATIENT’S TEETH WHILE THEY’RE IN YOUR CARE.

If your patient is max assist (need assistance for all transfers/self care) offer to brush their teeth. Every day. Not every couple days or once a week. Brush their tongue, be careful not to make them gag, brush the fronts and backs of all their teeth. Give them a couple sips of water to swish and spit until they dont feel gritty anymore. 

Trust me, this means the world to patients, they will love, trust and respect you for going the extra mile rather than just giving them some watery sponge sticks to rub around their mouth. Very few people actually feel like their mouth is clean clean after those sponges.

Free Dental Work!

Hey, Portland area folks (or anyone who can get to Portland)–OHSU’s dental school really really really needs patients for their graduate exams May 5 and 6, 2017! If you have cavities or need a dental scaling/deep clean you may be able to get the work done free of charge. The work will take longer because it’s an exam, but–free! Contact Alex Bouneff at bouneff(at)ohsu(dot)edu for more details.

You do need to go in twice before May 5 but they have a lot of openings and are in desperate need of patients. This only happens once a year so now’s the opportunity.

I went in for my initial consult today and everything was very professional. I am a total wimp when it comes to dental stuff and it was one of the best experiences I’ve had. These are students who are doing their final exam before graduating to be full fledged dentists, and they know their stuff.

Yes, you can reblog this!

lillieisabllagrace  asked:

Can you give me your professional advice? My dog needs a dental. Our groomer can do a less detailed version than the vet, but she does it without sedation. I'm nervous about my dog going under as even though she's healthy, she is 11. Her teeth are pretty gnarly. I understand you can't say for sure she will survive sedation, but she sees are vet regularly and is very healthy. So, in your opinion, should I go with a poorer quality cleaning or risk the sedation?

I do not recommend so-called ‘non-anaesthetic dentals’ and I don’t foresee that changing anytime soon.

These so-called dentals carried out by laypeople are increasingly popular, claiming that anaesthetics are so risky while their method is ‘safe’, but this is not universally the case and these non-anaesthetic dentals do not actually treat pathology in the mouth.

I have seen the results of these so-called dentals, and have been thoroughly unimpressed. They’re not too bad when you only have very mild plaque or tartar guild up, but when there is actual dental and oral pathology they do nothing to fix this. There are numerous times when I’ve looked at these ‘treated’ mouths to say “Well yes, the teeth are cleaner, but we still need to remove several of them because they’re fractured/infected/exposed bifurcation.”

Really a non-anaesthetic dental is little more than a thorough brushing of the teeth. The teeth might look nicer, and they certainly do look whiter, but rotten teeth, teeth that need extraction, fractured teeth and gingivitis remain untreated.

There are also several cases of dogs having a non-anaesthetic dental which struggled and have had lacerations to their mouth, including one that received permanent nerve damage to its tongue and being rendered unable to eat. Don’t be led to believe that they are risk-free, just because they are growing in popularity at the moment.

If your vet thinks your dog will cope with the sedation/anaesthetic, and in your own words her teeth are ‘pretty gnarly’, then I would recommend getting her dental done properly instead of wasting time and money on a ‘cleaning’ that will be basically cosmetic only.

My recent post about the Gore Girls of Instagram reminded me of something I’d heard at one of the science/space travel panels at ConCarolinas:

Astronauts have to have near-perfect teeth.

Why?  Two reasons.  One is that during launch, the astronauts are subjected to immense pressures, which can cause improperly-fitted dental bridges, crowns, and fillings to become loose or fall out.  Worse, changes in atmospheric pressure during flight can cause any small air pocket in the tooth – like in a cavity, or an improperly-fitted bridge, crown, or filling – to rapidly expand, causing anything from mild discomfort to the tooth literally exploding.

violaslayvis submitted:

I would like to submit my friend Shay, a bi black trans scholar & organizer in Chicago. From his website http://decolonizeallthethings.com: “I’m Shay Akil McLean (twitter.com/Hood_Biologist), I’m a Pan Africanist (Nkrumah Toureist/scientific socialist) & anti-colonial community organizer (on & offline). I’m a Transman of African descent on stolen Indigenous land, writer, public intellectual, human skeletal biologist & sociologist.

I’m a sociologist & biological anthropologist studying STS/HASTS, bioethics, medical ethics, philosophy of biology, genomics, health, knowledge production and medicine. As a scholar I study how systemic inequity results in the differential distribution of health, illness, quality of life, and death. I’m currently working on my PhD in Sociology, specializing in STS/HASTS, genomics, & bioinformatics.

My academic work includes studying the impact of social, political, & economic inequality on human skeletal biology. My Master’s work looked at the impact of food insecurity, high poverty, & racial residential segregation on the dental health of poor Blacks in the 4th poorest city in the U.S..  It is through this work that I aim to construct community based grassroots interventions that change the marginalized’s relationships to knowledge and power to strategically gain equitable access to the very resources that heavily impact disease risk & life determinants while also resisting the ever present processes of settlement and displacement.”

He consistently provides invaluable knowledge on both on his website & his twitter so any donations at http://cash.me/ShayAkil would go directly towards a black trans person.